妇人乳痈，属胆胃二腑热毒，气血壅滞。故初起肿痛，发于肌表，肉色 赤，其人表热发热
，或发寒热，或憎寒头痛，烦渴引冷，用人参败毒散、神效栝蒌散、加味逍遥散治之，其自
消散。若至数日之间，脓成溃窍，稠脓涌出，脓尽自愈。若气血虚弱，或误用败毒，久不收
敛，脓清脉大，则难治。乳岩属肝脾二脏郁怒，气血亏损，故初起小核，结于乳内，肉色如
故，其人内热夜热，五心发热，肢体倦瘦，月经不调，用加味归脾汤、加味逍遥散、神效瓜
蒌散，多自消散。若荏苒日月渐大，HT 岩色赤，出水腐溃深洞，用前归脾汤等药，可延岁月
，若误用攻伐，危殆迫矣。大凡乳症，若因恚怒，宜疏肝清热。 痛寒热，宜发表散邪。肿
痛甚，宜清肝消毒，并隔蒜灸。不作脓，或脓不溃，补气血为主。不收敛，或脓稀，补脾
胃为主。脓出反痛，或发寒热，补气血为主。或晡热内热，补血为主。若饮食少思，或作呕
吐，补胃为主。饮食难化，或作泄泻，补脾为主。劳碌肿痛，补气血为主。怒气肿痛，养肝
血为主。儿口所吹，须吮通揉散。成痈，治以前法。潮热暮热，亦主前药。大抵男子多由房
劳，耗伤肝肾。妇人郁怒，亏损肝脾。治者审之。（世以孕妇患此，名曰内吹。然其所致之因
则一，惟用药不可犯其胎耳。）
治验
一妇人内热胁胀，两乳不时作痛，口内不时辛辣，若卧而起急，则脐下牵痛，此带脉为患，
用小柴胡加青皮、黄连、山栀二剂而瘥。
一妇人因怒两乳肿，兼头痛寒热，用人参败毒散，二剂表症已退，用小柴胡加芎、归、枳壳
一妇人久郁，右乳内肿硬，用八珍汤加远志、贝母、柴胡、青皮及隔蒜灸，兼服神效栝蒌散，两月余而消。
一妇人左乳内肿如桃，不痛不赤，发热渐瘦，用八珍加香附、远志、青皮、柴胡百余剂，又
兼服神效栝蒌散三十余剂，脓溃而愈。
一妇人郁久，左乳内结核如杏许，三月不消，心脉涩而脾脉大，按之无力，以八珍加贝母、
远志、香附、柴胡、青皮、桔梗，五十余剂而溃，又三十余剂而愈。
一妇人禀实性躁，怀抱久郁，左乳内结一核，按之微痛，以连翘饮子二十余剂少退，更以八
珍加青皮、香附、桔梗、贝母，二十余剂而消。
一妇人发热作渴，至夜尤甚，两乳忽肿，肝脉洪数，乃热入血室也，用加味小柴胡汤，热止肿消。
一妇人因怒，左乳作痛发热，表散太过，肿热益甚，用益气养荣汤，数剂热止脓成，不从用
针，肿胀热渴，针脓大泄，仍以前汤，月余始愈。此症若脓成未破，有薄皮剥起者，用代针
之剂，其脓自出。不若及时用针，不致大溃。若脓血未尽，辄用生肌，反助其邪。慎之!
