【歌】五瘿多缘气与痰，结于颈项两颐间。若生身体肌肤内，气聚成瘤不等闲。
【论】夫瘿有五∶气、血、石、筋、肉是也。瘤有六∶骨、肉、脓、血、脂、石是也。瘿但生于颈项之间；
瘤则遍身体头面、手足，上下不拘其处，随气凝结于皮肤之间，日久结聚不散，累积而成。若人之元气循环周
流，脉络清顺流通，焉有瘿瘤之患也，必因气滞痰凝，隧道中有所留止故也。瘿气绝不可破，破则脓血崩溃，
多致夭枉，但当破气豁痰，咸剂以软其坚结，自然消散。丹溪云∶瘿气先须断浓味。只此一言，深达病机之旨
也。盖瘿初起如梅、李，久则滋长如升、斗，大小不一，盖非一朝一夕之故也。然六瘤中惟脂瘤可破，去脂粉
则愈，余皆不可轻易决破也。慎之！慎之！
瘿
五瘿，破结散。男女项下瘿，不分久近，神效开结散。项下结核如梅、李，不消，以大蜘蛛不拘多少，酒
浸研烂，酒调，临卧服。五瘿，用昆布一两，切碎，醋浸，徐徐咽下自消。
破结散
治五瘿。
海蛤（三分） 通草（三分） 昆布（三分） 海藻（三分，洗） 胆草（三分） 枯矾（三分） 松萝（三分）
麦面（四分） 半夏（二分） 贝母（二分）
末之，酒调服，日三次，忌鲫鱼、猪肉。
神效开结散
沉香（二钱） 木香（三钱） 陈皮（四两） 珍珠（四十九颗，炒，内泥封口） 海藻（二钱） 猪厌肉子
（生雄猪项，红色，四十九个，瓦上焙干）
末之，服二钱。
瘤
治瘤大如拳，小如粟，或软或硬，无药可疗，不可骤用针破，用南星膏。一切瘿瘤，不问新久，昆布丸。
南星膏
治头面生瘤，大如拳，小如枣，不知痛痒。
大南星（一个）
为末，醋调如膏，以针轻刺患处，令气透，然后敷之，南星若得新鲜者尤佳。
昆布丸
治一切瘿瘤，不拘久近。
昆布（洗一两，小麦醋煮干） 海藻（一两，小麦醋煮干）
末之，蜜丸弹子大，每一丸噙化下。
[Verse] The five types of Ying (goiter) mostly arise from Qi stagnation and Phlegm accumulation, knotting between the neck and the parotid regions. If they arise within the body's skin and flesh, Qi gathering to form a Liu (tumor) is no trivial matter.
[Dissertation] There are five types of Ying: Qi Ying, Blood Ying, Stone Ying, Sinew Ying, and Flesh Ying. There are six types of Liu: Bone Liu, Flesh Liu, Pus Liu, Blood Liu, Fat Liu, and Stone Liu. Ying only arises in the neck region; whereas Liu can appear all over the body, head, face, hands, and feet, without restriction on location, condensing with Qi between the skin. Over time, they knot and accumulate without dispersing. If a person's Yuan Qi circulates smoothly and meridians are clear and unobstructed, how could there be a disaster of Ying or Liu? It must be due to Qi stagnation and Phlegm coagulation, causing stasis in the collaterals and tunnels. Ying absolutely must not be ruptured; if ruptured, pus and blood will collapse, often leading to premature death. One should instead use methods to move Qi and resolve Phlegm, combined with salty agents to soften the hard knots, allowing them to dissipate naturally. Danxi said, "In treating Ying Qi, one must first cut off rich flavors." This single statement deeply grasps the essence of the pathogenesis. Generally, Ying initially appears the size of a plum or cherry; after a long time, it grows to the size of a sheng or dou vessel. Sizes vary, as this does not happen overnight. However, among the six types of Liu, only Fat Liu can be ruptured; removing the fat powder leads to cure. The others must not be easily punctured. Be cautious! Be cautious!
Ying
For the five types of Ying, use Po Jie San (Break Knots Powder). For Ying below the neck in both men and women, regardless of duration, Shen Xiao Kai Jie San (Divine Efficacy Opening Knots Powder) is highly effective. For submandibular nodules the size of plums or cherries that do not resolve, use large spiders in any quantity, soak in wine, grind into a paste, mix with wine, and take before bed. To treat the five types of Ying, use 1 liang of Kelp (Kunbu), chopped, soaked in vinegar, and swallowed slowly to dissolve naturally.
Po Jie San (Break Knots Powder)
Treats the five types of Ying.
Haige (Clam Shell, 3 fen) Tongcao (Tetrapanax Pith, 3 fen) Kunbu (Kelp, 3 fen) Haizao (Sargassum, 3 fen, washed) Danshen (Salvia Root, 3 fen)* [Note: Text says Dansheng/Dancao, likely referring to a bitter cold herb like Scutellaria or similar, literal translation 'Gallbladder Grass'] Gufan (Alum, 3 fen) Songluo (Usnea, 3 fen) Maimian (Wheat Flour, 4 fen) Banxia (Pinellia Tuber, 2 fen) Beimu (Fritillaria Bulb, 2 fen)
Grind into fine powder, take mixed with wine, three times daily. Avoid crucian carp and pork.
Shen Xiao Kai Jie San (Divine Efficacy Opening Knots Powder)
Chenxiang (Aquilaria Wood, 2 qian) Muxiang (Aucklandia Root, 3 qian) Chenpi (Citrus Peel, 4 liang) Zhenzhu (Pearl, 49 pieces, stir-fried, sealed in mud) Haizao (Sargassum, 2 qian) Zhu Yan Rouzi (Pig Neck Meat, from a live male pig, red, 49 pieces, dried on tiles)
Grind into fine powder, take 2 qian per dose.
Liu
To treat Liu, whether large as a fist or small as millet, soft or hard, if no medicine works, do not suddenly puncture with a needle; use Nanxing Gao (Arisaema Paste). For all Ying and Liu, regardless of new or old, use Kunbu Wan (Kelp Pill).
Nanxing Gao (Arisaema Paste)
Treats tumors on the head and face, large as a fist, small as a date, with unknown sensation of pain or itch.
Daxing (Large Arisaema Rhizome, 1 piece)
Grind into powder, mix with vinegar to form a paste. Lightly prick the affected area with a needle to allow Qi penetration, then apply the paste. Fresh Daxing is especially good.
Kunbu Wan (Kelp Pill)
Treats all Ying and Liu, regardless of duration.
Kunbu (Kelp, 1 liang washed, boiled dry in wheat vinegar) Haizao (Sargassum, 1 liang, boiled dry in wheat vinegar)
Grind into powder, make pills with honey the size of a bullet. Take one pill at a time, holding it in the mouth to dissolve and swallow.