（瘰 结核 流注 乳痈乳岩 阴疮）
金匮云。少阴脉滑而数者。阴中生疮。阴中蚀疮烂者。野狼牙汤洗之。
少阴脉滑而数。热结下部也。治用野狼牙煮汤。缠箸如茧。浸汤沥阴中。日四遍。以解毒杀虫。
但用一味。以取专功。盖此证多患于嫠寡。证必咳逆经闭。骨蒸寒热。凡见颊赤。中有白斑。下
唇红中白点。皆阴蚀之候。虽用上法。及服降火滋阴药。终归必亡。此情志之病。非药可治。故
仲景但用外法。绝不及于汤药。厥有旨哉。
胃气下泄。阴吹而正喧。此谷气之实也。猪膏发煎导之。
导之者。服之使病从小便而出。非外用导引之谓。详阴吹正喧。妇人恒有之疾。然多隐忍不
言。以故方书不载。医不加察。金匮明言胃气不清。谷气之实。所以腹中喧响。则气从前阴吹出。
如失气之状。第用猪膏发煎之治。难于推测。余治一仆人之妇。经闭三月。少腹痛贯彻心。而见
前证不已。与失笑散一服。瘀血大下。遂不复作。又治一贵显之媳。小产后寒热腹痛。亦有前证。
与炮黑楂肉、熬焦黑糖为丸。用伏龙肝煮水澄清。煎独参汤送三钱。一服结粪大下。再进瘀血续
行。而前证顿止。始悟猪膏发煎。皆为逐瘀而设。虽皆未用其方。而实不离金匮之法也。
瘰 妇人瘰 。多因忧思郁怒。伤损肝脾。累累然如贯珠。多生于耳之前后。项侧胸胁间。
若寒热肿痛。乃肝经气郁而为病。不可峻用痰药。加味逍遥散。若寒热既止而核不消。乃肝经之
血亦病。四物汤加白术、茯苓、柴胡、丹皮。若饮食减少。经事不调。为脾胃亏损。六君子加香
附、丹皮、柴胡、当归。若初生如豆粒。附着于筋肉。色不变。而后渐大肿痛。内热口干。精神
倦怠。久不消溃。乃肝脾亏损。逍遥散、归脾汤。健脾土。培肝木。切不可轻用散坚追毒之剂。
误下之。必犯病禁经禁。若久溃脉浮大。邪火盛也。面色皎白。金克木也。皆难治。凡风木之病。
但壮脾土。则木自不能克
矣。若行伐肝。则脾胃先伤。而木反来侮土矣。
结核 妇人结核。皆因郁怒亏损肝脾。触动肝火所致。非但妇人多郁患此。则小儿胎中受母
气之郁。生后至七八岁外。往往有之。多结于项侧耳前后。或发寒热。属胆经风热怒火。柴胡清
肝散加钩藤、山栀以清肝火。若结于肉里。其色不变。晡热内热。属肝火血虚。加味逍遥散。或
结于肢节。或累累如贯珠。其色不变。亦肝火血燥而筋挛急。小柴胡加钩藤。佐以六味丸。若时
消时作。此气滞而痰结也。用归脾、六君二汤以调和脾胃之气。外用一味香附末。唾调作饼艾灸。
干即易之。勿令伤肉。常灸自消。丹方治痰核。用贝母、全蝎、连皮胡桃肉各百枚。同捣蜜丸。
空心日服弹子大二三丸效。又方。用羯羊角瓷片刮下为末。或旧明角琉璃刮下为末尤良。每斤入
贝母四两。全蝎二两。蜜丸空腹服三钱。外用皂荚肉。入鲫鱼腹中 灰存性。蜜和醋调涂大效。
若溃而肉不腐。或肉不生。或脓水清稀。肌寒肉冷。自汗盗汗。寒热内热。面色痿黄。食少体倦。
便利不调者。五脏皆虚也。但用补中、六君、益气养营等汤。调补脾胃。则各证自退。故经云。
气伤痛。形伤肿。慎不可轻用行气破血之剂。
流注 妇人流注。多因忧思郁怒。亏损肝脾。以致营气不从。逆于肉里。或因腠理不密。外
邪客之。或湿痰流注。或跌扑血滞。或产后恶露凝积。盖气流而注。血注而凝。或生于四肢关节。
或留于胸腹腰臀。或结块。或漫肿。皆属郁火。急用葱熨法。内服益气养营汤。未成自消。已成
自溃。须久服无间。自然收功。若久而肿起作痛。肢体倦怠。病气有余。形气不足。尚可调治。
若漫肿微痛。属形气病气俱不足。最为难治。或不作肿。或脓成不溃。气血虚也。人参养荣汤。憎
寒畏寒。阳气虚也。十全大补汤。晡热内热。阴血虚也。四物加参、术。作呕欲呕。胃气虚也。
六君子加炮姜。食少体倦。脾
气虚也。补中益气加茯苓、半夏。四肢逆冷。小便频数。命门火衰也。八味丸。小便频数。痰盛
作渴。肾水亏损也。六味丸加麦门冬。月经过期。多日不止。肝脾虚也。八珍加柴胡、丹皮。凡
溃而气血虚弱不敛者。十全大补煎膏服之。久溃而寒邪凝滞不敛者。豆豉饼祛散之。其溃而内有
脓管不敛者。用药腐化之。若不补气血。不节饮食。不慎起居。不戒七情。或用寒凉克伐。俱不治。
乳痈乳岩 妇人乳痈。有内吹外吹。上逆下顺之异。总属胆胃二经热毒。气血凝滞。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。烦渴引饮。加味逍遥散加
