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[Formula Song] The five types of Ying (goiter) belong to Yang, and the six types of Liu (tumors) belong to Yin. Ying is categorized into blood, qi, flesh, stone, and tendon; Liu is categorized into qi, blood, flesh, fat, tendon, and bone. Only Fat Liu (lipoma), when ulcerated, does not damage the body. The pedicle of Ying is thin, red in color, and not tight; the root of Liu is wide, white in color, and bright like new. These conditions arise from wind, water, and qi pathogens affecting the interior and exterior. Treatment requires abstaining from anger and resentment.

[Note] Ying and Liu are conditions occurring in the skin, flesh, blood, and bones. "Ying" resembles a tassel or knot; "Liu" refers to masses that remain stationary due to Qi stagnation, hence the name. They are mostly caused by external contraction of the Six Evils (pathogenic factors), leading to coagulation and stagnation of Ying (Defensive) and Wei (Nutritive) Qi and Blood; or internally by the Seven Emotions, such as worry, indignation, and anger, causing damp-phlegm and blood stasis obstruction, as well as mountain wind and water qi. They typically present without pain or itching. Ying conditions are Yang-type: red in color, elevated and protruding, with loose skin that is not tight, having a small pedicle and hanging down. Liu conditions are Yin-type: white in color, diffusely swollen, with tender and shiny skin, a small apex, and a large base.

There are five types of Ying: Those with unchanged skin color are called Rou Ying (Flesh Goiter); those with visible tendons are called Jin Ying (Tendon Goiter); those with intersecting red vessels are called Xue Ying (Blood Goiter); those that fluctuate in size with emotions of joy and anger are called Qi Ying (Qi Goiter); those that are hard and immovable upon pushing are called Shi Ying (Stone Goiter). None of these five Ying should be incised; if incised, pus and blood will collapse, often leading to fatal consequences.

There are six types of Liu: Hard and purple, with clustered blue veins coiling like earthworms, is also called Jin Liu (Tendon Tumor) or Shi Liu (Stone Tumor); slightly purple or red, mixed hardness and softness, with hidden red threads entangled in the skin, causing occasional pulling pain, and continuous bleeding if accidentally broken, is called Xue Liu (Blood Tumor); soft as cotton or hard as a steamed bun, with normal skin color, neither tight nor loose, resembling an inverted liver throughout, is called Rou Liu (Flesh Tumor); soft but not firm, normal skin color, fluctuating with emotions, without cold or heat sensations, which may suppurate over time, is called Qi Liu (Qi Tumor) or Nong Liu (Pus Tumor); purple-black in color, hard as stone, nodular and stacked, immovable, and firmly attached to the bone, is called Gu Liu (Bone Tumor); soft and unbroken, with pale red skin, is called Zhi Liu (Fat Tumor), also known as Fen Liu (Powder Tumor). Thus are the shapes and colors of the six Liu.

Ying generally occurs on the shoulders, neck, and both sides of the jaw; Liu can occur anywhere. The Liver governs the tendons; anger injures the Liver, causing excessive fire and dry blood, leading to Jin Ying and Jin Liu. Treatment should clear the Liver, resolve depression, nourish blood, and relax tendons, primarily using Qinggan Lulu Wan (Liver-Clearing Aloe Pill). The Heart governs blood; excessive violence causes fire to surge and boil blood, combined with external pathogens, leading to Xue Ying and Xue Liu. Treatment should nourish blood, cool blood, suppress fire, nourish Yin, calm and anchor the Shen (Spirit), and harmonize blood vessels, primarily using Qinlian Ermu Wan (Scutellaria and Coptis Two Mother Pills). The Spleen governs muscles; depression injures the Spleen, causing muscle wasting and failure of Earth Qi to circulate, reversing into the muscle tissue, leading to Rou Ying and Rou Liu. Treatment should regulate the Spleen, broaden the middle, unblock Stomach Qi, resolve depression, move phlegm, and adjust diet, primarily using Jiawei Guipi Wan (Modified Restore the Spleen Pill). The Lung governs Qi; labor injury depletes Yuan Qi, making the Couli (pores) loose, allowing external cold to attack, leading to Qi Ying and Qi Liu. Treatment should clear Lung Qi, regulate meridians, remedy labor injury, and harmonize Ying and Wei, primarily using Tongqi Sanjian Wan (Unblocking Qi and Dissolving Hardness Pill). The Kidney governs bones; indulgence injures the Kidney, causing Kidney Fire to be suppressed and bones lacking nourishment, leading to Shi Ying and Gu Liu. Shi Liu is treated primarily with Haizao Yuhu Tang (Seaweed Jade Pot Decoction); Gu Liu especially requires tonifying the Kidney, dissipating hardness, moving blood stasis, and benefiting orifices, primarily using Yaoyuan Shenqi Wan (Regenerating Origin Kidney Qi Pill).

