乳必使呼通,如不通,必乳肿,作寒热之状,此非前症,为乳所阻耳。宜用香附、栝蒌、通草、橘叶煎服,
其药渣煎洗。如不自乳子者,只煎炒麦芽三钱熏洗,乳退热亦退。
此证不服药,过二三日自愈。(徐评)
产后凭乳以养儿。乳少者,皆因气血不足。然酒虽引血生乳,宜用淡酒,或冲开水、油汤中饮。若多饮
及饮好酒,每致少乳。药服黄 补血汤加山药极妙,或以虾斤许煎淡酒去虾饮。
黄 补血汤(见前,加山药三五钱)
(乳内吹外吹)
妇人乳疾,必发寒热。儿在腹中,七八个月乳忽红肿,名曰内吹。产后有硬块者,或乳不通,宿乳积成,或
被子含口中乳气贯入,名为外吹。俱防生痈,宜服栝蒌散,外敷香附饼自可消散。又有妇人肝气郁怒者,并用
前方加柴胡(三分),白芍(一钱俱酒炒),橘叶(十片)煎服,以早为消散,或服逍遥散亦可。
栝蒌散
栝蒌(一个敲碎) 明乳香(二钱)
水煎,冲酒服。
香附饼
香附(四两,炒为末) 麝香(三分)
二味共为末,另用蒲公英(二两),银花(三钱)。
酒煮去渣,以此药酒调香附末炖热,敷患处,内服栝蒌散,自可消散。予常令煎麦芽、橘叶水洗乳,亦妙。
逍遥散
当归(二钱) 白芍(一钱,炒) 柴胡(三分,酒略炒) 茯苓(一钱五分) 白术(一钱,炒) 甘
草(五分,炙) 薄荷(五分) 加姜(二片)
煎服此方,加丹皮、炒黑山栀,名加味逍遥散,平肝火也。
乳房必须保持通畅,如果不通,必然导致乳房肿胀,出现类似寒热的症状,这并非之前的病症,而是由乳汁阻滞所致。适宜使用香附、栝蒌、通草、橘叶煎汤服用,药渣再煎水外洗。如果不亲自哺乳婴儿的,只需煎炒麦芽三钱进行熏洗,乳汁消退后发热也会随之退去。此证若不服药,过两三天可自行痊愈。(徐评)
产后依靠乳汁来养育婴儿。乳汁稀少,都是因为气血不足。然而酒虽然能引血生乳,宜用淡酒,或者兑入开水、油汤中饮用。如果多饮或饮用烈性好酒,往往会导致乳汁减少。药物治疗可用黄耆补血汤加入山药效果极佳,或者用虾一斤煎煮淡酒,去虾后饮用。
黄耆补血汤(见前文,加山药三五钱)
(乳内吹与外吹)
妇女乳房疾病,必定伴有寒热症状。胎儿在腹中时,怀孕七八个月时乳房突然红肿,称为“内吹”。产后乳房有硬块,或者乳汁不通,宿积的乳汁凝聚而成,或者是被婴儿含在口中时乳汁之气反灌入乳房,称为“外吹”。这两种情况都要防止发展成痈疽,适宜服用栝蒌散,外部敷贴香附饼即可自行消散。又有妇女因肝气郁结愤怒而致病者,并在前方基础上加柴胡(三分)、白芍(一钱,均用酒炒)、橘叶(十片)煎服,尽早使其消散,或者服用逍遥散也可以。
栝蒌散
栝蒌(一个,敲碎) 明乳香(二钱)
用水煎煮,冲入酒服用。
香附饼
香附(四两,炒成粉末) 麝香(三分)
将这两味药共同研为粉末,另外取蒲公英(二两)、银花(三钱)。
用酒煮后去渣,以此药酒调匀香附末炖热,敷于患处,内部服用栝蒌散,自然可以消散。我常令患者煎煮麦芽、橘叶水洗乳房,也非常奇妙。
逍遥散
当归(二钱) 白芍(一钱,炒) 柴胡(三分,酒略炒) 茯苓(一钱五分) 白术(一钱,炒) 甘草(五分,炙) 薄荷(五分) 加生姜(二片)
煎服此方,加入丹皮、炒黑山栀,名为加味逍遥散,用于平抑肝火。
The breasts must be kept unobstructed; if obstructed, breast swelling will inevitably occur, presenting with symptoms resembling chills and fever. This is not the previous condition but rather obstruction caused by milk stasis. It is advisable to decoct Cyperi Rhizoma (Xiangfu), Trichosanthis Fructus (Gualou), Tetsu Herba (Tongcao), and Citri Reticulatae Pericarpium Viride (Juye) for oral administration, and use the dregs for external washing. For those who do not breastfeed their infants, simply decoct three qian of fried Malto (Maiya) for fumigation and washing; as the milk supply recedes, the fever will also subside. If no medication is taken, this condition will resolve spontaneously after two or three days. (Commentary by Xu)
Postpartum mothers rely on milk to nourish their infants. Scanty lactation is primarily due to deficiency of Qi and Blood. Although wine can promote blood generation and lactation, light wine should be used, diluted with boiled water or oil soup. Excessive consumption or drinking strong wine often leads to reduced milk production. Pharmacologically, Huangqi Buxue Tang (Astragalus Decoction for Nourishing Blood) added with Dioscoreae Rhizoma (Shanyao) yields excellent results; alternatively, one jin of shrimp may be decocted in light wine, and the liquid consumed after removing the shrimp.
