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Deficiency and loss of function, failure of dispersing and draining; the swelling of scrofula (scrofula) is due to liver fire stagnation and discomfort. Therefore, using Yangrong Tang (Nourishing Prosperity Decoction) with added Rougui (Cinnamon Twig), after more than a month there were signs of recovery. Subsequently, alternating the previous prescription with Guipi Tang (Restore the Spleen Decoction) and Yangxin Decoction (Nourish Heart Decoction), adhering to this regimen for three months led to complete recovery.

Zhou Hanqing treated the daughter of the Wang family in Qiantang, who had developed scrofula around her head and armpits, totaling nineteen openings. The openings ruptured and discharged white pus, and she was on the verge of death. Zhou Hanqing excised the openings and probed deeply two cun, while cauterizing the rest with fire (moxibustion). After several days, scabs formed and healed. (From *History of Ming*)

Zhang Hezi treated a woman suffering from scrofula that extended to the chest and epigastrium, forming large connected ulcers with no healthy skin or flesh remaining. Zhang said: "This is caused by excessive pathogenic fire; it should be treated with salty-cold methods." He ordered the use of Cangyan (Blue Salt) to induce vomiting. After one episode of vomiting, scabs formed. He then administered Liangge San (Cooling the Diaphragm Powder) and Jiedu Tang (Detoxification Decoction), after which the skin and flesh recovered as before.

For treating scrofula, place the hand palm-up on the shoulder, slightly raise the elbow, and locate the acupoint at the tip of the elbow bone. Treat the affected side: if on the left, moxa the left; if on the right, moxa the right. Use moxa cones the size of a small sinew head, three moxibustions are sufficient for cure. If it recurs, repeat the moxibustion as before; no more than three times will permanently eradicate the root. Tang Shouzi, when serving as magistrate in Zhongli, had a young maid with an ulcerated sore. She passed this method to a local grain transport official. Early moxibustion dried the pus by evening; only two sessions were needed for full recovery. It was later used successfully on many others. Lady Luo Anzhi suffered for four or five years with scrofula crusts resembling snail shells, sunken and unhealed. Moxibustion applied at Chen hour (7-9 AM) resulted in detachment by Shen hour (3-5 PM). Deeply impressed, she noted that three recurrences required three treatments, leading to permanent relief.

Xue Lizhai treated a man who indulged in sexual desires and mental labor, disliked heat and preferred cold, and only wore cotton clothing in mid-winter. He developed scrofula with a surging but forceless pulse. Xue said: "This is consumption of yin qi, leaving yang without attachment. Yang floats outward causing aversion to heat." He prescribed Baidu San (Eliminate Toxin Powder) with Huangqin (Scutellaria Root), Lian (Gardenia Fruit), and Zhizi (Gardenia Fruit), taken for four doses with slight improvement. Then, Siwu Tang (Four Substances Decoction) with Huangqin, Lian, Baizhi (Angelica Dahurica Root), Jiegenggen (Platycodon Root), Gancao (Licorice Root), and Jinyinhua (Honeysuckle Flower) was given for several doses until resolution. (Xu Lingtai's note: Since the pulse indicates yin depletion and floating yang, why does Article 13 advocate Bu Zhong Yi Qi Tang? Using Baidu San here is also an case of excessive releasing of the exterior.)

Miao Zhongchun treated Zhu Wenxue for scrofula by moxibusting the Jianjing (GB21) and Zuijian (Elbow Tip) acupoints, several moxibustions per point, resulting in cure. (From *Guang Biji*)

Xue Lizhai treated a woman with scrofula extending to the chest and armpits, with dripping pus. Long-standing symptoms included five-palm heat, limb pain, heavy head and eyes, palpitations, flushed cheeks, dry mouth and throat, fever, night sweats, poor appetite, lethargy, irregular menstruation, and abdominal pain. He stated this was not due to the sore itself, but to blood deficiency. She took Xiaoyao San (Free and Easy Wanderer Powder) for over a month with slight relief. Then Bazhen Tang (Eight Treasures Decoction) with Danpi (Moutan Bark) and Xiangfu (Cyperus Rhizome) was given for another month, restoring menstruation. Astragalus (Huangqi) and Atractylodes (Baizhu) were added, leading to recovery after two months.

The wife of Mr. Shen suffered from scrofula that did not resolve for a long time, with spontaneous sweating and aversion to cold, indicating dual deficiency of qi and blood. She was given Shiquan Dabu Tang (Ten Significant Tonifying Decoction). After over a month, it suppurated. Although the hard nodule was removed, the wound failed to close. Moxibustion with Fermented Soybean Cake (Douchi Bing) was applied, along with the previous medicine plus Wuyao (Lindera Root) and Xiangfu. Recovery occurred after two months. Generally, hardness without suppuration or failure to heal after suppuration is due to insufficient qi. I have seen patients whose wounds healed but lacked tonification, often transforming into consumptive diseases.

