产后月水不通者，不必药也。妇人冲任之脉，为经络之海，皆起胞内。手太阳、手少阴二经，上为
乳汁，下为月水。若产后去血过多，常有月水不通。若乳子者，半岁一岁之内，月经不行，此犹常候。
若半岁左右便行，是必少壮血盛之人。若产
后一二年月经不通，无他疾苦，亦不必服通经之药。盖因劳伤营卫，冲任脉虚，气血衰少耳。但服健脾
胃及滋补气血之药，自然通行。若强通之，是犹揠苗者也。
新产半月左右，忽发痈肿于四肢、胸腹者，是败血不尽，流滞经络。或气血虚弱，营气不从，逆于肉
理也。如败血瘀滞者，则 肿赤痛，而脉弦洪有力，当补血行血之中，佐以导瘀疏气为主。如气血虚弱，
营涩卫逆者，则平塌散漫，而脉虚微无力，当大补气血为主。如十全、八珍之属，以固本元，扶胃气。气
壮血和，其毒自解。若以毒治，而用清凉解毒，势必不脓不溃，变成坏证矣。
产妇冲任血旺，脾胃气壮，则乳足而浓，乃生化之源旺也。如无他证但少乳，是气血滞，用行气下乳
汤。若脾胃气弱，饮食少进，冲任素亏，其人面必黄色，则乳少而薄，所乳之子，亦怯弱而多病。务服滋
养气血，兼通利之剂，宜十全大补汤
加红花五分，或四物汤加茯苓、花粉、甘草、王不留行、麦冬、漏芦、穿山甲、通草，猪蹄汁煎服。如
既服通利之药，亦无大效，仍然乳少，系此妇气血亏甚，津液短少，何以为乳？须另觅乳母可耳。至于
选乳母之法，择其人肥瘦适中，无病经调善食者佳。太肥则多痰，太瘦则多火，儿饮其乳，亦复如是。
且人乳原无定性，随饮食性气而变。故饮食之调摄，乳母又不可不慎也。但凡乳汁，须要验其浓白光彩，
入盏中，上面莹然如玉为上，白色清薄为下，不可使之哺儿也。至于产后乳汁不行，身体壮热，头目昏
痛，或乳下发热身痛，玉露散主之。世有产妇气血旺而壅滞不行者，法当疏而通之，生化汤加木香、青
皮、白芷、花粉、穿山甲煎服。又有用麦冬、栝蒌仁、天花粉、人参、葵子、猪胰、木通、漏芦、猪蹄
之类，煮食而乳行矣。再考《全书》内，治肥盛妇人，痰气壅结，乳汁不行，用漏芦汤利之。至于血气虚而
燥涩阻滞不行者，宜十全、八珍之类，补其虚而自行。《全书》内有猪蹄汤二方，治气血不足，乳汁不行。
如脾虚饮食少无乳，宜香砂四君子汤。若乳将至而未得通畅者，宜猪蹄羹、涌泉散。若夫乳汁自出者，乃
阳明胃气不固，亦宜八珍或十全补之。若阳明血热而溢者，宜保阴煎或四君子加栀子。若肝经怒火上冲，
乳胀而溢者，宜
加减一阴煎。若乳多胀满而溢者，不必服药，宜温帛熨而散之。若未产而乳自出，谓之乳泣，生子多不
育。若产妇劳役，乳汁涌下，此阳气虚而厥也，独参汤主之。
行气下乳汤 治产妇气血滞，无他证，但少乳。
生地 当归 川芎（各一钱） 白术（土炒） 茯苓（各六分） 制香附 陈皮 红花（各五分）
穿山甲（三片，炒） 木香（二分）
水、酒各半，煎服。
玉露散 治乳汁不行，身体壮热，头目晕痛属虚者。
人参 茯苓 当归 白芍（炒） 桔梗（各一钱） 川芎 柴胡 炙草（各六分）
水煎服。《准绳》及《全书》俱无柴胡，有白芷一钱，参、苓、归、草各五分，炒白芍七分，
桔梗、川芎各一钱。
漏芦汤 治产妇肥盛，脉气壅结乳少。
漏芦（一两） 蛇蜕（一条） 土瓜根
共为末，酒调下二钱。此方峻厉不宜用。录之以备参考耳。
猪蹄汤 治产妇气血不足，乳汁不下。用八珍汤料，加炙黄 、漏芦、陈皮、木通，
先用猪蹄一副，煮汁二碗，煎药服之。或加天花粉。
又方
川芎（一两） 通草（二两） 甘草（一钱） 穿山甲（十四片，炒）
用猪蹄一副，洗切，入水六碗，同药煎至三碗，加葱姜盐料，取汁饮之，助其气血，乳汁自下。夏
月不可失盖，时用葱汤洗乳为佳，忌生冷食物。
香砂四君子汤 治产妇脾虚，食少无乳。
人参 白术（土炒） 茯苓 麦冬（去心。各八分） 当归（一钱） 陈皮 制香附 砂仁
红花 炙草（各四分）
水煎服。
通草猪蹄羹
猪蹄（一只） 通草（四两）
水煮去一半，饮汤，兼服涌泉散即通。
涌泉散
王不留行 瞿麦 麦冬 龙骨（ ） 穿山甲（炒。各等分）
上为末，每服一钱，热酒调下，饮猪蹄羹少许。以油木梳在两乳上，梳二三十梳。日二服，俱如前梳
法即通。一方无穿山甲，用猪蹄汁一碗，酒一杯，煎服。
以木梳于乳上照前法梳之。
加减一阴煎 治水亏火胜。
生地 白芍（炒） 麦冬（去心。各二钱） 熟地（三五钱） 知母（炒） 地骨皮（各一钱）
炙草（五七分）
水煎服。
独参汤 治产后乳汁涌下。
人参（随证多少用之）
水煎浓汤，作茶饮。
十全大补汤（见上卷胎不长养门。） 四物汤（见上卷安胎门。） 生化汤（见本卷
生化汤论后。） 八珍汤（见上卷诸痛门。） 保阴煎（见上卷恶露不止门。） 四君
子汤（见上卷胎逆上逼门。）
