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In women, scrofula (Luo Li, 瘰疬) may arise from blood loss due to pregnancy, childbirth, or postpartum hemorrhage, leading to a deficiency of the Liver and Kidney; or from worry, overthinking, depression, and anger, damaging the Liver and Spleen; or from indignation combined with wind-heat, causing dryness of the Liver and Gallbladder blood; or from depletion of Kidney water and blood deficiency, resulting in tendon spasms where nodules accumulate like beads. Thus, it often occurs around the ears, sides of the neck, and between the chest and hypochondrium. If accompanied by chills, fever, swelling, and pain, it is a disease caused by disordered Qi movement in the Liver channel. Treatment primarily uses Chaihu Zhizi San (Bupleurum and Gardenia Powder) to clear Liver fire, assisted by Xiaoyao San (Free and Easy Wanderer Powder) to nourish Liver blood. If chills and fever cease but the nodules do not dissipate, it indicates that the blood of the Liver channel is also diseased; treatment primarily uses Jiawei Siwu Tang (Modified Four Substances Decoction) to nourish Liver blood, assisted by Chaihu Zhizi San to clear Liver fire. If initially bean-sized, attached to tendons, with unchanged skin color, internal heat, dry mouth, mental fatigue, and failure to ulcerate for a long time, it is due to Liver and Spleen deficiency. Use Xiaoyao San, Guipi Tang (Restore the Spleen Decoction), and Liuwei Wan (Six-Ingredient Pill with Rehmannia) to strengthen Earth (Spleen) and cultivate Wood (Liver). One must absolutely avoid using harsh agents to dissipate hardness and chase toxins. *Waitai Miyao* states: "Deficient heat in the Liver and Kidney generates scrofula." *Bingji* states: "Scrofula is not caused by rich food or carbuncles/toxins, but by consumptive disease and Qi stagnation." By tonifying form and Qi, and regulating meridians, the sores will naturally dissipate. Misusing purgatives violates disease and meridian contraindications. If a chronic ulcer presents with a floating and large pulse, it indicates excessive pathogenic fire; if the complexion is pale white, it indicates Metal overcoming Wood, both being difficult to treat. If red vessels penetrate the pupil, death will occur within the corresponding number of years.

Case Record 1:
A woman suffered from the condition for a long time without recovery. Some believed it was an excess of Wood (Liver), and used Sanzhong Kuijian Tang (Disperse Swelling and Harden Dissolution Decoction) to attack it, resulting in increased swelling and hardness. I considered it a deficiency of Qi and Blood in the Liver channel and should nourish the source of transformation. I used Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), and she recovered in spring. If this condition were acute Wind-Fire in the Liver channel with intact Yuan Qi, the aforementioned attacking decoction would be appropriate. If Wind is not excessive but the disease arises spontaneously, Xieqing Wan (Drain Green Pill) is suitable; for deficiency, Dihuang Wan is used. If Water fails to generate Wood, Dihuang Wan is also used. If Metal comes to overcome Wood, one should tonify Spleen Earth to generate Kidney Water. Generally, for Wind-Wood diseases, strengthening Spleen Earth ensures Wood cannot overcome it. Forcibly attacking the Liver first injures the Spleen and Stomach, causing Wood to overcome Earth instead.

Case Record 2:
Another woman suffered from this, fearing it was incurable, leading to insomnia. After more than a year, the sore broke, oozing pus continuously. Her menstruation occurred every fifty days or two months. She mistakenly took Tongjing Wan (Unblock Menses Pill), resulting in restless insomnia, chills before noon, and fever after noon. I considered this a deficiency of Spleen Blood due to overthinking. I prepared Guipi Tang as pills, administered with Liujunzi San (Six Gentlemen Powder) before noon, and Xiaoyao San after noon. After more than two months, she could sleep peacefully. After half a year, her menstruation returned to its regular schedule, and after more than a year, the sore healed.

Case Record 3:
A woman, after ulceration, experienced fever, restlessness, and thirst, with a large and empty pulse. She was treated with Danggui Buxue Tang (Angelica Tonifies the Qi and Nourishes Blood Decoction); after six doses, chills and fever subsided. Then Shengyu Tang (Holy to Save Life Decoction) was given for several doses until recovery. Subsequently, Bazhen Tang (Eight Treasures Decoction) added with Beimu (Fritillaria Bulb) and Yuanzhi (Polygala Root) was taken for more than thirty doses until the wound closed.

Case Record 4:
A woman had cervical lymph node tuberculosis with chills, fever, headache, distending pain in the hypochondrium and breasts, internal heat, bitter taste in the mouth, and frequent urination. The syndrome belonged to Liver Fire and Blood Deficiency. She was cured using Siwu Tang added with Chaihu (Bupleurum Root), Shanzhi (Gardenia Fruit), and Dancao (Gentian Root), and then stabilized with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder).

Case Record 5:
After a woman’s scrofula ulcerated, her whole body itched. Her pulse was large but empty upon pressure. She was treated with Shiquan Dabu Tang (Perfect Great Tonification Decoction) added with Xiangfu (Cyperus Rhizome) and recovered. Generally, after ulceration, itching occurring before noon indicates Qi deficiency, while itching after noon indicates Blood deficiency. Treating it as a Wind syndrome will certainly lead to death.

Case Record 6:
A woman had painful swelling of cervical nodules. Observing that both Qi and Blood were excess, I first administered Yixiao San (Sure Effect Powder) to purge, followed by Yiqi Yangrong Tang (Augment Qi and Nourish Ying Decoction) for tonification. After more than thirty doses, it dissipated. In treating this condition, if suppuration is desired, for weak patients, use the aforementioned tonifying decoction first. Wait until Qi and Blood are slightly replenished, then use Yixiao San to remove toxins, followed by tonic medicines, which are invariably effective. For un-suppurated cases, moxa on Zhoushan (Elbow Tip) acupoint, regulating meridians and resolving stagnation, and garlic-partitioned moxibustion often cause spontaneous resolution. If pus is present, puncture it. If Qi and Blood recover but nodules remain, and dispersing-hardness agents fail after a month without damaging Qi and Blood, use Yixiao San. Once toxins are expelled, administer copious amounts of Yiqi Yangrong Tang. If ineffective, moxa on Zhoushan can be used. If the wound does not close, use Douchi Bing (Fermented Soybean Cake) and Hupo Gao (Amber Plaster). If both Qi and Blood are deficient, or if dietary and emotional precautions are neglected, it is untreatable. However, this condition depends primarily on Qi and Blood. If Qi and Blood are strong, even without cauterizing agents, necrosis and discharge can occur naturally. The goal is merely to facilitate easy closure. Using cauterizing agents when Blood is deficient is not only futile but detrimental.