夫乳痈之生也，有因乳儿之时，偶尔贪睡，儿以口气吹之，使乳内之气闭塞不通，以致
作痛（此即外吹证），因循失治而成者；有因所乳之子，膈有滞痰，口气 热，贪乳而睡，热
气吹入乳房，凝滞不散，乳汁不通，以致结核化脓而成者；亦有忧郁暴怒伤肝，肝气结滞而
成者；又有肝胃湿热凝聚，或风邪客热壅滞而成者。始时疼痛坚硬，乳汁不出，渐至皮肤
肿，寒热往来，则痈成而内脓作矣。凡初起，当发表散邪、疏肝清胃，速下乳汁，导其壅塞
，则自当消散；若不散成脓，宜用托里；若溃后肌肉不生，脓水清稀，宜补脾胃；若脓出反
痛，恶寒发热，宜调营卫；若晡热 肿作痛，宜补阴血；若食少作呕，宜补胃气，切戒清凉
解毒，反伤脾胃也。况乳本血化，不能漏泄，遂结实肿，乳性清寒，又加凉药，则肿硬者难
溃脓，溃脓者难收口矣。其药初起，如牛蒡子散、橘叶汤、逍遥散之类；溃后，则宜益气养
营汤。又若半夏、贝母、栝蒌消胃中壅痰，青皮疏厥阴之滞，公英、木通、山甲解热毒、利
关窍，当归、甘草补正和邪，一切清痰疏肝、和血解毒之品，随宜用之可也。又有湿火挟肝
阳逆络，或时疫、或伏邪聚结而成者，起时乳头肿硬，乳房 红漫肿，恶寒身热，毛孔深陷
，二、三日后，皮即湿烂，隔宿焦黑已腐，再数日后，身热退而黑腐尽脱，其生新肉如榴子
象。掺以珍珠散，以白玉膏盖之；内服疏肝清湿热之剂以收功。此湿火乳痈也。再妇人乳头
有数孔，一孔又有一络，络于乳房。其始生痈也，祗患一络，迨其脓血出尽，又患一络，逐
络递及，遂至满乳，则危而不救者多矣。初起，每早服元寿丹，可保不传余络。（今外科谓
乳有数穣，欲传穣者非也）
若其始生硬肿，即有头出，后复旁生数头，头中有脓不多，此名乳疽。是为阳明痰热之
毒，兼挟肝胆之火结成。治当清理痰气、疏通肝邪、解毒和营，如荆、防、苏叶、白芷、
贝母、栝蒌、青皮、夏枯草等物，在所需用矣。
附∶内吹，孕妇二、三月，或至八、九个月，乳中有核成痈。是胎气旺而上冲，致阳明
乳房结肿疼痛。宜服石膏散清之可消；若溃后虽脓出腐脱肌生，必俟分娩后始能收口。
乳头风，乳头干燥而裂，痛如刀刺，或揩之出血，或流粘水，或结黄脂。此由暴怒抑郁
，肝经火邪不能施泄所致，胎前产后俱有之。内服加味逍遥散；外以白芷末，乳汁顿熟调敷
。
男子乳疖，与女子不同。男子乳头属肝，乳房属肾，以肝虚血燥，肾虚精怯，故结肿痛
。治当以六味地黄汤加归、芍、青皮主之。
乳房痈肿的发生，有的是因为哺乳时，母亲偶尔贪睡，婴儿用口气吹入乳头，导致乳内气机闭塞不通，从而引起疼痛（这就是外吹证），因拖延失治而形成的；有的是因为所哺乳的婴儿，膈间有停滞的痰湿，口中有热气，贪恋吃奶而睡着，热气吹入乳房，使乳汁凝滞不散，乳汁不通，从而形成结核并化脓；也有的是因为忧郁或暴怒损伤肝脏，肝气结滞而形成的；还有的是因为肝胃湿热凝聚，或者风邪客热壅滞而形成的。起初表现为疼痛且乳房坚硬，乳汁排不出，逐渐发展到皮肤肿胀，出现寒热往来的症状，这时痈肿已成，内部开始化脓。凡是初起阶段，应当采用发表散邪、疏肝清胃的方法，迅速通下乳汁，疏导壅塞之气，这样自然就会消散；如果未能消散而化为脓液，适宜使用托里透脓法；如果溃破后肌肉不生，脓水清稀，适宜补益脾胃；如果脓出后反而疼痛，伴有恶寒发热，适宜调和营卫；如果午后潮热、肿胀作痛，适宜滋补阴血；如果食欲减少、恶心呕吐，适宜补益胃气，切记要戒除使用清凉解毒药物，以免反伤脾胃。况且乳汁是由血液化生的，不能随意漏泄，于是凝结结实而肿胀，乳房本性清寒，如果再使用凉药，那么肿胀坚硬的将难以溃脓，已经溃破的将难以收口愈合。初期用药，如牛蒡子散、橘叶汤、逍遥散之类；溃破后，则适宜服用益气养营汤。另外，若用半夏、贝母、栝蒌消除胃中的壅滞痰湿，青皮疏通厥阴肝经的郁滞，蒲公英、木通、穿山甲解除热毒、利通关窍，当归、甘草扶助正气、调和邪气，一切清化痰湿、疏肝理气、和血解毒的药物，根据具体情况选用即可。又有湿火夹杂肝阳逆乱经络，或者由时疫、伏邪聚结而成的，发病时乳头肿胀坚硬，乳房弥漫性红肿，恶寒身热，毛孔深陷，两三天后，皮肤即湿烂，隔夜焦黑腐烂，再过几天，身热退去，黑色腐肉完全脱落，新生的肌肉像石榴籽一样。外掺珍珠散，用白玉膏覆盖；内服疏肝清湿热之剂以收功。这是湿火乳痈。再如妇人乳头有几个孔，每个孔又有一根络脉，联络于乳房。其初生痈肿时，只患一根络脉，等到这根络脉的脓血流尽后，又患另一根络脉，逐络依次波及，直到整个乳房都患病，这种情况大多危险而无法救治。初起时，每天早晨服用元寿丹，可以保证不传染到其他络脉。（现在外科认为乳房有几房穣，想要传变到穣的说法是不对的）
如果起初就是硬肿，并且立即有疮头出现，后来旁边又生出几个疮头，疮头中脓液不多，这名叫乳疽。这是阳明经痰热毒邪，兼挟肝胆之火凝结而成。治疗应当清理痰气、疏通肝经邪气、解毒和营，如荆芥、防风、苏叶、白芷、贝母、栝蒌、青皮、夏枯草等药物，在所需情况下使用即可。
附注：内吹，孕妇怀孕二三个月，或者至八九个月，乳房中出现核块并形成痈肿。这是因为胎气旺盛而上冲，导致阳明经乳房结肿疼痛。适宜服用石膏散清热可消；如果溃破后虽然脓出腐脱新肌生长，也必须等到分娩后才能收口愈合。
乳头风，乳头干燥而裂开，疼痛如刀刺，或者擦拭时出血，或者流出粘水，或者结成黄脂。这是由于暴怒抑郁，肝经火邪不能宣泄所致，产前产后都有发生。内服加味逍遥散；外用白芷末，用乳汁调熟后敷贴。
男子乳疖，与女子不同。男子的乳头属于肝，乳房属于肾，因为肝虚血燥，肾虚精怯，所以结肿疼痛。治疗应当以六味地黄汤加入当归、芍药、青皮为主方。
The occurrence of breast abscess (Ru Yong) arises from several causes. Some cases result from the mother occasionally falling asleep during breastfeeding, allowing the infant's breath to blow into the nipple, causing stagnation and blockage of Qi within the breast, leading to pain (this is known as the "External Blow" syndrome). If neglected or treated improperly over time, it develops further. Other cases occur because the nursing infant has phlegm-stagnation in the diaphragm and hot breath; while greedily suckling and sleeping, this hot breath enters the breast, causing stagnation and preventing milk