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Biejia Wan (Turtle Shell Pill)
Yeming Sha (Candor, 夜明砂) (cleaned, lightly stir-fried), Biejia (Testudinis Carapax et Plastrum, 鳖甲) (boiled in vinegar until yellow, remove hard ribs), Zhike (Aurantii Fructus, 枳壳), Huanglian (Coptidis Rhizoma, 黄连) (each two liang), Xiong Quanxie (Scorpio, 全蝎) (one male scorpion), Hezi (Terminaliae Chebulae Fructus, 诃子) (one raw, one cooked).
Grind all into powder. Add a small amount of Shexiang (Moschus, 麝香), and form pills with honey the size of mung beans. Take five pills per dose, administered after meals with rice water.

Chen Shigong stated: Yingliu (Goiter and Tumor) are not swellings formed by the knotting of yin and yang qi, but are caused by blood stasis, turbid qi, and phlegm stagnation in the five zang organs. Ying (Goiter) is yang.
Its color is red and it protrudes high; some have a small pedicle and hang down. Liu (Tumor) is yin.
Its color is white and it presents as diffuse swelling, without itching or pain, often unnoticed by people. (Zhengzong)
He further stated: Jinying (Sinew Goiter) is characterized by exposed sinews and bones, associated with the Liver. Xueying (Blood Goiter) features intersecting red vessels, associated with the Heart. Rouying (Flesh Goiter) shows unchanged skin color, associated with the Spleen. Qiying (Qi Goiter) fluctuates with emotions of joy and anger, associated with the Lung. Shiying (Stone Goiter) is hard and immobile, associated with the Kidney. Treatment should aim at dissipation. It will naturally shrink. One must never lightly use knives or needles to pierce it; otherwise, uncontrolled bleeding may lead to critical danger. Over time, pus and blood may collapse and leak continuously, ultimately causing death. (Zhengzong)
[Image: Yingliu]
He further stated: Jinliu (Sinew Tumor) is hard and purple, with coiled blue veins appearing in clusters; severely, it knots like earthworms. This is caused by the Liver governing sinews; anger stirring Liver fire, leading to dry blood and spasming sinews. Treatment should focus on clearing the Liver, resolving depression, nourishing blood, and relaxing sinews. Qinggan Lulu Wan (Liver-Clearing Aloe Pill) is indicated.
He further stated: Xueliu (Blood Tumor) is slightly purple or red, with mixed hardness and softness; the skin shows faint red threads. If scratched, blood flows uncontrollably. This is caused by the Heart governing blood; sudden excess leads to vigorous fire forcing blood to boil, compounded by external pathogens. Treatment should focus on nourishing and cooling blood, suppressing fire, nourishing yin, calming the spirit, and harmonizing the blood vessels. Qinlian Ermu Wan (Scutellaria and Anemarrhena Pill) is indicated.
He further stated: Roulou (Flesh Lump) is soft as cotton, hard as steamed bun, with unchanged skin color, neither tight nor loose, resembling a covered liver throughout the year. This is caused by the Spleen governing muscles; depression injuring the Spleen, leading to thinning muscles and stagnant Earth qi reversing into the flesh causing swelling. Treatment should focus on regulating the Spleen, widening the middle, unblocking Stomach qi, resolving depression, moving phlegm, and adjusting diet. Jiawei Guipi Tang (Modified Restore the Spleen Decoction) is indicated.
He further stated: Qilou (Qi Lump) is soft yet firm, with normal skin color, fluctuating in size without fever or chills. This is caused by the Lung governing qi; labor injury depleting primordial qi, loose interstices allowing external cold to transmit and cause swelling. Treatment should focus on clearing Lung qi, regulating meridians, treating labor injury, and harmonizing Ying and Wei. Tongqi Sanjian Wan (Qi-Unblocking Hardness-Dissipating Pill) is indicated.
He further stated: Guli (Bone Tumor) is purple-black, hard as stone, with raised nodules that do not move, firmly attached to the bone. This is caused by the Kidney governing bones; excessive desire injuring the Kidney, depressing Kidney fire, and failing to nourish bones, causing swelling. Treatment should focus on nourishing and tonifying Kidney qi, nourishing blood, moving stasis, dissipating swelling, breaking hardness, and opening orifices. Diaoyuan Shenqi Wan (Origin-Regulating Kidney Qi Pill) is indicated.
He further stated: Fenliu (Powder Tumor) is pink-red, mostly occurring behind the ears and neck, sometimes on the lower body, entirely formed by phlegm and qi knotting. It is suitable to use a lancet to break it, remove the powder, insert Sanpin Yitiaoqiang (Three-Grade Single-Spear), and repeat until the inner membrane is dissolved for self-healing.
