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Five types of Ying (goiter) belong to Yang, and six types of Liu (tumor) belong to Yin. Ying is differentiated into five categories: Xue Ying (Blood Goiter), Qi Ying (Qi Goiter), Rou Ying (Flesh Goiter), Shi Ying (Stone Goiter), and Jin Ying (Tendon Goiter). Liu is differentiated into six categories: Qi Liu (Qi Tumor), Xue Liu (Blood Tumor), Rou Liu (Flesh Tumor), Zhi Liu (Fat Tumor), Jin Liu (Tendon Tumor), and Gu Liu (Bone Tumor). Only Zhi Liu (Fat Tumor), when ulcerated, does not damage the body's fundamental integrity. The pedicle of Ying is small, red in color, and not tight; the root of Liu is diffuse and large, with a white, tender, and shiny appearance. These conditions arise from internal and external factors, including mountain dampness and water qi. Treatment requires abstaining from anger and resentment.

[Note] Both Ying and Liu occur 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 often caused by external contraction of the Six Excesses (Six Evils), leading to stagnation and constraint of Ying Wei (Defensive and Nutritive Qi) and Blood-Qi; internally, they result from the Seven Emotions (Seven Affects), such as worry, indignation, and anger, combined with damp-phlegm stasis and mountain dampness. These lesions typically present without pain or itching. Ying belongs to Yang, appearing red and elevated, with loose, non-tight skin, a small pedicle, and a hanging nature; Liu belongs to Yin, appearing white and diffusely swollen, with tender, shiny skin, a small apex, and a broad base.

There are five types of Ying: Rou Ying (Flesh Goiter) where the color remains unchanged; Jin Ying (Tendon Goiter) where tendons are visible; Xue Ying (Blood Goiter) where red vessels interlace; Qi Ying (Qi Goiter) which fluctuates in size with emotional changes; and Shi Ying (Stone Goiter) which is hard and immovable. None of these five Ying should be incised, as doing so may cause rupture of pus and blood, often leading to fatal consequences.

There are six types of Liu: Jin Liu (Tendon Tumor), also called Shi Liu (Stone Tumor), is hard, purple, with prominent veins, coiled like earthworms; Xue Liu (Blood Tumor) is slightly purple-red, with mixed hardness and softness, faint red threads under the skin, causing pulling pain, and continuous bleeding if ruptured; Rou Liu (Flesh Tumor) is soft as cotton or hard as a steamed bun, with normal skin color, neither tight nor loose, resembling a covered liver; Qi Liu (Qi Tumor) is soft but not firm, with normal skin color, fluctuating with emotions, and lacking cold or heat sensations; it may suppurate over time, also known as Nong Liu (Pus Tumor); Gu Liu (Bone Tumor) is purple-black, hard as stone, nodular, immovable, and adherent to the bone; Zhi Liu (Fat Tumor), also known as Fen Liu (Powder Tumor), is soft, not hard, with pale red skin. These are the morphological characteristics of the six Liu.

Ying mostly occurs on the shoulders and neck sides, whereas Liu can occur anywhere. The Liver governs tendons; anger agitates 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 Qing Gan Lu Hui Wan (Liver-Clearing Aloe Pill). The Heart governs Blood; extreme violence causes Fire to surge and boil Blood, compounded by external pathogens, leading to Xue Ying and Xue Liu. Treatment should nourish and cool Blood, suppress Fire, nourish Yin, calm the Spirit, and harmonize the vessels, primarily using Huang Qin Er Mu Wan (Scutellaria and Anemarrhena Pill). The Spleen governs muscles; depression injures the Spleen, causing thin muscles and stagnant Spleen Qi reversing into the flesh, leading to Rou Ying and Rou Liu. Treatment should regulate the Spleen, broaden the middle Jiao, unblock Stomach Qi, resolve depression, move phlegm, and adjust diet, primarily using Jia Wei Gui Pi Wan (Modified Restore the Spleen Pill). The Lung governs Qi; labor injury damages Yuan Qi, making pores loose and 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 Tong Qi San Jian Wan (Qi-Unblocking Hardness-Dispersing Pill). The Kidney governs bones; indulgence injures the Kidney, causing Kidney Fire to be constrained and bones to lack nourishment, leading to Shi Ying and Gu Liu. Shi Ying is treated primarily with Hai Zao Yu Hu Tang (Kelp Jade Pot Decoction); Gu Liu especially requires tonifying the Kidney, dispersing hardness, moving stasis, and opening orifices, primarily using Diao Yuan Shen Qi Wan (Regulating Origin Kidney Qi Pill).

