经云。怒则气上。思则气结。上则逆而不下。结则聚而不行。人之气血。贵于条达。则百脉
畅遂。经络流通。苟或怫郁。则气阻者血必滞。于是随其经之所属而为痈肿。况乎乳房。阳明胃
经所司。常多气多血。乳头。厥阴肝经所属。常多血少气。女子心性偏执善怒者。则发而为痈。
沉郁者则渐而成岩。痈之为患。乳房红肿。
寒热交作。宜化毒为主。栝蒌、忍冬之属。可使立已。岩之为病。内结成核。久乃穿溃。宜开郁
为要。贝母、远志之类。不容少弛。若男子则间有。不似妇人之习见也。陈氏则云微有异者。女
损肝胃。男损肝肾。肝虚血燥。肾虚精怯。血脉不得上行。肝筋无以荣养。遂结痛肿。似亦有见。
至既溃之后。气血必耗。惟以归脾、逍遥、人参养荣无间调之。又必患者怡情适志。寄怀潇洒。
则毋论痈症可痊、而岩症亦庶几克安矣。倘自恃己性。漫不加省。纵有神丹。亦终无如何也。
一乳痈。恶寒发热。乳房红肿。用橘叶散。
一乳吹。乳房作胀。枳壳散。乳汁不通。膨闷。王不留行汤。
一郁怒伤肝。左乳结核。加味逍遥散。入贝母、金银花、青皮、香附。思虑伤脾。右乳结核。
加味归脾汤。入贝母、金银花。
一乳疖溃后不敛。人参养荣汤、归脾汤、八珍汤。调养之。余毒未解。入忍冬花。
一乳岩溃后。须前方久服勿辍。调和情性。若郁结不舒者不治。
橘叶散
金银花 栝蒌 青皮 当归 皂针 连翘（各一钱） 橘叶（十片） 柴胡（七分） 甘草节（三分）
水煎。心思不遂者。加远志、贝母。
枳壳散
枳壳 木通 生地 当归 广皮 金银花（各一钱） 甘草（三分） 钩藤（二钱）
灯芯一握。水煎。
王不留行汤
穿山甲（炒） 麦门冬（去心） 王不留行（炒） 当归 白芍药（酒炒） 熟地黄
茯苓 通草（各一钱） 川芎（五分） 甘草（三分）
用猪前蹄煮汁二碗煎药。食远服之。以热木梳梳其乳房。其乳立至。
蓬术汤 治乳核。
蓬术（七分醋煮） 甘草节（三分） 远志肉（甘草制） 人参 金银花 贝母（去心研）
香附（醋炒） 白芍药（酒炒） 当归身（各一钱） 水煎。
麦 汤 消乳膨。
麦芽（一两炒研） 川芎 白芍药（酒炒） 熟地 当归（各一钱）
水煎服。外用布紧束两乳。以手揉按。乳自消退。
一方用栝蒌两个。炒熟捣烂。酒水各半。煎服。痈肿初起者立消。
一方用蒲公英二两。连根带蒂。酒煎服。亦效。
治验
一女子发热七八日。脉数身热口干。诸医作伤寒治。用发表消导药。其势益甚。延余诊之。
疑其阴血亏损。及细叩其有无痛处。则曰左乳红肿作疼。余乃笑曰。此乳痈症。而误认伤寒。焉
得不至于此。急与米饮。兼进栝蒌、贝母、忍冬、茯神、远志、钩藤、麦冬、甘草。生津解毒。三剂而愈。
一女子产后乳痈。三四旬余。反发寒热。延余诊之。脉得 弱。气血二亏。用八珍汤数剂始痊。
《黄帝内经》中说：愤怒会导致气机上逆，思虑过度会导致气机郁结。气机上逆则阻碍下行，气机郁结则聚而不散。人体的气血，贵在条达通畅，这样百脉才能顺畅，经络流通无阻。如果情志怫郁不舒，那么气机阻滞必然导致血液瘀滞，于是随着所属经络的循行部位发生痈肿。况且乳房，由足阳明胃经所主管，通常多气多血；乳头，由足厥阴肝经所主管，通常多血少气。女子若性情偏执、易怒，就会发为痈症；性情沉郁者，则会逐渐演变为岩症（乳岩）。
痈这种病症，表现为乳房红肿，寒热交替发作，治疗应以解毒化毒为主，使用栝蒌、忍冬等药物，可以使病情迅速痊愈。岩这种疾病，内部结成肿块，日久才会穿破溃烂，治疗应以开郁散结为关键，贝母、远志之类的药物不可片刻松懈。至于男子患此病的情况间或有之，不像妇女那样常见。陈氏则认为略有不同：女子损伤肝胃，男子损伤肝肾。肝虚则血燥，肾虚则精怯，血脉不能上行，肝筋得不到荣养，于是结聚成痛肿。这说法似乎也有道理。
等到溃疡之后，气血必然耗损，只有用归脾汤、逍遥散、人参养荣汤不间断地调理。还必须让患者心情愉悦、志向舒展，寄托情怀于潇洒自在之中，那么无论痈症还是岩症，大概都能治愈或安定下来。倘若依仗自己的性格，漫不经心不加反省，即使有神仙丹药，最终也无能为力。
一例乳痈，恶寒发热，乳房红肿，使用橘叶散。
