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，四物汤调炒麦芽二两，煎服立消。予谓麦芽过
多伤胃，若用三钱亦足矣。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
南星末，温汤调敷，更以手揉散之。势甚者，惟连翘金贝煎最妙。《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，患此等证而误
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，温汤调涂。
连翘金贝煎 治阳分痈毒，或在脏腑肺膈、胸乳之间者，此方最佳。甚者，连用数服，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，或五七钱。去心）
用好酒二碗，煎一碗服，服后暖卧片时。不能饮者，酒水各半煎之。火盛烦渴乳肿者，加天花粉。若阳
毒内热，或在头项之间者，水煎亦可。
橘叶散 治妇人有孕，胎热为内吹，有儿食乳为外吹，致乳结成肿痛，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） 甘草（各一钱）
橘叶（二十片）
水二钟，煎八分，食远服。渣再煎服。
清肝解郁汤 治惯吹乳。
熟地 茯苓 白芍（炒） 贝母（去心） 栀子（炒） 当归（各一钱） 柴胡 丹皮 川芎
陈皮（各六分） 甘草（五分）
水煎服。虚，加人参、白术。
《尊生》治吹乳初起一
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）
水酒煎二服。
《尊生》治吹乳身热二
羌活 独活 前胡 柴胡 枳壳（炒） 桔梗 贝母（去心） 白芷 青皮 当归 穿山甲（炒，各等分）
水煎服。
《尊生》治吹乳已结肿三
陈皮 牛蒡子 山栀（炒） 忍冬 甘草 栝蒌 黄芩 花粉 连翘（去心） 皂角刺（各
一钱） 柴胡 青皮（各五分）
煎服。内热，加石膏。予谓皂角刺，不宜用一钱，用四五分足矣。
人参败毒散（又名败毒散。） 治四时伤寒瘟疫，憎寒壮热，风湿风眩，项强身体疼痛。岭
南烟障之地，疫疠时行，或脾湿香港脚，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）
水一钟半，姜三片，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 疮毒犹效。凡一切痈疽余毒，皆宜用之。
栝蒌（一个，研烂） 当归（酒洗） 生粉草（各五钱） 乳香 没药（各一钱。《尊生》乳、
没各二钱五分）
上用酒煎服，良久再服。如不能饮，以酒水各半煎之。如数剂不效，宜以补气血之药兼服之。若
肝经血虚，结核不消，佐以四物、柴胡、升麻、白术、茯苓。若肝脾气血虚弱，佐以四君、芎归、
柴胡、升麻。若忧郁伤脾，气血亏损，佐以归脾汤。
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，服之即消。
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，水三钟，煎一钟，食后服。仍以槐艾水不时洗之。
定痛消毒饮 治乳顶旁或乳房吹乳成痈，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
浙贝母（去心，研。各一钱） 皂角刺（七分或五分） 柴胡梢（八分或一钱。乳顶肿结用之。若乳房，
易白芷） 牡丹皮 广皮（各八分） 明乳香 没药（各五分） 生草（三分）
红枣二枚，去核，灯心五十寸，水三钟，煎八分。临服加无灰酒小半酒杯，入药，滚数滚服之。
不时用槐艾水洗。
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
松萝茶叶末渗上。
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。
四物汤（见上卷安胎门。） 加味逍遥散（见上卷胎逆上逼门，附逍遥散下。）
Postpartum "Du Ru" (Jealousy of Milk), caused by the infant not suckling, leads to milk accumulation and breast distension. Alternatively, when a woman's blood and qi are abundant, the breasts become distended, resulting in redness, swelling, and pain, accompanied by aversion to cold and fever. If the milk is not manually expressed or sucked out to clear the ducts, it will inevitably develop into an abscess. Siwu Tang (Four Substances Decoction) mixed with two liang of stir-fried Maiya (Folium Hordei, 炒麦芽) should be decocted and taken; the condition will resolve immediately. I believe that excessive use of Maiya damages the stomach; using only three qian is sufficient. Furthermore, if small superficial hot sores appear on the nipples, oozing yellow fluid upon scratching, this is also termed "Du Ru". It can be washed with decoctions of Hu Pi (Quercus variabilis bark) or Tianma Cao. Regarding "Chui Ru" (Blown Milk), there are distinctions between internal blowing, external blowing, upward reversal, and downward smooth flow, all belonging to heat-toxin in the Gallbladder and Stomach meridians, causing stagnation of blood and qi. Internal blowing refers to fetal heat. External blowing occurs when the infant sucks milk and blows oral air into the ducts. Both result in blocked milk flow, congestion, swelling, and pain. If not treated promptly, they often develop into abscesses. One should quickly consume Gualou San (Trichosanthes Powder) and apply Nanxing powder (Rhizoma Arisaematis) mixed with warm water externally, while massaging to disperse the lump. For severe cases, Lianqiao Jinbei Jian (Forsythia and Fritillaria Decoction) is most effective. *Waike Zhengzong* uses Juye San (Tangerine Leaf Powder) for both internal and external blown milk. *Yitong* states: at the onset of blown milk with chills and fever, administer Jiawei