（附论）
夫热毒瘰 者。由人脏腑俱实。气血充盛。内有积热。不得宣通。热毒之气。流于项腋
之间。搏于肌肉而生。故谓之热毒瘰 也。
方
玄参散（出圣惠方）治热毒瘰 。痈肿疼痛。宜服此散热毒除根。
玄参 连翘 知母 当归 雄黄（细研） 牵牛（微炒黑豆炒热） 黄芩 犀角 赤芍
药
空青 茌子 矾石（泥裹烧半白细研各三分） 地胆（一分以糯米炒黄为度去翅足） 斑蝥
（一
分以糯米拌炒以米黄为度去翅足） 上为散。入研了药令匀。空心以温酒下。一服一钱。三
五服后。小便出烂肉为度。
连翘散（出圣惠方）治肝膈热毒瓦斯盛攻项腋。生瘰 肿痛。心神烦闷。背胛急
疼。四肢不利。
连翘 漏芦 知母 桂心 黄芩 玄参 甘草（微炙赤各三分） 木通（锉） 柴胡（去
苗）
大黄（微炒） 朴硝（各一两） 上为散。每服四钱。以水一盏。煎至六分。去滓。每服于
食前
温服。以利为度。
紫参丸（出圣惠方）治热毒瘰 肿痛未成者内消。已破者行脓。
紫参 苦参 丹参 连翘（各二两） 腻粉 麝香（别研各三钱） 滑石（二两半） 上
为
末。用玄参一斤捣碎。以酒三碗。浸三日。去滓。皂角子三百枚煨熟捣为末。用玄参酒熬皂
子末成膏。和前药为丸如桐子大。每服一丸。黄 汤下。日加一丸。至患人岁数止。日减一
丸。疮自干。有结内消。
犀角丸（出圣惠方）治热毒结成瘰 。日夜疼痛。
甘草（炙微赤一两） 犀角屑（一两半） 黑豆（炒熟一两） 麝香（半两细研） 斑
蝥（半两
以糯米拌炒米黄为度去翅足） 上为末。炼蜜和丸如桐子大。空心以米饮下七丸。服后觉疮
痛即住药。其病当从小便出。却于盆子内看之。若小便涩即服木通散。
木通散（出圣惠方）
木通（一分锉） 葵子（一分） 滑石（一两） 上为末。以葱白汤调下一钱。日三四。
又方（出圣惠方）
斑蝥（一分以糯米拌炒米黄为度去头翅足） 预知子（一两） 犀角屑（一分） 水蛭
（一分
微炒黄色） 黑豆（一百粒炒熟） 虫（一分炒令微黄去头足翅） 上为末。以酒煮面糊
和丸
如黍米大。大人每日空心以酒下五丸。小儿二丸。
雄鼠粪丸（出圣惠方）治热毒瘰 结硬不消。
雄鼠粪（二十一枚研） 绿豆粉（一钱） 腻粉（一钱） 斑蝥（二十一枚去头翅足以
糯米拌
炒米黄为度） 上相和研令匀。以冷水和丸如小豆大。空心以温酒下二十丸。两日后。再服。
病根即并出。
地胆散（出圣惠方）治热毒瘰 内消。
地胆（一分去头足翅以糯米拌炒令黄为度） 滑石（半钱） 朴硝（一分熬令汁尽） 上
为
散。空心以米饮调下半钱。服后觉小便中下恶物即减地胆少许。十日见效。
又方（出圣惠方）
鸡子（一枚开眼子） 斑蝥（二十一枚去头足翅糯米拌炒米黄为度） 腻粉（一钱） 上
鸡子
去黄留白。入二味药在内。以纸盖蒸两炊久。取出。丸如小豆大。每日五更初。以温酒下五
丸。当泻出病根。如服未效。即日更服。
治热毒瘰 疮肿疼痛。宜服此方。（出圣惠方）
颗盐（一分微炒） 黄丹（半两微炒） 白矾（一分烧令汁尽） 黄柏（一分锉） 白
蔹（一分）
上为散。每先用温盐浆水洗疮令净尽。拭干。以鸡子清调涂于帛上贴之。
山豆根方（出仁斋直指方）治咽喉上膈热毒患瘰 者。常含汁咽下。仍服之。
山豆根 紫苏叶 上用细锉煎汤。临卧服之。
解热方治瘰 四畔红肿多结为热证。
小黑豆（二合） 紫苏（一两） 生姜（七片） 上细锉煎汤食后服。
治热毒瘰 内消方。
斑蝥（十枚去头足翅糯米同炒令黄色） 大黄（一两锉微炒） 上为散。食前温酒调一
钱。
又方
皂荚子（二百粒不蛀汤浸经宿用炒令黄为末） 杏仁（一百粒汤洗去皮尖双仁微炒黄为
捣
膏糊为丸用蜜和） 上同研令匀。炼蜜和丸如桐子大。食前以粥饮下三十丸。
斑蝥散 治热毒瘰 。
斑蝥（三枚糯米拌炒令黄色去头足翅） 滑石（一分） 上为散。分为两服。空心糯米
饮调
下。如人行十里每服觉小肠涩。即煎黑豆汤服。须臾小肠内取下烂肉片子即瘥。如未愈。隔
日再服。
大蓟根散 治热结瘰 。
用蓟根一斤捣为散。每服用药三钱匕。食后温酒调下。日再服。
【附论】
所谓热毒瘰疬（颈部淋巴结结核），是由于人体脏腑功能亢盛，气血充盈旺盛，体内蕴积热邪，无法宣散通畅。热毒之气流注于颈项和腋下之间，与肌肉搏结而生成，因此称之为热毒瘰疬。
方剂
玄参散（出自《太平圣惠方》），治疗热毒瘰疬。痈肿疼痛，适宜服用此方以散热毒、除病根。
