薛立斋治一妇，产后劳役，忽乳汁如涌，昏昧吐痰，此阳气虚而厥也，灌以独参汤而苏，更以十全大补汤，
数剂而安。若妇人气血方盛，乳房作胀，或无儿饮，胀痛憎寒发热，用麦芽二三两，炒熟，水煎服，立消。其
耗散气血如此，何脾胃虚弱，饮食不消方中，多用之邪。
张隐庵治一妇，产后乳上发痈，肿胀将半月，周身如针刺，饮食不进。诊之，六脉沉紧有力，左乳则肿连
胸胁，用麻黄、葛根、荆芥、防风、杏仁、甘草、石膏，温服取汗遂愈。《金匮》云∶产后妇人喜中风。经云∶
开阖不得，寒气从之，荣气不从，逆于肉理，乃生痈肿。此系风寒内壅，火热内闭，荣卫不调所致。众以凉药
治热，不知开阖之故。今毛窍一开，气机旋转，荣卫流行，而肿痛解矣。经云∶食气入胃，散精于肝。病属阳
明厥阴二经，是以饮食不进。今经气疏通，自能食矣。孰谓疡医可不知经乎？
薛立斋治一妇人，产次子而无乳，服下乳药，但作胀。曰∶人乳气血所化，今胀而无乳，是气血竭而津液
亡也，当补其气血，自然有乳。乃与八珍汤，倍参、术，少加肉桂，二十余剂，乳遂生。后因劳役复竭，夫其
初产有乳，再产而无，其气血只给一产耳，其衰可知。
王肯堂治一娠妇，患乳肿不散。八月，用火针取脓，用十全大补汤，外敷铁箍散不效，反加喘闷。九月，
产一女，溃势愈大，两乳旁烂尽，延及胸腋，脓水稠粘，出脓六七升，略无敛势。十一月，乃用解毒和中平剂，
外渗生肌散、龙骨、寒水石等，脓出不止，流溅所及，即肿泡溃脓，两旁紫黑，疮口十数，胸前胁下皆肿痛，
不可动侧，其势可畏。此产后毒瓦斯乘虚而炽，令服黄 解毒，归、参和血生血为臣，升麻、葛根、漏芦为足阳
明本经药，连翘、防风散结疏经，蒌仁、蒡子解毒去肿，角刺引脓，白芷排脓长肌，川芎、桂、炒黄柏为引，
每剂入酒一杯，送白玉霜丸，疏脓解毒。时脓水稠粘，不可遽用收涩之剂，理宜追之，乃制青霞散外糁。明日
脓水顿稀，痛定秽减，始有向安之势。至正月，皆生新肉，有紫肿处，俱用葱熨法，随手消散。但近胁足少阳
分尚未敛，乃加柴胡一钱，青皮三分，及倍川芎。脓水将净，即用搜脓散糁之。元宵后，遂全安。凡治痈疽，
须审经络部分，今所患正在足阳明之分，少侵足少阳经分，俗医不复省别，一概用药，药无向导，终归罔功，
甚可叹也。（是症得生，全在脓水稠粘，其人必能食，故可治也。）
按∶乳病全是肝火上逆入胃，大络不降而成，即肝木侮胃之病。近治鲍渌饮夫人，素有血虚肝病，忽
一日，憎寒壮热，头痛口苦，乳肿痛不堪，熨吮俱无效，予用生地、杞子、当归各五钱，麦冬、蒌仁各二
钱，丹皮、赤芍各一钱五分，地丁、银花各三钱，二剂即愈。凡用此方最效者，不可枚举矣。
朱丹溪治一妇人，产后患乳痈，用香白芷、连翘、甘草节、当归、赤芍、青皮、荆芥穗各半两，贝母、花
粉、桔梗各一钱，栝蒌半个，作一帖水煎，半饥半饱服，细细呷之。有热加柴胡、黄芩，忌酒肉椒料。敷药用
南星、寒水石、皂角、白芷、川贝、草乌、大黄，七味为膏，醋调，鹅翎扫敷肿痛效。（《治法》。）
陈良甫曰∶余荆布因产前食素，得痰瘦弱，产后乳脉不行，已七十日，服诸药无效，婴儿甚苦。偶有人送
赤豆一斗，遂如常煮赤豆粥食之，当夜乳脉通行。因阅本草，赤小豆能通奶乳，谩载之。
王洪绪曰∶产后两乳伸长，情势如鸡肠，垂过小腹，痛难刻忍，此名乳悬，急用芎、归各一斤，内取各四
两，水煎时服。以所余斤半，于产妇面前放一棹，下放火炉，将芎、归入炉慢烧，令妇伏于棹上，口鼻及乳皆
吸烟气，便可缩上。如未愈，取蓖麻子一粒，冰水磨涂，一缩即洗去。但用此药，恐异日再产，必复发不救。