一妇人因怒，左乳作痛，胸膈不利，以方脉流气饮加木香、青皮，四剂而安。
一妇人脓清肿硬，面黄食少，内热晡热，自汗盗汗，月经不行，此肝脾气血俱虚，用十全大
补加远志、贝母及补中益气，各三十余剂，外用葱熨患处，诸症寻愈。
一妇人脓成胀痛，余欲针之，不从，数日始针，出败脓三四碗许，虚症蜂起，几至危殆，用
大补两月余而安。若元气虚弱，不作脓者，用益气养荣汤补之，脓成即针。若肿痛寒热，怠
惰食少，或至夜热甚，用补中益气汤兼逍遥散，补之为善。
一产妇因乳少，服药通之，致乳房肿胀，发热作渴，以玉露散补之而愈。夫乳汁乃气血所化
，在上为乳，在下为经，若冲任之脉盛，脾胃之气壮，则乳汁多而浓，衰则淡而少，所乳之
子，亦弱而多病。又有屡产无乳，或大便涩滞，乃亡津液也，当滋化源。
一妇人右乳内结三核，年余不消，朝寒暮热，饮食不甘，此乳岩，以益气养荣汤，百余剂，
血气渐复，更以木香饼熨之，喜其谨疾，年余而消。
至英内年二十有五，素虚弱，多郁怒，时疫后，脾胃愈虚，饮食愈少，又值气忿，右乳胁下
红肿，膺内作痛，用炒麸皮熨之，肿虽少散，内痛益甚，转侧胸中，如物悬坠，遂与加减四
物汤，内肿如鹅卵，外大如盘，胸胁背心相引而痛，夜热势甚，时治者皆以攻毒为言，叩诸
先生，乃云∶此病后脾弱，而复怒伤肝，治法惟主于健脾气，平肝火，则肿自消，而病自愈
矣。承惠方以八物加陈皮、黄 、柴胡、山栀、白芷，服八剂，病减六七，去白芷加青皮、
木香、桔梗，又六剂而痊愈。奏功之奇，获效之速，盖出于寻常万万也。感激浓恩，昕夕不
忘，录此乞附医案，以诏后之患者，毋为攻毒者之所惑也。晚生尤至英顿首再拜书。
一妇人乳内结核年余，晡热少食，余欲用益气养荣汤治之，彼以为缓，乃服行气之剂，其势
愈甚，溃而日出清脓而殁。
郭氏外家，乃放出宫女，乳内结一核如栗，亦服流气等药，大如覆碗，坚硬如石，出水而殁。
[Original Text]
妇人乳痈，属胆胃二腑热毒，气血壅滞。故初起肿痛，发于肌表，肉色赤，其人表热发热，或发寒热，或憎寒头痛，烦渴引冷，用人参败毒散、神效栝蒌散、加味逍遥散治之，其自消散。若至数日之间，脓成溃窍，稠脓涌出，脓尽自愈。若气血虚弱，或误用败毒，久不收敛，脓清脉大，则难治。
[English Translation]
Mastitis (acute suppurative disease of the breast) in women is attributed to heat-toxin accumulation in the Gallbladder and Stomach fu-organs, leading to stagnation and obstruction of Qi and Blood. Consequently, at the onset, there is swelling and pain on the surface of the skin and muscle, with redness of the local tissue. The patient may exhibit exterior fever, alternating chills and fever, aversion to cold accompanied by headache, restlessness, thirst, and a desire for cold drinks. Treatment with Renshen Baidu San (Ginseng Detoxification Decoction), Shenxiao Gualou San (Miraculous Efficacy Trichosanthes Powder), or Jiawei Xiaoyao San (Modified Free Wanderer Powder) often leads to spontaneous resolution. If, after several days, pus forms and ruptures through the skin, with thick pus gushing out, the wound will heal naturally once the pus is exhausted. However, if the patient has deficient Qi and Blood, or if toxic-clearing drugs were mistakenly used, causing the wound to fail to heal for a long time, with thin pus and a large pulse, the condition becomes difficult to treat.
[Original Text]
乳岩属肝脾二脏郁怒，气血亏损，故初起小核，结于乳内，肉色如故，其人内热夜热，五心发热，肢体倦瘦，月经不调，用加味归脾汤、加味逍遥散、神效瓜蒌散，多自消散。若荏苒日月渐大，HT 岩色赤，出水腐溃深洞，用前归脾汤等药，可延岁月，若误用攻伐，危殆迫矣。
[English Translation]
Breast cancer (Ru Yan) is caused by depression and anger affecting the Liver and Spleen zang-organs, resulting in deficiency and loss of Qi and Blood. Initially, it presents as a small nodule within the breast, with normal skin color. The patient experiences internal heat, night fevers, heat in the five centers (palms, soles, and chest), physical fatigue and emaciation, and irregular menstruation. Treatment with Jiawei Guipi Tang (Modified Heart-Spleen Tonifying Decoction), Jiawei Xiaoyao San, or Shenxiao Gualou San often results in spontaneous resolution. If neglected over time, the nodule gradually enlarges, the nipple and surrounding area become red, discharge fluid, and rot into deep ulcers. Using the aforementioned Guipi Tang and similar formulas can prolong life; however, mistaken use of attacking/draining methods would lead to imminent danger.
