《灵枢》云∶虚邪之入于身也深，寒与热相搏，久留而内着，寒胜其热，则骨疼肉枯，
热胜其寒，则烂肉腐肌为脓，内伤骨。内伤骨为骨蚀，有所疾前筋，（疾前二字，衍文也。筋
当作结）筋屈不得伸，邪气居其间而不反发，为筋瘤。有所结气归之，卫气留之，不得反，
津液久留，合为肠瘤。久者数岁乃成，以手按之柔。已有所结，气归之，津液留之，邪
气中之凝结，日以易甚，连以聚居，为昔瘤，以手按之坚。有所结，深中骨，气因于骨，骨
与气并，日以益大，则为骨疽。有所结，中于肉，宗气居之，邪留而不去，有热则化而
为脓，无热则为肉疽。凡此数气者，其发无常处，而有常名也。（《刺节真邪篇》。 此皆虚邪
中人为病，弗去而久留着，故积岁累月而成疽瘤也。）
《三因》云∶瘿多着于肩项，瘤则随气凝结，此等皆年数深远，浸大浸长，坚硬不可
移者，名曰石瘿。皮色不变者，名曰肉瘿。筋脉露结者，名曰筋瘿。赤脉交结者，名曰血
瘿，随忧愁消长者，名曰气瘿。五瘿皆不可妄决破，决破则脓血崩溃，多致夭枉。瘿则
有六，骨瘤、脂瘤、气瘤、肉瘤、脓瘤、血瘤，亦不可决溃，肉瘤尤不可治，治则杀人。
唯脂瘤，破而去其脂粉则愈。 丹溪云∶服瘿瘤药，先须断浓味。
海藻丸 治瘿瘤通用。
海藻（洗晒） 川芎 当归 官桂 白芷 细辛 藿香 白蔹 昆布（洗晒） 明矾（ ，各一
两） 海蛤（ ） 松萝（各七钱半）
为细末，炼蜜丸如弹子大，每服一丸，食后，含咽下。
守瘿丸 治瘿瘤结硬。
通草（二两） 杏仁（去皮尖，研） 牛蒡子（各一合） 昆布（洗） 射干 诃梨勒 海藻（洗，各四两）
上为细末，炼蜜和丸，如弹子大。每服一丸，食后，噙化，日三。
海藻酒方 治颈下，卒结核渐大，欲成瘿瘤。
上用海藻，洗去咸一斤，酒二升，渍一宿，取一二合饮之，酒尽，将海藻曝干，捣
末。酒调一钱匕，日三，即瘥。如浸，用绢袋盛了浸，春夏二日，秋冬三日。
白头翁丸 治气瘿，气瘤。
白头翁（半两） 昆布（十分，洗） 通草 海藻（洗，各七分） 连翘 玄参（各八分） 桂心（三分）
白蔹（六分）
上为细末，炼蜜和丸，如梧桐子大。每服五丸，用酒送下，忌蒜、面、生葱，猪、鱼。
海藻散坚丸 治肝经瘿瘤。
海藻 昆布（各二两） 小麦（四两，醋煮，炒干），龙胆草（二两）
上为末，炼蜜丸桐子大。每服二三十丸，临卧白汤送下，并噙化咽之。
〔五瘿〕
在颈项间，皮宽不急，累累而垂者是也。宜破结散、消 丸、海藻丸、昆布丸，黄药
酒、藻药散，兼以针灸法同施，方有效；及常服复元通气散、蜡矾丸，自然缩小。
木通散 治颈下卒生结囊，欲成瘿。
木通 松萝 桂心 蛤蚧（酥炙） 白蔹 琥珀 海藻（洗） 昆布（洗，各一两）
上为细末。每服二钱，不拘时，温酒调下。
五瘿丸
菖蒲（二两） 海蛤 白蔹 续断 海藻 松萝 桂心 倒挂草 蜀椒 半夏（各一两）
神曲（三两） 羊靥（百枚）
上为细末。以牛、羊脂髓为丸，如芡实大。每服一丸，食后，临卧噙化服。
昆布丸
槟榔 昆布 海藻（各二两）
上为末，炼蜜丸弹子大。每用一丸，含咽化下。
藻药散 治气瘿。
海藻（酒洗，一两） 黄药子（二两，万州者佳）
上为末。置掌中，以舌时时舐，以津咽下。消三分之二止药。先须断浓味，戒酒色。
（按∶《本草》黄药子，主诸恶肿，疮 。《斗门方》以浸酒，疗项下瘿气。《医学纲目》及丹溪，误作
黄柏，盖柏、药字相近，又误柏为连，则其失愈远矣。）
二海丸 治气瘿。
海藻 昆布（各酒洗，晒干）
上等分为末，炼蜜丸杏核大。稍稍咽汁，又用海藻洗净，切碎，油醋熟，作常菜食之。
消瘿散 治瘿气。
海藻（酒洗） 海带（酒洗） 昆布（酒洗） 海马（酒炙） 海红蛤 石燕（各 ） 海螵蛸（各一两）
上为末，清茶下。兼服含化丸，兼灸，相济以收全功。
含化丸 治瘿气。
海藻 海蛤（ ） 海带 昆布 瓦龙子（ ） 文蛤（即花蛤，背有斑文） 诃子（去核） 五灵
脂（各一两） 猪FS （十四个，焙干，另研）
上为末，炼蜜丸。临卧含化，时时咽下。兼灸法，以助丸功。
通气丸 治瘿气。
海藻 海带 昆布 夏枯草 木通（各一两） 诃子 薄荷（各五钱） 杏仁（少许）
上为末，炼蜜丸如芡实大。每用一丸，噙化。兼灸，以泄瘿气方效。
黄药酒 治忽生瘿疾及一二年者。
上用万州黄药子三斤，须紧重者为上，如轻虚即是他州者，力慢须加一倍。以无灰酒
一斗，投药在内，固济瓶口，以糠火烧一伏时停。待酒冷即令患者时时饮一盏，勿令绝
酒气，经三五日，常把镜自照，觉消则停饮，不尔，令人项细也。用火时，不可多，惟烧
酒气香出，瓶头有津，即止火不待经宿也，已验如神，忌毒食。
昆布散 治瘿气，去风火郁滞，散痰气壅结。
防风 荆芥 黄连（酒炒） 昆布 海藻 海粉 羌活 升麻 连翘 青皮 胆星 贝
母牛蒡子（炒） 夏枯草 沉香 香附子 抚芎 黄芩（酒炒）
上薄荷煎服，或末、或丸俱可。痰多加南星、半夏，又宜灸天突穴，为妙。
三因破结散
海藻（洗） 草龙胆 海蛤 通草 昆布 矾石（枯） 松萝（各三分） 麦面（四分） 半夏 贝
母（各二分）
上为末。酒服方寸匕，日三。忌鲫鱼、猪肉、五辛、生菜诸杂毒物。十日知，二十日
愈。
玉壶散 治三种瘿。
海藻（洗） 海带（洗） 昆布 雷丸（各一两） 青盐 广术（各半两）
上为细末。陈米饮丸，如榛子大，噙化。以炼蜜丸，亦好。
子和人参化瘿丹。
海带（洗） 海藻（洗） 海蛤 昆布（以上四味，皆焙） 泽泻（炒） 连翘（以上各等分） 猪靥
羊靥（各十枚，猪、羊靥即猪羊外肾，乃囊中之卵也）
上为末，蜜丸如芡实大。临卧，噙化一、二丸。忌油腻物。
罗氏宝金散 偏医瘿气，无不瘥。
猪羊靥（十对，暖水洗去脂膜后，晒干，杵为细末） 海藻（洗） 海带（各二两，洗） 丁香 木香
琥珀（研） 麝香（研，各二钱半） 真珠（研，半两）
上件，先将丁香、木香、海藻、海带杵为细末。入下项药末，合和再研细，重罗过。
每服一钱，热酒一盏，调服。夜卧服垂头而