For all Ying and Liu conditions, medication should be used slowly to gradually dissolve them. If they suppurate for a long time, with bursting pus and blood and 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) can be incised. It is pinkish-red, often occurring behind the ears and neck, or on the lower body, formed entirely by phlegm condensation and Qi knotting. Treatment involves using a Bi Zhen (Bi Needle) to break open and remove the fat powder, inserting Bai Jiang Dan (White Reduction Elixir) threadlets, repeatedly dissolving the inner membrane until clean, then applying Sheng Ji Yu Hong Gao (Vitality-Generating Jade Red Ointment) for self-healing.

Another type is Hei Sha Liu (Black Sand Tumor), mostly occurring on buttocks and legs, with varying sizes of swelling. When lifted by hand, black sand is found inside. It is also punctured with a needle, releasing black sand with sound, varying in hardness. Fa Liu (Hair Tumor) mostly occurs about one cun below the hair behind the ear, soft, small, elevated, and painless upon pressure. It is also punctured, expelling powdery hair completely. Li Liu (Louse Tumor) causes intense itching penetrating the bones. Upon incision, numerous lice emerge, starting with one large louse, after which all others exit. The external treatment for Hei Sha, Fa, and Li Liu is the same as for Fen Liu, allowing the wound to heal. Chong Liu (Insect Tumor) often occurs under the ribs. Its treatment follows the principles for Yong Ju (Abscesses and Ulcers) sections, but since it arises from sorrow and thinking, it is often difficult to cure. All these conditions have different shapes, resulting from damp-heat, pathogenic fire, turbidity, and stasis in the Five Zang Organs, never generated by healthy Qi.

Qing Gan Lu Hui Wan (Liver-Clearing Aloe Pill)
Dang Gui (Angelicae Sinensis Radix), Sheng Di Huang (Rehmanniae Radix, 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 (Sepiae Endoconcha), Ya Zao (Gleditsiae Sinensis Spina), Gan Cao Jie (Glycyrrhizae Radix et Rhizoma with nodes), Kun Bu (Laminariae Thallus, stir-fried with wine), Lu Hui (Aloe) (each 5 qian).
Grind into fine powder, make pills with Shen Qu (Mass Medicamentum Fermentatum Chinense) paste, size of Sophora seeds. Take 80 pills per dose, with plain boiled water, before or after meals depending on the disease location.

[Fang Ge] Qing Gan Lu Hui treats Liver injury from anger, tendon knots in goiter/tumor stem from dry blood. Si Wu, Huang Lian, Qing Pi, Hai Fen, Ya Zao, Gan Cao, Kun Bu, Shen Qu paste form the pill.

Huang Qin Er Mu Wan (Scutellaria and Anemarrhena Pill)
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), Sheng Di Huang (Rehmanniae Radix), Shu Di Huang (Rehmanniae Radix Preparata), 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, make pills with Ce Bai Ye (Platycladi Cacumen) decoction and Han Shi Mian (Cold Food Dough) paste, size of Sophora seeds. Take 70 pills per dose, with Deng Xin Cao (Junci Medullae) decoction.

[Fang Ge] Huang Qin Er Mu treats Xue Liu and Xue Ying, boiling blood and cold coagulation cause slight purple-red hue. Gui, Shao, Ling Yang Jiao, Sheng/Shu Di, Pu Huang, Di Gu Pi, Gan Cao, Chuan Xiong.

