人有两臂之间忽然生疮而变成痈疽者，亦阴痈也。虽较头面、对口、肩背上少
轻，然治不得法，亦能杀人。故须辩阴阳之治，大约痛者阳症，痈者阴症，不难于
治也。如阳症用三星汤，一、二剂便可立消。若阴症，三星汤又不可用，必须大补
气血，而佐之消痰化毒之剂，始能奏功。不可谓手足非心腹之疾，不须补虚也。夫
阴主静，而两手则至动者也，至动而生阴痈，则动变为静矣，反常之道也，可不畏
乎。况动变为静，又趋阴之道也。阳趋于阴，非生近于死乎，欲阳返于阴则易，欲
阴返于阳则难，谁谓两手之痈而可小视之哉。治法仍宜慎重，方用消痈还阳丹∶
人参（三钱） 白术（一两） 生甘草（三钱） 天花粉（三钱） 生黄 （一两） 金银花（二两）
肉桂（一钱） 当归（五钱） 乳香末（一钱） 水煎服。一剂而痒变为痛矣，二剂而痛如失，三剂
而全消，不必四剂也。
此方与七圣汤相同，而意气各异，七圣治已溃者也，此方治未溃者也。已溃者
以生肉为先，未溃者以护肌为主，所以七圣汤内无乳香、天花粉者，正以二味之中
有拥卫之功耳。
人有乳上生肿，先痛后肿，寻常发热，变成疡痈。此症男妇皆有，而妇人居多。
盖妇人生子，儿食乳时后偶尔贪睡，儿以口气吹之，使乳内之气闭塞不通，遂至生
痛。此时即以解散之药治之，随手而愈。倘因循失治，而乳痈之症成矣。若男子则
不然，乃阳明胃火炽盛，不上腾于口舌而中拥于乳房，乃生此病。故乳痈之症，
阳病也，不比他痈有阴有阳，所以无容分阴阳为治法，但当别先后为虚实耳。盖
乳痈初起多实邪，久经溃烂为正虚也。虽然邪之有余，仍是正之不足，于补中散邪，
亦万全之道，正不必分先宜攻而后宜补也。方用和乳汤∶
贝母（三钱） 天花粉（三钱） 当归（一两） 蒲公英（一两） 生甘草（二钱） 穿山甲（土炒，
一片，为末）
水煎服。一剂而乳房通，肿亦消矣，不必二剂。
此方用贝母、天花粉者，消胃中之壅痰也。痰壅而乳房之气不通，化其痰则胃
火失其势。而后以蒲公英、穿山甲解其热毒，利其关窍，自然不攻而自散矣。又恐
前药过于迅逐，加入当归、甘草补正和解，正既无伤而邪又退舍矣，此决不致火毒
不行而变为乳岩之病也哉。
人有先生乳痈，虽已收口，后因不慎房事，以致复行溃烂，变成乳岩，现成无
数小疮口，如管非管，如漏非漏，竟成蜂窝之状，肉向外生，终年累月而不愈。服
败毒之药，身愈野狼狈，而疮口更加腐烂，人以为毒深结于乳房也，谁知气血之大亏
乎。凡人乳房内肉外长，而筋束于乳头，故伤乳即伤筋也。此处生痈，原须急散，
迟则有筋弛难长之虞。况又加泄精以损伤元气，安得不变非常乎。当时失精之后，
即大用补精填髓之药，尚不至于如此之横。今既因虚而成岩，复见岩而败毒，不已
虚而益虚乎。毋怪其愈败愈坏也。治法必须大补其气血，以生其精，不必再泄其毒，
以其病原无毒之可泄耳。方用化岩汤∶
人参（一两） 白术（二两） 黄 （一两） 当归（一两） 忍冬藤（一两） 茜根（二钱）
白芥子（二钱） 茯苓（三钱） 水煎服。连服二剂，而生肉红润。再服二剂，脓尽痛止。又二剂，
漏管重长。又二剂全愈。再二剂永不再发。
此方全去补气血，不去消毒，实为有见。虽忍冬藤乃消毒之药，其性亦补，况
同入于补药中，彼亦纯于补矣。惟是失精变岩，似宜补精，乃不补精，而止补气血
何也？盖精不可以速生，补精之功甚缓，不若补其气血，转易生精。且乳房属阳明
之经，既生乳痈，未必阳明之经能多气多血矣。补其气血，则阳明之经旺，自然
生液生精以灌注于乳房，又何必复补其精，以牵掣参、 之功乎，此方中所以不用
生精之味耳。
人有左乳内忽大如桃，复又不痛，色亦不赤，身体发热，形渐瘦损，人以为痰
气之郁结，孰知肝气之不舒。夫乳属阳明，乳肿宜责之阳明胃经，而谓之肝病者，
盖阳明胃土最畏肝木之克，肝气不舒，而胃气亦不舒矣。盖胃见肝木之郁，惟恐肝
旺来克，于是胃亦畏首畏尾，伏而不扬。况乳又近于两胁，而两胁正肝之部位也，
与肝相远尚退缩而不敢舒，与肝为怜亦何敢恣肆而吐气哉。气不舒而肿满之形成，
气不敢舒而畏惧之色现，不痛不赤，正显其畏惧也。治法不必治阳明之胃，但治肝
而肿自消矣。方用逍遥散加味治之。
柴胡（二钱） 白芍（五钱） 当归（二钱） 陈皮（五钱） 甘草（一钱） 白术（三钱）
茯神（三钱） 人参（一钱） 川芎（一钱） 栝蒌（三钱） 半夏（三钱） 水煎服。十剂而内消矣。
去栝蒌，再服十剂，不再发。
逍遥最解肝气之滞，肝气一解，而胃气自舒。况益之栝蒌、半夏，专能治胸中
之积痰，痰去而肿尤易消也。
妇人产后，细小两乳又下垂过小腹，痛甚，以为乳痈，孰知胃血之燥也。夫胃
为水谷之海，血之腑也。产后亡血过多，则胃中空虚，而饮食又不能遽进，即进饮
食，而各脏腑取给于胃甚急，则胃气困矣。胃气困而胃血益燥矣，胃血益燥，无以
解各脏腑之纷争。而子又索母之乳，内外取资，胃无以应。乳房者，胃之外廓也。
乳头者，胃之门户也。胃苦内之纷争，欲避出于外而不可得，而外又不免于儿口之
吮咂，细小下垂以至于腹，有逃遁难藏，入地无门之状，此倒悬切肤之痛，至危之
病也。治法急救其胃气而益之补血之味，则胃气生而胃不燥，内足以分给于脏腑，
又何至外痛而倒悬哉。方用解悬汤治之。
人参（二两） 当归（四两） 川芎（二两） 荆芥（三钱） 益母草（三两） 麦冬（一两）
炮姜（一钱） 水煎服。四剂而乳头收，再四剂全愈。
此方人参生胃气于无何有之乡。用当归、川芎于乘危至急之地。用荆芥、益母
草分解各脏腑以归其经络。用麦冬、炮姜者，因阳明胃火之燥，未免火动而炎烧，
产后不便大用寒凉，故用麦冬、微凉之品，少解其火势之烈也。
[Arm Carbuncle]
