凡头脑骨，及两腮骨部位，不生痰 。其余颈项以下，及周身皆可发生。初起寒热交作
，结
核红肿者，痰子也。初起不发寒热，色白不痛者，瘰 也。以红属阳，白属阴，阳易治而阴
难治。
凡痈疽初起时，旁亦核起。然痈疽之核，按之甚形活动。而痰 结核，按之则推移不动
也。
凡痰 结核，在皮膜内。初则形如棋子、豌豆、绿豆等粒，起发时寒热交作，大者如鸡
卵，
如覆碗。或长形不一，色红肿而起发速者，皆属痰子。色白微红，不甚浮肿，而起发迟者，
多属瘰 。
凡痰 溃破后，多不结痂，秽水时出，生肌膏药，此塞彼溃，难于取效。惟用后载火攻
之法，收工甚速，且不复发，否则蔓延遍身，至津液枯竭，遂成痨瘵。
凡痰 结核，多以形状及部位而定其名，随举数者，可以例推。如结核在舌下，即名为
垫舌
痰。核在咽喉左右各一枚者，名铁门拴。耳下八方颊车穴结核者，为颊车痰。颈项筋间，核
长如马刀者，名马刀 。沿颈前面，至两耳下，核起累累如贯珠者，名马挂铃。核在胁眼，
突然肿大者，为夹胁痰。附两手大骨结核者，为贴骨痰。核生于胸膈上者，为气痰。在腰眼
者，名缠腰痰。在两臀上，形如覆碗者，名煨督痰。在胯内鼠鼷穴，及足上 骨结核者，亦名贴骨痰。结核此溃彼起，
遍身而无
定处者，名曰游痰。其蔓生不已，节节破溃，溃口不收者，名瓜藤 。然得其大概，即昔人
云七十二种痰症，亦不难辨矣，观后第一图，已得概要。
\r第一图\p04-a32a1.bmp\r
帮助
上第一图，所志各小圈，皆痰 生于人身各部位，因之而定其名。庶治者觇核结何部位
，及
何形像，即可知之。总之，痰 多缘骨隙而生，而瘰 纯属阴分，其愈期及治法，亦较痰子
难十数倍也。
凡是头部、颅骨以及两侧腮骨部位，不会发生痰核。其余颈部以下及全身各处都可以发生。初起时寒热交替发作，结成肿块且红肿的，是痰子（阳证痰核）。初起时不出现寒热，颜色发白且不痛的，是瘰疬（阴证痰核）。以红色属阳，白色属阴，阳证容易治疗而阴证难以治疗。
凡是痈疽初起时，周围也会结块隆起。然而痈疽的肿块，按压时感觉非常活动灵活。而痰核肿块，按压时推之不动。
凡是痰核肿块，位于皮膜之内。初起时形状像棋子、豌豆、绿豆等颗粒，发作时寒热交替，大的如鸡蛋，如倒扣的碗。或者形状长短不一，颜色红肿且发作迅速的，都属于痰子。颜色白而微红，浮肿不明显且发作迟缓的，多属于瘰疬。
凡是痰核溃破后，大多不结痂，时常流出污秽脓水，使用生肌膏药，此处堵塞彼处又溃烂，难以见效。只有使用后文记载的火攻疗法，收效迅速，且不复发，否则蔓延遍身，导致津液枯竭，最终形成虚劳病（痨瘵）。
凡是痰核肿块，多以形状及部位来确定其名称，列举其中几种，可以类推其他。如肿块在舌下，就命名为垫舌痰。肿块在咽喉左右各一枚的，名为铁门拴。耳下方颊车穴处的肿块，为颊车痰。颈项筋脉之间，肿块长如马刀的，名为马刀瘘。沿颈前部至两耳下，肿块累累相连如串珠的，名为马挂铃。肿块在胁肋间隙，突然肿大的，为夹胁痰。附着于两手大骨处的肿块，为贴骨痰。肿块生于胸膈上方的，为气痰。在腰眼部位的，名为缠腰痰。在两臀部上方，形状如倒扣碗的，名为煨督痰。在胯内鼠鼷穴及足部骨骼处的肿块，也名为贴骨痰。肿块此处溃破彼处又起，遍布全身而无固定位置的，名叫游痰。其蔓延生长不止，节节破溃，溃口不能愈合的，名为瓜藤疮。掌握了大概情况，就是古人所说的七十二种痰症，也不难辨别了，看后面的第一张图，已经得到了概要。
\r第一图\p04-a32a1.bmp\r
帮助
上面第一图中，所标注的各个小圆圈，都是痰核生于人身各部位，因此而定其名。这样医生观察肿块结于何种部位，及呈现何种形象，就可以知道了。总之，痰核多因骨隙而生，而瘰疬纯属阴分，其痊愈周期及治疗方法，也比痰子难治十数倍。
In the regions of the head, skull, and bilateral zygomatic bones, phlegm nodules do not occur. However, they can arise in the neck, below the neck, and throughout the entire body. When initially presenting with alternating chills and fever, forming a lump that is red and swollen, it is classified as *Tanzi* (Phlegm Child, a type of yang-phlegm nodule). When initially presenting without chills or fever, with a white color and no pain, it is classified as *Luoli* (Scrofula, a type of yin-phlegm nodule). Redness belongs to Yang, while whiteness belongs to Yin; Yang conditions are easier to treat, whereas Yin conditions are difficult to treat.
