乳岩初结核隐疼，肝脾两损气郁凝，核无红热身寒热，速灸养血免患攻。耽延续发
如堆栗，坚硬岩形引腋胸，顶透紫光先腐烂，时流污水日增疼。溃后翻花怒出血，即成败证药不灵。
【注】此证由肝、脾两伤，气郁凝结而成。自乳中结核起，初如枣栗，渐如棋子，无红
无热，有时隐痛。速宜外用灸法，内服养血之剂，以免内攻。若年深日久，即潮热恶寒，
始觉大痛，牵引胸腋，肿如覆碗坚硬，形如堆栗，高凸如岩，顶透紫色光亮，肉含血丝，
先腐后溃，污水时津，有时涌冒臭血，腐烂深如岩壑，翻花突如泛莲，疼痛连心。若复
因急怒，暴流鲜血，根肿愈坚，期时五脏俱衰，即成败证，百无一救；若患者果能清心
涤虑，静养调理，庶可施治。初宜服神效栝蒌散，次宜清肝解郁汤，外贴季芝鲫鱼膏，其
核或可望消。若反复不应者，疮势已成，不可过用克伐峻剂，致损胃气，即用香贝养荣
汤。或心烦不寐者，宜服归脾汤；潮热恶寒者，宜服逍遥散，稍可苟延岁月。如得此证
者，于肿核初起，即加医治，宜用豆粒大艾壮，当顶灸七壮，次日起 ，挑破，用三棱
针刺入五六分，插入冰螺散捻子，外用纸封
糊，至十余日其核自落，外贴绛珠膏、生肌玉红膏，内服舒肝、养血、理脾之剂，生肌敛口自愈。
\r乳岩图\p04-34a121.bmp\r
季芝鲫鱼膏
活鲫鱼肉 鲜山药（去皮，各等分）
上共捣如泥，加麝香少许，涂核上，觉痒极，勿搔动，隔衣轻轻揉之，七日一换，旋涂即消。
【方歌】鲫鱼膏贴乳岩疾，肿如覆碗似堆栗，山药同研加麝香，涂于患处七日易。
冰螺捻
砂（二分） 大田螺（去壳，线穿晒干，五枚） 冰片（一分） 白砒（即人言。面裹煨熟，去面
用砒，一钱二分）
将螺肉切片，同白砒研末，再加 片同碾细，以稠米糊，搓成捻子，瓷罐密收。用
时将捻插入针孔，外用纸糊封，贴核上勿动，十日后四边裂缝，其核自落。
【方歌】冰螺捻消诸核 ， 砂螺肉煨白砒，再加冰片米糊捻，乳岩坚硬用之宜。
神效栝蒌散（见乳劳）
香贝养荣汤（见项部上石疽）
清肝解郁汤 归脾汤（俱见乳中结核）
逍遥散（见背部上搭手）
绎珠膏 生肌玉红膏（俱见溃疡门）
乳岩（乳腺癌）初期表现为乳房内结块，伴有隐隐作痛，这是肝脾两脏受损、气机郁滞凝结所致。肿块表面不红不热，身体有时出现寒热症状，此时应迅速采用艾灸疗法以养血，防止病邪内攻。若拖延延续导致病情发作，肿块如堆积的栗子般坚硬，呈岩石形状，并牵引至腋下和胸部。若肿块顶部透出紫色光泽，随后先发生腐烂，时常流出污水，疼痛每日加重。溃破后疮口翻花状突起，愤怒时出血，这即已转化为败证（晚期恶疾），药物难以奏效。
【注】此病症由肝、脾两脏受伤，气机郁结凝聚而成。从乳房内部开始结块，起初像枣或栗子大小，逐渐增大如棋子，表面无红肿发热，有时有隐痛。此时适宜外用灸法，内服养血药剂，以避免病邪内攻入里。如果病程日久，就会出现潮热恶寒，才感到剧烈疼痛，并牵引胸胁和腋下，肿胀如倒扣的碗般坚硬，形状如堆积的栗子，高凸如岩石，顶部透出紫色光亮，肉质含有血丝，先腐烂后溃破，污水时时渗出，有时涌出臭血，腐烂深度如岩石沟壑，翻花突起如泛起的莲花，疼痛连心。如果再因急怒，暴流鲜血，根部肿胀更加坚硬，届时五脏俱衰，即成为败证，百无一救；如果患者真能清心涤虑，静养调理，或许还可以施治。初期宜服用神效栝蒌散，其次宜服用清肝解郁汤，外贴季芝鲫鱼膏，其肿块或许有望消散。如果反复治疗无效，疮势已成，不可过度使用猛烈攻伐的药物，以免损伤胃气，此时可用香贝养荣汤。如果心烦失眠者，宜服用归脾汤；潮热恶寒者，宜服用逍遥散，稍可勉强维持岁月。如得此病者，在肿核初起时即加以医治，宜用豆粒大小的艾炷，直接在顶部灸七壮，第二天起床后，挑破皮肤，用三棱针刺入五六分深，插入冰螺散捻子，外用纸张封糊，到十余日后其核自然脱落，外贴绛珠膏、生肌玉红膏，内服舒肝、养血、理脾的药剂，肌肉生长伤口愈合即可自愈。
季芝鲫鱼膏
活鲫鱼肉 鲜山药（去皮，各等分）
以上共同捣烂如泥，加入少许麝香，涂抹于肿块上，感觉极痒，不要搔动，隔着衣服轻轻揉搓，七日更换一次，随即涂抹即可消散。
【方歌】鲫鱼膏贴治乳岩疾，肿胀如覆碗似堆栗，山药同研加麝香，涂于患处七日易。
冰螺捻
轻粉（二分） 大田螺（去壳，线穿晒干，五枚） 冰片（一分） 白砒（即人言。面裹煨熟，去面用砒，一钱二分）
将螺肉切片，同白砒研成粉末，再加轻粉同碾细，用稠米糊搓成捻子，瓷罐密封收藏。使用时将捻插入针孔，外用纸糊封，贴在肿块上不要移动，十日后四周裂缝，其核自然脱落。
【方歌】冰螺捻消诸核，轻粉螺肉煨白砒，再加冰片米糊捻，乳岩坚硬用之宜。
神效栝蒌散（见乳劳章节）
香贝养荣汤（见项部上石疽章节）
清肝解郁汤 归脾汤（均见乳中结核章节）
逍遥散（见背部上搭手章节）
绛珠膏 生肌玉红膏（均见溃疡门章节）
Ru Yan (Breast Cancer) initially presents as a lump in the breast with dull pain, caused by damage to the Liver and Spleen and condensation of Qi stagnation. The lump is neither red nor hot, and the body may experience alternating chills and fever; at this stage, moxibustion should be applied promptly to nourish Blood and prevent the pathogen from attacking inward. If neglected and allowed to progress, the condition develops with lumps hard like piled chestnuts, taking on a rock-like shape and radiating pain to the axilla and chest. If the top of the lump reveals a purple sheen followed by necrosis, it will intermittently discharge foul fluid, with pain increasing daily. After ulceration, the wound everts like flower petals, and bleeding occurs upon anger; this indicates a terminal syndrome (Bai Zheng), where medication is ineffective.