故膏药不可以蓖麻煎入，倘贴孕婢下体疮疖，即致小产，再贴即致命。巴豆、蓖麻之害如此，不可轻用也。（何
廉访郡伯云∶此症以女人臭裹脚布扎敷即收上。曾用有效，亦古方也。）
薛立斋治疗一位妇人，产后因劳累过度，突然乳汁如涌出般大量流失，神志昏沉并呕吐痰涎，这是阳气虚弱导致的厥证。灌服独参汤后苏醒，随后服用十全大补汤，经过数剂药后病情安定。如果妇人气血正旺盛，乳房胀痛，或者没有婴儿吸吮，出现胀痛、怕冷发热等症状，使用麦芽二三两，炒熟后水煎服用，症状立刻消除。其耗散气血如此厉害，为什么在脾胃虚弱、饮食不消化的方子中，也多用麦芽呢？
张隐庵治疗一位妇人，产后乳房上发生痈肿，肿胀持续将近半个月，全身感觉像针刺一样疼痛，饮食无法进用。诊察发现六脉沉紧有力，左侧乳房肿胀牵连胸胁，使用麻黄、葛根、荆芥、防风、杏仁、甘草、石膏，温服后取汗而痊愈。《金匮要略》说：产后妇人容易患中风。经书说：开阖功能失常，寒气随之侵入，营气运行不畅，逆乱于肌肉纹理之间，从而产生痈肿。这属于风寒内壅，火热内闭，营卫不调所致。众人用凉药治疗热症，不知道开阖的道理。如今毛窍一开，气机旋转，营卫流通，肿痛便解除了。经书说：食物之气进入胃中，将精微散布到肝脏。此病涉及阳明、厥阴二经，所以饮食不进。如今经络之气疏通，自然能进食了。谁说外科医生可以不精通医经呢？
薛立斋治疗一位妇人，生第二个孩子时却没有乳汁，服用下乳药物，只感到乳房胀痛。他说：人乳是由气血化生的，现在只有胀痛而没有乳汁，是气血枯竭、津液亡失的表现，应当补益气血，自然会有乳汁。于是给予八珍汤，加倍人参、白术，少量加入肉桂，二十多剂后，乳汁生成。后来因为劳累过度再次枯竭，回想她初产时有乳汁，再产时却没有，说明她的气血只能供给一次生产，其衰退程度可以推知。
王肯堂治疗一位孕妇，患有乳房肿胀不散。八月时，用火针排脓，使用十全大补汤，外敷铁箍散无效，反而加重了喘闷。九月时，产下一女婴，溃烂情况更加严重，两侧乳房旁边腐烂殆尽，蔓延至胸腋，脓水稠粘，排出脓水六七升，完全没有收敛的迹象。十一月时，才使用解毒和中的平性药剂，外渗生肌散、龙骨、寒水石等，脓水仍然不止，流溅到的地方，随即肿泡溃破流脓，两旁呈紫黑色，疮口有十多个，胸前胁下都肿痛，不能移动侧身，形势令人畏惧。这是产后毒邪乘虚炽盛，令患者服用黄芪解毒，当归、人参作为臣药调和气血，升麻、葛根、漏芦为足阳明本经药物，连翘、防风散结疏经，瓜蒌仁、牛蒡子解毒消肿，皂角刺引脓外出，白芷排脓长肉，川芎、肉桂、炒黄柏作为引经药，每剂药加入一杯酒送服白玉霜丸，以疏脓解毒。当时脓水稠粘，不可急于使用收涩之剂，按理应该追托脓毒，于是制作青霞散外敷。第二天脓水顿时变稀，疼痛停止，秽浊减少，开始有向安好的趋势。到了正月，都长出新肉，对于有紫肿的地方，都用葱熨法，随手消散。但靠近胁部的足少阳分尚未收敛，于是加柴胡一钱，青皮三分，以及加倍川芎。脓水将净时，即用搜脓散外敷。元宵节后，完全康复。凡是治疗痈疽，必须审察经络部位，现在所患之处正在足阳明之分，稍微侵犯足少阳经分，普通医生不再分辨，一概用药，药物没有向导，最终归于无功，实在令人叹息。（这个病症得以存活，全在于脓水稠粘，此人必定能进食，所以可治。）