睡。若在室男女，十服必效；如男子、妇女患者，一月见效，有胎不可服。
海带丸 治瘿气，久不消。
海藻（洗） 贝母 青皮 陈皮（各等分）
上件为细末，炼蜜为丸，弹子大，食后，噙化一丸效。
针砂方 治气瘿。
上用针砂浸于水缸中，平日饮食皆用此水。十日一换针砂，服之半年，自然消散。
昆布散 治瘿气结肿，胸膈不利，宜服。
昆布（洗） 海藻（洗） 松萝 半夏（汤泡） 细辛 海蛤（细研） 白蔹 甘草（炙，各一两） 龙
胆草 土瓜根 槟榔（各二两）
上为细末。每服二钱，食后，温酒调下。
治瘿气胸膈壅塞，颈项渐粗，宜服此方。
商陆 昆布（洗，各二两） 射干 羚羊角（镑） 木通 海藻（洗） 杏仁（汤浸，去皮尖，麸炒黄，
各一两） 牛蒡子（一两半，微炒）
上 咀。每服三钱，水一中盏，入生姜半分煎至六分，去滓。不拘时温服。
治瘿气神验方
琥珀 桔梗（各半两） 乌 鱼骨 昆布（洗，各一两） 赤小豆（酒煮熟，焙） 小麦（酒煮，各三分）
上为细末，炼蜜丸如小弹大，绵裹一丸，常噙咽津。
神效开结散 治瘿疾，不问年岁极验。
沉香 木香 橘红（四两） 猪靥子（生于豚猪项下） 珍珠（四十丸粒，砂锅内泥封口， 过丝，
一枚如枣大，取四十九）
上为末。每服一钱，临卧，冷酒调搽，徐徐咽下，轻者三五服；重者一料，全愈。修
合用除日效。忌咸、酸、油腻、涩气等物。
六瘤者，随气凝结皮肤之中，忽然肿起，状如梅李，皮软而光，渐如杯卵。若发肿都
软，不痛者血瘤。发肿日渐增长，而不大热，时时牵痛者气瘤。气结微肿，久而不消，后
亦成脓。诸癃瘤、疣赘等，至年衰皆自内溃，治于壮年，可无后忧。按之推移得动者，可
用取法去之，如推之不动者，不可取也，瘤无大小，不量可否而妄取之，必妨人命。俗
云∶瘤者留也，不可轻去，不为无理。 治法∶先以铁罐膏，点瘤顶上令肉黑腐，不痛，
方可以刀剪去黑腐，又以药涂，令肉腐溃，又可剪之，又涂又剪，瘤根去尽为度，若怕针
刀者，却以井金散涂之，令肉黑极，十分腐烂，方可用刀剪之、刮之。若稍有些肉不黑
尽，恐肉未死；肉未死血亦未死，血未死则不可剪刮，恐血来多，致有昏晕之失。其肉
十分黑极，十分腐烂，推得动者，此肌肉死也，肌死则血死。其血死乃可剪刮无妨，虽
血瘤、肉瘤取之亦无妨也。小瘤取之即愈，大瘤取之有半载肌肉麻痹也，宜服养气血药，久
之自愈。
〔薛〕 《内经》云∶肝统筋而藏血，心裹血而主脉，脾主肉而统血，肺主气而司腠
理，肾统骨而主水。若怒动肝火，血涸而筋挛者，其自筋肿起，按之如箸，久而或有血
缕，名曰筋瘤，用六味地黄丸，四物、山栀、木瓜之类。若劳役火动，阴血沸腾，外邪所
搏而为肿者，其自肌肉肿起，久而有赤缕，或皮俱赤，名曰血瘤，用四物、茯苓、远志之
类。若郁结伤脾，肌肉消薄，外邪所搏而为肿者，其自肌肉肿起，按之实软，名曰肉瘤，
用归脾、益气二汤。若劳伤肺气，腠理不密，外邪所搏而壅肿者，其自皮肤肿起，按之浮
软，名曰气瘤，用补中益气之类。若劳伤肾水，不能荣骨而为肿者，其自骨肿起，按之
坚硬，名曰骨瘤，用地黄丸及补中益气汤主之。夫瘤者，留也。随气凝滞，皆因脏腑受
伤，气血乖违，当求其属而治其本。大凡属肝胆二经结核。八珍加山栀、胆草以养气血，
清肝火；六味丸以养肺金，生肾水，若属肝火血燥，须生血凉血，用四物、二地、丹皮、
酒炒黑胆草、山栀。中气虚者，补中益气兼服。若治失其法，脾胃亏损，营气虚弱，不
能濡于患处，或寒气凝于疮口，荣气不能滋养于患处，以致久不生肌而成漏者，悉调补
脾胃，则气血壮而肌肉自生矣。若不慎饮食
起居，及六淫七情，或用寒凉蚀药，蛛丝缠，芫花线等法以治其外，则误矣。 长洲庠王
天爵，辛丑春，左腿近环跳患之，状如大桃，按之濡软，恪服除湿，流气、化痰之剂，恶
寒发热，食少体倦，形气俱虚，脉洪大而虚，气瘤也，肺主之。盖胆属木，肺属金，然发
于胆经部分，乃肺金侮肝木，元气亏损而其脓已内溃矣，遂用十全大补汤数剂，出清白
稀脓甚多，顿加寒热，烦渴头痛，殊类伤寒状，予谓此因脓泄而血气益虚耳，仍用前汤，
其势益甚，脉洪数大，按之如无，乃加附子一钱，其势愈甚而脉复如前，此虚甚而药未
能及也，更加附子二钱，三剂诸症顿退。乃朝用补中益气汤，夕用十全十补汤，各三十
余剂，出腐骨五块，疮口将完。后因不慎起居，患处复溃。诸症更发，咽间如焚，口舌
无皮，用十全大补加附子一钱服之，诸症悉愈。二日不服，内病悉至，患处复溃。二年
后又患，服前药不应，诊其尺脉微细如丝，此属命门火衰，用八味丸为主，佐以十全大补
汤稍愈。至乙巳，仍患虚寒之症而殁。 一男子，左腿外侧近臀，肿一块，上有赤缕三
年类鸡距，一类羊角，腕不能钏，向明望之如桃胶
然，夫家欲弃之。戴人见之曰∶在手背者为胶瘤，在面者为粉瘤。此胶瘤也，以 针十
字刺破，按出黄胶脓三二匙，立平。瘤核更不再作，婚事复成。非素明者，不敢用此法
耳。
清上消郁汤 治痰火，气血郁结，作核成瘤，脉弦而滑在上部者。
昆布（洗） 玄明粉 陈皮 半夏（姜制） 黄连 海藻 莪术 川芎 香附 青黛 白芥子
上薄荷煎服
解下除湿汤 治湿热郁结，血气凝滞，作核成瘤在下部者。
海藻(洗) 黄柏 三棱 香附 青皮 栀子（炒） 连翘 槟榔 木通
上薄荷煎服。
南星散 治皮肤、颈项、面上瘤，大者如拳，小者如栗，或软或硬，不痒不痛，宜
用此药，切不可辄用针灸，多致不救。
生南星（大者，一枚）
上细研烂，入好醋五七点，杵如膏。先以细针刺患处令气透，却以膏药摊贴，觉痒，
则频换贴，取效。
枯瘤膏 治六瘤，瘰 ，痔漏。（如无此膏，以铁罐膏代之，更捷。）
草乌（四两） 川乌（二两） 干桑耳 桑朽木（各一两半） 矿锻石 桑柴灰 荞麦秸灰（各一碗）
上将草乌、川乌，桑耳、桑朽木，共烧成灰，和矿锻石、桑柴灰、荞麦秸灰，一处装入
