乳发如痈胃火成,男女皆生赤肿疼,溃久不敛方成漏,只为脓清肌不生。
【注】此证发于乳房, 赤肿痛,其势更大如痈,皮肉尽腐,由胃腑湿火相凝而成。治
法急按乳痈∶未成形者消之,已成形者托之,腐脱迟者黄灵药撒之,以免遍溃乳房,至伤
囊,难以收敛。若久不收口,外寒侵袭,失于调养,时流清水者,即成乳漏。外用红升
丹作捻,以去腐生肌;再兼用豆豉饼灸法,缓缓灸之以怯寒;内当大补气血。节劳烦,慎
起居,忌发物,渐可生肌敛口而愈。
黄灵药 红升丹(俱见溃疡门)
豆豉饼(见首卷灸法内)
乳中结核梅李形,按之不移色不红,时时隐痛劳岩渐,证由肝脾郁结成。
【注】此证乳房结核坚硬,小者如梅,大者如李,按之不移,推之不动,时时隐痛,皮
色如常。由肝、脾二经气郁结滞而成。情势虽小,不可轻忽。若耽延日久不消,轻成乳
劳,重成乳岩,慎之慎之!初起气实者,宜服清肝解郁汤;气虚宜服香贝养荣汤。若郁
结伤脾,食少不寐者,服归脾汤。外俱用木香饼熨法消之甚效。
清肝解郁汤
当归 生地 白芍(酒炒) 川芎 陈皮 半夏(制,各八分) 贝母(去心,研) 茯神 青皮
远志(去心) 桔梗 苏叶(各六分) 栀子(生,研) 木通 甘草(生,各四分) 香附(醋炒,一钱)
水二盅,姜一片,煎八分,食远服。
【方歌】清肝解郁贝茯神,四物青皮远夏陈,栀桔通苏香附草,能消乳核气郁伸。
归脾汤
人参 白术(土炒) 枣仁(炒,研) 龙眼肉 茯神(各二钱) 黄 (一钱五分) 当归(酒洗,
一钱) 远志(去心) 木香(末) 甘草(炙,各五分)
生姜三片,红枣肉二枚,水煎服。
【方歌】归脾汤治脾胃怯,食少怔忡夜不安,枣远龙眼参归草,茯神 术木香煎。
木香饼
生地黄(捣烂,一两) 木香(研末,五钱)
共和匀,量结核大小,作饼贴肿上,以热熨斗间日熨之;坚硬木痛者,每日熨之。
【方歌】木香饼消乳核方,舒通结滞功倍强,生地研烂木香末,和饼贴患熨之良。
香贝养荣汤(见项部上石疽)
乳房部位发生类似痈肿的病症,多由胃火炽盛所致,男女均可发病,表现为局部红肿疼痛。若溃破后长期不愈合,最终形成乳漏,主要是因为脓液清稀、肌肉无法生长所致。
【注】此证发作于乳房,出现红、肿、热、痛,其严重程度甚至超过一般痈肿,导致皮肤和肌肉全部腐烂,这是由胃腑中的湿邪与火邪相互凝结而成的。治疗方法应紧急参照治疗乳痈的原则:尚未化脓成形的,采用消散法;已经化脓成形的,采用托毒排脓法;腐肉脱落迟缓的,撒布黄灵药以去腐生肌,以免乳房广泛溃烂,进而损伤乳腺囊袋,导致难以收敛愈合。如果久不收口,又受外寒侵袭,且缺乏调养,时常流出清水的,即形成乳漏。外用红升丹制成捻子(条状药线),以去除腐肉、促进新肌生长;同时配合使用豆豉饼灸法,缓慢施灸以驱散寒邪;内服药物应当大补气血。注意节制劳累,谨慎起居生活,忌食发物,逐渐可以生肌收口而痊愈。
黄灵药、红升丹(均见溃疡门章节)
豆豉饼(见首卷灸法部分)
乳房内部出现结核肿块,形状像梅子或李子,按压时位置固定不移,肤色不变,时常有隐隐作痛,随着病情发展可能逐渐演变为乳岩(乳腺癌)。此证是由肝、脾两经气机郁结阻滞而成。
【注】此证表现为乳房结核坚硬,小的如梅子,大的如李子,按压时位置固定,推动也不移动,时常感到隐隐作痛,皮肤颜色正常。这是由于肝、脾二经的气机郁结停滞所形成的。虽然病情看似轻微,不可轻视。如果拖延日久不消退,轻则形成乳劳,重则形成乳岩,务必谨慎!初起阶段体质偏实者,适宜服用清肝解郁汤;体质偏虚者适宜服用香贝养荣汤。若因郁结损伤脾胃,出现食欲不振、失眠者,服用归脾汤。外部均使用木香饼熨法来消散,效果显著。
清肝解郁汤
当归、生地、白芍(酒炒)、川芎、陈皮、半夏(制,各八分)、贝母(去心,研碎)、茯神、青皮、远志(去心)、桔梗、苏叶(各六分)、栀子(生,研碎)、木通、甘草(生,各四分)、香附(醋炒,一钱)。
用水二盅,生姜一片,煎至八分,饭后服用。
【方歌】清肝解郁贝茯神,四物青皮远夏陈,栀桔通苏香附草,能消乳核气郁伸。
归脾汤
人参、白术(土炒)、枣仁(炒,研碎)、龙眼肉、茯神(各二钱)、黄芪(一钱五分)、当归(酒洗,一钱)、远志(去心)、木香(末)、甘草(炙,各五分)。
生姜三片,红枣肉二枚,水煎服。
【方歌】归脾汤治脾胃怯,食少怔忡夜不安,枣远龙眼参归草,茯神 术木香煎。
木香饼
生地黄(捣烂,一两)、木香(研末,五钱)。
混合均匀,根据结核大小做成饼状贴在患处,用热熨斗隔日熨烫;若肿块坚硬且麻木不仁者,每日熨烫。
Mammary gland inflammation resembling carbuncle is caused by stomach fire, occurring in both men and women with redness, swelling, and pain. If the ulcer fails to heal for a long time, it eventually becomes a mammary fistula (breast fistula), primarily due to thin pus and failure of tissue regeneration.