For postpartum amenorrhea (cessation of menstruation), medication is not necessary. The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) in women are the seas of the collaterals and meridians, both originating from within the Bao Gong (Uterus). The Hand-Taiyin Intestinal Meridian and the Hand-Shaoyin Heart Meridian transform upwards into breast milk and downwards into menstrual blood. If excessive blood loss occurs after childbirth, amenorrhea often ensues. For women who are breastfeeding, the absence of menstruation within six months to one year is still a normal physiological state. If menstruation resumes around half a year postpartum, it indicates a woman who is young, vigorous, and has abundant blood. If menstruation remains absent for one or two years postpartum without other discomforts, there is no need to take medicines that promote menstruation. This is due to fatigue damaging Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi), leading to deficiency of the Chong and Ren vessels, and depletion of Qi and Blood. Simply taking medicines to strengthen the Spleen and Stomach and nourish Qi and Blood will naturally restore flow. Forcing menstruation would be akin to pulling up seedlings to help them grow.
Around half a month after childbirth, sudden carbuncles or swellings appearing on the limbs, chest, or abdomen indicate that lochia (postpartum discharge) is incomplete, causing stagnant blood to flow and lodge in the collaterals and meridians. Alternatively, it may result from weak Qi and Blood, where Ying Qi fails to follow its course and rebels against the muscle tissue. In cases of stagnant blood and blood stasis, symptoms include swelling, redness, and pain, with a wiry, surging, and forceful pulse. Treatment should focus on nourishing and moving blood, assisted by methods to guide out stasis and regulate Qi. In cases of weak Qi and Blood, with stagnant Ying Qi and rebellious Wei Qi, symptoms present as flat, diffuse swellings with a faint, minute, and forceless pulse. Treatment should primarily involve strongly tonifying Qi and Blood, using formulas such as Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction) or Bazhen Tang (Eight Treasures Decoction) to consolidate the root Yuan Qi and support Stomach Qi. When Qi is strong and Blood is harmonious, the pathogenic factor resolves spontaneously. Using cold-natured herbs to clear heat and detoxify will inevitably prevent suppuration and ulceration, resulting in a deteriorated condition.