《灵枢》说：虚邪侵入人体很深，寒气和热气相互搏结，长久停留并深入体内。如果寒气胜过热气，就会导致骨头疼痛、肌肉枯瘦；如果热气胜过寒气，就会使肌肉腐烂化为脓液，内伤骨骼。内伤骨骼称为骨蚀；如果筋脉发生病变（“疾前”二字为衍文，“筋”字应为“结”），导致筋脉屈曲不能伸展，邪气停留在其间而不发散，就形成筋瘤。如果有气机郁结汇聚于此，卫气停留其中不能返回，津液长久滞留，结合而成肠瘤。病程长的要经过数年才能形成，用手按压感觉柔软。已经有所郁结，气机汇聚于此，津液停留，邪气侵入其中凝结，每天逐渐加重，连续聚集，形成昔瘤，用手按压感觉坚硬。如果有郁结，深达骨骼，气机依附于骨，骨与气相结合，每天逐渐增大，就形成骨疽。如果有郁结，位于肌肉之中，宗气停留于此，邪气留滞不去，有热就会化而为脓，无热就形成肉疽。以上几种病邪，它们的发作没有固定的部位，但有固定的名称。（出自《刺节真邪篇》。这些都是虚邪中人致病，如果不祛除而长久留滞，所以积累岁月而成疽瘤。）
《三因极一病证方论》说：瘿病多发生在肩颈部，瘤则随气机凝结。这些疾病都历时久远，逐渐变大变长，坚硬不可移动，称为石瘿。皮肤颜色不变的，称为肉瘿。筋脉显露结节的，称为筋瘿。血脉交错结聚的，称为血瘿。随情绪忧愁消长的，称为气瘿。这五种瘿病都不可随意切开破溃，一旦破溃会导致脓血崩溃，大多导致早亡。瘿病共有六种分类：骨瘤、脂瘤、气瘤、肉瘤、脓瘤、血瘤，也不可轻易决溃，其中肉瘤尤其难以治疗，若强行治疗会致死。只有脂瘤，破开去除其中的脂粉即可痊愈。朱丹溪说：服用治疗瘿瘤的药物，必须先断绝浓味饮食。
海藻丸：治疗瘿瘤通用方。
海藻（清洗晒干）、川芎、当归、官桂、白芷、细辛、藿香、白蔹、昆布（清洗晒干）、明矾（煅），各一两；海蛤（煅）、松萝（各七钱半）。
研成细末，用炼蜜制成如弹子大小的丸药。每次服用一丸，饭后含服咽下。
守瘿丸：治疗瘿瘤结硬。
通草（二两）、杏仁（去皮尖，研磨）、牛蒡子（各一合）、昆布（清洗）、射干、诃梨勒、海藻（清洗，各四两）。
研成细末，用炼蜜和丸，如弹子大小。每次服用一丸，饭后含化，每日三次。
海藻酒方：治疗颈下突然结核逐渐增大，欲成瘿瘤。
取上述海藻，清洗去咸味一斤，加酒二升，浸泡一夜，取一二合饮用。酒喝完，将海藻晒干，研成末。用酒调服一钱匕，每日三次，即可痊愈。如果浸泡，用绢袋盛好浸泡，春夏两天，秋冬三天。
白头翁丸：治疗气瘿、气瘤。
白头翁（半两）、昆布（十分，清洗）、通草、海藻（清洗，各七分）、连翘、玄参（各八分）、桂心（三分）、白蔹（六分）。
研成细末，用炼蜜和丸，如梧桐子大小。每次服用五丸，用酒送下，忌食蒜、面、生葱、猪肉、鱼肉。
海藻散坚丸：治疗肝经瘿瘤。
海藻、昆布（各二两）、小麦（四两，醋煮后炒干）、龙胆草（二两）。
研成细末，用炼蜜制成如梧桐子大小的丸药。每次服用二三十丸，睡前用白开水送下，并含化咽下。
〔五瘿〕
在颈项之间，皮肤宽松不急迫，累累下垂的就是。宜用破结散、消瘿丸、海藻丸、昆布丸、黄药酒、藻药散，配合针灸法同时施治，才有效；以及常服复元通气散、蜡矾丸，可使其自然缩小。
木通散：治疗颈下突然生结囊，欲成瘿。
木通、松萝、桂心、蛤蚧（酥炙）、白蔹、琥珀、海藻（清洗）、昆布（清洗，各一两）。
研成细末。每次服用二钱，不拘时候，温酒调下。
五瘿丸
菖蒲（二两）、海蛤、白蔹、续断、海藻、松萝、桂心、倒挂草、蜀椒、半夏（各一两）、神曲（三两）、羊靥（一百枚）。
研成细末。用牛、羊脂髓和丸，如芡实大小。每次服用一丸，饭后、睡前含化服用。
昆布丸
槟榔、昆布、海藻（各二两）。
研成细末，用炼蜜制成如弹子大小的丸药。每次用一丸，含化咽下。
藻药散：治疗气瘿。
海藻（酒洗，一两）、黄药子（二两，万州产的为佳）。
研成细末。置于掌心，用舌头不时舔舐，以唾液咽下。症状消除三分之二即停药。必须先断绝浓味饮食，戒酒色。
（按：《本草》记载黄药子主治各种恶肿、疮疡。《斗门方》用它浸酒，治疗颈下瘿气。《医学纲目》及朱丹溪误作黄柏，大概是因为柏、药字形相近，又误柏为连，那就错得更远了。）
二海丸：治疗气瘿。
海藻、昆布（各酒洗，晒干）。
上等分为末，用炼蜜制成如杏核大小的丸药。慢慢咽汁，另外用海藻洗净切碎，用油醋煮熟，作为常菜食用。
消瘿散：治疗瘿气。
海藻（酒洗）、海带（酒洗）、昆布（酒洗）、海马（酒炙）、海红蛤、石燕（各适量）、海螵蛸（各一两）。
研成细末，清茶送下。兼服含化丸，兼灸，相辅相成以收全功。
含化丸：治疗瘿气。
海藻、海蛤（煅）、海带、昆布、瓦龙子（煅）、文蛤（即花蛤，背有斑纹）、诃子（去核）、五灵脂（各一两）、猪靥（十四个，焙干，另研）。
研成细末，用炼蜜制丸。睡前含化，不时咽下。兼用灸法，以助丸药功效。
通气丸：治疗瘿气。
海藻、海带、昆布、夏枯草、木通（各一两）、诃子、薄荷（各五钱）、杏仁（少许）。
研成细末，用炼蜜制成如芡实大小的丸药。每次用一丸，含化。兼用灸法，以泄瘿气才有效。
黄药酒：治疗忽生瘿疾及患有一两年的。
取万州黄药子三斤，必须沉重者为上品，如果轻虚就是其他州的，药效慢需加倍。用无灰酒一斗，投入药在内，密封瓶口，用糠火烧一个时辰后停止。待酒冷就让患者时时饮一盏，不要让酒气断绝，经过三五天，常拿镜子自照，觉得消退了就停饮，否则，会让人脖子变细。用火时，不可太多，只要烧到酒气香出，瓶头有水珠，就停止火，不必等到过夜。已验证如神，忌食毒物。
昆布散：治疗瘿气，祛风火郁滞，散痰气壅结。
防风、荆芥、黄连（酒炒）、昆布、海藻、海粉、羌活、升麻、连翘、青皮、胆星、贝母、牛蒡子（炒）、夏枯草、沉香、香附子、抚芎、黄芩（酒炒）。
上薄荷煎服，或做散剂、丸剂均可。痰多加南星、半夏，又适宜灸天突穴，为妙。
三因破结散
海藻（清洗）、草龙胆、海蛤、通草、昆布、矾石（枯）、松萝（各三分）、麦面（四分）、半夏、贝母（各二分）。
研成细末。酒服方寸匕，每日三次。忌食鲫鱼、猪肉、五辛、生菜等杂毒物。十日见效，二十日痊愈。
