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If applying Tiegu San (Iron Hoard Powder) is ineffective, it may instead exacerbate symptoms such as wheezing and chest oppression. In the ninth month, a daughter was born, but the ulceration worsened significantly, with the entire breast tissue rotting away and spreading to the chest and axilla. The pus was thick and sticky, with an output of nearly six or seven sheng (a traditional Chinese unit of volume), showing no signs of healing. It was not until the eleventh month that she sought medical treatment from me. I switched to a moderate-dose decoction for detoxification with mild properties, applied Shengji San (Flesh-Regenerating Powder) externally, and used herbs such as Longgu (Dragon Bone) and Hanshuishi (Calcitum). However, pus continued to flow profusely; areas splashed by the pus developed swollen blisters that ulcerated and suppurated. The sides turned purple-black, with over ten open sores. The chest and axilla were all swollen and ulcerated, making it impossible to turn or lie on one side; the condition was terrifying. I stated: "Postpartum toxic pathogens have flared up due to deficiency. She should take large doses of Huangqi (Astragali Radix) to clear toxicity, nourish blood, boost qi, and generate flesh." However, her previous physician dared not use it. After mid-December, the condition deteriorated further, with more than twenty sores. All other medications had failed. Only then did they switch to my prescription. At that time, the pus was foul and viscous. Washing the area with a decoction of Zhiye (Paper Mulberry Leaf) and pig trotters provided immediate relief. I then prescribed a formula named Huangqi Tuoli Tang (Astragalus Supporting the Interior Decoction). Huangqi (Astragali Radix), being sweet and warm, serves as the sovereign herb to expel pus, boost qi, and generate flesh; Gancao (Glycyrrhizae Radix et Rhizoma) tonifies stomach qi and clears toxicity, while Danggui Shen (Angelicae Sinensis Radix) harmonizes and generates blood, serving as the minister herbs; Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Radix), and Loulu (Euphorbiae Humifusae Herba) are herbs specific to the Foot-Yangming Stomach meridian; Lianqiao (Forsythiae Fructus) and Fangfeng (Saposhnikoviae Radix) both dissipate nodules and unblock meridians; Gualou Ren (Trichosanthis Semen) and Shunianzi (Arctii Fructus) clear toxicity and reduce swelling; Zaogao Ci (Gleditsiae Spina) guides the medicine to the ulcerated site; Baizhi (Angelicae Dahuricae Radix) enters the Yangming meridian, eliminates foul pus, and promotes tissue growth; additionally, Chuanxiong (Ligustici Chuanxiong Rhizoma) in small dosage, along with Rougui (Cinnamomi Cortex) and Chao Baihu (Phellodendri Cortex prepared with stir-frying) are used as guiding herbs. Each dose is decocted with one cup of wine, and accompanied by Bayu Shuang Wan (White Jade Frost Pills) to drain pus and clear toxicity. Since the pus was still thick and viscous and the pathogenic factor was at its peak, astringent medicines should not be used immediately. Instead, it is appropriate to apply Cuqing Dingzi (Emerald Green Plaster) externally. The next day, the pus became thin, pain subsided, and foulness cleared, indicating a trend toward recovery. By the New Year of the Xinwei year, new flesh had grown over the affected areas. For any remaining purple swelling, the Congyun method (Onion Moxibustion) was applied, resulting in immediate resolution. However, the area near the axilla, corresponding to the Foot-Shaoyang Gallbladder meridian, had not yet healed. Therefore, Chaihu (Bupleuri Radix) and Qingpi (Citri Reticulatae Pericarpium Viride) were added, along with double the amount of Chuanxiong. As the pus neared clearance, Sou Nong San (Pus-Searching Powder) was applied externally. After the Lantern Festival, full recovery was achieved.