[Note] This condition manifests on the breast with redness, swelling, heat, and pain, often more severe than ordinary carbuncles, leading to necrosis of skin and flesh. It results from the condensation of dampness and fire in the Stomach organ. Treatment should urgently follow the principles for treating mammary abscess (lactational mastitis): if not yet formed into an abscess, use resolution methods; if already formed, use suppuration-promoting methods; if sloughing is slow, apply Huang Ling Yao (Yellow Spirit Medicine) to remove necrotic tissue and promote muscle growth, preventing widespread breast ulceration and damage to the mammary sac, which would be difficult to heal. If the wound fails to close for a long time, combined with external cold invasion and lack of care, resulting in continuous discharge of clear fluid, it constitutes a mammary fistula. Externally, apply Hong Sheng Dan (Red Ascending Cinnabar) as a thread to remove necrotic tissue and generate new muscle; simultaneously use Fermented Soybean Cake Moxibustion, applying moxa slowly to dispel cold; internally, strongly tonify Qi and Blood. Restrain labor, regulate daily life, avoid stimulating foods, and gradually the tissue will regenerate and the wound will close for recovery.
Huang Ling Yao, Hong Sheng Dan (see Chapter on Ulcers)
Fermented Soybean Cake (see Volume 1, Moxibustion section)
Lumps in the breast resembling plums or apricots are fixed upon pressure without redness, accompanied by occasional dull pain, potentially progressing to mammary carcinoma over time. This condition arises from Qi stagnation and knotting in the Liver and Spleen meridians.
[Note] This condition presents as hard lumps in the breast, small like a plum or large like an apricot, fixed upon pressure and immovable when pushed, with occasional dull pain and normal skin color. It is caused by Qi stagnation and obstruction in the Liver and Spleen meridians. Although the situation may seem minor, it must not be neglected. If delayed and unresolved for a long time, it may lightly become mammary consumption or severely develop into mammary carcinoma; exercise extreme caution! In the initial stage, if Qi is excess, Qing Gan Jie Yu Tang (Clear Liver and Resolve Depression Decoction) is suitable; if Qi is deficient, Xiang Bei Yang Rong Tang (Aucklandia and Fritillaria Nourishing Nutrient Decoction) is suitable. If depression injures the Spleen, causing poor appetite and insomnia, Gui Pi Tang (Restore the Spleen Decoction) should be taken. Externally, apply Mu Xiang Bing (Aucklandia Cake) moxibustion for resolution, which is highly effective.
Qing Gan Jie Yu Tang (Clear Liver and Resolve Depression Decoction)
Dang Gui (Angelicae Radix), Sheng Di (Rehmanniae Radix), Bai Shao (Paeoniae Radix Alba, wine-fried), Chuan Xiong (Chuanxiong Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Tuber, processed), each 8 fen; Bei Mu (Fritillariae Bulbus, heart removed, ground); Fu Shen (Poria with Hostwood), Qing Pi (Citri Reticulatae Pericarpium Viride), Yuan Zhi (Polygalae Radix, heart removed), Jie Geng (Platycodonis Radix), Su Ye (Perillae Folium), each 6 fen; Zhi Zi (Gardeniae Fructus, raw, ground), Mu Tong (Akebiae Caulis), Gan Cao (Glycyrrhizae Radix et Rhizoma, raw), each 4 fen; Xiang Fu (Cyperii Rhizoma, vinegar-fried), 1 qian.
Decoct two cups of water with one slice of fresh ginger until reduced to eight-tenths; take after meals.
[Formula Song] Clear Liver Resolve Depression Bei Fu Shen, Si Wu Qing Pi Yuan Xia Chen, Zhi Jie Tong Su Xiang Fu Cao, Can Dissolve Breast Lumps and Extend Qi Stagnation.
Gui Pi Tang (Restore the Spleen Decoction)
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Zao Ren (Ziziphi Spinosae Semen, fried, ground), Long Yan Rou (Longan Aril), Fu Shen (Poria with Hostwood), each 2 qian; Huang Qi (Astragali Radix), 1.5 qian; Dang Gui (Angelicae Radix, wine-washed), 1 qian; Yuan Zhi (Polygalae Radix, heart removed), Mu Xiang (Aucklandiae Radix, powder), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), each 5 fen.
Decoct three slices of fresh ginger and two pieces of red date flesh in water; take orally.
[Formula Song] Gui Pi Tang treats Spleen-Stomach Deficiency, Poor Appetite Palpitations Night Insomnia, Zao Yuan Long Yan Shen Gui Cao, Fu Shen Zhu Mu Xiang Decocted.
Mu Xiang Bing (Aucklandia Cake)
Sheng Di Huang (Rehmanniae Radix, pounded, 1 liang), Mu Xiang (Aucklandiae Radix, powdered, 5 qian).
Mix evenly, form into cakes according to the size of the lump, apply to the swelling, and iron with a hot iron every other day; if hard and numb, iron daily.
[Formula Song] Mu Xiang Bing Formula for Resolving Breast Lumps, Relieving Obstruction Power Doubled Strong, Sheng Di Pounded Mu Xiang Powder, Mixed Cake Applied to Affliction Ironed Well.
Xiang Bei Yang Rong Tang (Aucklandia and Fritillaria Nourishing Nutrient Decoction) (see Neck Scrofula section)