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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.)