Xue Lizhai treated a woman with swelling and pain below the ear due to anger, prescribing Jingfang Baidu San (Perilla and Saposhnikovia Eliminate Toxin Powder) with Chaiqiao (Forsythia Fruit) and Huangqin, cured in four doses. For cases lasting ten days without resolution, he used qi and blood tonics and Yuanzhi Wine (Polygala Root wine: Polygala root powder mixed with wine, clarified and drunk; dregs applied externally after soaking the area in rice water. Especially effective for female breast abscesses). Swelling subsided spontaneously. Even without pus, it would ulcerate spontaneously. Difficult to treat if anger is not restrained.

A woman, angered, had swelling below the ear, headache, chills, and fever. Given Jingfang Baidu San with Huangqin, exterior symptoms resolved, but appetite decreased and afternoon fever appeared. Dongyuan said: "Even with deficient heat, do not attack too severely; removing heat generates cold." Thus, Xiao Chaihu Tang (Minor Bupleurum Decoction) with Digupi (Groundsel Root), Chuanxiong (Ligusticum Rhizome), Danggui (Angelica Sinensis Root), Fuling (Poria), Baizhu (Atractylodes Macrocephala Rhizome), and Chenpi (Tangerine Peel) was given for over ten doses, curing her. The following spring, recurrence with hardness and no suppuration occurred. She requested a formula; I gave Bazhen Tang with Xiangfu, Chaihu (Bupleurum Root), Digupi, and Jiegeng (Platycodon Root). After six or seven doses, finding it slow, she resumed Renshen Baidu San (Ginseng Eliminate Toxin Powder), worsening the condition. Taking Liuqi Yin (Flowing Qi Drink) caused night sweats, fever, dry mouth, and poor appetite. Seeking treatment again in autumn, her qi and blood were extremely depleted; I declined treatment, and she died. Nowadays, people with sores do not assess the deficiency or excess of yuan qi or the location of disease in interior/exterior, but take Baidu or Liuqi medicines. Unknowingly, Baidu San is an exterior-releasing formula; even with exterior symptoms, only one or two doses are suitable. Overuse damages yuan qi and intensifies toxicity; even with Ginseng, it cannot be supplemented. Liuqi Yin consumes blood; even with qi stagnation and chest fullness, only one or two doses are suitable. Overuse injures qi and blood further, leading to fatal conditions; even with Chuanxiong and Danggui, rescue is impossible. Danxi said: "This is not a change from rich food or toxic substances, but caused by deficiency labor and qi stagnation."

A woman with unresolved scrofula and thin, non-healing pus improved slightly with Bazhen Tang. Suddenly, she had shoulder and back pain preventing turning of the head, caused by bladder meridian qi stagnation. She should have been treated with Fangfeng Tongqi Tang (Saposhnikovia Regulating Qi Decoction). The bladder meridian starts at the inner canthus, goes up to the vertex, passes behind the head through Fengfu (GV16), down the neck to the shoulders, and a branch descends to the lower back. When this meridian moves, it causes spinal pain, stiff neck, and waist pain resembling breaking. Is this not a bladder meridian syndrome? The patient claimed scrofula is a gallbladder meridian disease, running along the side of the neck, caused by fire moving in the meridian. She self-medicated with liver-clearing and fire-descending herbs, leading to anorexia and increased pain. Upon re-evaluation, her stomach qi was weaker. First, Six Gentlemen Decoction (Sijunzi Tang) with Chenpi, fried Shaoyao (Peony Root), Banxia (Pinellia Tuber), Qianghuo (Notopterygium Rhizome), and Manjingzi (Vernonia Seed) was given for four doses, improving appetite and stopping pain. Then Fangfeng Tongqi Tang for two doses cured her. Another woman with chronic suppurating liuzhu (flowing deposits) suddenly developed fever, indicating deficiency. Two doses of tonics were given. Refusing them, she took Renshen Baidu San, leading to high fever and death. In elderly and weak persons, even with wind pathogens, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. How much more so when it is not an exterior syndrome but harsh exterior-releasing methods are used? Death is inevitable. (Scrofula is a deficiency-consumption disease, most difficult to treat. Ancients had established methods, but they were often ineffective. I obtained a plaster formula: One red-feathered rooster, taking the whole skeleton. Fry in sesame oil until crisp, remove residue. Add Jiangxiang (Aquilaria Wood) 5 liang, Qianliben (Hooves of mules/horses that have rested) 5 qian, Danggui 1 qian, Gancao 1 qian, Huai Zhi (Locust Branch) 30 cun. Fry until crisp, remove residue. Collect paste with Huangdan (Red Lead). Apply on red silk. Unformed nodules dissipate; formed ulcers produce thick pus. Tested repeatedly with success. Also treats all unformed swellings; application causes immediate dissipation, extremely effective.)

