经云∶肝主筋，心主血，脾主肉，肺主气，肾主骨。故云∶肝为筋瘤，心为血瘤，脾为肉瘤，肺为气瘤，肾为骨
瘤。小儿患之，多因禀赋不足，乳母七情起居，饮食失调，
致儿五脏不和，内火沸腾，血凝气滞也。夫瘤者留也。随气凝滞，脏腑受伤，气血不和所致。五瘤之外，更有脂瘤、粉
瘤、虱瘤、虫瘤之类。若行气破血，或敷寒凉追蚀之药，或用蛛丝缠芫花线等法，以治其外则误矣。
一小儿因乳母郁怒，臂前 肿硬，皮色如常，日出脓水，乃脾肺之虚症也，用加味归脾汤、如圣饼，三月余肿渐
消。后因母怒发热，儿患处复肿，用加味逍遥散，母服二十余剂，儿日服杯许，赤肿渐退，仍以前药久服而愈。
一小儿头后患之，久不敛，目睛多白，此禀肾虚之症，母子并服六味丸、补中汤，外以六味丸料加鹿茸作饼，热熨
患处，每日一次而敛。
一女子腿外 一瘤寸许，色赤，破而血逆漂甚多，发热作渴，先用当归补血汤，渴热渐愈；又用加味逍遥散，疮口
寻愈。
一小儿落草，大腿外股如指尖一块，肉色如常，按之不痛，至数月误触破，出如粉浆，内股 痛，寒热如疟，手足
抽搐如急惊状，此脓水出多，气血虚而内生风也，先用异功散加钩藤钩二剂，又用八珍汤加钩藤钩而安，用托里散而痊。
一小儿二岁，项间自分娩有一核。余谓但调治乳母其儿自愈。彼欲速效，外涂牡蛎、硝黄之类，内服海藻、蓬术之
类，脾胃复伤而殁。
一小儿九岁，项间患之，余谓禀肾肝血燥所致，当滋水生木。不信，另用药破之，脓水淋漓，仍服散坚之药而殁。
一女子腿前肿一小瘤作痒，搔破出虫，如蚊而飞去，寒热如疟，乃肝经之症，即虱瘤之类，用加味逍遥散而愈。又
有一种发瘤，破开有发，属肾经之症也。
加味归脾汤（方见腹痈）
地黄丸（方见作渴不止）
加味逍遥散
八珍汤（二方见发热不止）
托里散（方见热毒疮疡）
补中益气汤（方见肌肉不生）
五味异功散（方见败毒之药）
如圣饼（方见流注）
《黄帝内经》记载：肝主管筋，心主管血，脾主管肌肉，肺主管气，肾主管骨。因此说：肝对应的瘤称为筋瘤，心对应的瘤称为血瘤，脾对应的瘤称为肉瘤，肺对应的瘤称为气瘤，肾对应的瘤称为骨瘤。小儿患此病，多因先天禀赋不足，加上乳母情绪波动、起居失常、饮食失调，导致小儿五脏功能不和，体内虚火旺盛，血液凝滞、气机阻滞所致。“瘤”字意为停留，指随气机凝滞，脏腑受损，气血不和而形成的病变。在五瘤之外，还有脂瘤、粉瘤、虱瘤、虫瘤等类型。如果使用行气破血的方法，或者外敷寒凉腐蚀的药物，或者使用蛛丝缠绕芫花线等方法来治疗外部症状，那就是错误的。
有一个小儿因为乳母郁结愤怒，手臂前方出现肿块坚硬，皮肤颜色正常，日出时流出脓水，这是脾肺虚弱的证候，使用加味归脾汤和如圣饼，三个多月后肿块逐渐消退。后来因为母亲发怒发热，患儿患处再次肿胀，使用加味逍遥散，母亲服用二十多剂，患儿每天饮用一杯左右，红肿逐渐消退，继续长期服用之前的药物而痊愈。
另一个小儿头部后方患病，久不愈合，眼白较多，这是先天肾虚的证候，母子共同服用六味丸和补中益气汤，外用六味丸的药料加入鹿茸制成饼状，热敷患处，每天一次，伤口得以收敛。
一个女子腿部外侧长了一个约一寸大小的瘤，颜色发红，破裂后出血逆流且量很大，伴有发热口渴，先用当归补血汤，口渴发热逐渐好转；又用加味逍遥散，疮口很快愈合。
一个小儿出生时，大腿外侧有一块如指尖大小的肿块，肉质颜色正常，按压不痛，几个月后因误触破裂，流出像浆粉一样的液体，内侧大腿疼痛，寒热往来像疟疾一样，手足抽搐如同急惊风的样子，这是因为脓水流出过多，气血虚弱而生内风，先用异功散加钩藤钩两剂，又用八珍汤加钩藤钩使病情安定，最后用托里散而痊愈。
一个两岁的小儿，颈部在分娩时就有一个核状物。我认为只需调理乳母，孩子自然会好。他们想要快速见效，外用涂抹牡蛎、硝石大黄之类的药物，内服海藻、蓬术之类的药物，导致脾胃进一步受伤而死亡。
一个九岁的小儿，颈部患病，我认为这是由于先天肝肾血燥所致，应当滋水生木（滋养肾水以涵养肝木）。家属不信，另用药将其破除，导致脓水淋漓不止，仍服用散坚的药物而死亡。
一个女子腿部前方肿起一个小瘤并感到瘙痒，抓破后流出虫子，像蚊子一样飞走，伴有寒热往来像疟疾一样，这是肝经的病症，属于虱瘤之类，用加味逍遥散而痊愈。还有一种发瘤，破开后有头发长出，属于肾经的病症。
加味归脾汤（方剂见腹痈章节）
地黄丸（方剂见作渴不止章节）
加味逍遥散
八珍汤（两个方剂见发热不止章节）
托里散（方剂见热毒疮疡章节）
补中益气汤（方剂见肌肉不生章节）
五味异功散（方剂见败毒之药章节）
如圣饼（方剂见流注章节）
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The Liver governs the sinews, the Heart governs the blood, the Spleen governs the muscles, the Lung governs the Qi, and the Kidney governs the bones. Therefore, it is said: The tumor associated with the Liver is called Sinew Tumor (*Jin Liu*), the one associated with the Heart is Blood Tumor (*Xue Liu*), the one associated with the Spleen is Flesh Tumor (*Rou Liu*), the one associated with the Lung is Qi Tumor (*Qi Liu*), and the one associated with the Kidney is Bone Tumor (*Gu Liu*). Children suffering from this condition often do so due to insufficient congenital endowment, combined with the wet nurse's emotional fluctuations, irregular daily routine, and dietary imbalance, leading to disharmony among the five Zang organs, boiling internal fire, coagulation of blood, and stagnation of Qi. The character "Liu" (Tumor) implies staying or remaining; it refers to lesions caused by Qi stagnation, injury to the Zang-Fu organs, and disharmony of Qi and blood. Besides the Five Tumors, there are also types such as Lipoma (*Zhi Liu*), Sebaceous Cyst (*Fen Liu*), Louse Tumor (*Shi Liu*), and Worm Tumor (*Chong Liu*). Treating these externally by using methods that move Qi and break blood, applying cold and corrosive medicines, or using techniques such as wrapping with spider silk and *Kansui* root thread would be erroneous.