栝蒌霜。若至数日之间。脓成满窍。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。非大剂开郁理气。温补气血。不能收功。丹方治乳痈初起。用蒲公英草捣汁。和陈酒
服。以滓敷肿处即消。然此施于藜藿之人辄效。若膏粱七情内郁所致者。良非所宜。当用鹿角。
瓷锋刮屑。加麝香温酒调服。若肥盛多痰郁滞者。用橘皮摘碎如豆大。汤泡净。以飞罗面拌炒。
去面为末。黑糖调二钱。醇酒服之。又方。用蟹壳 存性。醇酒服三钱。又乳房 肿。用贝母、
栝蒌实、甘草节各三钱煎服效。已溃。加忍冬一两佳。乳岩属肝脾二脏久郁。气血亏损。故初起
小核结于乳内。肉色如故。其人内热夜热。五心烦热。肢体倦瘦。月经不调。益气养营汤、加味
逍遥散。多服渐散。气虚必大剂人参。专心久服。其核渐消。若服攻坚解毒。伤其正气。必致溃
败。多有数年不溃者最危。溃则不治。周季芝云。乳癖乳岩结硬未溃。以活鲫鱼同生山药捣烂。
入麝香少许。涂块上。觉痒极。勿搔动。隔衣轻轻揉之。七日一涂。旋涂渐消。若荏苒岁月。以
致溃腐。渐大类 岩。色赤出水。深洞臭秽。用归脾汤等药。可延岁月。若误用攻伐。危殆迫矣。
曾见一妇乳房结核如杯。数年诸治不效。因血崩后。日服人
参两许。月余参尽二斤。乳核霍然。
阴疮 妇人阴疮。乃七情郁火伤损肝脾。湿热下注。其外证。有阴中舒出如蛇。俗呼阴挺。
有翻突如饼。俗呼阴菌。亦有如鸡冠。如鼠乳。亦有生诸虫。肿病湿痒。溃烂出水。胀闷脱坠者。
其内证。口干内热体倦。经候不调。饮食无味。晡热发热。胸膈不利。胁腹不调。小腹痞胀。赤
白带下。小水淋沥。其治法。肿痛者。四物加柴胡、山栀、丹皮、胆草。湿痒者。归脾汤加山栀、
柴胡、丹皮。淋沥者。龙胆泻肝汤加白术、丹皮。溃腐者。加味逍遥散。肿闷脱坠者。补中益气
加山栀、丹皮。佐以外治之法可也。若阴中有虫痒痛。乃肝经湿热。此惟独阴无阳。郁火内蕴所
致。患此者。必骨蒸潮热。经水不调。干咳吐红。面赤声哑。虽日用开郁降火之药。多不能愈。
大抵五志之病。非药可医。而失合证治尤难。外治之法。以桃仁研膏和雄黄末、轻粉。涂猪肝纳
阴中。并用肥汤煎苦参洗涤。或以鲫鱼胆涂之。然旋治旋发。如菌蒂生虫。不腐不止。又有交接
时辄出血作痛。此肝伤而不能藏血。脾伤而不能摄血也。多用加味逍遥散加肉桂。或归脾汤下加
减八味丸自愈。
《金匮要略》记载：少阴脉滑而数，是阴中生疮。若阴部发生蚀疮溃烂，用野狼牙汤清洗。
少阴脉滑而数，说明热邪结聚在下部。治疗应用野狼牙煮汤，将药棉缠在筷子上如蚕茧大小，浸入药汤中沥干后冲洗阴道，每日四次，以解毒杀虫。
仅用这一味药，是为了取其专一的功效。大概这种病症多发生在寡妇身上，症状必定伴有咳嗽气逆、月经闭止、骨蒸潮热恶寒。凡是见到两颊发红，中间有白斑，下唇红中有白点，都是阴部蚀疮的征候。虽然采用上述外治法，以及服用降火滋阴的药物，最终仍难免死亡。这是情志所致的疾病，非药物所能治愈。所以张仲景只使用外治法，绝不涉及内服汤药，这确实是有深意的。
胃气向下泄漏，导致阴吹且声音喧闹，这是谷气实盛的表现。用猪膏发煎来引导排出。
所谓“导之”，是指服药后使病邪从小便排出，并非指外用的导引术。详细分析阴吹正喧，是妇女常有的疾病，但大多隐忍不言，因此医书不载，医生不加考察。《金匮要略》明确说是胃气不清，谷气实盛，所以腹中作响，气从前阴吹出，如同放屁的样子。只是用猪膏发煎治疗，难以推测其理。我曾治疗一个仆人的妻子，闭经三个月，小腹痛彻心，且出现前证不止，给予失笑散一服，瘀血大量排出，于是病症不再发作。又治疗一位显贵人家的儿媳，小产后寒热腹痛，也有前证，给予炮黑山楂肉、熬焦黑糖制成丸药，用伏龙肝煮水澄清，煎独参汤送服三钱，一服后结粪大量排出，再进服则瘀血继续下行，前证顿时停止。这才领悟到猪膏发煎，都是为了逐瘀而设。虽然都没有直接使用这个方子，但实际上并没有脱离《金匮要略》的法度。
瘰疬 妇女患瘰疬，多因忧思郁怒，损伤肝脾，结节累累如串珠，多生于耳前后、项侧胸胁间。
若有寒热肿痛，乃是肝经气郁所致，不可峻猛使用化痰药，可用加味逍遥散。若寒热已止而结节不消，乃是肝经之血亦受病，可用四物汤加白术、茯苓、柴胡、丹皮。若饮食减少，月经不调，为脾胃亏损，可用六君子汤加香附、丹皮、柴胡、当归。若初起如豆粒，附着于筋肉，颜色不变，而后逐渐肿大疼痛，伴有内热口干，精神倦怠，久不消散溃破，乃是肝脾亏损，可用逍遥散、归脾汤，健脾土，培补肝木。切不可轻率使用散坚追毒的药物，误用攻下，必犯病禁和经禁。若久溃后脉象浮大，是邪火旺盛；面色皎白，是金克木之象，都难治疗。凡风木之病，只要壮实脾土，则木自然不能克制脾土。若行伐肝之法，则脾胃先伤，而木反来侮土了。
