〔大〕产后吹奶者，因儿吃奶之次，儿忽自睡，呼气不通，乳不时泄，蓄积在内，遂
成肿硬，壅闭乳道，津液不通，伤结疼痛。亦有不痒不痛，肿硬如石，名曰吹奶。若不急
治，肿甚成痈。产后吹奶，最宜急治，不尔结痈，逮至死者。速服皂角散、栝蒌散，敷
以天南星散，以手揉之则散矣。
〔薛〕前证用药，切不可损其气血。余详外科乳痈条。
栝蒌散方
乳香（一钱，研） 栝蒌实（一个） 研匀，温酒煎服。
天南星散
南星（为末） 温汤调，以鹅翎蘸涂患处。
皂角散
歌曰∶妇人吹奶治如何？皂角烧灰蛤粉和，热酒一杯调八字，须臾揉散笑呵呵。
治奶结硬疼痛。
百药煎为细末，每服三钱，酒一盏，煎数沸，热服。
乳硬作痛
嫩桑叶生研，以米饮调，摊纸花贴肿处。
《补遗》治产后吹奶，结实肿痛。
用陈皮（一两） 甘草（一钱）
水二碗，煎至一碗，分两服。次用荆芥、羌活、独活煎汤熏洗，即散。
夫妒乳者，由新产后儿未能饮之，及乳不泄，或乳胀捏其汁不尽，皆令乳汁蓄结，与
血气相搏，即壮热大渴引饮，牢强掣痛，手不得近是也。初觉便知以手捋捏去汁，更令
旁人助吮引之，不尔，或作疮有脓，其热势盛，必成痈也。轻则为吹乳、妒乳，重则为
痈。虽有专门，不可不知。
连翘汤 治产后妒乳并痈。
连翘 升麻 芒硝 玄参 芍药 白蔹 防风 射干 大黄 杏仁 甘草（各一钱）
上作一服，水二盅，煎至一盅，食后服。
疗产后妇乳初结胀不消，令败乳自退方。
栝蒌（一个，半生半炒） 大粉草（一寸，半生半炙） 生姜（一块，半生半煨）
上同锉，用酒一碗，煮取一盏，去渣服之。其痛一会不可忍，即搜去败乳，临卧再
一服，顺所患处乳侧卧于床上，令其药行故也。
疗产后吹乳作痈。
葵茎及子
上捣筛为散，酒服方寸匕，即愈。
又方 鸡屎干为末，酒服方寸匕，须臾三服愈。
又方 皂角十条，以酒一升，揉取汁，消石半两，煎成膏敷之。
疗乳肿将次结成痈方。
上以马溺涂之立愈。
《补遗》疗产后吹奶、妒奶，但未结成痈，或成痈未作有脓者。
蔓荆子捣烂酒服，仍以渣敷患处。
又方 用赤小豆酒研烂，温酒服；滓封患处。
又方 仙人掌草一握，小酒糟一块，生姜一大块，同研烂，入桂末少许炒，酒服留
滓罨患处。
《集验》论曰∶凡妇人女子，乳头生小浅热疮，搔之黄汁出，浸淫为长，百种疗不瘥
者，动经年月，名为妒乳病。妇人饮儿者，乳皆欲断，世谓苟抄乳是也。宜以赤龙皮汤
及天麻汤洗之，敷二物飞乌膏及飞乌散佳。始作者可敷以黄芩漏芦散、黄连胡粉散并
佳。
赤龙皮汤
槲皮（三升，切）
上以水一斗，煮五升，夏冷用，秋冬温之，分以洗乳。
天麻汤
天麻草（五升，切）
上以水一斗半，煎取一斗，随寒温分洗乳以杀痒也。此草叶如麻叶，冬生，夏着花，
赤如鼠尾花。亦以洗浸淫黄烂热疮、痒疽、湿阴蚀疮、小儿头疮，洗毕敷膏散。
飞乌膏散方
用烧朱砂作水银上黑烟（名维粉者三两，熬令焦燥） 矾石（三两，烧粉）
上二味，以绢筛细，以甲煎和之，令如脂，以敷乳疮，日三。作者不须和，有汁自
着可用散。亦敷诸热疮，黄烂浸淫汁疮，蜜疮，丈夫阴蚀痒湿，诸小儿头疮，疳蚀，口
浸淫疮，蜗疮等，并以此敷之。
又黄连胡粉膏散方
黄连（二两） 胡粉（二两半） 水银（一两，同研令消散）
上三味，捣黄连为末，三物相和，皮裹熟 之，自和合也。纵不成一家，且得水银
细散人粉中，以敷乳疮，诸湿痒、黄烂肥疮。若着甲煎为膏，《千金》同。
《补遗》妇人乳头小浅疮烂痒。以芙蓉花或叶干为末，掺之。又有妇人乳头裂痛，取
秋后冷落茄子花裂开者，阴干烧存性，水调涂之。
[Da] Postpartum "Chui Nai" (Blown Milk) occurs when the infant falls asleep suddenly while nursing, causing obstruction of milk flow. Milk leaks intermittently but accumulates internally, leading to swelling and hardness, blocking the lactiferous ducts. The fluids fail to circulate, resulting in injury, condensation, and pain. There are also cases presenting with no itching or pain, where the breast is swollen and hard as stone, termed "Chui Nai". If not treated urgently, severe swelling may develop into an abscess (Yong). Postpartum Chui Nai requires immediate treatment; otherwise, it will form an abscess, potentially leading to death. One should quickly administer Zaojiao San (Gleditsia Sinensis Powder) and Gualou San (Trichosanthes Fruit Powder), apply Tiannanxing San (Arisaema Cum Bile Powder) externally, and massage with hands to disperse the accumulation.
