（附乳岩 无乳并男子乳痈）
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（二百六四）二十
剂少退。更以八珍汤（十四）加青皮、桔梗、香附、贝母。二十余剂而消。（此因症因情也。）
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。（此因症因脉也。）
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、山栀
而愈。（此因症也。）
一妇郁久。左乳内结核如杏许。三月不消。心脉涩。脾脉大。按之无力。以八珍汤（十
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。（此因情因脉也。）
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。
血气枯槁之症。宜补气血。解郁结。遂以益气养荣汤（二百二一）百余剂。血气渐复。更以木
香饼灸之。嘉其谨疾而消。（此因症因情也。）
一妇脓成不溃。胀痛。予欲针之。令毒不侵展。不从。又数日。痛极始针。涌出败脓三
四碗。虚症蜂起几殆。用大补药两月余始安。（此因症也。）
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。（此因症
一妇右乳肿。发热。怠惰嗜卧。无气以动。致夜热尤甚。以补中益气汤兼逍遥散而痊。
（此因症也）
一产妇因乳少。服药通之。致乳房肿胀。发热作渴。状若伤寒。以玉露散补之而愈。
夫乳汁乃气血行化。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。再产乳无。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。有血气弱涩而不行者。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、猪蹄、鲫鱼之
类。概可见矣。亦有乳出不止者。多属于虚不约束也。
一妇乳痈。愈后发热。服养气血药不应。八珍汤加炮姜四剂而愈。仍以前汤加黄 香附
三十余剂而安。（此因症也。）
一妇患此。脓成畏针。病势渐盛。乃强针之。脓出三碗许。脉数发渴。以大补药三十余
剂而愈。（此因症也。）
一妇乳痈脓成。针刺之及时。不月而愈。
一妇产次子而无乳。服下乳药但作胀。予谓乳皆气血所化。今胀而无乳。是气血竭而津
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。后因劳役复
竭。（此因症也。）
盖初产有乳。再产而无。其气血只给一产耳。其衰可知。闻有产后乳出不止。亦为气虚
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。
一妇因怒。两乳肿兼头痛寒热。以人参败毒散二剂。表症已退。以小柴胡（五）加芎、归
、桔梗、枳壳。四剂而痊。（此因症也。）
一妇郁久。右乳内肿硬。以八珍汤加远志、贝母、柴胡、青皮。及隔蒜灸、兼服神效栝
蒌散。（五三）两月余而消。（此因情因症也。）
一妇左乳内肿如桃许。不痛。色不变。发热。渐消瘦。以八珍汤（十四）加香附、远志、
青皮、柴胡百余剂。又间服神效栝蒌散（五三）三十余剂。脓溃而愈。（此因症也。）
患者或责效大速。或不戒七情。俱难治。大抵四十以后者尤难治。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。此乳劳症也。肝经血
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。（此因症因治而处也。）
又有乳疽一症。肿硬木闷。虽破而不溃。肿亦不消。尤当急服此散及隔蒜灸。此二症乃
七情所伤。气血所损。亦劳症也。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。与人参败毒散倍加参一剂。表症悉退。但
少思。日晡微热。更以小柴胡合六君子二剂。热退食进。方以托里药加柴胡十余剂。针出脓
而愈。（此因禀受、因症、因脉也。）
一妇亦患此。予谓须多服养气血解郁结药。可保无害。不信。乃服克伐之剂。反大如碗
。日出清脓。不敛而殁。（此误治也。）
一妇郁久。乳内结核。年余不散。日晡微热。饮食少思。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。
一人年逾五十。患子不立。致左乳肿痛。左胁胀痛。肝脉弦数而涩。先以龙荟丸二服。
顿退。又以小柴胡对四物加青皮、贝母、远志数剂。脓成。予欲针之。仍用养气血解郁结。
