暴怒、或儿口气所吹，痛肿者，疏肝行气。
肿 痛甚者，清肝消毒。 痛发寒热者，发散表邪。
未成脓者，疏肝行气。不作脓或不溃，托里为主。
溃而不敛，或脓清者，大补气血。
一妇禀实性躁，怀抱久郁，左乳内结一核不消，按之微痛，以连翘饮子，二十余剂少
退；更以八珍汤，加青皮、桔梗、香附、贝母，二十余剂而消。
一妇发热作渴，至夜尤甚，两乳忽肿，服败毒药热反炽，诊之，肝脉洪数，乃热入血室。
以加味小柴胡治之，热止肿消。
一妇两乳内时常作痛，口内常辣，卧起若急，脐下牵痛，以小柴胡加青皮、黄连、栀
子而愈。
一妇郁久，左乳内结核如杏许，三月不消，心脉涩，脾脉大，按之多力，以八珍汤
加贝母、远志、香附、柴胡、青皮、桔梗，五十余剂而溃，又三十余剂而愈。
一妇久郁，右乳内结三核，年余不消，朝寒暮热，饮食不甘，此乳岩也，乃七情所伤，肝
经血气枯槁之证，宜补气血，解郁结。遂以益气养荣汤，百余剂，血气渐复；更以木香饼灸
之，嘉其谨疾而消。
一妇脓成不溃，胀痛，予欲针之，令毒不侵展，不，又数日，痛极始针，涌出败毒三四
碗，虚证蜂起，几殆，用大剂补之，两月余始安。
夫乳者有囊橐，有脓不针，则遍患诸囊矣，少壮者得以收敛，老弱者多致不救。
一妇肿而不作脓，以益气养荣汤加香附、青皮，数剂脓成，针之，旬日而愈。
一妇右乳肿，发热，怠惰嗜卧，无气以动，至夜热尤甚，以补中益气汤兼逍遥散而痊。
一产妇因乳少，服药通之，致乳房肿痛而胀，发热作渴，状若伤寒，以玉露散而愈。
夫乳汁，气血行化者，在上为乳，在下为经。若冲任脉盛，脾胃气壮，则乳汁多而浓；
血衰，则少而淡，所乳之子，亦弱而多病，此自然之理也。亦有屡产有乳，再产无乳，或
大便涩滞，乃亡津液也。《三因论》云∶产妇乳脉不行有二，有气血盛，闭而不行者，有
气血弱，涩而不行者。虚当补之，盛当疏之。盛者，当用通草、漏芦、土瓜根辈，虚者，当
用炼成钟乳粉、猪悬蹄、鲫鱼之类，概可见矣。亦有乳汁不止者，多属于虚不约束也。
一妇乳痈愈后发热，服养气血药不应，八珍汤加炮干姜，四剂而愈；仍以前汤加黄 、
香附，三十余剂而安。
一妇乳痈脓成，针刺之及时，不月而愈。
一妇因怒两乳肿，兼头痛寒热，以人参败毒散，二剂表证以退；以小柴胡加芎归、桔梗、
枳壳，四剂而痊。
一妇郁久，乳内结核，余年不散，日晡微热，饮食不思，治以益气养荣汤，嫌缓，乃
服行气之剂，势愈甚，溃而日出清脓不止，复求治。诊之脉洪而数，辞不治，又年余，果殁。
一妇产次子而无乳，服下乳药，但作胀。予谓∶乳皆血气所化，今胀而无乳，是气血
竭而津液亡也，当补气血，自有乳矣。与八珍汤，倍加参术，少加肉桂，二十余剂，乳遂生。
后因劳役伤竭。
盖初产有乳，再而无，其气血只给一产耳，其衰可知。间有产后乳出不止，亦为气虚，宜
补药止之。其或断乳，儿不吮亦能作胀，用麦芽炒为末，白汤调服，以散之。若儿吮破乳头，
成疮，用蒲公英末或黄连胡粉散掺之，若乳头裂破，以丁香末或蛤粉、胭脂末敷之，并效。
一妇郁久，右乳肿硬，以八珍汤加远志、贝母、柴胡、青皮，及隔蒜灸，兼服神效栝蒌
散，两月而消。
一妇左乳内肿如桃许，不痛，色不变，发热，渐消瘦，以八珍汤加香附、远志、青皮、
柴胡，百余剂，又间服神效栝蒌散，三十余剂，脓溃而愈。
患者或责效大速，或不戒七情，俱难治。大抵四十余后者，尤难治，盖因阴血日虚也。况医
用药，不分经络虚实，未有能保痊也。
一妇乳内肿一块，如鸡子大，劳则作痛，久而不消，服托里药不应，此乳劳证也，肝经血
