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This is a bizarre condition, which occasionally occurs in the world. After childbirth, both breasts elongate, becoming thin like chicken intestines, hanging down past the lower abdomen, with pain that is unbearable. Urgently use Chuanxiong Rhizoma (Chuanxiong) and Danggui Radix (Danggui), take four liang of each first, slice them, decoct in water, and take frequently. Take the remaining one jin and half, cut into large pieces, place a table in front of the parturient woman, put a charcoal stove underneath, and slowly roast the Chuanxiong and Danggui in the stove. Let the woman lie prone on the table, inhaling the smoke from her mouth and nose and breasts. If the smoke dissipates and the disease is not cured, repeat the previous method of decoction and fumigation; the breasts will then retract. If it cannot be saved, take one seed of Ricinus communis L. (Bimazu), grind it with cold water to make juice, and apply it to the top of the head. When the breasts return to their original size, wash it off immediately for recovery. If she gives birth again after recovery, the disease will definitely recur and be incurable.

Therefore, plasters should not be prepared by decocting Ricinus communis L. (Bimazu). If applied to sores or boils on the lower body of a pregnant woman, it may cause abortion. Postpartum women do not realize the harm of plasters, so applying them again can be fatal. Thus, the dangers of Croton tiglium L. (Badou) and Ricinus communis L. (Bimazu) are as follows.

Mr. Ma said: This is an ancient prescription, safe and effective. If there is no response, add eight liang of Scutellariae Radix (Huangqin), decoct and take it, and it will be effective.

Mr. Tao said: Binding the breasts with the foul cloth used by foot-binding women can also make them retract.

The proverb says: Seeing is better than learning a thousand times. Therefore, when studying medicine under a master, one must follow the master's guidance and observe cases clinically, hoping to broaden one's horizons and knowledge, so that one can handle diseases without doubt. I have thus selected one or two strange, dangerous, and critical cases from my forty years of clinical experience, along with treatments based on deduction and reasoning, and recorded them below for students to reference, sparing them the need for masters to lead them in clinical observation.

A man surnamed Gong from Changmen suffered from a carbuncle on his waist. The base spread over two chi in circumference, extending forward to the abdomen and backward to the bones. It was neither red nor swollen, neither painful nor soft, and felt hard like wood upon pressure. Initially, he consulted me, and I prescribed Rougui (Cinnamon Bark) and Paojiang (Prepared Ginger) at the beginning of the prescription. Afterwards, he sought treatment from three or four famous doctors inside and outside Suzhou City. They all criticized my prescription, asking how heat-inducing medicines could be used in the intense summer heat. Disagreeing with me, they proposed using purgative and cooling methods. After five days of treatment, the patient became comatose and lost his stomach qi. He then consulted me again. The lesion remained painless, the color resembled overnight pork liver, speech was slurred, and he could not eat or drink. I said, "If he survives until tonight, we can discuss further." He died that night. However, he did not feel pain even until death. Soon after, his relative suffered from the same condition. I treated him with Yanghe Decoction (Warming Yang and Resolving Phlegm Decoction). The next day, he felt relieved. After continuing the medication, the carbuncle reduced by less than half. Then, Xihuang Wan (Calculus Bovis Pill) and Yanghe Decoction were administered alternately morning and evening. By the fifth day, he recovered. Later, patients with similar back carbuncles recovered with the same treatment.

A young man married for one hundred days had his wife return to her mother's home for a month. During the intense summer heat, perhaps due to indulgence in coolness or fan usage, at dawn (five o'clock), he experienced throat pain and rebellious qi, alternating chills and fever. Upon inquiry, he said his throat had slight pain three days ago, but at dawn today, the swelling and pain became severe. His uvula was swollen as thick as a fat person's thumb. I diagnosed this as fire from deficiency and excess of the Heart and Kidney, combined with wind invasion after intercourse, resulting in a blockage of wind and fire. Using dispersing exterior methods would increase deficiency, while using cold medicines would trap wind and fire. Therefore, I prescribed Qianhu (Peucedani Radix), Su Zi (Perillae Fructus), Lianqiao (Forsythiae Fructus), Xuanshen (Scrophulariae Radix), Chishao (Paeoniae Radix Rubra), Zhebei Mu (Fritillariae Thunbergii Bulbus), Gancao (Glycyrrhizae Radix et Rhizoma), and Jiegeng (Platycodonis Radix) decocted together. He recovered immediately.

