乳劳初核渐肿坚，根形散漫大如盘，未溃先腐霉斑点，败脓津久劳证添。
【注】此证即由乳中结核而成。或消之不应，或失于调治，耽延数日，渐大如盘如碗，
坚硬疼痛，根形散漫，串延胸肋腋下，其色或紫、或黑，未溃先腐，外皮霉点，烂斑数
处，渐渐通破，轻津白汁，重流臭水，即败浆脓也。日久溃深伤膜，内病渐添，午后烦
热、干嗽、颧红、形瘦、食少、阴虚等证俱见，变成疮劳。初结肿时，气实者宜服蒌贝
散，及神效栝蒌散；气虚者逍遥散，及归脾汤合而用之。阴虚之证已见，宜服六味地黄
汤，以培其本。外治法按痈疽溃疡门。然此疮成劳至易，获效甚难。
蒌贝散
栝蒌 贝母（去心，研） 南星 甘草（生） 连翘（去心，各一钱）
水二盅，煎八分，澄渣，加酒二分，食远服。一加青皮、升麻。
【方歌】蒌贝散治乳结核，渐大失调变乳劳，初肿气实须服此，南星甘草共连翘。
神效栝蒌散
大栝蒌（去皮，焙为末，一个） 当归 甘草（生，各五钱） 没药 乳香（各二钱）
共研细末，每用五钱，醇酒三盅，慢火熬至一盅，去渣，食后服之。
【方歌】神效栝蒌没乳香，甘草当归研末良，乳劳初肿酒煎服，消坚和血是神方。
逍遥散（见背部上搭手）
归脾汤（见乳中结核）
六味地黄汤（即六味地黄丸改作煎剂。见面部雀斑）
Ru Lao (Breast Tuberculosis/Chronic Breast Abscess) begins with a nodule that gradually swells and becomes hard. The base is diffuse, spreading like a plate. Before ulceration, putrefaction occurs with mold-like spots; prolonged discharge of foul pus and fluids exacerbates the consumptive syndrome.
[Note] This condition originates from nodules in the breast. If resolution therapy fails or treatment is neglected, after several days, the swelling enlarges to the size of a plate or bowl, becoming hard and painful. The base is diffuse, extending to the chest, hypochondrium, and axilla. The color may be purple or black. Before ulceration, putrefaction sets in, with mold-like spots on the skin surface and multiple ulcerated areas that eventually break through completely. Mild cases discharge white fluid; severe cases discharge foul-smelling water, known as foul purulent exudate. Prolonged deep ulceration damages the membranes, leading to internal complications. Symptoms such as afternoon fever, dry cough, malar flush, emaciation, poor appetite, and Yin deficiency appear, transforming into Chuang Lao (consumption due to chronic sores). At the initial stage of swelling and nodule formation, patients with excess Qi should take Lou Bei San (Trichosanthes and Fritillaria Powder) and Shen Xiao Gua Lou San (Miraculous Trichosanthes Powder); those with deficient Qi should take Xiao Yao San (Free and Easy Wanderer Powder) combined with Gui Pi Tang (Restore the Spleen Decoction). If Yin deficiency symptoms are evident, Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Decoction) should be taken to nourish the root. External treatment follows the protocols for carbuncles and ulcers. However, this sore easily progresses to consumption, and achieving efficacy is very difficult.
Lou Bei San
Gualou (Trichosanthis Fructus), Beimu (Fritillariae Bulbus, heart removed and ground), Nanxing (Arisaematis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, raw), Lianqiao (Forsythiae Fructus, heart removed), each 1 qian.
Decoct two zhong of water to eight fen, clarify the dregs, add two fen of wine, and take far from meals. Optionally add Qingpi (Citri Reticulatae Pericarpium Viride) and Shengma (Cimicifugae Rhizoma).
[Prescription Verse] Lou Bei San treats breast nodules, which enlarge and transform into Ru Lao if neglected; for initial swelling with Qi excess, take this formula: Nanxing, Gancao, and Lianqiao together.
Shen Xiao Gua Lou San
Da Gualou (Trichosanthis Fructus, peel removed, roasted and ground, one fruit), Danggui (Angelicae Sinensis Radix), Gancao (Glycyrrhizae Radix et Rhizoma, raw), each 5 qian; Moyao (Myrrha), Ruxiang (Olibanum), each 2 qian.
Grind all into fine powder. Take 5 qian per dose, decoct with three zhong of strong wine over slow fire until reduced to one zhong, strain, and take after meals.
[Prescription Verse] Shen Xiao Gua Lou contains Myrrha and Olibanum, mixed with Angelica and Licorice powder; decocted in wine for early-stage Ru Lao swelling, it is a miraculous formula for resolving hardness and harmonizing blood.
Xiao Yao San (See "Upper Hand on Back" section)
Gui Pi Tang (See "Nodules in Breast" section)
Liu Wei Di Huang Tang (i.e., Liu Wei Di Huang Wan modified as a decoction. See "Facial Freckles" section)