乳疽乳痈乳房生，肝气郁结胃火成。痈形红肿 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。
\r乳疽图\p04-34a119.bmp\r
\r乳痈图\p04-34a120.bmp\r
【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，宜服栝
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，宜服托里排脓汤；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。
栝蒌牛蒡汤
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）
水二盅，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。
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）
Ru Ju (Breast Carbuncle) and Ru Yong (Breast Abscess) both occur in the breast region, primarily caused by Liver Qi Stagnation (Liver Qi Stagnation: impairment of the smooth flow of Liver Qi) and Stomach Fire Hyperactivity (Stomach Fire Hyperactivity: excessive heat in the Stomach channel). The manifestation of Ru Yong is characterized by redness, swelling, heat, and pain; whereas Ru Ju presents as numbness, hardness, and slight pain. Ru Yong typically suppurates within fourteen days after onset, while Ru Ju may take over a month to form pus. Before ulceration, treatment should focus on supporting the healthy Qi to expel toxins and drain pus; after ulceration, major tonification of Qi and Blood to nourish Ying and Wei (Ying and Wei: Nutritive and Defensive Qi) is required.
[Note] This condition generally arises from Liver Qi Stagnation and Stomach Heat obstruction. It is rare in men but common in women, occurring in the breast area. Redness, swelling, heat, and pain indicate Ru Yong, which suppurates in fourteen days; hardness with numbness and pain indicates Ru Ju, which suppurates in over a month. In the initial stage accompanied by alternating chills and fever, Gualou Niubang Tang (Trichosanthes and Arctium Decoction) is suitable. If chills and fever subside completely but swelling and induration persist, Fuyuan Tongqi San (Restoring Vitality and Promoting Circulation Powder) is used to dissipate the mass. If there is no response and throbbing sensations occur, indicating imminent rupture, Tuoli Tou Nong Tang (Supporting Interior and Penetrating Pus Decoction) is appropriate. For distending pain due to pus accumulation, acupuncture for drainage is indicated, along with Tuoli Pai Nong Tang (Supporting Interior and Draining Pus Decoction). For deficiency patterns, tonification is applied, such as Renshen Yangrong Tang (Ginseng and Nutritive Qi Decoction) or Shiquan Dabu Tang (Ten Complete Tonifying Decoction), all of which can be selected. External applications follow the protocols listed under the sections for Ulcerative Sores and Ulcers.
Gualou Niubang Tang (Trichosanthes and Arctium Decoction)
Gualou Ren (Trichosanthis Semen), Niubang Zi (Arctii Fructus, stir-fried and crushed), Huafen (Trichosanthis Radix), Huangqin (Scutellariae Radix), Sheng Zhizi (Gardeniae Fructus, raw and crushed), Lianqiao (Forsythiae Fructus, heart removed), Zaocis Spina (Spatholobi Caulis thorns), Jinyinhua (Lonicerae Japonicae Flos), Gancao (Licorice Root, raw), Chenpi (Citri Reticulatae Pericarpium) [each 1 qian]; Qingpi (Aurantii Fructus Immaturus), Chaihu (Bupleuri Radix) [each 0.5 qian].
Add two cups of water, decoct until eight-tenths remain, mix with one cup of boiled wine, and take after meals.
[Prescription Verse] Gualou and Niubang address Stomach Fire stagnation, aversion to cold and high fever in Ru Yong and Ru Ju; the formula contains Qingpi, Chaihu, Huafen, Huangqin, Lianqiao, Zaocis Spina, Jinyinhua, Zhizi, Gancao, and Chenpi.
Fuyuan Tongqi San (See section on Ulcerative Sores)
Tuoli Tou Nong Tang (See section on Head Region Brain-Penetrating Carbuncle)
Tuoli Pai Nong Tang (See section on Neck Region Fish-Tail Toxicity)
Renshen Yangrong Tang (See section on Ulcers)
Shiquan Dabu Tang (See section on Ulcers)