Xiaoyao San (Modified Free Wanderer Powder) combined with Gualou Shuang (Trichosanthes Frost) to dissipate the swelling. *Zunsheng* treats habitual blown milk with Qinggan Jieyu Tang (Soothe Liver and Resolve Depression Decoction). It also establishes three formulas for blown milk, treating based on initial fever or formed lumps respectively. As for "Ru Yong" (Breast Abscess), it results from unresolved blown milk accumulating over time. It is said: mild cases are Du Ru, severe cases are Ru Yong. These are also caused by heat-toxin in the Gallbladder and Stomach fu-organs, leading to qi and blood stagnation. In cases of excess pathogenic factors, Lianqiao Jinbei Jian is highly recommended. For early-stage swelling and pain with red skin, or chills/fever, aversion to cold/headache, irritability, thirst, before suppuration, choose one of Renshen Baidu San (Ginseng Toxin-Resolving Powder), Jiawei Xiaoyao San, or Shenxiao Gualou San (Miraculous Efficacy Trichosanthes Powder); the swelling will naturally subside. After several days, if pus forms and ruptures, thick pus flows out, and the condition heals itself after the pus is exhausted. In my treatment of blown milk, retained milk, and breast abscess, I established two formulas of Xiaodu Yin (Detoxification Decoction) and an external Huai Ai Wash (Locust Twig and Mugwort Wash) to treat breast conditions generally, with efficacy surpassing many others. Additionally, Gualou Beimu Yin (Trichosanthes and Fritillaria Drink) is also effective and is appended after the other formulas. If a postpartum woman has weak blood and qi but mistakenly uses toxin-resolving drugs, leading to non-healing wounds, thin pus, and a large pulse, the prognosis is poor. *Yitong* states: with thin pus and a large pulse, large doses of herbs to open depression, regulate qi, and warm-nourish blood and qi are required to achieve success.
Gualou San treats swollen and painful blown milk.
Gualou (one fruit, crushed) Xurxiang (Frankincense, 2 qian)
Decoct in wine and take. Externally, apply Nanxing powder mixed with warm water.
Lianqiao Jinbei Jian treats yang-level carbuncles and toxins, especially those in the zang-fu organs, lungs/diaphragm, or chest/breasts; this formula is best. For severe cases, continuous administration ensures recovery.
Jinyinhua (Honeysuckle Flower, 3 qian) Tubei Mu (Fritillaria Cirrhosa Bulb, heart removed, 3 qian) Pugongying (Dandelion, 3 qian) Xiakucao (Prunella Spike, 3 qian) Hongteng (Sargentodoxa Caulis, 7-8 qian) Lianqiao (Forsythia Fruit, heart removed, 1 liang or 5-7 qian)
Decoct two bowls of good wine to one bowl and take. Lie down warmly for a while after taking. For those who cannot drink alcohol, use half wine and half water. For intense fire, irritability, thirst, and breast swelling, add Huafen (Trichosanthes Root). For yang-toxin with internal heat, or located in the head/neck, water decoction is acceptable.
Juye San treats pregnant women with internal blowing due to fetal heat, or external blowing due to infant suckling, causing milk retention, swelling, pain, alternating chills and fever, and severe vomiting.
Chaihu (Bupleurum Root, 1 qian) Chenpi (Aged Tangerine Peel, 1 qian) Chuanxiong (Ligusticum Rhizome, 1 qian) Zhizi (Gardenia Fruit, stir-fried, 1 qian) Qingpi (Green Tangerine Peel, 1 qian) Shigao (Gypsum Fibrosum, 1 qian) Huangqin (Scutellaria Root, stir-fried, 1 qian) Lianqiao (Forsythia Fruit, heart removed, 1 qian) Gancao (Licorice Root, 1 qian)
Juye (Tangerine Leaves, 20 leaves)
Decoct two zhong of water to eight fen. Take far from meals. Decoct the dregs again and take.
