【方歌】乳中桔核梅李形，按之不移色不红，时时隐痛劳岩渐，
证由肝脾郁结成。
【注】此证乳房结核坚硬，小者如梅，大者如李，按之不移推
之不动，时时隐痛，皮色如常。由肝、脾二经气郁结滞
而成，形势虽小，不可轻忽。若耽延日久不消，轻成乳
劳，重成乳岩，慎之慎之！初起气实者，宜服清肝解郁
汤；气虚宜服香贝养荣汤。若郁结伤脾，食少不寐者，
服归脾汤。外俱用木香饼熨法，消之甚效。
方剂：清肝解郁汤
组成：当归 生地
白芍（酒炒） 川芎
陈皮 半夏（制，各八分）
贝母（去心，研） 茯神
青皮 远志（去心）
桔梗 苏叶（各六分）
栀子（生，研） 木通
甘草（生，各四分） 香附（醋炒，各一钱）
水二钟，姜一片，煎八分，食远服。
【方歌】清肝解郁贝茯神，四物青皮远夏陈，栀桔通苏香附草，
能消乳核气郁伸。
又方：归脾汤
组成：人参 白术（土炒）
枣仁（炒，研） 龙眼肉
茯神（各二钱） 黄耆（一钱五分）
当归（酒洗，一钱） 远志（去心）
木香（末） 甘草（炙，各五分）
生姜三片，红枣肉二枚，水煎服。
【方歌】归脾汤治脾胃怯，食少怔忡夜不安，枣远龙眼参归草，
茯神耆术木香煎。
又方：木香饼
组成：生地黄（捣烂，一两） 木香（研末，五钱）
共和匀，量结核大小，作饼贴肿上，以热熨斗间日
熨之；坚硬木痛者，每日熨之。
【方歌】木香饼消乳核方，舒通结滞功倍强，生地研烂木香末，
和饼贴患熨之良。
又方：香贝养荣汤（见项部上石疽）
[Formula Verse] The nodules in the breast resemble the shape of citrus seeds, plums, or apricots. They remain fixed upon pressure without reddening of the skin, accompanied by occasional dull pain, gradually progressing to Ru Yan (breast cancer). This condition arises from the stagnation and accumulation of Qi in the Liver and Spleen meridians.
[Annotation] This syndrome presents as hard nodules in the breast, small ones resembling plums and large ones resembling apricots. They are immovable upon palpation and pushing, accompanied by occasional dull pain, while the skin color remains normal. It is caused by the stagnation and obstruction of Qi in the Liver and Spleen meridians. Although the manifestation may seem minor, it must not be neglected. If left untreated for a long time without resolution, it may lightly develop into Ru Lao (chronic breast disease) or severely progress to Ru Yan (breast cancer); caution is advised! In the initial stage, if the condition is characterized by excess Qi, Qinggan Jieyu Tang (Liver-Clearing and Depression-Resolving Decoction) is suitable; if characterized by deficient Qi, Xiangbei Yangrong Tang is suitable. If the stagnation damages the Spleen Qi, resulting in poor appetite and insomnia, Guipi Tang (Spleen-Restoring Decoction) should be administered. Externally, Muxiang Bing (Aucklandia Cake) moxibustion/ironing therapy should be used, which is highly effective in dissipating nodules.
Formula: Qinggan Jieyu Tang (Qinggan Jieyu Tang, Liver-Clearing and Depression-Resolving Decoction)
Composition: Danggui (Angelicae Sinensis Radix), Shengdi (Rehmanniae Radix), Baishao (Paeoniae Radix Alba, stir-fried with wine), Chuanxiong (Chuanxiong Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Tuber, processed), each 8 fen; Beimu (Fritillariae Bulbus, heart removed, ground), Fushen (Poria with Hostwood), Qingpi (Citri Reticulatae Pericarpium Viride), Yuanzhi (Polygalae Radix, heart removed), each 6 fen; Jiegeng (Platycodonis Radix), Zuye (Perillae Folium), each 6 fen; Zhizi (Gardeniae Fructus, raw, ground), Mutong (Akebiae Caulis), Gancao (Glycyrrhizae Radix et Rhizoma, raw), each 4 fen; Xiangfu (Cyperi Rhizoma, vinegar-fried), each 1 qian.
Decoct 2 zhong of water with 1 slice of Shengjiang (Zingiberis Rhizoma Recens) until 0.8 zhong remains; take after meals.
[Formula Verse] Qinggan Jieyu Tang contains Beimu and Fushen, combined with Siwu (referring to blood-nourishing herbs like those in Four Substances Decoction), Qingpi, Yuanzhi, Banxia, Chenpi, along with Zhizi, Jiegeng, Mutong, Zuye, Xiangfu, and Gancao. It can dissipate breast nodules and relieve Qi stagnation.
Another Formula: Guipi Tang (Guipi Tang, Spleen-Restoring Decoction)
Composition: Ren Shen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, soil-stir-fried), Zaoren (Ziziphi Spinosae Semen, fried, ground), Longyanrou (Longan Aril), Fushen (Poria with Hostwood), each 2 qian; Huangqi (Astragali Radix) 1.5 qian; Danggui (Angelicae Sinensis Radix, washed with wine) 1 qian; Yuanzhi (Polygalae Radix, heart removed), Muxiang (Aucklandiae Radix, powder), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), each 5 fen.
Decoct with 3 slices of Shengjiang (Zingiberis Rhizoma Recens) and 2 pieces of Hongzaorou (Longan Aril) in water; take orally.
[Formula Verse] Guipi Tang treats deficiency of the Spleen and Stomach, manifesting as poor appetite, palpitations (Zhengchong), and sleeplessness at night. It is decocted with Zaoren, Yuanzhi, Longyanrou, Renshen, Danggui, Gancao, Fushen, Huangqi, Baizhu, and Muxiang.
Another Formula: Muxiang Bing (Muxiang Bing, Aucklandia Cake)
Composition: Shengdihuang (Rehmanniae Radix, fresh, pounded to paste) 1 liang, Muxiang (Aucklandiae Radix, powdered) 5 qian.
Mix evenly, form into cakes according to the size of the nodule, apply to the swollen area, and iron with a hot iron every other day; if the mass is hard and painful, iron daily.
[Formula Verse] Muxiang Bing is a formula for dissipating breast nodules, with doubled efficacy in unblocking stagnation. Pounded fresh Rehmannia mixed with Aucklandia powder forms a cake; applying it to the affected area and ironing yields good results.
Another Formula: Xiangbei Yangrong Tang (See "Scrofula on the Upper Neck" section)