不从。乃杂用流气败毒之剂。致便秘发热作渴。复求治。予谓脓成不溃。阳气虚不能鼓舞也
。（此因情因脉也。）
一外家。放出宫人。年四十。左乳内结一核。坚硬。按之微痛。脉弱懒言。此郁结症也。
乳岩。须服解郁结益气血药百贴可保。彼不为然。服十宣散、流气饮。疮反盛。逾二年复请
予视。其形如覆碗。肿硬如石。脓出如泔。予曰脓清脉大。寒热发渴。治之无功。果殁。（
此因情因脉因症而处治。）
一妇因怒。左乳内肿痛。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。仍以前汤百余帖始愈。（此因误治也。）
一妇因怒。左乳作痛。胸膈不利。以方脉流气饮加木香青皮四剂而安。（此因情也）
一男子左乳肿硬痛甚。以仙方活命饮二剂。更以十宣散加青皮、香附四剂。脓成针之而
若脓成未破。疮头有薄皮剥起者。用代针之剂点皮起处。以膏药覆之。脓亦自出。不若及时
之。不致大溃。如出不利。更 搜脓化毒之药。若脓血未尽。辄用生肌之药。反助邪气。纵
早合。必再发。不可不慎。
一人因怒。左乳肿痛。肝脉弦数。以复元通气散二服少愈。以小柴胡加青皮、芎、归而
消。（此因情因脉也。）
一妇年逾三十。每怒后乳内作痛。或肿。此肝火也。与小柴胡合四物汤。加青皮、桔梗
壳、香附而愈。彼欲绝去病根。自服流气饮。遂致朝寒暮热。益加肿痛。此气血被损而然。
予与八珍汤三十余剂。赖其年壮。元气易复。得愈。
一治妇人两乳间出黑头疮。疮顶陷下。作黑眼子。脉弦洪。按之细小。并乳痈初起亦治
升麻 葛根 连翘（各钱半） 黄 归身 甘草（炙各一钱） 肉桂（三分） 黄柏（二分）
粘子（半钱） 锉。作一服。水二分。酒一分。同煎。食后服。此足阳明厥阴药。（此因症也
一后生作劳风寒。夜发热。左乳痛。有核如掌。脉细涩而数。此阴滞于阳也。询之已得
遂以栝蒌子。石膏干葛、川芎、白芷、蜂房、生姜同研。入酒饮之。四贴而安。（此因症因
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。皂用蒲公英、忍冬藤入少酒。煎服。即欲睡。是其功也。及觉而病安矣。未溃以
青皮、栝蒌、桃仁、连翘、川芎、橘叶、皂角刺、甘草节。随症加减。煎服。已溃以参、
、芎、归、白芍、青皮、连翘、栝蒌、甘草节、煎服。
一妇乳痈。气血颇实。但疮口不合。百法不应。与神效栝蒌散四剂少可。更与数剂。及
豆豉饼灸而愈。（此因人因治而处也。）
又有患此未溃。亦与此散三剂而消。良甫云。如有乳劳。便服此药。可杜绝病根。如毒
已成。能化脓为水。毒未成者。从大小便中散矣。
一妇乳痈。寒热头痛。与荆防败毒散一剂。更与蒲公英一握。入酒二三盏。再捣。取酒
热服。渣热罨患处而消。此因头痛发热。乃表症也。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
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。
生甘草节行污浊之血。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。（机按前条用
针。以已成脓言。此条禁针。以未成脓言。未成脓而针则伤良肉。反增疮势。已成脓不针。
则脓蚀良肉。延溃无休。其意各有在也。）
一妇形脉稍实。性躁。难于后姑。乳生隐核。以单味青皮汤间以加减四物汤。加行经络
之剂。两月而安。（此因情也。）
因暴怒或婴儿口气吹袭导致疼痛肿胀的。治宜疏肝行气。
肿胀疼痛剧烈的。治宜清肝解毒。
疼痛伴有寒热的。治宜发散表邪。
脓未形成的。治宜疏肝行气。
不化脓或不溃破的。以托里透脓为主。
溃破后不能愈合，或脓液稀薄的。治宜大补气血。
有一位妇女体质充实但性情急躁，长期怀抱抑郁，左侧乳房内结成一核块不消散，按压时微痛。服用连翘饮子二百零四剂后稍见消退，随后改用八珍汤十四加青皮、桔梗、香附、贝母，服用二十余剂后肿块消散。（这是因病机与情志因素所致。）
有一位妇女发热口渴，夜间尤为严重，双侧乳房突然肿胀。服用败毒药物后热势反而炽盛。诊察发现肝脉洪数，判断为热入血室。使用加味小柴胡汤治疗，热退肿消。（这是因病机与脉象所致。）
有一位妇女双侧乳房时常作痛，口中常感辛辣，卧起行动急促，脐下牵引作痛。使用小柴胡汤加青皮、黄连、山栀而痊愈。（这是因病机所致。）
有一位妇女郁结日久，左侧乳房内结核如杏核大小，三个月不消散。心脉涩，脾脉大，按之无力。使用八珍汤十加贝母、远志、香附、柴胡、青皮、桔梗，服用五十余剂后溃破，又三十余剂后痊愈。（这是因情志与脉象所致。）
有一位妇女久郁，右侧乳房内结三核，一年多不消散，早晨恶寒傍晚发热，饮食不甘美。此为乳岩症。乃七情所伤，气血枯槁之症。宜补气血，解郁结。遂用益气养荣汤二百二十一百余剂，气血逐渐恢复，再用木香饼灸患处，因其谨遵医嘱而消散。（这是因病机与情志所致。）