Qinggan Jieyu Tang treats habitual blown milk.
Shudi (Prepared Rehmannia Root, 1 qian) Fuling (Poria, 1 qian) Baishao (White Peony Root, stir-fried, 1 qian) Beimu (Fritillaria Bulb, heart removed, 1 qian) Zhizi (Gardenia Fruit, stir-fried, 1 qian) Danggui (Angelica Sinensis, 1 qian) Chaihu (Bupleurum Root, 1 qian) Danpi (Moutan Bark, 1 qian) Chuanxiong (Ligusticum Rhizome, 1 qian)
Chenpi (Aged Tangerine Peel, 6 fen) Gancao (Licorice Root, 5 fen)
Decoct in water and take. For deficiency, add Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala Rhizome).
*Zunsheng* Formula 1 for Initial Blown Milk
Danggui (Angelica Sinensis, 1 qian) Beimu (Fritillaria Bulb, heart removed, 1 qian) Baizhi (Angelica Dahurica Root tip, 1 qian) Huafen (Trichosanthes Root, 8 fen) Zhi Xiangfu (Cyperus Rhizome, processed, 6 fen) Gualou Ren (Trichosanthes Seed, 6 fen) Gancao Jie (Licorice Joint, 6 fen)
Qingpi (Green Tangerine Peel, 5 fen) Xurxiang (Frankincense, 5 fen) Moyao (Myrrh, 5 fen) Chuanshanjia (Pangolin Scale, stir-fried, 1 qian) Chuanxiong (Ligusticum Rhizome, 4 fen)
Decoct in water and wine, take twice.
*Zunsheng* Formula 2 for Blown Milk with Fever
Qianghuo (Notopterygium Rhizome, equal parts) Duhuo (Angelica Pubescens Root, equal parts) Qianhu (Peucedanum Root, equal parts) Chaihu (Bupleurum Root, equal parts) Zhike (Bitter Orange Fruit, stir-fried, equal parts) Jiegeng (Platycodon Root, equal parts) Beimu (Fritillaria Bulb, heart removed, equal parts) Baizhi (Angelica Dahurica Root, equal parts) Qingpi (Green Tangerine Peel, equal parts) Danggui (Angelica Sinensis, equal parts) Chuanshanjia (Pangolin Scale, stir-fried, equal parts)
Decoct in water and take.
*Zunsheng* Formula 3 for Formed Lump in Blown Milk
Chenpi (Aged Tangerine Peel, 1 qian) Niubangzi (Arctium Fruit, 1 qian) Zhizi (Gardenia Fruit, stir-fried, 1 qian) Rendong (Honeysuckle Stem, 1 qian) Gancao (Licorice Root, 1 qian) Gualou (Trichosanthes Fruit, 1 qian) Huangqin (Scutellaria Root, 1 qian) Huafen (Trichosanthes Root, 1 qian) Lianqiao (Forsythia Fruit, heart removed, 1 qian) Zaogelaci (Gleditsia Spine, 1 qian) Chaihu (Bupleurum Root, 5 fen) Qingpi (Green Tangerine Peel, 5 fen)
Decoct and take. For internal heat, add Shigao (Gypsum Fibrosum). I suggest Zaogelaci should not exceed 4-5 fen.
Renshen Baidu San (also known as Baidu San) treats seasonal cold damage and epidemics, aversion to cold with high fever, wind-dampness wind-dizziness, neck stiffness, and body pain. It applies to miasma regions in Lingnan, epidemic diseases, spleen dampness with hong jiao (foot rot), and flaccidity syndromes.
Renshen (Ginseng, equal parts) Fuling (Poria, equal parts) Zhike (Bitter Orange Fruit, stir-fried, equal parts) Chuanxiong (Ligusticum Rhizome, equal parts) Qianghuo (Notopterygium Rhizome, equal parts) Duhuo (Angelica Pubescens Root, equal parts) Qianhu (Peucedanum Root, equal parts) Chaihu (Bupleurum Root, equal parts) Jiegeng (Platycodon Root, equal parts) Gancao (Licorice Root, equal parts)
Decoct one and a half zhong of water with three slices of ginger. Or grind into fine powder and take with boiling water.
Shenxiao Gualou San treats breast abscess and all initial carbuncles/furuncles; it eliminates swelling and pain immediately, promotes rupture when pus forms, and cures once pus drains. Among many formulas for carbuncles, this one is miraculous. It is also effective for scrofula and toxic sores. Suitable for all residual toxins from carbuncles.
