论曰产后乳结核者,以气血虚弱,风邪搏之,乳脉凝滞,故结而为核,日久不瘥。蕴积
生热,热胜则肿,甚则成痈也。
治产后乳结核,或成痈肿,发热疼痛。枳壳汤方
枳壳(去瓤麸炒) 芍药 人参 黄 (锉) 木通(锉) 当归(切焙) 桂(去粗
皮)
上一十味,粗捣筛,每服二钱匕,水一盏,煎七分,去滓温服,不拘时。
治产后乳结核,坚硬疼痛。当归散方
当归(切焙) 芍药 黄 (锉) 蒺藜子(炒去角) 鸡骨(炙) 附子(炮裂去皮
脐) 枳
上一十味,捣罗为散,每服三钱匕,酒调服,日三。
治产后乳结核,或坚硬疼痛。莽草散方
莽草叶(一两) 紫葛 大黄(各半两) 赤小豆(二两)
上四味,捣为细末,用醋调如糊,敷结核上,频易之,每易则先以热葱汤洗。
治产后乳肿热痛。外敷膏方
黄连(去须三分) 大黄(生) 鼠粪(炒各半两)
上三味,捣罗为末,用米糊调,敷乳四边,频易之。每易先用热葱汤洗。
治产后乳结核,及初结作痈,服此,麦门冬汤方
麦门冬(去心焙) 黄芩(去黑心) 黄 (锉) 芍药 赤茯苓(去黑皮) 甘草 木
通(
上一十味, 咀如麻豆大,每服五钱匕,水一盏半,入枣二枚擘,煎取一盏,去滓入
沙糖一枣大令销,温服不拘时候。乳消减,即服后方天门冬方
治产后乳结核,天门冬丸方
天门冬(去心焙二两半) 木通(锉) 黄 (锉) 防风(去叉) 生干地黄(焙) 桑
寄生(
分) 泽兰(去枝梗) 茯神(去木) 天
瓤麸炒) 五味子(各半两)
上一十七味,捣罗为末,炼蜜为丸,梧桐子大,每服二十丸,加至三十丸,温酒下,日
三。
治产后乳结核疼痛。或肿欲成痈。外消膏方
伏龙肝(半两) 大黄(锉半两) 生姜(一分洗切研细)
上三味,除姜外,为细末和匀,用醋调作膏,看大小摊贴病上,早晚易之。
治产后乳结核,欲坏不坏。托里散方
威灵仙(洗焙) 当归(切焙) 牡丹皮 芍药(锉) 黄 (锉) 桂(去粗各皮一
两)
上七味,捣罗为散,每服三钱匕,温酒调下,不拘时候。
治产后乳肿,或结核败坏热闷。升麻汤方
升麻 白蔹(各一两半) 大黄(生半两) 黄芩(去黑心一两) 芒硝(研半两) 桂
(去粗
上八味,捣为粗末,每服三钱匕,水一盏,煎七分,去滓温服,不拘时。
治产后乳肿痛烦热。蔓荆实散方
蔓荆(实炒二两) 甘草(炙半两)
上二味,捣罗为散,每服二钱匕,温酒调下,不拘时服。
治产后乳结核,肿痛发热烦闷。大黄汤方
大黄(锉略炒) 芍药 楝实(擘破炒去子) 马蹄(炙焦黄各一两)
上四味,粗捣筛,每服二钱匕,水一盏,煎七分,去滓温服,不拘时。
治产后乳初觉有核,渐发热痛,累日不退,欲成痈。黄芩汤方
黄芩(圆小者) 甘草(炙锉) 桑寄生(锉) 防风(去叉) 木通(锉) 麦门冬
(去
上九味,粗捣筛,每服五钱匕,水一盏半,煎至一盏,去滓温服,不拘时。
治乳结核坚硬。当归散方
当归(切焙) 桂(去粗皮各半两) 芍药 人参 枳实(去瓤麸炒各三分) 蒺藜子
(炒去
上九味,捣罗为散,每服二钱匕,空腹酒调下,日再。
论述:产后乳房出现结核(硬结),是因为气血虚弱,风邪侵袭搏结,导致乳脉凝滞,从而结成硬块,日久不愈。郁积化热,热盛则红肿,严重时会形成痈肿。
治疗产后乳房结核,或已发展为痈肿,伴有发热疼痛的枳壳汤方:
枳壳(去除瓤,用麸皮炒)、芍药、人参、黄芪(锉碎)、木通(锉碎)、当归(切后焙干)、桂枝(去除粗皮)。
以上十味药,捣成粗末并过筛,每次服用二钱匕,加水一盏,煎至七分满,去渣温服,不限时间。
治疗产后乳房结核,坚硬且疼痛的当归散方:
当归(切后焙干)、芍药、黄芪(锉碎)、蒺藜子(炒后去掉刺角)、鸡骨(炙烤)、附子(炮裂后去皮和脐)、枳实(去除瓤,用麸皮炒)。
以上十味药,捣碎过罗制成散剂,每次服用三钱匕,用酒调服,每日三次。
治疗产后乳房结核,或者坚硬疼痛的莽草散方:
莽草叶(一两)、紫葛、大黄(各半两)、赤小豆(二两)。
以上四味药,捣成细末,用醋调成糊状,敷在结核处,频繁更换。每次更换前,先用热葱汤清洗患处。
治疗产后乳房肿胀、热痛的外敷膏方:
黄连(去除须根,三分)、大黄(生用)、鼠粪(炒,各半两)。
以上三味药,捣碎过罗制成粉末,用米糊调和,敷在乳房四周,频繁更换。每次更换前先用热葱汤清洗。
治疗产后乳房结核,以及初起结聚即将成痈,服用此方的麦门冬汤方:
麦门冬(去除心,焙干)、黄芩(去除黑心部分)、黄芪(锉碎)、芍药、赤茯苓(去除黑皮)、甘草、木通(锉碎)。
以上十味药,切碎如麻豆大小,每次服用五钱匕,加水一盏半,放入两枚掰开的枣,煎取一盏,去渣后加入一块大枣大小的沙糖使其融化,温服,不限时间。乳房肿块消退减少后,即服用后面的天门冬方。
治疗产后乳房结核的天门冬丸方:
天门冬(去除心,焙干,二两半)、木通(锉碎)、黄芪(锉碎)、防风(去除叉枝)、生干地黄(焙干)、桑寄生(锉碎)、泽兰(去除枝梗)、茯神(去除木质部)、枳壳(去瓤,麸皮炒)、五味子(各半两)。
以上十七味药,捣碎过罗制成粉末,用炼蜜制成梧桐子大小的丸剂,每次服用二十丸,加量至三十丸,用温酒送下,每日三次。
治疗产后乳房结核疼痛,或者肿胀快要成痈的外消膏方:
伏龙肝(半两)、大黄(锉碎,半两)、生姜(一分,洗净切细研烂)。
以上三味药,除生姜外,其余制成细末混合均匀,用醋调成膏状,根据患处大小摊贴于病处,早晚更换。
治疗产后乳房结核,欲溃破而未溃破的托里散方:
威灵仙(洗后焙干)、当归(切后焙干)、牡丹皮、芍药(锉碎)、黄芪(锉碎)、桂枝(去除粗皮,各一两)。
以上七味药,捣碎过罗制成散剂,每次服用三钱匕,用温酒调服,不限时间。
治疗产后乳房肿胀,或者结核败坏、热闷不适的升麻汤方:
升麻、白蔹(各一两半)、大黄(生用,半两)、黄芩(去除黑心,一两)、芒硝(研细,半两)、桂枝(去除粗皮)。
以上八味药,捣成粗末,每次服用三钱匕,加水一盏,煎至七分满,去渣温服,不限时间。
治疗产后乳房肿痛、烦热的蔓荆实散方:
蔓荆子(炒,二两)、甘草(炙,半两)。
以上两味药,捣碎过罗制成散剂,每次服用二钱匕,用温酒调服,不限时间服用。
治疗产后乳房结核,肿痛发热、烦闷的大黄汤方:
大黄(锉碎略炒)、芍药、楝实(掰破炒后去子)、马蹄(炙焦黄,各一两)。
以上四味药,捣成粗末过筛,每次服用二钱匕,加水一盏,煎至七分满,去渣温服,不限时间。
治疗产后乳房初觉有核,逐渐发热疼痛,多日不退,欲成痈的黄芩汤方:
黄芩(圆小者)、甘草(炙后锉碎)、桑寄生(锉碎)、防风(去除叉枝)、木通(锉碎)、麦门冬(去除心)。
以上九味药,捣成粗末过筛,每次服用五钱匕,加水一盏半,煎至一盏,去渣温服,不限时间。
治疗乳房结核坚硬的当归散方:
当归(切后焙干)、桂枝(去除粗皮,各半两)、芍药、人参、枳实(去瓤,麸皮炒,各三分)、蒺藜子(炒后去刺角)。
以上九味药,捣碎过罗制成散剂,每次服用二钱匕,空腹时用酒调服,每日两次。
Commentary: Breast nodules (hard lumps) occurring postpartum are caused by deficiency of Qi and Blood, with Wind pathogen invading and clashing, leading to stagnation in the breast meridians, thus forming knots. If unresolved for a long time, accumulation generates Heat; excessive Heat causes swelling, and in severe cases, it becomes an abscess.
Decoction of Zhiqiao (Bitter Orange Fruit) for treating postpartum breast nodules, or those developed into abscesses, accompanied by fever and pain:
Zhiqiao (remove pulp, stir-fry with bran), Shaoyao (Peony Root), Renshen (Ginseng Root), Huangqi (Astragalus Root, sliced), Mutong (Akebia Stem, sliced), Danggui (Angelica Sinensis Root, sliced and dried), Guizhi (Cinnamon Twig, remove rough bark).
The above ten ingredients are coarsely crushed and sifted. Take two qianbi (approx. 6-9g) per dose, add one zhan (approx. 200ml) of water, decoct until seven-tenths remain, strain, and take warm. No specific timing required.
Powder of Danggui for treating postpartum breast nodules that are hard and painful:
Danggui (sliced and dried), Shaoyao, Huangqi (sliced), Jilizi (Tribulus Fruit, stir-fried and thorns removed), Jigu (Chicken Bone, roasted), Fuzi (Prepared Aconite Root, cracked, peel and navel removed), Zhishi (Immature Bitter Orange Fruit, remove pulp, stir-fry with bran).
The above ten ingredients are crushed, sieved, and made into powder. Take three qianbi per dose, mixed with wine. Three times daily.
Powder of Mangcao for treating postpartum breast nodules, or those that are hard and painful:
Mangcao Ye (Dichroa Leaf, 1 liang), Zige (Polygonum Multiflorum Vine), Dahuang (Rhubarb Root, each 0.5 liang), Chixiaodou (Adzuki Bean, 2 liang).
The above four ingredients are crushed into fine powder. Mix with vinegar to form a paste. Apply to the nodule. Change frequently. Before each change, wash the area first with hot scallion soup.
External Plaster for treating postpartum breast swelling, heat, and pain:
Huanglian (Coptis Rhizome, remove rootlets, 3 fen), Dahuang (Raw, 0.5 liang), Shufen (Mouse Feces, stir-fried, 0.5 liang).
The above three ingredients are crushed, sieved, and made into powder. Mix with rice paste. Apply to the surrounding area of the breast. Change frequently. Wash with hot scallion soup before each change.
Decoction of Maidong for treating postpartum breast nodules, and initial clustering about to become an abscess:
Maidong (Ophiopogon Tuber, remove heart, dry), Huangqin (Scutellaria Root, remove black heart), Huangqi (sliced), Shaoyao, Chifuling (Red Poria, remove black skin), Gancao (Licorice Root), Mutong (sliced).
The above ten ingredients are chopped like hemp seeds. Take five qianbi per dose, add one and a half zhan of water, include two split jujubes. Decoct until one zhan remains. Strain, add rock sugar the size of a jujube to dissolve. Take warm. No specific timing. Once the breast lump subsides, proceed to the following Tianmendong prescription.