[Xue] Regarding the aforementioned conditions, medications must strictly avoid damaging Qi and Blood. I have detailed this in the section on Surgical Breast Abscess (Ru Yong).
Gualou San Formula
Ruxiang (Frankincense, 1 qian, ground)
Gualou Shi (Trichosanthes Fruit, 1 piece)
Grind uniformly, decoct with warm wine, and take orally.
Tiannanxing San
Nanxing (Arisaema Rhizome, powdered)
Mix with warm water, dip a goose feather into the mixture, and apply to the affected area.
Zaojiao San
Song (Verse): How to treat postpartum blown milk? Burn Gleditsia sinensis to ash, mix with clam powder. Mix eight characters' worth [of medicine] with a cup of hot wine, rub until dispersed within moments, laughing heartily.
Treats breast induration with pain.
Baiyaojian (Myrobalan Fermented Cake) ground to fine powder. Take 3 qian per dose, decoct with one zhan of wine for several boils, and take hot.
Breast Hardness with Pain
Fresh mulberry leaves, ground raw. Mix with rice drink, spread on paper flowers, and apply to the swollen area.
[Bu Yi] Treats postpartum Chui Nai, characterized by solid induration, swelling, and pain.
Use Chenpi (Tangerine Peel, 1 liang) and Gancao (Licorice Root, 1 qian).
Decoct in two bowls of water until reduced to one bowl. Divide into two doses. Subsequently, fumigate and wash with a decoction of Jingjie (Schizonepeta), Qianghuo (Notopterygium), and Duhuo (Angelica Pubescens) to achieve dispersion.
As for "Du Nai" (Jealous Milk), it arises from the newborn's inability to suckle after birth, failure of milk secretion, or incomplete expression of milk during engorgement. This causes milk to accumulate and condense, battling with Qi and Blood, resulting in high fever, intense thirst with desire to drink, firm and strong pulling pain, and tenderness such that the hand cannot bear to touch it. Upon initial sensation, one should manually express the milk, having others assist in sucking to guide it out. Otherwise, it may transform into a sore with pus; if the heat pathogen is vigorous, it will certainly become an abscess. Mild cases are Chui Nai or Du Nai; severe cases are abscesses. Although there are specialized treatments, one must understand these distinctions.
Lianqiao Tang
Treats postpartum Du Nai and abscesses.
Lianqiao (Forsythia), Shengma (Cimicifuga), Mangxiao (Mirabilite), Xuanshen (Scrophularia), Shaoyao (Peony), Bailian (Belamcanda), Fangfeng (Saposhnikovia), Shegan (Belamcanda Rhizome), Dahuang (Rhubarb), Xingren (Apricot Seed), Gancao (Licorice) (each 1 qian).
Prepare as one dose. Decoct in two zhong of water until reduced to one zhong. Take after meals.
Formula to resolve initial postpartum breast induration and swelling, allowing stale milk to recede naturally.
Gualou (Trichosanthes Fruit, 1 piece, half raw, half stir-fried)
Dafengcao (Large Licorice Root, 1 cun, half raw, half honey-fried)
Shengjiang (Fresh Ginger, 1 piece, half raw, half baked)
Chop together. Decoct in one bowl of wine until reduced to one zhan. Strain dregs and take orally. The pain may become unbearable momentarily; immediately express the stale milk. Take another dose before sleep. Lie on the side of the affected breast to facilitate the action of the medicine.