Gualou (Trichosanthes Fruit, one fruit, mashed) Danggui (Angelica Sinensis, wine-washed, 5 qian) Sheng Gancao (Raw Licorice Root, 5 qian) Xurxiang (Frankincense, 1 qian) Moyao (Myrrh, 1 qian. *Zunsheng* uses 2.5 qian each)
Decoct in wine and take. Take again after some time. If unable to drink wine, use half wine and half water. If ineffective after several doses, combine with blood and qi tonics. For Liver meridian blood deficiency with nodules not resolving, assist with Siwu Tang (Four Substances Decoction), Chaihu, Shengma, Baizhu, Fuling. For Liver/Spleen qi and blood deficiency, assist with Sijun Zi Tang (Four Gentlemen Decoction), Xiong Gui Tang, Chaihu, Shengma. For melancholy injuring the Spleen with qi/blood loss, assist with Guipi Tang (Restore the Spleen Decoction).
Xiaodu Yin specifically treats swelling/toxins inside the black halo of the nipple or breast that have not ruptured, with fever, aversion to cold, pain or numbness at the lesion; it resolves upon ingestion.
Pugongying (Dandelion, 1.2 qian) Zihuadiding (Viola Yedoensis Herb, 1.2 qian) Danggui (Angelica Sinensis, wine-washed, 1 qian) Baishao (White Peony Root, vinegar-fried, 1 qian) Chishao (Red Peony Root, 1 qian) Danpi (Moutan Bark, 1 qian) Digupi (Cortex Lycii, 1 qian) Huafen (Trichosanthes Root, 1 qian)
Chenpi (Aged Tangerine Peel, 8 fen) Sheng Cao (Raw Licorice Root, 3 fen)
Decoct fifty cun of Dengxin (Juncus Medulla) and three zhong of water to one zhong. Take after meals. Wash frequently with Huai Ai Water (Locust Twig and Mugwort Decoction).
Dingtong Xiaodu Yin treats blown milk turning into abscess beside the nipple or in the breast, and retained milk, with fever, aversion to cold, spontaneous cold sweat, impending rupture with unbearable pain; it induces pus discharge and stops pain.
Pugongying (Dandelion, 1.2 qian) Zihuadiding (Viola Yedoensis Herb, 1.2 qian) Danggui (Angelica Sinensis, root for breast, tail for nipple, 1 qian) Baishao (White Peony Root, vinegar-fried, 1 qian) Chishao (Red Peony Root, 1 qian) Huafen (Trichosanthes Root, 1 qian) Zhe Beimu (Fritillaria Thunbergii Bulb, heart removed, ground, 1 qian) Zaogelaci (Gleditsia Spine, 7 or 5 fen) Chaihu Shao (Bupleurum Root tip, 8 or 1 qian. Use for nipple swelling/nodules; replace with Baizhi for general breast swelling) Mudanpi (Moutan Bark, 8 fen) Guangpi (Broad-leaved Atractylodes Peel/Tangerine Peel, 8 fen) Ming Xurxiang (Clear Frankincense, 5 fen) Moyao (Myrrh, 5 fen) Sheng Cao (Raw Licorice Root, 3 fen)
Two Red Dates (pitted), fifty cun of Dengxin (Juncus Medulla), three zhong of water, decoct to eight fen. Before taking, add a small half cup of pure wine to the medicine, boil briefly, and take. Wash frequently with Huai Ai Water.
Huai Ai Wash treats breast nodules and abscesses in postpartum women.
Huai Tiao (Locust Twig, any amount) Ai Ye (Mugwort Leaf, any amount)
One green onion with roots. Decoct locust twigs and mugwort in water, add a little vinegar, and wash frequently. If sores appear beside the nipple, clean the discharged pus, let the infant suckle, then sprinkle Songluo tea leaf powder on the wound.
Gualou Beimu Yin treats breast nodular swelling.
Gualou Shi (Trichosanthes Fruit, 3 qian) Tubei Mu (Fritillaria Cirrhosa Bulb, heart removed, 3 qian) Gancao Jie (Licorice Joint, 3 qian)
Decoct and take; effective. For already ruptured cases, add Rendong (Honeysuckle Stem) one liang for better effect.
Siwu Tang (See Vol. 1, An Tai Section). Jiawei Xiaoyao San (See Vol. 1, Tai Ni Shang Bi Section, attached under Xiaoyao San).