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Zhu Danxi stated: If a woman is dissatisfied with her husband or in-laws, leading to accumulated sorrow and anger, and qi stagnation over time, the Spleen Qi will be depleted, and Liver Qi will rebel horizontally. Consequently, hidden nodules form, resembling turtle shell scutes, painless and non-itchy. After ten or more years, they ulcerate into sunken sores, named "Ru Yan" (Breast Rock). Because the sore shape is sunken like a rocky cave, it becomes incurable at this stage. However, if at the initial onset, one can resolve the root cause, keeping the mind clear and spirit peaceful, and then apply treatment methods, there is a possibility of stabilization and recovery. My clan's niece-in-law suffered from this condition at age eighteen. Upon examination, her physique and pulse were slightly excess, but her temperament was irritable. While she lived harmoniously with her husband, she had difficulty with her mother-in-law. I prescribed Qingpi Tang (Green Peel Decoction) as a single formula, interspersed with Jiawei Siwu Tang (Modified Four Substance Decoction) and other agents to unblock meridians. She stabilized after two months.

This disease mostly arises from damp-heat phlegm accumulating in the diaphragm due to rich dietary flavors, which combats with stagnant breast milk. It can also result from infant breath causing milk stasis, or from rebellious anger triggering qi stagnation. Shigao (Gypsum Fibrosum), burnt Huapi (Bark of Betula Platyphylla), Gualouzi (Trichosanthis Fructus Seed), Gancaojie (Licorice Joint), and Qingpi (Aurantii Fructus Immaturus) are all miraculous drugs. For women with this disease, early treatment can eliminate it immediately. During menstruation, it is generally mild; however, after menopause at fifty or sixty, when menses cease and blood dries up, it must not be taken lightly. (When menstruation flows, Liver Qi can disperse; when it stops, blood dries.)

A sixty-year-old woman, prone to rich foods, emotional depression, with a robust physique and jealous nature, who sweated little in summer and had an impatient temper, suddenly developed a small nodule in the left breast, size of a chess piece, painless. She felt mentally poor and lost taste for food. Within half a month, she took Ren Shen (Ginseng Radix) powder mixed with Qingpi and Gancao (Licorice Root), administered with fresh ginger juice, sipped slowly, five or six times day and night. The nodule disappeared within five to seven days. This was the beginning of "Du Yan" (Jealousy Breast Rock). If not treated early, it may lie dormant for five to ten years before erupting painlessly and itchlessly, ulcerating below the breast like a cave, discharging pus. Or, after five to ten more years, despite normal diet, the internal organs become visible/exhausted, leading to death (regrettably). This specifically occurs in women unsatisfied with their husbands, as women view their husband as heaven; losing this support generates this disease. It is called "Yan" because it resembles a hollow, embedded cave, invisible externally. Patients usually suffer long delays. Only this woman was treated early, preventing disaster before manifestation; the other dozen or so died. I also treated a newlywed woman, curing her with only Qingpi and Gancao.

Gong stated: Breast rock initially presents as a swelling like a turtle scute, painless and itchless, becoming an ulcer after five to seven years. Initially, it is best to take many qi-regulating and blood-moving herbs. Recovery requires mental satisfaction. Once ulcerated, it resembles a rocky hollow or human lips, with red fluid and pus soaking the chest and abdomen, causing qi-attack pain. Use Wuhui Gao (Five Ashes Ointment) to remove necrotic tissue and generate new flesh, gradually contracting. This disease often stems from chronic depression and resentment. Middle-aged women without ulceration can still be treated; those with ulcers are ultimately incurable. One should take Shiliuwei Liuqi Yin (Sixteen-Ingredient Flowing Qi Decoction).

Xue stated: Breast rock is a syndrome of Liver meridian blood and qi exhaustion caused by the Seven Emotions. Generally, depression blocks Spleen Qi and rebels Liver Qi, forming hidden nodules that are painless and itchless. People often ignore them, making them hardest to treat. If this occurs, one must regulate emotions, avoid rich foods, resolve stagnation, and treat with blood-nourishing and qi-tonifying herbs to preserve life; otherwise, it is untreatable. One woman took Yiqi Yangrong Tang (Tonify Qi and Nourish Blood Decoction) for over a hundred doses, gradually restoring blood and qi, and used Muxiang Bing (Costus Cake) moxibustion. Fortunately, she was diligent, and it resolved in over a year. Another woman, whom I doubted, took attacking and qi-moving agents like Liuqi Yin and Baidu San (Eliminate Toxin Powder), causing the mass to enlarge like an inverted bowl, discharging clear pus, failing to contract, and dying.

