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In the initial stage, if the nodule is elevated, painful, and swollen, with a red, soft, and mobile texture, accompanied by slight chills and fever, and the shoulder and neck are stiff but still movable, it is easy to treat.

If the condition has progressed to formation, where the base is not hard, there are no clusters of small nodules inside, the spleen function is robust, and qi and blood are not depleted, it is easy to treat.

If already ulcerated, with thick pus, red and vibrant flesh, gradual reduction of swelling, free movement of shoulders and neck, and gradual healing of the wound, it is a favorable prognosis (Shun).

If after ulceration, the swelling dissipates easily, the wound heals easily, the body's qi is peaceful, the chest and diaphragm feel open and comfortable, and appetite is good, it is a favorable prognosis (Shun).

If the body has not yet formed a distinct shape, the patient is emaciated, experiencing alternating chills and fever, with stubborn and hard tubercles, accompanied by phlegm and cough, it is a dangerous condition (Xian).

If the condition has progressed, with hard nodules arranged continuously like beads, varying in size, stiff neck, tight sinews, and a weak pulse, it is a dangerous condition (Xian).

If already ulcerated, with thin and watery pus, wasting of muscle tissue, spontaneous sweating, night sweats, alternating chills and fever, and insomnia, it is an adverse prognosis (Ni).

If after ulceration, yin deficiency causes irritability, thirst, and constipation; men experience bone-steaming tidal fever; women experience amenorrhea; all these are adverse prognoses (Ni).

In the initial stage, if there is swelling and pain, aversion to cold with high fever, stiffness and urgency of the four limbs, stiff neck, and headache, treatment should involve releasing the exterior (Biao San).

If there is hard swelling and fever, constipation, dry mouth, discomfort in the chest and diaphragm, nausea, and a forceful pulse, treatment should involve purging and draining (Li).

If caused by accumulation of heat from rich foods, strong wines, and condensation of damp-phlegm, treatment should involve resolving phlegm, descending fire, and clearing the middle jiao.

If caused by excessive worry and anger injuring the liver, leading to tendon contraction and nodule formation, treatment should involve nourishing blood, relieving depression, and soothing the liver.

If caused by sexual exhaustion leading to yin deficiency, afternoon tidal fever, spontaneous sweating, cough, and emaciation, treatment should involve nourishing the kidney and strengthening the spleen.

If caused by obsession with fame and gain, emotional stagnation, unfulfilled desires, leading to yin-yang disharmony over many years; such patients have damaged essence and blood, so one must first nourish healthy qi, then treat the manifest disease.

For hard nodules that do not ulcerate, promote ulceration; for ulcerated wounds that do not heal, use tonification to promote healing; these are flexible therapeutic methods.

A man had swollen and painful nodules in the neck, with stiffness and aversion to cold. After two doses of Jingfang Baidu San (Coptis and Saposhnikovia Decoction), the exterior symptoms resolved, but the remaining nodules did not disappear. After more than ten doses of Sanzhong Kuijian Tang (Swelling-Reducing and Hardness-Resolving Decoction) added with Chuanxiong Rhizoma (Chuanxiong), Cyperi Rhizoma (Xiangfu), and Fritillariae Bulbus (Beimu), the nodules gradually subsided. Applied Hupo Gao (Amber Ointment) externally, he recovered within a month.

A man crossed a river in mid-winter, suddenly exposed to fog, and was frightened. The next day, he had alternating chills and fever, with swelling of the head, face, ears, and neck. After two doses of Huoxiang Zhengqi San (Agastache Powder for Regulating the Qi), the chills and fever stopped, and facial swelling subsided. However, the hard swelling in the neck persisted, turning red and painful, indicating toxin accumulation likely to suppurate. He was given Zhengqi San again with added Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), and Gleditsiae Spina (Zaocili) for several doses. Once the pus matured, it was punctured, and the swelling and pain immediately receded. Then, Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) was used until spleen function improved and muscle regeneration completed the healing.

A widow of six years, with a young son, developed nodules due to depression over half a year. She also had irregular menstruation, alternating chills and fever, emaciation, and a wiry-rapid pulse. This was damage to qi and blood from labor, with hyperactive liver fire. As stated, "for deficiency, tonify"; corrosive drugs should not be used to cause further damage. First, Xiaoyao San (Free and Easy Wanderer Powder) with added Cyperi Rhizoma (Xiangfu), Moutan Cortex (Mudanpi), and Fritillariae Bulbus (Beimu) was used to harmonize blood vessels and liver qi, eliminating chills and fever. Next, Yiqi Yangrong Tang (Qi-Nourishing and Blood-Supplementing Decoction) was taken for over a month, restoring qi and blood, regulating menstruation, and reviving primal qi. Externally, fire needles were used to pierce four holes in the nodule, inserting yellow thread medicine five or six times. When the holes enlarged, Bing Si San (Ice Snail Powder) was applied and covered. Thirteen days later, the nodule fell off naturally. Hong Gao (Red Ointment) was applied externally to generate flesh and close the wound. Internally, Renshen Yangrong Tang (Ginseng Nourishing Decoction) with added Cyperi Rhizoma (Xiangfu) and Aucklandiae Radix (Muxiang) was taken for over thirty doses, and the wound healed naturally. This woman followed advice on daily routine, emotional regulation, dietary restraint, and continuous care, thus achieving recovery; otherwise, it would have been impossible.