For all Ying and Liu conditions, medications should be used slowly to gradually dissolve them until they shrink naturally. If they persist for a long time and pus and blood collapse with continuous leakage, these are adverse signs. Do not lightly use knives or needles to incise, lest uncontrollable bleeding lead to immediate danger. Only Fen Liu (Powder Tumor/Lipoma) can be incised. It is pinkish-red, often occurring before and behind the ears, or sometimes on the lower body, formed entirely by phlegm condensation and Qi knotting. Treatment should use a Pi Zhen (blade needle) to incise and remove the fat powder, insert Baijiang Dan (White Reduction Powder) moxa sticks several times to dissolve the inner membrane, and apply Shengji Yuhong Gao (Regenerate Flesh Jade Red Ointment) for self-healing.

Another type is Heisha Liu (Black Sand Tumor), often occurring on the buttocks and thighs, with varying sizes of swelling. When lifted by hand, black matter inside confirms the diagnosis. Puncture with a needle releases black sand with sound; texture varies in hardness. Another is Fa Liu (Hair Tumor), often occurring about one cun below the hair behind the ear, soft, small, and protruding, painless on pressure. Puncture with a needle expels powdery hair completely. Another is Shi Liu (Louse Tumor), where itching penetrates the bone during onset. Upon opening and breaking, countless lice emerge, ending only when one extremely large louse exits. For Heisha, Fa, and Shi Liu, external treatment follows the same method as Fen Liu, allowing the wound to heal. Another is Chong Liu (Worm Tumor), often occurring under the hypochondrium. Treatment should follow the guidelines for Yong Ju (Carbuncles and Ulcers) swellings and ulcers. However, since this arises from sorrow and thinking, it is often difficult to achieve efficacy. The shapes of these conditions vary, all resulting from damp-heat, evil fire, turbidity, and stasis in the Five Zang Organs, contracted from various sources, and none are generated by righteous Qi.

Formula: Qinggan Lulu Wan (Liver-Clearing Aloe Pill)
Ingredients: Dang Gui (Angelicae Sinensis Radix), Sheng Di Huang (Rehmanniae Radix Preparata, soaked in wine, pounded into paste), Bai Shao (Paeoniae Radix Alba, stir-fried with wine), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (each 2 liang); Huang Lian (Coptidis Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride), Hai Fen (Concha Meretricis et Cyclinae), Ya Zao (Gleditsiae Sinensis Fructus Spina), Gan Cao Jie (Glycyrrhizae Radix et Rhizoma with nodes), Kun Bu (Eckloniae Thallus, washed with wine), Lu Hui (Aloe) (each 5 qian).
Grind into fine powder, make pills with Shen Qu (Mass Medicamentosa) paste, size of Sophora japonica seeds. Take 80 pills each time, with plain boiled water, according to the location of the disease (upper or lower body), taken before or after meals.

[Formula Song] Qinggan Lulu treats Liver injury from anger, tendon knots and Ying/Liu originate from dry blood; Four Substances, Huang Lian, Qing Dai, Hai Fen; Ya Zao, Gan Cao, Kun Bu, Shen Qu paste pills.

Another Formula: Qinlian Ermu Wan (Scutellaria and Coptis Two Mother Pills)
Ingredients: Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Bei Mu (Fritillariae Cirrhosae Bulbus, heart removed), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba, stir-fried with wine), Ling Yang Jiao (Capricornu Saigae Tataricae, shaved), Sheng Di Huang (Rehmanniae Radix Preparata), Shu Di Huang (Rehmanniae Radix Preparata, processed), Pu Huang (Typhae Pollen), Di Gu Pi (Lycii Cortex), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (each 1 liang); Gan Cao (Glycyrrhizae Radix et Rhizoma, raw, 5 qian).
Grind into powder, decoct Ce Bai Ye (Biota Tops) in water, mix with Han Shi Mian (Cold Food Dough) paste to make pills, size of Sophora japonica seeds. Take 70 pills each time, delivered with Deng Xin Cao (Junci Medulla) decoction.

[Formula Song] Qinlian Ermu treats Blood Tumor and Ying, boiling blood and cold coagulation cause slight purple-red; Dang Gui, Bai Shao, Ling Yang Jiao, Sheng/Shu Di Huang; Pu Huang, Di Gu Pi, Gan Cao, Chuan Xiong.

Another Formula: Jiawei Guipi Wan (Modified Restore the Spleen Pill)
Ingredients: Xiang Fu (Cyperi Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried), Yuan Zhi (Polygalae Radix, heart removed), Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Wu Yao (Linderae Radix), Chen Pi (Citri Reticulatae Pericarpium), Fu Shen (Poria with Hostwood), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried with earth), Bei Mu (Fritillariae Cirrhosae Bulbus, heart removed) (each 1 liang); Mu Xiang (Aucklandiae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) (each 3 qian).
Grind into fine powder, decoct He Huan Pi (Albiziae Cortex) four liang in water, cook Lao Mi Hu (old rice paste) to make pills, size of Sophora japonica seeds. Take 60 pills each time, well after meals, delivered with plain boiled water.

