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Shirong Syndrome (Malnutrition of the Neck) occurs beside the ears and in the neck and shoulder regions. Initially, the mass resembles a phlegm nodule (Tanhe), is immobile upon pushing, and feels hard as stone. The skin color remains normal while the mass gradually enlarges. This condition is caused by emotional distress, anger, qi stagnation, blood rebellion, and fire condensation. As the disease progresses, qi and body fluids decline, leading to emaciation. Upon ulceration, the lesion becomes harder with purple spots appearing. The sore rots and oozes, discharging blood and pus, with the wound margin everted like a cauliflower; treatment is extremely difficult.

[Note] Shirong Syndrome arises anterior and posterior to the ears and on the shoulders and neck. In its early stage, it presents as a phlegm nodule, is immobile when pushed, and is as hard as stone, with normal skin color but gradual enlargement. It results from the condensation of worry, anger, qi stagnation, blood rebellion, and fire. Long-standing cases are difficult to cure, with gradual decline of form and qi, muscle wasting, increasing hardness upon ulceration, appearance of purple spots, rotting and oozing, discharge of blood and water, widening of the wound, and hyperplastic tissue resembling a "flower-turning" tumor. Although treatments exist in ancient and modern times, it ultimately belongs to "defeated syndromes" (incurable or terminal conditions). However, one should not abandon treatment. Initially, He Rong San Jian Wan is suitable for internal use, and Awei Huajian Gao is applied externally. Nevertheless, this merely serves to prolong life temporarily.

He Rong San Jian Wan: Treats Shirong Syndrome, harmonizes Ying (Nutritive) Blood, dissipates hardness, and resolves stagnation.
Ingredients: Chuanxiong Rhizoma (Chuanxiong), Bai Shao Radix Paeoniae Alba (Bai Shao, stir-fried with wine), Danggui Radix Angelicae Sinensis (Danggui), Poria (Fuling), Shu Dihuang Radix Rehmanniae Preparata (Shudi), Chenpi Pericarpium Citri Reticulatae (Chenpi), Jiegeng Radix Platycodonis (Jiegeng), Xiangfu Rhizoma Cyperi (Xiangfu), Baizhu Rhizoma Atractylodis Macrocephalae (Baizhu, stir-fried with soil), each 1 qian; Renshen Radix Ginseng (Renshen), Gancao Radix Glycyrrhizae Preparata (Gancao, honey-roasted); Haifen Natrii Boras (Haifen), Kunbu Thallus Laminariae seu Eckloniae (Kunbu), Beimu Bulbus Fritillariae Cirrhosae (Beimu, heart removed), each 5 qian; Shengma Rhizoma Cimicifugae (Shengma), Honghua Flos Carthami Tinctorii (Honghua), each 3 qian; Xiakucao Herba Prunellae Spicae (Xiakucao, decocted into soup, then add 4 liang of red honey, continue boiling until paste consistency, total weight 1 jin).
Preparation and Administration: Grind all ingredients into fine powder. Mix with Xiakucao paste to form pills, size similar to Sophora seeds. Take 3 qian per dose, washed down with warm boiled water after meals.
Modifications: For fever, add Huangqin Cortex Scutellariae (Huangqin) and Chaihu Radix Bupleuri (Chaihu). For spontaneous sweating and night sweats, remove Shengma, double the dosage of Renshen, and add Huangqi Radix Astragali Membranacei (Huangqi). For loss of taste, add Huoxiang Herba Agastaches (Huoxiang) and Sharen Fructus Amomi Rotundus (Sharen). For indigestion, add Shanzha Fructus Crataegi (Shanzha) and Maiya Fructus Hordei Germinatus (Maiya). For chest fullness and oppression, add Zexia Herba Alismatis Orientalis (Zexia) and Muxing Fructus Aquilariae (Muxing). For cough with turbid phlegm/qi, add Xingren Semen Armeniacae Amarum (Xingren) and Maidonng Radix Ophiopogonis (Maidong). For dry mouth and thirst, add Zhimu Rhizoma Anemarrhenae (Zhimu) and Wuweizi Fructus Schisandrae Chinensis (Wuweizi). For restless sleep, add Huangbai Cortex Phellodendri (Huangbai), Yuanzhi Radix Polygalae (Yuanzhi), and Zaoren Semen Ziziphi Spinosae (Zaoren). For palpitations and forgetfulness, add Fushen Sclerotium Poriae Cum Radice (Fushen) and Shichangpu Rhizoma Acori Tatarinowii (Shichangpu). For sweating with aversion to cold, add Bohe Herba Menthae haplocalyx (Bohe) and Banxia Rhizoma Pinelliae Preparata (Banxia). For no sweating with aversion to cold, add Cangzhu Rhizoma Atractylodis Lanceae (Cangzhu) and Huoxiang. For irregular menstruation in women, add Yanshuso Rhizoma Corydalis Yanhusuo (Yanshusuo) and Danmu Pi Cortex Moutan (Danpi). For abdominal distension, add Houkou Cortex Magnoliae Officinalis (Houpo) and Dafupi Pericarpium Arecae Catechu (Dafupi).

[Fang Ge / Prescription Verse] He Rong San Jian Wan disperses stagnation, opens knots, benefits deficiency, and regulates Liver and Spleen. It contains Ba Zhen Tang components along with Beimu, Jiegeng, Chenpi, and Xiangfu; Kunbu, Haifeng, Shengma, Honghua, and Xiakucao are appropriate.

Awei Huajian Gao
Formula: Use one portion of Chan Su Pill powder, five Golden-headed Wugong Scolopendra (Wugong), and Zhi Huangqi Radix Astragali Membranacei (Huangqi, roasted, heads and feet removed). Grind uniformly together. Take 24 liang of Taiyi Gao, melt via double-boiling method. Remove from heat, add the aforementioned powder mixture, and stir until cool. To apply, melt again via double-boiling, spread onto red silk, and apply as a plaster. Change every half month. Mild cases will gradually resolve; severe cases may see slight relief. Regular application can prevent progression to "flower-turning" tumors.

[Fang Ge / Prescription Verse] Awei Huajian Gao eliminates knot accumulation. Chan Su pill powder is ground finely. Combined with roasted Wugong, Huangqi, and Taiyi Gao, melted and stirred evenly, its efficacy is rapid and extreme.

Taiyi Gao (See Ulcer Section)
Chan Su Pill (See Ding Chuang/Carbuncle Section)