Investigation on the Historical Origins of Traditional Chinese Medicine Diagnosis and Treatment of “Ruyong (Breast Abscess)”

 

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Abstract

“Ruyong (breast abscess)” has a high incidence rate. Traditional Chinese medicine (TCM) diagnosis and treatment of this condition demonstrate significant advantages, including diverse therapeutic methods, outstanding efficacy, and high safety. Based on TCM theory and combining relevant ancient texts and modern research, this paper systematically summarizes the different understandings of “Ruyong (breast abscess)” by physicians throughout history in terms of disease names, etiology, pathogenesis, and treatment. The ancient names for Ruyong (breast abscess) were varied, also referred to as “Duru (stagnation in breast)” or “Naichuang (breast sore )”. Its symptoms are diverse, with the main clinical manifestations being localized redness, swelling, heat, pain, and poor milk discharge in the affected breast. The etiology is primarily attributed to “milk stasis” “liver qi stagnation and stomach heat” and “exposure to external pathogens”. Additionally, this paper summarizes the treatment experiences from ancient and modern medical texts and highlights the complementary effects of internal and external therapies. This study provides a reference for modern clinical understanding and treatment of “Ruyong (breast abscess)” in the hope of further improvement of clinical efficacy.

CRediT Authorship Contribution Statement

Qi Liu: Conceptualization, funding acquisition, and writing -original draft. ke Li: Formal analysis, and writing-review & editing. Yazhou Han: Investigation, and writing-review & editing. Mingru Wang: Validation, and writing-review & editing. Xufeng Cheng: Formal analysis, methodology, and writing-review & editing.

Publication History

Received: 21 January 2025

Accepted: 10 March 2025

Article published online:
27 June 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