有一位妇女脓已形成但不溃破，胀痛。我想为她针刺，令毒邪不扩散蔓延，但她不听从。又过数日，疼痛极度剧烈才针刺，涌出败脓三四碗，虚证蜂拥而起，几乎危及生命。使用大补药两个多月才安定。（这是因病机所致。）
乳房有囊橐结构，若有脓而不针刺，则毒素会遍犯所有囊橐。年轻力壮者尚可收敛，年老体弱者多致不治。
有一位妇女肿胀但不化脓，用益气养荣汤加香附、青皮，数剂后脓成，针刺后十日痊愈。（这是因病机所致。）
有一位妇女右乳肿胀，发热，倦怠嗜卧，气短懒动，致使夜间热势尤甚。用补中益气汤兼逍遥散而痊愈。（这是因病机所致。）
一位产妇因乳汁少，服药通乳，导致乳房肿胀，发热口渴，症状像伤寒。用玉露散补益而痊愈。
乳汁是由气血运行化生而成，在上化为乳汁，在下化为月经。若冲任脉盛，脾胃气壮，则乳汁多且浓稠；血衰则乳汁少且清淡。所哺育的孩子也会虚弱多病。这是自然之理。也有屡产有乳，再产却无乳的情况，或因大便涩滞，乃是亡失津液所致。《三因论》说：产妇乳脉不通有二种情况，有气血盛闭而不通的，有血气弱涩而不通的。虚当补之，盛当疏之。盛者当用通草、漏芦、土瓜根之类；虚者当用炼成钟乳粉、猪蹄、鲫鱼之类。概可见矣。也有乳汁出不止的，多属于虚而不能约束。
有一位妇女患乳痈，愈后发热，服用养气血药无效，用八珍汤加炮姜四剂而愈，仍以前方加黄柏、香附三十余剂而安。（这是因病机所致。）
有一位妇女患此病，脓成畏针，病势渐盛，强行针刺，脓出约三碗，脉数发热口渴，用大补药三十余剂而愈。（这是因病机所致。）
一位产妇生第二个孩子而无乳汁，服下乳药只觉胀满。我认为乳汁皆由气血化生，如今胀而无乳，是气血竭乏津液枯竭。应当补气血，自有乳汁。给予八珍汤倍加人参、白术，少加肉桂，二十余剂后乳汁遂生。后因劳累再次枯竭。（这是因病机所致。）
大概初产有乳，再产而无，其气血只够供应一胎生产而已，其衰退可知。听说有产后乳汁出不止的，也是气虚，用补药止之。或者断奶时，婴儿不吸吮，也能造成胀满，用麦芽炒为末，白开水调服以消散之。若婴儿吸破乳头成疮，用蒲公英末，或黄连、胡粉散掺之。若乳头裂破，用丁香末，或蛤粉、胭脂末敷之。
有一位妇女因发怒，双侧乳房肿胀兼头痛寒热，用人参败毒散二剂，表症已退，用小柴胡汤五加川芎、当归、桔梗、枳壳，四剂而痊愈。（这是因病机所致。）
有一位妇女郁结日久，右侧乳房内肿硬，用八珍汤十四加远志、贝母、柴胡、青皮，以及隔蒜灸，兼服神效栝蒌散五十三，两月余而消散。（这是因情志与病机所致。）
有一位妇女左侧乳房内肿如桃核大小，不痛，颜色不变，发热，逐渐消瘦。用八珍汤十四加香附、远志、青皮、柴胡百余剂，又间服神效栝蒌散五十三三十余剂，脓溃而愈。（这是因病机所致。）
患者如果责备疗效太慢，或不戒除七情，都难治。大致四十岁以后者尤其难治。因为阴血日渐亏虚。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，劳累则作痛，久而不消，服用托里药无效。此为乳劳症。乃肝经血滞所致。先给神效栝蒌散四剂，更隔蒜灸，肿稍退，再服八珍汤，倍加香附、夏枯草、蒲公英，仍间服前散，月余而消散。（这是因病机与治疗处置所致。）
又有乳疽一症，肿硬木闷，虽破而不溃，肿也不消。尤其应当急服此散及隔蒜灸。这两症乃七情所伤，气血所损，也是劳症。宜戒怒，节饮食，慎起居，否则不治。
有一位妇女年逾二十，禀赋弱，乳房内作痛，头疼脉浮，给人参败毒散倍加人参一剂，表症悉退，但少思食，日晡微热，更用小柴胡合六君子二剂，热退食进，方用托里药加柴胡十余剂，针出脓而愈。（这是因禀受、病机、脉象所致。）
有一位妇女也患此病，我说须多服养气血解郁结药，可保无害。不信，乃服克伐之剂，反大如碗，日出清脓，不敛而死亡。（这是误治。）
有一位妇女郁结日久，乳房内结核，一年多不散，日晡微热，饮食少思，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，又年余果死亡。
一人年逾五十，患子不立，致左乳肿痛，左胁胀痛，肝脉弦数而涩。先以龙荟丸二服，顿退。又以小柴胡对四物加青皮、贝母、远志数剂，脓成。我想为他针刺，仍用养气血解郁结，他不听从，乃杂用流气败毒之剂，致便秘发热作渴，复求治，我说脓成不溃，阳气虚不能鼓舞也。（这是因情志与脉象所致。）
一位岳母，放出宫人，年四十，左乳内结一核，坚硬，按之微痛，脉弱懒言，此为郁结症也，乳岩，须服解郁结益气血药百贴可保。彼不为然，服十宣散、流气饮，疮反盛，逾二年复请予视，其形如覆碗，肿硬如石，脓出如泔，予曰脓清脉大，寒热发渴，治之无功，果死亡。（这是因情志、脉象、病机而处置。）
