妇人乳痈，属胆胃二腑热毒，气血壅滞。故初起肿痛，发于肌表，肉色 赤，其人表热发热
，或发寒热，或憎寒头痛，烦渴引冷，用人参败毒散、神效栝蒌散、加味逍遥散治之，其自
消散。若至数日之间，脓成溃窍，稠脓涌出，脓尽自愈。若气血虚弱，或误用败毒，久不收
敛，脓清脉大，则难治。乳岩属肝脾二脏郁怒，气血亏损，故初起小核，结于乳内，肉色如
故，其人内热夜热，五心发热，肢体倦瘦，月经不调，用加味归脾汤、加味逍遥散、神效瓜
蒌散，多自消散。若荏苒日月渐大，HT 岩色赤，出水腐溃深洞，用前归脾汤等药，可延岁月
，若误用攻伐，危殆迫矣。大凡乳症，若因恚怒，宜疏肝清热。 痛寒热，宜发表散邪。肿
痛甚，宜清肝消毒，并隔蒜灸。不作脓，或脓不溃，补气血为主。不收敛，或脓稀，补脾
胃为主。脓出反痛，或发寒热，补气血为主。或晡热内热，补血为主。若饮食少思，或作呕
吐，补胃为主。饮食难化，或作泄泻，补脾为主。劳碌肿痛，补气血为主。怒气肿痛，养肝
血为主。儿口所吹，须吮通揉散。成痈，治以前法。潮热暮热，亦主前药。大抵男子多由房
劳，耗伤肝肾。妇人郁怒，亏损肝脾。治者审之。（世以孕妇患此，名曰内吹。然其所致之因
则一，惟用药不可犯其胎耳。）
治验
一妇人内热胁胀，两乳不时作痛，口内不时辛辣，若卧而起急，则脐下牵痛，此带脉为患，
用小柴胡加青皮、黄连、山栀二剂而瘥。
一妇人因怒两乳肿，兼头痛寒热，用人参败毒散，二剂表症已退，用小柴胡加芎、归、枳壳
一妇人久郁，右乳内肿硬，用八珍汤加远志、贝母、柴胡、青皮及隔蒜灸，兼服神效栝蒌散，两月余而消。
一妇人左乳内肿如桃，不痛不赤，发热渐瘦，用八珍加香附、远志、青皮、柴胡百余剂，又
兼服神效栝蒌散三十余剂，脓溃而愈。
一妇人郁久，左乳内结核如杏许，三月不消，心脉涩而脾脉大，按之无力，以八珍加贝母、
远志、香附、柴胡、青皮、桔梗，五十余剂而溃，又三十余剂而愈。
一妇人禀实性躁，怀抱久郁，左乳内结一核，按之微痛，以连翘饮子二十余剂少退，更以八
珍加青皮、香附、桔梗、贝母，二十余剂而消。
一妇人发热作渴，至夜尤甚，两乳忽肿，肝脉洪数，乃热入血室也，用加味小柴胡汤，热止肿消。
一妇人因怒，左乳作痛发热，表散太过，肿热益甚，用益气养荣汤，数剂热止脓成，不从用
针，肿胀热渴，针脓大泄，仍以前汤，月余始愈。此症若脓成未破，有薄皮剥起者，用代针
之剂，其脓自出。不若及时用针，不致大溃。若脓血未尽，辄用生肌，反助其邪。慎之!
一妇人因怒，左乳作痛，胸膈不利，以方脉流气饮加木香、青皮，四剂而安。
一妇人脓清肿硬，面黄食少，内热晡热，自汗盗汗，月经不行，此肝脾气血俱虚，用十全大
补加远志、贝母及补中益气，各三十余剂，外用葱熨患处，诸症寻愈。
一妇人脓成胀痛，余欲针之，不从，数日始针，出败脓三四碗许，虚症蜂起，几至危殆，用
大补两月余而安。若元气虚弱，不作脓者，用益气养荣汤补之，脓成即针。若肿痛寒热，怠
惰食少，或至夜热甚，用补中益气汤兼逍遥散，补之为善。
一产妇因乳少，服药通之，致乳房肿胀，发热作渴，以玉露散补之而愈。夫乳汁乃气血所化
，在上为乳，在下为经，若冲任之脉盛，脾胃之气壮，则乳汁多而浓，衰则淡而少，所乳之
子，亦弱而多病。又有屡产无乳，或大便涩滞，乃亡津液也，当滋化源。
一妇人右乳内结三核，年余不消，朝寒暮热，饮食不甘，此乳岩，以益气养荣汤，百余剂，
血气渐复，更以木香饼熨之，喜其谨疾，年余而消。
至英内年二十有五，素虚弱，多郁怒，时疫后，脾胃愈虚，饮食愈少，又值气忿，右乳胁下
红肿，膺内作痛，用炒麸皮熨之，肿虽少散，内痛益甚，转侧胸中，如物悬坠，遂与加减四
物汤，内肿如鹅卵，外大如盘，胸胁背心相引而痛，夜热势甚，时治者皆以攻毒为言，叩诸
