妇人产后,有乳少者,有吹乳者,有妒乳者。乳为气血所化,若元气虚弱,则乳汁不生
必须补养气血为主。若乳房掀胀,是有乳而未通也,宜疏导之。复有乳儿之际,为儿口气
所吹,致令乳汁不通,壅滞肿痛,不急治,即成乳痈,速服栝蒌散,敷以香附饼,立见消散
亦有儿饮不尽,余乳停蓄,以致肿痛,名曰妒乳,速宜吮通,并敷服前药,免成痈患。若
妇人乳盛,不自乳子,宜用炒麦芽五钱煎服,其乳即消。若妇人郁怒而乳肿者,于栝蒌散内
更加柴胡、赤芍、甘草、橘叶之属。
敷乳痈,实时消散,一切痈肿皆可敷。
香附(细末,净,一两) 麝香(二分)
上二味,研匀,以蒲公英二两,煎酒,去渣,以酒调药,顿热,敷患处。
乳痈者,乳房肿痈,数日之外, 肿而溃,稠脓涌出,脓尽而愈。此属胆胃热毒,
气血壅滞所致,犹为易治。若乳岩者,初起内结小核,如棋子,不赤不痛,积久渐大崩溃,
形如熟榴,内溃深洞,血水淋沥,有 岩之势,故名曰乳岩。此属脾肺郁结,气血亏损
最为难治。乳痈初期,若服栝蒌散,敷以香附饼,即见消散。如已成脓,则以神仙太乙膏
贴之,吸尽脓自愈矣。乳岩初起,若用加味逍遥散,加味归脾汤,二方间服,亦可内消。及
其病势已成,虽有卢扁,亦难为力。但当确服前方,补养气血,纵未脱体,亦可延生。若妄
用行气破血之剂,是速其危也。更有乳卸症,乳头拖下长一、二尺,此肝经风热发泄也。用
小柴胡汤,加羌活、防风主之。外用羌活、防风、白蔹,烧烟熏之。仍以蓖麻子四十九粒,
麝香一分,研烂,涂顶心,俟乳收上,急洗去。此属怪症,女人盛怒者多得之。不可不识。
栝蒌散 香附饼(俱见前。
妇女在产后,会出现乳汁稀少、吹乳(因婴儿口气吹入导致乳汁不通)、妒乳(因余乳停蓄导致肿痛)等情况。乳汁是由气血化生而成的,如果元气虚弱,就会导致乳汁不生,治疗必须以补养气血为主。如果乳房出现红肿胀痛,说明有乳汁但排出不畅,适宜采用疏导的方法。另外,在哺乳期间,因为婴儿的口气吹入,导致乳汁不通,壅滞而肿痛,如果不及时救治,就会形成乳痈(急性乳腺炎),应迅速服用栝蒌散,并外敷香附饼,即可立即消散。也有的是因为婴儿没有喝完奶,剩余乳汁停积,导致肿痛,这叫做妒乳,应当迅速吸通乳汁,并外敷和内服前面的药物,以免形成痈患。如果妇女乳汁旺盛,但不亲自哺乳,宜用炒麦芽五钱煎服,乳汁就会消退。如果妇女因抑郁愤怒而导致乳房肿胀,可在栝蒌散中增加柴胡、赤芍、甘草、橘叶等药物。
此方外敷乳痈,可即时消散,一切痈肿都可以外敷。
香附(细末,净选,一两),麝香(二分)。
以上两味药,研匀,用蒲公英二两,加酒煎煮,去渣,用酒调制药粉,趁热敷于患处。
乳痈,表现为乳房红肿成痈,数日之后,肿胀溃破,流出稠脓,脓液排尽后痊愈。这属于胆胃热毒,由气血壅滞所致,还算容易治疗。如果是乳岩(乳腺癌),初起时内部结有小核,像棋子一样,不红不痛,积聚久了逐渐变大并崩溃,形状像熟透的石榴,内部溃烂成深洞,血水淋漓,有岩石般坚硬之势,所以名叫乳岩。这属于脾肺郁结,气血亏损,最为难治。乳痈初期,如果服用栝蒌散,外敷香附饼,即可看到消散。如果已经成脓,则用神仙太乙膏贴敷,吸尽脓液后即可自愈。乳岩初起,如果使用加味逍遥散和加味归脾汤,两方交替服用,也可以使肿块内消。等到病势已成,即使有卢医扁鹊那样的神医,也难以施展手脚。此时只应当确切服用前面的方剂,补养气血,纵然不能彻底摆脱疾病,也可以延长生命。如果妄用行气破血的药剂,是加速其危险。更有乳卸症,乳头下垂长达一、二尺,这是肝经风热发泄所致。用小柴胡汤,加羌活、防风为主进行治疗。外用羌活、防风、白蔹,烧烟熏之。仍以蓖麻子四十九粒,麝香一分,研烂,涂于头顶心,等到乳头收回后,急忙洗去。这属于怪症,多因女人盛怒而得。不可不认识。
栝蒌散、香附饼(均见前文)。
In postpartum women, there are cases of scanty lactation, "blown breast" (lactation obstruction caused by infant's breath), and "jealous breast" (pain and swelling due to retained milk). Milk is transformed from Qi and Blood. If the primordial Qi is weak, milk will not be produced; treatment must primarily focus on tonifying Qi and Blood. If the breasts are distended and swollen, it indicates that milk exists but is not flowing freely; dredging and guiding methods should be used. Furthermore, during nursing, if an infant's breath enters the breast ducts, causing milk stasis, congestion, pain, and swelling, failure to treat it promptly will result in Ru Yong (Acute Mastitis). One should quickly administer Gualou San (Trichosanthes Powder) and apply Xiangfu Bing (Cyperi Cataplasm), which will lead to immediate resolution. In other cases, if the infant does not finish feeding, residual milk accumulates, causing pain and swelling, known as Du Ru (Jealous Breast). It should be rapidly drained by suction, and the aforementioned internal and external remedies applied to prevent abscess formation. If a woman has abundant milk but does not nurse her child, one should decoct five qian of fried malt (Chao Maiya) for oral administration, and the milk will subside. If breast swelling is caused by depression and anger, add Chaihu (Bupleuri Radix), Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma), and Juye (Citri Reticulatae Pericarpium Viride) to Gualou San.