有一位妇女因发怒，左乳内肿痛，发热，表散太过，致热益甚，用益气养荣汤数剂，热止脓成，痛，针刺不从，遂肿胀，大热发渴始针，脓大泄，仍以前方百余帖始愈。（这是因误治所致。）
有一位妇女因发怒，左乳作痛，胸膈不利，用方脉流气饮加木香青皮四剂而安。（这是因情志所致。）
一男子左乳肿硬痛甚，用仙方活命饮二剂，更以十宣散加青皮、香附四剂，脓成针之而愈。
若脓成未破，疮头有薄皮剥起者，用代针之剂点皮起处，以膏药覆之，脓亦自出，不若及时针刺，不致大溃。如出不利，更搜脓化毒之药。若脓血未尽，辄用生肌之药，反助邪气，纵使早合，必再发，不可不慎。
一人因发怒，左乳肿痛，肝脉弦数，用复元通气散二服少愈，用小柴胡加青皮、川芎、当归而消散。（这是因情志与脉象所致。）
有一位妇女年逾三十，每怒后乳内作痛，或肿，此为肝火也，与小柴胡合四物汤，加青皮、桔梗、枳壳、香附而愈。彼欲绝去病根，自服流气饮，遂致朝寒暮热，益加肿痛，此为气血被损而然。予与八珍汤三十余剂，赖其年壮，元气易复，得愈。
一治妇人两乳间出黑头疮，疮顶陷下，作黑眼子，脉弦洪，按之细小，并乳痈初起亦治。升麻、葛根、连翘（各钱半）、黄芪、归身、甘草（炙各一钱）、肉桂（三分）、黄柏（二分）、粘子（半钱）。锉，作一服，水二分，酒一分，同煎，食后服。此足阳明厥阴药。（这是因病机所致。）
一后生作劳风寒，夜发热，左乳痛，有核如掌，脉细涩而数，此为阴滞于阳也。询之已得遂以栝蒌子、石膏干葛、川芎、白芷、蜂房、生姜同研，入酒饮之，四贴而安。（这是因病机与脉象所致。）
乳头属厥阴经，乳房属阳明所属。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。所以必须针刺而后愈。皂角刺用蒲公英、忍冬藤入少酒，煎服，即欲睡，是其功也。及觉而病安矣。未溃以青皮、栝蒌、桃仁、连翘、川芎、橘叶、皂角刺、甘草节，随症加减，煎服。已溃以人参、黄芪、川芎、当归、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，百法不应，与神效栝蒌散四剂少可，更与数剂，及豆豉饼灸而愈。（这是因人因治疗处置所致。）
又有患此未溃，亦与此散三剂而消。良甫云：如有乳劳，便服此药，可杜绝病根。如毒已成，能化脓为水，毒未成者，从大小便中散矣。
有一位妇女乳痈，寒热头痛，与荆防败毒散一剂，更与蒲公英一握，入酒二三盏，再捣，取酒热服，渣热罨患处而消。此因头痛发热，乃表症也。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。乳痈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，生甘草节行污浊之血，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。（汪机按：前条用针，以已成脓言；此条禁针，以未成脓言。未成脓而针则伤良肉，反增疮势；已成脓不针，则脓蚀良肉，延溃无休。其意各有在也。）
有一位妇女形脉稍实，性躁，难于侍奉公婆，乳生隐核，以单味青皮汤间以加减四物汤，加行经络之剂，两月而安。（这是因情志所致。）
(Attached: Breast Cancer [Ru Yan], Absence of Milk, and Male Breast Abscess [Ru Yong])
For pain and swelling caused by sudden anger or being blown upon by an infant's breath: Treat with soothing the Liver and promoting Qi circulation.
For severe swelling and pain: Treat with clearing the Liver and detoxifying.
For pain accompanied by aversion to cold and fever: Treat with dispersing exterior pathogens.
When pus has not yet formed: Treat with soothing the Liver and promoting Qi circulation.
When pus does not form or does not ulcerate: Prioritize supporting the interior (Tuo Li).
When ulcerated but not healing, or when pus is thin: Treat with major tonification of Qi and Blood.
