集验论疗妇人妒乳,乳痈,诸产生后,宜勤挤乳,不宜令汁蓄积不去,便不复出,恶汁
于内引热,温壮结坚掣痛,大渴引饮,乳急痛,手不得近,成妒乳,非痈也方。
始妒乳,急灸两手鱼际各二七壮,断痈脉也,便可令小儿手助将之。则乳汁大出,皆如
脓状,内服连翘汤汁自下,外以小豆散薄涂之痈处,当瘥。(千金同)
又产后不自饮儿,及失儿无儿饮乳,乳蓄喜结痈,不饮儿令乳上肿者方。
以鸡子白和小豆散,涂之乳房,令消结也,若饮儿不泄者,数捻去之,亦可令大者子含
水,使漱口中冷,为嗍取乳汁吐去之,不含水漱,令乳头作疮,乳孔寒也。(千金同)
又疗妒乳乳痈,连翘汤方
连翘 升麻 杏仁(去皮尖) 射干 防己 黄芩 大黄 芒硝 柴胡(各三两) 芍
药
上十一味切,以水九升,煮取三升,分服,忌海藻菘菜。(千金同)
又方
取葵茎烧灰捣散,服方寸匕,日三即愈。(千金同)
又疗妒乳生疮方。
蜂房猪甲中土车辙中土各等分,末,苦酒和涂之,良。(千金同一方又有车毂上脂一味)
又疗妇人女子乳头生小浅热疮,搔之黄汁出,侵淫为长,百疗不瘥者,动经年月,名为
妒乳病,妇人饮儿者,乳皆欲断,世论苟抄乳是也。宜以赤龙皮汤及天麻汤洗之,敷二物飞
鸟膏及飞乌散佳。始作者可敷以黄芩漏芦散,及黄连胡粉散并佳,方如下,赤龙皮汤方。
槲皮切三升,以水一斗,煮取五升,夏冷用之秋冬温之。分以洗乳,亦洗诸深败烂久疮
。洗毕敷膏散。(千金同)
又天麻草汤方。
天麻草切五升,以水一斗半,煎取一斗,随寒温分洗乳,以杀痒也。此草叶如麻叶冬生
夏着花。赤如鼠尾花,亦以洗侵淫黄烂热疮痒疽湿阴蚀疮,小儿头疮,洗毕敷膏散。(千金
同)
又飞乌膏散方。
用烧朱砂作水银上黑烟(一名细粉者三两) 矾石(三两烧粉)
上二味,以绢筛了,以甲煎和之令如脂
,以敷乳疮,日三,作散者不须和。有汁自着可用散,亦敷诸热疮,黄烂侵淫汁疮蜜疮,丈
夫阴蚀痒湿,诸小儿头疮疳蚀,口边肥疮,蜗疮等,并以此敷之。(千金同)
又黄连胡粉膏散方。
黄连(二两) 胡粉(十分) 水银(一两同研令消散)
上三味,捣黄连为末三物相和,合皮裹熟 之
自和合也,纵不成一家,且得水银细散入粉中也,以敷乳疮,诸湿痒黄烂肥疮若着甲煎为膏
。(千金同)
备急短剧妒乳方。
黄芩 白蔹 芍药(各等分)
上三味下筛,浆水服一钱五匕,日三,若右乳结,将去左乳汁左乳
结即将去右乳汁服,即消(千金同)
又方
柳白皮,酒煮令热,以熨上即消
又方
苦酒磨升麻,若青木香,或紫檀香,以摩上并良,一味即得佳。
又方
已入腹者,麝香薰陆香青木香鸡舌香各一两,以水四升煮,取二升,分再服,忌蒜,面
,酒,牛马猪肉。
必效疗妇人妒乳痈疮迟愈,五物雄黄 茹膏方。
雄黄 白蔹 雌黄 茹(各一分并切) 乱发(如鸡子一枚)
上以猪脂半斤合煎三沸,去滓,乃纳乱发,发尽,药成以涂疮,不过十日瘥。
《集验方》论述治疗妇人妒乳、乳痈,以及诸种产后病症,应当勤加挤奶,不宜让乳汁蓄积不去,否则乳汁不再流出,恶汁在体内引发热邪,导致体温升高、结块坚硬、牵引性疼痛,极度口渴想饮水,乳房急痛,手不能触碰,形成妒乳,这并非痈肿。
初起妒乳时,紧急灸双手鱼际穴各十四壮,以断绝痈脉,随即可以让小儿用手帮助吸吮。这样乳汁就会大量流出,状如脓液,内服连翘汤后乳汁自然下行,外用小豆散薄涂于患处,应当痊愈。(与《千金方》相同)
又有产后不亲自哺乳婴儿,以及失去婴儿或无婴儿可哺乳,导致乳汁蓄积容易结成痈肿,若不哺乳使乳房肿胀的方子。
用鸡蛋清调和少量豆散,涂抹于乳房,以消散结块。如果哺乳后乳汁仍不通畅,多次捻去乳汁;也可以让较大的孩子含水漱口使其变冷,由他吸吮乳汁并吐出。如果不含水漱口,会导致乳头生疮,因为乳孔受寒所致。(与《千金方》相同)