药材：玄参、连翘、知母、当归、雄黄（细研）、牵牛子（微炒，用黑豆同炒至热）、黄芩、犀角、赤芍药、空青、茺蔚子（注：原文“茌子”疑为茺蔚子或类似草药，此处保留原意）、矾石（用泥包裹烧至半白，细研，各三分）、地胆（一分，用糯米炒至黄色为度，去翅足）、斑蝥（一分，用糯米拌炒至米变黄为度，去翅足）。以上药物研为散剂，加入已研好的药物混合均匀。空腹时以温酒送服一钱。服用三到五服后，小便中排出腐烂组织即为痊愈标准。
连翘散（出自《太平圣惠方》），治疗肝膈热毒炽盛，攻冲颈腋，生发瘰疬肿痛；伴有心神烦闷，背胛急痛，四肢活动不利。
药材：连翘、漏芦、知母、桂心、黄芩、玄参、甘草（微炙至赤色，各三分）、木通（锉碎）、柴胡（去苗）、大黄（微炒）、朴硝（各一两）。以上药物研为散剂。每次服用四钱，用水一盏，煎至六分，滤去药渣。每次在饭前温服。以大便通畅为度。
紫参丸（出自《太平圣惠方》），治疗热毒瘰疬肿痛尚未化脓者，使其内消；已经破溃者，促进排脓。
药材：紫参、苦参、丹参、连翘（各二两）、腻粉、麝香（分别研细，各三钱）、滑石（二两半）。以上药物研为末。用玄参一斤捣碎，以酒三碗浸泡三天，滤去药渣。取皂角子三百枚煨熟后捣为末，用玄参酒将皂角子末熬成膏状，与前药混合制成如梧桐子大小的丸剂。每次服用一丸，用黄耆汤送下。每日增加一丸，直到达到患者的年龄岁数为止；然后每日减少一丸，直至疮口自然干燥。若有硬结，可内消。
犀角丸（出自《太平圣惠方》），治疗热毒凝结成瘰疬，日夜疼痛。
药材：甘草（炙至微赤，一两）、犀角屑（一两半）、黑豆（炒熟，一两）、麝香（半两，细研）、斑蝥（半两，用糯米拌炒至米变黄为度，去翅足）。以上药物研为末，用炼蜜调和制成如梧桐子大小的丸剂。空腹时以米饮送服七丸。服药后若感觉疮处疼痛即停药。该病邪气应当从小便排出，可在盆中观察。如果小便涩滞不畅，则服用木通散。
木通散（出自《太平圣惠方》）
药材：木通（一分，锉碎）、葵子（一分）、滑石（一两）。以上药物研为末。用葱白汤调服一钱，每日三四次。
又一方（出自《太平圣惠方》）
药材：斑蝥（一分，用糯米拌炒至米变黄为度，去头翅足）、预知子（一两）、犀角屑（一分）、水蛭（一分，微炒至黄色）、黑豆（一百粒，炒熟）、虻虫（一分，炒至微黄，去头足翅）。以上药物研为末，用酒煮面糊调和制成如黍米大小的丸剂。成人每日空腹以酒送服五丸，小儿二丸。
雄鼠粪丸（出自《太平圣惠方》），治疗热毒瘰疬结块坚硬不消散。
药材：雄鼠粪（二十一枚，研细）、绿豆粉（一钱）、腻粉（一钱）、斑蝥（二十一枚，去头翅足，用糯米拌炒至米变黄为度）。以上药物混合研匀，用冷水调和制成如小豆大小的丸剂。空腹时以温酒送服二十丸。两天后再服一次。病根即可一并排出。
地胆散（出自《太平圣惠方》），治疗热毒瘰疬内消。
药材：地胆（一分，去头足翅，用糯米拌炒至黄色为度）、滑石（半钱）、朴硝（一分，熬至汁尽）。以上药物研为散剂。空腹时以米饮调服半钱。服药后若感觉小便中排出恶物，即减少少许地胆用量。十日可见效。
又一方（出自《太平圣惠方》）
药材：鸡蛋（一枚，开一小孔）、斑蝥（二十一枚，去头足翅，用糯米拌炒至米变黄为度）、腻粉（一钱）。将鸡蛋去黄留清，放入上述两种药物，用纸盖住蒸两个炊具的时间。取出后，制成如小豆大小的丸剂。每日五更初，以温酒送服五丸。应当泻出病根。如果服药无效，当天继续服用。
治疗热毒瘰疬疮肿疼痛，适宜服用此方。（出自《太平圣惠方》）
药材：颗盐（一分，微炒）、黄丹（半两，微炒）、白矾（一分，烧至汁尽）、黄柏（一分，锉碎）、白蔹（一分）。以上药物研为散剂。每次先用温盐水清洗疮口使其洁净，擦干，用蛋清调药涂在帛上贴敷。
山豆根方（出自《仁斋直指方》），治疗咽喉及上膈热毒患瘰疬者。常含药汁咽下，并内服。
药材：山豆根、紫苏叶。以上药物细锉后煎汤，临睡前服用。
解热方，治疗瘰疬四周红肿多结，属热证。
药材：小黑豆（二合）、紫苏（一两）、生姜（七片）。以上药物细锉后煎汤，饭后服用。
治疗热毒瘰疬内消方。
药材：斑蝥（十枚，去头足翅，与糯米同炒至黄色）、大黄（一两，锉碎，微炒）。以上药物研为散剂。饭前以温酒调服一钱。
又一方
药材：皂荚子（二百粒，无蛀虫，用水浸泡过夜，炒至黄色为末）、杏仁（一百粒，用水洗去皮尖，双仁的，微炒黄后捣成膏糊状作为粘合剂）。以上药物混合研匀，用炼蜜调和制成如梧桐子大小的丸剂。饭前以粥饮送服三十丸。
斑蝥散，治疗热毒瘰疬。