A woman with a robust constitution but irritable temperament, suffering from long-term emotional depression, had a nodule forming in her left breast that did not resolve. It was slightly painful upon palpation. After taking Linqiao Yinzi (Forsythia Decoction) for 20 doses, it subsided slightly. Subsequently, Bazhen Tang (Eight-Treasure Decoction) was modified with Qingpi (Green Tangerine Peel), Jiegeng (Platycodon Root), Xiangfu (Cyperus Rhizome), and Beimu (Fritillaria Bulb), taken for over 20 doses until the nodule disappeared. (This case was due to pathological mechanisms and emotional factors.)
A woman experienced fever and thirst, worse at night, with sudden swelling of both breasts. After taking detoxifying drugs, the heat intensified. Examination revealed a surging and rapid Liver pulse, indicating Heat entering the Blood Chamber. Treatment with Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction) resolved the fever and swelling. (This case was due to pathological mechanisms and pulse findings.)
A woman frequently experienced pain in both breasts, a spicy sensation in the mouth, urgency in lying down and rising, and pulling pain below the umbilicus. She was cured using Xiaochaihu Tang (Minor Bupleurum Decoction) modified with Qingpi (Green Tangerine Peel), Huanglian (Coptis Rhizome), and Shanzhi (Gardenia Fruit). (This case was due to pathological mechanisms.)
A woman with long-standing depression had a nodule in her left breast the size of an apricot kernel that persisted for three months. The Heart pulse was choppy, and the Spleen pulse was large but weak upon pressure. Treatment with Bazhen Tang (Eight-Treasure Decoction) modified with Beimu (Fritillaria Bulb), Yuanzhi (Polygala Root), Xiangfu (Cyperus Rhizome), Chaihu (Bupleurum Root), Qingpi (Green Tangerine Peel), and Jiegeng (Platycodon Root) for over 50 doses led to ulceration, followed by recovery after another 30 doses. (This case was due to emotional factors and pulse findings.)
A woman with long-standing depression had three nodules in her right breast persisting for over a year, accompanied by morning chills and evening fevers, and poor appetite. This was diagnosed as Ru Yan (Breast Cancer), caused by injury from the Seven Emotions, resulting withered Qi and Blood. Treatment involved tonifying Qi and Blood and resolving stagnation using Yiqi Yangrong Tang (Qi-Nourishing and Blood-Enriching Decoction) for over 100 doses, gradually restoring Qi and Blood. Moxibustion with a Muxiang cake was applied to the affected area. Due to strict adherence to medical advice, it resolved. (This case was due to pathological mechanisms and emotional factors.)
A woman had formed pus but did not ulcerate, experiencing distending pain. The physician intended to puncture it to prevent toxin spread, but she refused. Days later, extreme pain prompted puncture, draining three to four bowls of foul pus. Deficiency symptoms arose rapidly, nearly causing death. Major tonifying medicines were used for over two months before stability was achieved. (This case was due to pathological mechanisms.)
The breast contains sac-like structures. If pus forms and is not punctured, toxins will invade all sacs. Young and strong individuals may recover; old and weak individuals often die.
A woman had swelling without pus formation. Treatment with Yiqi Yangrong Tang (Qi-Nourishing and Blood-Enriching Decoction) modified with Xiangfu (Cyperus Rhizome) and Qingpi (Green Tangerine Peel) for several doses led to pus formation. Puncture resulted in recovery within ten days. (This case was due to pathological mechanisms.)
A woman had right breast swelling, fever, lethargy, and shortness of breath, with worsening night fevers. Recovery was achieved using Buzhong Yiqi Tang (Middle-Warmer-Boosting Qi-Rescuing Decoction) combined with Xiaoyao San (Free Wanderer Powder). (This case was due to pathological mechanisms.)
A postpartum woman took medicine to promote lactation due to low milk supply, resulting in breast swelling, fever, and thirst resembling Taiyang disease. She recovered after treatment with Yulu San (Jade Dew Powder) to tonify.
Milk is transformed from Qi and Blood. Above, it becomes milk; below, it becomes menstruation. If Chong and Ren vessels are vigorous and Spleen and Stomach Qi are strong, milk is abundant and thick; if Blood is deficient, milk is scant and thin. The nursed child will also 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 loss of body fluids. The *San Yin Lun* states there are two causes for blocked lactation: obstruction due to excess Qi and Blood, or blockage due to weak and sluggish Qi and Blood. Deficiency requires tonification; excess requires dispersion. For excess, use Tongcao (Tetrapanax Pith), Loulu (Radix Euphorbiae Humifusae), and Tuguagen (Radix Trichosanthis); for deficiency, use refined Zhongru Fen (Calcitum Powder), pig trotters, and crucian carp. There are also cases of continuous milk leakage, usually due to deficiency failing to constrain.
A woman had fever after recovering from a breast abscess. Tonifying Qi and Blood was ineffective. Bazhen Tang (Eight-Treasure Decoction) modified with Paojiang (Roasted Ginger) for four doses cured her. Continuation with the same formula plus Huangbai (Phellodendron Bark) and Xiangfu (Cyperus Rhizome) for over 30 doses ensured stability. (This case was due to pathological mechanisms.)