少所致。先与神效栝蒌散，四剂，更隔蒜灸，肿少退；再服八珍汤，倍加香附、夏枯草、蒲
公英，仍间服前散，月余而消。
又有乳疽一证，肿硬木闷，虽破而不溃，肿亦不消，尤当急服此散，及隔蒜灸。此二证，
乃七情所伤，气血所损，亦荣证也。宜戒怒，节饮食，慎起居，否则不治。
一妇年逾二十，禀弱，乳内作痛，头疼脉浮，与人参败毒散，倍参，一剂表证悉退，但
饮食少思，日晡微热，更以小柴胡同六君子，二剂热退食进，方以托里药加柴胡，十余剂，针出
脓而愈。
一妇亦患此，予谓须多服养气血、解郁结药，可保无害，不信，乃服攻伐之剂，及大如碗
口，出脓乃清，
不敛而没。
一妇因怒左乳作痛，内肿发热，表散太过，致热益甚，以益气养荣汤，数剂热止，脓成
痛，针之，不从，遂肿胀大热发渴，始针，脓大泄，以前汤百余剂始愈。
一人因怒左乳肿痛，肝脉弦数，以复元通气散，二剂少愈，以柴胡汤加青皮、芎归而消。
一后生作劳风寒夜发热，左乳痛，有核如掌，脉细涩而数，此因阴滞于阳也，询之，以酒
得，遂以栝蒌子、石膏、干葛、川芎、白芷、蜂房、生姜同研，入酒饮之，四帖而安。
夫乳头厥阴所经，乳房阳明所属。厥阴者，肝也，乃女子致命之地，宗筋之所，且各有
囊橐，其始 肿虽盛，受患止于一二橐，若脓成不刺，攻溃诸囊矣。壮者犹可，弱者多致不
救，所以必针而后愈。用蒲公英、忍冬藤少入酒煎服，即欲睡，是其功也，及觉而病安矣。
未溃，以青皮加栝蒌、桃仁、连翘、川芎、橘叶、皂角刺、甘草节，随证加减煎服。已溃，以
芎、归、参、 、白芍、青皮、连翘、栝蒌、甘草节煎。
一妇乳痈，气血颇实，但疮口不合，百法不应，与神效栝蒌散，四帖少可，更与四帖，
及豆豉饼灸而愈。
一妇乳痈，寒热头痛，与荆防败毒散一帖，更以蒲公英一握，入酒二三盏，再捣，取酒热
服，渣热罨患处而消。此因头痛发热，乃表证也，故用表散。蒲公英俗呼孛孛丁，夏秋间开黄
花似菊，散热毒，消肿核，散滞气，解金石毒圣药。乳硬，多因乳母不知调养所致，或忿怒所逆，
郁闷所遏，浓味所酿，以致厥阴之气不行，故窍闭而汁不通，阳明之血沸腾，故热甚而化脓。
或因乳子膈有滞痰，含乳而睡，口气 热所吹，而成结核，初便忍痛，揉软吮令汁透可散，否
则结成矣。治以青皮疏厥阴之滞，石膏清阳明之热，生甘草节行浊滞之血，栝蒌子导毒消肿，
或加没药、青橘叶、皂角刺、金银花、当归，或汤或散，佐以少酒，若加艾火两三
壮于痛处尤妙。粗工便用针刀，必惹崛病。
暴怒，或被婴儿口气吹袭，导致乳房疼痛肿胀的，采用疏肝行气的方法。
如果肿胀疼痛严重的，采用清肝解毒的方法。
如果疼痛伴随寒热症状的，采用发散表邪的方法。
脓液尚未形成的，采用疏肝行气的方法。
如果不化脓或不溃破的，以托毒外出、补益正气为主。
如果已经溃破但伤口不愈合，或者脓液稀薄的，采用大补气血的方法。
有一位妇女体质壮实且性情急躁，长期怀抱抑郁，左侧乳房内结成一个硬块不消散，按压时有轻微疼痛，使用连翘饮子，服用二十多剂后稍见减退；后来改用八珍汤，加入青皮、桔梗、香附、贝母，又服用二十多剂后硬块消除。
有一位妇女发热口渴，到了夜间尤其严重，双侧乳房突然肿胀，服用败毒药物后热势反而更盛，诊察发现肝脉洪数，这是热邪陷入血室。使用加味小柴胡汤治疗，热退肿消。
有一位妇女双侧乳房时常作痛，口中常觉辛辣，卧起动作急促时牵引脐下疼痛，使用小柴胡汤加入青皮、黄连、栀子而痊愈。
有一位妇女长期抑郁，左侧乳房内结核如杏核大小，三个月不消散，心脉涩，脾脉大，按之有力，使用八珍汤加入贝母、远志、香附、柴胡、青皮、桔梗，服用五十多剂后溃破，又服用三十多剂后痊愈。