[Original Text]
大凡乳症，若因恚怒，宜疏肝清热。痛寒热，宜发表散邪。肿痛甚，宜清肝消毒，并隔蒜灸。不作脓，或脓不溃，补气血为主。不收敛，或脓稀，补脾胃为主。脓出反痛，或发寒热，补气血为主。或晡热内热，补血为主。若饮食少思，或作呕吐，补胃为主。饮食难化，或作泄泻，补脾为主。劳碌肿痛，补气血为主。怒气肿痛，养肝血为主。儿口所吹，须吮通揉散。成痈，治以前法。潮热暮热，亦主前药。大抵男子多由房劳，耗伤肝肾。妇人郁怒，亏损肝脾。治者审之。（世以孕妇患此，名曰内吹。然其所致之因则一，惟用药不可犯其胎耳。）
[English Translation]
Generally, for breast conditions: if caused by anger, soothe the Liver and clear heat; if accompanied by chills and fever, release the exterior and disperse pathogens; if swelling and pain are severe, clear the Liver and detoxify, combined with Garlic-Separated Moxibustion; if pus does not form or fails to rupture, tonify Qi and Blood primarily; if the wound fails to close or pus is thin, tonify the Spleen and Stomach primarily; if pain recurs after pus drainage or chills/fever return, tonify Qi and Blood primarily; if evening fevers or internal heat occur, nourish Blood primarily; if appetite is poor or vomiting occurs, tonify the Stomach primarily; if food is hard to digest or diarrhea occurs, tonify the Spleen primarily; if swelling/pain results from overwork, tonify Qi and Blood primarily; if swelling/pain results from anger, nourish Liver Blood primarily. For blockage caused by an infant's breath, suction and massage are required to unblock and dissipate. If an abscess forms, treat according to the above methods. For tidal or evening fevers, the aforementioned formulas are also primary. Generally, men suffer from this due to sexual excess damaging the Liver and Kidney; women suffer from it due to emotional depression and anger damaging the Liver and Spleen. Physicians must examine carefully. (In ancient times, when pregnant women suffered from this, it was called "Internal Blowing." However, the etiology is the same; only the medication must avoid harming the fetus.)
[Original Text]
治验
一妇人内热胁胀，两乳不时作痛，口内不时辛辣，若卧而起急，则脐下牵痛，此带脉为患，用小柴胡加青皮、黄连、山栀二剂而瘥。
[English Translation]
Clinical Case 1: A woman experienced internal heat, hypochondriac distension, intermittent pain in both breasts, and occasional spiciness in the mouth. Upon rising quickly from lying down, she felt traction pain below the umbilicus. This was diagnosed as a disorder of the Dai Mai (Girdle Vessel). She was treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Qingpi (Green Tangerine Peel), Huanglian (Coptis Rhizome), and Shanzhi (Gardenia Fruit) for two doses, resulting in recovery.
[Original Text]
一妇人因怒两乳肿，兼头痛寒热，用人参败毒散，二剂表症已退，用小柴胡加芎、归、枳壳
[English Translation]
Case 2: A woman developed bilateral breast swelling due to anger, accompanied by headache and chills/fever. She was given Renshen Baidu San, which resolved the exterior symptoms after two doses. Subsequently, Xiao Chai Hu Tang was modified with Xiong (Ligusticum Rhizome), Gui (Angelica Sinensis), and Zhike (Aurantii Fructus)... [Text incomplete in source].
[Original Text]
一妇人久郁，右乳内肿硬，用八珍汤加远志、贝母、柴胡、青皮及隔蒜灸，兼服神效栝蒌散，两月余而消。
[English Translation]
Case 3: A woman with long-term emotional depression had a swollen and hard mass in her right breast. She was treated with Bazhen Tang (Eight Treasures Decoction) added with Yuanzhi (Polygalae Radix), Beimu (Fritillariae Bulbus), Chaihu (Bupleuri Radix), and Qingpi, along with Garlic-Separated Moxibustion, and concurrently took Shenxiao Gualou San. The mass dissipated after more than two months.
[Original Text]
一妇人左乳内肿如桃，不痛不赤，发热渐瘦，用八珍加香附、远志、青皮、柴胡百余剂，又兼服神效栝蒌散三十余剂，脓溃而愈。
[English Translation]
Case 4: A woman had a peach-sized swelling in her left breast, without pain or redness, but with fever and gradual emaciation. She took over one hundred doses of Bazhen Tang added with Xiangfu (Cyperi Rhizoma), Yuanzhi, Qingpi, and Chaihu, and concurrently took more than thirty doses of Shenxiao Gualou San. The abscess ruptured, and she recovered.
[Original Text]
一妇人郁久，左乳内结核如杏许，三月不消，心脉涩而脾脉大，按之无力，以八珍加贝母、远志、香附、柴胡、青皮、桔梗，五十余剂而溃，又三十余剂而愈。
[English Translation]
Case 5: A woman with chronic depression had an apricot-sized nodule in her left breast that did not resolve for three months. Her Heart pulse was choppy, and her Spleen pulse was large but weak upon pressure. She was treated with Bazhen Tang added with Beimu, Yuanzhi, Xiangfu, Chaihu, Qingpi, and Jiegeng (Platycodonis Radix). After fifty-plus doses, the nodule ulcerated; after another thirty-plus doses, she recovered.