结核 妇女患结核，皆因郁怒亏损肝脾，触动肝火所致。不仅妇人多有郁结患此病，小儿胎中受母气之郁，出生后到七八岁以外，往往也有此病。多结于项侧耳前后。
若发寒热，属胆经风热怒火，用柴胡清肝散加钩藤、山栀以清肝火。若结于肉里，颜色不变，午后发热内热，属肝火血虚，用加味逍遥散。或结于肢节，或累累如串珠，颜色不变，也是肝火血燥而筋挛急，用小柴胡汤加钩藤，佐以六味丸。若时消时作，这是气滞而痰结，用归脾汤、六君子汤二方调和脾胃之气。外用一味香附末，用唾液调成饼状艾灸，干了就换，不要伤及肌肉，常灸自能消散。丹方治疗痰核，用贝母、全蝎、连皮胡桃肉各百枚，同捣蜜丸，空腹日服弹子大二三丸有效。又一方法，用羯羊角瓷片刮下为末，或用旧明角琉璃刮下为末尤其好。每斤药入贝母四两，全蝎二两，蜜丸空腹服三钱。外用皂荚肉，放入鲫鱼腹中烧灰存性，蜜和醋调涂，大效。若溃破后肉不腐，或肉不生，或脓水清稀，肌寒肉冷，自汗盗汗，寒热内热，面色萎黄，食少体倦，大小便不调者，是五脏皆虚。只用补中益气汤、六君子汤、益气养营汤等，调补脾胃，则各证自退。所以经文说：气伤痛，形伤肿，切不可轻率使用行气破血的药剂。
流注 妇人流注，多因忧思郁怒，亏损肝脾，以致营气不从，逆于肉里。或因腠理不密，外邪客之，或湿痰流注，或跌扑血滞，或产后恶露凝积。盖气流而注，血注而凝。
或生于四肢关节，或留于胸腹腰臀，或结块，或漫肿，皆属郁火。急用葱熨法，内服益气养营汤，未成脓可自行消散，已成脓可自行溃破。须久服不间断，自然收功。若久而肿起作痛，肢体倦怠，病气有余，形气不足，尚可调治。若漫肿微痛，属形气病气俱不足，最为难治。或不作肿，或脓成不溃，是气血虚，用人参养荣汤。憎寒畏寒，是阳气虚，用十全大补汤。午后发热内热，是阴血虚，用四物汤加人参、白术。作呕欲呕，是胃气虚，用六君子汤加炮姜。食少体倦，是脾气虚，用补中益气汤加茯苓、半夏。四肢逆冷，小便频数，是命门火衰，用八味丸。小便频数，痰盛作渴，是肾水亏损，用六味丸加麦门冬。月经过期，多日不止，是肝脾虚，用八珍汤加柴胡、丹皮。凡溃后气血虚弱不收敛者，用十全大补煎膏服之。久溃而寒邪凝滞不收敛者，用豆豉饼祛散之。其溃而内有脓管不收敛者，用药腐化之。若不补气血，不节饮食，不慎起居，不戒七情，或用寒凉克伐，都不治。
乳痈、乳岩 妇人乳痈，有内吹外吹，上逆下顺的不同。总属胆胃二经热毒，气血凝滞，故初起肿痛，发于肌表，肌肉色赤，其人表热发热，或发寒热，或憎寒头痛，烦渴引饮，用加味逍遥散加栝蒌霜。若至数日之间，脓成满窍，稠脓涌出，脓尽自愈。若气血虚弱，或误用败毒药，久不收敛，脓清脉大，非大剂开郁理气，温补气血，不能收功。
丹方治疗乳痈初起，用蒲公英草捣汁，和陈酒服，以药渣敷肿处即消。然而此法施于贫贱之人辄效，若由膏粱厚味、七情内郁所致者，良非所宜。当用鹿角，瓷锋刮屑，加麝香温酒调服。若肥盛多痰郁滞者，用橘皮摘碎如豆大，汤泡净，以飞罗面拌炒，去面为末，黑糖调二钱，醇酒服之。又一方法，用蟹壳烧存性，醇酒服三钱。又乳房肿胀，用贝母、栝蒌实、甘草节各三钱煎服有效。已溃，加忍冬一两佳。
乳岩属肝脾二脏久郁，气血亏损，故初起小核结于乳内，肉色如故，其人内热夜热，五心烦热，肢体倦瘦，月经不调，用益气养营汤、加味逍遥散，多服渐散。气虚必大剂人参，专心久服，其核渐消。若服攻坚解毒药，伤其正气，必致溃败。多有数年不溃者最危，溃则不治。周季芝说：乳癖、乳岩结硬未溃，以活鲫鱼同生山药捣烂，入麝香少许，涂块上，觉痒极，勿搔动，隔衣轻轻揉之，七日一涂，旋涂渐消。若荏苒岁月，以致溃腐，渐大类岩，色赤出水，深洞臭秽，用归脾汤等药，可延岁月。若误用攻伐，危殆迫矣。曾见一妇乳房结核如杯，数年诸治不效，因血崩后，日服人参两许，月余参尽二斤，乳核霍然消散。
阴疮 妇人阴疮，乃七情郁火伤损肝脾，湿热下注。其外证，有阴中舒出如蛇，俗呼阴挺；有翻突如饼，俗呼阴菌；亦有如鸡冠，如鼠乳；亦有生诸虫，肿病湿痒，溃烂出水，胀闷脱坠者。
