【方歌】乳劳初核渐肿坚，根形散漫大如盘，未溃先腐霉斑点，
败脓津久劳证添。
【注】此证即由乳中结核而成。或消之不应，或失于调治，耽
延数月，渐大如盘如盅，坚硬疼痛，根形散漫，串延胸
肋腋下，其色或紫或黑，未溃先腐，外皮霉点，烂斑数
处，渐渐通破，轻津白汁，重流臭水，即败浆脓也。日
久溃深伤膜，内病渐添，午后烦热、干嗽、颧红、形瘦
、食少、阴虚等证俱见，变成疮劳。初结肿时，气实者
宜服蒌贝散，及神效栝蒌散；气虚者逍遥散，及归脾汤
合而用之。阴虚之证已见，宜服六味地黄汤，以培其本
。外治法按痈疽溃疡门。然此疮成劳至易，获效甚难。
方剂：蒌贝散
组成：栝蒌 贝母（去心，研）
南星 甘草（生）
连翘（去心，各一钱）
水二钟，煎八分，澄滓，加酒二分，食远服。一加
青皮、升麻。
【方歌】蒌贝散治乳结核，渐大失调变乳劳，初肿气实须服此，
南星甘草共连翘。
又方：神效栝蒌散
组成：大栝蒌（去皮，焙为末，一个）
当归 甘草（生，各五钱）
没药 乳香（各二钱）
共研粗末，每用五钱，醇酒三钟，慢火熬至一钟，
去滓，食后服之。
【方歌】神效栝蒌没乳香，甘草当归研末良，乳劳初肿酒煎服，
消坚和血是神方。
又方：逍遥散（见背部上搭手）
归脾汤（见乳中结核）
六味地黄汤（即六味地黄丸改作煎剂。见面部雀斑）
【方歌】乳劳初期，乳房出现核块并逐渐肿胀坚硬，根部形态散漫，大小如同盘子。在溃破之前，患处先发生腐烂，表面出现霉斑。若病程迁延，流出败脓和津液，会导致虚劳症状加重。
【注】此证即由乳房中的结核（肿块）发展而成。如果消散治疗无效，或未能及时调治，拖延数月后，肿块逐渐增大如盘如盅，质地坚硬且疼痛，根部形态散漫，并向胸肋、腋下串连蔓延。患处颜色或紫或黑，未溃破前先腐坏，外皮出现霉点，烂斑数处，渐渐穿透皮肤，轻者流出白色汁液，重者流出臭水，这就是败浆脓。日久溃烂加深伤及膜络，内部病变逐渐增加，午后烦热、干咳、颧骨发红、形体消瘦、食欲不振、阴虚等证候均会出现，最终变成疮劳（因疮疡久不愈合导致的虚劳）。在初结肿时，气实者适宜服用蒌贝散，以及神效栝蒌散；气虚者适宜服用逍遥散，以及归脾汤合用。若阴虚之证已经显现，适宜服用六味地黄汤，以培补根本。外治法参照痈疽溃疡门的方法。然而此疮转化为劳证非常容易，获得疗效却很难。
方剂：蒌贝散
组成：栝蒌、贝母（去心，研碎）、南星、甘草（生用）、连翘（去心），各一钱。
用法：水二钟，煎至八分，澄清药渣，加入酒二分，饭后服用。可加青皮、升麻。
【方歌】蒌贝散治疗乳房结核，逐渐增大失调变为乳劳，初起肿胀气实者须服此方，南星、甘草共配连翘。
又方：神效栝蒌散
组成：大栝蒌（去皮，焙干研为末，一个）、当归、甘草（生用，各五钱）、没药、乳香（各二钱）。
用法：共研为粗末，每次取五钱，用醇酒三钟，慢火熬至一钟，去渣，饭后服用。
[Formula Verse] In the early stage of Ru Lao (Breast Tuberculosis/Chronic Breast Abscess), a nodule appears in the breast and gradually swells and hardens. The base is diffuse, and the size resembles a plate. Before ulceration, putrefaction occurs first, presenting with mold-like spots on the skin. If the condition persists for a long time, draining foul pus and fluids will exacerbate symptoms of consumptive disease.
[Note] This condition originates from nodules within the breast. If resolution therapy fails or if proper treatment is neglected, delaying for several months, the mass gradually enlarges to the size of a plate or bowl, becoming hard and painful. The base is diffuse, spreading to the chest, hypochondrium, ribs, and axilla. The color may be purple or black. Before ulceration, putrefaction occurs; the outer skin shows mold-like spots and several ulcerated patches that gradually penetrate the skin. Mild cases discharge white fluid, while severe cases discharge foul-smelling water, which is known as "bai jiang nong" (foul purulent exudate). Over time, deep ulceration damages the membranes, internal pathology worsens, and symptoms such as afternoon fever, dry cough, malar flush, emaciation, poor appetite, and Yin deficiency appear, eventually transforming into Chuang Lao (consumptive disease resulting from chronic ulcers). At the initial stage of swelling and nodulation, patients with excess Qi should take Lou Bei San (Trichosanthes and Fritillaria Powder) and Shen Xiao Gua Lou San (Miraculous Trichosanthes Decoction); those with deficient Qi should take Xiao Yao San (Free and Easy Wanderer Powder) combined with Gui Pi Tang (Spleen-Restoring Decoction). If signs of Yin deficiency are already evident, Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Decoction) should be taken to nourish the root. External treatment follows the guidelines for Carbuncles and Ulcers. However, it is very easy for this sore to transform into a consumptive disease, yet difficult to achieve efficacy.
Formula: Lou Bei San (Trichosanthes and Fritillaria Powder)
Composition: Trichosanthis Fructus (Gualou, 瓜蒌), Fritillariae Bulbus (Beimu, 贝母 - heart removed, ground), Arisaematis Rhizoma (Nanxing, 南星), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草 - raw), Forsythiae Fructum (Lianqiao, 连翘 - heart removed), each 1 qian.
Preparation and Administration: Decoct 2 zhong of water until reduced to 0.8 zhong, filter the dregs, add 0.2 zhong of wine, and take after meals. Optionally add Citri Reticulatae Pericarpium (Qingpi, 青皮) and Cimicifugae Rhizoma (Shengma, 升麻).
[Formula Verse] Lou Bei San treats breast nodules; neglect leads to Ru Lao. For initial swelling with Qi excess, take this formula: Nanxing, Gancao, and Lianqiao together.
Another Formula: Shen Xiao Gua Lou San (Miraculous Trichosanthes Decoction)
Composition: Large Trichosanthis Fructus (Da Gualou, 大瓜蒌 - peel removed, roasted and ground, one fruit), Angelicae Sinensis Radix (Danggui, 当归), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草 - raw, each 5 qian), Myrrha (Moyao, 没药), Olibanum (Ruxiang, 乳香, each 2 qian).
Preparation and Administration: Grind into coarse powder. Take 5 qian per dose, decoct with 3 zhong of strong wine over slow fire until reduced to 1 zhong, filter, and take after meals.
[Formula Verse] Shen Xiao Gua Lou San contains Myrrha and Olibanum; Gancao and Danggui ground are excellent. For initial swelling of Ru Lao, decoct with wine to consume; it dissipates hardness and harmonizes blood, a miraculous formula.
Another Formula: Xiao Yao San (See section on Upper Back Da Shou)
Gui Pi Tang (See section on Breast Nodules)
Liu Wei Di Huang Tang (i.e., Liu Wei Di Huang Wan modified into a decoction. See section on Facial Freckles)