先生，乃云∶此病后脾弱，而复怒伤肝，治法惟主于健脾气，平肝火，则肿自消，而病自愈
矣。承惠方以八物加陈皮、黄 、柴胡、山栀、白芷，服八剂，病减六七，去白芷加青皮、
木香、桔梗，又六剂而痊愈。奏功之奇，获效之速，盖出于寻常万万也。感激浓恩，昕夕不
忘，录此乞附医案，以诏后之患者，毋为攻毒者之所惑也。晚生尤至英顿首再拜书。
一妇人乳内结核年余，晡热少食，余欲用益气养荣汤治之，彼以为缓，乃服行气之剂，其势
愈甚，溃而日出清脓而殁。
郭氏外家，乃放出宫女，乳内结一核如栗，亦服流气等药，大如覆碗，坚硬如石，出水而殁。
【原文】
妇人乳痈，属胆胃二腑热毒，气血壅滞。故初起肿痛，发于肌表，肉色赤，其人表热发热，或发寒热，或憎寒头痛，烦渴引冷，用人参败毒散、神效栝蒌散、加味逍遥散治之，其自消散。若至数日之间，脓成溃窍，稠脓涌出，脓尽自愈。若气血虚弱，或误用败毒，久不收敛，脓清脉大，则难治。
【白话翻译】
妇女的乳痈（乳房急性化脓性疾病），属于胆腑和胃腑的热毒蕴结，导致气血运行受阻、郁滞不通。因此，疾病初期会出现肿胀疼痛，病变部位在皮肤肌肉表面，局部皮肤发红，患者伴有体表发热，或者出现忽冷忽热的症状，或者怕冷并伴有头痛，心中烦躁且口渴想喝冷水。治疗时可使用人参败毒散（含人参的解毒发散方剂）、神效栝蒌散（以瓜蒌为主药的神奇效验方剂）或加味逍遥散（在逍遥散基础上加减的方剂）进行治疗，病情多能自行消散。如果经过几天时间，脓液形成并破溃流出，浓稠的脓液涌出，待脓液排尽后，伤口便会自然愈合。如果患者气血虚弱，或者错误地使用了过于苦寒败毒的药物，导致伤口长久不能愈合收敛，且脓液稀薄、脉象洪大，这就难以治疗了。
【原文】
乳岩属肝脾二脏郁怒，气血亏损，故初起小核，结于乳内，肉色如故，其人内热夜热，五心发热，肢体倦瘦，月经不调，用加味归脾汤、加味逍遥散、神效瓜蒌散，多自消散。若荏苒日月渐大，HT 岩色赤，出水腐溃深洞，用前归脾汤等药，可延岁月，若误用攻伐，危殆迫矣。
【白话翻译】
乳岩（类似现代医学的乳腺癌）是由于肝脾两脏因长期抑郁或愤怒导致气机郁结，进而造成气血亏损。因此，疾病初期表现为乳房内部出现小结节，皮肤颜色正常无变化，患者感到体内发热、夜间发热，手心、脚心和心口（五心）发热，身体疲倦消瘦，月经周期紊乱。治疗时可使用加味归脾汤（补益心脾的方剂）、加味逍遥散或神效瓜蒌散，多数情况下结节可自行消散。如果拖延时日，结节逐渐增大，乳头及周围皮肤变红，渗出液体，腐烂溃烂形成深洞，此时继续使用上述归脾汤等药物，可以延缓病情发展；但如果错误地使用攻伐性强的药物，就会使病情陷入极度危险的境地。
【原文】
大凡乳症，若因恚怒，宜疏肝清热。痛寒热，宜发表散邪。肿痛甚，宜清肝消毒，并隔蒜灸。不作脓，或脓不溃，补气血为主。不收敛，或脓稀，补脾胃为主。脓出反痛，或发寒热，补气血为主。或晡热内热，补血为主。若饮食少思，或作呕吐，补胃为主。饮食难化，或作泄泻，补脾为主。劳碌肿痛，补气血为主。怒气肿痛，养肝血为主。儿口所吹，须吮通揉散。成痈，治以前法。潮热暮热，亦主前药。大抵男子多由房劳，耗伤肝肾。妇人郁怒，亏损肝脾。治者审之。（世以孕妇患此，名曰内吹。然其所致之因则一，惟用药不可犯其胎耳。）
【白话翻译】