玉壶散：治疗三种瘿。
海藻（清洗）、海带（清洗）、昆布、雷丸（各一两）、青盐、广术（各半两）。
研成细末。陈米饮和丸，如榛子大小，含化。用炼蜜制丸也可以。
子和人参化瘿丹。
海带（清洗）、海藻（清洗）、海蛤、昆布（以上四味，皆焙干）、泽泻（炒）、连翘（以上各等分）、猪靥、羊靥（各十枚，猪、羊靥即猪羊外肾，乃囊中之卵也）。
研成细末，蜜丸如芡实大小。睡前，含化一、二丸。忌油腻物。
罗氏宝金散：偏医瘿气，无不痊愈。
猪羊靥（十对，暖水洗去脂膜后，晒干，杵为细末）、海藻（清洗）、海带（各二两，清洗）、丁香、木香、琥珀（研）、麝香（研，各二钱半）、真珠（研，半两）。
先将丁香、木香、海藻、海带杵为细末。加入下项药末，混合再研细，过筛。
每次服用一钱，热酒一盏，调服。夜间服药垂头而睡。若在室男女，十服必效；如男子、妇女患者，一月见效，孕妇不可服。
海带丸：治疗瘿气，久不消。
海藻（清洗）、贝母、青皮、陈皮（各等分）。
研成细末，炼蜜为丸，如弹子大小，饭后含化一丸有效。
针砂方：治疗气瘿。
取针砂浸于水缸中，平日饮食皆用此水。十日一换针砂，服用半年，自然消散。
昆布散：治疗瘿气结肿，胸膈不利，宜服。
昆布（清洗）、海藻（清洗）、松萝、半夏（汤泡）、细辛、海蛤（细研）、白蔹、甘草（炙，各一两）、龙胆草、土瓜根、槟榔（各二两）。
研成细末。每次服用二钱，饭后，温酒调下。
治疗瘿气胸膈壅塞，颈项渐粗，宜服此方。
商陆、昆布（清洗，各二两）、射干、羚羊角（镑）、木通、海藻（清洗）、杏仁（汤浸，去皮尖，麸炒黄，各一两）、牛蒡子（一两半，微炒）。
锉碎。每次服用三钱，水一中盏，入生姜半分煎至六分，去滓。不拘时候温服。
治瘿气神验方
琥珀、桔梗（各半两）、乌贼鱼骨、昆布（清洗，各一两）、赤小豆（酒煮熟，焙）、小麦（酒煮，各三分）。
研成细末，炼蜜丸如小弹大，绵裹一丸，常含咽津。
神效开结散：治疗瘿疾，不问年岁极验。
沉香、木香、橘红（四两）、猪靥子（生于豚猪项下）、珍珠（四十丸粒，砂锅内泥封口，煅过丝，一枚如枣大，取四十九）。
研成细末。每次服用一钱，睡前，冷酒调搽，徐徐咽下，轻者三五服；重者一料，全愈。修合用除日效。忌咸、酸、油腻、涩气等物。
六瘤，随气凝结在皮肤之中，突然肿起，状如梅李，皮软而光，逐渐如杯卵。如果发肿全部柔软，不痛的，是血瘤。发肿日渐增长，而不大热，时时牵痛的，是气瘤。气结微肿，久而不消，后来也成脓。诸癃瘤、疣赘等，到了年老体衰都会自行从内部溃烂，如果在壮年治疗，可无后忧。按压推移能动的，可用取法去除，如果推之不动的，不可取。瘤无大小，不量可否而妄取，必妨人命。俗话常说：瘤者留也，不可轻去，不为无理。
治法：先用铁罐膏，点瘤顶上令肉黑腐，不痛，方才可以用刀剪去黑腐，又以药涂，令肉腐溃，又可剪之，又涂又剪，瘤根去尽为止。如果怕针刀的，却以井金散涂之，令肉黑极，十分腐烂，方可用刀剪之、刮之。如果稍有些肉不黑尽，恐肉未死；肉未死血亦未死，血未死则不可剪刮，恐血来多，致有昏晕之失。其肉十分黑极，十分腐烂，推得动者，此肌肉死也，肌死则血死。其血死乃可剪刮无妨，虽血瘤、肉瘤取之亦无妨也。小瘤取之即愈，大瘤取之有半载肌肉麻痹也，宜服养气血药，久之自愈。
〔薛己〕《内经》说：肝统筋而藏血，心裹血而主脉，脾主肉而统血，肺主气而司腠理，肾统骨而主水。如果怒动肝火，血涸而筋挛者，其自筋肿起，按之如箸，久而或有血缕，名曰筋瘤，用六味地黄丸，四物、山栀、木瓜之类。如果劳役火动，阴血沸腾，外邪所搏而为肿者，其自肌肉肿起，久而有赤缕，或皮俱赤，名曰血瘤，用四物、茯苓、远志之类。如果郁结伤脾，肌肉消薄，外邪所搏而为肿者，其自肌肉肿起，按之实软，名曰肉瘤，用归脾、益气二汤。如果劳伤肺气，腠理不密，外邪所搏而壅肿者，其自皮肤肿起，按之浮软，名曰气瘤，用补中益气之类。如果劳伤肾水，不能荣骨而为肿者，其自骨肿起，按之坚硬，名曰骨瘤，用地黄丸及补中益气汤主之。夫瘤者，留也。随气凝滞，皆因脏腑受伤，气血乖违，当求其属而治其本。大凡属肝胆二经结核。八珍加山栀、胆草以养气血，清肝火；六味丸以养肺金，生肾水，若属肝火血燥，须生血凉血，用四物、二地、丹皮、酒炒黑胆草、山栀。中气虚者，补中益气兼服。若治失其法，脾胃亏损，营气虚弱，不能濡于患处，或寒气凝于疮口，荣气不能滋养于患处，以致久不生肌而成漏者，悉调补脾胃，则气血壮而肌肉自生矣。若不慎饮食起居，及六淫七情，或用寒凉蚀药，蛛丝缠，芫花线等法以治其外，则误矣。
长洲庠王天爵，辛丑春，左腿近环跳患之，状如大桃，按之濡软，恪服除湿、流气、化痰之剂，恶寒发热，食少体倦，形气俱虚，脉洪大而虚，气瘤也，肺主之。盖胆属木，肺属金，然发于胆经部分，乃肺金侮肝木，元气亏损而其脓已内溃矣，遂用十全大补汤数剂，出清白稀脓甚多，顿加寒热，烦渴头痛，殊类伤寒状，予谓此因脓泄而血气益虚耳，仍用前汤，其势益甚，脉洪数大，按之如无，乃加附子一钱，其势愈甚而脉复如前，此虚甚而药未能及也，更加附子二钱，三剂诸症顿退。乃朝用补中益气汤，夕用十全十补汤，各三十余剂，出腐骨五块，疮口将完。后因不慎起居，患处复溃。诸症更发，咽间如焚，口舌无皮，用十全大补加附子一钱服之，诸症悉愈。二日不服，内病悉至，患处复溃。二年后又患，服前药不应，诊其尺脉微细如丝，此属命门火衰，用八味丸为主，佐以十全大补汤稍愈。至乙巳，仍患虚寒之症而殁。
一男子，左腿外侧近臀，肿一块，上有赤缕三年类鸡距，一类羊角，腕不能钏，向明望之如桃胶然，夫家欲弃之。戴人见之曰：在手背者为胶瘤，在面者为粉瘤。此胶瘤也，以针十字刺破，按出黄胶脓三二匙，立平。瘤核更不再作，婚事复成。非素明者，不敢用此法耳。
清上消郁汤：治疗痰火，气血郁结，作核成瘤，脉弦而滑在上部者。
昆布（清洗）、玄明粉、陈皮、半夏（姜制）、黄连、海藻、莪术、川芎、香附、青黛、白芥子。