A child developed a hard swelling on the anterior aspect of the arm due to his wet nurse's depression and anger. The skin color was normal, but pus discharged at sunrise. This was identified as a deficiency syndrome of the Spleen and Lung. He was treated with *Jiawei Guipi Tang* (Modified Gui Pi Decoction) and *Rusheng Bing* (Rusheng Cake). After more than three months, the swelling gradually subsided. Later, when the mother became angry and developed fever, the child's lesion swelled again. *Jiawei Xiaoyao San* (Modified Xiao Yao Powder) was prescribed; the mother took over twenty doses, and the child drank about one cup per day. The redness and swelling gradually receded, and he recovered after long-term administration of the previous medications.
Another child suffered from a lesion on the posterior aspect of the head that failed to heal for a long time, accompanied by excessive whiteness in the eyes. This indicated a congenital Kidney deficiency. Both mother and child took *Liujun Wan* (Six-Ingredient Pill with Rehmannia) and *Buzhong Yiqi Tang* (Bu Zhong Yi Qi Decoction). Externally, a cake made from the ingredients of *Liujun Wan* plus *Deer Antler* (*Lurong*) was applied hot to the lesion once daily, leading to healing.
A girl had a tumor approximately one cun in size on the lateral aspect of her leg. It was red in color. Upon rupture, severe bleeding occurred, accompanied by fever and thirst. She was first treated with *Danggui Buxue Tang* (Danggui Bu Xue Decoction), after which the thirst and fever gradually improved. Subsequently, *Jiawei Xiaoyao San* (Modified Xiao Yao Powder) was used, and the wound healed quickly.
A newborn boy had a lump on the lateral thigh, the size of a fingertip, with normal flesh color and no pain upon pressure. Several months later, accidental trauma caused it to rupture, discharging fluid resembling powder slurry. Pain occurred in the medial thigh, chills and fever alternated like malaria, and convulsions of the hands and feet resembled acute wind-stroke. This was diagnosed as internal wind generation due to Qi and blood deficiency resulting from excessive discharge of pus. Initially, *Yigong San* (Yigong Powder) with *Gouteng* (Uncaria Rhynchophylla) was administered for two doses. Then, *Bazhen Tang* (Eight-Treasure Decoction) with *Gouteng* stabilized the condition, and finally, *Tuoli San* (Supporting the Interior Powder) led to recovery.
A two-year-old child had a nodular mass in the neck since birth. I advised regulating the wet nurse, after which the child would heal naturally. Desiring rapid results, they applied external substances such as *Oyster Shell* (Muli) and *Niter* with *Rhubarb* (Xiaohuang), and internally administered *Sargassum* (Haizao) and *Curcuma* (Pzhu). This further injured the Spleen and Stomach, leading to death.
A nine-year-old child suffered from a lesion in the neck. I attributed it to congenital dryness of the Liver and Kidney blood, recommending nourishment of Water to generate Wood (nourishing Kidney Water to support Liver Wood). Disbelieving this, they used other medications to break the mass, causing profuse purulent discharge. Continued use of hardness-dispersing drugs resulted in death.
A girl had a small, itchy tumor on the anterior aspect of her leg. Scratching it released insects resembling mosquitoes that flew away. She experienced chills and fever alternating like malaria. This was a Liver Meridian syndrome, similar to Louse Tumor (*Shi Liu*), and was cured with *Jiawei Xiaoyao San* (Modified Xiao Yao Powder). Another type, Hair Tumor (*Fa Liu*), characterized by hair emerging upon rupture, belongs to the Kidney Meridian syndrome.
*Jiawei Guipi Tang* (See Abdominal Carbuncle chapter for formula)
*Dihuang Wan* (See Unrelenting Thirst chapter for formula)
*Jiawei Xiaoyao San*
*Bazhen Tang* (See both formulas in Unrelenting Fever chapter)
*Tuoli San* (See Toxic Heat Sores and Ulcers chapter for formula)
*Buzhong Yiqi Tang* (See Failure of Muscle Regeneration chapter for formula)
*Wuyi Yigong San* (See Poisonous Drugs chapter for formula)
*Rusheng Bing* (See Flowing Abscess chapter for formula)