Appreciation of Feng Zhirong's Medical Case of Breast Hyperplasia
Feng Zhirong, chief physician and former president of the Zigang (Sichuan) Chinese Medicine Hospital, once published a case of breast hyperplasia that is well worth studying.
The patient, Teng, female, 23, unmarried, first presented on April 28, 1995. She reported breast distending pain, especially before menstruation, and had noticed a breast lump for more than three months. Her menses were normal, as were appetite, sleep, and bowel and bladder function. On palpation, a pigeon-egg-sized, movable, tender mammary lump could be felt. The tongue was pale red with a slightly thick white coating; the pulse was wiry and slippery.
Old Master Feng's pattern differentiation was intermingled phlegm and stasis with liver depression and qi stagnation; the treatment principle was to soften hardness and scatter nodulation, activate blood and resolve stasis, and soothe the liver and move qi.
First-visit prescription: Muli (Ostrea Concha, oyster shell) 30 g, Biejia (Trionycis Carapax, turtle shell) 10 g, Sanleng (Sparganii Rhizoma) 10 g, Ezhu (Curcumae Rhizoma) 10 g, Kunbu (Eckloniae Thallus, kelp) 10 g, Xiakucao (Prunellae Spica) 30 g, Danshen (Salviae Miltiorrhizae Radix) 30 g, Danggui (Angelicae Sinensis Radix) 10 g, Fuling (Poria) 30 g, Gualou (Trichosanthis Fructus) 15 g, Ruxiang (Olibanum) 10 g, Moyao (Myrrha) 10 g, Chaihu (Bupleuri Radix) 10 g, Qingpi (Citri Reticulatae Pericarpium Viride) 15 g. Four doses, decocted in water.
On her return visit on May 4, 1995, the patient reported that the breast pain had greatly lessened and the lump had shrunk. Old Master Feng, holding that an effective formula should not be changed, had her continue for another ten doses to observe further effect. After the ten doses, all symptoms had resolved.
In this case the breast pain and lump were clearly related to the patient's menstrual cycle. From a modern medical standpoint, such patients are under estrogenic stimulation. Breast growth and development are influenced by estrogen; under normal conditions there is no hyperplasia, but abnormal estrogen secretion can lead to mammary hyperplasia.
From a traditional Chinese medicine standpoint, since the patient already had a palpable, substantial breast mass with marked pain, this belonged to the "pain due to non-free flow" pattern of intermingled phlegm-stasis and qi stagnation. Women's emotions fluctuate around menstruation, and the condition is closely tied to emotional state. That is why Old Master Feng chose the treatment principles of soothing the liver and resolving depression, softening hardness and scattering nodulation, and activating blood and resolving stasis.
In this formula, Muli, Biejia, Kunbu, Xiakucao, and Gualou all soften hardness and scatter nodules; Sanleng, Ezhu, Danshen, Danggui, Ruxiang, and Moyao activate blood and resolve stasis; Chaihu soothes the liver and resolves depression; Qingpi breaks qi and disperses accumulation; Fuling fortifies the spleen and drains dampness. Together the herbs form a comprehensive yet elegant formula with immediate effect. From a modern pharmacology perspective, Gualou, Qingpi, and Chaihu are among the Chinese herbs with specific effects on mammary hyperplasia.
Old Master Feng's prescription is rigorous and classic in its reasoning; I believe it can serve as an empirical formula for treating breast hyperplasia with Chinese medicine. When treating such conditions, we may use it as a base formula and make small adjustments according to the individual patient.