[Formula Song] Jiawei Guipi contains Xiang Fu and Ren Shen, Zao Ren, Yuan Zhi, Dang Gui, Huang Qi, Wu Yao, Chen Pi; Fu Shen, Bai Zhu, Mu Xiang, Bei Mu; eliminates Ying and Liu, extends Spleen depression.

Another Formula: Tongqi Sanjian Wan (Unblocking Qi and Dissolving Hardness Pill)
Ingredients: Ren Shen (Ginseng Radix et Rhizoma), Jie Geng (Platycodonis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Hua Fen (Trichosanthis Radix), Huang Qin (Scutellariae Radix, stir-fried with wine), Zhi Shi (Aurantii Fructus Immaturus, bran-fried), Chen Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma Preparatum), Bai Fu Ling (Poria), Dan Xing (Arisaematis Cum Bile), Bei Mu (Fritillariae Cirrhosae Bulbus, heart removed), Hai Zao (Sargassum Thallus, washed), Xiang Fu (Cyperi Rhizoma), Shi Chang Pu (Acori Tatarinowii Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma, raw) (each 1 liang).
Grind into fine powder, make pills with He Ye (Nelumbinis Folium) decoction, size of pea seeds. Take 1 qian each time, well after meals, delivered with Deng Xin Cao (Junci Medulla) and Sheng Jiang (Zingiberis Rhizoma Recens) decoction.

[Formula Song] Tongqi Sanjian treats Ying hardness and Qi Liu, Mai Dong, Jie Geng, Chuan Xiong, Dang Gui, Hua Fen administered; Huang Qin, Zhi Shi, Er Chen Tang, Dan Xing, Bei Mu, Hai Zao; Xiang Fu, Shi Chang Pu, patients gradually recover.

Another Formula: Haizao Yuhu Tang (Seaweed Jade Pot Decoction)
Ingredients: Hai Zao (Sargassum Thallus, washed), Chen Pi (Citri Reticulatae Pericarpium), Bei Mu (Fritillariae Cirrhosae Bulbus, heart removed), Lian Qiao (Forsythiae Fructus, heart removed), Kun Bu (Eckloniae Thallus), Ban Xia (Pinelliae Rhizoma Preparatum), Qing Pi (Citri Reticulatae Pericarpium Viride), Du Huo (Angelicae Pubescentis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Gan Cao Jie (Glycyrrhizae Radix et Rhizoma with nodes) (each 1 qian), Hai Dai (Laminariae Thallus, washed, 5 fen).
Decoct in two zhong of water until eight fen remains. Take before or after meals, depending on whether the disease is in the upper or lower body.

[Formula Song] Haizao Yuhu Tang treats Stone Ying, Chen Pi, Bei Mu, Lian Qiao, Kun Bu, Ban Xia, Qing Pi; Du Huo, Chuan Xiong, Dang Gui, Gan Cao, Hai Dai; dissolves hardness and eliminates firmness, most spiritual.

Another Formula: Yaoyuan Shenqi Wan (Regenerating Origin Kidney Qi Pill)
Ingredients: Sheng Di Huang (Rehmanniae Radix Preparata, boiled in wine, pounded into paste, 4 liang), Shan Yu Rou (Corni Fructus), Shan Yao (Dioscoreae Rhizoma, stir-fried), Mu Dan Pi (Moutan Cortex), Bai Fu Ling (Poria) (each 2 liang), Ze Xie (Alismatis Rhizoma), Mai Dong (Ophiopogonis Radix, heart removed, pounded into paste), Ren Shen (Ginseng Radix et Rhizoma), Dang Gui Shen (Angelicae Sinensis Radix radix portion), Long Gu (Fossilia Ossis Mastodi, calcined), Di Gu Pi (Lycii Cortex) (each 1 liang), Zhi Mu (Anemarrhenae Rhizoma, stir-fried with child's urine), Huang Bo (Phellodendri Cortex, stir-fried with salt water) (each 5 qian), Suo Sha Ren (Amomi Fructus, stir-fried), Mu Xiang (Aucklandiae Radix) (each 3 qian).
Grind into fine powder. Use Lu Jiao Jiao (Colla Cornus Cervi) four liang, melted in old wine to a thick consistency, add Si Liang of honey, decoct together until drops form pearls. Mix with medicine powder to make pills, size of Sophora japonica seeds. Take 80 pills each time, on an empty stomach with warm wine. Avoid radishes, strong alcohol, and sexual intercourse.

[Formula Song] Yaoyuan Shenqi contains Suo Sha, Shi Chang Pu, Liu Wei Di Huang, Zhi Mu, Mai Dong, Ren Shen; Dang Gui, Huang Bo, Mu Xiang, Long Gu, Di Gu Pi; taking this for Bone Liu also nourishes Yin.

Another Formula: Baijiang Dan (White Reduction Powder), Shengji Yulong Gao (Regenerate Flesh Jade Dragon Ointment) (both see Section on Ulcers).