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In "Advice on Practicing Medicine," there is another discussion regarding "Ru Chui" (Breast Blow/Blocked Milk Duct), with detailed explanations, which is recorded here. Whenever a woman first develops Ru Chui, she must not seek medical treatment immediately. I often see doctors treating breast diseases by applying yellow poultices mixed with chrysanthemum leaves to the affected area, and internally administering powder of Gleditsia Sinensis Spina (Zao Jiao Jia) and other substances to accelerate pus formation. When the breast becomes red but has not yet matured into an abscess, they use a Pi Zhen (Bicheng Needle) to puncture about one cun deep, then forcibly squeeze out the toxic matter with their hands. The pain often causes the patient to faint, resulting in excessive bleeding and little pus. Since internal resolution is difficult, the patient suffers for a long time, the wound fails to heal, and over time it forms a fistula. The rotting and lingering condition makes the patient unable to live or die peacefully, while the nursing infant will also perish from lack of milk. The gravity of this sin is beyond counting. The doctor's original intention is merely to be consulted repeatedly to gain wealth, or hoping the disease lingers so they can demand higher fees. Do they not know that hell has already reserved a seat for them? Therefore, for conditions such as Ru Chui and Ru Yong (Acute Mastitis), at the initial stage, it is sufficient to internally administer Xiao Yao San (Free and Easy Wanderer Powder), Liu Shen Wan (Six Gods Pill), and ash from Nelumbo Nucifera Calyx (Lian Fang Hui), taken with Fu Ju Jiu (Fortune Tangerine Wine). Externally, decoct Perilla Frutescens Folium (Zi Su Ye), Citrus Reticulata Semen (Ju He), Luffa Cylindrica Retinerve (Si Gua Luo), Melia Toosendan Fructus (Chuan Lian Zi), Angelica Sinensis Radix (Dang Gui), Carthamus Tinctorius Flos (Hong Hua), Aconitum Carmichaelii Radix Praeparata (Chuan Wu), Cyperi Rhizoma (Xiang Fu), and Cinnamomum Cassia Cortex (Guan Gui) in water. Use two towels soaked in hot water, wring them out, and apply alternately to warm the breast. In mild cases, the milk will disperse and flow freely. If it remains blocked, the patient must endure the pain and have a large boy forcefully suck out the accumulated milk, spitting it out immediately. After three to five times, relief is invariably achieved, without the need to consult a doctor. As for Ru Ju (Deep Breast Abscess), Ru Yan (Breast Cancer), and Ru Pi (Breast Nodule/Hyperplasia), the symptoms vary, and treatments differ. This requires renowned physicians to calmly observe and understand, relying primarily on decoctions, which are beyond the capability of general surgeons to effect a cure.

Pediatric "Jie Lu" (Delayed Closure of Fontanelle with Enlarged Head) occurs because the kidney qi is weak in childhood, and the brain marrow is insufficient, failing to consolidate, leading to an enlarged head. It is advisable to urgently administer Di Huang Wan (Rehmannia Pill) to tonify. Zhai's "You Ke Fa Hui" states: A child had four split sutures on the head, with tight, shiny skin and very small eyes. Wan Quan said: The brain is the sea of marrow. The Kidneys govern bones and marrow; if latent fire exists within, it causes heat in the marrow, leading to skull splitting, a large forehead, and small eye sockets. Administration of Di Huang Wan is appropriate. The parents did not believe this, and the child died at age fourteen. My clan's grand-nephew suffered from Jie Lu with a large head and small face in childhood, and died at sixteen. My commentary notes: Tortoise Shell (Gui Ban) treats unclosed fontanelles in children; adding it to Di Huang for decoction seems even more effective.

To treat pediatric Jing Feng (Convulsions), Sha Xue Wan uses Cinnabaris (Zhu Sha) and Hydrargyrum Chloridum Corrosivum (Qing Fen) each one qian, Bombyx Batryticatus (Jiang Can) ten pieces, and Scorpio (Quan) three pieces. These are pounded together with insects found in Artemisia Annua nodes (Qing Hao Jie Zhong Chong) and formed into pills, ground fine, and taken with human milk. This prescription is traditionally considered miraculous. My commentary notes: Qing Fen is acrid, dry, and toxic. If treated improperly, its toxicity may invade the meridians, causing other diseases with severe consequences. It is better to use powder of Qing Hao Chong mixed with Equisetum Hiemale Ash (Deng Cao Hui) dissolved in human milk for oral administration, or to feed it to the child. Alternatively, when the child sleeps, blow the mixture of Qing Hao Chong powder and Deng Cao Hui into the mouth using a copper tube. This method is simple and ingenious, yielding frequent success, and should not be ignored.

