治瘰 。
牡蛎（十两， ） 生黄 （四两） 三棱（二两） 莪术（二两） 朱血竭（一两） 生明乳香（一两）
生明没药（一两） 龙胆草（二两） 玄参（三两） 浙贝母（二两）
上药十味，共为细末，蜜丸桐子大。每服三钱，用海带五钱，洗净切丝，煎汤送下，日再服。
瘰 之证，多在少年妇女，日久不愈，可令信水不调，甚或有因之成劳瘵者。其证系肝胆之火上升，与痰
涎凝结而成。初起多在少阳部位，或项侧，或缺盆，久则渐入阳明部位。一颗垒然高起者为瘰，数颗历历不断
者为 。身体强壮者甚易调治。
此方重用牡蛎、海带，以消痰软坚，为治瘰 之主药，恐脾胃弱者，久服有碍，故用黄 、三棱、莪术以
开胃健脾（三药并用能开胃健脾，十全育真汤下曾详言之），使脾胃强壮，自能运化药力，以达病所。且此证
之根在于肝胆，而三棱、莪术善理肝胆之郁。此证之成，坚如铁石，三棱、莪术善开至坚之结。又佐以血竭、
乳香、没药，以通气活血，使气血毫无滞碍，瘰 自易消散也。而犹恐少阳之火炽盛，加胆草直入肝胆以泻之，
玄参、贝母清肃肺金以镇之。且贝母之性，善于疗郁结利痰涎，兼主恶疮。玄参之性，《名医别录》谓其散颈
下核，《开宝本草》谓其主鼠 ，二药皆善消瘰 可知。
血竭，色赤味辣。色赤故入血分，味辣故入气分，其通气活血之效，实较乳香、没药为尤捷。诸家本草，
未尝言其辣，且有言其但入血分者，皆未细心实验也。然此药伪者甚多，必未研时微带紫黑，若血干之色。研
之红如鸡血，且以置热水中则溶化，须臾复凝结水底成块者，乃为真血竭。
曾治一少年，项侧起一瘰 ，其大如茄，上连耳，下至缺盆。求医治疗，言服药百剂，亦不能保其必愈。
而其人家贫佣力，为人芸田，不惟无钱买如许多药，即服之亦不暇。然其人甚强壮，饮食甚多，俾于一日三餐
之时，先用饭汤送服 牡蛎细末七八钱，一月之间消无芥蒂。
又治一妇人，在缺盆起一瘰 ，大如小橘。其人亦甚强壮无他病，俾煮海带汤，日日饮之，半月之间，用
海带二斤而愈。若
身体素虚弱者，即煮牡蛎、海带，但饮其汤，脾胃已暗受其伤。盖其咸寒之性，与脾胃不宜也。
族侄女患此证，治数年不愈。为制此方，服尽一料而愈。
治疗瘰疬。
牡蛎（十两，煅） 生黄芪（四两） 三棱（二两） 莪术（二两） 朱血竭（一两） 生明乳香（一两）
生明没药（一两） 龙胆草（二两） 玄参（三两） 浙贝母（二两）
以上十味药，共同研成细末，用蜂蜜制成如梧桐子大小的丸剂。每次服用三钱，用海带五钱，洗净切丝，煎汤送服，每日服用两次。
瘰疬这一病症，多见于少年妇女，若日久不愈，可能导致月经失调，甚至因此发展为虚劳痨病。其病机系肝胆之火上升，与痰涎凝结而成。初起多在少阳经部位，或在颈侧，或锁骨上窝处，久则逐渐侵入阳明经部位。一颗垒然高起的称为“瘰”，数颗历历不断相连的称为“疬”。身体强壮者甚易调治。
此方重用牡蛎、海带，以消痰软坚，为治疗瘰疬的主药，但担心脾胃虚弱者长期服用会有碍胃气，故使用黄芪、三棱、莪术来开胃健脾（这三药并用能开胃健脾，在十全育真汤下曾详细论述过），使脾胃强壮，自然能够运化药力，以到达病所。而且此病的根源在于肝胆，而三棱、莪术善于疏理肝胆之郁结。此病形成后，坚硬如铁石，三棱、莪术善于攻破最坚硬的结聚。又辅以血竭、乳香、没药，以通气活血，使气血毫无滞碍，瘰疬自然容易消散。然而还担心少阳之火炽盛，加入龙胆草直入肝胆以泻火，玄参、贝母清肃肺金以制约肝火。且贝母的药性，善于治疗郁结利化痰涎，兼主恶疮。玄参的药性，《名医别录》称其能消散颈部下的核块，《开宝本草》称其主治鼠瘘，这两味药都善于消除瘰疬，由此可知。
血竭，颜色赤红，味道辛辣。颜色赤红所以入血分，味道辛辣所以入气分，其通气活血的功效，确实比乳香、没药更为快捷。各家本草著作，未曾言其味辣，且有言其只入血分的，都是没有细心实验的缘故。然而此药伪品很多，必须未研磨时微带紫黑色，像干血的颜色。研磨后红如鸡血，且将其放入热水中则溶化，片刻后又凝结在水底成块的，才是真血竭。
曾治疗一位少年，颈侧长出一颗瘰疬，大小如茄子，向上连至耳部，向下至锁骨上窝。求医治疗，医生说服药百剂，也不能保证必定痊愈。而其人家贫靠出卖力气为人耕田，不仅没钱买如此多的药，即使有药也顾不上服用。然而此人身体非常强壮，饮食量很大，嘱咐他在一日三餐时，先用饭汤送服牡蛎细末七八钱，一个月之间就消除得干干净净，毫无痕迹。
又治疗一位妇人，在锁骨上窝长出一颗瘰疬，大小如小橘子。此人也非常强壮无其他疾病，嘱咐她煮海带汤，日日饮用，半个月之间，用了二斤海带而痊愈。如果身体素来虚弱的人，即使煮牡蛎、海带，只喝其汤，脾胃也会暗中受到损伤。因为其咸寒的性质，与脾胃不相适宜。
族侄女患此病，治疗数年不愈。为她配制此方，服完一料药而痊愈。
Treatment for Scrofula (Luo Li).
