经络 正中行属任脉经。两旁各开第二行属足少阴经。第三行属足肠明经。第四行属足太阴经。
缺盆疽 生于缺盆陷中。一名锁骨疽。由胃与三焦二经积热所致。其症寒热食少腹胀。必小水不利。
初宜隔蒜灸之。服蟾酥丸、贵金丸而势退。惟小水不利者。用六一散利之。次服十全大补汤调理。
此症失治。则溃而难敛。又名曰蠹疽。
甘疽 生于胸傍高处。灵枢云。发于膺。形如谷实栝蒌。苦寒热。急宜去其寒热。不则十日死。死后方出
脓。
膻中疽 生心窝之上。两乳之间。膻为气海。主分部阴阳。膻处生疽。由气郁所致也。灸阴谷穴三七
壮。艾如绿豆大。
井疽 生于心窝。初起如豆。皮色不变。必先肌热盗汗。心烦饮冷。舌燥唇焦。乃其候也。红肿易治。黑陷
难疗。再神昏呕吐肚胀者。七日死。灸 门穴三七壮。艾如绿豆大。如久溃而不敛。亦无痛痒者。
名穿心冷漏。
蜂窠疽 生胸乳之间。由心火热盛所致。宜急导心经之火。迟则热毒攻心。难疗。
胃疽(生心胸之傍) 脾发(生心窝之下亦傍些) 二症由炙爆太过所致。必人迎脉盛。宜清本经之积热。
若服药作呕。饮食不进者。不治。
按上诸症。肿溃治法。儿后腹部。再与首卷肿溃治法参考。
乳吹 乳毒 生近乳头。孕妇为内吹。胎气旺也。宜清之。有儿食乳为外吹。又名乳毒。由肝气滞也。如
乳痛发热。作渴夜甚。左关脉洪数者。热入血室也。宜小柴胡汤加当归、芍药、胆草、栀子。乳痛牵脐。
内热口辛肋胀者。带脉为患也。宜小柴胡汤加黄连、栀子、青皮。或升葛汤。
乳痈 乳疽 生于乳房。红肿热痛者为痈。坚硬木痛者为疽。由肝气郁结。胃热壅滞而成也。初起者
升葛汤。已成者复元通气散。已溃者神效栝蒌散。虚者补之。十全大补汤。
乳发 乳漏 发为乳房 赤俱肿。势大如痈。未成形者消之。已成形者托之。内有肿者针之。以免遍
溃。诸囊为害。防损囊隔。致难收敛。脓出未尽者。慎勿生肌。捻入药锭吸之。煎楮叶橘皮汤洗之。
久不收口。时流清水者。为漏。外用药线去腐生肌。内当大补。
乳中结核 如梅如李。虽患日浅。亦乳岩之渐也。由肝脾虚者。用四君子汤加芎、归、升麻、柴胡。由郁结
伤脾者。用归脾汤。轻者蒌贝散。
乳劳 乳房结核。初如梅子。数月不疗。渐大如鸡子。串延胸胁。破流稀脓白汁而内实相通。外见阴虚
等症。初起宜隔蒜灸之。绀珠青贴之。蒌贝散消之。已成者用栝蒌散调之。兼八珍汤加姜、炒香附、夏
枯草、蒲公英补之。已成者必见阴虚等症。兼用六味地黄丸料。以培其本。
乳岩 亦乳中结核。不红热。不肿痛。年月久之。始生疼痛。疼则无已。未溃时。肿如覆碗。形如堆粟。紫黑
坚硬。秽气渐生。已溃时。深如岩穴。突如泛莲。痛苦连心。时流臭血。根肿愈坚。斯时也五大俱衰。百无
一救。若自能清心涤虑以静养。兼服神效栝蒌散、益气养荣汤。只可苟延岁月而已。
初起时。宜艾灸核顶。次日起泡挑破。用铍针针入四五分。插去腐灵药捻子。纸封之。至十余日。其核
自落。用绛珠膏敛口。再当保养。庶不再发。惜乎初时必不肯如是治也。
按乳头属足厥阴肝经。乳房属足阳明胃经。外属足少阳胆经。是症也。女子多发于乳。盖由胎产忧
郁损于肝脾。中年无夫者多有不治。男子多发于腹。必由房劳恚怒伤于肝肾。治宜六君子汤加芎、
归、柴胡、栀子数十剂。元气复而自溃。仍痛而恶寒者。气血虚也。易十全大补汤加柴、栀、丹皮。兼六味
地黄丸。若两目连睫。肝脉微弦者。前十全大补汤更加胆草。
经络:正中行走的属于任脉经。两旁各开第二行属于足少阴经。第三行属于足阳明经。第四行属于足太阴经。
缺盆疽:生于缺盆穴凹陷处。又名锁骨疽。由胃经与三焦经积热所致。其症状为寒热往来、食欲减退、腹胀,必然伴有小便不利。初期适宜隔蒜灸治疗。服用蟾酥丸、贵金丸使病情消退。只有小便不利的情况,用六一散通利小便。随后服用十全大补汤进行调理。此症若失治,则溃烂后难以收敛。又名为蠹疽。
甘疽:生于胸旁高处。《灵枢》记载:发于膺部,形状像谷实栝蒌(瓜蒌),苦于寒热交作,应尽快去除寒热症状,否则十日内死亡。死后脓液才流出。
