大全云∶妇人乳汁乃气血所化，其或不行者，皆由气血虚弱，经络不调所致，凡乳汁勿
令投于地，虫蚁食之，令乳无汁，若乳盈溢，可泼东壁上佳。或产后乳涨，或 作者，此年
少之人初经产乳，内有风热也，须服清利之药则乳行。若累经产而无乳者，亡津液故也，须
服滋阴之药以助之。若虽有乳，却又不甚多者，须服通经之药以动之，仍以羹 引之。盖
妇人之乳，资以冲脉，冲与胃经通故也。有屡经产而乳汁常多者，亦妇人血气不衰使然，若
妇人素有疾在冲任，乳汁少而色带黄者，生子则怯弱而多疾。
三因方云∶产妇有二种乳脉不行，有血气盛而壅闭不行者，有血少气弱涩而不行者，虚
当补之，盛当疏之，盛者当用通草、漏芦、土瓜根辈，虚者当用炼成钟乳粉（钟乳原从气化而
成，故取之，以天人合气也，微乎微乎）、猪蹄、鲫鱼之属，概可见矣。
薛氏曰∶前证若气血虚弱而不能生化者，宜壮脾胃；怒动肝胆而乳肿汁出者，宜清肝
火。夫乳汁乃气血所化，在上为乳，在下为经，若屡产无乳，或大便涩滞，当滋化源。
一产妇因乳少，服药通之，致乳房肿胀，发热作渴，余谓血气虚，以玉露散补之而愈。
通草散 治产后血气盛实，乳汁不通。（以下五方皆治盛实壅滞，各有经济法度，宜
熟味之）
桔梗（二钱） 瞿麦 柴胡 天花粉（各一钱）
通草（七分） 青皮 白芷 赤芍药 连翘 木通 甘草（各五分）
上锉一剂，水煎细饮，更摩乳房。
漏芦散 治妇人肥盛，气脉壅滞，乳汁不通，或经络凝滞，乳内胀痛，或作痈肿，将欲成
者。此药服之，自然内消，乳汁通行。
漏芦（一两半） 蛇蜕（炙，十条） 栝蒌（十枚，急火 存性。一方用根十枚。切片炒焦）
上为末，每服二钱，酒调下，仍食猪蹄羹助之。经验方有牡蛎烧存性（此厥阴阳明药，
加牡蛎尤奇）。一方只用牡蛎 末，酒调下。
秘传涌泉散 治乳妇气脉壅塞，乳汁不行，及经络凝滞，奶乳胀痛，或作痈肿。
王不留行 白丁香 漏芦 天花粉 僵蚕 穿山甲（火炮黄色，各等分，一方无此味）
上为末，每服四钱，用猪悬蹄煮汁调下。（此散结通塞剂也，而白丁香宜查）
罗氏涌泉散 治气滞少乳。
瞿麦穗 麦门冬（去心） 王不留行 龙骨 穿山甲（炮黄，各等分）
上为细末，每服一钱，热酒调下，先食猪悬蹄羹，后服此药，服后以木梳刮左右乳房三
十余下，日三服（立斋方无穿山甲，而以猪蹄汁一碗，酒一杯煎服。其用龙骨与气滞何居，
意以通中用塞也。取义而已）。忌食姜椒辛辣之物。
涌泉散 治乳汁不通。不问虚盛，先用木梳频刮乳房，后服药。
穿山甲 白僵蚕 肉豆蔻（面包煨熟，各四钱） 皂角（五钱） 胡桃仁（去皮。四两） 芝麻（炒，半斤）
上为细末，每服不拘多少，温酒调下，任意饮之。（涌泉三方，俱有奇药，而此以穿山、
僵蚕、皂角通塞，胡桃、芝麻生乳，若肉豆蔻者，其善温胃化食者欤，可与智者生巧）
产宝方 治产后乳无汁。
土瓜根 漏芦（各三两） 通草（四两） 甘草（二两）
上锉碎。以水八升煎取二升，分温三服
（若为乳无汁须以补气血为主，而此以土瓜根桂心通血脉，有冷热不同，全无气血之剂，而
甘草一味又超于法外矣）。一方加桂心，并为末，酒服方寸匕。
胡桃散 治妇人少乳及乳汁不行。
核桃仁（去皮，十个，捣烂） 穿山甲（为末，一钱）
上捣和一处，共酒调服。
皂角散 治乳汁不通及乳结硬疼痛。
皂角（烧粉） 蛤粉
上为末，每服二钱，热酒调服。歌曰∶妇人吹乳意如何，皂角烧灰蛤粉和，热酒一杯调八
字。须臾核散笑呵呵。
张氏方 滋益气脉荣卫，行津液。
葵子（炒香） 缩砂仁（各等分）
上为细末，每服二钱，热酒调下。
杂方 下乳汁。
栝蒌子洗净，炒令香熟，瓦上 令白色为末，酒调下一钱，合面卧，少时再服。
一方 栝蒌一枚熟捣，以白酒一斗煮取四升，去滓，温饮一升，日三。
一方 土瓜根为末，酒调下一钱，日三服。
一方 京三棱三个，水二碗煮取一碗，洗之，取汁下为度，妙。（以洗法通气，又是一法）
一方 穿山甲洗净一两，灰炒燥，为细末，酒调服方寸匕，治产乳无汁，亦治乳结痈肿。
以上治乳滞不行之剂。
加味四物汤 治气血虚，乳汁不通。（以下皆补法，而诸法不同，然会其理，则各臻至
妙也，试法尤为入门便诀）
当归 川芎 白芍药（酒炒） 生地黄 木通 王不留行 天花粉（各等分）
上锉一剂，同 猪蹄旁肉四两，煎汤二钟，入药同服，先将葱汤频洗乳房。（按第一方
以四物不用熟地，第二方合四君而无白术，更去生地，第三方有黄 ，或归或芎或甘草，以
至粳糯米、羊蹄、钟乳，种种更改，皆不出于至中至正之道。噫，其能复超于法外否）
玉露散 治产后乳脉不行，身体壮热疼痛，头目昏痛，大便涩滞，此药凉膈压热下乳。
人参 白茯苓 当归（各五分） 芍药（七分） 川芎 桔梗（炒） 白芷（各一钱） 甘草（五分）
上 咀，水煎，食后服。如热甚，大便秘，加大黄炒三分。
当归补血加葱白汤 治产后无乳。
当归（二钱） 黄 （一两） 葱白（十根）
