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The occurrence of breast abscess (Ru Yong) arises from several causes. Some cases result from the mother occasionally falling asleep during breastfeeding, allowing the infant's breath to blow into the nipple, causing stagnation and blockage of Qi within the breast, leading to pain (this is known as the "External Blow" syndrome). If neglected or treated improperly over time, it develops further. Other cases occur because the nursing infant has phlegm-stagnation in the diaphragm and hot breath; while greedily suckling and sleeping, this hot breath enters the breast, causing stagnation and preventing milk flow, eventually forming nodules that suppurate. There are also cases caused by depression or sudden anger injuring the Liver, resulting in Liver Qi stagnation. Additionally, there are cases due to the accumulation of Damp-Heat in the Liver and Stomach, or obstruction by Wind-Heat pathogenic factors. Initially, there is pain and hardness with no milk discharge, gradually progressing to skin swelling and alternating chills and fever, indicating that the abscess has formed and internal suppuration is occurring. In the early stage, treatment should focus on releasing the exterior and dispersing pathogens, soothing the Liver and clearing the Stomach, rapidly promoting milk discharge, and guiding the resolution of obstruction, which will naturally lead to dissipation. If it fails to dissipate and turns into pus, a method of supporting the interior and expelling pus should be used. If after ulceration the flesh does not regenerate and the pus is clear and thin, tonifying the Spleen and Stomach is appropriate. If pain persists after pus discharge accompanied by chills and fever, harmonizing Ying and Wei is indicated. If there is afternoon tidal fever with swelling and pain, nourishing Yin and Blood is suitable. If appetite is poor with nausea, tonifying Stomach Qi is required. One must strictly avoid cooling and detoxifying herbs, as they may damage the Spleen and Stomach. Since milk is transformed from blood and cannot leak freely, it condenses and swells. The nature of the breast is cool and cold; adding cooling medicines makes hardened swelling difficult to suppurate and existing ulcers difficult to heal. For early stages, formulas such as Niubangzi San (Burdock Fruit Powder), Juye Tang (Tangerine Leaf Decoction), or Xiaoyao San (Free and Easy Wanderer Powder) may be used. After ulceration, Yiqi Yangying Tang (Qi-Tonifying and Ying-Nourishing Decoction) is appropriate. Furthermore, Banxia (Pinelliae Rhizoma), Beimu (Fritillariae Bulbus), and Gualou (Trichosanthis Fructus) can eliminate stomach phlegm stagnation; Qingpi (Aurantii Fructus Immaturus) soothes Jueyin Liver stagnation; Gongying (Taraxaci Herba), Mutong (Akebiae Caulis), and Shanjia (Manis Squama) resolve heat toxicity and open orifices; Danggui (Angelicae Sinensis Radix) and Gancao (Glycyrrhizae Radix et Rhizoma) support healthy Qi and harmonize with pathogenic factors. All herbs that clear phlegm, soothe the Liver, harmonize blood, and detoxify can be used according to circumstances. Another type involves Damp-Fire combined with rebellious Liver Yang affecting collaterals, or formation due to epidemic toxins or latent pathogens. Onset presents with swollen and hard nipples, diffuse redness and swelling of the breast, chills, fever, and deep-set pores. After two to three days, the skin becomes wet and rotting, turning black and necrotic overnight. Several days later, fever subsides, and black necrotic tissue sheds completely, with new flesh resembling pomegranate seeds. Apply Zhenzhu San (Pearl Powder) externally and cover with Baiyu Gao (White Jade Ointment); internally administer formulas that soothe the Liver and clear Damp-Heat to complete the cure. This is Damp-Fire Breast Abscess. Furthermore, women have several pores on the nipple, each connected to a collateral network linked to the breast. Initially, only one collateral is affected. Once its pus and blood are exhausted, another collateral becomes involved, spreading sequentially until the entire breast is affected, a condition that is often critical and incurable. At the onset, taking Yuanshou Dan (Longevity Pill) every morning can prevent transmission to other collaterals. (It is incorrect for modern surgery to claim breasts have multiple lobes and that disease spreads between them.)

If the initial presentation is hard swelling with immediate emergence of a head, followed by several additional heads appearing later, with little pus inside these heads, it is named Breast Carbuncle (Ru Ju). This is caused by Toxic Heat-Phlegm of the Yangming channel combined with Fire of the Liver and Gallbladder. Treatment should involve clearing Phlegm-Qi, unblocking Liver pathogenic factors, detoxifying, and harmonizing Ying. Herbs such as Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Ziye (Perillae Folium), Baizhi (Angelicae Dahuricae Radix), Beimu (Fritillariae Bulbus), Gualou (Trichosanthis Fructus), Qingpi (Aurantii Fructus Immaturus), and Xiakucao (Prunellae Spica) may be used as needed.

Appendix: Internal Blow (Nei Chui) occurs in pregnant women at two to three months or eight to nine months of gestation, where nodules form in the breast leading to abscess. This is due to vigorous fetal Qi rushing upward, causing swelling and pain in the Yangming breast. Taking Shigao San (Gypsum Powder) can clear and resolve it. Even if after ulceration pus drains, necrotic tissue falls off, and new muscle grows, healing can only be completed after delivery.

Nipple Wind (Routou Feng) involves dryness and cracking of the nipple, pain like knife stabs, bleeding upon wiping, discharge of sticky fluid, or formation of yellow crusts. This is caused by sudden anger or depression, where Liver Meridian Fire cannot vent. It occurs both before and after childbirth. Internally take Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder); externally apply Baixia powder (Baizhi powder) mixed with breast milk.

Male Nodule (Nanzi Ru Ji) differs from females. In men, the nipple belongs to the Liver, and the breast belongs to the Kidney. Due to Liver deficiency with dry blood and Kidney deficiency with weak essence, swelling and pain result. Treatment should primarily use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) added with Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), and Qingpi (Aurantii Fructus Immaturus).