Gualou (one fruit), Ming Rushan (Clear Frankincense, two qian); decoct with wine for oral administration.
This preparation, when applied externally to Ru Yong, causes immediate dissipation; it can be applied to all types of carbuncles and swellings.
Xiangfu (fine powder, purified, one liang), Shexiang (Musk, two fen).
Grind the above two ingredients evenly. Decoct two liang of Puguanying (Taraxaci Herba) in wine, strain, and use the wine to mix the powder. Apply warm to the affected area.
Ru Yong (Acute Mastitis) presents as redness, swelling, and abscess formation in the breast. After several days, it ruptures, discharging thick pus; healing occurs once the pus is exhausted. This condition belongs to Heat-Toxin of the Gallbladder and Stomach, caused by Qi and Blood stagnation, and is relatively easy to treat. Ru Yan (Breast Cancer), however, initially presents as a small internal nodule, like a chess piece, without redness or pain. Over time, it gradually enlarges, breaks down, and resembles a ripe pomegranate, with deep internal ulceration and dripping blood and fluid, possessing the hard, unyielding nature of rock, hence the name Ru Yan. This condition stems from Spleen and Lung Qi Depression and Constriction with Qi and Blood deficiency, making it extremely difficult to treat. In the early stage of Ru Yong, administering Gualou San and applying Xiangfu Bing leads to dissipation. If suppuration has already occurred, apply Shenxian Taiyi Gao (Divine Immortal Great Unity Plaster) to absorb the pus, leading to self-healing. In the early stage of Ru Yan, alternating between Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Jiawei Guipi Tang (Modified Restore the Spleen Decoction) can resolve the mass internally. Once the disease is fully established, even masters like Lu Qian (Lu Yijian and Bian Que) would find it difficult to help. At this stage, one should strictly adhere to the previous formulas to tonify Qi and Blood; although complete recovery may not be achieved, life can be prolonged. The reckless use of Qi-moving and Blood-breaking agents accelerates danger. There is also a rare condition called Ru Xie (Breast Ptosis/Descent), where the nipple hangs down for one or two chi, caused by Wind-Heat venting from the Liver Meridian. Treat with Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix). Externally, smoke the patient with burning Qianghuo, Fangfeng, and Bailian (Ianthini Bulbus). Additionally, grind forty-nine seeds of Bimazi (Ricini Semen) with one fen of Shexiang into a paste and apply it to the vertex (Dingxin). Wash it off immediately once the nipple retracts. This is a bizarre syndrome, often resulting from intense anger in women. It must be recognized.
Gualou San and Xiangfu Bing (see above).