大凡乳房疾病，如果是因愤怒引起的，应当采用疏肝理气、清泻肝火的方法。如果伴有恶寒发热的表证，应当采用发汗解表、驱散外邪的方法。如果肿胀疼痛严重，应当清肝解毒，并可配合隔蒜灸疗法。如果脓液未形成，或已形成但未破溃，治疗应以补益气血为主。如果伤口久不愈合收敛，或脓液稀薄，治疗应以补益脾胃为主。如果脓液排出后反而疼痛，或再次出现寒热症状，应以补益气血为主。如果出现傍晚发热或体内发热，应以补血为主。如果食欲不振，或发生呕吐，应以补胃为主。如果食物难以消化，或发生腹泻，应以补脾为主。如果因劳累导致肿痛，应以补益气血为主。如果因愤怒导致肿痛，应以滋养肝血为主。如果是婴儿呼吸热气熏蒸乳房导致的堵塞，必须通过吸吮和按摩来疏通消散。如果已经形成痈肿，按照上述方法治疗。如果有潮热或傍晚发热，也主要使用前面的方药。大体上而言，男性患此类疾病多由房事过度引起，耗伤了肝肾精气；女性患此类疾病多由情绪抑郁愤怒引起，亏损了肝脾功能。医生诊治时必须仔细辨别。（世间将孕妇患此病称为“内吹”。然而其致病原因本质上是一样的，只是在用药时不可伤害胎儿即可。）
【原文】
治验
一妇人内热胁胀，两乳不时作痛，口内不时辛辣，若卧而起急，则脐下牵痛，此带脉为患，用小柴胡加青皮、黄连、山栀二剂而瘥。
【白话翻译】
医案：一位妇女感到体内发热、胁肋部胀满，两侧乳房不时疼痛，口中不时感觉辛辣，如果躺下后突然起身，则会牵引脐下疼痛，这是带脉受病所致。服用加入青皮、黄连、山栀的小柴胡汤，两剂药后痊愈。
【原文】
一妇人因怒两乳肿，兼头痛寒热，用人参败毒散，二剂表症已退，用小柴胡加芎、归、枳壳
【白话翻译】
又一位妇女因愤怒导致双侧乳房肿胀，并伴有头痛和寒热症状。先服用人参败毒散，两剂后表证（恶寒发热等）已消退，随后改用加入川芎、当归、枳壳的小柴胡汤（注：原文此处似有缺漏，依文意续译）。
【原文】
一妇人久郁，右乳内肿硬，用八珍汤加远志、贝母、柴胡、青皮及隔蒜灸，兼服神效栝蒌散，两月余而消。
【白话翻译】
又一位妇女长期情绪抑郁，右侧乳房内部肿胀坚硬。使用八珍汤（补气养血方）加入远志、贝母、柴胡、青皮，并配合隔蒜灸疗法，同时服用神效栝蒌散，两个多月后肿块消散。
【原文】
一妇人左乳内肿如桃，不痛不赤，发热渐瘦，用八珍加香附、远志、青皮、柴胡百余剂，又兼服神效栝蒌散三十余剂，脓溃而愈。
【白话翻译】
又一位妇女左侧乳房内部肿胀如桃子大小，不痛也不发红，但伴有发热且身体逐渐消瘦。服用加入香附、远志、青皮、柴胡的八珍汤一百多剂，同时兼服神效栝蒌散三十多剂，最终脓液溃破排出后痊愈。
【原文】
一妇人郁久，左乳内结核如杏许，三月不消，心脉涩而脾脉大，按之无力，以八珍加贝母、远志、香附、柴胡、青皮、桔梗，五十余剂而溃，又三十余剂而愈。
【白话翻译】
又一位妇女长期抑郁，左侧乳房内部出现如杏子大小的结节，三个月未消散。诊察发现心脉涩滞，脾脉大而按之无力。使用八珍汤加入贝母、远志、香附、柴胡、青皮、桔梗，服用五十多剂后结节溃破，再服用三十多剂后痊愈。
【原文】
一妇人禀实性躁，怀抱久郁，左乳内结一核，按之微痛，以连翘饮子二十余剂少退，更以八珍加青皮、香附、桔梗、贝母，二十余剂而消。
【白话翻译】
又一位妇女体质壮实但性格急躁，长期怀抱抑郁，左侧乳房内部结成一个核块，按压时有轻微疼痛。先服用连翘饮子二十多剂，症状略有缓解；随后改用八珍汤加入青皮、香附、桔梗、贝母，再服用二十多剂后肿块消散。
【原文】
一妇人发热作渴，至夜尤甚，两乳忽肿，肝脉洪数，乃热入血室也，用加味小柴胡汤，热止肿消。
【白话翻译】
又一位妇女发热且口渴，到了夜晚症状尤为严重，双侧乳房突然肿胀。诊察发现肝脉洪大且快速，这是热邪进入血室（指子宫或冲任脉）的表现。使用加味小柴胡汤治疗，热退肿消。
【原文】
一妇人因怒，左乳作痛发热，表散太过，肿热益甚，用益气养荣汤，数剂热止脓成，不从用针，肿胀热渴，针脓大泄，仍以前汤，月余始愈。此症若脓成未破，有薄皮剥起者，用代针之剂，其脓自出。不若及时用针，不致大溃。若脓血未尽，辄用生肌，反助其邪。慎之!