上锉，水煎服。（此方亦从补法来，而以葱白引入乳房，尤为快捷方式）
通脉散 治女人乳少。
当归 天花粉 木通 牡蛎 穿山甲
上为细末，用猪蹄汤入酒少许调服。
通乳汤 治乳后气血不足，经血衰弱，乳汁涩少。
猪蹄（下节，四只） 通草（二两） 川芎（一两） 穿山甲（十四片，炒黄） 甘草（一钱）
上用水五升煮汁饮之，忌生冷，避风寒，夜卧不宜失盖，更以葱汤频洗乳房。
一方 治乳汁不通。
当归 穿山甲（酥炙，各五钱） 天花粉 王不留行 甘草（各三钱）
上为细末，每服三钱，猪蹄汤或热酒调下，其乳即通。
猪蹄汤 治妇气少力衰，脉涩不行，绝乳汁。
猪蹄（一只） 通草（四两）
上将猪蹄净洗，根据食治法，次用水一斗同通草浸煮，得四五升，取汁饮之，末作二料。
立效散 下乳汁。
粳米 糯米（各半合） 莴苣子（一合，并淘净） 生甘草（半两）
上研细，用水二升煎取一升，去滓，分三服，立下。（全以谷气为主，即糯米又为养阴助
乳之大药也）
又方 治乳汁少。
栝蒌根 薄荷干身（各等分）
上为粗末，先吃羊蹄汁一碗，次服药，后再吃葱丝羊羹汤少许，立效。（羊肉补形，薄荷
葱丝和味，引经通滞）
钟乳散 治乳妇气少血衰，脉涩不行，乳汁绝少，成炼钟乳粉研细，浓煎漏芦汤调下二钱。
杂方 有人乳汁不行已十七日，诸药无效，遇有人送赤豆一斗，遂时常煮粥食之，当
夜乳脉通行。
一方 麦门冬不拘多少，去心，焙为末，以酒磨犀角约一钱许，暖调二钱服之，不过两
服，乳汁便下。（此清心法可为焦劳者一助云，乃又超于法外矣）
以上治乳少不行之剂。
*Daquan* states: Women's milk is transformed from Qi and Blood. If it does not flow, it is caused by deficiency of Qi and Blood and irregularity of the meridians. Milk should never be allowed to drip onto the ground, lest insects and ants consume it, causing the milk to cease; if milk overflows, it may be splashed on the east-facing wall, which is considered auspicious. If there is breast distension after childbirth, or [text unclear/omitted], this occurs in young women experiencing childbirth and lactation for the first time, due to internal wind-heat. One must administer clearing and draining herbs to promote milk flow. If a woman has given birth multiple times yet has no milk, it is due to the loss of body fluids (Jin-Ye); one must administer yin-nourishing herbs to assist. If there is milk but the volume is insufficient, one must administer herbs that unblock the meridians to stimulate secretion, using meat broth as a vehicle (Yin). Generally, women's milk relies on the Chong Mai (Penetrating Vessel), as the Chong Mai connects with the Stomach Meridian. Some women who have given birth multiple times still produce abundant milk; this is also due to their robust Qi and Blood. If a woman has chronic diseases affecting the Chong and Ren Mai (Conception and Directing Vessels), producing scanty yellowish milk, her offspring will be weak and prone to illness.
