【方歌】乳疽乳痈乳房生，肝气郁结胃火成。痈形红肿焮热痛，
疽形木硬觉微疼，痈发脓成十四日，疽发月余脓始成。
未溃托里排脓治，已溃大补养荣灵。
【注】此证总由肝气郁结，胃热壅滞而成。男子生者稀少，女
子生者颇多，俱生于乳房。红肿热痛者为痈，十四日脓
成；若坚硬木痛者为疽，月余成脓。初起寒热往来，宜
服括蒌牛蒡汤；寒热悉退，肿硬不消，宜用复元通气散
消之。若不应，复时时跳动者，势将溃脓，宜用托里透
脓汤；脓胀痛者针之，宜服托裹排脓汤；虚者补之，如
人参养荣、十全大补等汤，俱可选用。外敷贴之药，俱
按痈疽肿疡、溃疡门。
方剂：栝蒌牛蒡汤
组成：栝蒌仁 牛蒡子（炒，研）
花粉 黄芩
生栀子（研） 连翘（去心）
皂刺 金银花
甘草（生） 陈皮（各一钱）
青皮 柴胡（各五分）
水二钟，煎八分，入煮酒一杯和匀，食远服。
【方歌】栝蒌牛蒡胃火郁，憎寒壮热乳痈疽，青柴花粉芩翘刺，
银花栀子草陈皮。
又方：复元通气散（见肿疡门）
托里透脓汤（见头部侵脑疽）
托里排脓汤（见项部鱼尾毒）
人参养荣汤、十全大补汤（俱见溃疡门）
【方歌】乳发如痈胃火成，男女皆生赤肿疼，溃久不敛方成漏，
只为脓清肌不生。
【注】此证发于乳房，焮赤肿痛，其势更大如痈，皮肉尽腐，
由胃腑湿火相凝而成。治法急按乳痈：未成形者消之，
已成形者托之，腐脱迟者黄灵药撒之，以免遍溃乳房，
致伤囊桶，难以收敛。若久不收口，外寒侵袭，失于调
养时流清水者，即成乳漏。外用红升丹作捻，以去腐生
肌；再兼用豆豉饼炙法，缓缓灸之以袪寒；内当大补气
血。节劳烦，慎起居，忌发物，渐可生肌敛口而愈。
方剂：黄灵药、红升丹（俱见溃疡门）
豆豉饼（见卷首灸法内）
[Verse] Ruju (Breast Carbuncle) and Ruyong (Breast Abscess) arise in the breast, caused by Liver Qi Stagnation and Stomach Fire. The appearance of an abscess involves redness, swelling, burning heat, and pain; the appearance of a carbuncle involves numbness, hardness, and slight pain. An abscess forms pus within fourteen days; a carbuncle takes over a month to form pus. Before ulceration, treatment focuses on supporting the interior and draining pus; after ulceration, major tonification to nourish Ying and Wei is required.
[Commentary] This condition generally results from Liver Qi Stagnation and Stomach Heat congestion. It is rare in men but common in women, occurring in the breast region. Redness, swelling, heat, and pain characterize an abscess, with pus forming in fourteen days; hardness, numbness, and pain characterize a carbuncle, with pus forming in over a month. In the initial stage with alternating chills and fever, Gualou Niuxiao Tang (Trichosanthes and Arctium Decoction) should be taken. If chills and fever subside but swelling and hardness persist, Fuyuan Tongqi San (Restoring Flow and Promoting Circulation Powder) should be used to dissipate them. If ineffective and throbbing occurs intermittently, indicating imminent ulceration, Tuoli Tou Nong Tang (Supporting Interior and Penetrating Pus Decoction) is indicated. For painful distension due to pus, puncture is needed, followed by Tuoli Pai Nong Tang (Supporting Interior and Draining Pus Decoction). For deficiency, tonification is applied, such as Ren Shen Yang Rong Tang (Ginseng and Nutritive-Qi Supporting Decoction) or Shiquan Dabu Tang (Ten Complete Tonifying Decoction), all of which are selectable. External applications follow the records for sores/ulcers and open ulcers.
Formula: Gualou Niuxiao Tang (Trichosanthes and Arctium Decoction)
Composition: Trichosanthis Semen (Gualou Ren), Arctii Fructus (Niuxiaizi, stir-fried and crushed), Puerariae Radix (Huafen), Scutellariae Radix (Huangqin), Gardeniae Fructus (Sheng Zhizi, crushed), Forsythiae Fructum (Lianqiao, heart removed), Gleditsiae Spina (Zaoci), Lonicerae Japonicae Flos (Jinyinhua), Glycyrrhizae Radix et Rhizoma (Sheng Gancao), Citri Reticulatae Pericarpium (Chenpi) [each 1 qian]; Aurantii Fructus Viridis (Qingpi), Bupleuri Radix (Chaihu) [each 0.5 qian].
Usage: Decoct with two zhong of water until reduced to eight fen, add one cup of boiled wine, mix well, and take after meals.
[Verse] Gualou Niuxiao Tang treats stomach fire stagnation causing aversion to cold and high fever in breast abscesses/carbuncles; it contains Qingpi, Chaihu, Huafen, Huangqin, Lianqiao, Zaoci, Jinyinhua, Zhizi, Gancao, and Chenpi.
Another Formula: Fuyuan Tongqi San (See Sores/Ulcers Section)
Tuoli Tou Nong Tang (See Head Area Brain-Penetrating Carbuncle)
Tuoli Pai Nong Tang (See Neck Area Fish-Tail Toxicity)
Ren Shen Yang Rong Tang, Shiquan Dabu Tang (Both See Ulcer Section)
[Verse] Rufa (Breast Cellulitis) resembles an abscess, caused by Stomach Fire, affecting both men and women with redness, swelling, and pain. If ulcerated and not healing for a long time, it becomes a fistula (Lou), solely because the pus is thin and muscle does not regenerate.
[Commentary] This condition arises in the breast with burning redness, swelling, and pain, more severe than typical abscesses, with complete rotting of skin and flesh, caused by the condensation of Damp-Heat in the Stomach Fu. Treatment urgently follows the protocol for Breast Abscess: if not formed, dissipate it; if formed, support the interior to expel toxins; if sloughing is slow, apply Huang Lingyao (Yellow Spirit Medicine) to prevent widespread ulceration of the breast that could damage the mammary ducts, making healing difficult. If the wound fails to close for a long time, invaded by external Cold, and discharging clear fluid due to poor care, it becomes a Breast Fistula. Externally, use Hongshengan (Red Ascending Cinnabar) made into a moxa stick/pill to remove necrotic tissue and generate muscle; concurrently use Douchi Bing (Fermented Soybean Cake) moxibustion to slowly warm and dispel Cold. Internally, greatly tonify Qi and Blood. Rest from labor and worry, regulate daily life, avoid triggering foods, and gradually muscle will regenerate and the wound will close, leading to recovery.
Formulas: Huang Lingyao, Hongshengan (Both See Ulcer Section)
Douchi Bing (See Moxibustion Methods at the Beginning of the Volume)