膻中疽:生于心窝之上,两乳之间。膻中为气海,主管分部阴阳。膻中处生疽,由气机郁结所致。灸阴谷穴三七壮,艾炷如绿豆大小。
井疽:生于心窝。初起时如豆粒,皮色不变。必然先出现肌肉发热、盗汗、心烦、想喝冷饮、舌燥唇焦等症状,这是其征候。红肿者易治,黑陷者难疗。若再出现神志昏迷、呕吐、肚胀,七日内死亡。灸气门穴三七壮,艾炷如绿豆大小。若久溃而不收敛,也没有痛痒感,名为穿心冷漏。
蜂窠疽:生于胸乳之间。由心火炽盛所致。应当急导心经之火,迟缓则热毒攻心,难以治疗。
胃疽(生于心胸之旁) 脾发(生于心窝之下,也偏旁边一些):这两种病症由烧烤食物太过所致。必然有人迎脉盛大。应当清泄本经的积热。如果服药后作呕,饮食不进,则属不治之症。
按上述诸症,肿疡和溃疡的治疗方法,详见后文腹部章节,并与首卷肿疡溃疡治疗方法参考。
乳吹 乳毒:生于近乳头处。孕妇患此称为内吹,因胎气旺盛所致。宜清热。有婴儿吃奶的称为外吹,又名乳毒。由肝气滞涩所致。如乳房疼痛发热,口渴夜间加重,左关脉洪数,是热入血室。宜用小柴胡汤加当归、芍药、龙胆草、栀子。乳房疼痛牵引脐部,内热口辛肋胀,是带脉为患。宜用小柴胡汤加黄连、栀子、青皮。或升葛汤。
乳痈 乳疽:生于乳房。红肿热痛的是痈。坚硬木痛的是疽。由肝气郁结、胃热壅滞而成。初起用升葛汤。已成脓用复元通气散。已溃破用神效栝蒌散。虚证则补益,用十全大补汤。
乳发 乳漏:发为乳房全部赤肿,势大如痈。未成形的消散它。已成形的托毒外出。内有肿块者针刺它,以免遍体溃烂。各种囊袋为害,防止损伤囊隔,导致难以收敛。脓出未尽者,切勿急于生肌,捻入药锭吸出脓液。煎楮叶橘皮汤清洗。久不收口,时常流出清水的,称为漏。外用药物线去腐生肌。内服当大补元气。
乳中结核:如梅如李,虽然患病时间短,也是乳岩的征兆。由肝脾虚弱者,用四君子汤加川芎、当归、升麻、柴胡。由郁结伤脾者,用归脾汤。轻者用蒌贝散。
乳劳:乳房结核,初起如梅子,数月不治疗,逐渐增大如鸡蛋,串延至胸胁,破溃后流稀脓白汁而内部实质相通,外部出现阴虚等症状。初起适宜隔蒜灸。绀珠膏贴敷。蒌贝散消散。已成形的用栝蒌散调理。兼用八珍汤加生姜、炒香附、夏枯草、蒲公英补益。已成形的必然见阴虚等症状。兼用六味地黄丸药料,以培补根本。
乳岩:也是乳中结核,不红热,不肿痛,年月久了,才开始产生疼痛,疼则无休止。未溃时,肿如倒扣的碗,形如堆积的粟米,紫黑坚硬,秽气渐生。已溃时,深如岩穴,突如泛莲,痛苦连心,时常流出臭血,根部肿胀更坚。此时五脏俱衰,百无一救。若能自己清心涤虑静养,兼服神效栝蒌散、益气养荣汤,只可苟延岁月而已。
初起时,适宜艾灸核顶。次日起泡挑破,用铍针针刺入四五分,插入去腐灵药捻子,用纸封住。到十余日,其核自然脱落。用绛珠膏敛口。再当保养,才不会复发。可惜起初必定不肯这样治疗。
按乳头属于足厥阴肝经。乳房属于足阳明胃经。外部属于足少阳胆经。此症女子多发于乳房,大概由于胎产忧郁损伤肝脾。中年无夫者多有不治。男子多发于腹部,必由房劳恚怒损伤肝肾。治疗宜用六君子汤加川芎、当归、柴胡、栀子数十剂。元气恢复后自然溃破。仍痛且恶寒的,是气血虚。改用十全大补汤加柴胡、栀子、丹皮。兼用六味地黄丸。若两目连睫,肝脉微弦的,前十全大补汤更加龙胆草。
Meridians: The one running in the center belongs to the Ren Mai (Conception Vessel) meridian. The second row on each side belongs to the Foot Shaoyin Kidney meridian. The third row belongs to the Foot Yangming Stomach meridian. The fourth row belongs to the Foot Taiyin Spleen meridian.