A woman feared puncture despite pus formation, leading to worsening condition. Forced puncture drained about three bowls of pus. Rapid pulse, fever, and thirst were treated with major tonifying medicines for over 30 doses until recovery. (This case was due to pathological mechanisms.)
A woman with a breast abscess and formed pus was punctured timely and recovered within a month.
A woman giving birth to her second child had no milk. Medicines to promote lactation only caused distension. Since milk is transformed from Qi and Blood, distension without milk indicates exhaustion of Qi and Blood and depletion of fluids. Tonification of Qi and Blood was prescribed. Bazhen Tang (Eight-Treasure Decoction) with doubled Renshen (Ginseng Root) and Baizhu (Atractylodes Rhizome), plus a little Rougui (Cinnamon Bark), administered for over 20 doses produced milk. Later, labor caused recurrence of exhaustion. (This case was due to pathological mechanisms.)
Generally, initial lactation occurs, but subsequent births yield none, as Qi and Blood suffice only for one pregnancy; decline is evident. Postpartum continuous leakage is due to Qi deficiency, treated with tonics. Weaning without suckling can cause distension; fried malt powder mixed in warm water disperses it. If the nipple is cracked by the infant, apply Dugongying (Dandelion) powder, or Huanglian (Coptis Rhizome) and Hufen (Lead White) powder. For cracked nipples, Dingxiang (Clove) powder, or Ge Fen (Concha Meretricis) and Yanzhi (Vermilion) powder can be applied.
A woman, angered, had bilateral breast swelling with headache and aversion to cold/fever. Renshen Baidu San (Ginseng Detoxification Powder) for two doses resolved exterior symptoms. Xiaochaihu Tang (Minor Bupleurum Decoction) modified with Xiong (Ligusticum Rhizome), Danggui (Angelica Sinensis), Jiegeng (Platycodon Root), and Zhike (Aurantii Fructus) for four doses cured her. (This case was due to pathological mechanisms.)
A woman with long-standing depression had hard swelling in her right breast. Bazhen Tang (Eight-Treasure Decoction) modified with Yuanzhi (Polygala Root), Beimu (Fritillaria Bulb), Chaihu (Bupleurum Root), and Qingpi (Green Tangerine Peel), combined with Garlic-Separated Moxibustion and Shenxiao Gualou San (Miraculous Efficacy Trichosanthes Powder) for over two months resolved it. (This case was due to emotional and pathological factors.)
A woman had a peach-sized non-painful, color-normal swelling in her left breast, with fever and gradual emaciation. Bazhen Tang (Eight-Treasure Decoction) modified with Xiangfu (Cyperus Rhizome), Yuanzhi (Polygala Root), Qingpi (Green Tangerine Peel), and Chaihu (Bupleurum Root) for over 100 doses, interspersed with Shenxiao Gualou San (Miraculous Efficacy Trichosanthes Powder) for over 30 doses, led to pus discharge and recovery. (This case was due to pathological mechanisms.)
Patients demanding rapid results or failing to regulate emotions are difficult to treat. Those over forty are particularly difficult due to daily decline of Yin Blood. Physicians who fail to distinguish meridian excess or deficiency cannot ensure cure.
A woman had an egg-sized lump in her breast, painful upon exertion, persisting without response to interior-supporting medicines. This was Ru Lao (Breast Labor), caused by Liver meridian blood stasis. Shenxiao Gualou San (Miraculous Efficacy Trichosanthes Powder) for four doses and garlic-separated moxibustion reduced swelling. Bazhen Tang (Eight-Treasure Decoction) with increased Xiangfu (Cyperus Rhizome), Xiakucao (Prunella Spike), and Dugongying (Dandelion), interspersed with the previous powder, resolved it within a month. (This case was due to pathological mechanisms and treatment strategy.)
Ru Ju (Breast Carbuncle) presents with hard, numb swelling that does not ulcerate even if broken, nor does swelling subside. Urgent application of this powder and garlic-separated moxibustion is required. These conditions result from Seven Emotions injury and Qi/Blood damage, classified as Labor syndromes. Anger must be regulated, diet moderated, and rest ensured; otherwise, it is untreatable.
A woman over twenty with weak constitution had breast pain, headache, and floating pulse. Renshen Baidu San (Ginseng Detoxification Powder) with doubled Renshen (Ginseng Root) for one dose resolved exterior symptoms. Lingering lack of appetite and afternoon mild fever were treated with Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Liu Junzi Tang (Six Gentlemen Decoction) for two doses, stopping fever and improving appetite. Interior-supporting medicines with Chaihu (Bupleurum Root) for over ten doses, followed by puncture, cured her. (This case was due to constitutional factors, pathological mechanisms, and pulse findings.)
