某氏 孀居，右乳溃脓，已穿六孔，左乳核坚抽痛，寒热食少，脉弦数。审为肝脾郁结，气血亏损，
为疏济生归脾汤。其戚属云∶前服归脾反痛奈何？因检前方， 、术皆炒用。予谓∶此致痛之由也。但生用自
效，彼疡医不谙药性生熟耳。三服寒热止，食进。前汤加栝蒌、贝母、白芍、陈皮，五服右疮平，左核俱软，
以前药为丸服而消。
许氏 产后乳头红肿 痛，用鲜天门冬捣汁，和酒蒸，热服，以渣敷患处，两三次愈。
何氏 乳房结核，症属阴寒。用鹿角尖磨水，酒冲服效。
吴氏 暑月左乳 肿成脓，寒热往来，脉右小数，左弦长。症由肝郁生火。仿清肝解郁汤，内用当归、白
芍、大贝、栝蒌、天冬、乳香、丹皮、山栀、甘草、银花。外用内消散加减，甲片、乳香、没药、归尾、角刺、
生大黄、黄芩，蜜调敷。左乳头溃，根盘漫肿，右乳又硬，急用内托带消法。生黄 、天冬、栝蒌、香附、
归身、白芍、贝母、桔梗、陈皮、甘草，一服痛定。左疮孔脓稠，右肿稍软。又数服数敷，根盘消散，疮口用
生肌散得平。
张氏 产后妒乳，去冬溃未即敛，今春近旁肿痛。夫乳头属厥阴，乳房属阳明。今患在乳头，不致转囊，
但溃后药忌乳、没消肿，宜托消兼用。旋复花、香附生、大贝、黄 生、栝蒌、广皮、郁金、甘草节、当归，二
服痛止肿软。四服溃敛。
何氏 左乳结核，经六七载，溃后深洞如碗，是名乳岩。由脾肝郁结，气血失畅。结核渐大，溃则 岩
深陷可畏。一僧犹用乳、没破耗气血。不知年衰茹素，日夕抽痛，脓水清稀，营卫日亏，毒奚由化，恐三伏难
延矣。峻补气血，托里滋液。患口虽难遽敛，尚冀痛势略定，迁延岁月耳。八珍汤去炒术，加生 、五味、
麦冬、大贝，数服脓稠痛缓。入夏延秋，患内作痒者肉腐蛆生。（以乌梅肉腊雪水浸，雄黄末，鸡羽蘸抹。）
其弟妇张氏，并系早孀，亦患乳核，二十余年未溃，坚大如胡桃，劳则抽痛，脉来沉缓。症属郁损心脾，用归脾
汤加香附汁、炒熟地、牡蛎粉、大贝、忍冬藤，数十服而核渐软。
某姓患者，寡妇居住。右侧乳房溃烂流脓，已经穿透六个孔洞；左侧乳房有硬结，坚硬且伴有牵引性疼痛，伴有寒热往来、食欲减退，脉象弦而数。辨证为肝脾郁结，气血亏损。于是开具济生归脾汤。她的亲戚说：“之前服用归脾汤反而导致疼痛加剧，这是为什么？”于是检查之前的处方，发现白术、苍术都是炒制使用的。我说：“这就是导致疼痛的原因。如果生用自然有效，是那位外科医生不熟悉药物生用的药性罢了。”服用三剂后，寒热停止，食欲增进。在前方的基础上加入瓜蒌、贝母、白芍、陈皮，服用五剂后，右侧疮口平复，左侧硬结全部变软，将前面的药物制成丸剂服用，最终消散。
许姓患者，产后乳头红肿疼痛。使用新鲜天门冬捣取汁液，与酒混合蒸热后内服，并将药渣敷在患处，两三次即痊愈。
何姓患者，乳房结核，症状属于阴寒证。使用鹿角尖磨成水，用酒冲服，效果显著。
吴姓患者，夏季左侧乳房肿胀化脓，寒热往来，右脉稍小略数，左脉弦长。病症由肝气郁结化火引起。仿照清肝解郁汤的方义，内服药物包括当归、白芍、大贝母、瓜蒌、天冬、乳香、丹皮、山栀、甘草、金银花。外用内消散加减，药物包括穿山甲片、乳香、没药、当归尾、皂角刺、生大黄、黄芩，用蜂蜜调匀外敷。左侧乳头溃破，根部周围漫肿，右侧乳房又变硬，紧急采用内托兼消散的方法。药物包括生黄芪、天冬、瓜蒌、香附、当归身、白芍、贝母、桔梗、陈皮、甘草，服用一剂后疼痛安定。左侧疮孔脓液稠厚，右侧肿胀稍软。又经过多次服药和敷药，根部肿胀消散，疮口使用生肌散得以平复。
张姓患者，产后妒乳（乳汁淤积），去年冬天溃破后未能立即愈合，今年春天附近出现肿痛。中医认为乳头归属于厥阴经，乳房归属于阳明经。现在病变在乳头，虽然不会转变为囊痈，但溃破后用药忌讳只用乳香、没药来消肿，应当托毒排脓与消散并用。药物包括旋覆花、生香附、大贝母、生黄芪、瓜蒌、广陈皮、郁金、甘草节、当归，服用两剂后疼痛停止、肿胀变软。服用四剂后溃口收敛。
何姓患者，左侧乳房结核，历经六七年后，溃破后形成深洞如碗状，这名叫乳岩。这是由于脾肝郁结，气血运行不畅。结核逐渐增大，溃破后岩穴深陷，令人畏惧。有一位僧人仍然使用乳香、没药破耗气血。不知道患者年事已高且吃素，日夜抽痛，脓水清稀，营卫之气日渐亏损，毒素如何能化解？恐怕难以熬过三伏天了。采用峻补气血、托里滋液的方法。患口虽然难以迅速收敛，还希望疼痛势头略微安定，能够拖延时日罢了。使用八珍汤去掉炒白术，加入生黄芪、五味子、麦冬、大贝母，服用数剂后脓液变稠、疼痛缓解。进入夏天延续到秋天，患处内部发痒，肌肉腐烂生出蛆虫。（用乌梅肉浸泡在腊雪水中，加入雄黄末，用鸡羽毛蘸取涂抹。）