There are cases where a sore suddenly appears between the two arms and develops into a carbuncle or ulcer, which also belongs to Yin Carbuncle (Yin Yong). Although it is slightly milder than those on the head and face, duikou carbuncle, or shoulder and back, if treated improperly, it can still be fatal. Therefore, one must distinguish between Yin and Yang to determine the treatment. Generally speaking, severe pain indicates a Yang syndrome, while redness and swelling indicate a Yin syndrome; treating them is not difficult. For Yang syndromes, using Sanxing Tang (Three Star Decoction) for one or two doses can eliminate it immediately. For Yin syndromes, Sanxing Tang should not be used; instead, one must greatly tonify Qi and Blood, assisted by agents that resolve phlegm and transform toxins, to achieve success. One cannot assume that because the disease is on the limbs rather than the heart and abdomen, deficiency supplementation is unnecessary. Yin governs stillness, whereas the hands are the most active parts of the body. Developing a Yin Carbuncle in such an active state means movement has turned into stillness, which is contrary to normal physiology and should be feared. Moreover, turning from movement to stillness is a trend towards Yin. When Yang trends towards Yin, is it not approaching death? It is easy for Yang to return to Yin, but difficult for Yin to return to Yang. Who would say that a carbuncle on the hand can be underestimated? The treatment method should remain cautious. The prescription is Xiaoyong Huan Yang Dan (Carbuncle Resolving Yang-Returning Elixir): Ren Shen (Ginseng Radix et Rhizoma, 3 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 liang), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma, 3 qian), Tian Hua Fen (Trichosanthis Radix, 3 qian), Sheng Huang Qi (Astragali Radix, 1 liang), Jin Yin Hua (Lonicerae Japonicae Flos, 2 liang), Rou Gui (Cinnamomi Cortex, 1 qian), Dang Gui (Angelicae Sinensis Radix, 5 qian), Ru Xiang Mo (Frankincense Powder, 1 qian). Decoct in water and take orally. After one dose, itching turns to pain; after two doses, pain disappears; after three doses, the carbuncle completely resolves, without needing a fourth dose.