flow, eventually forming nodules that suppurate. There are also cases caused by depression or sudden anger injuring the Liver, resulting in Liver Qi stagnation. Additionally, there are cases due to the accumulation of Damp-Heat in the Liver and Stomach, or obstruction by Wind-Heat pathogenic factors. Initially, there is pain and hardness with no milk discharge, gradually progressing to skin swelling and alternating chills and fever, indicating that the abscess has formed and internal suppuration is occurring. In the early stage, treatment should focus on releasing the exterior and dispersing pathogens, soothing the Liver and clearing the Stomach, rapidly promoting milk discharge, and guiding the resolution of obstruction, which will naturally lead to dissipation. If it fails to dissipate and turns into pus, a method of supporting the interior and expelling pus should be used. If after ulceration the flesh does not regenerate and the pus is clear and thin, tonifying the Spleen and Stomach is appropriate. If pain persists after pus discharge accompanied by chills and fever, harmonizing Ying and Wei is indicated. If there is afternoon tidal fever with swelling and pain, nourishing Yin and Blood is suitable. If appetite is poor with nausea, tonifying Stomach Qi is required. One must strictly avoid cooling and detoxifying herbs, as they may damage the Spleen and Stomach. Since milk is transformed from blood and cannot leak freely, it condenses and swells. The nature of the breast is cool and cold; adding cooling medicines makes hardened swelling difficult to suppurate and existing ulcers difficult to heal. For early stages, formulas such as Niubangzi San (Burdock Fruit Powder), Juye Tang (Tangerine Leaf Decoction), or Xiaoyao San (Free and Easy Wanderer Powder) may be used. After ulceration, Yiqi Yangying Tang (Qi-Tonifying and Ying-Nourishing Decoction) is appropriate. Furthermore, Banxia (Pinelliae Rhizoma), Beimu (Fritillariae Bulbus), and Gualou (Trichosanthis Fructus) can eliminate stomach phlegm stagnation; Qingpi (Aurantii Fructus Immaturus) soothes Jueyin Liver stagnation; Gongying (Taraxaci Herba), Mutong (Akebiae Caulis), and Shanjia (Manis Squama) resolve heat toxicity and open orifices; Danggui (Angelicae Sinensis Radix) and Gancao (Glycyrrhizae Radix et Rhizoma) support healthy Qi and harmonize with pathogenic factors. All herbs that clear phlegm, soothe the Liver, harmonize blood, and detoxify can be used according to circumstances. Another type involves Damp-Fire combined with rebellious Liver Yang affecting collaterals, or formation due to epidemic toxins or latent pathogens. Onset presents with swollen and hard nipples, diffuse redness and swelling of the breast, chills, fever, and deep-set pores. After two to three days, the skin becomes wet and rotting, turning black and necrotic overnight. Several days later, fever subsides, and black necrotic