【白话翻译】
又一位妇女因愤怒导致左侧乳房疼痛发热，此前医生发汗解表过度，导致肿胀和发热更加严重。使用益气养荣汤（补益气血、滋养营卫的方剂），几剂药后热退并开始成脓。患者拒绝针刺排脓，导致肿胀、发热、口渴加剧。后来针刺排脓，大量脓液流出，但仍继续服用之前的益气养荣汤，一个月后才痊愈。这种病症如果脓液已成但未破溃，表皮有薄层隆起时，应使用代替针刺的药物（促溃药），让脓液自行排出。这不如及时针刺，以免导致大面积溃烂。如果脓血尚未排尽，就急于使用生肌敛疮的药物，反而会助长邪气。务必谨慎！
【原文】
一妇人因怒，左乳作痛，胸膈不利，以方脉流气饮加木香、青皮，四剂而安。
【白话翻译】
又一位妇女因愤怒导致左侧乳房疼痛，胸膈部位气机不畅。使用方脉流气饮加入木香、青皮，四剂药后病情安定。
【原文】
一妇人脓清肿硬，面黄食少，内热晡热，自汗盗汗，月经不行，此肝脾气血俱虚，用十全大补加远志、贝母及补中益气，各三十余剂，外用葱熨患处，诸症寻愈。
【白话翻译】
又一位妇女脓液清稀、乳房肿胀坚硬，面色萎黄、食欲减退，伴有体内发热和傍晚发热，自汗（白天不因活动而出汗）和盗汗（夜间睡眠中出汗），月经停止。这是肝脾气血俱虚的表现。使用十全大补汤（大补气血方）加入远志、贝母，以及补中益气汤（补中益气、升阳举陷方），各服用三十多剂，并在患处外用葱白熨烫，各种症状随即痊愈。
【原文】
一妇人脓成胀痛，余欲针之，不从，数日始针，出败脓三四碗许，虚症蜂起，几至危殆，用大补两月余而安。若元气虚弱，不作脓者，用益气养荣汤补之，脓成即针。若肿痛寒热，怠惰食少，或至夜热甚，用补中益气汤兼逍遥散，补之为善。
【白话翻译】
又一位妇女脓液形成导致胀痛，我打算为她针刺排脓，她不同意，过了几天才同意针刺，结果排出败脓约三四碗，导致虚损症状蜂拥而至，几乎危及生命。随后使用大补气血的方法治疗两个多月才安稳。如果元气虚弱，无法化生脓液的，应使用益气养荣汤进行补益，一旦脓液形成立即针刺。如果出现肿胀疼痛、寒热往来、精神倦怠、食欲减少，或者到夜晚发热严重，应使用补中益气汤兼服逍遥散，以补益为主才是良策。
【原文】
一产妇因乳少，服药通之，致乳房肿胀，发热作渴，以玉露散补之而愈。夫乳汁乃气血所化，在上为乳，在下为经，若冲任之脉盛，脾胃之气壮，则乳汁多而浓，衰则淡而少，所乳之子，亦弱而多病。又有屡产无乳，或大便涩滞，乃亡津液也，当滋化源。
【白话翻译】
又一位产妇因为乳汁稀少，服用通乳药物，导致乳房肿胀、发热口渴。使用玉露散（滋阴清热方）进行补益治疗后痊愈。乳汁是由气血化生而成的，在上方化为乳汁，在下方化为月经。如果冲脉和任脉充盛，脾胃之气强壮，那么乳汁就多且浓稠；如果衰退，乳汁就清淡且量少，所哺育的孩子也会体弱多病。还有多次分娩后无乳汁，或者大便干结难解的，这是因为津液耗竭，应当滋养生化的源头（即补益脾胃肾精）。
【原文】
一妇人右乳内结三核，年余不消，朝寒暮热，饮食不甘，此乳岩，以益气养荣汤，百余剂，血气渐复，更以木香饼熨之，喜其谨疾，年余而消。
【白话翻译】
又一位妇女右侧乳房内部结有三个核块，一年多未消散，早晨怕冷、傍晚发热，饮食无味，这是乳岩病。使用益气养荣汤服用一百多剂，气血逐渐恢复，再用木香饼热敷患处，庆幸患者能够谨慎调养，一年多的时间后肿块消散。
【原文】
至英内年二十有五，素虚弱，多郁怒，时疫后，脾胃愈虚，饮食愈少，又值气忿，右乳胁下红肿，膺内作痛，用炒麸皮熨之，肿虽少散，内痛益甚，转侧胸中，如物悬坠，遂与加减四物汤，内肿如鹅卵，外大如盘，胸胁背心相引而痛，夜热势甚，时治者皆以攻毒为言，叩诸先生，乃云∶此病后脾弱，而复怒伤肝，治法惟主于健脾气，平肝火，则肿自消，而病自愈矣。承惠方以八物加陈皮、黄 、柴胡、山栀、白芷，服八剂，病减六七，去白芷加青皮、木香、桔梗，又六剂而痊愈。奏功之奇，获效之速，盖出于寻常万万也。感激浓恩，昕夕不忘，录此乞附医案，以诏后之患者，毋为攻毒者之所惑也。晚生尤至英顿首再拜书。
【白话翻译】
尤至英内年仅二十五岁，平时体质虚弱，经常抑郁愤怒。在经历时疫（流行病）之后，脾胃更加虚弱，饮食更少，恰逢生气愤怒，导致右侧乳房及胁下红肿，胸部内部疼痛。起初用炒过的麦麸皮热敷，肿胀虽然稍微消散，但内部疼痛更加严重，转身时感觉胸中有物体悬垂下坠。于是给予加减四物汤（调和营血的方剂），此时内部肿胀如鹅卵，外部大如盘子，胸部、胁肋和背部相互牵引疼痛，夜间发热势头很猛。当时的医生都主张用攻毒的方法治疗。请教各位先生后，他们说：这是大病后脾气虚弱，又因愤怒损伤肝脏，治疗方法只在于健脾益气、平抑肝火，这样肿胀自然会消退，疾病也会自愈。承蒙赐予方药，使用八物汤（八珍汤去茯苓？或指基础补血方，此处依原文保留“八物”）加入陈皮、黄芪、柴胡、山栀、白芷，服用八剂后，病情减轻六七成，去掉白芷，加入青皮、木香、桔梗，又服用六剂后痊愈。疗效之神奇，见效之迅速，大概是平常方法的万万倍。感激深厚的恩情，早晚不敢忘记，记录此事请求附在医案中，以此告诫后来的患者，不要被那些主张攻毒的医生所迷惑。晚辈尤至英恭敬叩首再拜上书。
【原文】
一妇人乳内结核年余，晡热少食，余欲用益气养荣汤治之，彼以为缓，乃服行气之剂，其势愈甚，溃而日出清脓而殁。
【白话翻译】
又一位妇女乳房内部结节一年多未消，伴有傍晚发热和食欲减退。我打算用益气养荣汤治疗，她认为药效太慢，于是服用了行气破气的药物，导致病情越来越严重，最终溃烂，每天流出清稀脓液而死。
【原文】
郭氏外家，乃放出宫女，乳内结一核如栗，亦服流气等药，大如覆碗，坚硬如石，出水而殁。
【白话翻译】