按语：乳病完全是由于肝火上逆入胃，大络不降而成，即肝木侮胃的病证。最近治疗鲍渌饮夫人，素有血虚肝病，忽然有一天，怕冷高热，头痛口苦，乳房肿痛不堪忍受，熨烫吸吮都无效，我用生地、枸杞、当归各五钱，麦冬、瓜蒌仁各二钱，丹皮、赤芍各一钱五分，地丁、银花各三钱，两剂即愈。凡是用此方最有效的，不可枚举。
朱丹溪治疗一位妇人，产后患乳痈，使用香白芷、连翘、甘草节、当归、赤芍、青皮、荆芥穗各半两，贝母、天花粉、桔梗各一钱，栝蒌半个，作一帖水煎，在半饥半饱时服用，细细呷之。有热象加柴胡、黄芩，忌酒肉椒料。敷药用南星、寒水石、皂角、白芷、川贝、草乌、大黄，七味制成膏药，醋调匀，用鹅翎扫敷肿痛处有效。（《治法》。）
陈良甫说：我早年穿布衣时，因产前吃素，导致痰湿瘦弱，产后乳脉不通，已经七十天，服用各种药物无效，婴儿非常痛苦。偶然有人送来赤豆一斗，于是照常煮赤豆粥食用，当晚乳脉通行。因此查阅本草，赤小豆能通奶乳，随意记载于此。
王洪绪说：产后两乳伸长，情势如鸡肠，垂过小腹，痛得难以忍受，此名乳悬，急用川芎、当归各一斤，内取各四两，水煎时时服用。用剩余的斤半，在产妇面前放一张桌子，桌下放火炉，将川芎、当归放入炉中慢烧，让妇女伏在桌子上，口鼻及乳房都吸入烟气，便可缩回。如果未愈，取蓖麻子一粒，冰水磨涂，一缩即洗去。但使用此药，恐怕日后再次生产，必然复发且无法救治。所以膏药不可以用蓖麻煎入，倘若贴孕婢下体疮疖，即导致小产，再贴即致命。巴豆、蓖麻的危害如此，不可轻用。（何廉访郡伯说：此症用女人臭裹脚布扎敷即可收回。曾用有效，也是古方。）
Xue Lizhai treated a woman who, after childbirth and overexertion, suddenly experienced an excessive outflow of milk as if gushing, accompanied by unconsciousness and vomiting of phlegm. This was a case of jue syndrome (reversal syndrome) caused by deficiency of yang qi. She was revived by administering Dushen Tang (Single Ginseng Decoction), and subsequently recovered after taking several doses of Shiquan Dabuzi Tang (Ten-Ingredient Great Tonifying Decoction). If a woman has abundant qi and blood but suffers from breast distension and pain, or experiences chills and fever due to lack of infant suckling, using two to three liang of fried malt decocted in water will immediately resolve the symptoms. Given how much it dissipates qi and blood, why is malt frequently used in formulas for spleen and stomach weakness with indigestion?
