两乳头陷顶。
黄 （蜜炙三钱） 当归身 葛根 升麻 黄柏 连翘（各二钱） 牛蒡子（研） 炙甘草（各一钱） 上肉桂（五
分）
水二盅，酒半盅，煎一盅，食后服。
《心法》曰∶乳头属足厥阴肝经。如暴怒或抑郁，肝经怒火不能施泄，是以乳头
破裂，痛如刀刺，或揩之出血，或流粘水，或结黄脂。治当以加味逍遥散主之。
验方 取秋后冷露茄子裂开者，阴干烧存性，研细，水调敷。
又方 胭脂、蛤粉研细，敷之。
妇女乳房并不坚肿结核，唯乳窍常流鲜血，此名乳衄。乃属忧思过度，肝脾受
伤，肝不藏血，脾不统血，肝火亢盛，血失统藏，所以成衄也。治当平肝散郁，养血扶脾为主。（澄论。）
冯鲁瞻曰∶其有乳汁自出者，若胃气虚而不能敛摄津液者，宜补胃气以敛之；若
气血大虚，气不卫外，血不荣里，而为妄泄者，宜调补荣卫以止之；若未产而乳自
出者，谓之乳泣，生子多不育；若产妇劳役，乳汁涌下，此阳气虚而厥也，独参汤主之。（《锦囊》）
十全大补汤
人参 于白术 甘草（炙） 白茯苓 当归 白芍药 川芎 熟地黄 肉桂 黄 （蜜炙）
姜枣为引，煎服。
申斗垣曰∶有养螟蛉之子，为无乳强与吮之，久而成疮，经年不愈，或腐去半
截，似破莲蓬样，苦楚难忍，内中败肉不去，好肉不生，乃阳明胃中湿热而成，名曰乳疳。（《启玄》）
\r乳疳\p04-a41a137.bmp\r
凡初生女孩，必须于月子内大人以手挤其两乳，使乳头长出。若不知此，长大
其女必是一对瞎奶。生育之后，乳头微露，大半藏在乳房之内，小儿吮乳，每每吮破
乳头，化去一半，疼痛难忍。若畏痛不与小儿吮食，必肿胀成乳痈矣。务令产妇忍
痛令儿吮之，外搓玉红膏、珍珠散自愈。澄曾看一小儿，初生吐乳，血膜与乳相间，细
询产妇，始知产妇是瞎奶，被小儿吮破溃烂，所以小儿吐出之物，系乳中吮出之血
膜也。只治产妇之乳，小儿不药而愈。（自识。）
两个乳头凹陷。
黄（蜜炙三钱） 当归身 葛根 升麻 黄柏 连翘（各二钱） 牛蒡子（研碎） 炙甘草（各一钱） 上肉桂（五分）
用水两盅，酒半盅，煎至一盅，饭后服用。
《医宗心法》说：乳头归属于足厥阴肝经。如果暴怒或抑郁，导致肝经怒火无法宣泄，因此乳头破裂，疼痛如刀刺，或者擦拭时出血，或者流出粘稠液体，或者结成黄色脂状物。治疗应当以加味逍遥散为主方。
验方 取秋天后冷露中裂开的茄子，阴干后烧存性，研成细末，用水调敷。
又一方 胭脂、蛤粉研成细末，敷贴患处。
妇女乳房并没有坚肿结核，只有乳窍经常流出鲜血，这名叫乳衄。这是由于忧思过度，肝脾受伤，肝不能藏血，脾不能统血，肝火亢盛，血液失去统摄和藏守，所以形成衄血。治疗应当以平肝散郁，养血扶脾为主。（顾澄论述。）
冯鲁瞻说：如果有乳汁自行流出的，如果是胃气虚弱而不能收敛津液的，适宜补益胃气来收敛它；如果是气血大虚，气不能卫护体表，血不能荣养体内，而妄自泄出的，适宜调和补益营卫来停止它；如果是未生产而乳汁自出的，叫做乳泣，生下的孩子大多不育；如果是产妇劳累役使，乳汁涌下，这是阳气虚弱导致的厥证，用独参汤主治。（《锦囊》）
十全大补汤
人参 于白术 甘草（炙） 白茯苓 当归 白芍药 川芎 熟地黄 肉桂 黄（蜜炙）
用姜、枣作为药引，煎服。
申斗垣说：有收养螟蛉之子（非亲生子女），因为无乳强行让婴儿吮吸，久而久之形成疮疡，经年不愈，或者腐烂去了一半，像破败的莲蓬样子，痛苦难以忍受，内部坏肉不去除，好肉长不出来，这是阳明胃中湿热而成，名叫乳疳。（《启玄》）
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凡是初生的女孩，必须在月子内由大人用手挤压其双乳，使乳头长出。如果不知道这一点，长大后的女儿必定是一对瞎奶（乳头内陷）。生育之后，乳头微露，大半藏在乳房之内，婴儿吮吸乳汁，常常吸破乳头，化去一半，疼痛难忍。如果畏惧疼痛不让婴儿吮食，必定肿胀形成乳痈。务必让产妇忍耐疼痛让婴儿吮吸，外涂玉红膏、珍珠散即可自愈。顾澄曾看过一个婴儿，初生吐乳，血膜与乳汁相间，仔细询问产妇，才知道产妇是瞎奶，被婴儿吮破溃烂，所以婴儿吐出的东西，是从乳中吮出的血膜。只治疗产妇的乳房，婴儿不用药而自愈。（自记。）
Two nipples are depressed.