郭家的岳母，是一位被放出的宫女，乳房内部结有一个如栗子大小的核块，也服用了流气等行气药物，导致肿块变得像倒扣的碗一样大，坚硬如石头，渗出液体后死亡。
[Original Text]
妇人乳痈，属胆胃二腑热毒，气血壅滞。故初起肿痛，发于肌表，肉色赤，其人表热发热，或发寒热，或憎寒头痛，烦渴引冷，用人参败毒散、神效栝蒌散、加味逍遥散治之，其自消散。若至数日之间，脓成溃窍，稠脓涌出，脓尽自愈。若气血虚弱，或误用败毒，久不收敛，脓清脉大，则难治。
[English Translation]
Mastitis (acute suppurative disease of the breast) in women is attributed to heat-toxin accumulation in the Gallbladder and Stomach fu-organs, leading to stagnation and obstruction of Qi and Blood. Consequently, at the onset, there is swelling and pain on the surface of the skin and muscle, with redness of the local tissue. The patient may exhibit exterior fever, alternating chills and fever, aversion to cold accompanied by headache, restlessness, thirst, and a desire for cold drinks. Treatment with Renshen Baidu San (Ginseng Detoxification Decoction), Shenxiao Gualou San (Miraculous Efficacy Trichosanthes Powder), or Jiawei Xiaoyao San (Modified Free Wanderer Powder) often leads to spontaneous resolution. If, after several days, pus forms and ruptures through the skin, with thick pus gushing out, the wound will heal naturally once the pus is exhausted. However, if the patient has deficient Qi and Blood, or if toxic-clearing drugs were mistakenly used, causing the wound to fail to heal for a long time, with thin pus and a large pulse, the condition becomes difficult to treat.
[Original Text]
乳岩属肝脾二脏郁怒，气血亏损，故初起小核，结于乳内，肉色如故，其人内热夜热，五心发热，肢体倦瘦，月经不调，用加味归脾汤、加味逍遥散、神效瓜蒌散，多自消散。若荏苒日月渐大，HT 岩色赤，出水腐溃深洞，用前归脾汤等药，可延岁月，若误用攻伐，危殆迫矣。
[English Translation]
Breast cancer (Ru Yan) is caused by depression and anger affecting the Liver and Spleen zang-organs, resulting in deficiency and loss of Qi and Blood. Initially, it presents as a small nodule within the breast, with normal skin color. The patient experiences internal heat, night fevers, heat in the five centers (palms, soles, and chest), physical fatigue and emaciation, and irregular menstruation. Treatment with Jiawei Guipi Tang (Modified Heart-Spleen Tonifying Decoction), Jiawei Xiaoyao San, or Shenxiao Gualou San often results in spontaneous resolution. If neglected over time, the nodule gradually enlarges, the nipple and surrounding area become red, discharge fluid, and rot into deep ulcers. Using the aforementioned Guipi Tang and similar formulas can prolong life; however, mistaken use of attacking/draining methods would lead to imminent danger.
