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According to the *Bing Yuan Lun* (Treatise on Disease Sources): A "liu" (tumor) is a sudden swelling in the skin and flesh, initially the size of a plum or apricot pit, which gradually enlarges. It is neither itchy nor painful, nor does it become hard. Because the mass remains knotted and does not dissipate, it is called "liu". If left untreated, it may grow very large but cease to cause pain. It is not fatal, yet one must be cautious and never rupture it arbitrarily.

According to the *Fan Wang Fang*: If the swelling is uniformly soft, it is a "xue liu" (blood tumor). If the swelling is extremely large but consists of flesh, it is a "rou liu" (flesh tumor), not an "yong" (carbuncle/abscess).

The *Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) provides a formula for treating tumors:
Shi Fan Shi (Alumen, Alum), Xiong (Ligusticum Rhizome, Chuanxiong), Dang Gui (Angelicae Sinensis Radix), Da Huang (Rhei Radix et Rhizoma), Huang Lian (Coptidis Rhizoma), Xi Yao (Paeoniae Radix Alba, White Peony Root), Bai Lian (Ampelopsis Radix), Huang Qin (Scutellariae Radix) (each 2 fen), Wu Zhu Yu (Evodiae Fructus) (1 fen).
Grind these nine ingredients into powder, mix with egg yolk, apply onto fine linen cloth, and patch according to the size of the tumor. Replace when dry. The medication should induce suppuration (formation of pus) and liquefaction, allowing it to drain slowly through pores. After pressing out all pus and blood, apply a flesh-regenerating ointment. If pus is not fully drained, recurrence will occur.

It also states: The flesh-regenerating ointment treats carbuncles, ruptured tumors, and various sores from metal wounds. Formula:
Dang Gui (Angelicae Sinensis Radix) (1 liang), Fu Zi (Aconiti Lateralis Radix Praeparata, Prepared Aconite Root), Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root), Bai Zhi (Angelicae Dahuricae Radix, Dahurian Angelica Root), Xiong (Ligusticum Rhizome, Chuanxiong), Sheng Di Huang (Rehmanniae Radix, Fresh Rehmannia Root), Xie Bai (Allii Macrostemonis Bulbus, Garlic Bulb) (5 liang).
Chop these seven ingredients, decoct in 2.5 sheng of lard until Bai Zhi turns yellow, strain, and apply while slightly warm three times daily. The *Seng Shen Fang* agrees.

It further states: Do not treat flesh tumors; treatment can be fatal. Be extremely cautious.

The *Seng Shen Fang* provides a formula for blood tumors:
Cut deer meat, roast over charcoal fire until hot, and apply as a compress. Re-roast when cool. Roast the meat until dry; repeat roasting and changing four times. If it does not resolve, moxibustion of seven cones (zhuang) is sufficient.

The *Yu Xiang Fang* provides a Poplar Tree Wine formula for treating tumors and goiters:
Take thirty jin of poplar tree roots from riverbanks where water flows, wash thoroughly, and finely chop. Decoct in one shi of water to obtain five dou of liquid. Add three dou of rice and three jin of flour to ferment into wine. Take one sheng upon completion. (The *Ji Yan Fang* agrees.)

According to the *Bing Yuan Lun*: Goiter (ying) arises either from imbalance of cold and heat leading to qi and blood stagnation, or from irregular diet allowing essences of wild wolves or rats to enter the zang-fu organs. Toxicity flows into the meridians, causing transformation. This leads to blood vessel aggregation, interaction of cold and heat, eventual suppuration, and ulceration. Growths on the skin and flesh may resemble stone abscesses at onset. The difference lies in palpation: multiple nodules are felt within the swelling. They commonly appear on the sides of the neck, or bilaterally, characterizing the condition. They may also appear in both axillae and temporal regions. Initially, they are often painless and non-thermal. If treatment is delayed, fever and chills develop. Severity varies by location. Severe cases include two types: one appears on the upper palate with tubercles of varying sizes, resembling peach or apricot pits, representing insect nests; the other appears below the mouth without tubercles but ulcerates.

It further states: Insect toxins reside不定ly in the zang-fu. Thus, goiters may appear in multiple body locations. Those that are interconnected often result in death. The morphology and origin are discussed in the following chapter.

The *Yang Sheng Fang* states: In the sixth month, do not eat fruits that have fallen naturally. After overnight exposure, ants, mole crickets, and dung beetles may crawl on them, predisposing to nine types of goiters. In the twelfth month, do not consume leftover dog or rat meat, as this may cause sores and goiters on the neck, mouth, or throat.

Regarding prognosis: Turn the eyes upward to observe red vessels penetrating the pupil. One vessel indicates death in one year; one and a half vessels in one and a half years; two vessels in two years; two and a half vessels in two and a half years; three vessels in three years. Red vessels that do not penetrate the pupil downward are treatable.

The texts describe nine types of neck goiters: wolf goiter, rat goiter, mole cricket goiter, bee goiter, ant goiter, white grub goiter, floating abscess goiter, scrofula goiter, and pulse-turning goiter. There are additionally thirty-six types of goiters listed in formulas, including dung beetle and earthworm goiters, totaling thirty-six varieties.

The *Duan Ju Fang* states: Goiters initially resemble stone abscesses. Palpation reveals multiple nodules. Initially painless and non-thermal, apply thin layers of Lian Shi (Kaolin) externally and internally administer Fang Ji Lian Qiao Tang (Stephania and Forsythia Decoction) to purge. Resolution follows. If neglected and suppurating, apply Lian Shi to hasten ripening, then use fire needle and ointment powder, similar to abscess treatment. Early application of Adzuki bean paste also resolves it.

