Two Formulas from the Shenji Zonglu for Treating Postpartum Mastitis with Swelling and Pain

The Shenji Zonglu (Comprehensive Record of Divine Assistance) contains two formulas for treating mastitis with swelling and pain: one is the externally applied "Tuowai Gao" (Out-supporting Plaster), and the other is the orally taken "Danggui Yin" (Angelica Decoction).

Tuowai Gao is composed of: huangqi (astragalus root, filed) 1 liang 5 qian (45 g), baizhi (angelica dahurica root) and dahuang (rhubarb, filed and stir-fried), each 1 liang (30 g), danggui (angelica sinensis root, cut and stir-fried) and xuduan ( teasel root), each 3 qian (9 g), xiebai (Chinese scallion, cut) 1 liang 8 qian (54 g), songzhi (pine resin) 2 liang (60 g, ground separately), zhuzhi (lard) 5 liang (150 g), shengdihuang zhi (fresh rehmannia juice) 1 sheng, and la (beeswax) 1 liang 5 qian (45 g).

Grind these five herbs into a fine powder, add rehmannia juice, and simmer over low heat until it gradually thickens; then add lard, pine resin, scallion powder and beeswax, and continue simmering into a plaster. Strain through fresh cloth, store in a new porcelain vessel, allow it to cool, and spread it on silk. The plaster may be applied according to the size of the lesion, and changed once daily. This formula has the actions of supporting the interior and resolving toxicity, and of dispersing swelling and expelling pus; it is used for postpartum mastitis with swelling and pain where the pus does not disperse.

Danggui Yin is composed of: danggui (angelica root, cut and dried), baishao (white peony root), mudanpi (moutan bark), shengdihuang (fresh rehmannia, dried), renshen (ginseng), huangqi (astragalus, filed), dahuang (raw), shengma (cimicifuga rhizome) and lianqiao (forsythia fruit), each 1 liang. Coarsely crush all the herbs; each time take 5 qian (15 g), add 225 ml of water, and decoct to 160 ml, then strain out the dregs. Take it warm, regardless of before or after meals. This formula has the actions of boosting qi and nourishing blood, and of dissipating nodules and dispersing swelling; it is indicated for postpartum mastitis that is about to form nodules but has not yet formed them, with fever, swelling and pain.

These two formulas are both swelling-dispersing and pain-relieving prescriptions for postpartum acute mastitis.