加味四物汤
1.产后血虚乳汁少, 四物花粉不留行, 木通猪蹄汤熬服, 葱白煎汤
乳房淋.
【注】产后乳汁不行, 因去血过多, 血少不行者, 宜四物汤加花粉,
王不留行, 木通, 猪蹄熬汤, 煎药服. 外用葱白煎汤, 时时淋洗乳房
,以通其气.
涌泉散
2.气脉壅塞乳胀痛, 涌泉散用白丁香, 王不留行天花粉, 漏芦僵蚕
猪蹄汤.
【注】产后乳汁不行, 因瘀血停留, 气脉壅滞者, 其乳必胀痛, 宜用
涌泉散, 即白丁香, 王不留行, 花粉, 漏芦, 僵蚕, 猪蹄汤煎服也.
兔怀散 麦芽煎
3.产后乳汁暴涌出, 十全大补倍参耆, 食少乳多欲回乳, 兔怀红花
归芎膝, 无儿食乳乳欲断, 炒麦芽汤频服宜.
【注】产后乳汁暴涌不止者, 乃气血大虚, 宜十全大补汤, 倍用人参
,黄耆. 若食少乳多, 欲回其乳者, 宜兔怀散, 即红花, 归尾, 赤芍
,牛膝也; 若无儿食乳, 欲断乳者, 用麦芽炒熟, 熬汤作茶饮之.
4.乳房忽然红肿痛, 往来寒热乳痈成, 乳被儿吹因结核, 坚硬不通
吹乳名. 初起结核不肿痛, 年深内溃乳岩凶, 乳头生疮名妒乳, 细长
垂痛乳悬称.
【注】妇人乳房忽然红肿坚硬疼痛, 增寒壮热, 头痛者, 此欲成乳痈
也.若乳儿之时, 乳被儿口中气吹, 以致乳管不通结核者, 名曰吹乳
.更有乳内结核如围棋子, 不肿不痛, 但坚硬不散, 日久内溃者, 谓
之乳岩, 其证甚凶. 若乳头生小细疮痛者, 为妒乳. 若瘀血上攻, 乳
房之忽然细小下垂, 长过于腹, 此名乳悬, 惟产后有之.
Jiawei Siwu Decoction (Modified Four Substances Decoction)
1. Postpartum scanty lactation due to Blood deficiency: Use Siwu Tang (Four Substances Decoction), Tianhuafen (Trichosanthes Root), Wangbuliuxing (Vaccaria Seed), Mu Tong (Akebia Caulis), and pig trotters boiled into a decoction for oral administration; additionally, scallion white decoction should be used to wash the breasts externally.
[Annotation] Postpartum failure of lactation caused by excessive blood loss, resulting in insufficient Blood and poor circulation, is treated with Siwu Tang (Four Substances Decoction) added with Tianhuafen (Trichosanthes Root), Wangbuliuxing (Vaccaria Seed), and Mu Tong (Akebia Caulis), decocted in pig trotter broth. Externally, scallion white decoction is used to frequently wash the breasts to unblock Qi mechanism.
Yongquan Powder
2. Breast distension and pain due to Qi and vessel obstruction: Use Yongquan Powder containing Bai Dingxiang (Turdus Albigularis Faeces), Wangbuliuxing (Vaccaria Seed), Tianhuafen (Trichosanthes Root), Loulu (Radix Euphorbiae Humifusae), Jiangcan (Bombyx Batryticatus), decocted in pig trotter broth.
[Annotation] Postpartum failure of lactation caused by retained Blood stasis and stagnation of Qi and vessels results in breast distension and pain. It is treated with Yongquan Powder, composed of Bai Dingxiang (Turdus Albigularis Faeces), Wangbuliuxing (Vaccaria Seed), Tianhuafen (Trichosanthes Root), Loulu (Radix Euphorbiae Humifusae), and Jiangcan (Bombyx Batryticatus), decocted in pig trotter broth.
Tuai San (Rabbit Pregnancy Powder) & Maiya Decoction (Malt Decoction)
3. Sudden profuse lactation postpartum: Use Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction) with doubled Renshen (Ginseng Radix) and Huangqi (Astragali Radix). If food intake is low but lactation is excessive, and one wishes to suppress lactation (wean), use Tuai San containing Honghua (Carthami Flos), Guiwei (Angelicae Sinensis Radix), Chishao (Paeoniae Radix Rubra), and Niuxi (Achyranthis Bidentatae Radix). If there is no infant to suckle and one wishes to wean, frequent oral administration of decoction made from stir-fried Maiya (Hordei Fructus Germinatus) is appropriate.
[Annotation] Sudden continuous profuse lactation postpartum is due to severe deficiency of Qi and Blood, treated with Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction) using doubled doses of Renshen (Ginseng Radix) and Huangqi (Astragali Radix). If food intake is low but lactation is excessive, and suppression of lactation is desired, Tuai San is used, consisting of Honghua (Carthami Flos), Guiwei (Angelicae Sinensis Radix), Chishao (Paeoniae Radix Rubra), and Niuxi (Achyranthis Bidentatae Radix). If there is no infant to suckle and weaning is desired, stir-fried Maiya (Hordei Fructus Germinatus) is decocted and drunk as tea.
4. Sudden redness, swelling, and pain of the breasts, alternating chills and fever, indicating the formation of Ru Yong (Breast Abscess); hard nodules due to infant's breath obstructing the ducts, known as Chui Ru (Blown Breast). Initial nodules are non-painful and non-swollen; long-standing internal ulceration indicates Ru Yan (Breast Cancer), which is ominous. Ulcers on the nipple are called Du Ru (Jealous Breast); elongated, hanging, and painful breasts are called Ru Xuan (Hanging Breast).
[Annotation] When a woman’s breasts suddenly become red, swollen, hard, and painful, accompanied by aversion to cold, high fever, and headache, this indicates the impending formation of Ru Yong (Breast Abscess). During breastfeeding, if the nipple is exposed to the infant's breath, causing obstruction of the milk ducts and formation of nodules, it is named Chui Ru (Blown Breast). Additionally, nodules within the breast resembling Go stones, which are neither swollen nor painful but remain hard and do not dissipate, may ulcerate internally over time; this is termed Ru Yan (Breast Cancer), a grave condition. Small painful ulcers on the nipple are called Du Ru (Jealous Breast). If Blood stasis attacks upward, causing the breasts to suddenly become small, hang loosely, and extend beyond the abdomen, it is named Ru Xuan (Hanging Breast), occurring only postpartum.