妇人产后数日，绝无点滴之乳，人以为乳管之闭也，谁知气血之涸乎。夫无血
不能生乳，而无气亦不能生乳。乳者，气血所化也。然二者之中，血之化乳，又不若
气之化乳为速。新产之后，血已大亏，生血不遑，何能生乳，全藉气以行血而成乳
也。今数日乳不下，血诚少，而气尤微。世人不知补气之妙，一味通乳，无气则血
从何生？无血则乳从何化？不几向乞人而求食，问贫儿而索金耶。治法补其气以生
血，不可利其窍而通乳也。方用通乳丹∶
人参（一两） 当归（二两） 麦冬（五钱） 黄 （一两） 猪蹄（二个） 木通（三分） 桔梗（三分）
水煎服。二剂而乳如泉流矣。
此方但补气血以生乳，正以乳生于气血也。
用化乳丹亦佳。
当归 熟地 黄 （各一两） 麦冬（三钱） 山茱萸（四钱） 川山甲（一片） 菟丝子（五钱）
枸杞子（三钱） 水煎服。
连用四剂，即多乳矣。
有壮妇生产后数日，或闻丈夫之嫌，或听公姑之啐，遂至两乳胀满作痛，乳汁
不通，人以为阳明之火也，谁知肝气之郁结哉。夫阳明多气多血之腑，乳汁之化，
原属阳明，然而阳明属土，必得肝木之气相通，则稼穑作甘，始成乳汁，未可全责
之阳明也。壮妇产后，虽亡血过多，而气实未衰，乳汁之化，全在气而不尽在血也。
今产数日而两乳胀满作痛，是欲化乳而不可得，明是有郁而肝气不扬，阳明之土气
亦因之同郁，木土不相合而相郁，安得而化乳哉。治法大抒其肝木之气，则阳明
之气血自通，不必通乳而乳自通也。方用通肝生乳汤∶
白芍（五钱） 当归（五钱） 麦冬（五钱） 通草（一钱） 柴胡（二钱） 白术（五钱） 甘草（三分）
熟地（一两） 远志（一钱） 水煎服。一剂即通。
此方药味太重，治产妇似乎不宜。不知健妇抱郁，不妨权宜用之，若非少壮之
女，虽因郁少乳，不可全用。减半治之，亦不全失，又在临症时裁酌之也。
用生汁汤亦佳。
当归（二两） 川芎（四钱） 通草（一钱） 柴胡（五分） 麦冬（四钱） 白术（五钱） 甘草（三分）
熟地（一两） 水煎服。四剂必大通。
A woman, several days after childbirth, has absolutely no milk. People assume it is due to the blockage of the milk ducts (Ru Guan), but who would know that it is actually the exhaustion of Qi and Blood (Qi Xue). Without blood, milk cannot be generated; without Qi, milk also cannot be generated. Milk is transformed from Qi and Blood. However, among these two, the transformation of blood into milk is not as rapid as the transformation of Qi into milk. After a new delivery, blood has been severely depleted, leaving no time to generate blood, let alone milk. It entirely relies on Qi to move blood to form milk. Now, after several days, milk has not come down; blood is indeed scarce, and Qi is even more微弱 (weak). The world does not understand the wonder of tonifying Qi, instead blindly using methods to unblock milk. Without Qi, from where can blood be generated? Without blood, from where can milk be transformed? Is this not like begging a beggar for food or asking a poor child for gold? The treatment method should tonify Qi to generate blood, rather than benefiting the orifices to unblock milk. Use Tong Ru Dan (Unblocking Milk Decoction): Ren Shen (Ginseng Radix) (1 liang), Dang Gui (Angelicae Sinensis Radix) (2 liang), Mai Dong (Ophiopogonis Tuber) (5 qian), Huang Qi (Astragali Radix) (1 liang), Zhu Ti (Swine Trotters) (2 pieces), Mu Tong (Akebiae Caulis) (3 fen), Jie Geng (Platycodonis Radix) (3 fen). Decoct in water and take orally. After two doses, milk flows like a spring.
This formula merely tonifies Qi and Blood to generate milk, precisely because milk is born from Qi and Blood.
Using Hua Ru Dan (Transforming Milk Decoction) is also excellent. Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Rehmanniae Radix Praeparata), Huang Qi (Astragali Radix) (each 1 liang), Mai Dong (Ophiopogonis Tuber) (3 qian), Shan Zhu Yu (Corni Fructus) (4 qian), Chuan Shan Jia (Manis Squama) (1 piece), Tu Si Zi (Cuscutae Semen) (5 qian), Gou Qi Zi (Lycii Fructus) (3 qian). Decoct in water and take orally. Using continuously for four doses will result in increased milk.
A robust woman, several days after childbirth, heard her husband's disdain or her parents-in-law's scolding, leading to distension and pain in both breasts with blocked milk flow. People attribute this to Fire (Huo) in the Yang Ming (Stomach/Large Intestine channels), but who would know it is actually the stagnation of Liver Qi (Gan Qi)? The Yang Ming channel is a fu-organ abundant in Qi and Blood. The transformation of milk originally belongs to Yang Ming; however, Yang Ming belongs to Earth, and it must receive the penetrating Qi of Liver Wood to transform, just as crops produce sweetness, finally forming milk. One cannot solely blame Yang Ming. A robust woman postpartum, although having lost excessive blood, has Qi that is not yet weakened. The transformation of milk depends entirely on Qi, not just blood. Now, several days after delivery, both breasts are distended and painful; she desires to transform milk but cannot. This clearly indicates stagnation and the failure of Liver Qi to ascend. The Earth Qi of Yang Ming is also stagnant due to this. Wood and Earth do not harmonize but stagnate together; how can milk be transformed? The treatment method is to greatly vent the Qi of Liver Wood, then the Qi and Blood of Yang Ming will naturally flow. There is no need to specifically unblock milk for it to flow spontaneously. Use Tong Gan Sheng Ru Tang (Unblocking Liver Generating Milk Decoction): Bai Shao (Paeoniae Radix Alba) (5 qian), Dang Gui (Angelicae Sinensis Radix) (5 qian), Mai Dong (Ophiopogonis Tuber) (5 qian), Tong Cao (Tetrapanacis Medulla) (1 qian), Chai Hu (Bupleuri Radix) (2 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (3 fen), Shu Di Huang (Rehmanniae Radix Praeparata) (1 liang), Yuan Zhi (Polygalae Radix) (1 qian). Decoct in water and take orally. One dose results in unblocking.
The medicinal ingredients in this formula are too heavy; treating postpartum women seems inappropriate. However, for a healthy woman with emotional stagnation, it may be used temporarily. If the patient is not young and robust, even if there is scant milk due to stagnation, the full dose should not be used. Halving the dose for treatment is also effective. This requires discretion during clinical practice.
Using Sheng Zhi Tang (Generating Fluids Decoction) is also excellent. Dang Gui (Angelicae Sinensis Radix) (2 liang), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (4 qian), Tong Cao (Tetrapanacis Medulla) (1 qian), Chai Hu (Bupleuri Radix) (5 fen), Mai Dong (Ophiopogonis Tuber) (4 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (3 fen), Shu Di Huang (Rehmanniae Radix Praeparata) (1 liang). Decoct in water and take orally. Four doses will surely result in significant unblocking.