消毒饮
乳痈初起消毒饮，青芷归柴浙贝蚕，花粉银花甘草节；寒热荆防羌独添；脓成皂刺穿山甲；溃后益气养荣煎。
【注】乳痈乃阳明、厥阴二经，风热壅盛初起宜服消毒饮，即青皮、白芷、当归、柴
胡、浙贝母、僵蚕、花粉、金银花、甘草节也。若兼憎寒壮热者，加荆芥、防风、羌活、
独活，以解散之；若服后不消，其脓已成者，宜加皂角刺、穿山甲，以穿发之∶若溃后气
血虚者，宜益气养荣汤培补之。他如溃久脓清不敛，又须急服大剂参、 、桂、附矣。
益气养荣汤（方见前首卷汇方内）
栝蒌散 外敷法
吹乳结核栝蒌散，乳没归甘用酒熬；更加皂刺名立效，已成脓溃未成消；外敷星夏蚕芷刺，草乌为末蜜葱调。
【注】吹乳结核不散者，当早消之，久则成痈。宜用栝蒌散，即栝蒌实、乳香、没药、
当归、甘草，酒熬服也。若服后不散者，加皂角刺，名立效散，脓成者溃，未成者消，外
用南星、半夏、僵蚕、白芷、皂角刺、草乌为末，用葱汁合蜜调敷。
十六味流气饮 青皮甘草散
乳岩郁怒损肝脾，流气饮归芍参 ，芎防苏芷枳桔草，槟榔乌朴桂通随；外熨木香生地饼，青皮甘
草服无时。溃后不愈须培补，十全八珍或归脾。
【注】乳岩之证，初起结核如围棋子大，不痛不痒。五七年或十余年，从内溃破，嵌
空玲珑，洞窍深陷，有如山岩，故名乳岩。皆缘抑郁不舒，或性急多怒，伤损肝脾所致。宜
速服十六味流气饮，其方即当归、白芍、人参、黄 、川芎、防风、苏叶、白芷、枳壳、
桔梗、甘草、槟榔、乌药、浓朴、官桂、木通。外以木香、生地捣饼，以热器熨之，且
不时以青皮、甘草为末，煎浓姜汤调服。戒七情，远荤味，解开郁怒，方始能愈。若溃
后久不愈，惟宜培补其气血，或十全大补汤、八珍汤，归脾汤选用之。
十全大补汤 八珍汤 归脾汤（方俱见首卷）
Xiaodu Yin (Disinfecting Decoction)
For the initial stage of Ru Yong (acute suppurative disease of the breast), Xiaodu Yin is indicated. The formula consists of Qingpi (Qingpi, Citri Reticulatae Pericarpium), Baizhi (Baizhi, Angelicae Dahuricae Radix), Danggui (Danggui, Angelicae Sinensis Radix), Chaihu (Chaihu, Bupleuri Radix), Zhe Beimu (Zhe Beimu, Fritillariae Thunbergii Bulbus), Jiangcan (Jiangcan, Bombyx Batryticatus), Huafen (Huafen, Trichosanthis Radix), Jinyinhua (Jinyinhua, Lonicerae Japonicae Flos), and Gancao Jie (Gancao Jie, Glycyrrhizae Radix et Rhizoma cum Melle). If accompanied by aversion to cold and fever, Jingjie (Jingjie, Schizonepetae Herba), Fangfeng (Fangfeng, Saposhnikoviae Radix), Qianghuo (Qianghuo, Notopterygii Rhizoma et Radix), and Duhuo (Duhuo, Angelicae Pubescentis Radix) may be added. If pus has formed, Zaocis Spina (Zaocis Spina, Gleditsiae Sinensis Spina) and Chuanshanjia (Chuanshanjia, Manis Squama) should be added to penetrate and drain the pus. After ulceration, if qi and blood are deficient, Yiqi Yangrong Jian (Yiqi Yangrong Decoction) should be used.
[Note] Ru Yong (acute suppurative disease of the breast) is caused by wind-heat congestion in the Yangming and Jueyin meridians. In the initial stage, Xiaodu Yin is indicated, comprising Qingpi, Baizhi, Danggui, Chaihu, Zhe Beimu, Jiangcan, Huafen, Jinyinhua, and Gancao Jie. If accompanied by chills and high fever, add Jingjie, Fangfeng, Qianghuo, and Duhuo to release the exterior. If the mass does not resolve after taking the medicine and pus has formed, add Zaocis Spina and Chuanshanjia to penetrate and discharge the pus. If qi and blood are deficient after ulceration, use Yiqi Yangrong Tang (Yiqi Yangrong Decoction) for tonification. In other cases, if the ulcer fails to heal for a long time with thin pus, large doses of Renshen (Renshen, Ginseng Radix), Huangqi (Huangqi, Astragali Radix), Rougui (Rougui, Cinnamomi Cortex), and Fuzi (Fuzi, Aconiti Lateralis Radix Praeparata) should be administered urgently.