他的弟妇张氏，也是早年守寡，也患有乳核，二十多年未溃破，坚硬巨大如胡桃，劳累时则牵引疼痛，脉象沉缓。病症属于郁结损伤心脾，使用归脾汤加入香附汁、炒熟地黄、牡蛎粉、大贝母、忍冬藤，服用数十剂后硬结逐渐变软。
A patient surnamed Mou, a widow, had her right breast ulcerated with pus discharge, having perforated six holes. The left breast had a hard nodule with pulling pain, accompanied by alternating chills and fever, poor appetite, and a wiry and rapid pulse. This was diagnosed as Liver-Spleen Qi stagnation with deficiency of Qi and Blood. A Jisheng Guipi Tang (Jisheng Spleen-Invigorating Decoction) was prescribed. Her relatives stated, "Why did taking Guipi Tang previously exacerbate the pain?" Upon examining the previous prescription, it was found that Atractylodis Rhizoma (Baizhu) and Cyperi Rhizoma (Cangzhu) were both used in a stir-fried form. I remarked, "This is the cause of the pain. If used raw, it would naturally be effective; it is the surgeon's ignorance of the properties of raw versus processed herbs." After three doses, the chills and fever ceased, and appetite improved. Trichosanthis Fructus (Gualou), Fritillariae Bulbus (Beimu), Paeoniae Radix Alba (Baishao), and Citri Reticulatae Pericarpium (Chenpi) were added to the previous formula. After five doses, the right wound flattened, and the left nodules softened. The previous medicine was made into pills for continued administration, leading to resolution.
A patient surnamed Xu suffered from redness, swelling, and pain of the nipples postpartum. Fresh Asparagi Radix (Tianmendong) juice was extracted by crushing, mixed with wine, steamed, and taken hot internally. The dregs were applied topically to the affected area, resulting in cure after two or three applications.
A patient surnamed He presented with breast nodules, characterized as a Yin-cold syndrome. Antler Horn Tip (Lujiaojian) was ground into water and taken with wine, yielding effective results.