连翘、升麻、杏仁(去皮尖)、射干、防己、黄芩、大黄、芒硝、柴胡(各三两)、芍药。
以上十一味药切碎,用水九升,煮取三升,分次服用,忌食海藻和菘菜。(与《千金方》相同)
又一方:
取冬葵茎烧成灰,捣碎成散剂,每次服用一方寸匕,每日三次即可痊愈。(与《千金方》相同)
蜂房土、猪腹甲中土、车辙中土各等分,研末,用醋调和涂抹,效果良好。(《千金方》同一方还有一味车毂上脂)
又治疗妇女、女子乳头生浅表热疮,搔抓后有黄色汁液流出,蔓延生长,多种疗法无效,病程经年累月,称为妒乳病。哺乳妇人的乳汁往往中断,世俗议论认为这是“苟抄乳”所致。适宜用赤龙皮汤及天麻汤清洗,敷贴二物飞鸟膏及飞鸟散较好。初起时可敷贴黄芩漏芦散,以及黄连胡粉散也很好,方子如下:
赤龙皮汤方:
槲皮切细三升,用水一斗,煮取五升,夏季冷用,秋冬温用。分次清洗乳房,也可清洗各种深部溃烂久治不愈的疮口。洗毕敷上膏散。(与《千金方》相同)
又天麻草汤方:
天麻草切细五升,用水一斗半,煎取一斗,根据冷热程度分次清洗乳房,以止痒。这种草叶像麻叶,冬天生长,夏天开花。花红色像鼠尾花,也可用于清洗蔓延的黄烂热疮、瘙痒疽症、湿阴蚀疮、小儿头疮,洗毕敷上膏散。(与《千金方》相同)
又飞鸟膏散方:
用烧朱砂产生的水银黑烟(一名细粉,三两)、矾石(三两,烧成粉)。
以上两味药,用绢筛过,用甲煎调和成脂状,涂抹于乳疮,每日三次。制成散剂则不需调和。若有汁液渗出可直接使用散剂,也可用于各种热疮、黄烂蔓延汁疮、蜜疮、丈夫阴部蚀痒湿症、各类小儿头疮疳蚀、口边肥疮、蜗疮等,均以此药敷贴。(与《千金方》相同)
以上三味药,捣黄连为末,将三物混合,合皮包裹煮熟自行调和。即使不成一家配方,只要能使水银细散融入粉中即可,用于敷贴乳疮、各种湿痒黄烂肥疮。若加入甲煎则为膏剂。(与《千金方》相同)
以上三味药下筛,用浆水送服一钱五匕,每日三次。若右侧乳房结块,就去除左侧乳汁;左侧乳房结块,就去除右侧乳汁服用,即可消散。(与《千金方》相同)
又一方:
又一方:
用醋磨升麻,或者青木香,或者紫檀香,摩擦患处都很好,单用一味即可佳效。
又一方:
病邪已入腹者,麝香、薰陆香、青木香、鸡舌香各一两,用水四升煮,取二升,分两次服用,忌食蒜、面、酒、牛马猪肉。
The *Jiyan Fang* discusses the treatment of women's "Du Ru" (jealous breast/lactation stasis), mammary abscess, and various postpartum conditions. It is advisable to frequently express milk to prevent accumulation. If milk is not expelled, it will cease to flow, causing foul fluids to accumulate internally, generating heat, leading to elevated temperature, hard nodules, pulling pain, extreme thirst with desire for drinking, acute breast pain where the area cannot be touched, resulting in "Du Ru," which is distinct from an abscess.