• References

• 1 Amir LH. Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #4: Mastitis, revised March 2014. Breastfeed Med 2014; 9 (05) 239-243
  CrossrefPubMedSearch in Google Scholar
• 2 Zhu JP. The Textual Research and Specification of Nouns of Traditional Chinese Medicine (Vol. 4). Shanghai: Shanghai Scientific & Technical Publishers; 2020
  Search in Google Scholar
• 3 Lin MY, Liu C. Discussion on the application of “treatment of liver and spleen” in lactation mastitis based on breast milk microecology. Tradit Chin Med J 2022; 21 (03) 27-29
  Search in Google Scholar
• 4 Xu YN, Liu YL, Yu YY. Current situation and analysis of traditional chinese and Western medicine in the treatment of lactation mastitis. Guangming J Chin Med 2023; 38 (20) 3896-3899
  Search in Google Scholar
• 5 Chen HF. Surgery of Chinese Medicine (Vol. 6). Beijing: China Press of Chinese Medicine; 2021
  Search in Google Scholar
• 6 He XP, Ma XJ, Zhao YZ. et al. Correlation analysis between the patients' behaviors and acute lactational mastitis. Chin J Brest Dis 2013; 7 (01) 39-42
  Search in Google Scholar
• 7 Zhang DX, Zhao WJ, Fu N. et al. Preliminary study on the academic thoughts of ‘FANG's surgery’ of Yanjing school in the treatment of breast-feeding diseases. Chin J Tradit Chin Med Pharm 2021; 36 (06) 3412-3415
  Search in Google Scholar
• 8 Li TH, Zhu DS, Zhong X. et al. Clinical study on external application of Rutong Powder combined with massage in treating initial acute mastitis. World J Integr Tradit West Med 2020; 15 (12) 2173-2175
  Search in Google Scholar
• 9 Zhang ZC, Zhang DX, Liu XR. Experience of FANGs' Surgery of Yanjing School in the treatment of bloody nipple discharge during lactation with “thinking and resolving”method. Chin J Info Tradit Chin Med 2023; 30 (04) 154-158
  Search in Google Scholar
• 10 Jiang JL. Clinical observation on treatment of acute mastitis with moxibustion of Zhuang medicine with thread moxibustion combined and Gualou Niubang Decoction in treating acute mastitis with liver-stomach stagnation syndrome. Nanning: Guangxi University of Chinese Medicine; 2019
  Search in Google Scholar
• 11 Qiao N. Clinical efficacy of Shugan Sanjie Decoction in treating plasma cell mastitis (mass stage) with liver-stomach stagnation heat syndrome and mechanism study based on network pharmacology. Nanjing: Nanjing University of Chinese Medicine; 2022
  Search in Google Scholar
• 12 Yao YY. Clinical observation of traditional Chinese medicine iontophoresis in the treatment of lactating mastitis (liver and stomach fever). Harbin: Heilongjiang University of Chinese Medicine; 2023
  Search in Google Scholar
• 13 Wang WZ, Pu HX. The therapeutic approach of Chaihu Qinggan Decoction for breast abscess with liver-stomach stagnation heat pattern. Heilongjiang J Tradit Chin Med 2023; 52 (06) 64-65
  Search in Google Scholar
• 14 Ren AL. Professor Zhang Yingqiang's clinical experience in treating acute mastitis. Guide Chin Med 2018; 16 (24) 175-176
  Search in Google Scholar
• 15 Situ HL, Liu XY. Lin Yi's Traditional Chinese Medicine Special Diagnosis and Treatment for Inflammatory Breast Diseases. Beijing: People's Medical Publishing House; 2020
  Search in Google Scholar
• 16 Wang Q, Ning P, Ma XJ. Guidelines for diagnosis and treatment of lactational mastitis in China. Chin J Brest Dis 2020; 14 (01) 10-14
  Search in Google Scholar
• 17 Situ HL, Zhu HY, Huang SY. Lin Yi's experience in treating acute mastitis. Shaanxi J Tradit Chin Med 2009; 30 (12) 1640-1641
  Search in Google Scholar
• 18 Hu SF, Chen HF, Lu DMLU. De-ming's experience in treating postpartum mastitis by stage. Zhonghua Zhongyiyao Xuekan 2011; 29 (01) 101-102
  Search in Google Scholar
• 19 Yin F, Ni Y, Liu W. et al. Research on the effect of Dandelion Gualuo Decoction in the treatment of breast-feeding mastitis with milk stasis. Guangming J Chin Med 2022; 37 (15) 2694-2696
  Search in Google Scholar
• 20 Jin LH, Zheng HL, Ye HJ. et al. The retrospective analysis of 35 lactation mammitis cases treated with Gualou Xiaoyong Decoction and painless discharge milk technique. Zhejiang J Tradit Chin Med 2023; 58 (06) 425-427
  Search in Google Scholar
• 21 Deng Q. Sixty-nine cases of stagnated acute mastitis treated primarily with Xiaoru Yin decoction. Mod J Integr Tradit Chin West Med 2011; 20 (23) 2941-2990
  Search in Google Scholar
• 22 Gao C. Clinical observation and network pharmacology study of Xiakucao Oral Liquid in treating lactational mastitis. Beijing: Beijing University of Chinese Medicine; 2022
  Search in Google Scholar
• 23 Xie L, Wan H. Wan Hua's clinical experience in the treatment of breast diseases. J Changchun Univ Chin Med 2022; 38 (02) 153-156
  Search in Google Scholar
• 24 Wan J, Chen XL, Yang XM. et al. Mechanism and anti-inflammatory effects of Hibiscus mutabilis gel on acute mastitis rats. Zhongchengyao 2021; 43 (12) 3321-3325
  Search in Google Scholar