Another woman with this condition was advised to take Qi/Blood tonics and emotion-resolving medicines to avoid harm. Disobeying, she took attacking/depleting medicines, causing the breast to swell like a bowl, discharging clear pus, failing to heal, and resulting in death. (This was misdiagnosis/mistreatment.)
A woman with long-standing depression had a breast nodule persisting for over a year, with afternoon mild fever and poor appetite. Yiqi Yangrong Tang (Qi-Nourishing and Blood-Enriching Decoction) was deemed too slow; she took Qi-moving medicines, worsening the condition. Ulceration occurred with continuous clear pus discharge. Upon return, her pulse was surging and rapid; treatment was declined. She died a year later.
A man over fifty, unable to establish offspring, developed left breast and hypochondriac swelling/pain. His Liver pulse was wiry, rapid, and choppy. Longhui Wan (Dragon Gallbladder Pill) for two doses brought immediate relief. Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Siwu Tang (Four Substance Decoction) modified with Qingpi (Green Tangerine Peel), Beimu (Fritillaria Bulb), and Yuanzhi (Polygala Root) for several doses formed pus. The physician intended puncture and continued tonifying Qi/Blood and resolving stagnation, but he refused, instead using miscellaneous Qi-flowing and detoxifying agents, causing constipation, fever, and thirst. Upon return, the physician stated that formed pus not ulcerating indicates deficient Yang Qi failing to urge expulsion. (This case was due to emotional factors and pulse findings.)
A mother-in-law, released from palace service, aged forty, had a hard, slightly painful left breast nodule with weak pulse and reluctance to speak. This was a stagnation syndrome, potentially Ru Yan (Breast Cancer). Hundred doses of emotion-resolving and Qi/Blood-tonifying medicines could ensure safety. She refused, taking Shixuan San (Ten-Vitality Powder) and Liqi Yin (Qi-Flowing Decoction), worsening the sore. Two years later, it resembled an inverted bowl, stone-hard, discharging milky pus. The physician noted clear pus, large pulse, fever/thirst, and declared treatment futile. She died. (This case was due to emotional, pulse, and pathological factors.)
A woman, angered, had left breast swelling/pain and fever. Excessive exterior-dispersing worsened the heat. Yiqi Yangrong Tang (Qi-Nourishing and Blood-Enriching Decoction) for several doses stopped fever and formed pus. Refusing puncture, swelling worsened. Extreme heat/thirst finally prompted puncture, draining large amounts of pus. Over 100 doses of the previous formula cured her. (This was mistreatment.)
A woman, angered, had left breast pain and chest diaphragm discomfort. Fangmai Liqi Yin (Pulse-Qi Flowing Decoction) modified with Muxiang (Aucklandia Root) and Qingpi (Green Tangerine Peel) for four doses relieved her. (This was due to emotional factors.)
A man had severe left breast swelling/hardness/pain. Xianfang Huoming Yin (Immortal Formula for Life-Preserving Decoction) for two doses, followed by Shixuan San (Ten-Vitality Powder) modified with Qingpi (Green Tangerine Peel) and Xiangfu (Cyperus Rhizome) for four doses, formed pus which was then punctured, curing him.
If pus is formed but unbroken, with thin skin peeling at the head, apply a needle-replacing agent to the raised skin, cover with plaster, and pus will drain naturally. Timely puncture prevents extensive ulceration. If drainage is difficult, use pus-searching and toxin-resolving medicines. Using flesh-generating medicines before pus/blood is cleared aids pathogens; even if healed early, recurrence is certain. Caution is essential.
A man, angered, had left breast swelling/pain with a wiry, rapid Liver pulse. Fuyuan Tongqi San (Restoring Origin and Promoting Qi Circulation Powder) for two doses improved symptoms slightly. Xiaochaihu Tang (Minor Bupleurum Decoction) modified with Qingpi (Green Tangerine Peel), Xiong (Ligusticum Rhizome), and Danggui (Angelica Sinensis) resolved it. (This was due to emotional factors and pulse findings.)
A woman over thirty experienced breast pain/swelling after anger, indicating Liver Fire. Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Siwu Tang (Four Substance Decoction) modified with Qingpi (Green Tangerine Peel), Jiegeng (Platycodon Root), Zhike (Aurantii Fructus), and Xiangfu (Cyperus Rhizome) cured her. Seeking to eliminate the root cause, she self-administered Liqi Yin (Qi-Flowing Decoction), causing morning chills/evening fevers and increased swelling/pain due to Qi/Blood damage. Bazhen Tang (Eight-Treasure Decoction) for over 30 doses cured her, aided by her youth and easy recovery of Yuan Qi.