At the onset of "Du Ru," urgently moxibustion both hands' Yuji (Lung 10) acupoints, fourteen repetitions each, to cut off the pulse of the abscess. Immediately thereafter, allow the infant to suckle with hand assistance. This will cause a large amount of milk to flow out, resembling pus. Internally administer Lianqiao Tang (Forsythia Decoction) so that milk naturally drains downwards. Externally apply Xiaodou San (Adzuki Bean Powder) thinly to the affected area; recovery should occur. (Same as *Qianjin Fang*)
Another prescription for postpartum cases where the mother does not nurse her own child, or has lost her child/no child to nurse, leading to milk accumulation prone to forming abscesses, and breast swelling due to lack of nursing:
Mix egg white with a small amount of Dou San (Bean Powder) and apply to the breast to dissipate the nodule. If nursing does not relieve the blockage, repeatedly express the milk. Alternatively, have an older child rinse their mouth with water to cool it, then suckle the milk and spit it out. If the child does not rinse with cold water, it may cause sores on the nipple due to cold entering the lactiferous ducts. (Same as *Qianjin Fang*)
Another formula for treating Du Ru and mammary abscess: Lianqiao Tang (Forsythia Decoction):
Lianqiao (Forsythiae Fructus), Shengma (Cimicifugae Rhizoma), Xingren (Prunus Armeniacae Semen, peeled and tip removed), Shegan (Belamcandae Rhizoma), Fangji (Stephaniae Tetrandrae Radix), Huangqin (Scutellariae Radix), Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), Chaihu (Bupleuri Radix) (each 3 liang), Shaoyao (Paeoniae Radix).
Cut the above eleven herbs, decoct in 9 sheng of water until 3 sheng remain. Divide into doses. Avoid consuming Haizao (Sargassum) and Songcai (Brassica vegetables). (Same as *Qianjin Fang*)
Another formula:
Burn the stems of Kuishu (Malva verticillata) to ash, grind into powder. Take one fangcun bi (approx. 2-3 grams) per dose, three times daily. Cure follows. (Same as *Qianjin Fang*)
Another formula for treating Du Ru with sores:
Fengfang Tu (soil from honeycomb nests), Zhujia Zhongtu (soil inside pig plastron), Chezhé Zhongtu (soil from cart ruts) in equal parts. Grind into powder, mix with Ku Jiu (vinegar) and apply. Effective. (*Qianjin Fang* same formula includes one additional ingredient: Chegu Shangzhi - grease from cart wheel hub).
