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(Luoli [Scrofula], Jiehe [Tubercles], Liuzhu [Flowing Abscesses], Ruyong [Mastitis], Ruyan [Breast Cancer], Yinchuang [Yin Sores])

The *Jinkui Yaolue* states: When the Shaoyin pulse is slippery and rapid, it indicates sores arising in the yin region. If erosive sores ulcerate in the yin region, wash with Ye Langya Decoction (Wild Wolf's Tooth Decoction).
A slippery and rapid Shaoyin pulse indicates heat accumulation in the lower jiao. Treatment involves boiling Ye Langya to make a decoction, wrapping medicinal cotton around a chopstick like a silkworm cocoon, dipping it into the hot decoction, wringing it out, and irrigating the vagina four times daily to resolve toxicity and kill parasites.
Using only this single herb aims to achieve a specific therapeutic effect. Generally, this condition often occurs in widows; symptoms must include coughing and qi rebellion, amenorrhea, bone-steaming tidal fever, and aversion to cold. Whenever redness appears on the cheeks with white patches in the center, or white spots appear within the red lower lip, these are signs of yin erosion. Although external treatments are applied and fire-descending, yin-nourishing medicines are taken, death remains inevitable. This is an illness caused by emotional factors, which cannot be cured by medicine alone. Therefore, Zhang Zhongjing used only external methods and never mentioned internal decoctions; this indeed has profound significance.

When stomach qi descends abnormally, causing "yin blowing" (flatulence from the vagina) with noisy sounds, this is due to excess grain qi. Use Pig Fat and Hair Decoction (Zhigao Fa Jian) to guide it out.
"Guiding it out" means that after taking the medicine, the pathogen exits via urination; it does not refer to external guiding techniques. Detailed analysis shows that yin blowing with noisy sounds is a common ailment among women, but they often endure it in silence without speaking, hence it is not recorded in medical texts, and physicians do not examine it closely. The *Jinkui Yaolue* clearly states that unclear stomach qi and excess grain qi cause abdominal rumbling, leading qi to blow out from the anterior yin, resembling flatulence. However, using Pig Fat and Hair Decoction for treatment is difficult to deduce rationally. I once treated the wife of a servant who had amenorrhea for three months, severe lower abdominal pain penetrating to the heart, and persistent prior symptoms. After one dose of Shixiao San (Pain-Stopping Powder), a large amount of blood stasis was discharged, and the symptoms ceased. I also treated the daughter-in-law of a prominent official who, after a miscarriage, suffered from chills, fever, and abdominal pain, presenting the same prior symptoms. I administered pills made from charred black hawthorn fruit and charred brown sugar, delivered with a decoction of Ginseng Monarch (Dushen Tang) prepared using clarified water boiled with Longgu (Dragon Bone/Fired Clay). After one dose, hard feces were largely expelled; upon further administration, blood stasis continued to flow down, and the prior symptoms stopped abruptly. It was then realized that Pig Fat and Hair Decoction was designed to expel blood stasis. Although neither case directly used this formula, the principles did not deviate from the *Jinkui Yaolue*.