Treatment for postpartum Chui Nai transforming into an abscess.
Kui Jing (Hibiscus Stem) and Kui Zi (Hibiscus Seed)
Pound and sieve into powder. Take with wine using a fangcun bi measure. Cure follows.
Another formula: Ji Shi Gan (Dried Chicken Droppings) ground to powder. Take with wine using a fangcun bi measure. Three doses within moments lead to cure.
Another formula: Ten strips of Zaojiao (Gleditsia Fruit). Rub in one sheng of wine to extract juice. Add Xiaoshi (Niter/Potassium Nitrate, 0.5 liang). Decoct into a paste and apply.
Formula for breast swelling about to form an abscess.
Apply horse urine (Ma Ni) topically for immediate cure.
[Bu Yi] Treats postpartum Chui Nai and Du Nai, where an abscess has not yet formed, or an abscess has formed but not yet suppurated.
Manjingzi (Vitex Fruit) pounded and taken with wine; apply the residue to the affected area.
Another formula: Hongxiaodou (Adzuki Bean) pounded with wine. Take the liquid with warm wine; apply the residue to the affected area.
Another formula: A handful of Zhangxianzhang Cao (Opuntia), a piece of small wine lees, and a large piece of fresh ginger. Pound together, add a little Gui Mo (Cinnamon Powder), stir-fry, take with wine, and retain the residue to compress the affected area.
[Ji Yan] Discussion states: Whenever women have small, superficial, hot sores on the nipples, scratching yields yellow fluid which spreads and grows. If various treatments fail to heal it over months or years, it is named Du Nai disease. In nursing women, milk secretion ceases; this is known in the world as "Gou Chao Ru". It is suitable to wash with Chilong Pi Tang (Oak Bark Decoction) and Tianma Tang (Achyranthes Decoction), and apply Feiwu Gao (Flying Bird Ointment) and Feiwu San (Flying Bird Powder). For early stages, Huangqin Lulü San (Scutellaria and Euphorbia Powder) and Huanglian Hufen San (Coptis and Lead White Powder) are also excellent.
Chilong Pi Tang
Hu Pi (Quercus variabilis Bark, 3 sheng, cut)
Decoct in ten dou of water until reduced to five sheng. Use cold in summer, warm in autumn and winter. Divide to wash the breasts.
Tianma Tang
Tianma Cao (Achyranthes bidentata Herb, 5 sheng, cut)
Decoct in one and a half dou of water until reduced to one dou. Wash the breasts according to temperature preferences to relieve itching. This herb has leaves like hemp, grows in winter, flowers in summer, and is red like mouse-tail flowers. It can also be used to wash spreading yellow-rotting hot sores, itchy ulcers, damp erosive sores of the yin, and infantile scalp sores. Apply ointments/powders after washing.
Feiwu Gao San Formula
Use black smoke collected above mercury produced by burning Zhusha (Cinnabar) (named Weifen, 3 liang, roasted until dry and scorched)
Fanshi (Alumen/Rock Alum, 3 liang, roasted to powder)
Sift the two ingredients through silk. Mix with Jiajian (Turtle Shell Glue) to form a consistency like fat. Apply to nipple sores three times daily. For early lesions without discharge, do not mix; use the powder directly if fluid is present. Also applies to various hot sores, spreading yellow-rotting fluid sores, honey sores, male genital erosive wet sores, infantile scalp sores, parasitic erosions, oral spreading sores, and pock-like sores.
Another Huanglian Hufen Gao San Formula
Huanglian (Coptis Rhizome, 2 liang)
Hufen (Lead Carbonate/White Lead, 2.5 liang)
Shuiyin (Mercury, 1 liang, ground together until dissolved)
Pound Huanglian to powder. Mix the three ingredients. Wrap in skin and cook熟 (cook thoroughly) until they fuse naturally. Even if they do not fully combine, ensure the mercury is finely dispersed in the powder. Apply to nipple sores, various wet itches, and yellow-rotting fatty sores. If mixed with Jiajian to form an ointment, refer to *Qianjin Fang*.
[Bu Yi] For women with small, superficial, rotting, and itchy sores on the nipples: Use Furong Hua (Hibiscus Flower) or leaves dried and ground to powder, sprinkle onto the area. For women with cracked and painful nipples: Take late-autumn, cold, split eggplant flowers, dry in shade, burn until charred but retaining nature (charcoal), mix with water, and apply.