Jia Wei Gui Pi Wan (Modified Restore the Spleen Pill)
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, soil-stir-fried), Bei Mu (Fritillariae Cirrhosae Bulbus, heart removed) (each 1 liang), Mu Xiang (Aucklandiae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-stir-fried) (each 3 qian).
Grind into fine powder, make pills with He Huan Pi (Albiziae Cortex) four liang decoction and old rice paste, size of Sophora seeds. Take 60 pills per dose, well after meals, with plain boiled water.

[Fang Ge] Jia Wei Gui Pi uses Xiang Fu and Ren Shen, Suan Zao Ren, Yuan Zhi, Dang Gui, Huang Qi, Wu Yao, Chen Pi. Fu Shen, Bai Zhu, Mu Xiang, Gan Cao, Bei Mu relieve goiter/tumor by extending Spleen depression.

Tong Qi San Jian Wan (Qi-Unblocking Hardness-Dispersing Pill)
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-stir-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 (Sargassii 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 per dose, well after meals, with Deng Xin Cao (Junci Medullae) and Sheng Jiang (Zingiberis Rhizoma Recens) decoction.

[Fang Ge] Tong Qi San Jian treats Qi Ying and Qi Liu, using Ren Shen, Jie Geng, Chuan Xiong, Dang Gui, Hua Fen. Huang Qin, Zhi Shi, Er Chen, Dan Xing, Bei Mu, Hai Zao, Xiang Fu, Shi Chang Pu alleviate the condition gradually.

Hai Zao Yu Hu Tang (Kelp Jade Pot Decoction)
Hai Zao (Sargassii Thallus, washed), Chen Pi (Citri Reticulatae Pericarpium), Bei Mu (Fritillariae Cirrhosae Bulbus, heart removed), Lian Qiao (Forsythiae Fructus, heart removed), Kun Bu (Laminariae 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 (Eckloniae Thallus, washed, 5 fen).
Boil in two cups of water until reduced to eight parts. Take before or after meals according to the disease location.

[Fang Ge] Hai Zao Yu Hu Tang treats Shi Ying, using Chen Pi, Bei Mu, Lian Qiao, Kun Bu, Ban Xia, Qing Pi. Du Huo, Chuan Xiong, Dang Gui, Gan Cao, Hai Dai effectively soften hardness and disperse solidity.

Diao Yuan Shen Qi Wan (Regulating Origin Kidney Qi Pill)
Sheng Di Huang (Rehmanniae Radix, wine-boiled, pounded into paste, 4 liang), Shan Zhu Yu (Corni Fructus), Shan Yao (Dioscoreae Rhizoma, stir-fried), 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 et Scapulae), Di Gu Pi (Lycii Cortex) (each 1 liang), Zhi Mu (Anemarrhenae Rhizoma, child’s urine-stir-fried), Huang Bo (Phellodendri Cortex, salt-water-stir-fried) (each 5 qian), Suo Sha Ren (Amomi Fructus, stir-fried), Mu Xiang (Aucklandiae Radix) (each 3 qian).
Grind into fine powder. Melt Lu Jiao Jiao (Colla Cornus Cervi) four liang in old wine until thick, add four liang of honey, simmer until drops form pearls. Mix with powder to make pills, size of Sophora seeds. Take 80 pills per dose, on an empty stomach with warm wine. Avoid radishes, strong alcohol, and sexual intercourse.

[Fang Ge] Diao Yuan Shen Qi Wan contains Suo Sha Ren, Liu Wei Di Huang, Zhi Mu, Mai Dong, Ren Shen, Dang Gui, Huang Bo, Mu Xiang, Long Gu, Di Gu Pi. Taking this for Gu Liu further nourishes Yin.

Bai Jiang Dan (White Reduction Elixir) and Sheng Ji Yu Hong Gao (Vitality-Generating Jade Red Ointment) (see Ulcer Section).