治相火迫聚，津液凝结成核，或绕顶夹耳，或循胁肋，不红不肿，不作脓者，谓之痰
核。此痰火之机，急宜消散，初无痰火之证，但见核者，宜此主之。
玄参（忌钱，一钱五分，滋阴降火，为消核之要品） 桔梗（一钱，为舟楫之药） 连翘（
带子，一钱五分，开结降火） 射干（去根，一钱，消瘿散结） 黄芩（酒炒，一钱，清金降火
）海藻 海带 昆布（水洗，各一钱，并咸以软坚） 蒲公英（一钱，散颈项结核） 白僵蚕（
炒，一钱，去风消核） 紫背天葵（干者，一钱，消瘿散核之要药） 夏枯草（干者，一钱，消
核散块） 甘草（一钱，泻火缓急） 薄荷（八分，清上消热） 川贝（一钱，消核，清痰解毒）
天花粉（一钱，消核，清热） 牡蛎（火 ，一钱，颈项核用茶引之，胁下核以浓朴引） 壮体
实者，加酒炒大黄一分。
上十七味，皆消核之专品，作一剂，水煎，食后入姜汁、竹沥同服。
若核在颈侧胁肋少阳之分，加柴胡八分。在头项太阳之分，加羌活五分。
治结核已溃，而有痰火诸证者，宜此主之。
玄参（忌铁，一钱） 桔梗（一钱） 沙参（一钱） 连翘（带子，一钱） 知母（蜜炒，一钱）
贝母（八分） 天门冬（去心皮，一钱） 麦门冬（去心，一钱） 陈皮（去白，一钱） 甘草（
八分） 海藻 海带 昆布（各洗，一钱） 白茯苓（去皮，一钱） 柴胡（八分） 黄 （蜜炒，
一钱）
上十六味作一剂，水煎食后服，仍看核结何分加引。
若气虚脉微缓者，加人参五分。他证悉如前痰火主方例增减。
To treat phlegm nodules (Tan He, phlegm-induced nodules) caused by the forcing and gathering of ministerial fire (Xiang Huo), leading to the coagulation of body fluids into nodules. These may encircle the crown and clamp the ears, or follow the hypochondriac region, presenting without redness, swelling, or suppuration. This pathology involves the mechanism of phlegm-fire; it is urgent to dissipate them. Even if there are no initial signs of phlegm-fire syndrome, but only nodules are observed, this principal formula is suitable.
* *Scrophulariae Radix* (Xuan Shen, avoid iron vessels, 1 qian 5 fen): A key herb for dissipating nodules, nourishing yin and descending fire.
* *Platycodonis Radix* (Jie Geng, 1 qian): Acts as a "vessel" to guide herbs upward.
* *Forsythiae Fructus* (Lian Qiao, with seeds, 1 qian 5 fen): Opens stagnation and descends fire.
* *Belamcandae Rhizoma* (She Gan, remove roots, 1 qian): Dissipates goiter and resolves masses.
* *Scutellariae Radix* (Huang Qin, wine-fried, 1 qian): Clears lung metal and descends fire.
* *Sargassum* (Hai Zao), *Laminaria Thallus* (Hai Dai), *Eckloniae Thallus* (Kun Bu) (washed, each 1 qian): All salty in flavor to soften hardness.
* *Taraxaci Herba* (Pu Gong Ying, 1 qian): Dissipates tubercles in the neck.
* *Bombyx Batryticatus* (Bai Jiang Can, fried, 1 qian): Dispels wind and dissipates nodules.
* *Omphalodes Lapidosa* (Zi Bei Tian Kui, dried, 1 qian): A key herb for dissipating goiter and nodules.
* *Prunellae Spica* (Xia Ku Cao, dried, 1 qian): Dissipates nodules and lumps.
* *Glycyrrhizae Radix et Rhizoma* (Gan Cao, 1 qian): Purges fire and relieves urgency/spasm.
* *Menthae Haplocalycis Herba* (Bo He, 8 fen): Clears upper heat.
* *Fritillariae Thunbergii Bulbus* (Chuan Bei, 1 qian): Dissipates nodules, clears phlegm, and detoxifies.
* *Trichosanthis Radix* (Tian Hua Fen, 1 qian): Dissipates nodules and clears heat.
* *Ostrea Concha* (Mu Li, calcined, 1 qian): For neck nodules, take with tea infusion; for hypochondriac nodules, take with *Magnoliae Officinalis Cortex* (Hou Po) infusion.
* For those with robust constitution, add *Rhei Radix et Rhizoma* (Da Huang, wine-fried), 1 fen.
These seventeen ingredients are all specialized agents for dissipating nodules. Prepare one dose, decoct in water, and take after meals with ginger juice and bamboo sap.
If the nodule is located in the Shaoyang distribution areas such as the side of the neck or hypochondrium, add *Bupleuri Radix* (Chai Hu), 8 fen. If located in the Taiyang distribution area such as the head and neck, add *Notopterygii Rhizoma et Radix* (Qiang Huo), 5 fen.
For tubercles that have already ulcerated and present with various symptoms of phlegm-fire, this principal formula is suitable.
* *Scrophulariae Radix* (Xuan Shen, avoid iron vessels, 1 qian)
* *Platycodonis Radix* (Jie Geng, 1 qian)
* *Glehniae Radix* (Sha Shen, 1 qian)
* *Forsythiae Fructus* (Lian Qiao, with seeds, 1 qian)
* *Anemarrhenae Rhizoma* (Zhi Mu, honey-fried, 1 qian)
* *Fritillariae Bulbus* (Bei Mu, 8 fen)
* *Asparagi Radix* (Tian Dong, remove heart and peel, 1 qian)
* *Ophiopogonis Radix* (Mai Dong, remove heart, 1 qian)
* *Citri Reticulatae Pericarpium* (Chen Pi, remove white pith, 1 qian)
* *Glycyrrhizae Radix et Rhizoma* (Gan Cao, 8 fen)
* *Sargassum* (Hai Zao), *Laminaria Thallus* (Hai Dai), *Eckloniae Thallus* (Kun Bu) (washed, each 1 qian)
* *Poria* (Fu Ling, remove skin, 1 qian)
* *Bupleuri Radix* (Chai Hu, 8 fen)
* *Astragali Radix* (Huang Qi, honey-fried, 1 qian)
Prepare these sixteen ingredients as one dose, decoct in water, and take after meals. Still, add guiding herbs according to the meridian distribution of the nodule.
If qi deficiency and a faint, slow pulse are present, add *Ginseng Radix* (Ren Shen), 5 fen. Adjustments for other syndromes should follow the examples of the aforementioned phlegm-fire principal formula.