其内证，口干内热体倦，经候不调，饮食无味，晡热发热，胸膈不利，胁腹不调，小腹痞胀，赤白带下，小水淋沥。其治法，肿痛者，四物汤加柴胡、山栀、丹皮、胆草。湿痒者，归脾汤加山栀、柴胡、丹皮。淋沥者，龙胆泻肝汤加白术、丹皮。溃腐者，加味逍遥散。肿闷脱坠者，补中益气汤加山栀、丹皮。佐以外治之法可也。若阴中有虫痒痛，乃肝经湿热，此惟独阴无阳，郁火内蕴所致。患此者，必骨蒸潮热，经水不调，干咳吐红，面赤声哑，虽日用开郁降火之药，多不能愈。大抵五志之病，非药可医，而失合证治尤难。外治之法，以桃仁研膏和雄黄末、轻粉，涂猪肝纳阴中。并用肥汤煎苦参洗涤。或以鲫鱼胆涂之。然旋治旋发，如菌蒂生虫，不腐不止。又有交接时辄出血作痛，此肝伤而不能藏血，脾伤而不能摄血也。多用加味逍遥散加肉桂，或归脾汤下加减八味丸自愈。
(Luoli [Scrofula], Jiehe [Tubercles], Liuzhu [Flowing Abscesses], Ruyong [Mastitis], Ruyan [Breast Cancer], Yinchuang [Yin Sores])
The *Jinkui Yaolue* states: When the Shaoyin pulse is slippery and rapid, it indicates sores arising in the yin region. If erosive sores ulcerate in the yin region, wash with Ye Langya Decoction (Wild Wolf's Tooth Decoction).
A slippery and rapid Shaoyin pulse indicates heat accumulation in the lower jiao. Treatment involves boiling Ye Langya to make a decoction, wrapping medicinal cotton around a chopstick like a silkworm cocoon, dipping it into the hot decoction, wringing it out, and irrigating the vagina four times daily to resolve toxicity and kill parasites.
Using only this single herb aims to achieve a specific therapeutic effect. Generally, this condition often occurs in widows; symptoms must include coughing and qi rebellion, amenorrhea, bone-steaming tidal fever, and aversion to cold. Whenever redness appears on the cheeks with white patches in the center, or white spots appear within the red lower lip, these are signs of yin erosion. Although external treatments are applied and fire-descending, yin-nourishing medicines are taken, death remains inevitable. This is an illness caused by emotional factors, which cannot be cured by medicine alone. Therefore, Zhang Zhongjing used only external methods and never mentioned internal decoctions; this indeed has profound significance.