有一位妇女长期抑郁，右侧乳房内结有三个硬块，一年多不消散，早晨怕冷傍晚发热，饮食无味，这是乳岩病，属于七情所伤，肝经气血枯槁的证候，应当补益气血，解郁结。于是使用益气养荣汤，服用一百多剂，气血逐渐恢复；再用木香饼灸患处，因其谨慎调养而痊愈。
有一位妇女脓液已成但不溃破，感到胀痛，我想为她针刺，令毒邪不扩散，她没有同意，过了几天，疼痛极度剧烈时才针刺，涌出败毒三四碗，虚证蜂拥而起，几乎危及生命，使用大剂量补益药，两个多月才安定。
乳房有囊袋结构，如果有脓液而不针刺，就会遍及各囊袋，年轻力壮者得以收敛，年老体弱者多致无法救治。
有一位妇女肿胀但不化脓，使用益气养荣汤加入香附、青皮，几剂后脓液形成，针刺后，十天痊愈。
有一位妇女右侧乳房肿胀，发热，倦怠嗜睡，无力活动，夜间热势尤其严重，使用补中益气汤兼服逍遥散而痊愈。
一位产妇因乳汁少，服药通乳，导致乳房肿痛胀满，发热口渴，症状像伤寒，使用玉露散而痊愈。
乳汁，是气血运行化生的产物，在上化为乳汁，在下化为月经。如果冲任脉旺盛，脾胃气壮，则乳汁多而浓稠；血衰，则乳汁少而清淡，所哺育的孩子，也虚弱多病，这是自然的道理。也有多次生产有乳汁，再次生产无乳汁，或者大便涩滞，这是亡失津液所致。《三因论》说：产妇乳脉不通有两种情况，一种是气血盛，闭阻而不行的，一种是气血弱，涩滞而不行的。虚证应当补益，实证应当疏通。实证，应当使用通草、漏芦、土瓜根之类，虚证，应当使用炼成钟乳粉、猪悬蹄、鲫鱼之类，大概可以知道了。也有乳汁不止的，多属于虚证不能约束所致。
有一位妇女乳痈痊愈后发热，服用补养气血的药物无效，使用八珍汤加入炮干姜，四剂后痊愈；仍然用前方加入黄芩、香附，三十多剂后安稳。
有一位妇女因愤怒导致双侧乳房肿胀，兼有头痛寒热，使用人参败毒散，两剂后表证消退；使用小柴胡汤加入川芎、当归、桔梗、枳壳，四剂后痊愈。
有一位妇女长期抑郁，乳房内结核，一年多不散，下午微热，不想饮食，治疗使用益气养荣汤，嫌药效缓慢，于是服用行气的药剂，病情更加严重，溃破后每天流出清脓不止，再次求治。诊察发现脉象洪大而数，推辞不治，又过了一年多，果然去世。
一位产妇生第二个孩子而没有乳汁，服用下乳药物，只感到胀满。我说：乳汁都是气血所化，现在胀满而无乳汁，是气血竭尽而津液亡失，应当补益气血，自然会有乳汁了。给予八珍汤，加倍人参、白术，少量肉桂，二十多剂后，乳汁产生。后来因为劳役损伤竭尽。
大概初次生产有乳汁，第二次就没有，其气血只够供给一次生产罢了，其衰退可知。间或有产后乳汁出不止的，也是气虚，宜用补药止住。如果是断奶，婴儿不吸吮也能感到胀满，用麦芽炒为粉末，白开水调服，以消散它。如果婴儿吸破乳头，形成疮疡，用蒲公英粉末或黄连胡粉散掺敷，如果乳头裂破，用丁香粉末或蛤粉、胭脂末敷贴，都有效。
有一位妇女长期抑郁，右侧乳房肿硬，使用八珍汤加入远志、贝母、柴胡、青皮，以及隔蒜灸，兼服神效栝蒌散，两个月后消散。
有一位妇女左侧乳房内肿胀如桃核大小，不痛，颜色不变，发热，逐渐消瘦，使用八珍汤加入香附、远志、青皮、柴胡，一百多剂，又间服神效栝蒌散，三十多剂，脓溃而愈。
患者如果责备疗效太大太速，或者不戒除七情，都难治。大概四十多岁以后的，尤其难治，这是因为阴血日益虚弱。况且医生用药，不分经络虚实，没有能保全痊愈的。
