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Xue Lizhai stated: Generally speaking, for breast diseases, if caused by anger, one should soothe the liver and clear heat; if accompanied by aversion to cold and fever, one should release the exterior and disperse pathogens; if swelling and pain are severe, one should clear the liver and detoxify, combined with garlic-separated moxibustion; if pus does not form or fails to rupture, tonifying qi and blood is primary; if the sore does not close or the pus is thin, tonifying the spleen and stomach is primary; if pain recurs after pus discharge or fever occurs, tonifying qi and blood is primary; if there is afternoon or night-time internal heat, nourishing blood is primary; if appetite is poor or vomiting occurs, tonifying the stomach is primary; if food is difficult to digest or diarrhea occurs, tonifying the spleen is primary; if swelling and pain result from overwork, tonifying qi and blood is primary; if swelling and pain result from anger, nourishing liver blood is primary; if caused by a baby's breath, it must be sucked open and massaged to dissipate; if an abscess forms, treat according to the aforementioned methods. If ru yan (breast cancer) belongs to depression and anger of the liver and spleen with qi and blood deficiency, initially small nodules form within the breast, skin color remains normal, five-center heat occurs, limbs become weak and emaciated, and menstruation is irregular. Taking Jiawei Guipi Tang (Modified Spleen-Tonifying Decoction), Jiawei Xiaoyao San (Modified Free Wanderer Powder), or Shen'eogua Lou San (Miraculous Trichosanthes Powder) in large amounts will naturally resolve them. If neglected for a long time and gradually enlarging, the lesion becomes red, exudes fluid, and ulcerates into deep cavities; using the aforementioned Guipi Tang etc. can prolong life. If mistakenly treated with purgatives/attacking methods, it becomes critical.

Shen Zhai commented: The above passage outlines the general principles for treating ru yong (breast abscess) and ru yan (breast cancer). Physicians of the world treat these conditions merely with cold-cooling herbs to clear fire and qi-breaking herbs to eliminate stasis. They do not realize that the origin of the disease lies in the deficiency of the liver and stomach, causing Ying and Wei (nutritive and defensive qi) to fail to circulate properly. Only Xue Lizhai advocated supporting the spleen and stomach, focusing on tonifying qi and blood, warning against excessive attacking methods that lead to premature death. His intent in leaving this instruction was profound.

Chen Liangfu stated: Female vulvar swelling is caused by deficiency damage and wind-pathogen invasion. When the Bao Luo (uterine collaterals) are deficient, wind pathogens lodge therein. Wind Qi attacks the yin region, combats with blood and qi, causing qi stagnation and obstruction. The pores become blocked and unable to vent, thus causing swelling.

Xu Chunfu stated: Vulvar swelling may result from excessive sexual exertion damaging the vaginal opening, requiring abstinence and regulation. It may also result from excessive desire generating intense heat and parasites, leading to severe swelling and itching; in all such cases, sexual abstinence and prompt treatment are required. If pathogens gradually intensify, causing vaginal ulceration and failure to heal, it is due to lack of early treatment.

Xue Lizhai commented: For the aforementioned conditions, if qi and blood are weak, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to raise and tonify; if damp-heat in the liver channel, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction) to drain and clear. In cases of liver-spleen depression and anger with sinking yuan qi and damp-heat stagnation, administer Guipi Tang plus Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) in the morning to resolve stagnation and tonify spleen qi, and Jiawei Xiaoyao San in the evening to clear liver fire, generate liver blood, and remove damp-heat.

Shen Zhai commented: The above two passages outline female vulvar swelling, distinguishing between external wind-pathogen invasion and internal injury from sexual fatigue. Regarding vulvar swelling, Daquan attributed it to wind-pathogen invasion, Chunfu attributed it to sexual fatigue, and Lizhai traced the root to damp-heat in the liver channel. This represents the key to understanding the pathogenesis.