上薄荷煎服。
解下除湿汤：治疗湿热郁结，血气凝滞，作核成瘤在下部者。
海藻(清洗)、黄柏、三棱、香附、青皮、栀子（炒）、连翘、槟榔、木通。
上薄荷煎服。
南星散：治疗皮肤、颈项、面上瘤，大者如拳，小者如栗，或软或硬，不痒不痛，宜用此药，切不可辄用针灸，多致不救。
生南星（大者，一枚）。
研烂，入好醋五七点，杵如膏。先以细针刺患处令气透，却以膏药摊贴，觉痒，则频换贴，取效。
枯瘤膏：治疗六瘤，瘰疬，痔漏。（如无此膏，以铁罐膏代之，更捷。）
草乌（四两）、川乌（二两）、干桑耳、桑朽木（各一两半）、矿锻石、桑柴灰、荞麦秸灰（各一碗）。
上将草乌、川乌，桑耳、桑朽木，共烧成灰，和矿锻石、桑柴灰、荞麦秸灰，一处装入
*Ling Shu* (Spiritual Pivot) states: When deficient evil penetrates deeply into the body, cold and heat contend with each other, lingering for a long time and settling internally. If cold predominates over heat, it results in bone pain and muscle emaciation; if heat predominates over cold, it causes flesh to rot and turn into pus, damaging the bones internally. Internal damage to the bones is termed "bone erosion" (Gu Shi). If there is an affection of the tendons (the characters "Ji Qian" are superfluous; "Tendon" should be "Knot"), causing tendon flexion and inability to extend, and the evil qi remains trapped without dispersing, it forms a "tendon tumor" (Jin Liu). If there is stagnation of Qi gathering there, Wei Qi (Defensive Qi) remains lodged and cannot return, and body fluids linger for a long time, combining to form an "intestinal tumor" (Chang Liu). Those that persist may take several years to form, feeling soft upon palpation. If there is already a knot, Qi gathers there, body fluids remain, and evil qi invades and condenses, worsening daily, accumulating continuously to form a "Xi tumor" (Xi Liu), which feels hard upon palpation. If there is a knot deep within the bone, Qi attaches to the bone, and bone and Qi combine, enlarging daily, it becomes a "bone abscess" (Gu Ju). If there is a knot within the muscle, Zong Qi (Pectoral Qi) resides there, and evil qi lingers without departing; if there is heat, it transforms into pus; if there is no heat, it becomes a "flesh abscess" (Rou Ju). These various evils have no fixed location of onset but have fixed names. (From *Ci Jie Zhen Xie Pian*. All these are diseases caused by deficient evil invading humans; if not expelled and left to linger, they accumulate over years and months to become abscesses and tumors.)
