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Ru Yan (Breast Cancer) initially presents as a lump in the breast with dull pain, caused by damage to the Liver and Spleen and condensation of Qi stagnation. The lump is neither red nor hot, and the body may experience alternating chills and fever; at this stage, moxibustion should be applied promptly to nourish Blood and prevent the pathogen from attacking inward. If neglected and allowed to progress, the condition develops with lumps hard like piled chestnuts, taking on a rock-like shape and radiating pain to the axilla and chest. If the top of the lump reveals a purple sheen followed by necrosis, it will intermittently discharge foul fluid, with pain increasing daily. After ulceration, the wound everts like flower petals, and bleeding occurs upon anger; this indicates a terminal syndrome (Bai Zheng), where medication is ineffective.

[Note] This condition arises from injury to the Liver and Spleen, leading to Qi stagnation and condensation. It begins as a nodule within the breast, initially resembling a date or chestnut, gradually enlarging to the size of a chess piece, without redness or heat, sometimes accompanied by dull pain. At this stage, external moxibustion and internal blood-nourishing decoctions are appropriate to prevent internal invasion. If the disease persists for years, tidal fever and aversion to cold develop, followed by severe pain radiating to the chest and axillae. The swelling becomes hard like an inverted bowl, shaped like piled chestnuts, protruding like a rock, with the apex showing a bright purple hue and blood vessels visible in the flesh. Necrosis precedes ulceration, with foul fluid oozing continuously, sometimes erupting with foul-smelling blood. The decay runs deep like a rocky gorge, with everted tissue resembling lotus flowers, causing pain that reaches the heart. If further aggravated by rage, profuse fresh blood flows, the root swelling becomes harder, and eventually all five Zang organs decline, resulting in a terminal syndrome with no hope of cure; however, if the patient can clear the mind, eliminate desires, and rest quietly, treatment may still be attempted. Initially, Shen Xiao Gua Lou San is indicated, followed by Qing Gan Jie Yu Tang, with Ji Zhi Ji Yu Gao applied externally, hoping for the resolution of the nodule. If repeated treatments fail and the ulcerative state is established, harsh purgative agents should not be overused to avoid damaging Stomach Qi; instead, Xiang Bei Yang Rong Tang may be used. For patients with irritability and insomnia, Gui Pi Tang is suitable; for those with tidal fever and aversion to cold, Xiao Yao San is appropriate, allowing for temporary prolongation of life. For patients diagnosed early when the nodule first appears, apply a bean-sized moxa cone directly on the apex for seven moxibustions. On the following day, puncture the skin, insert a three-edged needle 5-6 fen deep, introduce Bing Luo San thread into the wound, seal with paper paste, and after ten-plus days, the nodule will naturally fall off. Apply Jiang Zhu Gao and Sheng Ji Yu Hong Gao externally, and internally administer formulas to soothe the Liver, nourish Blood, and regulate the Spleen; muscle regeneration and wound closure will lead to spontaneous recovery.

Ji Zhi Ji Yu Gao (Seasonal Herb Crucian Carp Paste)
Fresh Crucian Carp Meat (Cyprinus carpio) Fresh Chinese Yam (Dioscorea opposita, peeled, equal parts)
Mash together into a paste, add a small amount of Moschus (She Xiang), apply to the nodule. Intense itching may occur; do not scratch. Gently rub through clothing. Change every seven days; application leads to dissolution.

[Prescription Verse] Ji Yu Gao treats Ru Yan disease, swelling like an inverted bowl or piled chestnuts; mashed with Chinese Yam and added Moschus, apply to the affected area and change every seven days.

Bing Luo Nian (Ice Snail Thread)
Calomel (Qing Fen, 2 fen) Large River Snail (Pomacea canaliculata, shell removed, threaded and sun-dried, 5 pieces) Borneol (Bing Pian, 1 fen) White Arsenic (Bai Pi, also known as Ren Yan. Wrapped in flour and roasted熟, discard flour, use arsenic only, 1 qian 2 fen)
Slice snail meat, grind together with White Arsenic into powder, then add Calomel and grind finely. Mix with thick rice paste to form threads, store tightly in a porcelain jar. To use, insert the thread into the puncture hole, seal externally with paper paste, keep the nodule immobile. After ten days, cracks appear around the edges, and the nodule falls off naturally.

[Prescription Verse] Bing Luo Nian resolves various nodules; Calomel, snail meat, and roasted White Arsenic; mixed with Borneol and rice paste into threads, suitable for hard Ru Yan.

Shen Xiao Gua Lou San (See "Ru Lao" chapter)
Xiang Bei Yang Rong Tang (See "Shang Shi Ju of Neck" chapter)
Qing Gan Jie Yu Tang, Gui Pi Tang (Both see "Nodules in Breast" chapter)
Xiao Yao San (See "Shang Da Shou of Back" chapter)
Jiang Zhu Gao, Sheng Ji Yu Hong Gao (Both see "Ulceration Section")