Oyster Shell (Shi liang, calcined) Astragalus Root (Huangqi, four liang) Spatholobus Stem (Sanleng, two liang) Curcuma Zedoaria Rhizome (Ezhu, two liang) Dragon's Blood (Zhu Xuejie, one liang) Frankincense (Ruxiang, one liang, raw and clarified) Myrrh (Moyao, one liang, raw and clarified) Gentian Root (Longdancao, two liang) Scrophularia Root (Xuanshen, three liang) Fritillaria Thunbergii Bulb (Zhe Beimu, two liang)
The above ten herbs are ground together into a fine powder. Honey pills the size of tung tree seeds are made. Each dose is three qian. Take with decoction prepared from five qian of Kelp (Haidai), washed and cut into strips. Administer twice daily.
Scrofula (Luo Li) commonly occurs in young women. If it persists for a long time without healing, it may lead to menstrual irregularities or even develop into consumptive disease (Lao Zhai). The pathogenesis involves the rising of Liver-Gallbladder Fire condensing with Phlegm-Saliva. Initially, it often appears in the Shaoyang channel areas, such as the side of the neck or the supraclavicular fossa. Over time, it gradually extends into the Yangming channel areas. A single nodule protruding high is termed "Luo," while multiple nodules connected continuously are termed "Li." Patients with strong constitution are easy to treat.
This formula heavily uses Oyster Shell and Kelp to resolve Phlegm and soften hardness, serving as the main herbs for treating Scrofula. However, fearing that long-term use might hinder those with weak Spleen-Stomach, Astragalus Root, Spatholobus Stem, and Curcuma Zedoaria Rhizome are added to stimulate appetite and strengthen the Spleen (the combination of these three herbs stimulates appetite and strengthens the Spleen, as detailed under Shiquan Yuzhen Decoction). This ensures the Spleen and Stomach become strong enough to transform and transport the medicinal power to the diseased area. Furthermore, the root of this condition lies in the Liver and Gallbladder, and Spatholobus Stem and Curcuma Zedoaria Rhizome are adept at resolving Liver-Gallbladder Qi stagnation. Since the resulting mass is hard as iron, Spatholobus Stem and Curcuma Zedoaria Rhizome are skilled at breaking up the hardest accumulations. Additionally, Dragon's Blood, Frankincense, and Myrrh are used to promote Qi circulation and invigorate Blood, ensuring no stagnation in Qi and Blood, allowing Scrofula to dissipate easily. To prevent excessive Shaoyang Fire, Gentian Root is added to directly enter the Liver and Gallbladder to drain fire, while Scrophularia Root and Fritillaria Thunbergii Bulb clear and purify Lung Metal to suppress the Liver. Fritillaria Thunbergii Bulb is particularly effective in treating stagnation and facilitating the resolution of Phlegm-Saliva, and also treats malignant sores. According to *Bie Lu* (Separate Records of Famous Physicians), Scrophularia Root disperses nodules below the neck; according to *Kaibao Bencao*, it treats Rat Fistula (Shu Lou). Both herbs are known to effectively eliminate Scrofula.
Dragon's Blood is red in color and pungent in taste. Its red color indicates entry into the Blood aspect, and its pungency indicates entry into the Qi aspect. Its efficacy in promoting Qi circulation and invigorating Blood is indeed more rapid than that of Frankincense and Myrrh. Most materia medica texts do not mention its pungency, and some state it only enters the Blood aspect; these authors have not conducted careful empirical experiments. However, fake versions of this herb are common. Genuine Dragon's Blood should be slightly purple-black before grinding, resembling dried blood. After grinding, it should be red like chicken blood. When placed in hot water, it dissolves but re-solidifies into a lump at the bottom after a short while.
I once treated a young man who had a Scrofula nodule on the side of his neck, the size of an eggplant, extending upwards to the ear and downwards to the supraclavicular fossa. He sought medical treatment, but the doctor stated that even taking a hundred doses of medicine could not guarantee a cure. His family was poor, and he worked as a laborer farming fields. He not only lacked money to buy such large quantities of medicine but also had no time to take them if he did. However, he was very strong and ate a lot. I instructed him to take seven or eight qian of finely ground Oyster Shell powder with rice soup during each of his three daily meals. Within one month, the nodule disappeared completely without a trace.
I also treated a woman who had a Scrofula nodule in the supraclavicular fossa, the size of a small orange. She was also very strong with no other illnesses. I instructed her to boil Kelp soup and drink it daily. Within half a month, using two jin of Kelp, she was cured. However, for those with a constitution that is inherently weak, even boiling Oyster Shell and Kelp and drinking only the soup can secretly damage the Spleen and Stomach. This is because their salty and cold nature is unsuitable for the Spleen and Stomach.
My clan niece suffered from this condition and was treated for several years without success. I prepared this formula for her, and she was cured after finishing one course of treatment.