有一位妇女乳房内肿一块，如鸡蛋大小，劳累时作痛，久而不消散，服用托里药物无效，这是乳劳证，由肝经血少所致。先给予神效栝蒌散，四剂，再隔蒜灸，肿块稍退；再服用八珍汤，加倍香附、夏枯草、蒲公英，仍间服前方，一个多月后消散。
又有乳疽一证，肿胀坚硬麻木闷痛，虽然破溃但不化脓，肿胀也不消退，尤其应当急服此散，及隔蒜灸。这两种证候，乃七情所伤，气血所损，也是荣证（此处指慢性溃疡类病症）。应当戒怒，节制饮食，谨慎起居，否则无法治疗。
有一位妇女年过二十，禀赋虚弱，乳房内作痛，头疼脉浮，给予人参败毒散，加倍人参，一剂后表证悉退，但饮食少思，下午微热，再使用小柴胡汤同六君子汤，两剂后热退食进，方用托里药加入柴胡，十余剂，针刺出脓而愈。
有一位妇女也患此病，我说必须多服用补养气血、解郁结的药物，可保无害，她不信任，于是服用攻伐的药剂，脓肿大如碗口，流出脓液清稀，不愈合而死亡。
有一位妇女因愤怒左乳作痛，内部肿胀发热，表散太过，导致热势更甚，使用益气养荣汤，几剂后热止，脓成痛，针刺时患者不从，于是肿胀大热发渴，才开始针刺，脓液大量泄出，用前方一百多剂才痊愈。
一名男子因愤怒左乳肿痛，肝脉弦数，使用复元通气散，两剂后稍好，使用柴胡汤加入青皮、川芎、当归而消散。
一名年轻人在劳作后感风寒，夜间发热，左乳痛，有核如手掌大，脉细涩而数，这是因为阴滞于阳，询问得知，因饮酒引起，于是使用栝蒌子、石膏、干葛、川芎、白芷、蜂房、生姜同研，入酒饮用，四帖后安稳。
乳头是厥阴经所经过，乳房是阳明经所属。厥阴经，即肝经，是女子致命之地，宗筋之所，且各有囊袋，其初始肿胀虽盛，受患仅止于一二个囊袋，如果脓成不刺，攻溃诸囊袋了。壮者还可以，弱者多致无法救治，所以必须针刺而后痊愈。使用蒲公英、忍冬藤少量加入酒煎服，就想睡觉，这是它的功效，等到醒来病就好了。
未溃破，使用青皮加入栝蒌、桃仁、连翘、川芎、橘叶、皂角刺、甘草节，随证加减煎服。已溃破，使用川芎、当归、人参、黄芪、白芍、青皮、连翘、栝蒌、甘草节煎服。
有一位妇女乳痈，气血颇实，但疮口不合，各种方法无效，给予神效栝蒌散，四帖稍可，再给四帖，以及豆豉饼灸而痊愈。
有一位妇女乳痈，寒热头痛，给予荆防败毒散一帖，再以蒲公英一把，加入酒二三盏，再捣，取酒热服，药渣热敷患处而消散。这因为头痛发热，是表证，所以用表散法。蒲公英俗呼孛孛丁，夏秋间开黄花似菊，散热毒，消肿核，散滞气，解金石毒圣药。乳硬，多因乳母不知调养所致，或因忿怒所逆，郁闷所遏，浓味所酿，以致厥阴之气不行，故窍闭而汁不通，阳明之血沸腾，故热甚而化脓。或因乳子膈有滞痰，含乳而睡，口气热气所吹，而成结核，初便忍痛，揉软吮令汁透可散，否则结成矣。治以青皮疏厥阴之滞，石膏清阳明之热，生甘草节行浊滞之血，栝蒌子导毒消肿，或加没药、青橘叶、皂角刺、金银花、当归，或汤或散，佐以少酒，若加艾火两三壮于痛处尤妙。粗工便用针刀，必惹崛病。
Anger, or being blown by an infant's breath, causing pain and swelling in the breast: treat with soothing the Liver and promoting Qi circulation.
If swelling and pain are severe: clear the Liver and detoxify.
If pain is accompanied by chills and fever: disperse exterior pathogens.