Huangqi Buxue Tang (See previous section, add 3-5 qian of Shanyao)
(Internal and External Blowing of the Breast)
Breast diseases in women are invariably accompanied by chills and fever. When the fetus is still in the womb, sudden redness and swelling of the breasts occurring at seven or eight months of pregnancy is termed "Internal Blowing." Postpartum hard lumps, or blocked lactation resulting from accumulated old milk, or milk qi forced back into the breast by the infant's sucking action, are termed "External Blowing." Both conditions risk developing into carbuncles (Yong). It is advisable to take Gualou San (Trichosanthes Powder) and apply an Xiangfu Bing (Cyperi Cake) externally, which will naturally dissipate. In cases where a woman suffers from liver Qi stagnation and anger, the aforementioned formula should be modified with Chaihu (Bupleuri Radix, 3 fen), Baishao (Paeoniae Radix Alba, 1 qian, both stir-fried with wine), and Juye (10 leaves) for decoction to ensure early dissipation; alternatively, Xiaoyao San (Free and Easy Wanderer Powder) may be taken.
Gualou San
Trichosanthis Fructus (Gualou, one fruit, crushed) Frankincense (Ruxiang, 2 qian)
Decoct in water and administer with wine.
Xiangfu Bing
Cyperi Rhizoma (Xiangfu, 4 liang, stir-fried and powdered) Moschus (Shexiang, 3 fen)
Grind these two ingredients into powder. Separately, use Dandelion (Pugongying, 2 liang) and Honeysuckle Flower (Yinhua, 3 qian).
Decoct with wine, strain, and use this medicinal wine to mix the Xiangfu powder, heat it, and apply to the affected area. Internally, take Gualou San to ensure dissipation. I often advise decocting Maiya and Juye for breast washing, which is also effective.
Xiaoyao San
Angelicae Sinensis Radix (Danggui, 2 qian) Paeoniae Radix Alba (Baishao, 1 qian, stir-fried) Bupleuri Radix (Chaihu, 3 fen, lightly stir-fried with wine) Poria (Fuling, 1.5 qian) Atractylodis Macrocephalae Rhizoma (Baizhu, 1 qian, stir-fried) Glycyrrhizae Radix et Rhizoma (Gancao, 5 fen, honey-fried) Menthae Haplocalycis Herba (Bohe, 5 fen) Add Zingiberis Rhizoma Recens (Shengjiang, 2 slices)
Decoct and take this formula. Adding Moutan Cortex (Danpi) and Gardeniae Fructus (Zhizi, stir-fried until black) creates Jia Wei Xiaoyao San (Modified Free and Easy Wanderer Powder), which pacifies Liver Fire.