（独形而小核者，为结核。）
河间云∶结核，火气热甚则郁结坚硬，如果中核也，不须溃发。但热气散则自消。
丹溪云∶结核，或在项、在颈、在臂、在身皮里膜外，不红不痛，不硬不作痛，多是痰
注作核不散。问其平日好食何物？吐下后，用药散核。 结核在颈项方∶僵蚕（炒）、大黄（酒浸），
青黛、胆星各等分，为末蜜丸，噙化。 结核在下颏，二陈汤加酒炒大黄、连翘、桔梗、
柴胡。 结核在臂，二陈汤加连翘、防风、川芎、酒芩、苍术，皂角刺、僵蚕、麝香，行
太阴、厥阴之积痰，使结核自消，甚捷。风核，以去风消核散，常服消之。 风热结
核，以大连翘饮加僵蚕，牛蒡子。 凡一切风核疼痛，宜以大荞麦根，及金线钓葫芦根。
磨半泔、半醋，暖涂之。
儒者杨泽之，缺盆间结一核。予谓∶此肝火血燥而筋挛，法当滋肾水，生肝血。彼
反用行气化痰，外敷南星，商陆，益大如碗。予用补中益气汤、六味地黄丸以滋肾水；间
用芦荟丸以清肝火，年余，元气复而消。一男子，颈间结核大溃；一妇人，左眉及发
际结核；并用栀子清肝散、海藻散坚丸，以清肝火，养肝血，益元气而愈。此症亦有大
如升斗者，亦治以前药，可愈。 一妇年二十，耳下结核，经每过期，午后头痛，服头
痛药愈甚。治以八珍汤加柴胡、地骨皮，二十余帖愈。 一妇因怒结核肿痛，察其气血
俱实，先以神效散下之，更以益气养荣汤，三十余剂而消。 常治此症，虚者先用益气养
荣汤，待其气血完充，乃取神效散去其毒，仍进前药，无不效者。 一儿七岁，项结二核，
时发寒热，日久不愈，治以连翘丸而消，若患在面、臂等处，尤宜此丸。若溃而不敛，兼
以托里之药。 一儿项结一核，坚硬如 ，面色痿黄，饮食不甘，服托里药不应，此无辜
疳毒也。以蟾蜍丸治之而愈。 若数服不消，按之转动软而不痛者，内有虫如粉，急针出
之。若不速去，则虫随气走，内蚀脏腑不治。（蟾蜍，夏月沟渠中，腹大不跳不鸣者。先取粪蛆一杓，
置桶中以尿浸之，桶近上令干，使蛆不得出，将蟾蜍扑死，投蛆中任蛆食昼夜，次以新布袋包紧，置水急
处，浸一宿取出，瓦上焙为末，入麝香一字，软饮丸如麻子大。每服二三十丸，空心，米饮送下。） 一
妇因怒不思食，发热倦怠，骨肉酸疼，体瘦面黄，经渐不通，颈间结核，以逍遥散、八珍汤治之少可。彼自
误服水蛭等药，血气愈虚，遂致不救。
海藻连翘汤 治诸般结核，瘰 马刀，瘿瘤痰核。
白茯苓 陈皮（去白） 连翘 半夏（姜制） 黄芩（酒拌，炒） 黄连（酒炒） 南星（姜制） 牛蒡子（炒）
柴胡 三棱（酒炒） 莪术（酒炒） 僵蚕（炒去丝） 昆布 海藻 羌活 防风 桔梗 夏枯草 川芎 升麻
上生姜、薄荷煎，食后服。
连翘丸
连翘 防风（去芦） 黄柏 肉桂（去粗皮） 桑白皮 香豉 独活 秦艽 牡丹皮（各半两）
海藻（二钱半）
上为末，炼蜜丸，如绿豆大。每服十丸，灯心汤下。
五香散 治肉中忽有恶核生，肿硬不消。恶肉恶脉，瘰 风毒肿气。
木香 鸡舌香 沉香（各一两） 麝香（细研，二钱半） 射干 薰陆香 干葛（锉） 川升麻
独活 桑寄生 连翘 甘草（生，各二两） 川大黄（三两，锉碎，微炒）
上锉碎，入麝香研匀。每服三钱，水一中盏煎至五分，去滓。入竹沥半盏，更煎一
二沸。温服日三。
连翘散 治项上恶核 肿。
连翘 射干 独活 川升麻 木香 沉香 木通（锉，各一两） 桑寄生 丁香（各半两）
川大黄（二两，锉碎，微炒）
上为细末。每服二钱，清粥饮调下，日三服。
独活散 治恶核，风结肿毒，四肢烦热拘急。
独活 木香 射干 桑寄生 连翘 升麻 沉香 川大黄（生用） 甘草（生，各一两）
上锉碎。每服四钱，水一中盏煎至六分，去滓。入竹沥半合，更煎一二沸。放温服，日
三，得快利为度。
清肝益荣汤 治肝、胆、小肠经，风热血燥，筋挛结核，或耳、项、胸乳、胁肋作
痛，或作瘊子，并一切肝火之症。
山栀 当归 木瓜（不犯铁器） 茯苓（各一钱） 柴胡 川芎 芍药（炒，各七分） 熟地黄（一
钱半） 白术（二钱） 龙胆草（八分） 炙甘草（五分）
上姜水煎服。
(Solitary, small nodular formations are termed *Jiehe* [Tubercles].)