药材：斑蝥（三枚，用糯米拌炒至黄色，去头足翅）、滑石（一分）。以上药物研为散剂，分为两次服用。空腹时以糯米饮调服。如果行走十里路后每服感觉小肠涩滞，即煎黑豆汤服用。不久小肠内会排出烂肉片即痊愈。如果未愈，隔日再服。
[Supplementary Discussion]
The so-called "Re Du Luo Li" (Scrofula caused by Heat-Toxin) arises from the excess state of the internal Zang-Fu organs and the abundance of Qi and Blood. Internal accumulation of heat fails to diffuse and circulate smoothly. The Qi of Heat-Toxin flows into the regions between the neck and axillae, where it contends with the muscles and tissues to form lesions; hence it is termed Re Du Luo Li.
Formulas
Xuan Shen San (Cave-lixir Powder), sourced from *Taiping Shenghui Fang* (Imperial Grace Formulary of the Tai Ping Era), treats Re Du Luo Li, carbuncles, swellings, and pain. It is suitable for taking this formula to dissipate heat-toxin and eradicate the root cause.
Ingredients: Scrophulariae Radix (Xuanshen), Forsythiae Fructus (Lianqiao), Anemarrhenae Rhizoma (Zhimu), Angelicae Sinensis Radix (Danggui), Realgar (Xionghuang, finely ground), Semen Persicae et Alismatis (Qianniuzi, lightly stir-fried and stir-fried with black beans until hot), Scutellariae Radix (Huangqin), Cornu Bubali (Xijiao), Paeoniae Radix Rubra (Chishaoyao), Azurite (Kongqing), Herba Elsholtziae (Chongweizi - note: original text 'Chizi' likely refers to this or similar herb), Alum (Fanshi, wrapped in mud and calcined until half-white, finely ground, 3 fen each), Eupolyphaga (Didan, 1 fen, stir-fried with glutinous rice until yellow, remove wings and feet), Mylabris (Banmao, 1 fen, stir-fried with glutinous rice until rice turns yellow, remove wings and feet). Grind all ingredients into a powder, mix evenly with the pre-ground medicines. Take one qian on an empty stomach with warm wine. After three to five doses, when putrid matter is discharged in urine, the treatment is considered complete.