Li stated: Depression and anger injure the Liver and Spleen, forming tubercles like turtle scutes, painless and itchless. After five to seven years, the exterior swells purple-black, and the interior ulcerates, named Breast Rock. Death follows when blood and qi are exhausted. Urgently use Shiliuwei Liuqi Yin combined with single-formula Qingpi Tang. For deficiency, use Qingpi Jieyu Tang (Clear Spleen and Resolve Depression Decoction) or Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction), plus mental clarity and rest, to prolong life. After years, an ulcer will appear below the breast discharging pus. Women past middle age without spouses die especially fast. At the very beginning, regardless of meridian involvement, urgently use Congbai (Scallion White) about one cun and Sheng Banxia (Pinellia Rhizoma Raw) one piece, pounded into pills the size of Euryale Seed (Qianshi). Insert into the nostril opposite the affected breast (left breast -> right nostril, right breast -> left nostril). It resolves in two nights. (Such efficacy is miraculous.)

Qingpi San (Green Peel Powder): Treats early Breast Rock resembling turtle scutes, painless and itchless. Take early to prevent long-term ulceration.
Ingredients: Qingpi (Aurantii Fructus Immaturus), Gancao (Licorice Root).
Preparation: Grind to powder. Decoct Ren Shen (Ginseng Radix), mix with fresh ginger juice, and sip slowly. Five to six times daily until resolved. Young women take with plain water.

Shiliuwei Liuqi Yin (Sixteen-Ingredient Flowing Qi Decoction): Treats Breast Rock.
Ingredients: Danggui (Angelicae Sinensis Radix), Chuanxiong (Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Huangqi (Astragali Radix), Renshen (Ginseng Radix), Guanzi Gui (Cinnamomi Ramulus), Houpo (Magnoliae Officinalis Cortex), Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus), Wuyao (Tsaoko Fructus), Mutong (Akebiae Caulis), Binglang (Arecae Semen), Baizhi (Angelicae Dahuricae Radix), Fangfeng (Saposhnikoviae Radix), Zisu (Perillae Folium), Gancao (Licorice Root).
Preparation: Cut into pieces for one dose. Decoct in water. Take frequently after meals and before bed. Externally apply Wuhui Gao (Five Ashes Ointment) to remove necrotic tissue and generate new flesh, gradually contracting. (See Hemorrhoids and Fistulas section for Wuhui Gao. Breast Rock mostly arises from depressed qi. The Liver governs anger and has a spreading nature; depression prevents smooth flow, distorting its upright quality. The nipple belongs to the Jueyin Meridian, where qi and phlegm accumulate, forming tubercles. Here, wind herbs follow its nature, qi herbs move stagnation, Ginseng, Astragalus, Angelica, and Peony tonify blood and qi, and Cinnamon acts as a blood herb to harmonize vessels. Also, "Wood withers with Cinnamon," making it a key drug for subduing Wood. Dosage varies based on blood/qi thickness and pathogen depth.) Add Qingpi for Ru Yong (Breast Abscess).

Yiqi Yangrong Tang (Tonify Qi and Nourish Blood Decoction): Treats depression and labor-induced blood/qi deficiency, causing swelling/hardness in neck, breasts, or limbs, or softness without redness/pain, afternoon fever, or non-healing ulcers.
Ingredients: Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried, 2 qian each), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Beimu (Fritillariae Bulbus), Xiangfu (Cyperi Rhizoma), Danggui (Angelicae Sinensis Radix, wine-treated), Chuanxiong (Chuanxiong Rhizoma), Huangqi (Astragali Radix, salt-water stir-fried), Shudihuang (Rehmanniae Radix Praeparata, wine-treated), Shaoyao (Paeoniae Radix, stir-fried), Jiegeng (Platycodonis Radix), Gancao (Licorice Root, stir-fried, 1 qian each).
Preparation: Cut into pieces for one dose. Add three slices of fresh ginger. Decoct in water. Take after meals. (This formula combines Liujunzi Tang minus Banxia plus Beimu, merged with Siwu Tang, plus Xiangfu, Huangqi, and Jiegeng, serving as a regulating agent.) For chest fullness, reduce Renshen and Shudihuang by 0.3 qian each; for dry mouth, add Wuweizi (Schisandrae Fructus) and Maidong (Ophiopogonis Radix); for alternating chills and fever, add Chaihu (Bupleuri Radix) and Gudupi (Lycii Cortex); for thin pus, add Renshen and Huangqi; for excessive pus, add Chuanxiong and Danggui; for non-stopping pus, add Renshen, Huangqi, and Danggui; for slow muscle regeneration, add Bailian (Hedyotis Diffusae Herba) and Guanzi Gui.

Muxiang Bing (Costus Cake): Treats all qi-stagnation swellings, whether painful or sprained, and pain from wind-cold invasion.
Ingredients: Muxiang (Aucklandiae Radix, 5 qian), Shengdihuang (Rehmanniae Radix Recens, 1 liang).
Preparation: Grind Muxiang to powder. Pound Shengdihuang into paste. Mix evenly. Form into cakes according to lesion size. Apply to swollen area and heat via hot compress or moxibustion.