Hejian (Liu Wansu) stated: *Jiehe* occurs when excessive fire-heat causes stagnation and hardening, resembling a fruit pit. It does not require suppuration or ulceration. Once the heat dissipates, it will resolve spontaneously.
Danxi (Zhu Zhenheng) stated: *Jiehe* may appear in the neck, lateral neck, arms, or between the skin and fascia of the body. They are neither red nor painful, nor hard, and typically result from phlegm condensing into nodules that fail to disperse. One should inquire about the patient's dietary preferences. After employing emetic or purgative methods, administer herbs to disperse the nodules. For *Jiehe* in the neck and nape: prepare equal parts of Cangcan (Bombyx Batryticatus, Silkworm), Dahuang (Rhei Radix et Rhizoma, Rhubarb), Qingdai (Indigo Naturalis), and Dansheng (Arisaematis Cum Bile, Pinellia with Bear Gallbladder). Grind into powder, form pills with honey, and hold in the mouth for dissolution. For *Jiehe* on the chin, use Erchen Tang (Two-Aged Decoction) added with Jiuchao Dahuang (Rhubarb stir-fried with wine), Lianqiao (Forsythiae Fructum, Forsythia Fruit), Jiegeng (Platycodonis Radix, Balloon Flower Root), and Chaihu (Bupleuri Radix, Bupleurum Root). For *Jiehe* in the arms, use Erchen Tang added with Lianqiao, Fangfeng (Saposhnikoviae Radix, Divaricate Saposhnikovia Root), Chuanxiong (Ligustici Chuanxiong Rhizoma, Szechwan Lovage Rhizome), Jiuhuang Qin (Scutellariae Radix stir-fried with wine), Cangzhu (Atractylodis Rhizoma, Atractylodes Rhizome), Zaojiaoci (Gleditsiae Spina, Chinese Honeylocust Thorn), Cangcan, and Shexiang (Moschus, Musk). This formula moves accumulated phlegm in the Taiyin and Jueyin meridians, causing the *Jiehe* to resolve spontaneously, with very rapid results. For wind-induced nodules, take Qufeng Xiaohes San (Wind-Dispersing Nodule-Dissolving Powder) regularly until they dissipate. For wind-heat *Jiehe*, use Da Lianqiao Yin (Large Forsythia Decoction) added with Cangcan and Niubangzi (Arctii Fructus, Greater Burdock Fruit). For all wind-induced nodular pain, grind Dayaqiaogen (Polygoni Cuspidati Radix, Fleeceflower Root) and Jinxian Diaohulu Gen (Trichosanthes Kirilowii Root or similar vine root) mixed with half rice-washing water and half vinegar; apply warm externally.