Yiqi Yangrong Tang (Formula see previous volume)
Gualou San (Trichosanthes Powder) External Application Method
For Chuiniu (breast lump caused by milk stasis postpartum) where nodules do not dissipate, Gualou San is indicated. The formula consists of Rushen (Rushen, Boswelliae Carthages Resina), Moyao (Moyao, Myrrha), Danggui, and Gancao, decocted with wine. If Zaocis Spina is added, it is named Li Xiao San (Li Xiao Powder), suitable for cases where pus has formed and ulcerated or has not yet formed but needs dissolving. For external application, Nanxing (Nanxing, Arisaematis Rhizoma), Banxia (Banxia, Pinelliae Rhizoma), Jiangcan, Baizhi, Zaocis Spina, and Caowu (Caowu, Aconiti Radix) are ground into powder and mixed with honey and scallion juice.
[Note] When Chuiniu causes nodules that do not dissipate, they should be resolved early; otherwise, they will develop into an abscess. Gualou San is indicated, consisting of Gualou Shi (Gualou Shi, Trichosanthis Fructus), Rushen, Moyao, Danggui, and Gancao, decocted with wine. If the nodules do not dissipate after taking the medicine, add Zaocis Spina, naming it Li Xiao San, which can cause formed pus to ulcerate and unformed lumps to dissolve. Externally, apply Nanxing, Banxia, Jiangcan, Baizhi, Zaocis Spina, and Caowu ground into powder, mixed with scallion juice and honey.
Shiliu Wei Liuqi Yin (Sixteen-Ingredient Qi-Moving Decoction) Qingpi Gancao San (Qingpi and Licorice Powder)
Ru Yan (breast carcinoma) is caused by depression and anger damaging the Liver and Spleen. Liuqi Yin contains Danggui, Baishao (Baishao, Paeoniae Radix Alba), Renshen, Huangqi, Chuanxiong (Chuanxiong, Ligustici Chuanxiong Rhizoma), Fangfeng, Ziye (Ziye, Perillae Folium), Baizhi, Zhike (Zhike, Aurantii Fructus), Jiegeng (Jiegeng, Platycodonis Radix), Gancao, Binglang (Binglang, Arecae Semen), Wuyao (Wuyao, Linderae Radix), Houpo (Houpo, Magnoliae Officinalis Cortex), Guigui (Guigui, Cinnamomi Ramulus), and Mutong (Mutong, Akebiae Caulis) according to symptoms. External warming can be done with a cake made of Muxiang (Muxiang, Aucklandiae Radix) and Shengdi (Shengdi, Rehmanniae Radix). Qingpi and Gancao powder can be taken at any time, mixed with strong ginger soup. After ulceration, if healing is delayed, tonification of qi and blood is required, using Shiquan Dabu Tang (Shiquan Dabu Decoction), Bazhen Tang (Bazhen Decoction), or Guipi Tang (Guipi Decoction).
[Note] The condition of Ru Yan (breast carcinoma) begins with nodules the size of a Go stone, painless and non-itchy. After five to seven years or more than ten years, it ulcerates from within, becoming hollow and deep, resembling a rock, hence the name Ru Yan. It is caused by depression and frustration or irritability and anger, damaging the Liver and Spleen. Shiliu Wei Liuqi Yin should be taken promptly, comprising Danggui, Baishao, Renshen, Huangqi, Chuanxiong, Fangfeng, Ziye, Baizhi, Zhike, Jiegeng, Gancao, Binglang, Wuyao, Houpo, Guigui, and Mutong. Externally, apply a cake of Muxiang and Shengdi warmed on a hot object. Take Qingpi and Gancao powder mixed with strong ginger soup frequently. Avoid emotional disturbances, stay away from rich foods, and relieve depression and anger for recovery. If the ulcer fails to heal for a long time, only tonification of qi and blood is appropriate, selecting from Shiquan Dabu Tang, Bazhen Tang, or Guipi Tang.
Shiquan Dabu Tang, Bazhen Tang, Guipi Tang (Formulas see first volume)