If pus has not yet formed: soothe the Liver and promote Qi circulation.
If pus does not form or does not ulcerate: focus on supporting the interior (Zang-Fu) to expel toxins.
If ulcerated but not healing, or if pus is thin: greatly tonify Qi and Blood.
A woman with a robust constitution and irritable temperament, suffering from long-term emotional depression, had a lump in her left breast that did not resolve; it was slightly tender upon palpation. She took Lianqiao Yin (Forsythia Decoction) for over twenty doses, resulting in slight improvement; subsequently, she took Bazhen Tang (Eight-Treasure Decoction) with added Qingpi (Green Tangerine Peel), Jiegeng (Platycodon Root), Xiangfu (Cyperus Rhizome), and Beimu (Fritillaria Bulb). After another twenty-plus doses, the lump disappeared.
A woman experienced fever and thirst, worse at night, with sudden swelling of both breasts. After taking detoxifying herbs, her heat intensified. Her Liver pulse was surging and rapid, indicating Heat entering the Blood Chamber (Xueshi). Treatment with Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction) stopped the fever and reduced the swelling.
A woman frequently experienced pain in both breasts, a spicy sensation in the mouth, and pulling pain below the umbilicus when rising or lying down hastily. She was cured using Xiaochaihu Tang (Minor Bupleurum Decoction) with added Qingpi, Huanglian (Coptis Rhizome), and Zhizi (Gardenia Fruit).