*San Yin Fang Lun* (Treatise on Three Causes) states: Ying (goiter) mostly occurs on the shoulders and neck, while Liu (tumors) form according to Qi stagnation. These conditions persist for many years, gradually enlarging and lengthening, becoming hard and immobile, named "Stone Ying" (Shi Ying). If the skin color remains unchanged, it is named "Flesh Ying" (Rou Ying). If tendons and vessels are exposed and knotted, it is named "Tendon Ying" (Jin Ying). If red vessels intersect and knot, it is named "Blood Ying" (Xue Ying). If it fluctuates with emotions of worry and sorrow, it is named "Qi Ying" (Qi Ying). None of these five types of Ying should be arbitrarily incised or ruptured; rupture leads to collapse of pus and blood, often resulting in premature death. There are six types of Liu: Bone Liu, Fat Liu, Qi Liu, Flesh Liu, Pus Liu, and Blood Liu, which also should not be ruptured. Flesh Liu is particularly difficult to treat; attempting treatment may cause death. Only Fat Liu can be cured by rupturing it and removing the fatty matter. Danxi stated: When taking medicine for Ying and Liu, one must first avoid rich and heavy flavors.
**Haizao Wan** (Sargassum Pill): A general formula for treating Ying and Liu.
*Sargassum pallidum* (washed and dried), *Ligusticum chuanxiong*, *Angelica sinensis*, *Cinnamomum cassia*, *Angelica dahurica*, *Asarum heterotropoides*, *Agastache rugosa*, *Ampelopsis japonica*, *Ecklonia stolonifera* (washed and dried), *Alumen* (calcined), each 1 liang; *Concha Arcae* (calcined), *Usnea* (each 7 qian 5 fen).
Grind into fine powder, mix with refined honey to make pills the size of a bullet. Take one pill after meals, holding it in the mouth to swallow slowly.
**Shou Ying Wan** (Goiter-Containing Pill): For treating hardened Ying and Liu knots.
*Tetrapanax tricuspidatis Caulis*, 2 liang; *Prunus armeniaca* seed (skin and tip removed, ground); *Arctium lappa* seed (each 1 he); *Ecklonia stolonifera* (washed); *Belamcanda chinensis*; *Terminalia chebula*; *Sargassum pallidum* (washed, each 4 liang).
Grind into fine powder, mix with refined honey to make pills the size of a bullet. Take one pill after meals, holding it in the mouth to dissolve, three times daily.
**Haizao Jiu Fang** (Sargassum Wine Recipe): For sudden nodules under the neck that gradually enlarge, threatening to become Ying.
Take the aforementioned *Sargassum pallidum*, wash to remove saltiness, 1 jin; add 2 sheng of wine, soak overnight. Drink 1-2 he. When the wine is finished, dry the *Sargassum pallidum*, grind into powder. Mix 1 qian bi with wine, three times daily, and it will heal. If soaking, use a silk bag; spring and summer for two days, autumn and winter for three days.