In the second month of the Gui Mao year (Wanli era), Zhao Gai'an, a Censor serving as Director of Education in Southern Jili, sent greetings through a county magistrate friend and invited me to meet at Maoshan. Due to our shared history as colleagues in the Hanlin Academy, I could not decline and traveled there specifically. He was seeking treatment for an illness. Upon exposing his chest, a sore on the left side of the breast was found, large as a bowl, with dark purple necrotic tissue deeply embedded, resembling a rocky cave, emitting a foul odor. I asked how he contracted this. He replied: "After failing multiple examinations at the academy, I felt depressed. In summer, I often rubbed my nipple with my hand, causing fluid to leak occasionally. Someone told me this was 'true essence' that must not be lost, so I covered it with a plaster. The leakage stopped, but a lump formed beside the breast. Later, while traveling south to supervise exams, mental strain caused the lump to swell and hurt frequently. A clerk who knew some medicine said that the fluid was blocked by the plaster and could not return to its proper channel, stagnating into a lump. He cited that women's blood rises to become milk, and since this fluid is also blood-like, drinking Xiongui Wine (Chuanxiong and Danggui Wine) would move the stagnant blood and dissolve the lump. I agreed and drank it, but the lump remained, and I began to vomit blood and suffer severe epistaxis. I then consulted Dr. Zhang from Jingkou. His treatment stopped the bleeding but induced intestinal wind (hematochezia). Dr. Zhang boasted that bleeding from below was a favorable sign, though my body became heavy and debilitated. Another doctor treated me, stopping the bloody stool, but the breast lump grew increasingly aggressive until it ulcerated. A folk healer, skilled in using arsenic for hemorrhoids, privately reasoned this was also a fistula, inserted the drug into the wound, causing excruciating pain and uncontrollable ulceration, leading to this state. I initially considered it incurable by standard methods, but seeing his spirit was intact and diet normal, without severe adverse signs, I thought he could survive for some time. I prescribed a formula and departed. Later, while examining scholars in Guangling, we lost contact. He switched to other doctors' prescriptions and died in early August from qi stagnation inducing hiccups. Men rarely suffer from Ru Yan (Breast Cancer/Rock Tumor). The onset was subtle, yet three incompetent physicians misdiagnosed him, leading to this tragedy. Arsenic indeed should never be inserted internally, but what fault do Chuanxiong and Danggui have? This must be recorded as a warning for posterity.

Dandelion (Pugongying) grass, crushed and applied to the affected area, yields miraculous results. Powdered Tian Nan Xing (Arisaematis Rhizoma) mixed with warm wine and applied topically treats breast abscesses in women. For breast pain developing into an abscess, Yimu Cao (Leonuri Herba) powdered and mixed with water, applied to the breast overnight, cures the condition spontaneously; fresh crushed application is also effective. For Ru Chui (Acute Mastitis/Lactational Breast Abscess), mulberry bark mixed with rice paste, pounded into a poultice and applied. For cracked nipples, Dingxiang (Caryophylli Flos) powder is applied.

For Ru Yong (Breast Abscess), needle the Ruzhong point (located centrally below the nipple; insert needle and glide horizontally backward 1.5 cun; apply moxibustion with draining method.)
[Alpha] For Ru Yong with chills and fever, shortness of breath, and restless sleep, Yingchuang (ST16) is indicated. For Ru Yong with aversion to cold and fever, and pain intolerable to touch, Rugen (ST18) is indicated. For acute breast pain following great fright, Liangqiu (ST34) is indicated. For Ru Yong with heat sensations, Zusanli (ST36) is indicated. (For Ru Yong where herbal medicines fail to relieve pain, needling Zusanli to a depth of 0.5 cun stops pain immediately.) For female Ru Yong with palpitations/fright, Shangjuxu (ST37) and Xiaolian (ST39) are indicated. (The *Qianjin Fang* states: for arm heaviness/swelling, inability to flex the foot, and heel pain.) For Ru Yong, Taichong (LR3) and Fuliou (KI7) are indicated. For Du Ru (Nipple Retraction/Obstruction), Taiyuan (LU9) is indicated. For residual ailments of the female breast, Mangmen (BL46) is indicated.