消毒饮
5.乳痈初起消毒饮, 青芷归柴浙贝蚕, 花粉银花甘草节, 寒热荆防
羌独添, 脓成皂刺穿山甲, 溃后益气养荣煎.
【注】乳痈乃阳明, 厥阴二经, 风热壅盛. 初起宜服消毒饮, 即青皮
,白芷, 当归, 柴胡, 浙贝母, 僵蚕, 花粉, 金银花, 甘草节也. 若
兼增寒壮热者, 加荆芥, 防风, 羌活, 独活, 以解散之; 若服后不消
,其脓已成者, 宜加皂角刺, 穿山甲, 以穿发之; 若溃后气血虚者,
宜益气养荣汤培补之. 他如溃久脓清不敛, 又须急服大剂参, 耆, 桂
,附矣.
益气养荣汤 方见首卷汇方
栝蒌散 外敷法
6.吹乳结核栝蒌散, 乳没归甘用酒熬, 更加皂刺名立效, 已成脓溃
未成消, 外敷星夏蚕芷刺, 草乌为末蜜葱调.
【注】吹乳结核不散者, 当早消之, 久则成痈, 宜用栝蒌散, 即栝蒌
实,乳香, 没药, 当归, 甘草, 酒熬服也. 若服后不散者, 加皂角刺
,名立效散, 脓成者溃, 未成者消. 外用南星, 半夏, 僵蚕, 白芷,
皂角刺, 草乌, 为末, 用葱汁合蜜调敷.
十六味流气饮 青皮甘草散
7.乳岩郁怒损肝脾, 流气饮归芍参耆, 芎防苏芷枳桔草, 槟榔乌朴
桂通随. 外熨木香生地饼, 青皮甘草服无时, 溃后不愈须培补, 十全
八珍或归脾.
【注】乳岩之证, 初起结核如围棋子大, 不痛不痒, 五, 七年, 或十
余年, 从内溃破, 嵌空玲珑, 洞窍深陷, 有如山岩, 故名乳岩. 皆缘
抑郁不舒, 或性急多怒, 损伤肝脾所致. 宜速服十六味流气饮, 其方
即当归, 白芍, 人参, 黄耆, 川芎, 防风, 苏叶, 白芷, 枳壳, 桔梗
,甘草, 槟榔, 乌药, 厚朴, 官桂, 木通, 外以木香, 生地捣饼, 以
热器熨之, 且不时以青皮, 甘草为末, 煎浓姜汤调服. 戒七情, 远荤
味,解开郁怒, 方始能愈. 若溃后久不愈, 惟宜培补其气血, 或十全
大补汤, 八珍汤, 归脾汤选用之.
十全大补汤 八珍汤 归脾汤 方俱见首卷
5. 乳痈（乳房急性化脓性疾病）初起宜用消毒饮，方含青皮、白芷、当归、柴胡、浙贝母、僵蚕、天花粉、金银花、甘草节；若兼有寒热症状，加荆芥、防风、羌活、独活。脓成时加皂角刺、穿山甲以透脓；溃后气血虚弱者，宜服益气养荣煎。
【注】乳痈乃阳明经、厥阴经风热壅盛所致。初起宜服用消毒饮，即由青皮、白芷、当归、柴胡、浙贝母、僵蚕、天花粉、金银花、甘草节组成。若兼见恶寒壮热者，加荆芥、防风、羌活、独活以疏散表邪；若服药后肿块不消，脓已成者，宜加皂角刺、穿山甲以穿透排脓；若溃后气血虚者，宜用益气养荣汤培补。其他如溃后久不收口、脓液清稀者，又须急服大剂量人参、黄芪、肉桂、附子。
益气养荣汤 方剂见首卷汇方
6. 吹乳（产后乳汁淤积形成的硬结）结核不散用栝蒌散，乳香、没药、当归、甘草用酒熬煮；再加皂角刺名为立效散，脓成则溃破，未成则消散。外用天南星、半夏、僵蚕、白芷、皂角刺、草乌研为末，用葱汁和蜂蜜调敷。
【注】吹乳导致结核不散者，应当尽早消散，日久则成痈，宜用栝蒌散，即栝蒌实、乳香、没药、当归、甘草，用酒熬煮服用。若服药后仍不散，加皂角刺，名为立效散，脓成者使其溃破，未成者使其消散。外用天南星、半夏、僵蚕、白芷、皂角刺、草乌，研为细末，用葱汁合蜂蜜调匀外敷。
7. 乳岩（乳腺癌）因郁怒损伤肝脾，宜服流气饮，方含当归、白芍、人参、黄芪、川芎、防风、苏叶、白芷、枳壳、桔梗、甘草、槟榔、乌药、厚朴、官桂、木通。外用木香、生地捣成饼状，加热后熨贴患处；并随时服用青皮、甘草散。溃后不愈须培补气血，可选用十全大补汤、八珍汤或归脾汤。
【注】乳岩之证，初起结核如围棋子大小，不痛不痒，经过五七年或十余年，从内部溃破，空洞玲珑，洞窍深陷，有如山岩，故名乳岩。皆因抑郁不舒，或性急多怒，损伤肝脾所致。宜速服十六味流气饮，其方即当归、白芍、人参、黄芪、川芎、防风、苏叶、白芷、枳壳、桔梗、甘草、槟榔、乌药、厚朴、官桂、木通。外用木香、生地黄捣成饼状，加热后熨贴患处，且不时将青皮、甘草研为末，用浓姜汤调服。需戒除七情过极，远离荤腥食物，解开郁怒，方能痊愈。若溃后久不愈合，惟宜培补气血，可选用十全大补汤、八珍汤、归脾汤。
Xiaodu Yin (Disinfecting Decoction)