A neighbor friend drank wine at my house and left at the second watch. The next morning, his servant reported that his penis was swollen and painful, making urination difficult, and sent someone to request medicine. I deduced that after drinking and intercourse, his wife wiped him with unwashed silk cloth that had likely been bitten by venomous insects. I immediately used Xianren Duizuo Cao (Sarcandra glabra) to resolve snake venom and Geren Teng (likely a local herb for centipede venom) to resolve centipede venom. These herbs were crushed, juice extracted, mixed with realgar powder, and applied. Pain and swelling subsided immediately, and he recovered by afternoon.

A village woman from Wuxi, aged thirty, was hungry on the afternoon of the fifteenth day of the fifth lunar month. As she was about to eat noodles, she suddenly experienced severe throat pain preventing eating. A local doctor prescribed Shegan (Belamcandae Rhizoma), Chishao, Lianqiao, Huangqin, Huafen (Trichosanthis Radix), and Niubangzi (Arctii Fructus) decocted. Immediately after taking it, phlegm surged filling her mouth, sounding like snoring, unable to spit out, with phlegm obstructing the mouth. Upon inquiry, I learned it was sudden onset. Moreover, taking cold medicines increased the danger. This was undoubtedly a yin-cold syndrome. However, with phlegm blocking the throat, administering medicine was extremely difficult. I took a goose feather dipped in a small amount of tung oil, inserted it into the throat, rolled it once, and the phlegm came out with the feather, vomiting about one sheng. I placed Rougui, Paojiang, and Sheng Gancao (Raw Licorice), each 5 fen, in a bowl, poured boiling water over them, kept the bowl in hot water, and fed her a spoonful. She immediately said she felt better. After three or four spoonfuls, she stood up, said she was hungry, and asked if she could eat rice. I replied that porridge was best.

A craftsman from Nanhao requested treatment for a throat condition at midnight. He could not answer questions. Bystanders said he was fine during dinner, sang and played music, fell asleep, and woke up with sudden throat pain. I placed a grain-sized piece of Zhifu Zi (Prepared Aconiti Lateralis Radix) on his tongue. He swallowed saliva several times and recovered.

A woman's calf was scalded. A doctor applied Bingpian (Borneolum Syntheticum) ground in snow water. Within moments, her leg swelled to the size of a dou, with excruciating pain. She begged me to relieve the pain, saying she didn't mind dying. I said, fortunately, it was on the hard ground of the lower calf. If it were on the waist or abdomen, this application would drive the fire toxin inward, making it incurable. I ground Diyug (Sanguisorbae Radix), mixed it with oil, and applied it. Pain stopped in half a moment. She applied it herself, recovering in one or two applications. A maid was scalded on the dorsum of her foot, causing a sore. I applied Fulong San (Dragon's House Powder) mixed with milk. She recovered in less than three days. Another neighbor's child was scalded on the abdomen by boiling water. In pain, he tore his abdominal skin with his hands. One application of oil stopped the pain. Dry dusting of Diyug powder on the wound promoted tissue regeneration the next day, and the unbroken skin healed.

Feng Youye from Yixing had a rotting leg on the right dorsum of the foot extending to the calf turn, initially caused by a scald. For over thirty years, hard nodules appeared around it, and the calf and foot swelled to the size of a dou. The rotting leg could accommodate a large fist, sometimes bleeding, often discharging foul pus, filling the room with odor. He packed it with cloth wrapped like a brick to fill the hole, otherwise it hurt deeply. At seventy-four years old, in the sixth year of Yongzheng, he consulted me. I used an old toad, opened its belly, pierced holes in its body, stuffed the cavity with toad viscera, and covered the external hole with the toad body. Every day, decoct Congjiao Tang (Green Onion and Pepper Soup), wait until warm, and wash morning and evening, replacing the toad daily. Internally, Xingxiao Wan (Awakening Stasis Pill) was taken twice daily. After three days, fresh Diding (Sonchidis Herba) and Dali Li (likely Arctii Fructus or similar) were crushed and stuffed into the hole, covered externally with Wu Jin Gao (Black Gold Plaster), and Xingxiao Wan continued daily. For hard blocks outside the anus with clear fluid exuding from the skin, Nen Gao (Young Plaster) mixed with Wu Mei San (Five Beauty Powder) was applied. For itching, Bai Hua Gao (White Flower Plaster) was used. For hard stones-like lumps, raw Shanglu (Phytolaccae Radix) was crushed and applied. Due to frequent bleeding from the hole, Sanqi (Notoginseng Radix) powder was sprinkled inside first, followed by stuffing with Diding, Niu Bang Ye (Arctii Folium), and root. After twenty-plus days, the leg swelling and itching subsided, hard blocks and nodules flattened, skin color darkened then turned black, inner flesh became bright red, the wound closed and shallowed, allowing cessation of grass packing. Daily application of Wu Bao San (Five Treasures Powder) and Wu Jin Gao continued. Since the old man's spirit and appetite remained strong, no tonifying herbs were used to close the wound.

