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Chen Shigong stated: "Ku Jin Jian" (Withered Tendon Arrow), is caused by melancholy injuring the Liver, leading to a lack of nourishment for the Liver blood and tendons, resulting in tendon qi emitting outward. Initially, it appears like a red bean, with a slightly elevated dry spot in the center. After a long time, it ruptures, emitting dry, fluffy tendon-like heads, and mostly occurs between the chest and breasts. It is appropriate to tie tightly with medicinal silk thread at the base; after seven days, the lesion will naturally fall off. Then apply Zhenzhu San (Pearl Powder) to allow the scar to heal naturally. One must also observe dietary restrictions. (*Waike Zhengzong*)

Chen Yuangong stated: "There are abscesses on the breast that first cause pain then swelling, accompanied by ordinary fever, transforming into ulcerative sores. This condition occurs in both men and women, but is more common in women. Generally, when women are nursing, if they occasionally sleep greedily, the infant may blow air from its mouth into the breast, causing the Qi within the milk ducts to become blocked and unobstructed, leading to pain. At this stage, treating with dispersing herbs leads to immediate recovery. If neglected or treated improperly, a Ru Yong (Breast Abscess) forms. In men, however, it is different; it arises from excessive Stomach Fire that does not ascend to the mouth and tongue but instead stagnates and obstructs in the breast, generating this condition. Therefore, Ru Yong belongs to Yang syndromes, unlike other sores which can be Yin or Yang. The treatment method need not distinguish between Yin and Yang, but only differentiate between early/late stages and deficiency/excess. Since the initial stage of Ru Yong involves excess pathogenic factors, and prolonged ulceration involves deficiency of healthy Qi, yet the presence of excess pathogens essentially indicates a deficiency of healthy Qi, the best approach is to tonify healthy Qi while dispersing pathogens, rather than attacking first and tonifying later. Use He Ru Tang (Harmonizing Milk Decoction): Bei Mu (Fritillaria Bulb) and Hua Fen (Trichosanthes Root) each 3 qian, Dang Gui (Angelica Sinensis) and Gong Ying (Dandelion) each 1 liang, Sheng Gan Cao (Raw Licorice Root) 2 qian, Chuan Shan Jia (Pangolin Scale) 1 piece (soil-fried and powdered). Decoct in water and take orally. After one dose, breast patency is restored and swelling subsides, not exceeding two doses. This formula uses Bei Mu and Hua Fen to eliminate phlegm stagnation in the Stomach; once phlegm is resolved, breast patency is restored, and Stomach Fire loses its support. Subsequently, Gong Ying and Chuan Shan Jia resolve heat toxins and open orifices, allowing the toxin to disperse without direct attack. To prevent the medicine from being too aggressive, Dang Gui and Gan Cao are added to tonify healthy Qi and harmonize. With healthy Qi protected, fire toxins will not transform into Ru Yan (Breast Cancer). (*Waike Yijian*)

Chen Shigong stated: "Women who fail to maintain proper daily care lead to turbid Stomach juices stagnating and transforming into pus, named Ru Yong." (*Waike Zhengzong*)

[Image: Breast Abscess]

He also stated: "There are cases where melancholy injures the Liver, causing Liver Qi stagnation and knotting into a swelling/abscess. It is appropriate to use Xiao Yao San (Free Wanderer Powder) with Ju Ye (Tangerine Leaf) to disperse."

He also stated: "There are cases where sudden anger injures the Liver, causing reckless Liver Fire to knot into a swelling. Use Ju Pi Tang (Tangerine Peel Decoction) to disperse."