Lianqiao San (Forsythia Powder), sourced from *Taiping Shenghui Fang*, treats Liver and Diaphragm heat-toxin flourishing and attacking the neck and axillae, causing scrofula with swelling and pain; accompanied by mental restlessness, tightness and pain in the back and shoulder blades, and impediment in the four limbs.
Ingredients: Forsythiae Fructus (Lianqiao), Rhizoma Leuzeae (Loulu), Anemarrhenae Rhizoma (Zhimu), Cinnamomi Ramulus (Guixin), Scutellariae Radix (Huangqin), Scrophulariae Radix (Xuanshen), Glycyrrhizae Radix et Rhizoma (Gancao, lightly roasted until red, 3 fen each), Akebiae Caulis (Mutong, chopped), Bupleuri Radix (Chaihu, remove seedlings), Rheum Palmatum Radix et Rhizoma (Dahuang, lightly stir-fried), Natrii Sulfas (Puxiao, 1 liang each). Grind into a powder. Take 4 qian per dose, decoct with one cup of water until reduced to 0.6 cups, filter dregs. Take warm before meals. Stop when bowel movement becomes unobstructed.
Zi Shen Wan (Purple Ginseng Pill), sourced from *Taiping Shenghui Fang*, treats Re Du Luo Li with swelling and pain that has not yet suppurated, promoting internal resolution; if already ulcerated, promotes pus discharge.
Ingredients: Codonopsis Radix (Zishen), Sophorae Flavescentis Radix (Kushen), Salviae Miltiorrhizae Radix (Danshen), Forsythiae Fructus (Lianqiao, 2 liang each), Calomelas (Nifen), Moschus (Shexiang, separately ground, 3 qian each), Talcum (Huashi, 2.5 liang). Grind into powder. Crush 1 jin of Scrophulariae Radix (Xuanshen), soak in three bowls of wine for three days, filter dregs. Roast 300 Gleditsiae Sinensis Fructus (Zaojiazi) until cooked, grind into powder. Use the Xuanshen wine to boil the Zaojiazi powder into a paste, mix with the previous medicines to form pills the size of paulownia seeds. Take one pill per dose, down with Astragali Decoction (Huangqi Tang). Increase dosage by one pill daily until reaching the patient's age in years, then decrease by one pill daily until the sore dries naturally. Internal nodules will resolve.
Xi Jiao Wan (Rhinoceros Horn Pill), sourced from *Taiping Shenghui Fang*, treats heat-toxin condensing into scrofula with day-and-night pain.
Ingredients: Glycyrrhizae Radix et Rhizoma (Gancao, roasted until slightly red, 1 liang), Cornu Bubali (Xijiao, sliced, 1.5 liang), Sojae Semen Praeparatum (Heidou, roasted, 1 liang), Moschus (Shexiang, 0.5 liang, finely ground), Mylabris (Banmao, 0.5 liang, stir-fried with glutinous rice until rice turns yellow, remove wings and feet). Grind into powder, mix with refined honey to form pills the size of paulownia seeds. Take seven pills on an empty stomach with rice drink. If pain is felt at the sore after taking the medicine, stop the medication. The pathogen should be discharged via urine; observe in a basin. If urination is difficult, take Mutong San.
Mutong San (Akebia Powder), sourced from *Taiping Shenghui Fang*.
Ingredients: Akebiae Caulis (Mutong, 1 fen, chopped), Abutilonis Semen (Kuizi, 1 fen), Talcum (Huashi, 1 liang). Grind into powder. Mix one qian with decoction of white parts of Allium fistulosum (Congbai) and take orally, three to four times daily.
Another Prescription (sourced from *Taiping Shenghui Fang*)
Ingredients: Mylabris (Banmao, 1 fen, stir-fried with glutinous rice until rice turns yellow, remove head, wings, feet), Stemonae Rhizoma (Yuzhizi, 1 liang), Cornu Bubali (Xijiao, sliced, 1 fen), Hirudo (Shuizhi, 1 fen, lightly stir-fried until yellow), Sojae Semen Praeparatum (Heidou, 100 grains, roasted), Blatta Orientalis (Machong, 1 fen, stir-fried until slightly yellow, remove head, feet, wings). Grind into powder, mix with flour paste boiled in wine to form pills the size of millet grains. Adults take five pills on an empty stomach with wine daily; children take two pills.
Xiong Shu Fen Wan (Male Rat Feces Pill), sourced from *Taiping Shenghui Fang*, treats Re Du Luo Li with hard, indissoluble knots.