The scholar Yang Zezhi had a nodule forming in the supraclavicular fossa. I reasoned: this is due to liver fire and blood dryness causing tendon contraction; the treatment should nourish kidney water and generate liver blood. He instead used qi-moving and phlegm-resolving herbs, and applied external Dansheng and Shanglu (Phytolaccae Radix, Pokeweed Root), resulting in the nodule enlarging to the size of a bowl. I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to nourish kidney water; intermittently used Lushui Wan (Aloe Pill) to clear liver fire. After more than a year, as his primordial qi recovered, the nodule resolved. A man had a large, suppurating cervical *Jiehe*; a woman had *Jiehe* at her left eyebrow and hairline. Both were treated with Zhizi Qinggan San (Gardenia Liver-Clearing Powder) and Haizao Sanjian Wan (Seaweed Hardness-Dispelling Pill) to clear liver fire, nourish liver blood, and benefit primordial qi, leading to recovery. Some cases present with nodules as large as a sheng or dou measure; these can also be cured with the aforementioned medicines. A twenty-year-old woman had subauricular *Jiehe*, delayed menstruation, and afternoon headaches. Her headache worsened after taking headache remedies. She was treated with Bazhen Tang (Eight-Treasure Decoction) added with Chaihu and Digupi (Lycii Cortex, Wolfberry Bark); she recovered after more than twenty doses. A woman developed painful, swollen *Jiehe* due to anger. Examination revealed excess in both qi and blood. Initially, Shenxiao San (Miraculous Efficacy Powder) was used to purge, followed by Yiqi Yangrong Tang (Benefit Qi and Nourish Blood Decoction); she recovered after more than thirty doses. In my frequent treatment of this condition, for deficiency patterns, I first use Yiqi Yangrong Tang until qi and blood are fully replenished, then use Shenxiao San to eliminate toxicity, followed again by the former medicine. This approach is invariably effective. A seven-year-old child had two cervical nodules with intermittent chills and fever persisting for a long time. Treated with Lianqiao Wan (Forsythia Pill), the nodules resolved. This pill is especially suitable if the lesions are on the face or arms. If ulcerated and failing to heal, combine with interior-supporting herbs. A child had a single, stone-hard cervical nodule with sallow complexion and poor appetite. Interior-supporting herbs were ineffective; this was identified as Wugu Gan Du (Innocent Malnutrition Toxin). Treated with Chan Chu Wan (Toad Pill), he recovered. If multiple doses fail to resolve the nodule, but it is mobile, soft, and painless upon palpation, there are likely worms inside resembling powder. Acupuncture should be used immediately to extract them. If not removed quickly, the worms will migrate with the qi and erode internal organs, rendering the case incurable. (Preparation of Chan Chu Wan: Select toads in summer ditches that are bloated but do not jump or croak. Take a scoop of maggot larvae, place them in a bucket soaked in urine, keeping the upper part dry so larvae cannot escape. Kill the toad and throw it into the bucket for the larvae to consume overnight. Wrap tightly in a new cloth bag, immerse in fast-flowing water overnight, remove, dry on tiles, and grind to powder. Add one zi of Shexiang (Musk). Form pills the size of hemp seeds using soft liquid. Take 20–30 pills on an empty stomach with rice drink.) A woman lost her appetite due to anger, suffered from fever, fatigue, bone and muscle soreness, emaciation, sallow complexion, and amenorrhea, accompanied by cervical *Jiehe*. Treatment with Xiaoyao San (Free and Easy Wanderer Powder) and Bazhen Tang provided slight relief. However, she mistakenly took Shizhi (Hirudo, Leech) and other blood-breaking herbs, further depleting qi and blood, leading to her death.
Haizao Lianqiao Tang (Seaweed and Forsythia Decoction) treats various *Jiehe*, Luoli (Scrofula), Daochang (Linear Scrofula), Yingliu (Goiter), and Tanhe (Phlegm Nodules).
Baifuling (Poria), Chenpi (Citri Reticulatae Pericarpium, Tangerine Peel - white part removed), Lianqiao, Banxia (Pinelliae Rhizoma, Pinellia Tuber - ginger processed), Huangqin (Scutellariae Radix, Scutellaria Root - wine mixed, fried), Huanglian (Coptidis Rhizoma, Coptis Rhizome - wine fried), Nanxing (Arisaematis Rhizoma, Arisaema Rhizome - ginger processed), Niubangzi, Chaihu, Sanleng (Sparganii Rhizoma, Lesser Galangal Rhizome - wine fried), Ezhu (Curcumae Rhizoma, Turmeric Rhizome - wine fried), Cangcan (fried, silk removed), Kunbu (Eckloniae Thallus, Kelp), Haizao (Sargassum Thallus, Seaweed), Qianghuo (Notopterygii Rhizoma et Radix, Chinese Notopterygium Root), Fangfeng, Jiegeng, Xiakucao (Prunellae Spica, Selfheal Spike), Chuanxiong, Shengma (Cimicifugae Rhizoma, Black Cohosh Rhizome).
Decoct with Shengjiang (Zingiberis Rhizoma Recens, Fresh Ginger) and Bohe (Menthae Haplocalycis Herba, Peppermint). Take after meals.