A seventeen-year-old maiden, whose father failed to find a suitable husband for her, delaying marriage until age twenty, developed multiple hard, stone-like nodules in the neck due to long-term emotional stagnation. This is a disease of liver meridian condensation and tendon contraction. She also had amenorrhea, malaria-like chills and fever, cough, and rapid pulse, though without malarial flush. This indicates yin deficiency with fire hyperactivity, progressing into consumption disease (Lao Zhai). Medication alone cannot cure this. Observing her complexion showed no signs of decay. I said, "To treat this, treating the mind first is possible." The father asked, "What medicine treats the mind?" I replied, "Not medicine. The *I Ching* states: Heaven and earth interact, transforming all things into purity; male and female unite, generating all life. This is the way of creation. This disease arises from isolated yin and scarce yang, unable to generate or transform. It is a disease against nature, resulting from missed marital timing, gradually becoming a disorder of excess/deficiency imbalance. The disease arises spontaneously, not by personal fault, but by temporal change. Therefore, medicine cannot reverse it; only when yin and yang harmonize and rain falls, and when husband and wife are harmonious and family order is established, can medication be effective." The father finally understood, arranged her marriage, and three months later, upon re-examination, symptoms had stabilized. First, Xiaoyao San with added Cyperi Rhizoma (Xiangfu), Citri Reticulatae Pericarpium (Qingpi), Gardeniae Fructus (Zhizi), Moutan Cortex (Danpi), and Fritillariae Bulbus (Beimu) for over ten doses to relieve depression and soothe the liver, stopping chills and fever. Then, Renshen Yangrong Tang with added Moutan Cortex (Danpi) and Carthami Flos (Honghua) to unblock blood vessels, facilitating heart blood generation and improving complexion. Next, Yiqi Yangrong Tang with doubled Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) to support spleen and stomach and increase appetite. Intermittently, Guipi Tang (Restore the Spleen Decoction) with added Ophiopogonis Radix (Maidong), Schisandrae Fructus (Wuweizi), Polygalae Radix (Yuanzhi), and Glehniae Radix (Shashen) to gather spirit and comfort temperament. Also, Shen Zhu Dihuang Gao (Ginseng, Atractylodes, and Rehmannia Paste) was taken for half a year, restoring spirit and menstruation. Only the nodules did not fully resolve. One nodule was pierced with fire needles and covered with Amber Ointment, gradually suppurating. Two months later, it healed. The remaining three nodules were gradually needled, ulcerated, and healed. Throughout, purely spleen-tonifying and depression-relieving medicines were used for one year until full recovery.

A man near thirty had multiple nodules in the neck, pale complexion, fatigued spirit, rough skin, and rapid pulse, indicating injury to primal qi. He should first tonify qi and blood, then treat the sore once the root is strong. He took over ten doses of Yangrong Jianpi medicines without effect. Thinking it too slow, he believed a quack's advice to seek internal resolution, self-administering Mylabris (Banmao), Croton Seed (Badou), and Moschus (Shexiang). After more than ten episodes of diarrhea, he suffered continuous dribbling urine, increased deficient heat, and reduced appetite. Upon re-examination, his internal state was ruined and untreatable; I declined treatment. He later regretted this. Although internal physicians were consulted, forced administration of tonifying and fire-descending medicines failed, and he died.

A woman in her prime, with a quick temper and a dissolute husband, developed a nodule on the left side of her neck for half a year, growing to the size of a chicken egg, hard as stone, with red veins winding on the skin. Both pulses were wiry and rapid. Wiry indicates hyperactive liver fire; rapid indicates severe spleen heat. First, Zhizi Qinggan Tang (Gardenia Clearing Liver Fire Decoction) was used to subdue liver wood. After five doses, the pulse normalized. Then, Qinggan Jieyu Tang (Clearing Liver and Resolving Depression Decoction) was taken for several doses to disperse stagnation. Next, Yiqi Yangrong Tang (Qi-Nourishing and Blood-Supplementing Decoction) regulated qi and blood. Intermittently, Sanzhong Kuijian Tang (Swelling-Reducing and Hardness-Resolving Decoction) softened the hardness. Externally, Hupo Gao (Amber Ointment) was applied. After one hundred days of regulation, primal qi recovered. Eight or nine-tenths of the hardness disappeared, leaving only small nodules. Believing herself cured, she stopped medication. A year later, due to her husband's gambling losses and litigation, she experienced sudden fright and anger, causing recurrence. Pulses were fine and numerous, indicating blood deficiency with hyperactive yang fire, not the previous excess syndrome. She also had chest discomfort, loss of taste, early and heavy menstruation, and haggard appearance. This shows spirit injured by worry leads to muscle wasting; intention injured by sorrow leads to limb paralysis; soul injured by grief leads to tendon contraction; corporeal soul injured by joy leads to withered skin; will injured by rage leads to inability to bend or straighten the waist and spine. All these are internal damages from the seven emotions. Treatment should nourish qi and blood, harmonize spleen and stomach, benefit kidney and clear heart, relieve depression, and scatter stagnation, ensuring safety. She refused to believe, insisting on taking Sanzhong Kuijian Tang and moxibustion on the swelling to achieve internal resolution. I said, "This is different now; I dare not treat it." She invited another doctor who prepared the same medicine and performed moxibustion on the lesion and the elbow tip. This further depleted true qi and strengthened pathogenic qi. Subsequently, fever, spontaneous sweating, cough, stiff neck, flaccid limbs, non-suppurating moxa sores, continuous bloody discharge, and intense swelling occurred. This indicated organ damage, predicting imminent death. Over a month later, she developed shortness of breath, hoarseness, expectoration of blood and phlegm, and died. I have often seen incompetent doctors failing to distinguish deficiency and excess, and patients refusing correct principles, relying on improper medications, leading to failure in eight or nine out of ten cases. Both doctors and patients should reflect and exercise caution.