《大全》曰∶妇人乳汁，气血所化，不行者，由气血虚弱，经络不调所致。或谓产后必有乳，乳虽胀而产
后作者，此年少之人，初经产乳，有风热，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
益之药助之。若有乳不甚多者，须服通经之药，仍以羹 引之。盖妇人之乳，资以冲脉与胃经通故也。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经者，乳汁少而色黄，生子亦怯弱多疾。
陈无择曰∶产妇有二种乳汁不行，有气血盛而壅闭不行；有血气少弱，涩而不行。虚当补之，盛当疏之。盛
者，当用通草、漏芦、土瓜根。虚者，用炼盅乳粉、猪蹄、鲫鱼之属。
薛立斋曰∶前证若气血虚弱，不能生化者，宜壮脾胃。怒动肝火，乳肿汁出者，宜清肝火。乳汁乃气血所
化，在上为乳，在下
为经。若屡产无乳，或大便涩滞者，亡津液也。当滋化源，冲任之脉盛，脾胃之气壮，则乳汁多而浓；衰则淡
而少，所乳之子，亦弱而多病。
《大全》曰∶产后乳汁自出，胃气虚也，宜补药以止之。若未产而乳自出者，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，独参汤补之。
薛立斋曰∶凡妇人气血方盛，乳房作胀，或无儿饮，痛胀寒热，用麦芽二三两炒熟，水煎服之立消。其耗
散血气如此，何脾胃虚弱，饮食不消方中多用之？一云，麦芽最消肾。若气血虚，而乳汁自出者，宜十全大补
汤。
《大全》说：妇女的乳汁，是由气血化生而成的。乳汁不通畅，是由于气血虚弱、经络不调畅所导致的。有人说产后一定会有乳汁，即使乳房胀满而产后才有的，这是年轻女性，初次经历生产哺乳，体内有风热之邪，必须服用清热利湿的药物才能使乳汁通畅。如果多次生育却没有乳汁的，是因为津液耗损的缘故。必须服用滋补益气的药物来辅助。如果有乳汁但量不多的，必须服用通经活络的药物，并仍以羹汤作为药引。大概妇女的乳汁，是依靠冲脉与胃经相通而化生的。有屡次生育而乳汁常常很多的，也是妇人血气旺盛不衰所致。如果妇人素有疾病在冲任二脉的，乳汁少且颜色发黄，所生的孩子也怯弱多病。
陈无择说：产妇有两种乳汁不行的情况，一种是气血盛实而壅滞闭塞导致乳汁不行；另一种是血气少弱，涩滞而不行。虚证应当补益，实证应当疏泄。实证，应当使用通草、漏芦、土瓜根。虚证，使用炼制的乳粉、猪蹄、鲫鱼之类。
薛立斋说：上述病症如果是气血虚弱，不能生化乳汁的，应当壮健脾胃。因愤怒触动肝火，导致乳房肿胀汁出的，应当清泻肝火。乳汁乃由气血化生，在上表现为乳汁，在下表现为月经。如果屡次生育没有乳汁，或者大便涩滞不通的，是津液亡失的表现。应当滋生化之源，冲任之脉旺盛，脾胃之气强壮，则乳汁多而浓稠；若衰败则乳汁清淡且量少，所哺育的孩子，也会体弱多病。
《大全》说：产后乳汁自行流出，是胃气虚弱的表现，宜用补益药物来止住。如果在未分娩前乳汁就自行流出的，称为“乳泣”，所生的孩子大多难以养活。如果产妇因劳役过度，乳汁涌出向下，这是阳气虚弱而厥逆的表现，可用独参汤来补益。
薛立斋说：凡是妇人气血正盛，乳房作胀，或者没有婴儿吸吮，出现疼痛胀满伴寒热的症状，用麦芽二三两炒熟，水煎服下即可立刻消散。麦芽耗散血气如此厉害，为什么在脾胃虚弱、饮食不消化的方剂中多用它呢？有一种说法认为，麦芽最易消损肾气。如果是气血虚弱，而乳汁自出的，宜用十全大补汤。
According to *Daquan* (General Collection): Women's milk is transformed from Qi and Blood. Its failure to flow is caused by deficiency of Qi and Blood and irregularity of the meridians. Some say that postpartum women must have milk; even if the breasts are distended, it appears after delivery. This applies to young women who are experiencing childbirth and lactation for the first time and have Wind-Heat pathogenic factors; they must take clearing and draining herbs to promote milk flow. If a woman has given birth multiple times but has no milk, it is due to the loss of Body Fluids (Jin Ye). She must take nourishing and tonifying herbs to assist. If there is some milk but not much, she must take herbs to unblock the meridians, still using soup as a vehicle for the medicine. Generally, women's milk relies on the connection between the Chong Mai (Penetrating Vessel) and the Stomach Meridian. There are women who have given birth repeatedly yet always have abundant milk; this is also because their Qi and Blood are vigorous and not declining. If a woman has chronic diseases in the Chong and Ren Mai (Conception Vessel), her milk will be scanty and yellowish, and her child will be frail and prone to illness.
Chen Wuyue said: There are two types of milk failure in postpartum women: one is where Qi and Blood are excessive and stagnant, blocking the flow; the other is where Qi and Blood are deficient and weak, causing sluggish flow. Deficiency should be tonified, excess should be dispersed. For excess cases, Tongcao (Tetrapanacis Medulla), Loulu (Cimicifugae Rhizoma), and Tuguagen (Polysiphoniae Thallus) should be used. For deficiency cases, refined milk powder, pig trotters, and crucian carp should be used.
Xue Lizhai said: In the aforementioned conditions, if Qi and Blood are deficient and unable to transform into milk, the Spleen and Stomach should be strengthened. If anger stirs Liver Fire, causing breast swelling and leakage of milk, Liver Fire should be cleared. Milk is transformed from Qi and Blood; when above, it becomes milk; when below, it becomes menstruation. If a woman has had multiple births without milk, or suffers from constipation, it indicates the loss of Body Fluids. One should nourish the source of transformation. When the Chong and Ren Mai are vigorous and the Qi of the Spleen and Stomach is strong, milk will be abundant and thick; when they decline, milk will be thin and scanty, and the nursed child will also be weak and prone to disease.
*Daquan* states: Spontaneous leakage of milk postpartum is due to deficiency of Stomach Qi; it should be stopped with tonifying medicines. If milk leaks spontaneously before delivery, it is called Ruqi (Milk Weeping); children born under such circumstances often fail to survive. If a postpartum woman, due to overwork, experiences gushing downward flow of milk, this is due to Yang Qi deficiency leading to Jue (Cold Reversal); Dushen Tang (Ginseng Decoction) should be used to tonify.
Xue Lizhai said: Whenever a woman's Qi and Blood are flourishing, causing breast distension, or if there is no infant suckling, resulting in painful distension accompanied by aversion to cold and fever, use 2-3 liang of fried Maitai (Fried Hordei Fructus), decocted in water and taken orally, which will dissipate immediately. Such is its ability to scatter Qi and Blood. Why then is it widely used in formulas for Spleen and Stomach weakness and indigestion? Another view holds that Maitai most easily damages Kidney Qi. If Qi and Blood are deficient and milk leaks spontaneously, Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) should be used.