A woman with long-term depression had a tubercle in her left breast, the size of an apricot kernel, persisting for three months without resolution. Her Heart pulse was choppy, and her Spleen pulse was large and forceful upon pressure. She took Bazhen Tang with added Beimu, Yuanzhi (Polygala Root), Xiangfu, Chaihu (Bupleurum Root), Qingpi, and Jiegeng. After fifty-plus doses, it ulcerated; after another thirty-plus doses, she recovered.
A woman with long-term depression had three nodules in her right breast persisting for over a year. She experienced morning chills and evening fevers, and loss of appetite. This was Ruyan (Breast Cancer/Tumor), caused by emotional injury leading to exhaustion of Qi and Blood in the Liver Meridian. The treatment should tonify Qi and Blood and resolve stagnation. She took Yiqi Yangrong Tang (Qi-Nourishing and Spirit-Supporting Decoction) for over one hundred doses, gradually restoring Qi and Blood. Subsequently, Muxiang Bing Jiu (Musk-fragrant Cake Moxibustion) was applied. Due to her careful self-care, she recovered.
A woman had formed pus but did not ulcerate, experiencing distending pain. I intended to puncture it to prevent toxin spread, but she refused. Several days later, the pain became extreme, and puncture was performed. Three to four bowls of foul pus drained out. Deficiency syndromes arose rapidly, nearly causing death. Large doses of tonic herbs were used, and she stabilized after more than two months.
The breast contains sac-like structures. If pus forms and is not punctured, it will infect all sacs. Young and strong individuals may recover through contraction, but the old and weak often die.
A woman had swelling without pus formation. She took Yiqi Yangrong Tang with added Xiangfu and Qingpi. After several doses, pus formed. Puncture led to recovery within ten days.
A woman had right breast swelling, fever, lethargy, and weakness. Fever was worse at night. She recovered using Buzhong Yiqi Tang (Midway-Uplifting Qi-Boosting Decoction) combined with Xiaoyao San (Free Wanderer Powder).
A postpartum woman, due to low milk supply, took medication to promote lactation, resulting in breast swelling, pain, distension, fever, and thirst, resembling Taiyang disease (Exterior Syndrome). She was cured using Yulu San (Jade Dew Powder).
Breast milk is transformed from Qi and Blood. Above, it becomes milk; below, it becomes menstruation. If Chong and Ren meridians are vigorous and Spleen-Stomach Qi is strong, milk is abundant and thick. If Blood is deficient, milk is scant and thin, and the nursing child will be weak and prone to illness. This is natural law. Some women have milk after multiple births but none after subsequent ones, or experience constipation due to fluid depletion. *San Yin Lun* states there are two causes for blocked lactation: excess Qi and Blood causing blockage, or deficiency causing sluggish flow. Deficiency requires tonification; excess requires unblocking. For excess, use Tongcao (Tetrapanax Pith), Loulu (Radix Euphorbiae Humifusae), and Tuguagen (Radix Trichosanthis Kirilowii); for deficiency, use refined Zhongru Fen (Stalactite Powder), Zhu Xuanti (Swine Trotter Hoof), and Crucian Carp. There are also cases of excessive lactation, usually due to deficiency failing to constrain.
A woman had fever after recovering from Ru Yong (Breast Abscess). Tonifying Qi and Blood herbs were ineffective. Bazhen Tang with Paogansjiang (Pounded Dried Ginger) cured her in four doses. She then took the same formula with Huangqin (Scutellaria Root) and Xiangfu for thirty-plus doses to stabilize.
A woman with formed pus in Ru Yong was punctured promptly and recovered within a month.
A woman had bilateral breast swelling, headache, and chills/fever due to anger. Ren Shen Bai Du San (Ginseng Detoxifying Powder) resolved the exterior syndrome in two doses. Xiaochaihu Tang with Xiongkuai (Ligusticum Rhizome), Danggui (Angelica Sinensis), Jiegeng, and Zhike (Aurantii Fructus) cured her in four doses.