Zhang Yin'an treated a woman who developed a breast abscess postpartum. The swelling persisted for nearly half a month, causing stabbing pain throughout the body and loss of appetite. Her six pulses were deep, tight, and forceful. The left breast swelling extended to the chest and hypochondrium. He prescribed Ephedrae Herba (Mahuang, 麻黄), Puerariae Radix (Gegen, 葛根), Schizonepetae Herba (Jingjie, 荆芥), Saposhnikoviae Radix (Fangfeng, 防风), Armeniacae Semen Amarum (Xingren, 杏仁), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), and Gypsum Fibrosum (Shigao). After warm administration inducing sweating, she was cured. The *Jin Gui Yao Lue* states: "Postpartum women are prone to wind-stroke." The Classics state: "When opening and closing functions fail, cold qi enters; when ying qi fails to circulate smoothly and rebels within the muscle tissue, abscesses and swellings arise." This condition resulted from internal congestion of wind-cold, internal closure of fire-heat, and disharmony of ying and wei. Most practitioners use cooling herbs to treat heat, ignoring the principle of opening and closing. Once the pores opened, qi mechanism rotated, ying and wei circulated freely, and the swelling and pain resolved. The Classics state: "The qi of food enters the stomach and distributes essence to the liver." This disease involves the Yangming and Jueyin meridians, hence the loss of appetite. Now that the meridian qi is unblocked, appetite naturally returns. Who says surgeons must not be proficient in medical classics?
Xue Lizhai treated a woman who had no milk during her second delivery. After taking galactagogues, she only experienced breast distension. He said: "Human milk is transformed from qi and blood. Distension without milk indicates exhaustion of qi and blood and loss of fluids. One must tonify qi and blood, and milk will naturally appear." He prescribed Bazhen Tang (Eight-Treasure Decoction) with doubled Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala Rhizome), plus a small amount of Rougui (Cinnamon Bark). After more than twenty doses, milk production resumed. Later, due to overexertion, lactation ceased again. Recalling that she had milk at first birth but not at the second, it is evident that her qi and blood could only support one pregnancy and birth, indicating significant decline.
Wang Kentang treated a pregnant woman with unresolved breast swelling. In the eighth month, pus was drained using fire needles, and she took Shiquan Dabuzut Tang externally applied with Tiegu San (Iron Hoop Powder) without effect; instead, wheezing and oppression worsened. In the ninth month, after delivering a daughter, the ulceration intensified. Both breasts beside the nipples were completely eroded, extending to the chest and axillae. The pus was thick and sticky, totaling six to seven sheng, with no sign of healing. In November, mild detoxifying and harmonizing formulas were used, along with external application of Shengji San (Generate Flesh Powder), Longgu (Fossilized Bones), and Hanshuishi (Calcitum). Pus continued to flow profusely; where it splashed, new blisters formed and ruptured. The sides turned purple-black, with over ten open sores. The chest and hypochondrium were swollen and painful, making movement impossible—a terrifying situation. This was caused by pathogenic toxins flaring up due to postpartum deficiency. He prescribed Huangqi (Astragalus Root) for detoxification, Danggui (Angelica Sinensis Radix) and Renshen (Ginseng) as minister herbs to harmonize and generate blood, Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Radix), and Loulu (Euphorbiae Humifusae Herba) as drugs specific to the Foot-Yangming channel, Lianqiao (Forsythiae Fructus) and Fangfeng (Saposhnikoviae Radix) to resolve nodules and unblock channels, Gualou Ren (Trichosanthis Semen) and Bangzi (Arctii Fructus) to detoxify and reduce swelling, Zhaocishi (Hedgehog Spine) to guide pus out, Baizhi (Angelicae Dahuricae Radix) to expel pus and promote flesh growth, Chuanxiong (Ligustici Chuanxiong Rhizoma), Rougui (Cinnamon Bark), and Chao Huangbai (Phellodendri Cortex Prepared with Wine) as guiding herbs. Each dose was taken with a cup of wine, followed by Baiyu Shuang Wan (White Jade Frost Pills) to drain pus and detoxify. Since the pus was thick and sticky, astringents should not be used hastily; rather, pus should be encouraged to drain. Thus, Qingxia San (Blue Cloud Powder) was prepared for external dusting. The next day, pus became thin, pain subsided, and foul odor decreased, showing signs of improvement. By January, new flesh had grown everywhere. For areas remaining purple and swollen, Congyun Fa (Scallion Moxibustion Method) was applied, resolving them instantly. However, the area near the hypochondrium involving the Foot-Shaoyang channel had not yet healed, so Chaihu (Bupleuri Radix) 1 qian, Qingpi (Citrus Aurantium Pericarpium Immaturum) 3 fen, and doubled Chuanxiong were added. As pus cleared, Sonong San (Search Pus Powder) was applied. After the Lantern Festival, full recovery was achieved. In treating carbuncles and sores, one must examine the meridian and location. Here, the lesion was primarily in the Foot-Yangming division, slightly invading the Foot-Shaoyang channel. Common physicians failed to distinguish this, applying uniform medications without guiding herbs, leading to failure—truly lamentable. (This patient survived largely because the pus was thick and sticky, and she could eat, indicating treatability.)