[Original Text]
大凡乳症，若因恚怒，宜疏肝清热。痛寒热，宜发表散邪。肿痛甚，宜清肝消毒，并隔蒜灸。不作脓，或脓不溃，补气血为主。不收敛，或脓稀，补脾胃为主。脓出反痛，或发寒热，补气血为主。或晡热内热，补血为主。若饮食少思，或作呕吐，补胃为主。饮食难化，或作泄泻，补脾为主。劳碌肿痛，补气血为主。怒气肿痛，养肝血为主。儿口所吹，须吮通揉散。成痈，治以前法。潮热暮热，亦主前药。大抵男子多由房劳，耗伤肝肾。妇人郁怒，亏损肝脾。治者审之。（世以孕妇患此，名曰内吹。然其所致之因则一，惟用药不可犯其胎耳。）
[English Translation]
Generally, for breast conditions: if caused by anger, soothe the Liver and clear heat; if accompanied by chills and fever, release the exterior and disperse pathogens; if swelling and pain are severe, clear the Liver and detoxify, combined with Garlic-Separated Moxibustion; if pus does not form or fails to rupture, tonify Qi and Blood primarily; if the wound fails to close or pus is thin, tonify the Spleen and Stomach primarily; if pain recurs after pus drainage or chills/fever return, tonify Qi and Blood primarily; if evening fevers or internal heat occur, nourish Blood primarily; if appetite is poor or vomiting occurs, tonify the Stomach primarily; if food is hard to digest or diarrhea occurs, tonify the Spleen primarily; if swelling/pain results from overwork, tonify Qi and Blood primarily; if swelling/pain results from anger, nourish Liver Blood primarily. For blockage caused by an infant's breath, suction and massage are required to unblock and dissipate. If an abscess forms, treat according to the above methods. For tidal or evening fevers, the aforementioned formulas are also primary. Generally, men suffer from this due to sexual excess damaging the Liver and Kidney; women suffer from it due to emotional depression and anger damaging the Liver and Spleen. Physicians must examine carefully. (In ancient times, when pregnant women suffered from this, it was called "Internal Blowing." However, the etiology is the same; only the medication must avoid harming the fetus.)
[Original Text]
治验
一妇人内热胁胀，两乳不时作痛，口内不时辛辣，若卧而起急，则脐下牵痛，此带脉为患，用小柴胡加青皮、黄连、山栀二剂而瘥。
[English Translation]
Clinical Case 1: A woman experienced internal heat, hypochondriac distension, intermittent pain in both breasts, and occasional spiciness in the mouth. Upon rising quickly from lying down, she felt traction pain below the umbilicus. This was diagnosed as a disorder of the Dai Mai (Girdle Vessel). She was treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Qingpi (Green Tangerine Peel), Huanglian (Coptis Rhizome), and Shanzhi (Gardenia Fruit) for two doses, resulting in recovery.
[Original Text]
一妇人因怒两乳肿，兼头痛寒热，用人参败毒散，二剂表症已退，用小柴胡加芎、归、枳壳
[English Translation]
Case 2: A woman developed bilateral breast swelling due to anger, accompanied by headache and chills/fever. She was given Renshen Baidu San, which resolved the exterior symptoms after two doses. Subsequently, Xiao Chai Hu Tang was modified with Xiong (Ligusticum Rhizome), Gui (Angelica Sinensis), and Zhike (Aurantii Fructus)... [Text incomplete in source].
[Original Text]
一妇人久郁，右乳内肿硬，用八珍汤加远志、贝母、柴胡、青皮及隔蒜灸，兼服神效栝蒌散，两月余而消。
[English Translation]
Case 3: A woman with long-term emotional depression had a swollen and hard mass in her right breast. She was treated with Bazhen Tang (Eight Treasures Decoction) added with Yuanzhi (Polygalae Radix), Beimu (Fritillariae Bulbus), Chaihu (Bupleuri Radix), and Qingpi, along with Garlic-Separated Moxibustion, and concurrently took Shenxiao Gualou San. The mass dissipated after more than two months.
[Original Text]
一妇人左乳内肿如桃，不痛不赤，发热渐瘦，用八珍加香附、远志、青皮、柴胡百余剂，又兼服神效栝蒌散三十余剂，脓溃而愈。
[English Translation]
Case 4: A woman had a peach-sized swelling in her left breast, without pain or redness, but with fever and gradual emaciation. She took over one hundred doses of Bazhen Tang added with Xiangfu (Cyperi Rhizoma), Yuanzhi, Qingpi, and Chaihu, and concurrently took more than thirty doses of Shenxiao Gualou San. The abscess ruptured, and she recovered.