tissue sheds completely, with new flesh resembling pomegranate seeds. Apply Zhenzhu San (Pearl Powder) externally and cover with Baiyu Gao (White Jade Ointment); internally administer formulas that soothe the Liver and clear Damp-Heat to complete the cure. This is Damp-Fire Breast Abscess. Furthermore, women have several pores on the nipple, each connected to a collateral network linked to the breast. Initially, only one collateral is affected. Once its pus and blood are exhausted, another collateral becomes involved, spreading sequentially until the entire breast is affected, a condition that is often critical and incurable. At the onset, taking Yuanshou Dan (Longevity Pill) every morning can prevent transmission to other collaterals. (It is incorrect for modern surgery to claim breasts have multiple lobes and that disease spreads between them.)
If the initial presentation is hard swelling with immediate emergence of a head, followed by several additional heads appearing later, with little pus inside these heads, it is named Breast Carbuncle (Ru Ju). This is caused by Toxic Heat-Phlegm of the Yangming channel combined with Fire of the Liver and Gallbladder. Treatment should involve clearing Phlegm-Qi, unblocking Liver pathogenic factors, detoxifying, and harmonizing Ying. Herbs such as Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Ziye (Perillae Folium), Baizhi (Angelicae Dahuricae Radix), Beimu (Fritillariae Bulbus), Gualou (Trichosanthis Fructus), Qingpi (Aurantii Fructus Immaturus), and Xiakucao (Prunellae Spica) may be used as needed.
Appendix: Internal Blow (Nei Chui) occurs in pregnant women at two to three months or eight to nine months of gestation, where nodules form in the breast leading to abscess. This is due to vigorous fetal Qi rushing upward, causing swelling and pain in the Yangming breast. Taking Shigao San (Gypsum Powder) can clear and resolve it. Even if after ulceration pus drains, necrotic tissue falls off, and new muscle grows, healing can only be completed after delivery.
Nipple Wind (Routou Feng) involves dryness and cracking of the nipple, pain like knife stabs, bleeding upon wiping, discharge of sticky fluid, or formation of yellow crusts. This is caused by sudden anger or depression, where Liver Meridian Fire cannot vent. It occurs both before and after childbirth. Internally take Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder); externally apply Baixia powder (Baizhi powder) mixed with breast milk.
Male Nodule (Nanzi Ru Ji) differs from females. In men, the nipple belongs to the Liver, and the breast belongs to the Kidney. Due to Liver deficiency with dry blood and Kidney deficiency with weak essence, swelling and pain result. Treatment should primarily use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) added with Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), and Qingpi (Aurantii Fructus Immaturus).