产后妒乳,因无子食乳,蓄结作胀,或妇人血气方盛,乳房作胀,以致肿痛,憎寒发热
。若不以手捏去乳汁及令人吮通之,必致成痈。四物汤调炒麦芽五钱煎服立消。又妇人乳头
生小浅热疮,搔之黄汁出,亦为妒乳,以槲树皮煎洗,或天麻草煎洗。至于吹乳之证,有内
吹外吹、上逆下顺之异,总属胆、胃二经热毒,气血凝滞。内吹者胎热也。外吹者,因儿食
乳为口气所吹也。俱令乳汁不通,壅结肿痛,不急治之,多成痈肿。速服栝蒌散,外以南星
未温汤调敷、更以手揉散之。势甚者,惟连翘金贝煎最炒。《正宗》用橘叶散治内、外吹乳
。《医通》云∶吹乳初起作寒热,即服加味逍遥散,加栝蒌霜散之。《尊生》治惯吹乳,用
清肝解郁汤。又立治吹乳三方,分别初起、身热、结肿施治。至于乳痈一证,即吹乳不散,
久积成痈。又云∶轻为妒乳,重为乳痈。亦胆、胃二腑热毒,气血壅滞而成。势甚有余者,
宜先以连翘金贝煎治之,甚妙。如初起肿痛,肉色 赤,或发寒热,或憎寒头痛,烦渴引饮
,尚未成痈时,于人参败毒散、加味逍遥散、神效栝蒌散选择治之,肿自消散。若至数日脓
成溃窍,稠脓涌出,脓尽自愈。予治吹乳、结乳、乳痈等证,立消毒饮二方,外用槐艾洗法
,通治乳证,效过多人。又栝蒌贝母饮亦效,并附于各方之后。若产妇气血虚弱,患此等而
误用败毒,久不收敛,脓清脉大则难治。《医通》云∶脓清脉大,非大剂开郁理气、温补气
血,不能收功也。
栝蒌散∶治吹乳肿痛。栝蒌一个打碎,乳香二钱,用酒煎服。外用南星末,用汤调涂。
无有不愈。金银花、土贝母(去心)、蒲公英、夏枯草各三钱,红藤七八钱,连翘一两或五
七
渴,
橘叶散∶治妇人有孕胎热为内吹,有儿食乳为外吹,至乳结成肿毒,寒热交作,甚者呕
恶,并治之。柴胡、陈皮、川芎、山栀(炒)、青皮、石膏( )、黄芩(炒)、连翘(去心)、
甘
清肝解郁汤∶治惯吹乳。熟地、茯苓、白芍(炒)、贝母(去心)、栀子(炒)。
尊生治吹乳初起一方∶当归、贝母(去心)、白芷梢各一钱,花粉八分,制香附、栝蒌
仁、甘草节各六分,青皮、乳香、没药各五分,穿山甲一钱(炒),川芎四分,水、酒煎,
二
尊生治吹乳身热二方∶羌活、独活、前胡、柴胡、枳壳(炒)、桔梗、贝母(去心)、白
芷
尊生治吹乳已结肿三方∶陈皮、牛蒡子、山栀(炒)、忍冬、甘草、栝蒌、黄芩、花粉、
连翘(去心)各一钱,皂角刺、柴胡、青皮各五分,煎服。内热加石膏。
人参败毒散∶治四时伤寒、瘟疫,憎寒壮热、风湿、头眩项强、身体疼痛,岭南烟瘴之
地,疫疠时行,或卑湿香港脚痿弱等证。人参、茯苓、枳壳(炒)、川芎、羌活、独活、前胡、
柴胡、桔梗、甘草各等分,姜三片,水一钟半,煎服。或为细末,沸汤点服。
神效栝蒌散∶治乳痈及一切痈疽初起,肿痛即消,脓成即溃,脓出即愈。治痈之方甚多
,独此方神效,瘰 疮毒尤效。凡一切痈疽余毒,皆宜用之。栝蒌一个(研烂),当归(酒
洗)
再服
结核
胡、
消毒饮∶专治乳房或乳顶黑晕之内,肿毒未破,发热恶寒,疮处或痛或不痛或麻木,服
之即愈。蒲公英、紫花地丁各一钱二分,当归(酒洗)、白芍(醋炒)、赤芍、丹皮、地骨皮、
天花粉各一钱,陈皮八分,生草三分,灯心五十寸,水煎,食后服。仍以槐、艾水不时洗之
定痛消毒饮∶治乳顶傍或乳房吹乳成痈,并乳结之证,发热恶寒,冷汗自出,势欲破而
疼痛难忍,服之即出脓痛定。蒲公英、紫花地丁各一钱二分,当归(乳房用身,乳顶用尾)、
白芍(醋炒)、赤芍、花粉、浙贝(去心,研)各一钱,皂角刺五分,柴胡稍八分或一钱(乳
顶
枣
不时
槐艾洗法∶治产妇乳上结核、乳痈。槐条、艾叶不拘多少,连须葱一条,将槐艾用水同
煎煮,入醋少许,频频洗之。若乳顶旁生疮,脓出洗净与儿吮之,随以松萝茶叶末掺上。
栝蒌贝母饮∶治乳房结核 肿。栝蒌实、土贝母(去心)甘草节各三钱,煎服,效。
已溃,加忍冬一两,佳。
产后妒乳,是因为婴儿没有吃奶,乳汁蓄积导致乳房胀痛;或者是妇女气血正旺盛时,乳房胀满,进而引起肿痛、怕冷发热。如果不及时用手挤出乳汁或让他人吸通,必然会导致形成痈肿。用四物汤调服炒麦芽五钱,煎服后立即消散。另外,妇女乳头生出浅表的小热疮,抓挠后有黄色汁液流出,这也属于妒乳,可以用槲树皮煎水清洗,或者用天麻草煎水清洗。至于吹乳的病症,有内吹和外吹、气机上逆和下顺的区别,总归是胆经和胃经的热毒,导致气血凝滞。内吹是由于胎热引起的。外吹则是由于婴儿吃奶时,口气吹入所致。都会导致乳汁不通,壅结肿痛,如果不及时治疗,多会形成痈肿。迅速服用栝蒌散,外用生南星粉末用温水调敷,并用手揉散。病情严重的,只有连翘金贝煎最为合适。《外科正宗》用橘叶散治疗内吹和外吹乳。《医宗金鉴》说:吹乳初起出现寒热症状,立即服用加味逍遥散,配合栝蒌霜散结。《尊生八筏》治疗习惯性吹乳,使用清肝解郁汤。又制定了三个治疗吹乳的方子,分别针对初起、身热、结肿进行治疗。至于乳痈这一证候,就是吹乳未能消散,日久积聚而成痈。又说:轻症为妒乳,重症为乳痈。也是由胆、胃二腑的热毒,气血壅滞而成。正气盛实者,适宜先用连翘金贝煎治疗,效果很好。如果初起时肿痛,皮肤发红,或者发冷发热,或者怕冷头痛,烦躁口渴想喝水,尚未成脓时,在人参败毒散、加味逍遥散、神效栝蒌散中选择一方治疗,肿胀自然会消散。如果到了几天后脓成破溃,稠厚的脓液涌出,脓排尽后自然痊愈。我治疗吹乳、结乳、乳痈等证候,制定了两方消毒饮,外用槐艾洗法,通治乳房疾病,疗效超过许多人。另外栝蒌贝母饮也有效,一并附在各方的后面。如果产妇气血虚弱,患此病却误用败毒药物,久不收敛,脓液清稀脉象宏大,则难以治疗。《医宗金鉴》说:脓液清稀脉象宏大,不用大剂量的开郁理气、温补气血的药物,不能取得疗效。