[Original Text]
一妇人郁久，左乳内结核如杏许，三月不消，心脉涩而脾脉大，按之无力，以八珍加贝母、远志、香附、柴胡、青皮、桔梗，五十余剂而溃，又三十余剂而愈。
[English Translation]
Case 5: A woman with chronic depression had an apricot-sized nodule in her left breast that did not resolve for three months. Her Heart pulse was choppy, and her Spleen pulse was large but weak upon pressure. She was treated with Bazhen Tang added with Beimu, Yuanzhi, Xiangfu, Chaihu, Qingpi, and Jiegeng (Platycodonis Radix). After fifty-plus doses, the nodule ulcerated; after another thirty-plus doses, she recovered.
[Original Text]
一妇人禀实性躁，怀抱久郁，左乳内结一核，按之微痛，以连翘饮子二十余剂少退，更以八珍加青皮、香附、桔梗、贝母，二十余剂而消。
[English Translation]
Case 6: A woman with a robust constitution but irritable temperament, suffering from long-term emotional depression, had a nodule in her left breast that was slightly painful upon pressure. She took Lianqiao Yinzi (Forsythia Decoction) for twenty-plus doses, showing slight improvement. Then, she took Bazhen Tang added with Qingpi, Xiangfu, Jiegeng, and Beimu for twenty-plus doses, resulting in the disappearance of the nodule.
[Original Text]
一妇人发热作渴，至夜尤甚，两乳忽肿，肝脉洪数，乃热入血室也，用加味小柴胡汤，热止肿消。
[English Translation]
Case 7: A woman experienced fever and thirst, worsening at night, with sudden bilateral breast swelling. Her Liver pulse was surging and rapid, indicating Heat entering the Blood Chamber (Chong and Ren vessels). She was treated with Jiawei Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction), which stopped the fever and reduced the swelling.
[Original Text]
一妇人因怒，左乳作痛发热，表散太过，肿热益甚，用益气养荣汤，数剂热止脓成，不从用针，肿胀热渴，针脓大泄，仍以前汤，月余始愈。此症若脓成未破，有薄皮剥起者，用代针之剂，其脓自出。不若及时用针，不致大溃。若脓血未尽，辄用生肌，反助其邪。慎之!
[English Translation]
Case 8: A woman developed pain and fever in her left breast due to anger. Previous excessive diaphoresis worsened the swelling and heat. She was treated with Yiqi Yangrong Tang (Qi-Tonifying and Nourishing Decoction). After several doses, the fever subsided and pus formed. Refusing needle drainage, her swelling, heat, and thirst increased. After needle drainage released large amounts of pus, she continued with the previous decoction and recovered after a month. Note: If pus is formed but not ruptured, with thin skin peeling up, use promulgatory agents to allow natural drainage rather than immediate needling to prevent extensive ulceration. If pus and blood are not fully drained, using flesh-regenerating agents prematurely aids the pathogen. Exercise caution!
[Original Text]
一妇人因怒，左乳作痛，胸膈不利，以方脉流气饮加木香、青皮，四剂而安。
[English Translation]
Case 9: A woman experienced left breast pain and chest/diaphragm discomfort due to anger. She was treated with Fangmai Liqi Yin (Pulse-Regulating Qi-Flowing Drink) added with Muxiang (Aucklandiae Radix) and Qingpi, resulting in relief after four doses.
[Original Text]
一妇人脓清肿硬，面黄食少，内热晡热，自汗盗汗，月经不行，此肝脾气血俱虚，用十全大补加远志、贝母及补中益气，各三十余剂，外用葱熨患处，诸症寻愈。
[English Translation]
Case 10: A woman presented with thin pus, hard swelling, sallow complexion, poor appetite, internal heat, evening fevers, spontaneous sweating, nocturnal sweating, and amenorrhea. This indicated deficiency of both Qi and Blood in the Liver and Spleen. She was treated with Shiquan Dabu Tang (Complete Great Tonifying Decoction) added with Yuanzhi and Beimu, and Buzhong Yiqi Tang (Middle-Boosting Qi-Invigorating Decoction), each for thirty-plus doses. External application of scallion moxibustion/warming was used on the affected area. All symptoms subsequently resolved.
[Original Text]
一妇人脓成胀痛，余欲针之，不从，数日始针，出败脓三四碗许，虚症蜂起，几至危殆，用大补两月余而安。若元气虚弱，不作脓者，用益气养荣汤补之，脓成即针。若肿痛寒热，怠惰食少，或至夜热甚，用补中益气汤兼逍遥散，补之为善。
[English Translation]
Case 11: A woman had painful swelling due to formed pus. I proposed needle drainage, but she refused. Days later, drainage yielded three to four bowls of foul pus, causing acute deficiency symptoms and near-critical condition. She was treated with major tonification for over two months to stabilize. If Yuan Qi is weak and pus fails to form, use Yiqi Yangrong Tang to tonify; drain immediately once pus forms. If there is swelling, pain, chills/fever, lethargy, poor appetite, or severe night fever, use Buzhong Yiqi Tang combined with Xiaoyao San, prioritizing tonification.