*San Yin Fang* states: There are two types of milk duct obstruction in postpartum women: one where Qi and Blood are excessive and obstructed, preventing flow; and another where Blood is deficient and Qi is weak, causing sluggish non-flow. Deficiency patterns require tonification, while excess patterns require dispersal. For excess patterns, use herbs such as Tongsao (Herba Clethrae), Loulu (Radix Euphorbiae Humifusae), and Tugegen (Rhizoma Trichosanthis Kirilowii). For deficiency patterns, use refined Zhongru Fen (Stalactitum), pig trotters, and crucian carp. This illustrates the principle clearly.
Xue notes: Regarding the aforementioned symptoms, if they result from Qi and Blood deficiency failing to generate milk, strengthen the Spleen and Stomach. If anger agitates the Liver and Gallbladder causing breast swelling and discharge, clear Liver Fire. Milk is transformed from Qi and Blood; above it manifests as milk, below it manifests as menstruation. If there is no milk after multiple births, or if bowel movements are constipated, nourish the source of transformation.
A postpartum patient, due to scanty milk, took herbs to promote flow, resulting in breast swelling, fever, and thirst. I diagnosed this as Qi and Blood deficiency and treated her with Yulu San (Jade Dew Powder) for tonification, leading to recovery.
Tongsao San (Clethra Decoction): Treats postpartum excess of Qi and Blood with obstructed milk flow. (The following five formulas all treat excess stagnation, each with specific methods; study them carefully.)
Jiegeng (Radix Platycodonis, 2 qian), Qumai (Herba Dianthi), Chaihu (Radix Bupleuri), Tianhuafen (Radix Trichosanthis, 1 qian each).
Tongsao (Herba Clethrae, 7 fen), Qingpi (Pericarpium Citri Reticulatae), Baizhi (Radix Angelicae Dahuricae), Chi Shaoyao (Radix Paeoniae Rubra), Lianqiao (Fructus Forsythiae), Mutong (Caulis Akebiae), Gancao (Radix Glycyrrhizae, 5 fen each).
Decoct one dose, drink slowly, and massage the breasts.
Loulu San (Euphorbia Decoction): Treats obese women with stagnant Qi and blood vessels, obstructed milk flow, or coagulated meridians causing breast pain/swelling or impending abscesses. This formula naturally resolves internal stagnation and promotes milk flow.
Loulu (Radix Euphorbiae Humifusae, 1.5 liang), Shetui (Exuviation Bombycis, roasted, 10 strips), Gualou (Fructus Trichosanthis, 10 pieces, quick-fire processed to retain nature. Alternative: 10 roots, sliced and charred).
Pulverize. Take 2 qian per dose, mixed with wine, and consume pig trotter soup to assist. Empirical formulas include Musli (Concha Ostreae) roasted until carbonized (a Jueyin/Yangming herb; adding Oyster Shell is particularly ingenious). Another method uses only Musli powder mixed with wine.
Secretly Transmitted Yongquan San (Springing Spring Powder): Treats lactating women with congested Qi and blood vessels, obstructed milk flow, coagulated meridians, breast swelling/pain, or abscess formation.
Wangbuliuxing (Semen Vignae), Bai Dingxiang (Faeces Domesticus Galli), Loulu, Tianhuafen, Jiangcan (Bombyx Batryticatus), Chuanshanjia (Squama Manis, fire-roasted to yellow, equal parts; alternative excludes this ingredient).
Pulverize. Take 4 qian per dose, mixed with juice boiled from pig trotters (Xuanti). (This is a formula for dissipating nodules and unblocking obstructions, but the use of Bai Dingxiang requires verification.)
Luo's Yongquan San: Treats scanty milk due to Qi stagnation.
Qumai Sui (Spica Dianthi), Maimendong (Radix Ophiopogonis, heart removed), Wangbuliuxing, Longgu (Os Draconis), Chuanshanjia (fire-roasted to yellow, equal parts).