Xu Yuwu's son from Yixing, aged one and a half years, suffered from eleven toxic swellings: one on the Taiyang area, two opposite the heart and navel on the back, one opposite the mouth behind the neck, two on the waist and abdomen, and five on both legs. All had normal skin color. Two on the thighs had already been incised by local doctors. Upon hearing of my arrival, they requested treatment. I prescribed Xiao Jin Dan (Little Golden Pill) twice daily. By the fifth day, nine swellings resolved. One more dose of Xiao Jin Dan was given. Due to the child's age, a wet nurse was added. After ten days, two wounds were reddish and moist. Baoyuan Tang (Protecting Origin Decoction) with raw Renshen (Ginseng Radix) and Gancao, plus 3 fen of Rougui, was decocted in one cup. Additionally, 6 fen of Renshen was decocted separately and mixed. After half a month, Renshen and Gancao were switched to processed forms. Recovery was achieved in one month.

Zhao Taiyuan's eldest son from Changshu suffered from Hengxuan (Inguinal Abscess/Glandular Swelling) and was incised by a doctor. I asked how long since the incision. He said half a month. I said, "Once broken, this is difficult to treat. He has nine months to live." I left. Three hundred days later, his relative from Suzhou reported he had died for over a month.

Lu family's seven-year-old boy from Xingyi had only an inch of hair on the crown and suffered from three abscesses. Ulcerated for a long time without healing, the holes were chess-piece sized, shallow, without pus, dry, and grayish. The child was listless and spiritless. Due to excessive intake of cold medicines, he could not eat. I said, "Gray color indicates loss of qi and blood; dryness without pus indicates exhaustion of essence and spirit. Combined with anorexia, life cannot be prolonged. How can it be treated?" He died the next day.

Min family from Fengzhen, aged over ten, suffered from Luoli (Scrofula) on the neck, ulcerating into patches, spreading to ears, armpits, and waist, with palm-sized areas. The child was emaciated and timid. Initially, Dongtian Jiuku Dan (Heavenly Cave Salvation Pill) was taken, causing massive discharge of toxic fluid. After ten days, Yanghe Decoction and Xingxiao Wan were taken morning and evening. After ten days, neck mobility improved, and appetite increased. Yanghe Gao (Yanghe Plaster) was applied externally, and Da Zao Wan (Jujube Pill) internally. Subsequently, the plaster was continued, neck washed with Jingjie Tang (Schizonepeta Decoction), and Shanlian San (Lotus Seed Powder) applied. Recovery took ninety days. Because Zilong Wan and Xiao Jin Dan were not taken, the toxin root remained. Later, malignant nodes appeared in the armpit, which were resolved with Zilong Wan to prevent recurrence.

Yao family's daughter from Shantang, aged twenty-nine, had a miscarriage over a month ago. A toxicity appeared where the left shoulder meets the hand, surrounding one chi five cun. Half a month later, another toxicity appeared on the back, extending from top to bottom, one chi three cun long, wide at top and pointed at bottom, all white and depressed. Ten days later, she consulted me. The condition was severe. After three doses of Yanghe Decoction, she could sit up. After five doses, spontaneous urination and defecation resumed. After twelve doses, subsequent toxicities resolved. The initial toxicity on the shoulder resolved except for a chess-piece sized area of pus at the apex. After four days, it burst painlessly, and recovery was achieved. She later complained of stiffness on the back. Ten pills of Xiao Jin Dan were taken, two daily. After finishing, skin stiffness resolved, and spirit returned.

Mother of Cheng family, aged seventy, suffered from Yin Du Liu Zhu (Yin Toxic Flowing Abscess) below the knee, ulcerated for months. New hard swellings appeared below and beside the old lesion. A doctor mistook the new toxicity for swelling beside the old lesion, failing to recognize Liu Zhu, and prescribed Tu Du (Pushing Toxin Out) agents. After two doses, the new toxicity became painful. I then treated her with Yanghe Decoction for three doses, resolving both new toxicities. Then, ten pills of Xiao Jin Dan were taken. Subsequently, nourishing yin and warming tonics were used, with Xingren San (Almond Powder) applied externally. After half a month, pus thickened. Baoyuan Tang with Rougui was taken for over ten doses, leading to recovery.

