薛立斋曰∶大凡乳证，若恚怒，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；若成痈，治以前法。若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，五心发热，肢体倦瘦，月经不调，加味归脾汤、加味逍遥散、神效栝萎散，多服
自消。若迁延日久渐大，岩色赤，出水，腐溃深洞，用前归脾汤等药可延岁月。若误攻伐，则危殆矣。
慎斋按∶以上一条，序治乳痈乳岩之大法也。世医治乳痈乳岩，不过寒凉清火，破气消瘀。岂知病之成也，
原于肝胃亏损，荣卫不能营运所致。唯立斋 于扶持脾胃，补气养血为主，戒人不可诛伐太过，以致夭枉，
垂训之意深矣。
陈良甫曰∶妇人阴肿，是虚损受风邪所为。胞络虚而风邪客之，风气乘于阴，与血气相搏，令气痞塞，腠
理壅闭不泄越，故令
肿。
徐春甫曰∶阴肿有因房劳过度，伤损阴户致肿，宜节欲调治。有欲胜而热甚生虫，以致肿痒甚者，皆宜戒
房室，速治之。有邪气渐盛，致阴户溃烂不收，失于早治也。
薛立斋按∶前证若气血虚弱，补中汤举而补之；肝经湿热，龙胆泻肝汤渗而清之。又有肝脾郁怒，元气下
陷，湿热壅滞，朝用归脾汤加升、柴，解郁结，补脾气，夕用加味逍遥散，清肝火，生肝血，除湿热。
慎斋按∶以上二条，序妇人阴户肿，有风邪之外感，有房劳之内伤也。阴肿病，《大全》主于风邪入客，
春甫主于劳伤房事，立斋推原于肝经湿热所致，此为病机之要。
薛立斋说：大凡乳房疾病，如果因愤怒引起，应当疏肝清热；如果伴有恶寒发热，应当发表散邪；如果肿胀疼痛严重，应当清肝解毒，并配合隔蒜灸法；如果不化脓，或者脓液不溃破，以补益气血为主；如果疮口不收敛，或者脓液稀薄，以补益脾胃为主；如果脓液排出后反而疼痛，或者出现寒热症状，以补益气血为主；如果午后或夜间内热，以补血为主；如果饮食减少、食欲不振，或者发生呕吐，以补益胃气为主；如果食物难以消化，或者发生泄泻，以补益脾气为主；如果因劳累导致肿痛，以补益气血为主；如果因怒气导致肿痛，以滋养肝血为主；如果是婴儿口气吹入所致，必须吮吸通畅并按揉消散；如果形成痈肿，按照上述方法治疗。如果乳岩属于肝脾两脏因郁怒导致的病症，伴有气血亏损。所以初期在乳房内部结出小核，皮肤颜色正常，五心烦热，肢体疲倦消瘦，月经不调，服用加味归脾汤、加味逍遥散、神效栝萎散，多服自然消散。如果拖延日久逐渐变大，岩色发红，流出液体，腐烂溃烂成深洞，使用前述归脾汤等药物可以延长寿命。如果误用攻伐之法，就会危及生命。
慎斋按语：以上一条，叙述了治疗乳痈和乳岩的大法。世间的医生治疗乳痈和乳岩，不过是用寒凉药清火，用破气药消瘀。哪里知道疾病的成因，原本是由于肝胃亏损，营卫之气不能正常运行所致。只有薛立斋主张扶持脾胃，以补气养血为主，告诫人们不可过度攻伐，以致造成夭折枉死，其垂训的意旨非常深远。
陈良甫说：妇人阴部肿胀，是虚损受风邪所致。胞络虚弱而风邪客居其中，风气侵袭阴部，与血气相互搏结，导致气机痞塞，腠理壅闭不通，所以导致肿胀。
徐春甫说：阴肿有因房劳过度，损伤阴户导致肿胀的，应当节制欲望并调理治疗。有因性欲过盛而生热生虫，导致肿胀瘙痒严重的，都应当戒除房事，迅速治疗。有因邪气逐渐旺盛，导致阴户溃烂无法愈合，是因为未能早期治疗。
薛立斋按语：前证如果气血虚弱，用补中益气汤提升并补益；如果肝经湿热，用龙胆泻肝汤渗利并清泻。又有因肝脾郁怒，元气下陷，湿热壅滞的，早晨服用加味归脾汤加升麻、柴胡，解郁结，补脾气，晚上服用加味逍遥散，清肝火，生肝血，除湿热。
慎斋按语：以上两条，叙述了妇人阴户肿胀，有风邪外感和房劳内伤两种情况。关于阴肿病，《大全》主张是风邪入侵，春甫主张是房事劳伤，立斋推究根源认为是肝经湿热所致，这是把握病机的关键。
Xue Lizhai stated: Generally speaking, for breast diseases, if caused by anger, one should soothe the liver and clear heat; if accompanied by aversion to cold and fever, one should release the exterior and disperse pathogens; if swelling and pain are severe, one should clear the liver and detoxify, combined with garlic-separated moxibustion; if pus does not form or fails to rupture, tonifying qi and blood is primary; if the sore does not close or the pus is thin, tonifying the spleen and stomach is primary; if pain recurs after pus discharge or fever occurs, tonifying qi and blood is primary; if there is afternoon or night-time internal heat, nourishing blood is primary; if appetite is poor or vomiting occurs, tonifying the stomach is primary; if food is difficult to digest or diarrhea occurs, tonifying the spleen is primary; if swelling and pain result from overwork, tonifying qi and blood is primary; if swelling and pain result from anger, nourishing liver blood is primary; if caused by a baby's breath, it must be sucked open and massaged to dissipate; if an abscess forms, treat according to the aforementioned methods. If ru yan (breast cancer) belongs to depression and anger of the liver and spleen with qi and blood deficiency, initially small nodules form within the breast, skin color remains normal, five-center heat occurs, limbs become weak and emaciated, and menstruation is