Pulverize finely. Take 1 qian per dose, mixed with hot wine. First eat pig trotter soup, then take this medicine. After taking it, scrape both breasts with a wooden comb more than thirty times. Take three times daily. (Lizhai's formula lacks Chuanshanjia, instead using one bowl of pig trotter juice and one cup of wine decocted together. The use of Longgu in Qi stagnation is puzzling; perhaps it implies "using astringency within unblocking." It is merely symbolic.) Avoid ginger, pepper, and spicy foods.
Yongquan San: Treats obstructed milk flow. Regardless of deficiency or excess, first frequently scrape the breasts with a wooden comb, then take the medicine.
Chuanshanjia, Bai Jiangcan (Bombyx Batryticatus), Roudoukou (Semen Myristicae, baked in dough until cooked, 4 qian each), Zaojiao (Fructus Gleditsiae Sinensis, 5 qian), Hetaoren (Semen Juglandis, peeled, 4 liang), Zhima (Semen Sesami, fried, half jin).
Pulverize finely. Take any amount, mixed with warm wine. (All three Yongquan formulas contain unique herbs; this one uses Chuanshanjia, Jiangcan, and Zaojiao to unblock, and Hetaoren and Zhima to generate milk. As for Roudoukou, it likely warms the stomach and transforms food. This invites wisdom and ingenuity.)
Chanbao Fang: Treats absence of milk after childbirth.
Tugegen (Rhizoma Trichosanthis Kirilowii), Loulu (equal parts, 3 liang each), Tongsao (4 liang), Gancao (2 liang).
Chop and crush. Decoct in 8 sheng of water to obtain 2 sheng. Divide into three warm doses.
(Note: If the cause is lack of milk, tonifying Qi and Blood should be primary. This formula uses Tugegen and Guixin (Cortex Cinnamomi) to move blood vessels, differing in cold/heat properties, and lacks Qi/Blood tonics. Gancao alone exceeds standard methodology.) Another method adds Guixin, pulverizes all, and takes with wine using a square-inch measure.
Hetao San (Walnut Decoction): Treats scanty milk and obstructed flow in women.
Hetaoren (Walnut Kernel, peeled, 10 pieces, pounded), Chuanshanjia (powder, 1 qian).
Mix and pound together, take mixed with wine.
Zaojiao San (Gleditsiae Decoction): Treats obstructed milk flow and hard, painful breast nodules.
Zaojiao (burnt to powder), Haifen (Calcaria Conchae).
Pulverize. Take 2 qian per dose, mixed with hot wine. Verse: "What is the matter with blowing milk in women? Mix burnt Gleditsiae ash with clam powder. Mix eight characters with a cup of hot wine. Soon the lump scatters, laughing heartily."
Zhang's Formula: Nourishes Qi, strengthens meridians, Ying and Wei, and moves body fluids.
Kuizi (Semen Malvae Verticillatae, fragrant-fried), Suosharen (Semen Amomi Rotundus, equal parts).
Pulverize finely. Take 2 qian per dose, mixed with hot wine.
Miscellaneous Formulas: Promotes milk flow.
Wash Gualouzi (Fructus Trichosanthis seed), fry until fragrant and ripe, bake on tile until white, pulverize. Take 1 qian mixed with wine. Lie face down, take again shortly after.
Another method: Pound one ripe Gualou, boil in 1 dou of white wine to obtain 4 sheng. Strain, drink 1 sheng warm, three times daily.
Another method: Pulverize Tugegen, take 1 qian mixed with wine, three times daily.
Another method: Use 3 Jing Sanleng (Rhizoma Sparganii), boil in 2 bowls of water to obtain 1 bowl. Wash the breasts with this juice, then drink the remaining liquid until flow resumes. Excellent. (Using washing to move Qi is another method.)
Another method: Clean 1 liang of Chuanshanjia, roast in ashes until dry, pulverize. Take 1 square-inch measure mixed with wine. Treats absent milk after childbirth and breast abscesses/nodules.
These are formulas for treating stagnant, non-flowing milk.
Jiawei Siwu Tang (Modified Four Substances Decoction): Treats Qi and Blood deficiency with obstructed milk flow. (Below are all tonifying methods, varying in approach, but understanding the principle leads to perfection. These are convenient keys for beginners.)
Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Baishaoyao (Radix Paeoniae Alba, wine-fried), Shengdihuang (Radix Rehmanniae Preparata), Mutong, Wangbuliuxing, Tianhuafen (equal parts).