Luoli [Scrofula] Women suffering from luoli often have it due to worry, thought, depression, and anger damaging the Liver and Spleen. The nodules accumulate like beads on a string, mostly occurring around the ears, sides of the neck, and between the chest and ribs.
If accompanied by chills, fever, swelling, and pain, it is caused by Qi stagnation in the Liver Meridian. Do not use harsh phlegm-resolving drugs; instead, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If chills and fever cease but the nodules do not dissipate, the blood of the Liver Meridian is also affected; use Siwu Tang (Four Substances Decoction) plus Baizhu (Atractylodis Rhizoma), Fuling (Poria), Chaihu (Bupleuri Radix), and Danpi (Moutan Cortex). If appetite decreases and menstruation is irregular, it indicates Spleen and Stomach deficiency; use Liujunzi Tang (Six Gentlemen Decoction) plus Xiangfu (Cyperus Rhizome), Danpi, Chaihu, and Danggui (Angelicae Sinensis Radix). If initially bean-sized, attached to muscles and sinews, with unchanged color, later gradually enlarging, becoming swollen and painful, accompanied by internal heat, dry mouth, and mental fatigue, failing to resolve or ulcerate over time, it indicates Liver and Spleen deficiency. Use Xiaoyao San or Guipi Tang (Restore the Spleen Decoction) to strengthen Earth (Spleen) and nourish Wood (Liver). Never lightly use drugs that disperse hardness and chase toxins. Misusing purgatives will violate contraindications for disease and menstruation. If chronic ulcers present with floating and large pulses, evil fire is excessive; if the complexion is pale white, Metal overcomes Wood; both are difficult to treat. For all Wind-Wood diseases, strengthening Spleen Earth ensures Wood cannot overcome it. If attacking the Liver is performed, the Spleen and Stomach are injured first, and Wood反而 (instead) insults Earth.

Jiehe [Tubercles] Women suffering from jiehe result from depression and anger damaging the Liver and Spleen, stirring up Liver Fire. Not only do women often suffer from this due to depression; children may also inherit maternal depressive qi in the womb, manifesting at ages seven or eight. They mostly cluster around the sides of the neck and ears.
If accompanied by chills and fever, it belongs to Wind-Heat and Fire Anger in the Gallbladder Meridian; use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) plus Gouteng (Uncariae Ramulus cum Uncis) and Shanzhi (Gardeniae Fructus) to clear Liver Fire. If clustered in the flesh with unchanged color, accompanied by afternoon tidal fever and internal heat, it belongs to Liver Fire and Blood Deficiency; use Jiawei Xiaoyao San. Or if clustered in limbs and joints, accumulating like beads on a string with unchanged color, it is also Liver Fire and Blood Dryness causing tendon spasms; use Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Gouteng, assisted by Liuwei Wan (Six-Ingredient Pill with Rehmannia). If appearing and disappearing intermittently, this is Qi stagnation and Phlegm knotting; use Guipi Tang and Liujunzi Tang to harmonize Spleen and Stomach Qi. Externally, use powder of Xiangfu alone, mixed with saliva into a cake for moxibustion. Replace when dry, avoiding skin injury. Regular moxibustion leads to spontaneous resolution. A folk prescription for phlegm nodules uses Beimu (Fritillariae Bulbus), Quanxie (Scorpio), and Hetaoren (Juglandis Semen with Skin), each one hundred pieces, pounded together with honey into pills. Take two or three pill-sized doses on an empty stomach daily for efficacy. Another method: scrape powder from sheep horn or old glass/mirror; add four taels of Beimu and two taels of Quanxie per jin, make honey pills, take three qian on an empty stomach. Externally, use Zaojiao (Gleditsiae Fructus) meat placed inside a crucian carp, burned to ash retaining nature, mixed with honey and vinegar for application, highly effective. If ulcerated with non-putrefying flesh, non-regenerating tissue, thin pus, cold muscle and flesh, spontaneous sweating, night sweats, chills, fever, internal heat, sallow complexion, poor appetite, fatigue, and irregular bowel movements, all five Zang organs are deficient. Use Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction), Liujunzi Tang, or Yiqi Yangying Tang (Qi-Nourishing and Ying-Nourishing Decoction) to tonify and regulate the Spleen and Stomach; then symptoms recede spontaneously. Thus, the Classics state: Qi injury causes pain, Form injury causes swelling. Lightly using Qi-moving and Blood-breaking agents must be avoided.

