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[Dai Yuanli] Postpartum "chui nai" (blown milk) occurs when the infant falls asleep suddenly while breastfeeding, causing obstruction of milk flow. Milk leaks intermittently but accumulates internally, leading to swelling and hardness, blocking the mammary ducts, obstructing the flow of fluids, resulting in injury, condensation, and pain. There are also cases with no itching or pain, where the breast is swollen and hard as stone, termed "chui nai". If not treated urgently, severe swelling may develop into an abscess. Postpartum chui nai requires urgent treatment; otherwise, it will form an abscess, potentially leading to death. One should quickly administer Zaojiao San (Gleditsia Sinensis Powder) and Gualou San (Trichosanthes Fruit Powder), apply Tiannanxing San (Arisaema Cum Bile Powder) externally, and massage with hands to dissipate the lump.

[Xue Ji] For the aforementioned conditions, medications must not damage Qi and Blood. I have detailed this in the section on Surgical Diseases: Ru Yong (Breast Abscess).

Gualou San Formula
Ruxiang (One qian, ground) Gualou Shi (One fruit)
Grind evenly, decoct with warm wine, and take orally.

Tiannanxing San
Nanxing (Ground into powder)
Mix with warm water, dip a goose feather into the mixture, and apply to the affected area.

Zaojiao San
Song verse: How to treat postpartum blown milk? Burn Gleditsia sinensis to ash, mix with clam powder, adjust eight characters with a cup of hot wine, rub away in moments, laughing happily.
Treats hard lumps and pain in the breasts.
Baiyaojian (Fermented Medicated Leaven) ground into fine powder, take three qian per dose, decoct with one zhan of wine for several boils, take hot.

Hard breasts with pain
Fresh mulberry leaves, ground raw, mixed with rice water, spread on paper flowers, and applied to the swollen area.

[Supplement] Treats postpartum chui nai, solid lumps with swelling and pain.
Use Chenpi (One liang) Gancao (One qian)
Decoct two bowls of water until one bowl remains, divide into two doses. Subsequently, fumigate and wash with a decoction of Jingjie, Qianghuo, and Duhuo, which will dissipate the condition.

The term "du ru" (jealous milk) refers to conditions where, after new childbirth, the infant fails to suckle, or milk does not discharge, or the breasts swell and squeezing does not empty the milk completely. This causes milk to accumulate and condense, battling with Qi and Blood, resulting in high fever, intense thirst requiring drinking, firm and strong pulling pain, and tenderness such that the hand cannot touch it. Upon initial sensation, one should know to use hands to stroke and squeeze out the milk, and ask others to help suckle and guide it. If not done so, it may turn into a sore with pus, and with intense heat, inevitably become an abscess. Mild cases are chui ru or du ru; severe cases are abscesses. Although there are specialized departments, one must not be unaware of this.

Lianqiao Tang treats postpartum du ru and abscesses.
Lianqiao Shengma Mangxiao Xuanshen Shaoyao Bailian Fangfeng Shegan Dahuang Xingren Gancao (Each one qian)
Take as one dose, decoct two zhong of water until one zhong remains, take after meals.

Formula to treat postpartum women whose breasts initially knot and swell without subsiding, allowing stale milk to recede naturally.
Gualou (One fruit, half raw half stir-fried) Dafengcao (One cun, half raw half roasted) Shengjiang (One piece, half raw half baked)
Chop together, decoct one bowl of wine until one zhan remains, remove dregs and take. The pain may become unbearable for a moment, then search out and remove the stale milk. Take another dose before sleep, lying on the side of the affected breast to facilitate the action of the medicine.

Treats postpartum chui ru developing into an abscess.
Kuijing and its seeds
Pound and sieve into powder, take with wine using a fangcun bi measure, and it will heal.

Another formula
Jisigan (Dried chicken manure) ground into powder, take with wine using a fangcun bi measure, take three doses within moments to heal.

Another formula
Take ten strips of Zaojiao, add one sheng of wine, knead to extract juice, add Xiaoshi (Mirabilite) half liang, decoct into a paste and apply.

Formula to treat breast swelling about to form an abscess.
Apply horse urine to it, and it will heal immediately.

[Supplement] Treats postpartum chui nai and du nai, but not yet formed into an abscess, or already an abscess but not yet suppurated.
Manjingzi pounded and taken with wine, still apply the residue to the affected area.

Another formula
Use Chixiaodou (Adzuki bean) pounded with wine, take with warm wine; seal the affected area with the residue.

Another formula
Take one handful of Zhangxianren Cao (Opuntia ficus-indica), one piece of small Jiucao (Wine lees), one large piece of Shengjiang (Fresh ginger), pound together until smooth, add a little Gui (Cinnamon bark) powder and stir-fry, take with wine, leave the residue to compress the affected area.

[Ji Yan] Discussion states: Whenever women have small, superficial, hot sores on the nipples, scratching yields yellow fluid, which spreads and grows, resisting all treatments for months or years, this is named Du Ru disease. The milk of nursing women will all cease, known in the world as Gouchao ru. It is suitable to wash with Chilongpi Tang and Tianma Tang, and applying Erwu Feiwu Gao and Feiwu San is excellent. At the onset, applying Huangqin Lulü San or Huanglian Hufen San is also excellent.

Chilongpi Tang
Hupi (Three sheng, cut)
Decoct one dou of water until five sheng remain, use cold in summer, warm in autumn and winter, divide to wash the breasts.

Tianma Tang
Tianmacao (Five sheng, cut)
Decoct one dan five sheng of water until one dou remains, wash the breasts according to cold or warmth to kill itching. This herb has leaves like hemp, grows in winter, flowers in summer, red like rat-tail flower. It can also be used to wash spreading yellow-rotting hot sores, itch-related abscesses, wet yin erosion sores, and children's head sores. After washing, apply ointment and powder.

Feiwu Gao San Formula
Use black smoke from burning Zhusha (Cinnabar) over mercury (named Weifen, three liang, roasted until dry) Fanshi (Three liang, roasted into powder)
Sift the two ingredients finely through silk, mix with Jiajian (Shellac preparation) to make a paste-like consistency, apply to breast sores, three times daily. For early stages, do not mix; if there is exudate, use the powder directly. Also applies to various hot sores, yellow-rotting spreading fluid sores, honey sores, men's yin erosion with itching and dampness, children's head sores, gan erosion, oral spreading sores, and snake sores, all applied with this.

Another Huanglian Hufen Gao San Formula
Huanglian (Two liang) Hufen (Two and a half liang) Shuiyin (Mercury, one liang, ground together until dispersed)
Pound Huanglian into powder, mix the three substances, wrap in skin and cook熟 (steam/boil) until they combine naturally. Even if not fully combined, at least ensure mercury is finely dispersed into the powder, apply to breast sores, various damp itches, yellow-rotting fatty sores. If mixed with Jiajian to form a paste, it is the same as in Qianjin Fang.

[Supplement] For women with small, superficial, rotting, itchy sores on nipples. Use Furonghua (Hibiscus mutabilis flower) or leaves dried and ground into powder, sprinkle on. For women with cracked and painful nipples, take eggplant flowers that have split open after autumn cooling, dry in shade, burn to retain properties, mix with water and apply.