Feng Luzhan stated: "The breasts of women and the Kidneys of men are both the roots of life. Human Qi and Blood circulate continuously without interruption. At Yin hour (03:00-05:00), it begins in the Hand Taiyin Lung Meridian, emerging from Yunmen (LU-2), located above the breast. At Chou hour (01:00-03:00), it returns to the Foot Jueyin Liver Meridian, entering Qimen (LR-14), located below the breast. Qi emerges from above and enters below; the Lung governs Qi, and the Liver stores Blood; the breast resides precisely between them. The Foot Yangming Stomach Meridian descends from Quepen (ST-12) to the breast. The Chong Mai (Penetrating Vessel) originates at Qichong (ST-30), runs alongside the Foot Yangming Meridian, flanking the navel upward to the chest where it scatters. Thus, the breast belongs to the Foot Yangming Stomach Meridian, and the nipple belongs to the Foot Jueyin Liver Meridian. Women who do not know how to maintain their health damage the Chong and Ren vessels. Additionally, anger causes Qi rebellion, depression causes Qi obstruction, and rich foods breed damp-heat, leading to the failure of Jueyin Qi to flow and excessive heat in Yangming Blood. If invaded by Wind pathogens, Qi becomes stagnant and does not disperse, knotting in the breast, becoming hard or swollen, painful with nodules, and preventing lactation. This is called Du Ru (Jealousy Milk). Gradually, the skin swells, and alternating chills and fever occur, known as Ru Yong. Excess Wind leads to hard swelling with white color; excess Heat leads to red swelling. If untreated, blood coagulates, Qi stagnates, and interacts with fluids in the milk to rot and transform into pus. The treatment method: whenever there are chills, fever, swelling, and pain at the onset, release the exterior and disperse pathogens, soothe the Liver and clear the Stomach, rapidly promote lactation, and guide out the obstruction; the disease can then be cured. If not dispersed, it easily turns to pus, requiring Tuoli (Supporting Interior) methods. If after ulceration muscles do not regenerate and pus is thin/clear, tonify the Spleen and Stomach. If pain persists after pus discharge, with aversion to cold and fever, regulate Ying and Wei. If afternoon fever causes swelling and pain, tonify Yin and Blood. If poor appetite and vomiting occur, tonify Stomach Qi. Strictly avoid cooling and detoxifying herbs, as they damage the Spleen and Stomach. (*Waike Lili - Jin Nang*)

He also stated: "Some cases arise because the infant being nursed has phlegm stagnation in the diaphragm and hot breath. While sleeping with the nipple in the mouth, hot air blows into the breast, causing stagnation and knotting. If massaged soft and milk sucked out during the initial stage, it can dissipate. If missed and untreated, it will surely become an abscess. Some cases arise after weaning, where milk cannot return to normal, or due to excessive milk production with insufficient infant consumption, leading to accumulation and knotting. Others result from irregular menstruation, retrograde flow, internal pathogen stagnation, forming abscesses. Do not use cooling medicines at the onset, because milk is transformed from blood and should not leak; thus it knots and swells. Milk nature is clear and cold; adding cooling medicines leads to Yin decay. Cooling medicines are only suitable after rupture. For initial stages, apply Nan Xing (Arisaema Cum Bile) mixed with Ginger Juice externally to resolve internally. Add Ca Wu (Aconitum Carmichaelii Dehulled) to break bad blood and remove masses; it resolves when cold and suppurates when hot. Add Ru Xiang (Frankincense) and Mo Yao (Myrrh) to relieve pain. Internally, alternate taking Gua Lou Shi Xuan San (Trichosanthes Ten-Accumulation Powder) and Tong Qi San (Unblocking Qi Powder). However, those under forty years old often recover well due to vigorous Qi and Blood. Those over fifty should not be treated, as mortality is high due to the cessation of Tian Gui (Menstrual Essence). Untreated, they can live out their natural lifespan. If treatment is desired, focus primarily on regulating Qi and Blood."

He also stated: "If swelling and pain are caused by excessive Liver Fire from depression and anger, one should soothe the Liver and scatter depression, combined with nourishing and harmonizing Blood. This prevents Liver Yang from becoming hyperactive, and swelling recedes naturally. If depression is severe, Blood stagnation is uncomfortable, compounded by milk accumulation, leading to ulceration and pus formation, it becomes Ru Yong. With significant damage to Qi and Blood, heavy tonification is especially appropriate, assisted by mild Liver-soothing and detoxifying herbs. If one solely focuses on clearing and resolving, ulcers will struggle to form pus, and formed pus will struggle to heal."

Hu Gongbi stated: "Women's breasts have twelve lobes (Rang). Initial Ru Yong affects only one lobe. After pus and blood drain completely, another lobe becomes affected, circulating through them. If seven lobes are damaged, it spreads to the opposite breast. When both breasts are fully involved, many cases become critical and incurable. Take Yuanshou Dan (Longevity Pill) every morning at the onset to protect remaining lobes from transmitting toxicity." (*Qingnang Michuan*)

He also stated: "For cases where worry and anger injure the Liver, causing Qi stagnation and knotting, initial symptoms include irritability, thirst, vomiting, alternating chills and fever, and severe swelling/pain. Niubangzi Tang (Arctium Decoction) is the primary prescription. For cases caused by rich food/diet and sudden anger leading to Liver Fire knotting, Juye Tang (Tangerine Leaf Decoction) is the primary prescription."