Liuzhu [Flowing Abscesses] Women suffering from liuzhu often have it due to worry, thought, depression, and anger damaging the Liver and Spleen, causing Ying (Nutrient) Qi to fail to follow its course and reverse within the muscles. Or due to loose interstices allowing external pathogens to invade, or damp-phlegm flowing, or trauma causing blood stasis, or postpartum lochia accumulation. Qi flows and notes, Blood notes and coagulates.
They may arise in limbs and joints, remain in chest, abdomen, waist, or buttocks, forming lumps or diffuse swelling, all belonging to Depressive Fire. Urgently apply Congyi Method (Green Onion Moxibustion/Irritation), internally administer Yiqi Yangying Tang. Unformed abscesses dissipate spontaneously; formed abscesses rupture spontaneously. Continuous long-term intake is required for natural recovery. If swelling persists and becomes painful with limb fatigue, Pathogenic Qi is surplus while Form Qi is deficient; still treatable. If diffuse swelling with slight pain, both Form Qi and Pathogenic Qi are deficient; most difficult to treat. If no swelling occurs, or pus forms but does not rupture, it is Qi and Blood deficiency; use Renshen Yangrong Tang (Ginseng Nourishing Ying Decoction). Aversion to cold and fear of cold indicate Yang Qi deficiency; use Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction). Afternoon tidal fever and internal heat indicate Yin Blood deficiency; use Siwu Tang plus Renshen (Ginseng) and Baizhu. Nausea and vomiting indicate Stomach Qi deficiency; use Liujunzi Tang plus Paojiang (Prepared Ginger). Poor appetite and fatigue indicate Spleen Qi deficiency; use Buzhong Yiqi Tang plus Fuling and Banxia (Pinelliae Rhizoma). Cold extremities and frequent urination indicate Mingmen (Gate of Life) Fire decline; use Bawei Wan (Eight-Ingredient Pill). Frequent urination, profuse phlegm, and thirst indicate Kidney Water deficiency; use Liuwei Wan plus Maidong (Ophiopogonis Radix). Menstruation overdue and prolonged bleeding indicate Liver and Spleen deficiency; use Bazhen Tang (Eight Treasures Decoction) plus Chaihu and Danpi. For ulcers where Qi and Blood deficiency prevent healing, use Shiquan Dabu Tang as a paste. For chronic ulcers where Cold Evil stagnation prevents healing, use Douchi Bing (Fermented Soybean Cake) to dispel. For ulcers with internal sinus tracts preventing healing, use drugs to cauterize/resolve them. Without tonifying Qi and Blood, regulating diet, caring for lifestyle, guarding against Seven Emotions, or using cold/clearing and attacking drugs, it is untreatable.

Ruyong [Mastitis] and Ruyan [Breast Cancer] Women's mastitis differs in internal vs. external blowing, and upward reversal vs. downward smoothness. All belong to Heat-Toxin in the Gallbladder and Stomach meridians, with Qi and Blood stagnation. Thus, initial swelling and pain occur on the body surface, muscle redness, systemic fever, chills and fever, aversion to cold, headache, irritability, thirst with desire to drink. Use Jiawei Xiaoyao San plus Gualou Shuang (Trichosanthis Fruit Frost). Within several days, if pus fills the cavity and thick pus gushes out, self-heals when pus is exhausted. If Qi and Blood are weak, or toxic-cooling drugs were mistakenly used, preventing long-term healing, with thin pus and large pulse, only large doses of opening depression, regulating Qi, and warming/tonifying Qi and Blood can achieve results.
A folk prescription for early mastitis uses Pugongying (Taraxaci Herba) juice mixed with aged wine orally, applying dregs to the swelling for immediate resolution. However, this works for poor people; it is unsuitable for those caused by rich food and emotional depression. Instead, use Deer Antler, scraped with porcelain edge, mixed with Shexiang (Moschus), taken with warm wine. For obese patients with much phlegm and stagnation, use Chenpi (Citri Reticulatae Pericarpium) broken into bean sizes, washed with hot water, stir-fried with fine flour, remove flour, make powder, mix with black sugar two qian, take with pure wine. Another method: burn crab shell to ash, take three qian with pure wine. For breast swelling, use Beimu, Gualou Shi (Trichosanthis Fructus), and Gancao Jie (Licorice Joint) each three qian, decocted and taken; effective. Add Jinyinhua (Lonicerae Japonicae Flos) one liang if ulcerated.
Breast cancer results from long-term depression of Liver and Spleen, damaging Qi and Blood. Initially, small knots form inside the breast with normal skin color. The patient has internal heat, night fever, five-palm heat, limb fatigue and emaciation, irregular menstruation. Use Yiqi Yangying Tang or Jiawei Xiaoyao San; long-term intake gradually dissipates them. For Qi deficiency, large doses of Renshen must be taken diligently and long-term; knots gradually shrink. If attacking-hardening and detoxifying drugs are used, damaging righteous Qi, it inevitably leads to ulceration and collapse. Many cases do not ulcerate for years, which is critical; once ulcerated, it is untreatable. Zhou Qizhi said: For breast nodules or cancer hardened but un-ulcerated, pound live crucian carp with raw Chinese Yam, add a little Moschus, apply to the lump. Feel extreme itching, do not scratch, gently rub through clothing. Apply every seven days; gradual resolution follows. If time passes until ulceration and putrefaction, resembling rock-like sores, red with weeping fluid, deep foul-smelling cavities, use Guipi Tang etc. to prolong life. Mistakenly using attacking drugs brings imminent danger. I once saw a woman with a breast nodule the size of a cup; years of treatments failed. After metrorrhagia, she took roughly one tael of Renshen daily; within a month, consuming two jin, the breast nodule vanished suddenly.