When stomach qi descends abnormally, causing "yin blowing" (flatulence from the vagina) with noisy sounds, this is due to excess grain qi. Use Pig Fat and Hair Decoction (Zhigao Fa Jian) to guide it out.
"Guiding it out" means that after taking the medicine, the pathogen exits via urination; it does not refer to external guiding techniques. Detailed analysis shows that yin blowing with noisy sounds is a common ailment among women, but they often endure it in silence without speaking, hence it is not recorded in medical texts, and physicians do not examine it closely. The *Jinkui Yaolue* clearly states that unclear stomach qi and excess grain qi cause abdominal rumbling, leading qi to blow out from the anterior yin, resembling flatulence. However, using Pig Fat and Hair Decoction for treatment is difficult to deduce rationally. I once treated the wife of a servant who had amenorrhea for three months, severe lower abdominal pain penetrating to the heart, and persistent prior symptoms. After one dose of Shixiao San (Pain-Stopping Powder), a large amount of blood stasis was discharged, and the symptoms ceased. I also treated the daughter-in-law of a prominent official who, after a miscarriage, suffered from chills, fever, and abdominal pain, presenting the same prior symptoms. I administered pills made from charred black hawthorn fruit and charred brown sugar, delivered with a decoction of Ginseng Monarch (Dushen Tang) prepared using clarified water boiled with Longgu (Dragon Bone/Fired Clay). After one dose, hard feces were largely expelled; upon further administration, blood stasis continued to flow down, and the prior symptoms stopped abruptly. It was then realized that Pig Fat and Hair Decoction was designed to expel blood stasis. Although neither case directly used this formula, the principles did not deviate from the *Jinkui Yaolue*.