When a parturient’s Chong and Ren vessels have abundant blood and her Spleen and Stomach Qi are strong, breast milk will be sufficient and thick, indicating robust generation and transformation sources. If there are no other syndromes but only scant milk, it is due to stagnation of Qi and Blood; use Xingqi Xuru Tang (Qi-Regulating Lactation-Decreasing Decoction). If Spleen and Stomach Qi is weak, food intake is low, and the Chong and Ren vessels are chronically deficient, the complexion will likely be sallow; the milk will be scant and thin, and the nursing infant will be frail and prone to illness. It is essential to administer agents that nourish Qi and Blood while promoting flow. Suitable prescriptions include Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction) plus 5 fen of Honghua (Carthami Flos), or Siwu Tang (Four Substances Decoction) plus Fuling (Poria), Tianhuafen (Trichosanthis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Wangbuliuxing (Vaccariae Semen), Maidong (Ophiopogonis Radix), Loulu (Euphorbiae Humifusae Herba), Chuanshanjia (Manis Squama), Tongcao (Tetrapanacis Medulla), decocted in pig trotter juice. If lactation-promoting medicines yield little effect and milk remains scant, it signifies severe deficiency of Qi and Blood and shortness of Jin Ye (Body Fluids); how can milk be produced? A wet nurse must be sought. Regarding the selection of a wet nurse, choose someone of moderate build, free from disease, with regular menstruation and good appetite. Excessive fatness leads to Phlegm-Dampness; excessive thinness leads to Deficiency-Fire; if the infant drinks such milk, similar conditions may arise. Human milk lacks fixed nature and changes according to dietary properties. Therefore, dietary regulation for the wet nurse must not be neglected. All breast milk should be tested for thickness, whiteness, and luster; when poured into a cup, milk that appears crystal clear like jade is superior, while thin, white, watery milk is inferior and should not be used to feed the infant. For postpartum agalactia accompanied by high fever, dizziness, headache, or heat and body ache below the breasts, Yulu San (Jade Dew Powder) is indicated. In cases where a parturient has abundant Qi and Blood but suffers from congestion and stagnation preventing flow, the method is to soothe and unblock; use Shenghua Tang (Generate the Old Transform into New Decoction) plus Muxiang (Aucklandiae Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Baizhi (Angelicae Dahuricae Radix), Tianhuafen (Trichosanthis Radix), and Chuanshanjia (Manis Squama), decocted and taken orally. Other remedies include decocting and consuming Maidong (Ophiopogonis Radix), Gualouren (Benincasae Semen), Tianhuafen (Trichosanthis Radix), Renshen (Ginseng Radix), Kuizi (Abutilonis Semen), Zhu Yi (Pancreas Porci), Mutong (Akebiae Caulis), Loulu (Euphorbiae Humifusae Herba), and pig trotters to induce lactation. Further consulting the *Quan Shu*, for obese women with Phlegm-Qi congestion obstructing lactation, Loulu Tang (Loulu Decoction) is used to drain the obstruction. For cases where Qi and Blood deficiency causes dryness, astringency, and stagnation preventing flow, tonify the deficiency with Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction) or Bazhen Tang (Eight Treasures Decoction) to allow natural flow. The *Quan Shu* contains two recipes for Zhuti Tang (Pig Trotter Decoction) treating agalactia due to Qi and Blood insufficiency. For Spleen deficiency with poor appetite and no milk, Xiangsha Six Junzi Tang (Aucklandia and Amomum Six Gentlemen Decoction) is suitable. For impending lactation that is not yet smooth, Zhuti Geng (Pig Trotter Broth) and Yongquan San (Surging Spring Powder) are appropriate. For spontaneous leakage of milk, it is due to insecurity of Yangming Stomach Qi; tonify with Bazhen Tang (Eight Treasures Decoction) or Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction). For overflow due to Heat in the Yangming Blood, use Baoyin Jian (Protect Yin Decoction) or Six Junzi Tang (Six Gentlemen Decoction) plus Zhizi (Gardeniae Fructus). For distension and overflow caused by Liver Fire rebelling upward, use Jiajian Yiyin Jian (Modified One-Yin Decoction). For fullness and overflow due to excessive milk, medication is unnecessary; apply warm cloth compresses to dissipate the swelling. Spontaneous milk secretion before delivery is called Ru Qi (Breast Weeping); children born under this sign are often infertile. If a parturient experiences gushing milk due to overwork, it indicates Yang Qi deficiency with Jue (Cold Reversal); treat with Dushen Tang (Single Ginseng Decoction).
Xingqi Xuru Tang: Treats postpartum Qi and Blood stagnation with no other syndromes, only scant milk.
Shengdi (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 1 qian); Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Fuling (Poria) (each 6 fen); Zhi Xiangfu (Cyperi Rhizoma prepared), Chenpi (Citri Reticulatae Pericarpium), Honghua (Carthami Flos) (each 5 fen); Chuanshanjia (Manis Squama, 3 slices, fried); Muxiang (Aucklandiae Radix) (2 fen).
Decoct with half water and half wine, and take orally.
Yulu San: Treats agalactia with high fever, dizziness, and headache due to deficiency.
Renshen (Ginseng Radix), Fuling (Poria), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba, fried), Jiegeng (Platycodonis Radix) (each 1 qian); Chuanxiong (Ligustici Chuanxiong Rhizoma), Chaihu (Bupleuri Radix), Zhigancao (Glycyrrhizae Radix et Rhizoma preparata) (each 6 fen).