Treating black-headed sores between breasts with depressed centers and small black openings, wiry-surge pulse feeling fine-small on pressure, and early-stage breast abscess: Shengma (Cimicifuga Rhizome), Gegen (Pueraria Root), Linqiao (Forsythia Fruit) (each 1.5 qian), Huangqi (Astragalus Root), Danggui (Angelica Sinensis), Gancao (Licorice Root, roasted) (each 1 qian), Rougui (Cinnamon Bark) (0.3 qian), Huangbai (Phellodendron Bark) (0.2 qian), Nianzi (Semen Plantaginis) (0.5 qian). Crushed, decocted in 2 parts water and 1 part wine, taken after meals. This targets the Foot Yangming and Jueyin meridians. (This was due to pathological mechanisms.)
A young man exhausted by labor and wind-cold had night fevers, left breast pain, and a palm-sized nodule with a fine-choppy-rapid pulse. This indicated Yin stagnation in Yang. Treatment with Gualouzi (Trichosanthes Seed), Shigao (Gypsum), GanGe (Pueraria Root), Chuanxiong (Ligusticum Rhizome), Baizhi (Angelica Dahurica), Fengfang (Honeycomb), and Shengjiang (Fresh Ginger), ground and taken with wine for four doses, resolved it. (This was due to pathological mechanisms and pulse findings.)
The nipple belongs to the Jueyin meridian; the breast belongs to the Yangming. Jueyin is the Liver, the vital organ for women, and the site of Zongjin (tendons). Each has sac-like structures. Initial swelling affects only one or two sacs; if pus forms and is not punctured, other sacs will be invaded. Strong individuals may survive; weak ones often die. Hence, puncture is necessary for cure. For unulcerated stages, use Qingpi (Green Tangerine Peel), Gualou (Trichosanthes Fruit), Taoren (Peach Kernel), Linqiao (Forsythia Fruit), Chuanxiong (Ligusticum Rhizome), Juye (Tangerine Leaf), Zaocis Spina (Zanthoxylum Spine), and Gancao Jie (Licorice Joint). Modify according to symptoms. For ulcerated stages, use Renshen (Ginseng Root), Huangqi (Astragalus Root), Chuanxiong (Ligusticum Rhizome), Danggui (Angelica Sinensis), Baishao (White Peony Root), Qingpi (Green Tangerine Peel), Linqiao (Forsythia Fruit), Gualou (Trichosanthes Fruit), and Gancao Jie (Licorice Joint).
A woman with robust Qi/Blood but non-healing breast abscess wounds failed to respond to hundred methods. Shenxiao Gualou San (Miraculous Efficacy Trichosanthes Powder) for four doses showed slight improvement; continued doses and fermented soybean cake moxibustion cured her. (This was due to patient constitution and treatment strategy.)
Another case of unulcerated abscess resolved with three doses of this powder. Liangfu stated: For Ru Lao (Breast Labor), taking this medicine prevents recurrence. If toxin has formed pus, it converts pus to water; if not formed, it disperses via urine/stool.
A woman with breast abscess, chills/fever/headache, took Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxification Powder) for one dose, followed by a handful of Dugongying (Dandelion) pounded with 2-3 cups of wine, taken hot, with dregs applied hot to the site, resolving the condition. Headache/fever indicated exterior symptoms, hence exterior-dispersing was used.
Dugongying (Dandelion), commonly called Boboding, blooms yellow flowers like chrysanthemums in summer/autumn. It clears heat/toxin, reduces swelling/nodules, disperses stagnant Qi, and is a holy medicine for resolving mineral poison. Breast abscesses result from nursing mothers' failure to nourish themselves, anger, depression, or rich foods, causing Jueyin Qi stagnation (blocking ducts) and Yangming Blood boiling (causing heat/pus). Alternatively, phlegm-stagnation in the diaphragm while sleeping with the infant, or hot breath blown into the breast, can form nodules. Initially, gentle rubbing and sucking can disperse them; otherwise, they solidify. Treatment uses Qingpi (Green Tangerine Peel) to soothe Jueyin stagnation, Shigao (Gypsum) to clear Yangming heat, raw Gancao Jie (Licorice Joint) to move turbid blood, and Gualouzi (Trichosanthes Seed) to guide out toxin and reduce swelling. Modifications include Moyao (Myrrh), Qingjuye (Green Tangerine Leaf), Zaocis Spina (Zanthoxylum Spine), Jinyinhua (Honeysuckle Flower), and Danggui (Angelica Sinensis), in decoction or powder, assisted by a little wine. Adding 2-3 moxa cones to the painful spot is excellent. Crude practitioners using needles/knives prematurely invite serious complications. (Wang Ji notes: The previous section advocates puncture for formed pus; this section prohibits it for unformed pus. Puncturing unformed pus damages healthy flesh and worsens the sore; failing to puncture formed pus allows pus to erode flesh and prolongs ulceration. The intentions differ.)
A woman with slightly robust form/pulse but irritable temperament, struggling with filial duties, developed hidden breast nodules. Single-ingredient Qingpi Tang (Green Tangerine Peel Decoction) interspersed with modified Siwu Tang (Four Substance Decoction) and meridian-promoting agents resolved it within two months. (This was due to emotional factors.)