A woman had long-term depression with a breast tubercle persisting for over a year. She had afternoon low-grade fever and poor appetite. Treatment with Yiqi Yangrong Tang was deemed too slow, so she took Qi-moving herbs, worsening the condition. It ulcerated with continuous discharge of clear pus. Upon re-evaluation, her pulse was surging and rapid. I declined treatment. She died over a year later.
A postpartum woman had no milk after her second child. Taking lactation-promoting herbs only caused distension. I stated that milk is derived from Qi and Blood; distension without milk indicates exhaustion of Qi, Blood, and fluids. Tonification was needed. She received Bazhen Tang with doubled Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala Rhizome), plus a little Rougui (Cinnamon Bark). After twenty-plus doses, milk appeared. Later, labor exhausted her again.
Generally, milk appears after the first birth but not the second, as Qi and Blood suffice only for one production; their decline is evident. Occasionally, postpartum lactation is excessive due to Qi deficiency; tonics should stop it. For weaning, if engorgement occurs without suckling, fried Maiya (Hordeum Vulgare Sprout) powder taken with warm water disperses it. If the nipple is broken by the infant, forming a sore, Pugongying (Dandelion) powder or Huanglian Hufen (Scutellaria and Lead White Powder) can be applied. For cracked nipples, Dingxiang (Clove) powder or Ge Fen (Concha Margaritifera) and Yanzhi (Vermilion) powder are effective.
A woman with long-term depression had hard swelling in her right breast. She took Bazhen Tang with Yuanzhi, Beimu, Chaihu, and Qingpi, along with Gexuanjiu (Garlic-Separated Moxibustion) and Shenzhou Gualou San (Miraculous Trichosanthes Powder). Resolution occurred in two months.
A woman had a peach-sized swelling in her left breast, non-tender, unchanged in color, with fever and gradual emaciation. She took Bazhen Tang with Xiangfu, Yuanzhi, Qingpi, and Chaihu for over one hundred doses, interspersed with Shenzhou Gualou San for thirty-plus doses. Pus drained, and she recovered.
Patients demanding rapid results or failing to regulate emotions are difficult to treat. Those over forty are especially difficult due to daily decline of Yin Blood. Physicians who do not distinguish between meridian patterns and deficiency/excess cannot ensure cure.
A woman had an egg-sized lump in her breast, painful upon exertion, persisting for a long time. Interior-supporting herbs failed. This was Ru Lao (Breast Labor/Chronic Breast Disease), caused by Liver Blood deficiency. She first took Shenzhou Gualou San for four doses, followed by garlic-separated moxibustion, reducing swelling slightly. Then she took Bazhen Tang with doubled Xiangfu, Xiakucao (Prunella Spike), and Pugongying, interspersed with the previous powder. Resolution occurred in over a month.
Another condition, Lu Ju (Breast Carbuncle), presents with hard, numb, and stifling swelling. Even if broken, it does not ulcerate or reduce swelling. Urgent administration of this powder and garlic-separated moxibustion are required. These two conditions result from emotional injury and Qi/Blood damage, belonging to Ying (Nutritive) disorders. Anger must be avoided, diet regulated, and lifestyle guarded; otherwise, they are incurable.
A woman over twenty, with weak constitution, had breast pain, headache, and floating pulse. Ren Shen Bai Du San with doubled Ginseng resolved the exterior syndrome in one dose. However, she had poor appetite and afternoon low-grade fever. Xiaochaihu Tang combined with Liujunzi Tang (Six-Gentlemen Decoction) stopped fever and improved appetite in two doses. Finally, interior-supporting herbs with Chaihu cured her in over ten doses after puncturing pus.
Another woman had this condition. I advised prolonged use of Qi/Blood tonics and emotion-resolving herbs to ensure safety. She refused, taking attacking/draining herbs instead. An abscess the size of a bowl opened, draining clear pus. She did not heal and died.