[Original Text]
一产妇因乳少，服药通之，致乳房肿胀，发热作渴，以玉露散补之而愈。夫乳汁乃气血所化，在上为乳，在下为经，若冲任之脉盛，脾胃之气壮，则乳汁多而浓，衰则淡而少，所乳之子，亦弱而多病。又有屡产无乳，或大便涩滞，乃亡津液也，当滋化源。
[English Translation]
Case 12: A postpartum woman took galactagogues for low milk supply, resulting in breast swelling, fever, and thirst. She was treated with Yulu San (Jade Dew Powder) for tonification and recovered. Milk is transformed from Qi and Blood; above it becomes milk, below it becomes menses. If the Chong and Ren vessels are vigorous and Spleen/Stomach Qi is strong, milk is abundant and rich; if weak, it is scant and thin, affecting the child's health. Women with multiple births lacking milk or experiencing constipation have depleted Jin Ye (Body Fluids) and should nourish the source of transformation (Spleen/Kidney).
[Original Text]
一妇人右乳内结三核，年余不消，朝寒暮热，饮食不甘，此乳岩，以益气养荣汤，百余剂，血气渐复，更以木香饼熨之，喜其谨疾，年余而消。
[English Translation]
Case 13: A woman had three nodules in her right breast persisting for over a year, with morning chills, evening fevers, and poor taste in food. Diagnosed as Breast Cancer, she took Yiqi Yangrong Tang for over one hundred doses, gradually restoring Qi and Blood. External application of Muxiang Bing (Costus Cake) was used. Due to her careful compliance, the nodules dissipated after over a year.
[Original Text]
至英内年二十有五，素虚弱，多郁怒，时疫后，脾胃愈虚，饮食愈少，又值气忿，右乳胁下红肿，膺内作痛，用炒麸皮熨之，肿虽少散，内痛益甚，转侧胸中，如物悬坠，遂与加减四物汤，内肿如鹅卵，外大如盘，胸胁背心相引而痛，夜热势甚，时治者皆以攻毒为言，叩诸先生，乃云∶此病后脾弱，而复怒伤肝，治法惟主于健脾气，平肝火，则肿自消，而病自愈矣。承惠方以八物加陈皮、黄 、柴胡、山栀、白芷，服八剂，病减六七，去白芷加青皮、木香、桔梗，又六剂而痊愈。奏功之奇，获效之速，盖出于寻常万万也。感激浓恩，昕夕不忘，录此乞附医案，以诏后之患者，毋为攻毒者之所惑也。晚生尤至英顿首再拜书。
[English Translation]
Letter from You Zhiying: I am twenty-five years old, constitutionally weak, prone to depression and anger. After an epidemic, my Spleen and Stomach became weaker, and food intake decreased. Anger triggered redness and swelling under the right breast and pain in the chest. Initial external warming with bran provided little relief and worsened internal pain, feeling like a hanging weight in the chest. I was prescribed Jiajia Siwu Tang (Modified Four Substances Decoction). The swelling grew to the size of a goose egg internally and a plate externally, radiating pain to the back, with severe night fever. Local doctors advocated toxic-clearing attacks. Consulting senior physicians, they advised: Post-illness Spleen weakness compounded by Liver damage from anger requires strengthening Spleen Qi and calming Liver Fire. Swelling will subside, and the disease will heal. I received a prescription of Bayi Tang (Eight Items Decoction) added with Chenpi, Huangqi, Chaihu, Shanzhi, and Baizhi. After eight doses, symptoms improved by 60-70%. Baizhi was removed, and Qingpi, Muxiang, and Jiegeng were added. After six more doses, I recovered. The efficacy was miraculous, far surpassing ordinary treatments. I deeply appreciate this grace and record this case to warn future patients against being misled by toxic-clearing approaches. Your humble servant, You Zhiying, bows respectfully.
[Original Text]
一妇人乳内结核年余，晡热少食，余欲用益气养荣汤治之，彼以为缓，乃服行气之剂，其势愈甚，溃而日出清脓而殁。
[English Translation]
Case 14: A woman had a breast nodule for over a year, with evening fevers and poor appetite. I recommended Yiqi Yangrong Tang, but she considered it too slow and took Qi-moving agents instead. Her condition worsened, leading to ulceration with daily discharge of thin pus, resulting in death.
[Original Text]
郭氏外家，乃放出宫女，乳内结一核如栗，亦服流气等药，大如覆碗，坚硬如石，出水而殁。
[English Translation]
Case 15: The mother-in-law of the Guo family, a former palace maid, had a chestnut-sized nodule in her breast. She also took Liqi-type medicines. The mass grew to the size of an inverted bowl, became stone-hard, discharged fluid, and resulted in death.