Tong Jun stated: Equal parts of Chi Xiao Dou (Adzuki Bean), Bai Lian, Huang Qin, Huang Qi (Astragali Radix), and Mu Li (Ostrea Concha, Oyster Shell), sifted and taken with wine, one cun bi (measure).

Kun Bu Wan (Kelp Pill) for treating goiters and various masses:
Kun Bu (Laminariae Thallus, Kelp), Hai Zao (Sargassum Thallus, Sargassum), Xiao Mai (Tritici Semen, Wheat), Hai Ge (Arcae Shell, Clam Shell), Song Luo (Usneae Thallus, Old Man's Beard), Lian Qiao (Forsythiae Fructus, Forsythia Fruit), Bai Tou Weng (Pulsatillae Radix, Pulsatilla Root).
Grind and sieve these seven ingredients, mix with honey to form pills the size of mulberry seeds. Take nineteen pills three times daily, gradually increasing to thirty pills.

The *Qian Jin Fang* states: Goiters resembling stone abscesses with nodules in the neck or axillae, painless and non-thermal, should be treated with Lian Shi San (Kaolin Powder) externally and Wu Xiang Lian Qiao Tang (Five-Spice Forsythia Decoction) internally. Ulcerated cases are treated like abscesses. Note: Wu Xiang Lian Qiao Tang contains prescriptions for malignant goiters.
For scrofula (luo li) appearing first on the neck or axillae, indicating impending fistula formation, avoid pungent spices, alcohol, wheat products, and heating foods.

Moxibustion for fistulas:
Crush fresh Zhang Lu Gen (Verbenae Radix, Verbena Root), form into a cake, place on the fistula, and moxa above. Replace when hot. Moxa with three to four sheng of moxa wool for cure. (*Jing Xin Fang* agrees.)

Another formula: Ting Li Zi (Lepidii Semen, Lepidium Seed) two he, Dou Chi (Sojae Semnis Preparatum, Fermented Soybean) one sheng. Pound together until cooked, form into cakes the size of a large coin, thickness two fen. Place one over the wound aperture. Moxa with a cone the size of a small finger on the cake. Change after three cones; use three cakes for nine cones total, once daily. Repeat every three days.

Another method: Moxa around the periphery of the goiter for cure.

Treatment for fistulas:
Apply crushed Tu Gua Gen (Trichosanthes Radix, Trichosanthes Root); replace when dry, without time limit.

Another method: Burn dead dung beetles to ash, mix with vinegar, and apply.

Another method: Ash of dead snakes, mixed with vinegar, applied topically.

Ge Shi Fang general formula for various goiters/masses:
Take one blind mouse burrowing underground, eviscerate, dry, roast to powder, mix with lard from the twelfth lunar month, and apply to sores.

Another method: Burn mole crickets to powder, mix with pig fat, apply.

Another method: Burn white dog bones to powder, mix with pig fat, apply.

For masses located in the mouth between teeth and cheeks:
Finely chop three to four sheng of Mu Lian Gen (Rubiae Radix, Madder Root) growing eastward, decoct strongly in water, take the juice to gargle. Spit out repeatedly; do not swallow.

Qie Po Fang for thirty-year goiter sores:
Dry Asclepias root (Shuo Bi Gen), pound to remove soil, boil in a large pot until cooked, strain, squeeze clear juice, and reduce to a thick paste. Apply to crusts after removal. For deep lesions, use chicken feather to apply cooled/warmed paste until cured. Consume remaining dregs. If breath returns, burning dregs may trigger recurrence. Keep secret.

Guang Ji Jiu for chronic uncured goiters:
Ba Dou (Crotonis Fructus, Croton Seed) one liang (peeled), Da Zao (Ziziphi Jujubae Fructus, Jujube) one sheng.
Decoct in five sheng of water to obtain one sheng, strain, reduce to thick syrup, apply to sores three times daily.

Liu Juan Zi Fang effective prescription for refractory goiters:
Take several liang of Mu Meng (likely referring to a specific herb, possibly Astragalus or similar based on context, here kept as Mu Meng), pound, mix with water. Apply warm to sores. Replace when cool. Efficacy improves over days.

Xin Lu Fang for various goiters:
Lu Feng Fang (Vespae Nidus, Wasp Nest) powder, take one cun bi with wine.

Another method: Rabbit skin ash applied topically.

Another method: Mustard seed powder applied topically.

Another method: Peach leaves pounded to paste, applied as a poultice.

Jiu Ji Dan Yan Fang for various goiter sores:
Decoct Paulownia branches and leaves, wash sores cleanly, insert into cavities for great efficacy.

Another method: Shi Liu Huang (Realgar) powder placed in wound aperture, moxa immediately for effect.

Tao Hongjing's Commentary on Materia Medica for goiters:
Xuan Shen (Scrophulariae Radix, Figwort Root), steep in wine, drink for benefit.

Another method: KT rat feet, burned to powder, taken with wine.

Su Jing's Commentary on Materia Medica for goiters:
Ma Xian (Portulacae Herba, Purslane), pound and rub on affected area.

Another method: Eating pheasant meat is beneficial.

Cui Yuxi's Food Classic for goiters:
Eating one or two jin of Jue (Pteridis Tenuifoliae Rhizoma, Fern Rhizome) prevents disease for life.