Huang (honey-fried, 3 qian) Danggui Shen (Radix Angelicae Sinensis Root Part), Gegen (Radix Puerariae), Shengma (Rhizoma Cimicifugae), Huangbai (Cortex Phellodendri), Lianqiao (Fructus Forsythiae) (each 2 qian), Niubangzi (crushed), Zhigancao (honey-fried Licorice Root) (each 1 qian), Shang Rougui (Cortex Cinnamomi) (5 fen).
Boil with two cups of water and half a cup of wine until one cup remains; take after meals.
The *Xinfa* states: The nipples belong to the Foot-Jueyin Liver Meridian. If sudden anger or depression causes liver-fire to fail to dissipate, the nipples may crack, causing pain like knife stabs, bleeding upon wiping, flowing sticky fluid, or forming yellow lipid crusts. Treatment should primarily use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder).
Empirical Prescription: Take eggplants that have split open in the cold dew after autumn, dry them in the shade, burn them to retain their nature, grind into fine powder, mix with water, and apply externally.
Another Formula: Grind Yanzhi (Vermilion/Red Dye) and Hafan (Molluscum Shell Powder) into fine powder and apply.
In women, if the breasts are neither hard-swollen nor nodular, but the nipple orifice frequently flows bright red blood, this is called Ru Nü (Breast Hemorrhage). It results from excessive worry and thought injuring the Liver and Spleen; the Liver fails to store blood, the Spleen fails to control blood, liver-fire becomes hyperactive, and blood loses its controlled storage, thus causing hemorrhage. Treatment should focus on soothing the Liver, dispersing stagnation, nourishing blood, and supporting the Spleen. (Comment by Cheng.)
Feng Luzhan said: In cases where milk flows spontaneously, if it is due to deficient Stomach Qi failing to consolidate body fluids, tonifying Stomach Qi to consolidate is appropriate; if it is due to severe deficiency of Qi and Blood, where Qi fails to protect the exterior and Blood fails to nourish the interior, leading to reckless leakage, regulating and tonifying Ying and Wei (Nutritive and Defensive Qi) to stop it is appropriate; if milk flows spontaneously before childbirth, it is called Ru Qi (Nursing Cry), and children born thereafter often do not survive; if a postpartum woman experiences rushing milk due to overwork, this is a Jue syndrome caused by Yang Qi deficiency, treated primarily with Dushen Tang (Single Ginseng Decoction). (*Jinnang*)
Shiquan Dabu Tang (Complete Great Tonifying Decoction)
Renshen (Ginseng Root), Yu Baizhu (Atractylodes Macrocephala Rhizome), Zhigancao (honey-fried Licorice Root), Bai Fuling (Poria), Danggui (Angelica Sinensis), Baishaoyao (White Peony Root), Chuanxiong (Ligusticum Rhizome), Shudihuang (Prepared Rehmannia Root), Rougui (Cinnamon Bark), Huang (honey-fried Astragalus Root).
Use fresh ginger and jujube as guides, decoct and take orally.
Shen Douyuan said: There are cases of adopting a child (mingling zhi zi), forcing the infant to suckle due to lack of milk, which over time forms a sore that does not heal for years, or rots halfway, resembling a broken lotus pod, with unbearable suffering. If necrotic tissue inside is not removed, healthy flesh cannot grow. This is caused by damp-heat in the Yangming Stomach, named Ru Gang (Breast Chancre). (*Qixuan*)
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For newborn girls, adults must squeeze both breasts within the first month to ensure the nipples protrude. If this is ignored, the daughter will likely develop inverted nipples (blind breasts) when grown. After childbirth, if the nipples are slightly exposed but mostly hidden within the breast, infants sucking milk often break the nipples, causing half to slough off and unbearable pain. If one fears pain and prevents the infant from feeding, mastitis (Ru Yong) will surely result. The mother must endure the pain and allow the infant to suckle; applying external Yuhong Gao (Jade Red Ointment) and Zhenzhu San (Pearl Powder) will lead to self-healing. I once examined an infant who vomited milk mixed with blood membranes. Upon detailed inquiry, I learned the mother had inverted nipples that were broken and ulcerated by the infant's sucking. Thus, the substance vomited by the infant was blood membrane sucked from the breast. Treating only the mother's breast allowed the infant to recover without medication. (Self-recorded.)