一例乳吹（乳汁淤积），乳房胀痛，使用枳壳散。乳汁不通，乳房膨闷，使用王不留行汤。
一例因郁怒伤肝，左乳出现结核，使用加味逍遥散，加入贝母、金银花、青皮、香附。思虑伤脾，右乳出现结核，使用加味归脾汤，加入贝母、金银花。
一例乳疖溃后伤口不愈合，用人参养荣汤、归脾汤、八珍汤调养。余毒未解，加入忍冬花。
一例乳岩溃后，必须长期服用前方不要停止，调和性情。如果郁结不舒的，属于不治之症。
橘叶散
金银花、栝蒌、青皮、当归、皂角刺、连翘（各一钱），橘叶（十片），柴胡（七分），甘草节（三分）。水煎服。心思不畅者，加远志、贝母。
枳壳散
枳壳、木通、生地、当归、广陈皮、金银花（各一钱），甘草（三分），钩藤（二钱）。灯芯草一握，水煎服。
王不留行汤
穿山甲（炒）、麦门冬（去心）、王不留行（炒）、当归、白芍药（酒炒）、熟地黄、茯苓、通草（各一钱），川芎（五分），甘草（三分）。用猪前蹄煮出的汁液两碗来煎药。饭后服用。并用热木梳梳理乳房，乳汁立刻就会通畅。
蓬术汤 治疗乳核。
蓬术（七分醋煮）、甘草节（三分）、远志肉（甘草制）、人参、金银花、贝母（去心研碎）、香附（醋炒）、白芍药（酒炒）、当归身（各一钱）。水煎服。
麦汤 消除乳房胀满。
麦芽（一两炒后研碎）、川芎、白芍药（酒炒）、熟地、当归（各一钱）。水煎服。外用布带紧紧束住双乳，用手揉按，乳汁自然消退。
一方用栝蒌两个，炒熟捣烂，酒水各半，煎服。痈肿初起时立即消散。
一方用蒲公英二两，连根带蒂，酒煎服，也有效。
治验案例
一名女子发热七八天，脉数，身体发热口干，各位医生当作伤寒治疗，使用发表消导的药物，病情反而加重。请我诊治，怀疑她是阴血亏损，等到仔细询问是否有疼痛之处，她说左乳红肿疼痛。我笑着说：“这是乳痈症，却误认为是伤寒，怎么会发展到这个地步。”急忙让她喝米汤，同时进服栝蒌、贝母、忍冬、茯神、远志、钩藤、麦冬、甘草，生津解毒，三剂药后痊愈。
The *Yellow Emperor’s Inner Classic* states: Anger causes Qi to ascend; excessive thinking causes Qi to knot. Ascending Qi obstructs downward movement, while knotted Qi gathers without flowing. Human Qi and Blood value smoothness and unobstructed flow, so that all vessels are patent and meridians circulate freely. If emotional stagnation occurs, Qi obstruction inevitably leads to Blood stasis. Consequently, abscesses and swellings arise along the pathways of the affected meridians. Furthermore, the breast is governed by the Foot-Yangming Stomach Meridian, which typically has abundant Qi and Blood; the nipple is governed by the Foot-Jueyin Liver Meridian, which typically has abundant Blood but scant Qi. Women with rigid temperaments prone to anger may develop abscesses (Yong), while those with depressive dispositions may gradually develop carcinoma (Yan).