Yu Jiayan in "Wen Zheng Lang Zhao" states: For any child with fever and vomiting, if pox (smallpox/variolae) have not yet erupted, careful examination is required. One must not mistakenly use warming stomach medications. A neighbor, Song Hou, was an elderly father who indulged in food without restraint. He always took Xiang Sha Ping Wei San (Aucklandia and Amomum Powder to Pacify the Stomach) with great effect. One night, pox erupted accompanied by vomiting. He mistakenly took the previous medicine, resulting in red veins crisscrossing his entire head, dense spots clustering with exposed vessels, known as "Melon Vine Spots." The nephew of a Shangrao minister, selected as a tribute student in his youth, returned from a banquet with erupting pox and vomiting. His father administered Huo Xiang Zheng Qi Wan (Patchouli Powder to Rectify the Qi). Within one night, three black ding (carbuncles) appeared on the tongue, shaped like sharp chestnuts, and four yellow ding appeared under the tongue, shaped like milk drops. This occurred because the pox pathogen was trying to emerge but was blocked by the medication, leading to such ominous changes. This serves as a warning. My commentary notes: Children's illnesses often involve heat pathogens; warming and drying medicines should be used with caution, not only for pox cases. Recalling my time in Hangzhou, the son of a clerk surnamed Zhang, aged ten, contracted summerheat in summer, presenting with fever, aversion to cold, and anorexia. The doctor prescribed Huo Xiang Zheng Qi Wan, leading to intense heat, coma, scorched lips and tongue, and hemorrhage from the mouth and nose, resulting in death. Nie Jiu Ke in "Huo You Xin Fa" states: After prolonged vomiting in children, stomach qi is severely deficient, qi fails to return to its origin, and yang floats externally. This presents with red face, hot head, body heat, and thirst, resembling a heat syndrome. Quack doctors mistake this for heat and administer cooling medicines, killing patients as easily as flipping a hand. Therefore, when treating vomiting and diarrhea with ineffective medication, it is better to err on the side of warming and tonifying than cooling. Erring on warming and tonifying allows for potential rescue; erring on cooling brings rapid disaster that cannot be saved. My commentary notes: This view contradicts Yu's previous discussion. Reading both reveals merit in each; the key lies in accurate syndrome differentiation. Generally, early-stage symptoms of fever, thirst, and vomiting usually involve heat pathogens. However, fever and thirst recurring after vomiting often indicate deficiency-cold.

The guardian of life, Kong Yaliu, a learned scholar from our county, had a eldest daughter who cried once upon birth and then fell silent. Consulting medical texts, a cat was caught, wrapped in cloth, and brought near the girl's ear to bite the cat's ear through the cloth. The cat screamed loudly, and the girl cried in response. She recovered fully and later married and had children. This is what ancient texts call a "forbidden prescription," whose mechanism is unfathomable. "Yi Xue Ru Men" states: Infants crying frequently within the first month dissipate fetal heat, fetal toxins, and fetal fright, preventing strange diseases. Shen Qianlü agreed with this view, stating that infant crying should be handled by gently holding the baby, allowing them to cry until they stop naturally. One must not forcibly restrain them or make them suckle to stop crying. If no other illness exists, medication is unnecessary. I agree, but some crying stems from other causes. In Hangzhou, the daughter of Le Huaigu, still in swaddling clothes, cried incessantly. Patting her made her cry harder. Upon undressing her back, a sewing needle was seen slightly protruding with thread, while the rest was embedded in flesh. Doctors treated her with various topical applications, causing tissue ulceration, but the needle remained stuck for over 100 days. A wine seller provided a formula: remove the skin and heart of Ginkgo Biloba seeds (Yin Xing Ren), pound them into a paste, soak in rapeseed oil for a long time, and drip the oil into the wound. The needle eventually emerged through the wound, bent because it had been forced in during patting. Additionally, Zeng Shirong treated the son of Commander Wang on a boat. The child had a headache, red forehead, unresponsive to various treatments, and cried loudly upon movement. Careful examination revealed a small bamboo splinter from the boat canopy pierced into the skin above the fontanelle. Removal with tweezers cured him. Thus, if a child's crying differs from the norm, careful observation is essential. One should not indiscriminately medicate, nor simply ignore the crying.