When an abscess (*Yongju*) first appears, lumps may also rise around it. However, the lumps of an abscess feel very mobile upon palpation. In contrast, phlegm nodules are immobile when pushed.
Phlegm nodules are located within the subcutaneous tissue. Initially, they resemble particles such as chess pieces, peas, or mung beans. During their eruption, there is alternating chills and fever. Large ones may be the size of a chicken egg or an inverted bowl. They may vary in shape and length; those that are red, swollen, and erupt quickly belong to *Tanzi*. Those that are white with slight redness, exhibit minimal edema, and erupt slowly mostly belong to *Luoli*.
After a phlegm nodule ulcerates, it rarely forms a scab. Instead, foul-smelling discharge occurs intermittently. Applying muscle-regenerating plasters results in one area sealing up while another ulcerates, making treatment ineffective. Only by employing the fire-attack method described later can rapid healing be achieved without recurrence. Otherwise, the condition spreads over the whole body, leading to the depletion of body fluids and eventually developing into consumptive disease (*Laozai*).
The names of phlegm nodules are often determined by their shape and location. A few examples are listed here for reference:
If the nodule is under the tongue, it is named *Dianshi Tan* (Cushion-Tongue Phlegm).
If there is one nodule on each side of the throat, it is named *Tiemen Shuan* (Iron Gate Bolt).
If the nodule is at the Jiache acupoint below the ear, it is called *Jiache Tan* (Jiache Phlegm).
If the nodule is between the tendons of the neck and is long like a machete, it is named *Madao* (Machete Scrofula).
If nodules appear along the front of the neck down to below both ears, linked together like beads on a string, it is named *Magualing* (Horse-Hanging Bell).
If the nodule is in the hypochondriac region and swells suddenly, it is called *Jixie Tan* (Hypochondriac Phlegm).
If the nodule adheres to the large bones of the hands, it is called *Tiegu Tan* (Bone-Clinging Phlegm).
If the nodule arises above the chest and diaphragm, it is called *Qi Tan* (Qi Phlegm).
If it is in the lumbar region, it is named *Chanyao Tan* (Waist-Wrapping Phlegm).
If it is on the upper buttocks and shaped like an inverted bowl, it is named *Weidu Tan* (Roasting-Spine Phlegm).
If nodules appear in the Shuxi acupoint in the groin and on the foot bones, they are also named *Tiegu Tan* (Bone-Clinging Phlegm).
If nodules ulcerate in one place and appear in another, spreading throughout the body without a fixed location, it is called *You Tan* (Wandering Phlegm).
If it grows continuously, ulcerating segment by segment with wounds that fail to close, it is named *Guateng* (Gourd-Vine Ulcer).
By grasping these general principles, even the seventy-two types of phlegm syndromes mentioned by ancient physicians can be distinguished. The first diagram below provides an overview.
\rFirst Diagram\p04-a32a1.bmp\r
Help
The small circles marked in the First Diagram above indicate where phlegm nodules occur on the human body, which determines their names. Thus, practitioners can identify the condition by observing the location and morphology of the nodules. In summary, phlegm nodules often arise from bone gaps, whereas *Luoli* belongs purely to the Yin aspect. Consequently, its recovery period and treatment methods are more than ten times more difficult than those for *Tanzi*.