5. For the initial stage of Ru Yong (acute suppurative disease of the breast), Xiaodu Yin is indicated, containing Qingpi (Exocarpium Citri Reticulatae), Baizhi (Radix Angelicae Dahuricae), Danggui (Radix Angelicae Sinensis), Chaihu (Radix Bupleuri), Zhebeimu (Bulbus Fritillariae Thunbergii), Jiangcan (Bombyx Batryticatus), Huafen (Radix Platycodonis), Jinyinhua (Flos Lonicerae), and Gancao Jie (Caulis Glycyrrhizae). If accompanied by chills and fever, add Jingjie (Herba Schizonepetae), Fangfeng (Radix Saposhnikoviae), Qianghuo (Rhizoma et Radix Notopterygii), and Duhuo (Radix Angelicae Pubescentis). When pus has formed, add Zaocis Spina (Spina Gleditsiae Sinensis) and Chuanshanjia (Squama Manis) to promote drainage; after ulceration, if Qi and Blood are deficient, Yiqi Yangrong Jian (Decoction for Tonifying Qi and Nourishing Blood) should be taken.
[Note] Ru Yong is caused by the accumulation of Wind-Heat in the Yangming and Jueyin meridians. In the initial stage, Xiaodu Yin is indicated, composed of Qingpi, Baizhi, Danggui, Chaihu, Zhebeimu, Jiangcan, Huafen, Jinyinhua, and Gancao Jie. If accompanied by aversion to cold and high fever, add Jingjie, Fangfeng, Qianghuo, and Duhuo to disperse the exterior pathogen; if the mass does not resolve after medication and pus has formed, add Zaocis Spina and Chuanshanjia to penetrate and drain the pus; if Qi and Blood are deficient after ulceration, Yiqi Yangrong Tang (Decoction for Replenishing Qi and Nourishing Blood) should be used for tonification. In other cases where ulcers fail to heal with clear discharge over a long period, large doses of Renshen (Radix Ginseng), Huangqi (Radix Astragali), Rougui (Cortex Cinnamomi), and Fuzi (Radix Aconiti Lateralis Preparata) should be urgently administered.