Quepen Ju (Abscess at Quepen): Occurs in the depression of the Quepen acupoint. Also known as Suogu Ju (Clavicle Abscess). Caused by accumulated heat in the Stomach and Sanjiao (Triple Burner) meridians. Symptoms include alternating chills and fever, poor appetite, abdominal distension, and inevitably difficulty in urination. Initially, moxibustion with garlic partition is suitable. Administer Chansu Wan (Toad Venom Pill) and Guijin Wan (Precious Gold Pill) to subside the condition. For cases with difficulty in urination only, use Liuyi San (Six-to-One Powder) to promote diuresis. Subsequently, administer Shiquan Dabu Tang (Decoction for Ten-Accumulated Tonification) for regulation. If this condition is neglected, it will ulcerate and be difficult to heal. It is also named Du Ju (Maggot Abscess).
Gan Ju (Sweet Abscess): Occurs at a high point on the side of the chest. *Ling Shu* states: "Erupts on the Ying region, shaped like a grain fruit or Trichosanthes fruit (Gualou), suffering from chills and fever. One must promptly eliminate the chills and fever; otherwise, death occurs within ten days. Pus flows out only after death."
Shanzhong Ju (Abscess at Shanzhong): Occurs above the epigastrium, between the two breasts. Shanzhong is the Sea of Qi, governing the division of Yin and Yang. An abscess here is caused by Qi stagnation. Moxa the Yin Gu acupoint for 37 moxa cones, with moxa cones the size of mung beans.
Jing Ju (Well Abscess): Occurs at the epigastrium. Initially appears bean-sized, with unchanged skin color. Must first present with muscle fever, night sweats, mental restlessness, desire for cold drinks, dry tongue, and scorched lips; these are its signs. Redness and swelling are easy to treat; blackening and sinking are difficult. If accompanied by coma, vomiting, and abdominal distension, death occurs within seven days. Moxa the Qimen acupoint for 37 moxa cones, with moxa cones the size of mung beans. If it ulcerates for a long time without healing and has no pain or itching, it is named Chuanxin Leng Lou (Penetrating Heart Cold Fistula).
Fengke Ju (Honeycomb Abscess): Occurs between the chest and breasts. Caused by blazing heart fire. One should urgently guide away the fire of the Heart meridian; delay leads to heat-toxin attacking the heart, making it difficult to treat.
Wei Ju (Stomach Abscess - occurring beside the heart and chest) Pi Fa (Spleen Eruption - occurring below the epigastrium, slightly to the side): These two conditions are caused by excessive consumption of roasted and fried foods. There must be a full pulse at the Renying acupoint. One should clear the accumulated heat of the relevant meridian. If vomiting occurs after taking medicine and food intake ceases, it is incurable.
Note regarding the above conditions: Methods for treating swellings and ulcers are detailed in the subsequent Abdomen section; refer also to the methods for treating swellings and ulcers in the first volume.
Ruchui (Breast Blowing) Rudu (Breast Poison): Occurs near the nipple. In pregnant women, it is called Neichui (Internal Blowing) due to vigorous fetal Qi. Clearing heat is appropriate. In nursing mothers, it is called Waichui (External Blowing), also known as Rudu. It is caused by Liver Qi stagnation. If breast pain and fever occur, thirst worsens at night, and the left Guan pulse is surging and rapid, it indicates Heat entering the Blood Chamber. Use Xiaochaihu Tang (Minor Bupleurum Decoction) plus Danggui (Angelica Sinensis), Shaoyao (Peony), Longdancao (Gentian Root), and Zhizi (Gardenia Fruit). If breast pain radiates to the umbilicus, with internal heat, bitter taste, and rib distension, it is a disorder of the Dai Mai (Girdle Vessel). Use Xiaochaihu Tang plus Huanglian (Coptis Rhizome), Zhizi, and Qingpi (Aurantii Fructus Perforatus). Or Shengge Tang.