Luoli [Scrofula] Women suffering from luoli often have it due to worry, thought, depression, and anger damaging the Liver and Spleen. The nodules accumulate like beads on a string, mostly occurring around the ears, sides of the neck, and between the chest and ribs.
If accompanied by chills, fever, swelling, and pain, it is caused by Qi stagnation in the Liver Meridian. Do not use harsh phlegm-resolving drugs; instead, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If chills and fever cease but the nodules do not dissipate, the blood of the Liver Meridian is also affected; use Siwu Tang (Four Substances Decoction) plus Baizhu (Atractylodis Rhizoma), Fuling (Poria), Chaihu (Bupleuri Radix), and Danpi (Moutan Cortex). If appetite decreases and menstruation is irregular, it indicates Spleen and Stomach deficiency; use Liujunzi Tang (Six Gentlemen Decoction) plus Xiangfu (Cyperus Rhizome), Danpi, Chaihu, and Danggui (Angelicae Sinensis Radix). If initially bean-sized, attached to muscles and sinews, with unchanged color, later gradually enlarging, becoming swollen and painful, accompanied by internal heat, dry mouth, and mental fatigue, failing to resolve or ulcerate over time, it indicates Liver and Spleen deficiency. Use Xiaoyao San or Guipi Tang (Restore the Spleen Decoction) to strengthen Earth (Spleen) and nourish Wood (Liver). Never lightly use drugs that disperse hardness and chase toxins. Misusing purgatives will violate contraindications for disease and menstruation. If chronic ulcers present with floating and large pulses, evil fire is excessive; if the complexion is pale white, Metal overcomes Wood; both are difficult to treat. For all Wind-Wood diseases, strengthening Spleen Earth ensures Wood cannot overcome it. If attacking the Liver is performed, the Spleen and Stomach are injured first, and Wood反而 (instead) insults Earth.
Jiehe [Tubercles] Women suffering from jiehe result from depression and anger damaging the Liver and Spleen, stirring up Liver Fire. Not only do women often suffer from this due to depression; children may also inherit maternal depressive qi in the womb, manifesting at ages seven or eight. They mostly cluster around the sides of the neck and ears.
If accompanied by chills and fever, it belongs to Wind-Heat and Fire Anger in the Gallbladder Meridian; use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) plus Gouteng (Uncariae Ramulus cum Uncis) and Shanzhi (Gardeniae Fructus) to clear Liver Fire. If clustered in the flesh with unchanged color, accompanied by afternoon tidal fever and internal heat, it belongs to Liver Fire and Blood Deficiency; use Jiawei Xiaoyao San. Or if clustered in limbs and joints, accumulating like beads on a string with unchanged color, it is also Liver Fire and Blood Dryness causing tendon spasms; use Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Gouteng, assisted by Liuwei Wan (Six-Ingredient Pill with Rehmannia). If appearing and disappearing intermittently, this is Qi stagnation and Phlegm knotting; use Guipi Tang and Liujunzi Tang to harmonize Spleen and Stomach Qi. Externally, use powder of Xiangfu alone, mixed with saliva into a cake for moxibustion. Replace when dry, avoiding skin injury. Regular moxibustion leads to spontaneous resolution. A folk prescription for phlegm nodules uses Beimu (Fritillariae Bulbus), Quanxie (Scorpio), and Hetaoren (Juglandis Semen with Skin), each one hundred pieces, pounded together with honey into pills. Take two or three pill-sized doses on an empty stomach daily for efficacy. Another method: scrape powder from sheep horn or old glass/mirror; add four taels of Beimu and two taels of Quanxie per jin, make honey pills, take three qian on an empty stomach. Externally, use Zaojiao (Gleditsiae Fructus) meat placed inside a crucian carp, burned to ash retaining nature, mixed with honey and vinegar for application, highly effective. If ulcerated with non-putrefying flesh, non-regenerating tissue, thin pus, cold muscle and flesh, spontaneous sweating, night sweats, chills, fever, internal heat, sallow complexion, poor appetite, fatigue, and irregular bowel movements, all five Zang organs are deficient. Use Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction), Liujunzi Tang, or Yiqi Yangying Tang (Qi-Nourishing and Ying-Nourishing Decoction) to tonify and regulate the Spleen and Stomach; then symptoms recede spontaneously. Thus, the Classics state: Qi injury causes pain, Form injury causes swelling. Lightly using Qi-moving and Blood-breaking agents must be avoided.