A man, angered, developed scrofula below the ear and clavicle, ulcerating and extending to the armpit. His constitution was robust, but the wound failed to heal. Scanzhong Kuijian Wan (Disperse Swelling and Harden Nodules Pill) cured him. A woman with similar symptoms, whose qi and blood were not weak, also took this pill; nodules disappeared. However, the wound did not heal. Shiquan Dabu Tang and moxibustion with fermented soybean cake eventually cured her.

The nephew of Hanlin Academician Jiang, aged twenty, had scrofula below the ear with swelling and pain. The left guan pulse was rapid, indicating wind-heat in the liver meridian. Three doses of Jingfang Baidu San resolved exterior symptoms. Scanzhong Kuijian Wan was then given, but it recurred after a month.

A twenty-year-old woman had tubercles below the ear, delayed menstruation, and afternoon headaches. Headache medicines worsened her condition. Bazhen Tang with Chaihu and Digupi cured her after twenty-plus doses.

Formula for Scrofula Pills: Zhengshen (Prepared Scrophularia Root), Mudie (Calcined Oyster Shell), Cu Chao Chuan Beimu (Vinegar-fried Fritillaria Thunbergii Bulb, heart removed), each 4 liang. Make pills with refined honey. Take 3 qian each time with warm water, twice daily. This formula is miraculous, curing countless cases.

Wang Hongxu treated a seventeen-year-old with scrofula on the neck, spreading in patches and ulcerating, with multiple palm-sized areas in ears, armpits, and waist. He was emaciated and timid. Initially given Dongtian Jiuku Dan (Heavenly Cave Saving Souls Pill), causing profuse discharge of toxic fluid. Ten days later, Yanghe Tang (Warm Harmony Decoction) and Xingxiao Wan (Awakening消 Pill) were given morning and evening. Within ten days, neck mobility improved and appetite increased. Externally, Yanghe Gao (Warm Harmony Plaster) was applied; internally, Dazao Wan (Jujube Pill) was taken. Throughout, washed with Schizonepeta tea and dusted with Shanlian San (Lotus Mountain Powder). Recovery took ninety days. Because Zilong Wan (Dragon Child Pill) and Xiaojin Dan (Little Gold Pill) were not taken, the toxic root remained, and malignant nodules later appeared in the armpit, which were resolved with Zilong Wan.

Dongtian Jiuku Dan Formula: Dew-beehive nests containing larvae, Liangtoujian (Galium Verum Herb), Qingpi (Green Tangerine Peel), Kulianzi (Chinaberry Seed) (preferably collected after Start of Winter). Roast on tile until charred but retaining nature, grind to powder. Mix equal parts. Take 3 qian with aged wine, every two days.

Xingxiao Wan Formula: Rushing Incense (Ruxiang) 1 liang, Myrrh (Moyao) 1 liang, Musk (Shexiang) 1.5 qian, Realgar (Xionghuang) 5 qian. Pound with 1 liang of cooked rice to form pills the size of radish seeds. Dry in sun, avoid baking. Take 3 qian with aged wine, cover warmly to induce sweat.

Yanghe Jieniu Gao Formula: Fresh Arctium root, stem, and leaves 3 jin, fresh white balsam apple stems 4 liang. Fry in 10 jin of sesame oil until crisp, remove residue. Next day add raw Fuzi (Aconite Root), Guizhi (Cinnamon Twig), Dahuang (Rhubarb Root), Danggui, Wulingzhi (Trogopterus Dung), Rougui (Cinnamon Bark), Chuan Cao Wu (Aconitum Carmichaelii Root), Dilong (Earthworm), Chishao (Red Peony Root), Jiangcan (Silkworm), Baizhi, Bailian (Lily Bulb), each 2 liang, Guangmuxiang (Costus Root) 1 liang, Baiji (Bletilla Rhizome) 2 liang, Chuanxiong 4 liang, Xuduan (Dipsacus Root), Fangfeng (Saposhnikovia Root), Jingjie (Schizonepeta Spike), Xiangyuan (Citron), Chenpi, each 1 liang. Fry until crisp, remove residue. Cool oil overnight. Add 7 liang of calcined Huangdan per jin of oil, stir, simmer slowly until drops form beads in water. Move pot to cool place. Add 1 liang Rushing Incense powder, 1 liang fine Musk, 4 liang Suhé Oil. Mix evenly. Let stand half a month before applying. Specifically treats all ulcerations, yin abscesses, frostbite; apply to back for malaria.

Dazao Wan Formula: Dry goat dung roasted in pan until charcoal-like, retain nature, grind to powder. Remove skin and pits from jujubes, pound into paste, mix with powder to form pills. For severe ulcerations nearing internal rot, take 4 qian with black jujube soup.