Decoct one dose with 4 liang of pork cheek meat, boil to yield 2 zhong of soup. Add herbs and take together. First, frequently wash breasts with green onion soup. (Note: The first formula uses Siwu Tang without Shudi; the second combines Si Jun Zi Tang without Baizhu and removes Shengdi; the third includes Huangqi, or Danggui, Chuanxiong, or Gancao, extending to Jingsimi, Yangti, Zhongru. All variations stay within the orthodox path. Alas, can anything truly exceed the standard?)
Yulu San (Jade Dew Powder): Treats postpartum milk obstruction, high fever and body pain, dizziness/headache, constipation. This formula clears the chest, suppresses heat, and promotes milk flow.
Renshen (Radix Ginseng), Baifuling (Poria, 5 fen each), Danggui (5 fen), Shaoyao (7 fen), Chuanxiong, Jiegeng (fried), Baizhi (1 qian each), Gancao (5 fen).
Chop, decoct in water, take after meals. If heat is severe and constipation exists, add 3 fen of fried Dahuang (Radix et Rhizoma Rhei).
Danggui Buxue Tang plus Congbai (Angelica Tonifying Blood Decoction with Green Onion White): Treats absent milk after childbirth.
Danggui (2 qian), Huangqi (Radix Astragali, 1 liang), Congbai (Green Onion White, 10 stalks).
Chop, decoct in water, take orally. (This formula also derives from tonification, using Congbai to guide action to the breasts, making it particularly rapid.)
Tongmai San (Unblocking Pulse Powder): Treats scanty milk in women.
Danggui, Tianhuafen, Mutong, Muli (Concha Ostreae), Chuanshanjia.
Pulverize. Take mixed with pig trotter soup and a little wine.
Tongru Tang (Milk-Promoting Decoction): Treats insufficiency of Qi and Blood after childbirth, weakened menstruation, and scanty/sluggish milk.
Pig trotters (lower joints, 4 pieces), Tongsao (2 liang), Chuanxiong (1 liang), Chuanshanjia (14 slices, fried yellow), Gancao (1 qian).
Boil in 5 sheng of water, drink the juice. Avoid raw/cold foods, shield from wind/cold, do not uncover at night, and frequently wash breasts with green onion soup.
Another method: Treats obstructed milk flow.
Danggui, Chuanshanjia (fried in butter, 5 qian each), Tianhuafen, Wangbuliuxing, Gancao (3 qian each).
Pulverize. Take 3 qian per dose, mixed with pig trotter soup or hot wine. Milk will flow immediately.
Zhuti Tang (Pig Trotter Soup): Treats women with weak Qi and strength, sluggish pulse, and absent milk.
Pig trotter (1 piece), Tongsao (4 liang).
Clean the trotter thoroughly. Following dietary therapy methods, soak and boil with Tongsao in 1 dou of water to obtain 4-5 sheng. Drink the juice. Prepare two doses.
Lixiao San (Instant Effect Powder): Promotes milk flow.
Jingsmi (Semen Oryzae Glutinosa), Nuomi (Semen Oryzae Japonicae, half he each), Wujuzi (Semen Lactucae Sativae, one he, washed clean), Sheng Gancao (Radix Glycyrrhizae, half liang).
Grind finely, decoct in 2 sheng of water to obtain 1 sheng. Strain, divide into three doses. Immediate effect. (Relies primarily on grain Qi; Nuomi is a major herb for nourishing Yin and assisting milk production.)
Another method: Treats scanty milk.
Gualougen (Radix Trichosanthis), Bohegan (Herba Menthae, equal parts).
Coarsely pulverize. First drink one bowl of lamb trotter juice, then take the medicine, followed by a small amount of green onion silk and mutton soup. Immediate effect. (Mutton nourishes form; Bohe and green onion harmonize flavor, guide channels, and unblock stagnation.)
Zhongru San (Stalactite Powder): Treats lactating women with weak Qi, depleted Blood, sluggish pulse, and extremely scanty milk. Refine Zhongru Fen into fine powder, take 2 qian mixed with thickly decocted Loulu Tang.
Miscellaneous Case: A person suffered from obstructed milk flow for seventeen days with no effect from various medicines. Someone sent ten dou of red beans. She frequently cooked porridge with them and ate it. That night, milk flow resumed.
Another method: Take as much Maimendong as needed, remove heart, bake and pulverize. Grind Xijiao (Cornu Rhinocerotis) in wine to about 1 qian, mix warmly, take 2 qian. Within two doses, milk flows. (This Heart-clearing method aids those exhausted by worry, though it exceeds standard methodology.)
These are formulas for treating scanty, non-flowing milk.