Liuzhu [Flowing Abscesses] Women suffering from liuzhu often have it due to worry, thought, depression, and anger damaging the Liver and Spleen, causing Ying (Nutrient) Qi to fail to follow its course and reverse within the muscles. Or due to loose interstices allowing external pathogens to invade, or damp-phlegm flowing, or trauma causing blood stasis, or postpartum lochia accumulation. Qi flows and notes, Blood notes and coagulates.
They may arise in limbs and joints, remain in chest, abdomen, waist, or buttocks, forming lumps or diffuse swelling, all belonging to Depressive Fire. Urgently apply Congyi Method (Green Onion Moxibustion/Irritation), internally administer Yiqi Yangying Tang. Unformed abscesses dissipate spontaneously; formed abscesses rupture spontaneously. Continuous long-term intake is required for natural recovery. If swelling persists and becomes painful with limb fatigue, Pathogenic Qi is surplus while Form Qi is deficient; still treatable. If diffuse swelling with slight pain, both Form Qi and Pathogenic Qi are deficient; most difficult to treat. If no swelling occurs, or pus forms but does not rupture, it is Qi and Blood deficiency; use Renshen Yangrong Tang (Ginseng Nourishing Ying Decoction). Aversion to cold and fear of cold indicate Yang Qi deficiency; use Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction). Afternoon tidal fever and internal heat indicate Yin Blood deficiency; use Siwu Tang plus Renshen (Ginseng) and Baizhu. Nausea and vomiting indicate Stomach Qi deficiency; use Liujunzi Tang plus Paojiang (Prepared Ginger). Poor appetite and fatigue indicate Spleen Qi deficiency; use Buzhong Yiqi Tang plus Fuling and Banxia (Pinelliae Rhizoma). Cold extremities and frequent urination indicate Mingmen (Gate of Life) Fire decline; use Bawei Wan (Eight-Ingredient Pill). Frequent urination, profuse phlegm, and thirst indicate Kidney Water deficiency; use Liuwei Wan plus Maidong (Ophiopogonis Radix). Menstruation overdue and prolonged bleeding indicate Liver and Spleen deficiency; use Bazhen Tang (Eight Treasures Decoction) plus Chaihu and Danpi. For ulcers where Qi and Blood deficiency prevent healing, use Shiquan Dabu Tang as a paste. For chronic ulcers where Cold Evil stagnation prevents healing, use Douchi Bing (Fermented Soybean Cake) to dispel. For ulcers with internal sinus tracts preventing healing, use drugs to cauterize/resolve them. Without tonifying Qi and Blood, regulating diet, caring for lifestyle, guarding against Seven Emotions, or using cold/clearing and attacking drugs, it is untreatable.
Ruyong [Mastitis] and Ruyan [Breast Cancer] Women's mastitis differs in internal vs. external blowing, and upward reversal vs. downward smoothness. All belong to Heat-Toxin in the Gallbladder and Stomach meridians, with Qi and Blood stagnation. Thus, initial swelling and pain occur on the body surface, muscle redness, systemic fever, chills and fever, aversion to cold, headache, irritability, thirst with desire to drink. Use Jiawei Xiaoyao San plus Gualou Shuang (Trichosanthis Fruit Frost). Within several days, if pus fills the cavity and thick pus gushes out, self-heals when pus is exhausted. If Qi and Blood are weak, or toxic-cooling drugs were mistakenly used, preventing long-term healing, with thin pus and large pulse, only large doses of opening depression, regulating Qi, and warming/tonifying Qi and Blood can achieve results.