Pills of Tianmendong for treating postpartum breast nodules:
Tianmendong (Asparagus Tuber, remove heart, dry, 2.5 liang), Mutong (sliced), Huangqi (sliced), Fangfeng (Saposhnikovia Root, remove forked branches), Shengdihuang (Rehmannia Root, dried and baked), Sangjisheng (Taxillus Branch, sliced), Zelan (Lycopus Herb, remove stems), Fushen (Poria with Hostwood, remove wood), Zhike (Bitter Orange Fruit, remove pulp, stir-fry with bran), Wuweizi (Schisandra Fruit, each 0.5 liang).
The above seventeen ingredients are crushed, sieved, and made into powder. Form pills with refined honey, size of paulownia seeds. Take twenty pills per dose, increase to thirty pills, swallow with warm wine. Three times daily.
External Dissolving Plaster for treating postpartum breast nodule pain, or swelling about to become an abscess:
Fulonggan (Stove Earth, 0.5 liang), Dahuang (sliced, 0.5 liang), Shengjiang (Fresh Ginger, 1 fen, washed, sliced, finely ground).
The above three ingredients, excluding ginger, are made into fine powder and mixed evenly. Mix with vinegar to make a paste. Spread on the lesion according to size. Change morning and evening.
Internal Support Powder for treating postpartum breast nodules that desire to rupture but have not yet done so:
Weilingxian (Clematis Root, wash and dry), Danggui (sliced and dry), Mudanpi (Tree Peony Bark), Shaoyao (sliced), Huangqi (sliced), Guizhi (remove rough bark, each 1 liang).
The above seven ingredients are crushed, sieved, and made into powder. Take three qianbi per dose, mixed with warm wine. No specific timing required.
Decoction of Shengma for treating postpartum breast swelling, or ruptured nodules with heat and stifling sensation:
Shengma (Cimicifuga Rhizome), Bailian (Belamcanda Bulb, each 1.5 liang), Dahuang (raw, 0.5 liang), Huangqin (remove black heart, 1 liang), Mangxiao (Mirabilite, powdered, 0.5 liang), Guizhi (remove rough bark).
The above eight ingredients are coarsely crushed. Take three qianbi per dose, add one zhan of water, decoct until seven-tenths remain. Strain and take warm. No specific timing required.
Powder of Manjingzi for treating postpartum breast swelling, pain, and vexatious heat:
Manjingzi (Vitex Fruit, stir-fried, 2 liang), Gancao (roasted, 0.5 liang).
The above two ingredients are crushed, sieved, and made into powder. Take two qianbi per dose, mixed with warm wine. No specific timing required.
Decoction of Dahuang for treating postpartum breast nodules with swelling, pain, fever, and vexatious stifling:
Dahuang (sliced, slightly stir-fried), Shaoyao, Lianshi (Cherry Laurel Seed, broken, stir-fried, seeds removed), Matij (Hoof of Horse, roasted until yellow-brown, each 1 liang).
The above four ingredients are coarsely crushed and sifted. Take two qianbi per dose, add one zhan of water, decoct until seven-tenths remain. Strain and take warm. No specific timing required.
Decoction of Huangqin for treating early postpartum breast nodules, gradually becoming feverish and painful, persisting for days, about to become an abscess:
Huangqin (small round ones), Gancao (roasted and sliced), Sangjisheng (sliced), Fangfeng (remove forked branches), Mutong (sliced), Maidong (remove heart).
The above nine ingredients are coarsely crushed and sifted. Take five qianbi per dose, add one and a half zhan of water. Decoct until one zhan remains. Strain and take warm. No specific timing required.
Powder of Danggui for treating hard breast nodules:
Danggui (sliced and dry), Guizhi (remove rough bark, each 0.5 liang), Shaoyao, Renshen, Zhishi (remove pulp, stir-fry with bran, each 3 fen), Jilizi (stir-fried and thorns removed).
The above nine ingredients are crushed, sieved, and made into powder. Take two qianbi per dose, mixed with wine on an empty stomach. Twice daily.