An abscess manifests as redness and swelling of the breast, accompanied by alternating chills and fever. Treatment should primarily focus on resolving toxicity, using herbs such as Trichosanthis Fructus (Gualou) and Lonicerae Japonicae Flos (Jinyinhua), which can lead to rapid recovery. Carcinoma involves the internal formation of nodules, which only ulcerate after a long duration. Treatment must prioritize opening stagnation and dissipating knots; herbs like Pinelliae Rhizoma Preparatum (Beimu) and Polygalae Radix (Yuanzhi) are indispensable and cannot be neglected. Men occasionally suffer from this condition, unlike the common occurrence in women. Chen Shi argued there are slight differences: women injure the Liver and Stomach, while men injure the Liver and Kidney. Liver deficiency leads to dry Blood, and Kidney deficiency leads to weak Essence. The Blood vessels fail to ascend, and Liver tendons lack nourishment, resulting in painful swellings. This view also seems reasonable.
After ulceration, Qi and Blood are inevitably depleted. Regulation should be continuously maintained with Guipi Tang (Restore the Spleen Decoction), Xiaoyao San (Free Wanderer Powder), or Renshen Yangrong Tang (Ginseng Nourishing Ying-Decoction). Moreover, patients must maintain a joyful mood and open spirit, finding solace in a carefree attitude. Under these conditions, both abscesses and carcinomas can likely be cured or stabilized. However, if one relies on their own stubborn nature and fails to reflect, even divine elixirs will ultimately be ineffective.
Case 1: Breast abscess with aversion to cold, fever, and breast redness/swelling. Prescribed Juye San (Tangerine Leaf Powder).
Case 2: Milk blow (lactational mastitis) with breast distension. Prescribed Zhike San (Aurantium Powder). For blocked milk secretion causing breast engorgement and fullness, Wangbuliuxing Tang (Vaccaria Seed Decoction) was used.
Case 3: Liver injury due to depressed anger, presenting with nodules in the left breast. Prescribed Jiawei Xiaoyao San (Modified Free Wanderer Powder) added with Beimu, Jinyinhua, Qingpi, and Xiangfu. Spleen injury due to overthinking, presenting with nodules in the right breast. Prescribed Jiawei Guipi Tang (Modified Restore the Spleen Decoction) added with Beimu and Jinyinhua.
Case 4: Boil ulcerated but not healing. Regulated with Renshen Yangrong Tang, Guipi Tang, and Bazhen Tang. To clear residual toxins, add Jin Yin Hua.
Case 5: Post-ulceration of breast carcinoma. Long-term administration of the previous formula is required without cessation, alongside emotional regulation. Cases with persistent stagnation are considered incurable.
**Juye San (Tangerine Leaf Powder)**
Lonicerae Japonicae Flos (Jinyinhua), Trichosanthis Fructus (Gualou), Aurantii Fructus Viridis (Qingpi), Angelicae Sinensis Radix (Danggui), Gleditsiae Spina (Zaoren), Forsythiae Fructus (Lianqiao) (each 1 qian); Tangerine Leaf (Juye) (10 leaves); Bupleuri Radix (Chaihu) (7 fen); Glycyrrhizae Radix et Rhizoma cum Melle (Gancao Jie) (3 fen). Decoct in water. For mental frustration, add Polygalae Radix (Yuanzhi) and Pinelliae Rhizoma Preparatum (Beimu).