[Note] This condition arises from injury to the Liver and Spleen, leading to Qi stagnation and condensation. It begins as a nodule within the breast, initially resembling a date or chestnut, gradually enlarging to the size of a chess piece, without redness or heat, sometimes accompanied by dull pain. At this stage, external moxibustion and internal blood-nourishing decoctions are appropriate to prevent internal invasion. If the disease persists for years, tidal fever and aversion to cold develop, followed by severe pain radiating to the chest and axillae. The swelling becomes hard like an inverted bowl, shaped like piled chestnuts, protruding like a rock, with the apex showing a bright purple hue and blood vessels visible in the flesh. Necrosis precedes ulceration, with foul fluid oozing continuously, sometimes erupting with foul-smelling blood. The decay runs deep like a rocky gorge, with everted tissue resembling lotus flowers, causing pain that reaches the heart. If further aggravated by rage, profuse fresh blood flows, the root swelling becomes harder, and eventually all five Zang organs decline, resulting in a terminal syndrome with no hope of cure; however, if the patient can clear the mind, eliminate desires, and rest quietly, treatment may still be attempted. Initially, Shen Xiao Gua Lou San is indicated, followed by Qing Gan Jie Yu Tang, with Ji Zhi Ji Yu Gao applied externally, hoping for the resolution of the nodule. If repeated treatments fail and the ulcerative state is established, harsh purgative agents should not be overused to avoid damaging Stomach Qi; instead, Xiang Bei Yang Rong Tang may be used. For patients with irritability and insomnia, Gui Pi Tang is suitable; for those with tidal fever and aversion to cold, Xiao Yao San is appropriate, allowing for temporary prolongation of life. For patients diagnosed early when the nodule first appears, apply a bean-sized moxa cone directly on the apex for seven moxibustions. On the following day, puncture the skin, insert a three-edged needle 5-6 fen deep, introduce Bing Luo San thread into the wound, seal with paper paste, and after ten-plus days, the nodule will naturally fall off. Apply Jiang Zhu Gao and Sheng Ji Yu Hong Gao externally, and internally administer formulas to soothe the Liver, nourish Blood, and regulate the Spleen; muscle regeneration and wound closure will lead to spontaneous recovery.
Ji Zhi Ji Yu Gao (Seasonal Herb Crucian Carp Paste)
Fresh Crucian Carp Meat (Cyprinus carpio) Fresh Chinese Yam (Dioscorea opposita, peeled, equal parts)
Mash together into a paste, add a small amount of Moschus (She Xiang), apply to the nodule. Intense itching may occur; do not scratch. Gently rub through clothing. Change every seven days; application leads to dissolution.
[Prescription Verse] Ji Yu Gao treats Ru Yan disease, swelling like an inverted bowl or piled chestnuts; mashed with Chinese Yam and added Moschus, apply to the affected area and change every seven days.
Bing Luo Nian (Ice Snail Thread)
Calomel (Qing Fen, 2 fen) Large River Snail (Pomacea canaliculata, shell removed, threaded and sun-dried, 5 pieces) Borneol (Bing Pian, 1 fen) White Arsenic (Bai Pi, also known as Ren Yan. Wrapped in flour and roasted熟, discard flour, use arsenic only, 1 qian 2 fen)
Slice snail meat, grind together with White Arsenic into powder, then add Calomel and grind finely. Mix with thick rice paste to form threads, store tightly in a porcelain jar. To use, insert the thread into the puncture hole, seal externally with paper paste, keep the nodule immobile. After ten days, cracks appear around the edges, and the nodule falls off naturally.
[Prescription Verse] Bing Luo Nian resolves various nodules; Calomel, snail meat, and roasted White Arsenic; mixed with Borneol and rice paste into threads, suitable for hard Ru Yan.
Shen Xiao Gua Lou San (See "Ru Lao" chapter)
Xiang Bei Yang Rong Tang (See "Shang Shi Ju of Neck" chapter)
Qing Gan Jie Yu Tang, Gui Pi Tang (Both see "Nodules in Breast" chapter)
Xiao Yao San (See "Shang Da Shou of Back" chapter)
Jiang Zhu Gao, Sheng Ji Yu Hong Gao (Both see "Ulceration Section")