产后乳汁不通,其故有二∶一由气血两虚,乳来稀少;一由气闭血滞、壅塞不行。盖妇人多忧思忿怒,忧思
则气结而血亦结,忿怒则气逆而血亦逆,甚至乳硬管塞,胁痛烦热。故方于通乳药中多用香附、木香、青皮者,
以行气故也。用王不留行者,通乳而兼行血也。若惟由气血虚弱,则不必用利气药等味,须服猪蹄汤或钟乳饮。
猪蹄汤
猪蹄(一只) 通草(五钱)
煮汁服之。
钟乳饮
钟乳粉(二钱) 漏芦(三钱)
煎汁服。一方,鲫鱼、木通,煮汁食之。
按∶乳汁不通皆由气血不足之故。用猪蹄一只,有七星者佳,煮浓汁,入当归五钱,熟地六钱,人参一钱,
西党参八钱代之亦可,川芎一钱五分,通草一钱,杞子三钱,炙 三钱,煎服。如人壮气闭则加王不留行一钱,
不可多用。
产后乳汁不通,其原因有二:一是气血两虚,导致乳汁分泌稀少;二是气机闭塞、血液瘀滞,导致乳汁壅塞不行。妇女多因忧思和愤怒致病,忧思则导致气机郁结,血液也随之凝滞;愤怒则导致气机上逆,血液也随之逆行,甚至出现乳房硬结、乳管堵塞、胁肋疼痛、烦躁发热等症状。因此,在通乳方药中多用香附、木香、青皮,是为了行气的作用。使用王不留行(一种具有通经下乳功效的药材),是因为它能通乳并兼有活血的功效。如果仅仅是由于气血虚弱所致,则不必使用理气类药物,应当服用猪蹄汤或钟乳饮。
钟乳饮
钟乳粉(二钱) 漏芦(三钱)
煎取汁液服用。另一方法,用鲫鱼、木通,煮汁食用。
按语:乳汁不通都是由于气血不足的缘故。使用一只猪蹄(以带有七个乳头者为佳),煮成浓汁,加入当归五钱、熟地黄六钱、人参一钱、川芎一钱五分、通草一钱、枸杞子三钱、炙甘草三钱,煎服。若产妇体质壮实且气机闭塞,则加王不留行一钱,不可多用。
产妇无子而需要哺乳,或者乳汁过多想要回奶的,使用麦芽二两,炒后研为粉末,用四物汤调服即可消除乳汁。又一方,使用神曲二钱,炒后研为粉末,用酒送服,每日一次。
Postpartum agalactia (absence of milk secretion after childbirth) has two causes: one is deficiency of both Qi and Blood, leading to scanty milk production; the other is obstruction of Qi stagnation and blood stasis, causing blockage and failure of milk flow. Women are prone to worry, overthinking, and anger. Worry and overthinking cause Qi constraint and subsequent Blood coagulation; anger causes Qi rebellion and subsequent Blood counterflow. This can even lead to breast induration, ductal obstruction, hypochondriac pain, irritability, and fever. Therefore, in galactagogue formulas, herbs such as Cyperi Rhizoma (Xiangfu), Aucklandiae Radix (Muxiang), and Citri Reticulatae Pericarpium (Qingpi) are frequently used for their Qi-moving properties. Vaccariae Semen (Wangbuliuxing) is used because it promotes lactation and simultaneously invigorates Blood. If the condition is solely due to Qi and Blood deficiency, Qi-regulating herbs should not be used; instead, Pig Trotter Decoction (Zhuti Tang) or Zhuru Yin should be administered.
Pig Trotter Decoction (Zhuti Tang)
Sus scrofa domestica trotters (one piece)
Akebiae Caulis (Tongcao) (five qian)
Boil to extract the juice and drink.
Zhuru Yin
Gypsum Fibrosum powder (Zhongru) (two qian)
Euphorbiae Humifusae Herba (Loulu) (three qian)
Decoct to extract the juice and drink. Another method involves using Crucian carp (Jiyu) and Akebiae Caulis (Mutong), boiling them to extract the juice for consumption.
Note: Agalactia is generally caused by insufficiency of Qi and Blood. Use one pig trotter (preferably one with seven teats), boil into a thick decoction, then add Angelicae Sinensis Radix (Danggui) five qian, Rehmanniae Radix Praeparata (Shudi) six qian, Ginseng Radix (Renshen) one qian, Codonopsis Radix (Xidangshen) eight qian as a substitute, Chuanxiong Rhizome (Chuanxiong) one qian five fen, Akebiae Caulis (Tongcao) one qian, Lycii Fructus (Qizi) three qian, and Glycyrrhizae Radix et Rhizoma Praeparata (Zhi Gancao) three qian. Decoct and take orally. If the patient is robust with Qi obstruction, add Vaccariae Semen (Wangbuliuxing) one qian, but do not use excessive amounts.
For nursing mothers who have no infant to nurse or wish to suppress lactation, use Malto (Maiya) two liang, stir-fry until done, grind into powder, and take mixed with Siwu Tang (Four Substances Decoction) to eliminate milk. Another prescription uses Medicated Leaven (Shenqu) two qian, stir-fry until done, grind into powder, and swallow with wine, once daily.