Another treatment for superficial hot sores on the nipples of women and girls, where scratching yields yellow fluid, spreading progressively, unresponsive to many treatments, lasting months or years, termed "Du Ru Disease." In nursing mothers, milk supply often ceases; worldly theories attribute this to "Gouchao Ru." It is suitable to wash with Chilongpi Tang (Oak Bark Decoction) and Tianma Cao Tang (Akebia Decoction), followed by application of Erwu Feiniao Gao (Two-Ingredient Flying Bird Ointment) and Feiniao San (Flying Bird Powder). At the initial stage, apply Huangqin Lulü San (Scutellaria and Euphorbiae Fissurae Powder) or Huanglian Hufen San (Coptis and Lead White Powder), both are good. Formulas follow:
Chilongpi Tang (Oak Bark Decoction) Formula:
Hu Pi (Quercus variabilis bark), finely cut, 3 sheng. Decoct in 1 dou of water until 5 sheng remain. Use cold in summer, warm in autumn. Divide to wash the breasts; also suitable for washing deep, chronic, ulcerated sores. After washing, apply ointment or powder. (Same as *Qianjin Fang*)
Tianma Cao Tang (Akebia Decoction) Formula:
Tianma Cao (Akebiae Caulis), finely cut, 5 sheng. Decoct in 1.5 dou of water until 1 dou remains. Wash the breasts according to temperature preference to relieve itching. This herb has leaves like hemp, grows in winter, flowers in summer. The flowers are red like Salvia. It can also be used to wash spreading yellow, ulcerated hot sores, itching ulcers, wet genital erosions, pediatric head sores. After washing, apply ointment or powder. (Same as *Qianjin Fang*)
Feiniao Gao/San (Flying Bird Ointment/Powder) Formula:
Use black smoke collected from burning Zhusha (Cinnabar) to produce mercury (also known as Xifen, 3 liang); Fanshi (Alumen, 3 liang, calcined to powder).
Sift the above two ingredients through silk. Mix with Jiajian (turtle shell lacquer/glue) to form a paste consistency. Apply to breast sores three times daily. If prepared as a powder, no mixing is needed. For weeping lesions, the powder can be applied directly. Also applicable to various hot sores, yellow spreading exudative sores, honey-like sores, male genital erosion/itch/dampness, all pediatric head sores, fungal erosions, perioral fatty sores, ringworm, etc. Apply universally. (Same as *Qianjin Fang*)
Huanglian Hufen Gao/San (Coptis and Lead White Ointment/Powder) Formula:
Huanglian (Coptidis Rhizoma, 2 liang), Hufen (Lead White, 10 fen), Shuiyin (Mercurius, 1 liang, ground together until dispersed).
Grind Huanglian into powder. Mix the three ingredients. Wrap in skin and cook熟 (heat thoroughly) to self-homogenize. Even if not perfectly mixed, ensure mercury is finely dispersed into the powder. Apply to breast sores, various damp/itchy/yellow/ulcerated/fatty sores. If mixed with Jiajian, it becomes an ointment. (Same as *Qianjin Fang*)
Beiji Duanju Du Ru Formula:
Huangqin (Scutellariae Radix), Bailian (Pseudostellariae Radix), Shaoyao (Paeoniae Radix) in equal parts.
Sift the three ingredients. Take 1 qian 5 bi with Jiangshui (fermented grain water), three times daily. If the right breast has a nodule, express milk from the left breast; if the left breast has a nodule, express milk from the right breast. Consumption leads to resolution. (Same as *Qianjin Fang*)
Another formula:
Willow white bark (Liubai Pi), boiled in wine until hot. Apply as a compress; the swelling will dissipate.
Another formula:
Grind Shengma (Cimicifugae Rhizoma) with vinegar, or use Qingmuxiang (Aucklandiae Radix), or Zitanxiang (Sandalwood), to rub on the area. All are good; using a single herb is sufficient for excellent results.
Another formula:
For pathogens that have entered the abdomen: Shexiang (Musk), Xunluxiang (Olibanum), Qingmuxiang (Aucklandiae Radix), Jishe Xiang (Cardamomi Fructus) each 1 liang. Decoct in 4 sheng of water until 2 sheng remain. Divide into two doses. Avoid garlic, wheat products, alcohol, beef, horse, and pork.
Bixiao Formula for Slow Healing of Women's Du Ru Abscess Sores: Wuwu Xionghuang Ru Gao (Five-Ingredient Realgar and Ru Ointment):
Xionghuang (Realgar), Bailian (Pseudostellariae Radix), Cihuang (Orpiment), Ru (Commiphora Myrrha/Castoreum? Context suggests resinous substance, likely Myrrha based on typical pairings, but text says Ru), each 1 fen, cut finely; Luafa (Human hair clump, size of one chicken egg).
Decoct with half a jin of Pig Fat (Zhuzhi) for three boils. Remove dregs, add human hair. Once the hair completely dissolves, the medicine is ready. Apply to the sore. Recovery within ten days.