**Baitouweng Wan** (Patriniae Pill): For treating Qi Ying and Qi Liu.
*Patrinia scabiosifolia* (0.5 liang); *Ecklonia stolonifera* (10 fen, washed); *Tetrapanax tricuspidatis Caulis*; *Sargassum pallidum* (washed, each 7 fen); *Forsythia suspensa*; *Scrophularia ningpoensis* (each 8 fen); *Cinnamon twig* (3 fen); *Ampelopsis japonica* (6 fen).
Grind into fine powder, mix with refined honey to make pills the size of a paulownia seed. Take five pills with wine. Avoid garlic, wheat products, raw green onions, pork, and fish.
**Haizao Sanjian Wan** (Sargassum Hardness-Dispersing Pill): For treating Liver channel Ying and Liu.
*Sargassum pallidum*; *Ecklonia stolonifera* (each 2 liang); *Triticum aestivum* (4 liang, boiled in vinegar, stir-fried dry); *Gentiana scabra* (2 liang).
Grind into powder, mix with refined honey to make pills the size of paulownia seeds. Take 20-30 pills before sleep with warm water, holding them in the mouth to swallow.
[Five Yings]
Located between the neck and jaw, where the skin is loose and not tight, hanging in clusters, are these. Suitable formulas include Pojie San, Xiaoying Wan, Haizao Wan, Kunbu Wan, Huangyao Jiu, Zaoyao San, combined with acupuncture and moxibustion for effectiveness; also regularly taking Fuyuan Tongqi San and Lafen Wan to naturally shrink them.
**Mutong San** (Akebia Powder): For sudden cystic knots under the neck, threatening to become Ying.
*Akebia quinata* stem, *Usnea*, *Cinnamon twig*, *Gekko gecko* (fried in butter), *Ampelopsis japonica*, *Amber*, *Sargassum pallidum* (washed), *Ecklonia stolonifera* (washed, each 1 liang).
Grind into fine powder. Take 2 qian at any time, mixed with warm wine.
**Wu Ying Wan** (Five Ying Pill)
*Acorus tatarinowii*, *Concha Arcae*, *Ampelopsis japonica*, *Dipsacus asper*, *Sargassum pallidum*, *Usnea*, *Cinnamon twig*, *Polygonum aviculare*, *Zanthoxylum bungeanum*, *Pinellia ternata* (each 1 liang); *Medicated leaven* (3 liang); *Ovis caprae testis* (100 pieces).
Grind into fine powder. Mix with beef or mutton marrow fat to make pills the size of Chinese chestnuts. Take one pill after meals and before sleep, holding it in the mouth to dissolve.
**Kunbu Wan** (Ecklonia Pill)
*Areca catechu* seed; *Ecklonia stolonifera*; *Sargassum pallidum* (each 2 liang).
Grind into powder, mix with refined honey to make pills the size of bullets. Use one pill at a time, hold in mouth to dissolve and swallow.
**Zaoyao San** (Sargassum-Huangyao Powder): For treating Qi Ying.
*Sargassum pallidum* (wine-washed, 1 liang); *Dioscorea bulbifera* (2 liang, preferably from Wanzhou).
Grind into powder. Place in palm, lick occasionally with tongue, and swallow with saliva. Stop medication when symptoms reduce by two-thirds. First, avoid rich foods, and abstain from alcohol and sexual activity.
(Note: *Ben Cao* records *Dioscorea bulbifera* treats various malignant swellings and sores. *Doumen Fang* uses it soaked in wine to treat neck goiter. *Yixue Gangmu* and Danxi mistakenly used *Phellodendron amurense* (Huangbai), likely due to similar character shapes, and further confused it with *Isatis tinctoria* (Lian), compounding the error.)
**Erhai Wan** (Two Seas Pill): For treating Qi Ying.
*Sargassum pallidum*; *Ecklonia stolonifera* (each wine-washed and sun-dried).
Grind into equal parts powder, mix with refined honey to make pills the size of apricot kernels. Swallow juice slowly. Additionally, wash *Sargassum pallidum*, chop finely, cook with oil and vinegar, and eat as a vegetable.
**Xiaoying San** (Goiter-Reducing Powder): For treating Ying Qi.
*Sargassum pallidum* (wine-washed); *Sargassum fusiforme* (wine-washed); *Ecklonia stolonifera* (wine-washed); *Hippocampus* (wine-fried); *Mercenaria philippinarum*; *Swallow stone* (each appropriate amount); *Sepia esculenta* (each 1 liang).
Grind into powder, take with clear tea. Concurrently take Hanhua Wan and apply moxibustion to achieve complete efficacy.
**Hanhua Wan** (Holding-and-Dissolving Pill): For treating Ying Qi.
*Sargassum pallidum*; *Concha Arcae* (calcined); *Sargassum fusiforme*; *Ecklonia stolonifera*; *Longispira coronata* (calcined); *Meretrix meretrix* (flower clam, with spotted shell); *Terminalia chebula* (pitted); *Trogopterus dung* (each 1 liang); *Sus domesticus testis* (14 pieces, baked dry, ground separately).
Grind into powder, mix with refined honey to make pills. Hold in mouth before sleep, swallowing occasionally. Combine with moxibustion to assist the pill's effect.
**Tongqi Wan** (Unblocking Qi Pill): For treating Ying Qi.
*Sargassum pallidum*; *Sargassum fusiforme*; *Ecklonia stolonifera*; *Prunella vulgaris*; *Akebia quinata* stem (each 1 liang); *Terminalia chebula*; *Mentha haplocalyx* (each 5 qian); *Prunus armeniaca* seed (small amount).
Grind into powder, mix with refined honey to make pills the size of Chinese chestnuts. Use one pill, hold in mouth to dissolve. Combine with moxibustion to vent Ying Qi for efficacy.
