妇人之乳,男子之肾,皆性命之根也。人之气血周行无间,寅时始于手太阴肺经,出于云门穴,穴在乳上,丑时归
于足厥阴肝经,入于期门穴,穴在乳下。出于上,入于下,肺领气,肝藏血,乳正居于其间也。其足阳明之脉,自缺盆
下于乳。又冲脉者,起于气街,并足阳明夹脐上行,至胸中而散,故乳房属足阳明胃经,乳头属足厥阴肝经。妇人不知
调养,有伤冲任,且忿怒所逆,郁闷所遏,浓味所酿,以致厥阴之气不行,阳明之血热甚,或为风邪所容,则气壅不散,
结聚乳间,或硬或肿,疼痛有乳核,渐至皮肤 肿,寒热往来,谓之乳痈。风多则硬肿色白,热多则 肿色赤,不治则
血不流通,气为壅滞,而与乳内津液相搏,疡化为脓。治之之法,凡初起寒热 痛,即发表散邪,疏风清胃,速下乳汁,
导其壅塞,则病可愈。若不散而不易成脓,宜用托里;若溃后肌肉不生,脓水清稀,宜补脾胃;若脓出反痛,恶寒发热,
宜调荣卫;若晡热 肿作痛,宜补阴血;若食少作呕,宜补胃气。切戒清凉解毒,反伤脾胃也。
乳痈者,俗呼曰吹乳。吹者,风也。风热结汨于乳房之间,血脉凝注,久而不散,溃腐为脓。凡忽然壅肿结核色赤,
数日之外, 痛胀溃,稠脓涌出,此属胆胃热毒,气血壅滞,名曰乳痈,为易治。治法∶青皮疏厥阴之滞,石膏清阳明
之热,生草节解毒而行污浊之血,荆防散风而兼助药达表,栝蒌,没药、青桔叶、角刺、金银花、土贝母、当归及酒佐
之,毋非疏肝和血解毒而已。加艾隔蒜灸二三十壮于痛处最效。切忌刀针伤筋溃脉,为害不小。
有因妇人所乳之子膈有滞痰,口气 热,含乳而睡,热气吹入乳房,凝滞不散,遂生结核。若初起时忍痛揉软,吮
去乳汁,即可消散。失此不治,必成痈肿。亦有因小儿断乳后,不能回化,或妇人乳多,婴孩少饮积滞凝结,又或经候
不调,逆行失道。又有邪气内郁,结成痈肿。初发时,切勿用凉药,盖乳本血化,不能漏泄,遂结实肿,乳性清寒,又
加凉药,则阴烂宜也。惟凉药用之,既破之后则佳。如初发时宜用南星、姜汁敷之,可以内消,更加草乌一味,能破恶
血逐块,遇冷则消,遇热则溃。更加乳香、没药以定痛。内则用栝蒌仁、十宣散、通气散间服之。然年四十以下者,治
之多瘥,以气血旺故也。五十以上者,慎勿治之,多死,以天癸绝也,不治自能终其天年。若欲加治,惟调补气血为主。
妇人有忧怒抑郁,朝夕累积,脾气消阻,肝气横逆,气血亏损,筋失荣养,郁滞与痰结成隐核,不赤不痛,积之渐
大,数年而发,内溃深烂,名曰乳岩,以其疮形似岩穴也,慎不可治。此乃七情所伤,肝经气血枯槁之证。治法∶ 痛
寒热初起,即发表散邪,疏肝之中,兼以补养气血之药,如益气养荣汤,加味逍遥散之类,以风药从其性,气药行其滞,
参、 、归、芍补气血,乌药、木通疏积利壅,柴、防、苏叶表散,白芷除脓通荣卫,官桂行血和脉。轻者多服自愈,
重者尚可延年。若以清凉行气破血,是速其亡也。
妇女的乳房,男子的肾脏,都是生命的根本。人体的气血循环运行无间隙,寅时(凌晨3-5点)开始于手太阴肺经,从云门穴发出,该穴位位于乳房上方;丑时(凌晨1-3点)回归足厥阴肝经,进入期门穴,该穴位位于乳房下方。气血出于上部,入于下部,肺主领受气,肝主贮藏血,乳房正居于这两者之间。足阳明胃经的经脉,从缺盆穴下行至乳房。另外冲脉,起始于气街穴,与足阳明胃经并行夹脐上行,到达胸部后散开,所以乳房归属于足阳明胃经,乳头归属于足厥阴肝经。妇女如果不注意调养,损伤了冲脉和任脉,再加上愤怒导致气机逆乱,郁闷导致气机郁结,浓腻厚味的食物酿生湿热,以致足厥阴肝经的气机运行不畅,足阳明胃经的血分热盛,或者被风邪所侵袭,导致气机壅滞不散,结聚在乳房中间,或硬或肿,疼痛且有乳核,逐渐发展到皮肤肿胀,寒热往来,这叫做乳痈。风邪偏多则硬肿色白,热邪偏多则红肿色赤,如果不治疗,则血液流通受阻,气机壅滞,与乳房内的津液相互搏结,疮疡化为脓液。治疗的方法,凡是初起时有寒热疼痛,应当立即发表散邪,疏风清胃,迅速疏通乳汁,引导其壅塞解除,病就可以痊愈。如果脓液不散且不易成熟,宜用托里透脓法;如果溃破后肌肉不生,脓水清稀,宜补益脾胃;如果脓出反而疼痛,恶寒发热,宜调和营卫;如果午后发热、局部肿痛发作,宜补益阴血;如果饮食减少、作呕,宜补益胃气。切记不可滥用清凉解毒药,以免反伤脾胃。
乳痈,俗称吹乳。“吹”指的是风邪。风热邪气结聚于乳房之间,血脉凝注,时间久了不散,溃烂腐坏化为脓液。凡是突然壅肿结核、颜色红赤,数日之后,胀痛溃破,流出稠密的脓液,这属于胆胃热毒,气血壅滞,名叫乳痈,容易治疗。治疗方法:青皮疏解足厥阴肝经的郁滞,石膏清泄足阳明胃经的热邪,生甘草节解毒并推动污浊之血的运行,荆芥、防风疏散风邪并兼助药力达于体表,栝蒌、没药、青桔叶、角刺(皂角刺)、金银花、土贝母、当归以及酒作为辅助,无非是疏肝、和血、解毒罢了。在疼痛处加用艾隔蒜灸二三十壮最为有效。切忌用刀针切开损伤筋脉,危害不小。
有的因为妇女哺乳的孩子膈间有停滞的痰饮,口气热,含着乳头睡觉,热气吹入乳房,凝滞不散,于是产生结核。如果在初起时忍住疼痛揉软它,吸去乳汁,就可以消散。错过这个时机不治疗,必定成为痈肿。也有因为小儿断奶后,乳汁不能回化吸收,或者妇人乳汁过多,婴儿喝得少导致积滞凝结,又或者月经不调,逆行失道。又有邪气内郁,结成痈肿。初发时,千万不要用凉药,因为乳汁本是由血化生的,不能随意漏泄,于是结实肿胀,乳汁性质清寒,再加凉药,就会导致阴寒腐烂。只有当脓已破溃之后使用凉药才适宜。如初发时宜用南星、姜汁外敷,可以使其从内部消散,再加一味草乌,能破除恶血、驱逐肿块,遇冷则消散,遇热则溃破。再加乳香、没药以定痛。内服可用栝蒌仁、十宣散、通气散交替服用。然而四十岁以下的人,治疗大多痊愈,因为气血旺盛的缘故。五十岁以上的人,切勿轻易治疗,大多死亡,因为天癸已绝的缘故,不治疗也能自然终其天年。如果想要治疗,只有以调补气血为主。