Shanlian San Formula: One large live crucian carp, gutted. Stuff belly tightly with goat dung. Slow-roast on tile until dry, grind to powder. Add 1 qian Musk. Store tightly in porcelain bottle. For severe ulcerations separated from internal organs only by a membrane, apply externally for miraculous results.

Zilong Wan Formula: Processed Gansui (Euphorbia Kansui Root). For every 1 jin, use 4 liang Gancao (Licorice Root), decoct in water, soak for three days. When water turns black, discard water. Wash and rinse with river water, changing water several times daily. After three days, remove heart. Soak and rinse for four to five more days. Take a pinch, place in white porcelain basin. Leave overnight; if water remains clear, remove, drain, wrap in dough, bake in chaff fire until yellow and thorough. Stir-fry in pan, grind to powder. Processed Daji (Euphorbia Pekinensis Root): Remove branches, boil thoroughly in water, slice, dry. Fried Baijiezì (White Mustard Seed). Grind these three ingredients equally to powder. Form pills with refined honey. Take three times daily, 3 fen each time, with light ginger soup. This is a specific medicine for scrofula, malignant nodules, and flowing deposits.

A Wang family daughter-in-law had several scrofulae inside the neck, three malignant nodules in both armpits, and a toxin on the thigh that was neither painful nor itchy. After over a hundred days, it grew large, like a bushel, hard as stone, with blue veins showing on the skin, and frequent drawing pains. Wang examined it and said: "This is Shi Ju (Stone Abscess)." At onset, it could be dissipated. Now, having grown large with visible vein patterns, although hard as stone, pus has formed at the root. Occasional drawing pain indicates presence of pus. Blue veins indicate yellow serum inside; treatable. If small, rock-hard protrusions appear, untreatable; death by severe pain without suppuration in three days. Red veins indicate connection to Blood Sea; untreatable. Spots indicate spontaneous rupture; bleeding upon rupture leads to death within three days. Currently, blue veins appear. If treated until soft, success is half achieved. After suppuration, when pus becomes thick, recovery may be expected. Externally, crush fresh Phytolacca root and apply. Internally, Yanghe Tang. Ten days later, drawing pain stopped. Thirteen doses later, itching began. Sixteen doses later, the top softened. Eighteen doses later, the entire lesion softened. Neck scrofulae and armpit nodules completely dissipated. Only the stone abscess remained elevated with an internal pus bag. Prescribed 1 qian Ginseng. Puncture the tendon/muscle area with a silver needle, widen the opening with a knife, insert paper wick. The next day, over a dou of watery fluid drained twice. Large doses of tonic and interior-supporting herbs were used. Ginseng was omitted, and raw Huangqi (Astragalus Root) was doubled. Ten doses were well-tolerated. A doctor instructed roasting both Huangqi and Gancao. After three days, swelling occurred around the perimeter with internal pain. Wang was consulted again. Following the original prescription for twenty-plus doses, Yanghe Gao was applied fully except for the wound hole, bound with cloth. Wang said: "When a yin abscess is about to heal after suppuration, the outer skin gradually becomes active and inner membrane regenerates, which is a good omen. The discharged pus lies between skin and membrane. Simply emptying it is insufficient; muscle-generating powders cannot be inserted easily. Internal warming, tonifying, yin-nourishing, and blood-supplementing herbs, combined with warm plasters and binding, connect the skin and membrane, facilitating pus drainage and muscle regeneration. Indeed, after binding for several days, thick pus accumulated. Adding Ginseng, recovery was achieved in two months."

Huahe Gao (Nodule-Dissolving Plaster) specifically treats scrofula; application causes gradual disappearance. Internally, Zilong Wan eradicates the root and prevents recurrence. Geckos 14, spiders 28, snails 36. Fry in 4 jin rapeseed oil until crisp, remove residue. Add fresh Polygonum multiflorum vines/leaves, Matricaria roots, Mint, Arctium herbs, Xanthium herbs, each 0.5 jin. Fry vigorously until crisp, remove residue. When oil cools, add Forsythia, Scrophularia, Sophora, Anemarrhena, White Mustard Seed, Silkworm, Water Hyacinth Seed, Rhubarb, Schizonepeta, Saposhnikovia, each 4 liang. Soak overnight, fry until crisp, remove residue. Simmer until drops form beads. Add 7 liang Huangdan per jin of oil, fry until black. Add 2 qian Clove Oil, 2 qian Musk, 1 liang Suhé Oil. Mix well, let cool, apply. When treating scrofula, avoid Hai Zao (Sargassum) and Xiakucao (Prunella Vulgaris); long-term use leads to consumptive disease. In the following years, avoid eating oranges; consumption causes relapse.