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When lactation is obstructed, with nodules forming like a flat cake that do not dissipate, accompanied by alternating chills and fever and pain, it is advisable to rapidly massage and disperse them. The milk flow will then resume, and the nodular mass will naturally disappear. If the mass does not dissipate and progresses to form *Ru Yong* (Acute Mastitis), immediately crush green onions with their roots into a paste, apply it to the breast, and cover the onion paste with a pot of charcoal fire. After a short while, when sweating occurs, the swelling and pain will instantly subside.

Obstruction of lactation can be due to excess or deficiency patterns.

For excess patterns, the following is suitable: Jiegeng (Platycodon Root) (2 qian), Qumai (Dianthus Herb), Chaihu (Bupleurum Root), Tianhuafen (Trichosanthes Root) (each 1 qian), Tongcao (Tetrapanax Pith) (0.7 qian), Qingpi (Aurantii Fructus Immaturus), Baizhi (Angelicae Dahuricae Radix), Mutong (Akebia Caulis), Chishao (Paeoniae Radix Rubra), Lianqiao (Forsythiae Fructus), Gancao (Licorice Root).
Crush these ingredients for one dose, decoct in water, and take frequently. Simultaneously, massage the breasts.

For deficiency patterns, the following is suitable: Wangbuliuxing (Vaccariae Semen), Mutong (Akebia Caulis), Tianhuafen (Trichosanthes Root), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba) (stir-fried with wine), Shengdihuang (Rehmanniae Radix) (each in equal parts).
Crush these ingredients for one dose. Decoct four liang of pork trotter meat to obtain two bowls of broth, add the herbs, and take together. Before taking the medicine, frequently wash the breasts with green onion water.

Yongquan San (Surging Spring Powder): Treats obstructed lactation regardless of excess or deficiency. First, frequently scrape the breasts with a wooden comb, then administer the medicine. It is effective.
Chanshanjia (Manis Scaly Pangolin Scale) (stir-fried), Baijiangcan (Bombyx Batryticatus) (stir-fried), Roudoukou (Myristica Seed) (wrapped in flour and baked until cooked, each 4 qian), Zaojiao (Gleditsiae Fructus) (5 qian), Hutao Ren (Juglandis Semen) (peeled, 4 liang), Zhima (Sesamum Indicum Seed) (half jin).
Grind all into a fine powder. Take an unspecified amount each time, mixed with warm wine. It may be consumed at will.

Treatment for obstructed lactation:
Wangbuliuxing (Vaccariae Semen), Tianhuafen (Trichosanthes Root), Gancao (Licorice Root) (each 3 qian), Danggui (Angelicae Sinensis Radix), Chanshanjia (Manis Scaly Pangolin Scale).
Grind into a fine powder. Take 3 qian each time, mixed with pork trotter soup or hot wine. The milk flow will immediately resume.

Painful onset of *Ru Yong* (Acute Mastitis) is caused by blood stasis and stagnation that does not disperse.
Tianhuafen (Trichosanthes Root), Jinyinhua (Lonicerae Japonicae Flos), Zaojiaoci (Gleditsiae Spina) (earth-stir-fried), Chanshanjia (Manis Scaly Pangolin Scale) (earth-stir-fried), Dangguiwei (Angelicae Sinensis Radix Tail), Baizhishao (Angelicae Dahuricae Radix Tip), Gualouren (Benincasae Semen), Beimu (Fritillariae Bulbus), Gancaojie (Licorice Root Joint).
Crush these ingredients, decoct in wine, and take orally. This formula treats *Chui Ru* (Lactational Mastitis) and painful, swollen *Ru Yong* (Acute Mastitis) that is unbearable.

Gualou San (Trichosanthes Powder): Treats women's *Ru Ju* (Breast Carbuncle), *Ru Yong* (Acute Mastitis), and *Nai Lao* (Chronic Mastitis/Breast Tuberculosis).
Huanggualou (Trichosanthes Fruit) (use those with many seeds, do not remove skin, grind into paste), Danggui (Angelicae Sinensis Radix) (5 qian), Ruxiang (Olibanum) (1 qian, ground), Moyao (Myrrha) (1 qian, ground), Sheng Gancao (Raw Licorice Root) (5 qian).
Combine as one dose. Use three bowls of good wine, simmer slowly in silver or ceramic vessels until reduced to half a bowl. Divide into two doses, taken after meals. If suffering from *Nai Lao*, take this medicine to eradicate the root cause. If the pathogenic heat has already formed pus, it will transform into yellow discharge; if not yet formed, it will resolve internally. For severe cases, take another combined dose until cured.

For women suffering from *Chui Ru* (Lactational Mastitis), use one he of millet, taken down with yellow wine, which will dissipate the condition.

To treat women with *Chui Ru* causing hard and swollen breasts, body fever, aversion to cold, unbearable pain, and inability to eat, this prescription yields excellent results. Deer horn (Lu Jiao) one liang, calcined over charcoal fire until carbonized but retaining its nature, ground into powder. Divide into two doses. First, place five qian of the powder in a pot, then add one bowl of unadulterated wine. Boil for several boils, pour into a bowl, and drink completely while hot. Take before retiring to bed. Sweating will bring relief.

Immortal Formula for Treating *Chui Ru*: Crush a large bunch of green onions into a paste, spread it on the breast to a thickness of one finger. Cover the onion paste with a pot of charcoal fire. After a short while, when sweating occurs, swelling and pain instantly subside.

A postpartum woman, due to overexertion, suddenly experienced profuse lactation, mental confusion, and expectoration of phlegm. This was a *Jue* syndrome (collapse) due to deficiency of Yang Qi. She revived after being administered Dushen Tang (Single Ginseng Decoction) and stabilized after taking Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction).
(See formulas under Tonification.)

A woman with vigorous Blood and Qi experienced breast distension and pain, possibly because there was no infant to suckle, leading to distending pain, aversion to cold, and fever. Using two to three liang of stir-fried malt, decocted in water and taken orally, the swelling and pain instantly subsided. Its ability to dissipate Qi is so potent; hence, why is it widely used in formulas for Spleen and Stomach weakness and indigestion?