A woman had left breast pain, internal swelling, and fever due to anger. Over-dispersing exterior herbs worsened the heat. Yiqi Yangrong Tang stopped fever in several doses. When pus formed and pain persisted, she refused puncture. Swelling, intense heat, and thirst ensued. Puncture finally released large amounts of pus. She recovered after over one hundred doses of the previous formula.
A man had left breast swelling and pain due to anger. His Liver pulse was wiry and rapid. Fuyuan Tongqi San (Restoring Flow and Promoting Qi Powder) improved him in two doses. Chaihu Tang with Qingpi, Chuanxiong (Szechwan Lovage Rhizome), and Danggui resolved the condition.
A young man suffered night fever and left breast pain with a palm-sized nodule after labor and wind-cold exposure. His pulse was fine, choppy, and rapid. This was Yin stagnating in Yang. Inquiry revealed alcohol consumption. He took Gualouzi (Trichosanthes Seed), Shigao (Gypsum Fibrosum), Gange (Pueraria Lobata Root), Chuanxiong, Baizhi (Angelica Dahurica Root), Fengfang (Honeycomb), and Shengjiang (Fresh Ginger), ground together and drunk with wine. He stabilized after four doses.
The nipple belongs to the Jueyin Meridian (Liver), and the breast belongs to the Yangming Meridian (Stomach). Jueyin is the Liver, the vital organ for women, and the site of Zongjin (Sinews). Each has sac-like structures. Initial swelling, though severe, affects only one or two sacs. If pus forms and is not punctured, it attacks other sacs. Strong individuals may survive; the weak often die. Hence, puncture is necessary for cure. Pugongying (Dandelion) and Rendongteng (Japanese Honeysuckle Stem) decocted with a little wine induce sleep, demonstrating its efficacy. Upon waking, the patient is well.
Before ulceration: Qingpi, Gualou, Taoren (Peach Kernel), Lianqiao (Forsythia Fruit), Chuanxiong, Juye (Tangerine Leaf), Zaocispina (Gleditsia Spine), and Gancaojie (Licorice Joint) decocted with modifications.
After ulceration: Chuanxiong, Danggui, Renshen, Huangqi (Astragalus Root), Baishao (White Peony Root), Qingpi, Lianqiao, Gualou, and Gancaojie decocted.
A woman with Ru Yong had sufficient Qi and Blood but the wound would not close despite various methods. Shenzhou Gualou San improved her in four doses. Another four doses, plus Douchi Bing Jiu (Fermented Soybean Cake Moxibustion), cured her.
A woman with Ru Yong had chills, fever, and headache. Jingfang Bai Du San (Schizonepeta and Saposhnikovia Detoxifying Powder) was given for one dose. A handful of Pugongying was mixed with 2-3 cups of wine, pounded, and the hot wine drunk. The dregs were applied hot to the affected area, resolving the swelling. Headache and fever indicated an exterior syndrome, hence dispersing method was used. Pugongying (Dandelion), blooming yellow flowers like chrysanthemum in summer/autumn, clears heat-toxin, reduces swelling/nodules, moves stagnant Qi, and is a holy medicine for mineral poison. Hardness of the breast is often due to the mother's lack of care, anger, depression, or rich food, causing Jueyin Qi stagnation, blocking ducts and stopping flow. Yangming Blood boils, causing intense heat and pus formation. It can also result from phlegm-stagnation in the infant's diaphragm; sleeping while holding the breast and blowing hot breath creates tubercles. Initially, enduring pain and massaging/sucking to allow flow can disperse them; otherwise, they solidify. Treat with Qingpi to move Jueyin stagnation, Shigao to clear Yangming heat, raw Gancaojie to move turbid blood, and Gualouzi to guide out toxin and reduce swelling. Add Moyao (Myrrh), Qingjuye (Green Tangerine Leaf), Zaocispina, Jinyinhua (Honeysuckle Flower), or Danggui. Use decoction or powder, aided by a little wine. Adding 2-3 moxa cones to the painful spot is excellent. Crude practitioners using needles/knives inevitably cause stubborn diseases.