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[Prescription Verse] Juli Yong (Ulcerative Carbuncle) arises beside the breast, presenting as a tubercle with redness, swelling, hardness, and burning pain. This is caused by the congealing of phlegm in the Pericardium Collateral and Qi stagnation of the Spleen. The treatment should aim to warm, soothe, and resolve the induration.

[Note] This condition arises beside the breast. Initially, it presents as hard swelling resembling a tubercle, developing slowly, gradually increasing in redness, swelling, red color, and pain. It is formed by cold-phlegm in the Pericardium Collateral and Qi stagnation of the Spleen; it is a Cold syndrome rather than a Heat syndrome. Treatment should employ mild methods to soothe stagnation and resolve induration. Internally administer Neibu Shixuan San (Internal Tonifying Ten-Exertion Powder), and externally apply Huiyang Yulong Gao (Restore Yang Jade Dragon Ointment) to dissipate it. If it does not dissipate, pus formation is imminent. Internal and external treatments follow the protocols for Ulcerative Sores and Ulcers sections.

Formula: Neibu Shixuan San (Internal Tonifying Ten-Exertion Powder)
Composition: Ren Shen (Ginseng Radix et Rhizoma), Huang Qi (Astragali Radix), Dang Gui (Angelicae Sinensis Radix) [2 qian each], Jie Geng (Platycodonis Radix), Hou Po (Magnoliae Officinalis Cortex, processed with ginger), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Rou Gui (Cinnamomi Cortex), Fang Feng (Saposhnikoviae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) [1 liang each].
Grind into powder. Take 3 qian per dose, mixed with hot yellow wine. For those who do not drink alcohol, mix with decoction of Mu Xiang (Aucklandiae Radix).

[Prescription Verse] Neibu Shixuan San treats various swellings and toxins; if pus has formed, it promotes drainage; if not, it resolves the swelling. It contains Ginseng, Astragalus, Platycodon, Magnolia Bark, Ligusticum, Angelica, Licorice, plus Angelica Root, Cinnamon Twig, and Saposhnikovia, taken with hot wine.

Another Formula: Huiyang Yulong Gao (Restore Yang Jade Dragon Ointment) (See Ulcerative Sores Section)

[Prescription Verse] Chuiru (Blowing Breast) refers to breast toxicity causing breast swelling and pain. Neichui (Internal Blowing) results from fetal heat causing painful, red, and burning swelling. Waichui (External Blowing) results from cool air entering through the infant's nostrils during sucking, accompanied by alternating chills and fever, irritability, thirst, and nodular swelling pain.

[Note] The breast belongs to the Stomach, and the nipple belongs to the Liver, hence the distinction between Neichui and Waichui. Neichui occurs during the sixth or seventh month of pregnancy, characterized by chest fullness and upward rushing of Qi, resulting in breast nodular swelling and pain. If the color is red, it indicates excess Heat; if not red, it is due to Qi stagnation combined with vigorous fetal Qi. For cases with excess Heat, Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) is suitable. For Qi stagnation, Xiaoyao San (Free and Easy Wanderer Powder) is suitable, applied externally with Chonghe Gao (Harmonizing Ointment), which will surely dissipate the swelling. Alternatively, if initial swelling was neglected or the patient suffered emotional injury again, leading to severe swelling and pain, pus formation is inevitable. Use Xiaoyao San added with Huang Qi, Bai Zhi, and Lian Qiao to nourish blood and drain pus. After pus rupture, nourish Qi and Blood. After delivery, treat according to ulcer protocols to achieve healing. Pregnancy medication contraindications are detailed in another verse in Volume One. Waichui is caused by turbid Qi in the Liver and Stomach of the nursing mother, compounded by cool air from the sleeping infant's nostrils entering the breast during sucking, condensing with hot milk to cause swelling and pain, leading to alternating chills and fever, irritability, and thirst. Initially, Jingfang Niubang Tang (Schizonepeta, Saposhnikovia, and Arctostemon Decoction) is suitable, with external Garlic-Separator Moxibustion. When chills and fever subside but swelling remains, Ju Ye Gua Lou San (Tangerine Leaf and Trichosanthes Powder) is taken, with Chonghe Gao applied externally. If swelling does not resolve, indicating impending pus formation, Tou Nong San (Pus-Penetrating Powder) is used. Other internal and external treatments follow the Ulcerative Sores and Ulcers sections. There are also cases where toxicity arises without pregnancy or lactation; this affects skin and flesh without injuring the breast itself, caused by Damp-Heat condensation in the Liver and Stomach forming breast toxicity. Treat according to carbuncle and furuncle protocols, with effective results.

Formula: Jingfang Niubang Tang (Schizonepeta, Saposhnikovia, and Arctostemon Decoction)
Composition: Jing Jie (Schizonepetae Spica), Fang Feng (Saposhnikoviae Radix), Niu Bang Zi (Arctii Fructus, stir-fried and ground), Yin Hua (Lonicerae Japonicae Flos), Chen Pi (Citri Reticulatae Pericarpium), Fen Hua (Trichosanthis Radix), Huang Qin (Scutellariae Radix), Pu Gong Ying (Taraxaci Herba), Lian Qiao (Forsythiae Fructus, heart removed), Zao Ci (Gleditsiae Spina) [1 qian each], Chai Hu (Bupleuri Radix), Xiang Fu (Cyperi Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma, raw) [5 fen each].
Decoct 2 zhong of water to 8 fen. Take after meals.

[Prescription Verse] Jingfang Niubang Tang treats external blowing of the breast, addressing chills, fever, swelling, and pain. It contains Lonicera, Citrus Peel, Licorice, Bupleurum, and Cyperus, along with Trichosanthes Root, Scutellaria, Taraxacum, Forsythia, and Gleditsia Spine.

Another Formula: Ju Ye Gua Lou San (Tangerine Leaf and Trichosanthes Powder)
Composition: Ju Ye (Citri Reticulatae Folium) [20 leaves], Gua Lou (Trichosanthis Fructus) [half or one whole fruit depending on condition], Chuan Xiong (Ligustici Chuanxiong Rhizoma), Huang Qin (Scutellariae Radix), Zhi Zi (Gardeniae Fructus, raw and ground), Lian Qiao (Forsythiae Fructus, heart removed), Shi Gao (Gypsum Fibrosum, calcined), Chai Hu (Bupleuri Radix), Chen Pi (Citri Reticulatae Pericarpium), Qing Pi (Citri Reticulatae Pericarpium Viride) [1 qian each], Gan Cao (Glycyrrhizae Radix et Rhizoma, raw) [5 fen].
Decoct 2 zhong of water to 8 fen. Take after meals. Decoct the dregs again and take. Use Gypsum for purple, swollen, and burning pain; omit Gypsum for red swelling.

[Prescription Verse] Ju Ye Gua Lou San treats blowing breast syndrome, where cool air attacks and hot milk condenses. It contains Ligusticum, Scutellaria, Gardenia, Licorice, Forsythia, etc., plus Gypsum, Bupleurum, Citrus Peel, and Citrus Peel Viride.

Another Formula: Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) (See Head and Temple Carbuncle Section)
Xiaoyao San (Free and Easy Wanderer Powder) (See Upper Back Hand-Attacking Carbuncle Section)
Chonghe Gao (Harmonizing Ointment), Tou Nong San (Pus-Penetrating Powder) (See Ulcerative Sores Section)
Ge Suan Jiu Fa (Garlic-Separator Moxibustion Method) (See Moxibustion Methods in Volume One)