A folk prescription for early mastitis uses Pugongying (Taraxaci Herba) juice mixed with aged wine orally, applying dregs to the swelling for immediate resolution. However, this works for poor people; it is unsuitable for those caused by rich food and emotional depression. Instead, use Deer Antler, scraped with porcelain edge, mixed with Shexiang (Moschus), taken with warm wine. For obese patients with much phlegm and stagnation, use Chenpi (Citri Reticulatae Pericarpium) broken into bean sizes, washed with hot water, stir-fried with fine flour, remove flour, make powder, mix with black sugar two qian, take with pure wine. Another method: burn crab shell to ash, take three qian with pure wine. For breast swelling, use Beimu, Gualou Shi (Trichosanthis Fructus), and Gancao Jie (Licorice Joint) each three qian, decocted and taken; effective. Add Jinyinhua (Lonicerae Japonicae Flos) one liang if ulcerated.
Breast cancer results from long-term depression of Liver and Spleen, damaging Qi and Blood. Initially, small knots form inside the breast with normal skin color. The patient has internal heat, night fever, five-palm heat, limb fatigue and emaciation, irregular menstruation. Use Yiqi Yangying Tang or Jiawei Xiaoyao San; long-term intake gradually dissipates them. For Qi deficiency, large doses of Renshen must be taken diligently and long-term; knots gradually shrink. If attacking-hardening and detoxifying drugs are used, damaging righteous Qi, it inevitably leads to ulceration and collapse. Many cases do not ulcerate for years, which is critical; once ulcerated, it is untreatable. Zhou Qizhi said: For breast nodules or cancer hardened but un-ulcerated, pound live crucian carp with raw Chinese Yam, add a little Moschus, apply to the lump. Feel extreme itching, do not scratch, gently rub through clothing. Apply every seven days; gradual resolution follows. If time passes until ulceration and putrefaction, resembling rock-like sores, red with weeping fluid, deep foul-smelling cavities, use Guipi Tang etc. to prolong life. Mistakenly using attacking drugs brings imminent danger. I once saw a woman with a breast nodule the size of a cup; years of treatments failed. After metrorrhagia, she took roughly one tael of Renshen daily; within a month, consuming two jin, the breast nodule vanished suddenly.
Yinchuang [Yin Sores] Women's yin sores result from Seven Emotions' Depressive Fire damaging Liver and Spleen, with Damp-Heat pouring downward. External signs include prolapse like a snake (commonly called Yinting), protrusion like a pancake (Yinjun), chicken comb, or mouse teat; also generation of various insects, swelling, wetness, itching, ulceration, weeping, distension, heaviness, and prolapse.
Internal signs include dry mouth, internal heat, fatigue, irregular menstruation, loss of appetite, afternoon tidal fever, chest/diaphragm discomfort, hypochondriac/abdominal disharmony, lower abdominal fullness, red/white leukorrhea, dysuria. Treatment: For swelling/pain, Siwu Tang plus Chaihu, Shanzhi, Danpi, and Danshen (Gentianae Scabrae Radix - *Note: Dancao usually refers to Gentiana, here likely Danpi/Gentian mix contextually, standard is Longdan Cao*). For wetness/itching, Guipi Tang plus Shanzhi, Chaihu, Danpi. For dysuria, Longdan Xiegan Tang plus Baizhu, Danpi. For ulceration/putrefaction, Jiawei Xiaoyao San. For swelling/distension/prolapse, Buzhong Yiqi Tang plus Shanzhi, Danpi. Assist with external treatments. If insects in yin cause itching/pain, it is Liver Meridian Damp-Heat, resulting from exclusive Yin without Yang, internal entrapment of Depressive Fire. Patients must have bone-steaming tidal fever, irregular menstruation, dry cough with hemoptysis, red face, hoarse voice. Even with daily depression-opening and fire-descending drugs, cure is rare. Generally, illnesses of the Five Zangs (Emotions) are not curable by medicine alone, especially when misdiagnosed/treated. External treatment: Pound Taoren (Persicae Semen) into paste, mix with Xionghuang (Realgar) and Qingfen (Calomel), apply to pig liver, insert into yin. Also wash with Ku Shen (Sophorae Flavescentis Radix) decocted in fat broth. Or apply crucian carp bile. However, symptoms recur immediately after treatment; like fungus stalks growing worms, not stopping until putrefaction. Also, bleeding and pain during intercourse indicate Liver damage failing to store Blood and Spleen damage failing to control Blood. Mostly use Jiawei Xiaoyao Tang plus Rougui (Cinnamomi Cortex), or Guipi Tang combined with Jiawei Bawei Wan (Modified Eight-Ingredient Pill) for spontaneous recovery.