He further stated: Heishaliu (Black Sand Tumor) mostly occurs on buttocks and legs, with varying sizes of protrusion. Pinching reveals black material inside. Use a lancet to puncture internally; black sand exits with sound, varying in hardness.
He further stated: Faliu (Hair Tumor) mostly occurs about one cun below the hair behind the ear, soft, small, and protruding, non-painful upon pressure. Needling causes powdery hair to exit completely.
He further stated: Hui Chong Liu (Roundworm Tumor) occurs under the hypochondrium.
He further stated: Qu Liu (Maggot Tumor) occurs on the shoulders and arms.
He further stated: Shi Liu (Louse Tumor) releases lice when broken. However, the varied shapes of tumors are all caused by damp-heat, evil fire, turbid qi, and blood stasis in the five zang organs, each sensing different factors; they are not standard diseases.
He further stated: Xia'er Tai Liu (Infant Congenital Tumor) appears at birth on the head or between chest and breasts. Large ones resemble buns, small ones resemble plums. This is formed by stagnant blood in the womb. Wait until the infant is one month old, then prick with a needle. If red bean juice-like fluid exits, it is safe; internal administration of Wufu Huadu Dan (Five Blessings Detoxifying Pill) leads to cure.
He further stated: For treating Ying, if primordial qi is strong at onset, use Haizao Yuhu Tang (Seaweed Jade Pot Decoction) or Liu Jun Wan (Six-Army Pill); if primordial qi is deficient after a long time, use Hupo Heilong Dan (Amber Black Dragon Pill) or Shiquan Liuqi Yin (Perfect Ten Qi-Flowing Decoction). Select and treat accordingly.
Xue Lizhai stated: For various syndromes of Ying and Liu, only medication for gradual dissolution is suitable. Never lightly use knives or needles to pierce them; uncontrolled bleeding often leads to immediate danger. Both doctors and patients must be cautious and never act rashly.
Feng Luzhan stated: Ying attaches to the shoulder and neck; Liu forms with qi knotting. Avoid rich flavors, forbid reckless piercing. The five types of Ying must not be recklessly pierced; only Taiying (Congenital Ying) heals after piercing and removing its powder. (Jinnang)
Li Dongyuan's method for distinguishing Liu: If swelling is uniformly soft and painless, it is Xueliu (Blood Tumor). If swelling grows daily, is not hot, but causes pulling pain, it is Qilou (Qi Tumor). If qi knotting causes slight swelling that persists and eventually suppurates, it is caused by cold and heat. Long-standing accumulation generates yang from extreme yin, transforming cold into heat; thus, ulceration likely leads to fistulas. Early administration of Neisai San (Internal-Sealing Powder) to drain pus is advisable. Various ulcers, warts, and excrescences in old age will ulcerate internally; treating them in youth prevents future worries. (Shi Shu)
Baixiao Quanshu states: Ying and Liu are both formed by qi and blood stagnation knotting together. Ying arises from joy and anger, mostly attaching to the shoulder and neck, with loose, heavy, hanging skin. Liu forms where qi stays; initially like a plum, with tender, shiny skin, gradually becoming cup-shaped. Although Ying has five types, Liu has many categories. They are painless and itchless; do not rupture them, lest pus and blood collapse and leak endlessly, causing death. Rouliu (Flesh Tumor) especially should not be aggressively treated. For Zhi Liu (Fat Tumor) and Qilou (Qi Tumor) in robust individuals, Haizao Sanjian Wan (Seaweed Hardness-Dissipating Pill) or Li Dongyuan's Sanzhong Kuijian Tang (Swelling-Reducing Hardness-Ulcerating Decoction) taken in large amounts can also dissipate them. For weak individuals, caution is needed; do not solely use drugs that resolve phlegm, move qi, or break hardness.
Ling Shu states: When xu xie (deficient evils) enter deeply, cold and heat contend. Long retention leads to internal fixation. If cold overcomes heat, bone pain and muscle wasting occur; if heat overcomes cold, rotting flesh and corrupting muscle form pus, damaging bones internally, leading to bone erosion. If there is prior tendon pathology ("prior" is a textual error, "tendon" should be "knot"), tendon knots cannot extend, and evil qi occupies the space, causing Jinliu (Sinew Tumor). If there is knotting, qi gathers there, Wei qi stays and cannot return, fluids remain long-term, forming Changliu (Intestinal Tumor), taking years to form, soft upon palpation. If knotting exists, qi resides forming Xiliu (Ancient Tumor), hard upon palpation. If knotting worsens daily, gathering fluids and evil qi, condensing deep into bone, qi solidifies in bone, bone and qi combine, enlarging daily, forming Guju (Bone Abscess). If knotting occurs in flesh, Zong qi resides there; evil stays, heat transforms to pus, no heat forms Rouju (Flesh Abscess). These airs arise without fixed locations but have fixed names. (Ci Jie Zhen Xie Pian: These are diseases caused by deficient evils entering humans, lingering after the pathogen leaves, accumulating over years to form abscesses and tumors.)