Yiqi Yangrong Tang See formulas in the first volume.
Gualou San (Trichosanthes Powder) External Application Method
6. For Chuiniu (hard lumps formed by milk stasis postpartum) that do not dissipate, Gualou San is used, consisting of Ruxiang (Resina Draconis), Moyao (Resina Myrrhae), Danggui, and Gancao, decocted with wine. Adding Zaocis Spina creates Li Xiao San (Instant Effect Powder), which causes formed pus to ulcerate and unformed lumps to dissipate. Externally, apply Nanxing (Rhizoma Arisaematis), Banxia (Rhizoma Pinelliae), Jiangcan, Baizhi, Zaocis Spina, and Caowu (Radix Aconiti Kusnezoffii) powdered, mixed with juice of Congbai (Bulbus Allii Fistulosi) and honey.
[Note] For Chuiniu resulting in indurated nodules that do not dissipate, early resolution is necessary; otherwise, it will develop into an abscess. Gualou San is indicated, composed of Gualou Shi (Fructus Trichosanthis), Ruxiang, Moyao, Danggui, and Gancao, decocted with wine. If the lump does not dissipate after administration, add Zaocis Spina to create Li Xiao San, which promotes ulceration of formed pus and resolution of unformed lumps. Externally, powder Nanxing, Banxia, Jiangcan, Baizhi, Zaocis Spina, and Caowu, and mix with Congbai juice and honey for application.
Shiliu Wei Liuqi Yin (Sixteen-Ingredient Flow-Qi Decoction) Qingpi Gancao San (Qingpi and Licorice Powder)
7. Ru Yan (breast cancer) results from liver and spleen damage due to depression and anger. Liuqi Yin is indicated, containing Danggui, Baishao (Radix Paeoniae Rubra), Renshen, Huangqi, Chuanxiong (Rhizoma Chuanxiong), Fangfeng, Ziye (Folium Perillae), Baizhi, Zhike (Fructus Aurantii), Jiegeng (Radix Platycodonis), Gancao, Binglang (Areca Semen), Wuyao (Linderae Radix), Houpo (Cortex Magnoliae Officinalis), Guanzi Gui (Cortex Cinnamomi Cassiae), and Mutong (Caulis Akebiae). Externally, apply a cake made of Muxiang (Radix Aucklandiae) and Shengdi (Radix Rehmanniae Preparata), heated and ironed on the affected area. Internally, take Qingpi and Gancao powder frequently, mixed with strong ginger soup. After ulceration, if healing fails, tonification of Qi and Blood is required, using Shiquan Dabu Tang (Ten Substance Great Supplement Decoction), Bazhen Tang (Eight Treasure Decoction), or Guipi Tang (Restore the Spleen Decoction).
[Note] The condition of Ru Yan begins with a nodule the size of a Go stone, painless and non-itchy. After five to seven years or more than ten years, it ulcerates internally, becoming hollow and deeply sunken, resembling a rock, hence the name Ru Yan. It is caused by emotional depression or irritability leading to liver and spleen injury. Shiliu Wei Liuqi Yin should be taken promptly, composed of Danggui, Baishao, Renshen, Huangqi, Chuanxiong, Fangfeng, Ziye, Baizhi, Zhike, Jiegeng, Gancao, Binglang, Wuyao, Houpo, Guanzi Gui, and Mutong. Externally, apply a heated cake of Muxiang and Shengdi, and frequently take Qingpi and Gancao powder mixed with strong ginger soup. One must regulate emotions, avoid rich foods, and resolve depression and anger for recovery. If the ulcer fails to heal for a long time, only tonification of Qi and Blood is appropriate, selecting from Shiquan Dabu Tang, Bazhen Tang, or Guipi Tang.
Shiquan Dabu Tang, Bazhen Tang, Guipi Tang See formulas in the first volume.