妇女如果有忧怒抑郁,朝夕累积,导致脾气消阻,肝气横逆,气血亏损,筋脉失去荣养,郁滞与痰结形成隐核,不红不痛,积聚逐渐变大,几年后才发作,内部溃烂深重,名叫乳岩,因为疮形像岩穴一样,千万不可治疗。这是七情所伤,肝经气血枯槁的病证。治疗方法:初起有寒热疼痛时,立即发表散邪,在疏肝的同时,兼用补养气血的药物,如益气养荣汤、加味逍遥散之类,用风药顺从其性,气药行其郁滞,人参、[此处原文缺失,推测为黄芪或类似补气药]、当归、芍药补益气血,乌药、木通疏利积滞、通利壅塞,柴胡、防风、苏叶发散表邪,白芷排脓、通达营卫,官桂行血和脉。轻症多服自愈,重症尚可延年。如果用清凉、行气、破血的方法,是加速其死亡。
The breasts of women and the kidneys of men are both the roots of life. The qi and blood of humans circulate without interruption. At Yin hour (3:00-5:00 AM), it begins at the Hand-Taiyin Lung Meridian, emerging from Yunmen (Cloud Gate) acupoint, which is located above the breast. At Chou hour (1:00-3:00 AM), it returns to the Foot-Jueyin Liver Meridian, entering Qimen (Period Door) acupoint, which is located below the breast. Emerging from above and entering below, the Lung governs Qi, and the Liver stores Blood; the breast lies precisely between them. The meridian of the Foot-Yangming Stomach descends from Quepen (Empty Basin) to the breast. Additionally, the Chong Mai (Penetrating Vessel) originates at Qichuan (Gas Street), runs parallel to the Foot-Yangming Stomach Meridian flanking the umbilicus upwards, and disperses upon reaching the chest. Therefore, the breast belongs to the Foot-Yangming Stomach Meridian, and the nipple belongs to the Foot-Jueyin Liver Meridian. If women fail to maintain proper regulation, they may injure the Chong and Ren vessels. Furthermore, anger causes Qi rebellion, depression causes Qi stagnation, and rich, greasy foods brew damp-heat. This leads to the failure of Qi in the Foot-Jueyin Liver Meridian to move freely, and excessive heat in the blood of the Foot-Yangming Stomach Meridian. If invaded by Wind pathogen, Qi becomes congested and fails to disperse, accumulating in the breast, becoming hard or swollen, painful with a palpable mass, gradually extending to skin swelling, with alternating chills and fever. This is called Ru Yong (Breast Abscess). If Wind predominates, the hardness and swelling are white; if Heat predominates, the redness and swelling are red. If untreated, blood circulation is obstructed, Qi becomes stagnant, and it combats with the body fluids within the breast, turning the ulcer into pus. The treatment