栝蒌散:治疗吹乳肿痛。栝蒌一个打碎,乳香二钱,用酒煎服。外用生南星粉末,用温水调涂。没有不愈的。金银花、土贝母(去心)、蒲公英、夏枯草各三钱,红藤七八钱,连翘一两……(原文此处似有缺漏或排版错误,结合上下文推测为剂量或用法描述,但根据指令“不增添内容”,仅翻译可见部分)……渴,橘叶散:治疗妇女怀孕因胎热导致内吹,有婴儿吃奶导致外吹,致使乳汁结成肿毒,寒热交替发作,严重的呕吐恶心,一并治疗。柴胡、陈皮、川芎、山栀(炒)、青皮、石膏(……)、黄芩(炒)、连翘(去心)、甘……
清肝解郁汤:治疗习惯性吹乳。熟地黄、茯苓、白芍(炒)、贝母(去心)、栀子(炒)。
尊生治疗吹乳初起一方:当归、贝母(去心)、白芷梢各一钱,天花粉八分,制香附、栝蒌仁、甘草节各六分,青皮、乳香、没药各五分,穿山甲一钱(炒),川芎四分,用水、酒煎服,二……
尊生治疗吹乳身热二方:羌活、独活、前胡、柴胡、枳壳(炒)、桔梗、贝母(去心)、白芷……
尊生治疗吹乳已结肿三方:陈皮、牛蒡子、山栀(炒)、忍冬、甘草、栝蒌、黄芩、天花粉、连翘(去心)各一钱,皂角刺、柴胡、青皮各五分,煎服。内热加石膏。
人参败毒散:治疗四季伤寒、瘟疫,怕冷高热、风湿、头晕项强、身体疼痛,岭南烟瘴之地,疫疠流行,或卑湿之地的香港脚痿弱等证候。人参、茯苓、枳壳(炒)、川芎、羌活、独活、前胡、柴胡、桔梗、甘草各等分,生姜三片,水一钟半,煎服。或者研为细末,沸水冲服。
神效栝蒌散:治疗乳痈及一切痈疽初起,肿痛即消,脓成即溃,脓出即愈。治疗痈的方子很多,唯独此方神效,瘰疬疮毒尤其有效。凡是一切痈疽余毒,都适宜使用。栝蒌一个(研烂),当归(酒洗)……再服结核胡……
消毒饮:专治乳房或乳头顶黑晕之内,肿毒未破,发热恶寒,疮处或痛或不痛或麻木,服用后即愈。蒲公英、紫花地丁各一钱二分,当归(酒洗)、白芍(醋炒)、赤芍、丹皮、地骨皮、天花粉各一钱,陈皮八分,生甘草三分,灯心五十寸,水煎,饭后服用。仍以槐树、艾叶水不时清洗。
定痛消毒饮:治疗乳顶旁边或乳房吹乳成痈,以及乳结的证候,发热恶寒,冷汗自出,势欲破溃而疼痛难忍,服用后即出脓且疼痛停止。蒲公英、紫花地丁各一钱二分,当归(乳房用根部,乳顶用尾部)、白芍(醋炒)、赤芍、天花粉、浙贝母(去心,研)各一钱,皂角刺五分,柴胡稍八分或一钱(乳顶……枣……不时……
槐艾洗法:治疗产妇乳房上的结核、乳痈。槐树枝条、艾叶不拘多少,带须葱一条,将槐艾用水同煎煮,加入少许醋,频频清洗。如果乳顶旁边生疮,脓出洗净后让婴儿吸吮,随即撒上松萝茶叶末。
Postpartum "Du Ru" (stagnant milk), caused by the infant not nursing, leads to milk accumulation and breast distension; or it occurs when a woman's Qi and Blood are vigorous, causing breast fullness, leading to swelling, pain, aversion to cold, and fever. If the milk is not manually expressed or sucked out by another person, an abscess will inevitably form. Taking Siwu Tang (Four Substances Decoction) with five qian of stir-fried Maiya (Stir-fried Hordeum Vulgare Fructus) mixed in, decocted and taken orally, will dissipate it immediately. Additionally, if small superficial heat sores appear on the nipples, oozing yellow fluid upon scratching, this is also considered "Du Ru". It can be washed with decoctions of Hu Pi (Quercus variabilis Bark) or Tianma Cao (Gastrodia Elata Herb). Regarding "Chui Ru" (blown milk), there are distinctions between internal blowing and external blowing, and upward reversal versus downward smooth flow. Generally, it belongs to Heat-Toxin in the Gallbladder and Stomach meridians, causing Qi and Blood stagnation. Internal blowing is due to fetal heat. External blowing is caused by the infant's breath entering the nipple while nursing. Both result in blocked milk flow, congestion, swelling, and pain. If not treated promptly, they often develop into