Yinchuang [Yin Sores] Women's yin sores result from Seven Emotions' Depressive Fire damaging Liver and Spleen, with Damp-Heat pouring downward. External signs include prolapse like a snake (commonly called Yinting), protrusion like a pancake (Yinjun), chicken comb, or mouse teat; also generation of various insects, swelling, wetness, itching, ulceration, weeping, distension, heaviness, and prolapse.
Internal signs include dry mouth, internal heat, fatigue, irregular menstruation, loss of appetite, afternoon tidal fever, chest/diaphragm discomfort, hypochondriac/abdominal disharmony, lower abdominal fullness, red/white leukorrhea, dysuria. Treatment: For swelling/pain, Siwu Tang plus Chaihu, Shanzhi, Danpi, and Danshen (Gentianae Scabrae Radix - *Note: Dancao usually refers to Gentiana, here likely Danpi/Gentian mix contextually, standard is Longdan Cao*). For wetness/itching, Guipi Tang plus Shanzhi, Chaihu, Danpi. For dysuria, Longdan Xiegan Tang plus Baizhu, Danpi. For ulceration/putrefaction, Jiawei Xiaoyao San. For swelling/distension/prolapse, Buzhong Yiqi Tang plus Shanzhi, Danpi. Assist with external treatments. If insects in yin cause itching/pain, it is Liver Meridian Damp-Heat, resulting from exclusive Yin without Yang, internal entrapment of Depressive Fire. Patients must have bone-steaming tidal fever, irregular menstruation, dry cough with hemoptysis, red face, hoarse voice. Even with daily depression-opening and fire-descending drugs, cure is rare. Generally, illnesses of the Five Zangs (Emotions) are not curable by medicine alone, especially when misdiagnosed/treated. External treatment: Pound Taoren (Persicae Semen) into paste, mix with Xionghuang (Realgar) and Qingfen (Calomel), apply to pig liver, insert into yin. Also wash with Ku Shen (Sophorae Flavescentis Radix) decocted in fat broth. Or apply crucian carp bile. However, symptoms recur immediately after treatment; like fungus stalks growing worms, not stopping until putrefaction. Also, bleeding and pain during intercourse indicate Liver damage failing to store Blood and Spleen damage failing to control Blood. Mostly use Jiawei Xiaoyao Tang plus Rougui (Cinnamomi Cortex), or Guipi Tang combined with Jiawei Bawei Wan (Modified Eight-Ingredient Pill) for spontaneous recovery.