This formula has the same ingredients as Qisheng Tang (Seven Sage Decoction) but differs in intent. Qisheng Tang treats carbuncles that have already ulcerated, whereas this formula treats those that have not yet ulcerated. For ulcerated cases, promoting flesh regeneration is the priority; for non-ulcerated cases, protecting the muscle tissue is primary. This is why Qisheng Tang does not contain Ru Xiang (Frankincense) and Tian Hua Fen (Trichosanthes Root), as these two herbs have a clogging effect on defensive Qi.
[Breast Carbuncle: Initial Stage]
Some people develop swelling on the breast, starting with pain followed by swelling, accompanied by ordinary fever, evolving into an abscess. This condition occurs in both men and women, but is more common in women. It is often caused when a nursing infant falls asleep while feeding and blows air onto the nipple, causing the Qi within the breast to become blocked and stagnant, leading to pain and swelling. At this stage, treating with dispersing herbs leads to immediate recovery. If neglected, Breast Carbuncle (Ru Yong) forms. In men, however, it is different; it arises from excessive Fire in the Stomach Meridian of Yangming, which does not ascend to the mouth and tongue but instead obstructs the breast tissue, causing this disease. Thus, Breast Carbuncle is a Yang disease. Unlike other carbuncles which can be Yin or Yang, there is no need to differentiate Yin and Yang for treatment; one only needs to distinguish between excess and deficiency based on the onset. Generally, early-stage Breast Carbuncle involves excess pathogenic factors, while long-standing ulceration indicates deficiency of Zheng Qi (Upright Qi). Although there is an excess of pathogens, it fundamentally stems from a deficiency of Zheng Qi. Therefore, dispelling pathogens while tonifying Zheng Qi is a foolproof method, and it is not necessary to strictly separate attack and tonification phases. The prescription is He Ru Tang (Harmonizing Breast Decoction): Bei Mu (Fritillariae Bulbus, 3 qian), Tian Hua Fen (Trichosanthis Radix, 3 qian), Dang Gui (Angelicae Sinensis Radix, 1 liang), Pu Gong Ying (Taraxaci Herba, 1 liang), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma, 2 qian), Chuan Shan Jia (Manis Squama, earth-fried, one slice, powdered). Decoct in water and take orally. After one dose, the breast becomes unblocked and the swelling subsides, without needing a second dose.