Ingredients: Male Rat Feces (Xiong Shufen, 21 pieces, ground), Phaseoli Radiati Semen (Lvdoufen, 1 qian), Calomelas (Nifen, 1 qian), Mylabris (Banmao, 21 pieces, remove head, wings, feet, stir-fried with glutinous rice until rice turns yellow). Mix and grind evenly, bind with cold water to form pills the size of mung beans. Take twenty pills on an empty stomach with warm wine. Repeat after two days. The root of the disease will be expelled together.
Didan San (Eupolyphaga Powder), sourced from *Taiping Shenghui Fang*, treats internal resolution of Re Du Luo Li.
Ingredients: Eupolyphaga (Didan, 1 fen, remove head, feet, wings, stir-fried with glutinous rice until yellow), Talcum (Huashi, 0.5 qian), Natrii Sulfas (Puxiao, 1 fen, boiled until juice is gone). Grind into powder. Take half a qian mixed with rice drink on an empty stomach. If foul matter is discharged in urine after taking, reduce the amount of Didan slightly. Effect seen in ten days.
Another Prescription (sourced from *Taiping Shenghui Fang*)
Ingredients: Gallus gallus domesticus Ovum (Jizi, one egg, make a small hole), Mylabris (Banmao, 21 pieces, remove head, feet, wings, stir-fried with glutinous rice until rice turns yellow), Calomelas (Nifen, 1 qian). Remove yolk, keep albumen, insert the two medicines inside. Cover with paper and steam for the time it takes to cook two pots of rice. Take out and form pills the size of mung beans. At dawn (fifth watch), take five pills with warm wine. The root of the disease should be purged. If ineffective, continue taking it on the same day.
To treat Re Du Luo Li sores, swellings, and pain, this formula is suitable. (Sourced from *Taiping Shenghui Fang*)
Ingredients: Halitum (Keyan, 1 fen, lightly stir-fried), Minium (Huandan, 0.5 liang, lightly stir-fried), Alum (Baifan, 1 fen, calcined until juice is gone), Phellodendri Cortex (Huangbai, 1 fen, chopped), Ampelopsis Radix (Bailian, 1 fen). Grind into powder. First wash the sore clean with warm saline solution, dry it. Mix medicine with egg white, apply on cloth, and patch it on.
Shandougen Fang (Stemona Root Formula), sourced from *Ren Zhi Zhi Zhi Fang*, treats scrofula caused by heat-toxin in the throat and upper diaphragm. Constantly hold the juice in the mouth and swallow, and also take internally.
Ingredients: Stemona Radix (Shandougen), Perillae Folium (Zisuye). Finely chop and decoct in water. Take before retiring.
Jiere Fang (Heat-Resolving Formula), treats scrofula with redness, swelling, and multiple knots around the periphery, indicating a heat syndrome.
Ingredients: Black Soybean (Xiaoheidou, 2 he), Perillae Folium (Zisu, 1 liang), Zingiberis Rhizoma Recens (Shengjiang, 7 slices). Finely chop and decoct in water. Take after meals.
Formula for Internal Resolution of Re Du Luo Li.
Ingredients: Mylabris (Banmao, 10 pieces, remove head, feet, wings, stir-fry with glutinous rice until yellow), Rheum Palmatum Radix et Rhizoma (Dahuang, 1 liang, chopped, lightly stir-fried). Grind into powder. Mix one qian with warm wine and take before meals.
Another Formula
Ingredients: Gleditsiae Sinensis Fructus (Zaojiazi, 200 grains, non-moth-eaten, soaked in water overnight, stir-fried until yellow for powder), Armeniacae Semen Amarum (Xingren, 100 grains, washed in water, skin and tip removed, double-kernel ones, lightly stir-fried until yellow, pounded into paste for binding). Mix evenly, bind with refined honey to form pills the size of paulownia seeds. Take thirty pills before meals with gruel drink.
Banmao San (Mylabris Powder), treats Re Du Luo Li.
Ingredients: Mylabris (Banmao, 3 pieces, stir-fried with glutinous rice until yellow, remove head, feet, wings), Talcum (Huashi, 1 fen). Grind into powder, divide into two doses. Take on an empty stomach with glutinous rice drink. If bladder discomfort is felt after walking ten li per dose, take decoction of black soybeans immediately. Putrid meat slices will be discharged from the lower intestines shortly thereafter, leading to recovery. If not healed, repeat every other day.
Daji Gen San (Great Thistle Root Powder), treats heat-condensation scrofula.
Use 1 jin of Thistle Root (Jigen), pound into powder. Take three qianbi of medicine per dose, mixed with warm wine after meals, twice daily.