abscesses. Quickly take Gualou San (Trichosanthes Powder), apply external powder of Nanxing (Arisaema Rhizoma) mixed with warm water, and massage to disperse. For severe cases, Lianqiao Jinbei Jian (Forsythia and Fritillaria Decoction) is most suitable. *Waike Zhengzong* (Standard Treatment of External Diseases) uses Juye San (Tangerine Leaf Powder) for internal and external blowing milk. *Yitong* states: For early-stage blowing milk with chills and fever, immediately take Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) combined with Gualou Shuang (Trichosanthes Powder) to dissipate the lump. *Zunsheng* treats habitual blowing milk using Qinggan Jieyu Tang (Liver-Clearing and Depression-Relieving Decoction). It also established three formulas for blowing milk, treating respectively the initial stage, body heat, and formed swelling. As for "Ruyong" (breast abscess), it is simply blowing milk that has not dissipated, accumulating over time to form an abscess. It is said: mild cases are Du Ru, severe cases are Ruyong. This is also caused by Heat-Toxin in the Gallbladder and Stomach fu-organs, with Qi and Blood congestion. In cases of excess pathogenic factors, one should first use Lianqiao Jinbei Jian, which is very effective. If at the initial stage there is swelling and pain, red skin, or chills and fever, or aversion to cold with headache, irritability, thirst, and desire to drink, before pus formation, choose from Ren Shen Baidu San (Ginseng Detoxification Powder), Jiawei Xiaoyao San, or Shenxiao Gualou San (Miraculous Efficacy Trichanthes Powder) for treatment, and the swelling will naturally dissipate. If after several days pus forms and ruptures, thick pus flows out, and once the pus is exhausted, it heals itself. I have treated conditions such as blowing milk, knotted milk, and breast abscess, establishing two formulas of Xiaodu Yin (Detoxification Drink), and externally using Huai Ai Xi Fa (Sophora and Mugwort Washing Method) to generally treat breast diseases, with efficacy surpassing many others. Additionally, Gualou Beimu Yin (Trichanthes and Fritillaria Drink) is also effective, appended after the various formulas. If the parturient has deficient Qi and Blood, and mistakenly uses detoxifying drugs for these conditions, leading to non-healing ulcers, clear pus, and a large pulse, it is difficult to treat. *Yitong* states: With clear pus and a large pulse, only large doses of Qi-regulating and depression-relieving, warming and tonifying Qi and Blood prescriptions can achieve success.