Bei Mu (Fritillariae Bulbus) and Tian Hua Fen (Trichosanthes Root) are used to resolve phlegm stagnation in the Stomach. Phlegm stagnation blocks Qi flow in the breast; resolving the phlegm removes the support for Stomach Fire. Then, Pu Gong Ying (Taraxaci Herba) and Chuan Shan Jia (Manis Squama) are used to resolve heat-toxin and open orifices, allowing the condition to disperse naturally without aggressive attack. To prevent the previous herbs from being too harsh, Dang Gui (Angelicae Sinensis Radix) and Gan Cao (Glycyrrhizae Radix et Rhizoma) are added to tonify Zheng Qi and harmonize. With Zheng Qi intact and pathogens retreating, it is unlikely that the fire-toxin will fail to dissipate and transform into Ru Yan (Breast Cancer).
[Breast Carbuncle: Transformation to Rock]
Some patients initially suffer from Breast Carbuncle, which heals, but later recurs and ulcerates due to improper sexual activity, transforming into Ru Yan (Breast Cancer). This presents as countless small sores, resembling ducts but not quite, resembling fistulas but not quite, eventually forming a honeycomb-like structure with fleshy growth protruding outward, persisting for years without healing. Taking detoxifying herbs makes the patient’s condition worse, and the sores rot further. People assume the toxin is deeply rooted in the breast, but they do not realize it is a massive depletion of Qi and Blood. When flesh grows outward in the breast, tendons bind to the nipple; thus, injuring the breast injures the tendons. Carbuncles here require rapid dispersion; delay risks tendon laxity and failure to heal. Furthermore, seminal loss damages Yuan Qi (Primal Qi), inevitably leading to atypical pathology. Had substantial Jing-tonifying and Marrow-filling herbs been used immediately after seminal loss, the condition would not have worsened to this extent. Now, having formed Ru Yan due to deficiency, continuing to use detoxifying herbs upon seeing Ru Yan only increases deficiency. No wonder the condition deteriorates. The treatment must greatly tonify Qi and Blood to generate Essence, rather than attempting to drain toxins, as the root cause is not toxin accumulation. The prescription is Hua Yan Tang (Rock Transforming Decoction): Ren Shen (Ginseng Radix et Rhizoma, 1 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 2 liang), Huang Qi (Astragali Radix, 1 liang), Dang Gui (Angelicae Sinensis Radix, 1 liang), Ren Dong Teng (Lonicerae Caulis, 1 liang), Qian Gen (Rubiae Radix, 2 qian), Bai Jie Zi (Sinapis Semen, 2 qian), Fu Ling (Poria, 3 qian). Decoct in water and take orally. Take two consecutive doses for fresh, ruddy flesh growth. Take another two doses until pus stops and pain ceases. Take another two doses for fistula tracts to close. Take another two doses for complete recovery. Take another two doses to prevent recurrence.
This formula focuses entirely on tonifying Qi and Blood, avoiding detoxification, which demonstrates profound insight. Although Ren Dong Teng (Lonicerae Caulis) is a detoxifying herb, its nature is also tonifying, especially when combined with other tonics. However, since Ru Yan resulted from seminal loss, one might expect Jing-tonification. Why only tonify Qi and Blood? Because Jing cannot be generated quickly; Jing-tonification is slow. Tonifying Qi and Blood facilitates easier generation of Jing. Moreover, the breast belongs to the Yangming Meridian. After Breast Carbuncle, the Yangming Meridian may lack abundant Qi and Blood. Tonifying Qi and Blood strengthens the Yangming Meridian, which naturally generates fluids and Essence to nourish the breast. There is no need to add specific Jing-tonifying herbs that might hinder the efficacy of Ren Shen (Ginseng) and Huang Qi (Astragalus). This explains the absence of Jing-tonifying ingredients in this formula.