He also stated: "In men, nipples belong to the Liver, and breasts belong to the Kidney. In women, nipples belong to the Liver, and breasts belong to the Stomach."

He also stated: "Non-nursing women suffering from breast conditions are said to have 'Hai Gan Nai Zi' (Harmful Dry Milk Condition)."

Chen Shigong stated: "The breasts are governed by the Foot Yangming Stomach Meridian, and the nipples are governed by the Foot Jueyin Liver Meridian. They contain much blood and little Qi. In nursing women, it is named Wai Chui (External Blowing); in pregnant women, it is named Nei Chui (Internal Blowing)." (*Waike Zhengzong*)

Wang Shengzhi stated: "If a woman in her eighth or ninth month of pregnancy suffers from Nei Chui Ru (Internal Blowing Breast), even if pus drains and necrotic tissue falls off, muscle regeneration must wait until delivery before the wound can close." (*Waike Lili*)

Shen Douyuan stated: "When fetal Qi is vigorous and rushes upward, causing swelling in the Yangming breast, it is named Nei Chui, also known as Li Chui Nai (Inner Blowing Milk)." (*Qixuanwei*)

Feng Luzhan stated: "Ru Yong is commonly called Chui Ru (Blowing Milk). 'Chui' refers to Wind. Wind-Heat accumulates between the breasts, causing blood vessels to stagnate, pain, swelling, and ulceration with thick pus flowing out. This belongs to Gallbladder-Stomach Heat-Toxin and Qi-Blood stagnation, also named Ru Yong, and is easy to treat. Use Qing Pi (Green Tangerine Peel) to disperse Jueyin stagnation, Shi Gao (Gypsum) to clear Yangming heat, Gan Cao Jie (Licorice Knot) to detoxify and move turbid blood, Jing Jie (Schizonepeta) and Fang Feng (Saposhnikovia) to disperse wind and assist drugs reaching the exterior, Gua Lou (Trichosanthes Fruit), Mo Yao (Myrrh), Qing Ju Ye (Green Tangerine Leaf), Zao Ci (Gleditsia Spine), Yin Hua (Honeysuckle), Tu Bei Mu (Fritillaria Thunbergii), Dang Gui (Angelica Sinensis), and wine as assistants. All serve to soothe the Liver, harmonize Blood, and detoxify. Apply Ai Mollusc Garlic Moxibustion (Moxa separated by garlic) 20-30 moxa cones on the painful area for best effect. Strictly avoid knife or needle injuries to tendons and vessels, as the harm is significant." (*Waike Lili - Jin Nang*)

Gu Shicheng stated: "Furthermore, widows who have no children to suckle milk may still experience breast swelling and pain. This is called Xi Feng He Nai (Mat Wind Blowing Milk) and should be treated similarly to Gan Nai Zi (Dry Milk Condition)."

Chen Ziming stated: "Pregnancy-related breast disease is called Nei Chui, caused by vigorous fetal Qi rushing upward, leading to swelling in the Yangming breast. Use Shi Gao San (Gypsum Powder) to clear it; it can also dissipate. If delayed, it prolongs over time, eventually producing pus, and the milk sinus flows from the pus pore, making healing difficult." (*Waike Jingyao*)

*Xinfa* stated: "Nei Chui occurs in the sixth or seventh month of pregnancy, with chest fullness and Qi rushing upward, causing breast knotting, swelling, and pain. If red, it is due to excessive Heat; if not red, it is due to Qi depression combined with vigorous fetus. Wai Chui occurs when the nursing mother has turbid Liver-Stomach Qi, compounded by the infant sucking milk while asleep, allowing cool air from the nostrils to enter the breast, condensing with hot milk to cause swelling, pain, chills, fever, irritability, and thirst. There are also cases of swelling and pain in women who are neither pregnant nor nursing; this is a skin/flesh issue, not affecting the breast parenchyma, caused by Liver-Stomach Damp-Heat condensation."