• 25 Chen YH, Liang CX, Liao YJ. . Efficacy observation of anti-inflammatory and analgesic ointment external application in treating acute lactational mastitis 2020 ;24(23):3284–3286
• 26 Liu MF. Clinical observation of external application of traditional Chinese medicine combined with mammary duct perfusion on lactation mastitis. Changchun: Jilin University; 2022
  Search in Google Scholar
• 27 Mi HX, Zhu XQ, Lin X. et al. Clinical observation of treatment for early lactation acute mastitis by Xiaozhong Jiedu Ointment externally applies. J Emerg Tradit Chin Med 2017; 26 (02) 346-348
  Search in Google Scholar
• 28 Che LZ. Clinical observation of purple-ice oil external application and massage therapy for lactational mastitis. Inner Mongolia J Tradit Chin Med 2018; 37 (03) 77-78
  Search in Google Scholar
• 29 Shi XC, Zhang WD, Min ML. Clinical efficacy observation of Qingbao Powder topical application in treating lactational mastitis. Hebei J Tradit Chin Med 2019; 41 (09) 1356-1359
  Search in Google Scholar
• 30 Lyu ZY, Lou LH, Wo LK. et al. Professor Lou Lihua's experience in treating lactational mastitis by external therapy. J Zhejiang Chin Med Univ 2019; 43 (08) 772-775
  Search in Google Scholar
• 31 Wang TS, Chen ZZ. Summary of Professor Li Naiqi's clinical experience in external treatment of stagnation-phase lactational mastitis from liver perspective. Chin J Geri Care 2020; 18 (02) 95-96
  Search in Google Scholar
• 32 Zhang QY, Chen B, Gong YN. et al. The research of international standards on acupuncture and moxibustion. World Chin Med 2021; 16 (05) 819-825
  Search in Google Scholar
• 33 Guo MM, Wu PP. Acupuncture treatment for early-stage acute lactational mastitis: A report of 48 cases. Guangxi Zhongyiyao 2016; 39 (04) 37-38
  Search in Google Scholar
• 34 Huang YP, Qi W, Hu Z. et al. Clinical efficacy of acupuncture-moxibustion in treating acute mastitis. J Emerg Tradit Chin Med 2021; 30 (12) 2074-2077
  Search in Google Scholar
• 35 Chen QL, Jh BEI. Analysis on the efficacy of massage combined with pricking collaterals and cupping at back-shuacupoints in the early stage of acute mastitis during lactation. Chin Med Pharm 2021; 11 (11) 76-79
  Search in Google Scholar
• 36 Chen X, Wang AP, Deng LG. et al. Efficacy of massage combined with acupuncture in treating early-stage acute mastitis caused by improper weaning. Med Equip 2019; 32 (24) 112-113
  Search in Google Scholar
• 37 Hu SS. Clinical study on treatment of lactating mastitis with Shu acupoints moxibustion therapy. Wuhu: Wannan Medical College; 2020
  Search in Google Scholar
• 38 Liao CB, Liao XB, Wu YH. et al. Application analysis of seven-step therapy in the treatment of lactation mastitis. China Pract Med 2020; 15 (01) 4-7
  Search in Google Scholar
• 39 Du L. Clinical observation of 42 cases of early-stage acute mastitis treated with Ruyong decoction combined with massage dredging therapy. Zhejiang J Tradit Chin Med 2018; 53 (12) 887
  Search in Google Scholar
• 40 Liu LH, Li MF, Li QH. et al. Clinical observation of herbal internal and external administration in the treatment of lactation acute mastitis. Pract Pharm Clin Remed 2021; 24 (05) 433-436
  Search in Google Scholar
• 41 Ai P. Clinical observation on oral administration and external application of traditional Chinese medicine in the treatment of lactating mastitis. Guangming J Chin Med 2023; 38 (01) 85-87
  Search in Google Scholar
• 42 Chen YJ. Clinical Observation of Xiaoyong Ointment with internal administration in the treatment of acute mastitis at the initial stage. Jinzhong: Shanxi University of Chinese Medicine; 2020
  Search in Google Scholar
• 43 Duan QY. Efficacy observation of acupuncture combined with Gualou Lianqiao decoction in treating early-stage acute mastitis. J Pract Tradit Chin Med 2019; 35 (08) 931-932
  Search in Google Scholar
• 44 Liu AX, Jing J. Therapeutic effects of anti-inflammatory analgesic ointment topical application combined with mammary duct dredging massage in patients with acute lactational mastitis. Henan Med Res 2021; 30 (15) 2837-2839
  Search in Google Scholar
• 45 Huang R, Luo YS, Zhou XM. et al. Application effect of external treatment of traditional Chinese medicine combined with massage manipulation in patients with lactation acute mastitis. Clin Res Pract 2022; 7 (29) 196-198
  Search in Google Scholar
• 46 Tang JF, Ding ZQ, Xie CZ. et al. Observation on the therapeutic effect of manual lactation promotion combined with high-frequency therapy for lactational mastitis). Contemp Med 2021; 27 (34) 180-181
  Search in Google Scholar
• 47 Gao GY, Shi LB, Bu YH. et al. Therapeutic efficacy of manual massage combined with alternating hot-cold compress for lactational mastitis and its impact on breastfeeding. Mod J Integra Tradi Chin West Med 2022; 31 (24) 3444-3448
  Search in Google Scholar
• 48 Kong J, Zhang S, Xie SZ. et al. Analysis of the effect of breast massage combined with antibiotics in the treatment of breast-feeding mastitis. Electron J Pract Gynecol Endocrinol 2019; 6 (23) 128-129
  Search in Google Scholar