[Original Text]
一妇人禀实性躁，怀抱久郁，左乳内结一核，按之微痛，以连翘饮子二十余剂少退，更以八珍加青皮、香附、桔梗、贝母，二十余剂而消。
[English Translation]
Case 6: A woman with a robust constitution but irritable temperament, suffering from long-term emotional depression, had a nodule in her left breast that was slightly painful upon pressure. She took Lianqiao Yinzi (Forsythia Decoction) for twenty-plus doses, showing slight improvement. Then, she took Bazhen Tang added with Qingpi, Xiangfu, Jiegeng, and Beimu for twenty-plus doses, resulting in the disappearance of the nodule.
[Original Text]
一妇人发热作渴，至夜尤甚，两乳忽肿，肝脉洪数，乃热入血室也，用加味小柴胡汤，热止肿消。
[English Translation]
Case 7: A woman experienced fever and thirst, worsening at night, with sudden bilateral breast swelling. Her Liver pulse was surging and rapid, indicating Heat entering the Blood Chamber (Chong and Ren vessels). She was treated with Jiawei Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction), which stopped the fever and reduced the swelling.
[Original Text]
一妇人因怒，左乳作痛发热，表散太过，肿热益甚，用益气养荣汤，数剂热止脓成，不从用针，肿胀热渴，针脓大泄，仍以前汤，月余始愈。此症若脓成未破，有薄皮剥起者，用代针之剂，其脓自出。不若及时用针，不致大溃。若脓血未尽，辄用生肌，反助其邪。慎之!
[English Translation]
Case 8: A woman developed pain and fever in her left breast due to anger. Previous excessive diaphoresis worsened the swelling and heat. She was treated with Yiqi Yangrong Tang (Qi-Tonifying and Nourishing Decoction). After several doses, the fever subsided and pus formed. Refusing needle drainage, her swelling, heat, and thirst increased. After needle drainage released large amounts of pus, she continued with the previous decoction and recovered after a month. Note: If pus is formed but not ruptured, with thin skin peeling up, use promulgatory agents to allow natural drainage rather than immediate needling to prevent extensive ulceration. If pus and blood are not fully drained, using flesh-regenerating agents prematurely aids the pathogen. Exercise caution!
[Original Text]
一妇人因怒，左乳作痛，胸膈不利，以方脉流气饮加木香、青皮，四剂而安。
[English Translation]
Case 9: A woman experienced left breast pain and chest/diaphragm discomfort due to anger. She was treated with Fangmai Liqi Yin (Pulse-Regulating Qi-Flowing Drink) added with Muxiang (Aucklandiae Radix) and Qingpi, resulting in relief after four doses.
[Original Text]
一妇人脓清肿硬，面黄食少，内热晡热，自汗盗汗，月经不行，此肝脾气血俱虚，用十全大补加远志、贝母及补中益气，各三十余剂，外用葱熨患处，诸症寻愈。
[English Translation]
Case 10: A woman presented with thin pus, hard swelling, sallow complexion, poor appetite, internal heat, evening fevers, spontaneous sweating, nocturnal sweating, and amenorrhea. This indicated deficiency of both Qi and Blood in the Liver and Spleen. She was treated with Shiquan Dabu Tang (Complete Great Tonifying Decoction) added with Yuanzhi and Beimu, and Buzhong Yiqi Tang (Middle-Boosting Qi-Invigorating Decoction), each for thirty-plus doses. External application of scallion moxibustion/warming was used on the affected area. All symptoms subsequently resolved.
[Original Text]
一妇人脓成胀痛，余欲针之，不从，数日始针，出败脓三四碗许，虚症蜂起，几至危殆，用大补两月余而安。若元气虚弱，不作脓者，用益气养荣汤补之，脓成即针。若肿痛寒热，怠惰食少，或至夜热甚，用补中益气汤兼逍遥散，补之为善。
[English Translation]
Case 11: A woman had painful swelling due to formed pus. I proposed needle drainage, but she refused. Days later, drainage yielded three to four bowls of foul pus, causing acute deficiency symptoms and near-critical condition. She was treated with major tonification for over two months to stabilize. If Yuan Qi is weak and pus fails to form, use Yiqi Yangrong Tang to tonify; drain immediately once pus forms. If there is swelling, pain, chills/fever, lethargy, poor appetite, or severe night fever, use Buzhong Yiqi Tang combined with Xiaoyao San, prioritizing tonification.