A patient surnamed Wu developed swelling and suppuration in the left breast during summer, with alternating chills and fever. The right pulse was slightly small and rapid, while the left pulse was wiry and long. The condition arose from Liver Qi stagnation transforming into Fire. Following the principle of Qingjie Jieyu Tang (Clear Liver and Resolve Stagnation Decoction), internal medication included Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), large Fritillariae Bulbus (Dabei), Trichosanthis Fructus (Gualou), Asparagi Radix (Tiandong), Boswelliae Resina (Ruxiang), Moutan Cortex (Danpi), Gardeniae Fructus (Shanzhi), Glycyrrhizae Radix et Rhizoma (Gancao), and Lonicerae Japonicae Flos (Yinhua). Externally, Neixiao San (Internal Dissipation Powder) was modified with Manis Squama (Jiapian), Boswelliae Resina (Ruxiang), Myrrhae Resina (Moyao), Angelicae Sinensis Radix Rubra (Guiwei), Gleditsiae Spina (Jiaoci), Rheum Radix et Rhizoma (Dasheng), and Scutellariae Radix (Huangqin), mixed with honey for topical application. When the left nipple ulcerated with diffuse swelling at the base, and the right breast became hard again, an urgent strategy of internal support combined with dissipation was employed. Medications included Astragali Radix (Sheng Huangqi), Asparagi Radix (Tiandong), Trichosanthis Fructus (Gualou), Cyperi Rhizoma (Xiangfu), Angelicae Sinensis Radix (Guishen), Paeoniae Radix Alba (Baishao), Fritillariae Bulbus (Beimu), Platycodonis Radix (Jiegeng), Citri Reticulatae Pericarpium (Chenpi), and Glycyrrhizae Radix et Rhizoma (Gancao). Pain subsided after one dose. Pus from the left wound became thick, and right-side swelling softened slightly. After several more doses and applications, the base swelling dissipated, and the wound healed using Shengji San (Flesh-Regenerating Powder).
A patient surnamed Zhang suffered from "envying milk" (milk stasis) postpartum. An ulcer formed last winter but failed to heal promptly. In spring, swelling and pain appeared nearby. In TCM, nipples belong to the Jueyin channel, and breasts belong to the Yangming channel. Since the lesion was at the nipple, although it might not transform into a cystic abscess, after ulceration, it is contraindicated to use only Boswelliae Resina (Ruxiang) and Myrrhae Resina (Moyiao) for reducing swelling. Instead, supporting and dissipating methods should be combined. Medications included Inulae Flos (Xuanfuhua), fresh Cyperi Rhizoma (Xiangfu sheng), large Fritillariae Bulbus (Dabei), raw Astragali Radix (Huangqi sheng), Trichosanthis Fructus (Gualou), Guang Chenpi, Curcumae Radix (Yujin), Glycyrrhizae Radix et Rhizoma (Ganjie), and Angelicae Sinensis Radix (Danggui). Pain stopped and swelling softened after two doses. Ulceration healed after four doses.
A patient surnamed He had a left breast nodule for six or seven years. After ulceration, it formed a deep cavity like a bowl, known as Breast Cancer (Ru Yan). This resulted from Spleen-Liver Qi stagnation and unsmooth flow of Qi and Blood. The nodule gradually enlarged; upon ulceration, the crater sank deeply, which was alarming. A monk still used Boswelliae Resina (Ruxiang) and Myrrhae Resina (Moyiao), depleting Qi and Blood. Unaware that the patient was elderly, vegetarian, suffering nightly pulling pain, with thin pus, and declining Ying and Wei defenses, making toxin transformation impossible, it was feared she could not survive the dog days. A strong tonification of Qi and Blood with interior-supporting and fluid-nourishing method was adopted. Although the wound might not close quickly, hope remained for slight pain relief and prolonged survival. Bazhen Tang (Eight-Treasure Decoction) was used without stir-fried Atractylodis Rhizoma (Baizhu), adding raw Astragali Radix (Huangqi), Schisandrae Fructus (Wuweizi), Ophiopogonis Radix (Maidong), and large Fritillariae Bulbus (Dabei). After several doses, pus thickened and pain eased. From summer into autumn, itching inside the wound led to tissue rot and maggot generation. (Vinegar plum flesh soaked in snow water from the twelfth lunar month, mixed with Realgar powder, applied with chicken feathers.)
His sister-in-law, surnamed Zhang, also a young widow, suffered from a breast nodule for over twenty years without ulceration. It was hard and large as a walnut, with pulling pain upon exertion, and a deep-slow pulse. The condition belonged to stagnation damaging Heart and Spleen. Guipi Tang (Spleen-Invigorating Decoction) was administered with Cyperi Rhizoma juice (Xiangfu zhi), stir-fried Rehmanniae Radix Preparata (Shudi), Ostreae Concha (Muli fen), large Fritillariae Bulbus (Dabei), and Lonicerae Caulis (Rendongteng). After dozens of doses, the nodule gradually softened.