Wang family's daughter-in-law had several Luoli in the neck, three E He (Malignant Nodes) in armpits, and a toxicity on the thigh without pain or itching. Over a hundred days, it grew larger, reaching the size of a dou, hard as stone, with blue veins visible, and occasional throbbing pain. Several doctors called it a tumor. I said, "Tumors are soft. There are no stone-hard tumors in the world. This is Shi Ju (Stone Carbuncle)." Asked if curable, I replied, "Curable if treated early. If large with visible veins, though hard, pus has formed at the root. Occasional throbbing indicates pus. Blue veins indicate yellow pus inside; curable. Small, uneven, rock-like protrusions are incurable. After three hundred days, severe pain will occur, leading to death without ulceration. Red veins indicate internal pain and blood exhaustion; incurable. Spots indicate spontaneous ulceration. Bleeding upon ulceration leads to death within three days. Currently, blue veins indicate that softening the lesion halfway through treatment allows recovery after ulceration with thick pus. Externally, fresh Shanglu was crushed and applied. Internally, Yanghe Decoction was taken. After ten days, throbbing stopped. After thirteen doses, itching occurred internally and externally. After sixteen doses, the apex softened. After eighteen doses, the entire lesion softened. Neck masses and armpit nodes dissipated completely. Only the Stone Carbuncle remained. Pus bag formed underneath. One qian of Renshen was taken. Since it was in the meridian area, silver needles pierced it first, then the opening was widened with a knife. Paper wicks were inserted, and two dou of flowing pus drained. Large doses of tonifying and supporting interior herbs were used. Renshen was removed, and Sheng Huangqi (Raw Astragalus Radix) was doubled. Ten doses were taken continuously, bringing stability. A relative practicing surgery suggested switching Renshen and Gancao to processed forms. After three doses, swelling occurred externally, and internal pain arose. I instructed to continue the previous prescription for twenty-plus doses. Externally, Yanghe Gao was applied covering the base, leaving only the wound open, bound with cloth. Asked why plaster and binding were used together, I explained: For Yin Ju, outer skin becomes active, inner membrane regenerates. Incision damages the membrane; if the membrane rots, death ensues. Pus lies between skin and membrane. Cannot place tissue-regenerating drugs inside. Therefore, internal warming, tonifying, nourishing yin, and activating blood herbs are used, along with external warming and blood-activating plasters. Binding connects skin and membrane, facilitating pus drainage and tissue connection. After binding, pus thickened. Adding Renshen led to recovery in two months.

A boatman from Yixing had a scrotum swollen to the size of a dou. A wandering practitioner punctured it. Within days, the testicle exposed, egg-sized, with a tendon six to seven cun long, shaped like double chicken intestines, protruding with the testicle, emitting foul odor. I ordered washing the rotten tendon with Zisu (Perilla Leaf) decoction. Asked if testicle, urine, or lower abdomen hurt? He said no. I said, pain in these three areas is difficult to treat; no pain means curable. Daily washing with Zisu decoction, followed by dusting Sugen (Perilla Stem) powder, wrapped in green lotus leaves. Internally, Huanglian (Coptidis Rhizoma), Guiwei (Angelicae Sinensis Radix Tail), Huangqin, Gancao, and Mutong were taken for ten doses. After five days, the testicle retracted, and the sore shrunk. This was not toxicity but injury. With shrinking opening and reddish-white tissue, Dihuang Tang (Rehmannia Decoction) was taken internally, and Shengji San (Tissue Regeneration Powder) applied externally for recovery.

A Fujian merchant had widespread Guang Dou (likely referring to a specific skin condition or toxin) and Hengxuan. I reasoned Hengxuan is a yin-deficiency syndrome requiring warming tonics; Guang Dou is a fire-toxin syndrome requiring cooling resolution. These contradict. A drug benefiting one harms the other. Only Xi Huang Wan (Calculus Bovis Pill) suits both. Taken with wine on an empty stomach, three qian daily for ten doses, both conditions resolved. Later, a patient with heavier toxicity recovered with double dosage.