Lianqiao Wan (Forsythia Pill)
Lianqiao, Fangfeng (radicle removed), Huangbai (Phellodendri Cortex, Phellodendron Bark), Rougui (Cinnamomi Cortex, Cinnamon Bark - coarse bark removed), Sangbaipi (Mori Cortex, Mulberry Root Bark), Xiangchi (Sojae Preparata, Prepared Soybean), Duhuo (Angelicae Pubescentis Radix, Pubescent Angelica Root), Qinjiao (Gentianae Macrophyllae Radix, Largeleaf Gentian Root), Mudanpi (Moutan Cortex, Tree Peony Bark) (each ban liang), Haizao (two qian ban).
Grind to powder, form pills with refined honey, size of mung beans. Take ten pills per dose, washed down with Dengxin Cao Tang (Juncus Effusus Decoction, Rush Pith Decoction).
Wuxiang San (Five Fragrances Powder) treats sudden onset of malignant nodules in flesh, swelling and hardness that do not resolve. Malignant flesh and vessels, scrofula, wind-toxic swelling and qi stagnation.
Muxiang (Aucklandiae Radix, Aucklandia Root), Jishe Xiang (Styrax Benzoin, Benzoin), Chenxiang (Aquilariae Lignum Resinatum, Agarwood) (each one liang), Shexiang (fine powder, two qian ban), Shaye (Belamcandae Rhizoma, Blackberry Lily Rhizome), Xunluxiang (Olibanum, Frankincense), Gan Ge (Puerariae Lobatae Radix, Kudzu Root - sliced), Chuan Shengma, Duhuo, Sangjisheng (Taxilli Herba, Loranthus Herba), Lianqiao, Gancao (Glycyrrhizae Radix et Rhizoma, Licorice Root - raw, each two liang), Chuan Dahuang (Rhei Radix et Rhizoma, Rhubarb - three liang, sliced, slightly fried).
Slice finely, mix with Shexiang. Take three qian per dose. Decoct with one zhong of water until five fen remains. Strain. Add half zhong of Zhuli (Bambusae Caulis in Taenia, Bamboo Sap). Boil one or two times. Take warm, three times daily.
Lianqiao San (Forsythia Powder) treats malignant nodular swelling on the neck.
Lianqiao, Shaye, Duhuo, Chuan Shengma, Muxiang, Chenxiang, Mutong (Akebiae Caulis, Akebia Stem - sliced, each one liang), Sangjisheng, Dingxiang (Caryophylli Flos, Clove) (each ban liang), Chuan Dahuang (two liang, sliced, slightly fried).
Grind to fine powder. Take two qian per dose, mixed with clear porridge drink. Three times daily.
Duhuo San (Angelica Pubescens Powder) treats malignant nodules, wind-congealed toxic swelling, restlessness, heat, and stiffness in the four limbs.
Duhuo, Muxiang, Shaye, Sangjisheng, Lianqiao, Shengma, Chenxiang, Chuan Dahuang (raw), Gancao (raw) (each one liang).
Slice finely. Take four qian per dose. Decoct with one zhong of water until six fen remains. Strain. Add half he of Zhuli (Bamboo Sap). Boil one or two times. Take warm, three times daily. Stop when bowel movement becomes loose.
Qinggan Yirong Tang (Clear Liver and Benefit Blood Decoction) treats wind-heat and blood dryness in the Liver, Gallbladder, and Small Intestine meridians, causing tendon contraction and *Jiehe*. It also treats pain in the ears, neck, chest, breasts, and hypochondrium, warts, and all conditions related to liver fire.
Shanzhi (Gardeniae Fructus, Gardenia Fruit), Danggui (Angelicae Sinensis Radix, Dong Quai Root), Mugua (Chaenomelis Fructus, Papaya Fruit - avoid iron vessels), Fuling (Poria) (each one qian), Chaihu, Chuanxiong, Shaoyao (Paeoniae Radix Alba, White Peony Root - fried, each seven fen), Shudihuang (Rehmanniae Radix Praeparata, Prepared Rehmannia Root) (one qian ban), Baizhu (Atractylodis Macrocephalae Rhizoma, Largehead Atractylodes Rhizome) (two qian), Longdancao (Gentianae Radix, Gentian Root) (eight fen), Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, Honey-fried Licorice Root) (five fen).
Decoct with Jiangshui (Ginger Water) and take orally.