Note: Breast diseases are entirely caused by Liver Fire rebelling upward into the Stomach, failing to descend through the large collaterals, constituting a pathology of Liver Wood insulting Stomach Earth. Recently, I treated Mrs. Bao Luyin, who suffered from chronic blood deficiency and Liver disease. Suddenly, she experienced aversion to cold, high fever, headache, bitter taste in the mouth, and unbearable breast swelling and pain. Moxibustion and suction were ineffective. I used Dihuang (Rehmanniae Radix), Gouqi (Lycii Fructus), and Danggui (Angelicae Sinensis Radix) each 5 qian, Maidong (Ophiopogonis Radix) and Gualou Ren (Trichosanthis Semen) each 2 qian, Danpi (Moutan Cortex) and Chishao (Paeoniae Radix Rubra) each 1.5 qian, Diziding (Solani Tuber) and Yinhua (Lonicerae Japonicae Flos) each 3 qian. Two doses resulted in cure. Cases where this formula is most effective are too numerous to enumerate.
Zhu Danxi treated a woman with postpartum mastitis. He prescribed XiangBaizhi (Angelicae Dahuricae Radix), Lianqiao (Forsythiae Fructus), Gancaojie (Licorice Joint), Danggui (Angelicae Sinensis Radix), Chishao (Paeoniae Radix Rubra), Qingpi (Citrus Aurantium Pericarpium Immaturum), and Jingjiesui (Schizonepetae Spica) each 0.5 liang, Beimu (Fritillariae Bulbus), Huafen (Trichosanthis Radix), and Jiegeng (Platycodonis Radix) each 1 qian, and half a Gualou (Trichosanthes Fruit). This was decocted as one dose and taken slowly while half-hungry or half-full. If heat signs were present, Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix) were added. Alcohol, meat, and spicy condiments were forbidden. For external application, Nanxing (Arisaematis Rhizoma), Hanshuishi (Calcitum), Zaojiao (Gleditsiae Sinensis Fructus), Baizhi (Angelicae Dahuricae Radix), Chuanbei (Fritillariae Cirrhosae Bulbus), Caowu (Aconiti Radix), and Dahuang (Rhei Radix et Rhizoma) were made into a paste, mixed with vinegar, and swept onto the swollen and painful area with a goose feather for effectiveness. (*Zhifa*).
Chen Liangfu said: In my youth, due to a vegetarian diet before childbirth, I became weak with phlegm-dampness. Postpartum, my milk ducts did not function for seventy days. Various medicines failed, causing great suffering to the infant. Someone gave me one dou of red beans. I cooked them into porridge as usual. That night, my milk flow resumed. Consulting the Materia Medica, I found that Chi Xiaodou (Adzuki Bean) promotes lactation, so I recorded this casually.
Wang Hongxu said: Postpartum elongation of both breasts, resembling chicken intestines hanging below the abdomen, with unbearable pain, is named "Breast Suspension" (Ru Xuan). Urgently prescribe Xiong (Ligustici Chuanxiong Rhizoma) and Gui (Angelicae Sinensis Radix) each one jin. Take four liang of each, decoct in water, and drink frequently. Place the remaining one jin and half on a table before the patient, with a stove underneath. Slowly burn the Xiong and Gui in the stove. Have the woman lean over the table, inhaling the smoke through her mouth, nose, and breasts. The breasts will retract. If not cured, take one Ricinus Communis Seed (Bidanzi, 蓖麻子), grind it with ice water, apply to the area, and wash off immediately upon retraction. However, using this drug may cause recurrence in future pregnancies, which would be incurable. Therefore, plasters should not contain Ricinus Communis Seed decoction. Applying it to sores on the lower body of a pregnant maid can cause miscarriage; repeated application can be fatal. The harm of Croton Seed (Badou, 巴豆) and Ricinus Communis Seed is thus severe; they must not be used lightly. (He Lianfang Junbo said: This condition can be cured by tying a woman's smelly foot-binding cloth around the affected area. I have used this effectively; it is also an ancient prescription.)