Ruyong (Breast Carbuncle) Ruju (Breast Deep-Seated Abscess): Occurs in the breast. Redness, swelling, heat, and pain characterize Yong (Carbuncle). Hardness and numb pain characterize Ju (Deep-Seated Abscess). It results from Liver Qi stagnation and Stomach Heat obstruction. For early stage, use Shengge Tang. For formed stage, use Fuyuan Tongqi San. For ulcerated stage, use Shenxiao Gualou San. For deficiency, tonify using Shiquan Dabu Tang.
Ruifa (Breast Diffuse Inflammation) Rou Lou (Breast Fistula): Ruifa presents as diffuse redness and swelling of the entire breast, large like a carbuncle. For unformed stages, resolve it. For formed stages, expel toxins. For internal lumps, puncture with needle to prevent widespread ulceration. Prevent damage to the mammary septa to avoid difficulty in healing. When pus is not fully discharged, do not hastily apply flesh-regenerating agents; insert medicated wicks to absorb pus. Wash with decoction of Broussonetia leaves and Tangerine peel. If it fails to close for a long time and continuously discharges clear fluid, it is called Lou (Fistula). Use external medicinal threads to remove necrotic tissue and generate flesh. Internally, major tonification is required.
Ru Zhong Hejie (Nodule in Breast): Like a plum or pear. Even if the disease duration is short, it is a precursor to Ruyan (Breast Cancer). For Liver and Spleen deficiency, use Sijunzi Tang plus Chuanxiong, Danggui, Shengma, and Chaihu. For stagnation injuring the Spleen, use Guipi Tang. For mild cases, use Loubei San.
Ru Lao (Breast Consumption): Breast nodules, initially like a plum. If untreated for months, they gradually enlarge to the size of an egg, extending to the chest and hypochondrium. Upon rupture, they discharge thin pus and white fluid, with internal connection and external symptoms of Yin deficiency. Initially, use garlic-partitioned moxibustion. Apply Gan Zhu paste. Resolve with Loubei San. For formed stages, regulate with Gualou San. Supplement with Bazhen Tang plus Ginger, Fried Xiangfu, Xiakucao, and Pugongying. Formed stages inevitably show Yin deficiency symptoms. Concurrently use Liuwei Dihuang Wan ingredients to nourish the root.
Ruyan (Breast Rock/Cancer): Also a nodule in the breast, without redness, heat, pain, or swelling. After many years, pain begins, which is incessant. Before ulceration, the swelling is like an inverted bowl, shaped like piled millet, purple-black and hard, with gradual generation of foul odor. After ulceration, it is deep like a rock cave, protruding like a floating lotus, with pain piercing the heart, intermittently discharging foul blood. The root swelling becomes harder. At this time, the Five Zang organs are all depleted, and there is no hope of cure. If one can clear the mind and purify thoughts to rest quietly, and concurrently administer Shenxiao Gualou San and Yiqi Yangrong Tang, life may only be prolonged for a few years.
At the initial stage, moxa the top of the nodule. On the following day, when blisters form, pierce them. Insert a Bian needle four to five fen deep, insert a quorum-removing spiritual medicine wick, and seal with paper. After more than ten days, the nodule falls off naturally. Use Jiangzhu Ointment to close the wound. Maintain care thereafter to prevent recurrence. Alas, patients rarely agree to such treatment initially.
Note: The nipple belongs to the Foot Jueyin Liver meridian. The breast belongs to the Foot Yangming Stomach meridian. The exterior belongs to the Foot Shaoyang Gallbladder meridian. This condition occurs frequently in women's breasts, likely due to damage to the Liver and Spleen from childbirth and melancholy. Women without husbands in middle age often have incurable cases. Men frequently develop it in the abdomen, necessarily due to damage to the Liver and Kidneys from sexual excess and anger. Treatment should use Liujunzi Tang plus Chuanxiong, Danggui, Chaihu, and Zhizi for dozens of doses. After Yuan Qi recovers, it will naturally ulcerate. If pain and aversion to cold persist, it indicates Qi and Blood deficiency. Switch to Shiquan Dabu Tang plus Chaihu, Zhizi, and Danpi. Concurrently use Liuwei Dihuang Wan. If the eyes and eyelids are involved and the Liver pulse is slightly wiry, add Longdancao to the previous Shiquan Dabu Tang.