irregular. Taking Jiawei Guipi Tang (Modified Spleen-Tonifying Decoction), Jiawei Xiaoyao San (Modified Free Wanderer Powder), or Shen'eogua Lou San (Miraculous Trichosanthes Powder) in large amounts will naturally resolve them. If neglected for a long time and gradually enlarging, the lesion becomes red, exudes fluid, and ulcerates into deep cavities; using the aforementioned Guipi Tang etc. can prolong life. If mistakenly treated with purgatives/attacking methods, it becomes critical.
Shen Zhai commented: The above passage outlines the general principles for treating ru yong (breast abscess) and ru yan (breast cancer). Physicians of the world treat these conditions merely with cold-cooling herbs to clear fire and qi-breaking herbs to eliminate stasis. They do not realize that the origin of the disease lies in the deficiency of the liver and stomach, causing Ying and Wei (nutritive and defensive qi) to fail to circulate properly. Only Xue Lizhai advocated supporting the spleen and stomach, focusing on tonifying qi and blood, warning against excessive attacking methods that lead to premature death. His intent in leaving this instruction was profound.
Chen Liangfu stated: Female vulvar swelling is caused by deficiency damage and wind-pathogen invasion. When the Bao Luo (uterine collaterals) are deficient, wind pathogens lodge therein. Wind Qi attacks the yin region, combats with blood and qi, causing qi stagnation and obstruction. The pores become blocked and unable to vent, thus causing swelling.
Xu Chunfu stated: Vulvar swelling may result from excessive sexual exertion damaging the vaginal opening, requiring abstinence and regulation. It may also result from excessive desire generating intense heat and parasites, leading to severe swelling and itching; in all such cases, sexual abstinence and prompt treatment are required. If pathogens gradually intensify, causing vaginal ulceration and failure to heal, it is due to lack of early treatment.
Xue Lizhai commented: For the aforementioned conditions, if qi and blood are weak, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to raise and tonify; if damp-heat in the liver channel, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction) to drain and clear. In cases of liver-spleen depression and anger with sinking yuan qi and damp-heat stagnation, administer Guipi Tang plus Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) in the morning to resolve stagnation and tonify spleen qi, and Jiawei Xiaoyao San in the evening to clear liver fire, generate liver blood, and remove damp-heat.
Shen Zhai commented: The above two passages outline female vulvar swelling, distinguishing between external wind-pathogen invasion and internal injury from sexual fatigue. Regarding vulvar swelling, Daquan attributed it to wind-pathogen invasion, Chunfu attributed it to sexual fatigue, and Lizhai traced the root to damp-heat in the liver channel. This represents the key to understanding the pathogenesis.