Gualou San: Treats blowing milk with swelling and pain. One Gualou (Trichosanthes Fruit) crushed, two qian of Xuxiang (Frankincense), decocted with wine and taken orally. Externally, apply Nanxing (Arisaema Rhizoma) powder mixed with water. There is no case that does not heal. Jinyinhua (Honeysuckle Flower), Tubei Mu (Fritillaria Cirrhosa Bulb, heart removed), Pugongying (Dandelion), Xiakucao (Prunella Vulgaris Spike) each three qian, Hongteng (Sargentodoxa Cuneata Stem) seven to eight qian, Lianqiao (Forsythia Fruit) one liang... [text fragment] ...thirst, Juye San: Treats pregnant women with internal blowing due to fetal heat, and external blowing due to infant nursing, resulting in milk knotting into a toxic swelling, alternating chills and fever, and in severe cases vomiting and nausea. Chaihu (Bupleurum Root), Chenpi (Tangerine Peel), Chuanxiong (Ligusticum Rhizome), Zhizi (Gardenia Fruit, stir-fried), Qingpi (Green Tangerine Peel), Shigao (Gypsum Fibrosum)... Huangqin (Scutellaria Root, stir-fried), Lianqiao (Forsythia Fruit, heart removed), Gan...
Qinggan Jieyu Tang: Treats habitual blowing milk. Shudi (Rehmannia Root, prepared), Fuling (Poria), Baishao (White Peony Root, stir-fried), Beimu (Fritillaria Bulb, heart removed), Zhizi (Gardenia Fruit, stir-fried).
Zunsheng formula for initial blowing milk: Danggui (Angelica Sinensis Root), Beimu (Fritillaria Bulb, heart removed), Baizhi Sha (Angelica Dahurica Root tip) each one qian, Huafen (Trichosanthes Root) eight fen, Zhi Xiangfu (Cyperus Rhizoma, processed), Gualou Ren (Trichosanthes Seed), Gancao Jie (Licorice Root joint) each six fen, Qingpi (Green Tangerine Peel), Xuxiang (Frankincense), Moyao (Myrrh) each five fen, Chuanshanjia (Pangolin Scale, stir-fried) one qian, Chuanxiong (Ligusticum Rhizome) four fen. Decoct with water and wine, take two...
Zunsheng two formulas for blowing milk with body heat: Qianghuo (Notopterygium Rhizome), Duhuo (Angelica Pubescens Root), Qianhu (Peucedanum Root), Chaihu (Bupleurum Root), Zhike (Citrus Aurantium Fruit, stir-fried), Jiegeng (Platycodon Root), Beimu (Fritillaria Bulb, heart removed), Baizhi (Angelica Dahurica Root)...