**Zhike San (Aurantium Powder)**
Aurantii Fructus (Zhike), Akebiae Caulis (Mutong), Rehmanniae Radix (Shengdi), Angelicae Sinensis Radix (Danggui), Citri Reticulatae Pericarpium (Guangpi), Lonicerae Japonicae Flos (Jinyinhua) (each 1 qian); Glycyrrhizae Radix et Rhizoma cum Melle (Gancao) (3 fen); Uncariae Ramulus cum Uncis (Gouteng) (2 qian). Decoct with a handful of Juncus Arillus (Dengxin) in water.
**Wangbuliuxing Tang (Vaccaria Seed Decoction)**
Manis Squama (Chuanshanjia, stir-fried), Ophiopogonis Radix (Mendong, heart removed), Vaccariae Semen (Wangbuliuxing, stir-fried), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao, wine-fried), Rehmanniae Radix Praeparata (Shudihuang), Poria (Fuling), Tectonae Caulis (Tongcao) (each 1 qian); Chuanxiong Rhizoma (Chuanxiong) (5 fen); Glycyrrhizae Radix et Rhizoma cum Melle (Gancao) (3 fen). Decoct using two bowls of broth from pig trotters. Take after meals. Comb the breast with a hot wooden comb to promote immediate lactation.
**Pengzhu Tang** treats breast nodules.
Curcumae Rhizoma (Pengzhu, boiled in vinegar, 7 fen); Glycyrrhizae Radix et Rhizoma cum Melle (Gancao Jie) (3 fen); Polygalae Radix (Yuanzhi Rou, processed with Gancao); Ginseng Radix et Rhizoma (Renshen); Lonicerae Japonicae Flos (Jinyinhua); Pinelliae Rhizoma Preparatum (Beimu, dehearted and ground); Cyperi Rhizoma (Xiangfu, vinegar-fried); Paeoniae Radix Alba (Baishao, wine-fried); Angelicae Sinensis Radix (Danggui Shen) (each 1 qian). Decoct in water.
**Mai Tang** resolves breast engorgement.
Hordei Fructus Germinatus (Maiya, stir-fried and ground, 1 liang); Chuanxiong Rhizoma (Chuanxiong); Paeoniae Radix Alba (Baishao, wine-fried); Rehmanniae Radix Praeparata (Shudi); Angelicae Sinensis Radix (Danggui) (each 1 qian). Decoct and take orally. Externally, bind both breasts tightly with cloth and massage with hands until the engorgement subsides.
Another prescription uses two Trichosanthis Fructus (Gualou), stir-fried until cooked, pounded into a paste, decocted with half wine and half water. It disperses initial-stage abscesses immediately.
Another prescription uses two liang of Taraxaci Herba (Pugongying), roots and stems included, decocted in wine. This is also effective.
**Clinical Records**
A female patient had fever for seven to eight days, with a rapid pulse, body heat, and dry mouth. Other physicians treated it as Taiyang disease (Shanghan) using diaphoretic and digestive-promoting herbs, worsening the condition. Upon my consultation, I suspected Yin-Blood deficiency. After carefully asking about pain locations, she reported redness, swelling, and pain in the left breast. I smiled and said, "This is a breast abscess, yet misdiagnosed as Taiyang disease; how could it reach this state?" I urgently advised her to drink rice water and administered Trichosanthis Fructus (Gualou), Pinelliae Rhizoma Preparatum (Beimu), Lonicerae Japonicae Flos (Rendong), Poria (Fushen), Polygalae Radix (Yuanzhi), Uncariae Ramulus cum Uncis (Gouteng), Ophiopogonis Radix (Maidong), and Glycyrrhizae Radix et Rhizoma cum Melle (Gancao) to generate fluids and resolve toxicity. She recovered after three doses.
A postpartum female suffered from breast abscess. After more than thirty days, she developed alternating chills and fever again. Upon consultation, her pulse was weak, indicating dual deficiency of Qi and Blood. She recovered after several doses of Bazhen Tang (Eight-Treasure Decoction).