A woman had three phlegm nodules on the neck, forming sinuses over years. Treated with sinus extraction medicine. Changed daily, two healed in half a month, one remained shallow. Unexpectedly, her husband returned from afar, and the sinus deepened in two days. I said, "Treatment now will be ineffective. We will discuss later." Her mother asked. I said, "Wait for your son-in-law to leave; it can heal in half a month." Days later, the daughter returned, and treatment led to recovery. Another young man had two sinuses on the arm. Asked if he had hidden issues, he admitted nocturnal emissions. I modified Liu Wei Di Huang Wan by removing Ze Xie, adding Xian Jiao (Thread Collagen?), Long Gu (Fossilized Bones), Qianshi (Euryales Semen), and Lian Xu (Nelumbinis Stamen) into pills. Deer Antler Grass (Luhanzcao) decoction was taken morning and evening, three qian per dose. After finishing, both sinuses healed.

A woman had Ru Yan (Breast Cancer) in both breasts, lasting two years, size of a longan fruit, never treated. Due to grief over her son's death, the lesions grew to cup size. Wutong (likely a local herb or typo for Lingzhi/Wutong Pi) and Xi Huang Wan were taken alternately morning and evening. Fully resolved in nine days. Another man had breast toxicity. Neighbor applied Ji Yu Gao (Crucian Carp Plaster). In two days, it grew fist-sized and red. Removed plaster, gave Yanghe Decoction for four doses. If color turns white, curable. If still red, incurable. Four days later, color remained red. Begged for treatment. Xi Huang Wan and Yanghe Decoction alternated. After sixteen doses, others resolved, only the apex ulcerated. Chan (Toad) detoxification for three days, recovery in half a month.

Qin Bunian from Dongting had twelve malignant nodes in neck and armpits. Condition worsened with Lianqiao and Kunbu. Punctured and ulcerated for three years before seeking medical help. Yanghe Decoction and Xi Huang Wan alternated for half a month. Eight out of ten healed. Joyfully took medicine home. Bought and ate cold jelly, then cold water noodles. Next day, urinary and fecal retention. Died on the fifth day. This patient disregarded his life, so I record this as a warning.

Ye family guest from Nanhao had malignant nodes under ears. One punctured and formed a sinus, one cup-sized. Yanghe and Xiao Jin alternated. Unulcerated ones resolved. Asked if sinus heals easily. I said, "Sinus resolution is easy; healing follows. If nearly healed, any leakage causes recurrence, making prognosis uncertain." Being sincere, it healed.

Qian Yongtai's son from Dongting had smallpox toxin. Doctors used clearing fire and detoxifying agents. First doctor increased toxin by six or seven times; second doctor generated twenty more. By the second year, all holes had sinuses, discharging foul pus daily. Right leg contracted, unable to walk. Bedridden for three years before treatment. Yanghe, Xiao Jin, Xi Huang pills taken. Internal sinus-resolving medicine used. Half healed in half a month, sinuses resolved in one month, including bone fragments. Wanted to take son home. Given Shengji San and Qi Blood harmonizing pills. Son ate whatever he wanted, refused washing and dressing, ate sour fruits like orange and pomegranate daily. In severe winter, odor returned. I said, "Rot smells bad, healing smells good. Cold muscle and unhealed ju, daily sour/astringent food. Returned for three months, sinuses reverted. Parents harmed him."

A woman had Bai Ju (White Carbuncle) in breast, with chills, fever, and severe pain. Yanghe Wan and Er Chen Tang decocted together. Slept, pain ceased. Three doses led to recovery.

Another woman reported her brother, also a surgeon, used Xiaku Cao, Huafen, Lianqiao, Juye for five doses. Crying and pain persisted. I examined, seeing white turning slightly red, difficult to fully resolve. Prescribed Rougui, Paojiang, Mahuang, plus Er Chen Tang. Took it that night, pain stopped, slept. Next day, skin wrinkled and shrank. Continued doses, lesion became painless and ulcerated. Yanghe Jiening Gao applied for recovery.

Tan family woman from Mudu Town had a bowl-sized back lesion. Initially white, turned red, severe pain. During Dog Days, I wrote Yanghe Decoction. Bystander asked why use Mahuang for exterior release and heat-inducing Gui/Jiang in summer. I said, "This is a yin syndrome." They said, "Red color means yin changed to yang." Fearing patient anxiety, I ordered immediate decoction. Pain ceased shortly after taking. Four additional doses reduced lesion by 70%. The 30% with pus ulcerated painlessly. Recovery in five days.

An eleven-year-old boy had edema on hands, feet, arms, legs, fingers, face, and whole body. Heavy breathing prevented sleep. A distant guest suggested finding one Huangpi Ganzi (Yellow-skinned Citron), decocted with two jin of fermented rice wine until dry. Remove seeds, consume with wine. Recovered in two doses.

Mr. Ma said: The above cases have merits and flaws, stated in each case. No further elaboration here.