method: whenever there are initial chills, fever, and pain, one should immediately release the exterior and scatter pathogens, soothe the Liver and clear the Stomach, rapidly promote lactation, and guide the resolution of congestion, so the disease can be cured. If the pus does not disperse and fails to mature easily, use the method of supporting the interior to expel pus. If after ulceration the flesh does not regenerate and the pus is thin and clear, tonify the Spleen and Stomach. If pain persists after pus discharge, accompanied by aversion to cold and fever, harmonize Ying and Wei. If afternoon fever and localized swelling/pain occur, tonify Yin and Blood. If appetite is poor and vomiting occurs, tonify Stomach Qi. Strictly avoid cooling and detoxifying herbs, as they will damage the Spleen and Stomach.
Ru Yong (Breast Abscess) is commonly known as "Blown Breast." "Blowing" refers to Wind pathogen. Wind-Heat pathogen accumulates between the breasts, causing blood vessels to coagulate and stagnate. Over time, it fails to disperse, ulcerates, rots, and turns into pus. Whenever there is sudden congestion, swelling, nodules, and redness, followed by distending pain and ulceration after several days, with thick pus flowing out, this belongs to Gallbladder and Stomach Heat-Toxin, with Qi and Blood congestion and stagnation, named Ru Yong (Breast Abscess), which is easy to treat. Treatment method: Qingpi (Green Tangerine Peel) unblocks the stagnation of the Foot-Jueyin Liver Meridian; Shigao (Gypsum Fibrosum) clears the heat of the Foot-Yangming Stomach Meridian; Sheng Caojie (Raw Licorice Root Tip) detoxifies and moves turbid blood; Jingjie (Schizonepeta) and Fangfeng (Saposhnikovia) scatter Wind and assist drugs in reaching the exterior; Gualou (Trichosanthes Fruit), Moyao (Myrrh), Qingjuye (Mandarin Orange Leaf), Jiaoci (Gleditsia Spine), Jinyinhua (Honeysuckle), Tubeim (Fritillaria Thunbergii), Danggui (Angelica Sinensis), and wine are used, all for the purpose of soothing the Liver, harmonizing Blood, and detoxifying. Applying moxibustion with garlic partitioning (Garlic-Moxa Moxibustion) on the painful area for 20-30 moxa cones is most effective. One must strictly avoid using knives or needles to cut, as damaging tendons and vessels causes significant harm.