Decoct with water and take orally. *Zhunsheng* and *Quan Shu* do not list Chaihu; they list Baizhi (Angelicae Dahuricae Radix) 1 qian, Renshen, Fuling, Danggui, Zhigancao each 5 fen, fried Baishao 7 fen, Jiegeng and Chuanxiong each 1 qian.
Loulu Tang: Treats agalactia in obese parturients with congested pulse and Qi stagnation.
Loulu (Euphorbiae Humifusae Herba) (1 liang), Shetui (Bomby Batryticatus), Tugua Gen (Polymniae Radix).
Grind into powder, mix with wine, and take 2 qian. This formula is harsh and should not be used; recorded here for reference only.
Zhuti Tang: Treats agalactia due to Qi and Blood insufficiency. Use ingredients of Bazhen Tang (Eight Treasures Decoction), plus Zhi Huangqi (Astragali Radix preparata), Loulu (Euphorbiae Humifusae Herba), Chenpi (Citri Reticulatae Pericarpium), Mutong (Akebiae Caulis). First, boil one pig trotter to obtain two bowls of broth, then decoct the herbs in it and take orally. Alternatively, add Tianhuafen (Trichosanthis Radix).
Another prescription:
Chuanxiong (Ligustici Chuanxiong Rhizoma) (1 liang), Tongcao (Tetrapanacis Medulla) (2 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian), Chuanshanjia (Manis Squama, 14 slices, fried).
Take one pig trotter, wash and cut, add six bowls of water, decoct with the herbs until three bowls remain. Add scallion, ginger, salt, and seasonings, strain the juice, and drink to boost Qi and Blood, allowing milk to flow. Do not neglect covering in summer; washing breasts with scallion water is beneficial. Avoid raw and cold foods.
Xiangsha Six Junzi Tang: Treats postpartum Spleen deficiency with poor appetite and no milk.
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Fuling (Poria), Maidong (Ophiopogonis Radix, heart removed) (each 8 fen); Danggui (Angelicae Sinensis Radix) (1 qian); Chenpi (Citri Reticulatae Pericarpium), Zhi Xiangfu (Cyperi Rhizoma prepared), Sharen (Amomi Fructus), Honghua (Carthami Flos), Zhigancao (Glycyrrhizae Radix et Rhizoma preparata) (each 4 fen).
Decoct with water and take orally.
Tongcao Zhuti Geng:
Zhuti (Pig Trotter) (one piece), Tongcao (Tetrapanacis Medulla) (4 liang).
Boil water until reduced by half, drink the soup, and simultaneously take Yongquan San (Surging Spring Powder) to achieve flow.
Yongquan San:
Wangbuliuxing (Vaccariae Semen), Qumai (Dianthi Herba), Maidong (Ophiopogonis Radix), Longgu (Fossilia Ossis Mastii calcined), Chuanshanjia (Manis Squama, fried) (equal parts).
Grind into powder. Take 1 qian per dose, mixed with hot wine. Drink a small amount of Pig Trotter Broth. Comb the breasts twenty to thirty times with an oiled wooden comb. Take twice daily, following the combing method as described. Another version excludes Chuanshanjia; decoct one bowl of pig trotter juice with one cup of wine and take orally. Comb the breasts with a wooden comb as described above.
Jiajian Yiyin Jian: Treats Water deficiency with Fire excess.
Shengdi (Rehmanniae Radix), Baishao (Paeoniae Radix Alba, fried), Maidong (Ophiopogonis Radix, heart removed) (each 2 qian); Shudi (Rehmanniae Radix Preparata) (3-5 qian); Zhimu (Anemarrhenae Rhizoma, fried), Digupi (Borriciae Cortex) (each 1 qian); Zhigancao (Glycyrrhizae Radix et Rhizoma preparata) (5-7 fen).
Decoct with water and take orally.
Dushen Tang: Treats postpartum gushing of milk.
Renshen (Ginseng Radix) (dose varies according to syndrome).
Decoct with water to make a concentrated decoction, drink as tea.
Shiquan Dabu Tang (See Volume Upper, Section on Failure of Fetal Growth). Siwu Tang (See Volume Upper, Section on Fetus Stabilization). Shenghua Tang (See this volume, after the discussion on Shenghua Tang). Bazhen Tang (See Volume Upper, Section on Various Pains). Baoyin Jian (See Volume Upper, Section on Persistent Lochia). Six Junzi Tang (See Volume Upper, Section on Fetal Reversal Upward Pressure).