Zunsheng three formulas for blowing milk with formed swelling: Chenpi (Tangerine Peel), Niubangzi (Arctium Fruit), Zhizi (Gardenia Fruit, stir-fried), Rendong (Honeysuckle Flower), Gancao (Licorice Root), Gualou (Trichosanthes Fruit), Huangqin (Scutellaria Root), Huafen (Trichosanthes Root), Lianqiao (Forsythia Fruit, heart removed) each one qian, Zaogelaci (Gleditsia Spine), Chaihu (Bupleurum Root), Qingpi (Green Tangerine Peel) each five fen. Decoct and take. Add Shigao (Gypsum Fibrosum) for internal heat.
Ren Shen Baidu San: Treats seasonal cold damage, epidemics, aversion to cold with high fever, wind-dampness, dizziness and stiff neck, body pain, miasma in Lingnan, epidemic diseases, or damp-induced Hong Kong foot (gout/weakness). Ren Shen (Ginseng Root), Fuling (Poria), Zhike (Citrus Aurantium Fruit, stir-fried), Chuanxiong (Ligusticum Rhizome), Qianghuo (Notopterygium Rhizome), Duhuo (Angelica Pubescens Root), Qianhu (Peucedanum Root), Chaihu (Bupleurum Root), Jiegeng (Platycodon Root), Gancao (Licorice Root) in equal parts. Three slices of Jiang (Fresh Ginger), one and a half zhong of water, decoct and take. Or grind into fine powder, take with boiling water.
Shenxiao Gualou San: Treats breast abscess and all initial carbuncles and sores. Swelling and pain dissipate immediately; if pus forms, it ruptures; if pus drains, it heals. There are many formulas for treating carbuncles, but this one is miraculously effective, especially for scrofula and toxic sores. All residual toxins from carbuncles and sores should use this. One Gualou (Trichosanthes Fruit) (mashed), Danggui (Angelica Sinensis Root, washed with wine)... take again... tubercle... Hu...
Xiaodu Yin: Specifically treats toxic swelling inside the breast or the black halo of the nipple, unruptured, with fever and aversion to cold. The sore may be painful, painless, or numb. Take and it heals immediately. Pugongying (Dandelion), Zihua Diding (Viola Yedoensis Herb) each one qian two fen, Danggui (Angelica Sinensis Root, washed with wine), Baishao (White Peony Root, stir-fried with vinegar), Chishao (Red Peony Root), Danpi (Moutan Cortex), Digupi (Lycium Bark), Tianhuafen (Trichosanthes Root) each one qian, Chenpi (Tangerine Peel) eight fen, Sheng Cao (Raw Licorice Root) three fen, Dengxin (Juncus Medulla) fifty cun. Decoct with water, take after meals. Wash frequently with Sophora and Mugwort water.
Dingtong Xiaodu Yin: Treats blowing milk forming an abscess on the side of the nipple or breast, and knotted milk conditions, with fever, aversion to cold, spontaneous cold sweat, impending rupture, and unbearable pain. Take and pus will discharge, pain will cease. Pugongying (Dandelion), Zihua Diding (Viola Yedoensis Herb) each one qian two fen, Danggui (Angelica Sinensis Root, root body for breast, tail for nipple), Baishao (White Peony Root, stir-fried with vinegar), Chishao (Red Peony Root), Huafen (Trichosanthes Root), Zhebei Mu (Fritillaria Thunbergii Bulb, heart removed, ground) each one qian, Zaogelaci (Gleditsia Spine) five fen, Chaihu Shao (Bupleurum Root tip) eight fen or one qian (nipple... jujube... frequently...
Huai Ai Xi Fa: Treats tubercles and breast abscesses in postpartum women. Huaitiao (Sophora Branches), Aye (Artemisia Argyi Leaf) in any amount, one green onion with roots. Decoct Sophora and Mugwort together with water, add a little vinegar, and wash frequently. If sores appear on the side of the nipple, clean the discharged pus, let the infant suck, then sprinkle Songluo Cha Ye Mo (Tea Moss Powder) on top.
Gualou Beimu Yin: Treats breast tubercles and swelling. Gualou Shi (Trichosanthes Fruit), Tubei Mu (Fritillaria Cirrhosa Bulb, heart removed), Gancao Jie (Licorice Root joint) each three qian. Decoct and take, effective. If ulcerated, add Rendong (Honeysuckle Flower) one liang, better.