[Original Text]
一产妇因乳少，服药通之，致乳房肿胀，发热作渴，以玉露散补之而愈。夫乳汁乃气血所化，在上为乳，在下为经，若冲任之脉盛，脾胃之气壮，则乳汁多而浓，衰则淡而少，所乳之子，亦弱而多病。又有屡产无乳，或大便涩滞，乃亡津液也，当滋化源。
[English Translation]
Case 12: A postpartum woman took galactagogues for low milk supply, resulting in breast swelling, fever, and thirst. She was treated with Yulu San (Jade Dew Powder) for tonification and recovered. Milk is transformed from Qi and Blood; above it becomes milk, below it becomes menses. If the Chong and Ren vessels are vigorous and Spleen/Stomach Qi is strong, milk is abundant and rich; if weak, it is scant and thin, affecting the child's health. Women with multiple births lacking milk or experiencing constipation have depleted Jin Ye (Body Fluids) and should nourish the source of transformation (Spleen/Kidney).
[Original Text]
一妇人右乳内结三核，年余不消，朝寒暮热，饮食不甘，此乳岩，以益气养荣汤，百余剂，血气渐复，更以木香饼熨之，喜其谨疾，年余而消。
[English Translation]
Case 13: A woman had three nodules in her right breast persisting for over a year, with morning chills, evening fevers, and poor taste in food. Diagnosed as Breast Cancer, she took Yiqi Yangrong Tang for over one hundred doses, gradually restoring Qi and Blood. External application of Muxiang Bing (Costus Cake) was used. Due to her careful compliance, the nodules dissipated after over a year.
[Original Text]
至英内年二十有五，素虚弱，多郁怒，时疫后，脾胃愈虚，饮食愈少，又值气忿，右乳胁下红肿，膺内作痛，用炒麸皮熨之，肿虽少散，内痛益甚，转侧胸中，如物悬坠，遂与加减四物汤，内肿如鹅卵，外大如盘，胸胁背心相引而痛，夜热势甚，时治者皆以攻毒为言，叩诸先生，乃云∶此病后脾弱，而复怒伤肝，治法惟主于健脾气，平肝火，则肿自消，而病自愈矣。承惠方以八物加陈皮、黄 、柴胡、山栀、白芷，服八剂，病减六七，去白芷加青皮、木香、桔梗，又六剂而痊愈。奏功之奇，获效之速，盖出于寻常万万也。感激浓恩，昕夕不忘，录此乞附医案，以诏后之患者，毋为攻毒者之所惑也。晚生尤至英顿首再拜书。
[English Translation]
Letter from You Zhiying: I am twenty-five years old, constitutionally weak, prone to depression and anger. After an epidemic, my Spleen and Stomach became weaker, and food intake decreased. Anger triggered redness and swelling under the right breast and pain in the chest. Initial external warming with bran provided little relief and worsened internal pain, feeling like a hanging weight in the chest. I was prescribed Jiajia Siwu Tang (Modified Four Substances Decoction). The swelling grew to the size of a goose egg internally and a plate externally, radiating pain to the back, with severe night fever. Local doctors advocated toxic-clearing attacks. Consulting senior physicians, they advised: Post-illness Spleen weakness compounded by Liver damage from anger requires strengthening Spleen Qi and calming Liver Fire. Swelling will subside, and the disease will heal. I received a prescription of Bayi Tang (Eight Items Decoction) added with Chenpi, Huangqi, Chaihu, Shanzhi, and Baizhi. After eight doses, symptoms improved by 60-70%. Baizhi was removed, and Qingpi, Muxiang, and Jiegeng were added. After six more doses, I recovered. The efficacy was miraculous, far surpassing ordinary treatments. I deeply appreciate this grace and record this case to warn future patients against being misled by toxic-clearing approaches. Your humble servant, You Zhiying, bows respectfully.
[Original Text]
一妇人乳内结核年余，晡热少食，余欲用益气养荣汤治之，彼以为缓，乃服行气之剂，其势愈甚，溃而日出清脓而殁。
[English Translation]
Case 14: A woman had a breast nodule for over a year, with evening fevers and poor appetite. I recommended Yiqi Yangrong Tang, but she considered it too slow and took Qi-moving agents instead. Her condition worsened, leading to ulceration with daily discharge of thin pus, resulting in death.
[Original Text]
郭氏外家，乃放出宫女，乳内结一核如栗，亦服流气等药，大如覆碗，坚硬如石，出水而殁。
[English Translation]
Case 15: The mother-in-law of the Guo family, a former palace maid, had a chestnut-sized nodule in her breast. She also took Liqi-type medicines. The mass grew to the size of an inverted bowl, became stone-hard, discharged fluid, and resulted in death.