San Yin Fang states: Ying mostly attaches to the shoulder and neck; Liu forms with qi knotting.
Qi Tian Shi stated: Ying and Liu differ. Ying grows connected to flesh, with a large root and large body; Liu has a small root but large body. Among Liu, there are differences: Fenliu (Powder Tumor), Rouliu (Flesh Tumor), Jinliu (Sinew Tumor), and Wuliu (Object Tumor). Jinliu is untreatable and need not be treated; over ten years, it may only grow walnut-sized. Fenliu naturally ruptures after three years, expelling powder like incense ash; once expelled, it heals spontaneously, requiring no treatment. Rouliu is easiest to treat: mix Shuiyin (Mercurius, 水银) and Pengsha (Borax, 硼砂) one qian each, Xuexie (Draconis Sanguis, 血竭) and Ercha (Camelliae Semen, 儿茶) three qian each, Huangbai (Phellodendri Cortex, 黄柏) five qian, Bingpian (Borneolum Syntheticum, 冰片) and Shexiang (Moschus, 麝香) three fen each. Grind to fine powder and apply to the tumor base; it falls off upon application. Small-rooted tumors always fall off. Wuliu (Object Tumor) has a large root and is hardest to treat; it moves occasionally and makes sounds without cause, like insects or birds. One must cut a hole in it so the object cannot stay and escapes. Then apply miraculous flesh-regenerating medicine to dissolve the tumor into water, restoring normal appearance. (Milu)
He further stated: Wuliu results from disrespecting gods and ancestors, offending the Year Lord. The disease is unpredictable and beyond rational discussion, hence not mentioned in Nei Jing, yet such cases exist in the world.
He further stated: Ying varies in shape but is always a damp-heat disease. It grows from small to large, breaks from large, and leads to death from breaking. At onset, cut with a small knife to release clear white fluid, apply Shengji San (Flesh-Generating Powder) for immediate cure. If neglected, it grows larger. Apply medication to the depressed area; pain and fluid discharge occur in half a day. White fluid indicates easy cure; yellow or red indicates difficult cure.
Zhang Zhongjing stated: Some have arm sores turning into large masses, or abdominal sores forming hard lumps persisting all year, or拳头-sized masses. These must be cut out with a knife, but this causes fainting and should not be imitated. Instead, use a small knife to break the skin slightly, then apply Huadu Dan (Toxin-Dissolving Pill) to dissolve it into water. This formula is miraculous and should not be underestimated. For foot tumors the size of a dou, do not break them; gently prick with a needle, apply Huadu Dan, and fluid will flow incessantly. Immediately administer a decoction: Ren Shen (Ginseng Radix, 人参) and Huang Qi (Astragali Radix, 黄芪) three liang each, Sheng Gan Cao (Raw Glycyrrhizae Radix, 生甘草) and Yi Yi Ren (Coicis Semen, 薏苡仁) five liang each, Bai Jie Zi (Sinapis Semen, 白芥子) three qian. Decoct and drink. Two doses eliminate the fluid, leaving the patient without fatigue. This is an internal-external dual treatment. Its brilliance lies in tonifying primordial qi while promoting diuresis without depleting qi. Pricking releases fluid, which damages qi, but tonifying qi counters this fear. This is why the formula is miraculous.
Qi Tian Shi stated: Some have severe throat swelling, not Ying or Liu, with intermittent pain, five-colored patterns externally, and semi-empty/hard sensation internally. This is phlegm knotting, resembling Liu but not Liu, resembling Ying but not Ying. Xiaotan Tang (Phlegm-Resolving Decoction) is indicated. This is a sacred formula for resolving upper jiao phlegm. With Haizao (Sargassum Herba, 海藻) and Kunbu (Eckloniae Thallus, 昆布) to remove the external appearance of Ying/Liu and eliminate five-colored patterns, its妙 (wonder) lies in resolving phlegm without damaging qi, strengthening Stomach qi to facilitate phlegm resolution. One dose brings improvement, two reduce most symptoms, three eliminate completely, four prevent recurrence. This formula is also miraculous for treating Ying syndromes. (Milu)