[Breast Carbuncle: Liver Qi Stagnation]
Some people experience sudden swelling in the left breast, size like a peach, without pain or redness, accompanied by fever and gradual emaciation. People attribute this to Phlegm-Qi stagnation, but it is actually due to Liver Qi stagnation. The breast belongs to the Yangming Meridian, so swelling should theoretically be addressed via the Stomach Meridian of Yangming. However, it is attributed to Liver pathology because Earth (Stomach) fears Wood (Liver) control. When Liver Qi is stagnant, Stomach Qi also becomes stagnant. Seeing Liver Wood stagnation, the Stomach fears Liver Wood overacting, becoming timid and suppressed. Since the breast is near the hypochondrium, the domain of the Liver, even distant organs retreat in fear; how could the adjacent breast dare to expand freely? Qi stagnation causes swelling; fear prevents expansion, explaining the lack of pain and redness. Treatment should not target the Stomach directly but focus on the Liver, after which swelling will subside. The prescription is Xiaoyao San (Free and Easy Wanderer Powder) modified: Chai Hu (Bupleuri Radix, 2 qian), Bai Shao (Paeoniae Radix Alba, 5 qian), Dang Gui (Angelicae Sinensis Radix, 2 qian), Chen Pi (Citri Reticulatae Pericarpium, 5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Fu Shen (Poria with Hostwood, 3 qian), Ren Shen (Ginseng Radix et Rhizoma, 1 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 1 qian), Gua Lou (Trichosanthis Fructus, 3 qian), Ban Xia (Pinelliae Rhizoma, 3 qian). Decoct in water and take orally. After ten doses, internal resolution occurs. Remove Gua Lou (Trichosanthis Fructus) and take ten more doses to prevent recurrence.
Xiaoyao San (Free and Easy Wanderer Powder) best resolves Liver Qi stagnation. Once Liver Qi flows, Stomach Qi naturally relaxes. Additionally, Gua Lou (Trichosanthis Fructus) and Ban Xia (Pinelliae Rhizoma) specifically resolve accumulated Phlegm in the chest; removing Phlegm aids swelling resolution.
[Postpartum Breast Retraction]
After childbirth, some women have small breasts hanging down to the lower abdomen with severe pain. This is mistaken for Breast Carbuncle, but it is actually caused by dryness of Stomach Blood. The Stomach is the Sea of Water and Grain and the Mansion of Blood. Excessive blood loss postpartum leaves the Stomach empty. Food intake cannot immediately resume; even if food is taken, the Zang-Fu organs urgently draw resources from the Stomach, exhausting Stomach Qi. Exhausted Stomach Qi leads to drier Stomach Blood. Dry Stomach Blood fails to mediate conflicts among Zang-Fu organs. Meanwhile, the infant demands milk, creating internal and external resource demands that the Stomach cannot meet. The breast is the outer shell of the Stomach; the nipple is the gateway of the Stomach. Suffering from internal conflict, the Stomach tries to escape outward but cannot, while enduring external sucking, causing the breasts to shrink and hang to the abdomen. This resembles a desperate flight with no refuge, a "hanging upside down" pain, representing a critical condition. Treatment must urgently rescue Stomach Qi and supplement Blood. Restored Stomach Qi and moistened Blood allow internal distribution to Zang-Fu, preventing external pain and retraction. The prescription is Jie Xuan Tang (Suspension Resolving Decoction): Ren Shen (Ginseng Radix et Rhizoma, 2 liang), Dang Gui (Angelicae Sinensis Radix, 4 liang), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 2 liang), Jing Jie (Schizonepetae Spica, 3 qian), Yi Mu Cao (Leonuri Herba, 3 liang), Mai Dong (Ophiopogonis Radix, 1 liang), Pao Jiang (Zingiberis Rhizoma Preparatum, 1 qian). Decoct in water and take orally. After four doses, nipples retract. After another four doses, full recovery.
Ren Shen (Ginseng Radix et Rhizoma) generates Stomach Qi from the void (origin). Dang Gui (Angelicae Sinensis Radix) and Chuan Xiong (Ligustici Chuanxiong Rhizoma) are used in this critical emergency. Jing Jie (Schizonepetae Spica) and Yi Mu Cao (Leonuri Herba) resolve conflicts among Zang-Fu and guide them back to their meridians. Mai Dong (Ophiopogonis Radix) and Pao Jiang (Prepared Ginger) are used because Yangming Stomach Fire causes dryness and inflammation. Since cold herbs are contraindicated postpartum, Mai Dong (Ophiopogonis Radix), a mildly cooling herb, is used to gently reduce the intensity of the fire.