Some cases arise because the nursing infant has phlegm-stagnation in the diaphragm and hot breath. When the infant sleeps while holding the nipple, hot air is blown into the breast, causing stagnation that does not disperse, leading to nodules. If, at the onset, one endures the pain to massage it soft and suck out the milk, it can dissipate. Missing this opportunity and failing to treat it will inevitably lead to an abscess. Other cases occur after weaning, where milk cannot be reabsorbed, or when a woman produces excess milk but the infant drinks little, causing accumulation and condensation. Or due to irregular menstruation with retrograde flow. Also, internal pathogenic stagnation can form an abscess. At the initial stage, do not use cooling medicines. Milk is transformed from Blood and cannot leak freely; thus, it solidifies and swells. Milk nature is cool and cold; adding cooling medicine leads to Yin rot. Cooling medicines are only suitable after the abscess has ruptured. For initial stages, apply Nanxing (Arisaema Cum Bile) mixed with Ginger Juice externally to resolve it internally. Adding Caowu (Aconitum Kusnezoffii) can break bad blood and drive away masses; it resolves when cold and suppurates when hot. Add Ruxiang (Frankincense) and Moyao (Myrrh) to relieve pain. Internally, take Gualouren (Trichosanthes Seed), Shixuan San (Ten Acupoints Powder), and Tongqi San (Qi-Unblocking Powder) alternately. Patients under forty years old often recover well because their Qi and Blood are vigorous. Patients over fifty years old should not be treated aggressively; many die because Tian Gui (Menstrual Essence) has ceased. Without aggressive treatment, they may live out their natural lifespan. If treatment is desired, focus primarily on regulating and tonifying Qi and Blood.
Women who suffer from worry, anger, and depression accumulate day and night, causing Spleen Qi to be obstructed and Liver Qi to flare horizontally. This leads to Qi and Blood deficiency, with tendons losing nourishment. Stagnation and Phlegm bind to form hidden nodules, which are neither red nor painful. They gradually enlarge over years before erupting, with deep internal ulceration and rotting. This is named Ru Yan (Breast Cancer/Rock-like Ulcer), because the wound shape resembles a rock cave. It must not be treated aggressively. This is a syndrome caused by emotional injury, with exhaustion of Qi and Blood in the Liver Meridian. Treatment method: At the initial stage with chills, fever, and pain, immediately release the exterior and scatter pathogens. While soothing the Liver, simultaneously use herbs to tonify and nourish Qi and Blood, such as Yiqi Yangrong Tang (Benefit Qi and Nourish Prosperity Decoction) or Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Use Wind herbs to follow its nature, Qi herbs to move stagnation, Renshen (Ginseng), Huangqi (Astragalus - *inferred from context*), Danggui (Angelica Sinensis), and Baishao (White Peony Root) to tonify Qi and Blood, Wuyao (Lindera) and Mutong (Akebia) to drain accumulation and relieve congestion, Chaihu (Bupleurum), Fangfeng (Saposhnikovia), and Zisuye (Perilla Leaf) to scatter the exterior, Bai Zhi (Angelica Dahurica) to drain pus and unblock Ying and Wei, and Guirui (Cinnamon Bark) to move Blood and harmonize vessels. Mild cases often heal with prolonged administration; severe cases can still prolong life. Using cooling, Qi-moving, and Blood-breaking methods accelerates death.