**Huangyao Jiu** (Huangyao Wine): For sudden onset of Ying disease or those lasting one to two years.
Take 3 jin of *Dioscorea bulbifera* from Wanzhou; heavy ones are superior, light/void ones are from other regions and require double dosage. Add to 1 dou of unadulterated wine, seal bottle tightly, burn with rice husks for one shichen (2 hours), then stop. When cool, have the patient drink one cup frequently, ensuring the aroma of wine does not cease. After 3-5 days, check with a mirror; if reduced, stop drinking, otherwise the neck may become thin. During burning, do not use too much fire; stop when wine aroma emerges and moisture appears on the bottle neck, without needing overnight. Proven effective; avoid toxic foods.
**Kunbu San** (Ecklonia Powder): For treating Ying Qi, dispelling wind-fire stagnation, and scattering phlegm-Qi obstruction.
*Saposhnikovia divaricata*; *Schizonepeta tenuifolia*; *Coptis chinensis* (wine-fried); *Ecklonia stolonifera*; *Sargassum pallidum*; *Sea starch*; *Notopterygium incisum*; *Bupleurum chinense*; *Forsythia suspensa*; *Citrus reticulata* green peel; *Arisaema cum Bile*; *Fritillaria thunbergii*; *Arctium lappa* seed (stir-fried); *Prunella vulgaris*; *Aquilaria sinensis*; *Cyperi Rhizoma*; *Ligusticum wallichii*; *Scutellaria baicalensis* (wine-fried).
Decoct with *Mentha haplocalyx* and take, or make into powder/pills. Increase *Arisaema* and *Pinellia* if phlegm is heavy; moxibustion on Tiantu (CV22) is excellent.
**San Yin Pojie San** (Three Causes Breaking Knots Powder)
*Sargassum pallidum* (washed); *Gentiana scabra*; *Concha Arcae*; *Tetrapanax tricuspidatis Caulis*; *Ecklonia stolonifera*; *Alumen* (calcined); *Usnea* (each 3 fen); *Triticum aestivum* flour (4 fen); *Pinellia ternata*; *Fritillaria thunbergii* (each 2 fen).
Grind into powder. Take one fang cun bi with wine, three times daily. Avoid crucian carp, pork, five pungent spices, raw vegetables, and other toxic foods. Effective in 10 days, healed in 20.
**Yuhu San** (Jade Pot Powder): For treating three types of Ying.
*Sargassum pallidum* (washed); *Sargassum fusiforme* (washed); *Ecklonia stolonifera*; *Wolffia globosa* (each 1 liang); *Green salt*; *Curcuma wenyujin* (each 0.5 liang).
Grind into fine powder. Mix with aged rice decoction to make pills the size of hazelnuts, hold in mouth to dissolve. Mixing with refined honey is also good.
**Hezi Renshen Huaying Dan** (Hezi Ginseng Goiter-Resolving Pill)
*Sargassum fusiforme* (washed); *Sargassum pallidum* (washed); *Concha Arcae*; *Ecklonia stolonifera* (above four, all roasted); *Alisma orientalis* (stir-fried); *Forsythia suspensa* (equal parts above); *Sus domesticus testis*; *Ovis caprae testis* (each 10 pieces, pig/sheep testes).
Grind into powder, make honey pills the size of Chinese chestnuts. Before sleep, hold 1-2 pills in mouth to dissolve. Avoid greasy foods.
**Luoshi Baojin San** (Master Lu's Precious Gold Powder): Specifically for Ying Qi, universally curative.
*Sus domesticus testis* and *Ovis caprae testis* (10 pairs, wash off fat membrane with warm water, dry, grind to fine powder); *Sargassum pallidum* (washed); *Sargassum fusiforme* (each 2 liang, washed); *Syzygium aromaticum*; *Costus root*; *Amber* (ground); *Moschus* (ground, each 2 qian 5 fen); *Margarita* (ground, 0.5 liang).
First, pound *Syzygium aromaticum*, *Costus root*, *Sargassum pallidum*, *Sargassum fusiforme* into fine powder. Add remaining powders, mix and grind finely, sieve again.
Take 1 qian with one cup of hot wine. Take at night, sleeping with head lowered. For unmarried men/women, effective in 10 doses; for married patients, effective in one month. Contraindicated in pregnancy.
**Haidai Wan** (Sargassum Fusiforme Pill): For Ying Qi persisting for a long time.
*Sargassum pallidum* (washed); *Fritillaria thunbergii*; *Citrus reticulata* green peel; *Citrus reticulata* mature peel (equal parts).
Grind into powder, make honey pills the size of bullets. Hold one pill in mouth after meals for efficacy.
**Zhensha Fang** (Needle Sand Recipe): For treating Qi Ying.
Soak needle sand in a water vat; use this water for daily diet. Replace needle sand every 10 days. Take for half a year, and it will naturally dissipate.
**Kunbu San** (Ecklonia Powder): For Ying Qi with swelling, chest diaphragm discomfort.
*Ecklonia stolonifera* (washed); *Sargassum pallidum* (washed); *Usnea*; *Pinellia ternata* (soaked in boiling water); *Asarum heterotropoides*; *Concha Arcae* (finely ground); *Ampelopsis japonica*; *Glycyrrhiza uralensis* (honey-fried, each 1 liang); *Gentiana scabra*; *Trichosanthes kirilowii* root; *Areca catechu* seed (each 2 liang).
Grind into powder. Take 2 qian after meals with warm wine.
For Ying Qi with chest diaphragm fullness and gradual neck thickening.
*Phytolacca acinosa* root; *Ecklonia stolonifera* (washed, each 2 liang); *Belamcanda chinensis*; *Saiga tatarica* horn (shaved); *Akebia quinata* stem; *Sargassum pallidum* (washed); *Prunus armeniaca* seed (soaked in water, skin/tip removed, bran-fried yellow, each 1 liang); *Arctium lappa* seed (1.5 liang, lightly fried).
Cut into small pieces. Take 3 qian, decoct with 1 zhong lamp of water and 0.5 fen of ginger until 0.6 zhong remains, strain. Take warm at any time.
**Divine Efficacy Formula for Ying Qi**
*Amber*; *Platycodon grandiflorus* (each 0.5 liang); *Sepia esculenta*; *Ecklonia stolonifera* (washed, each 1 liang); *Phaseolus angularis* (boiled in wine, baked); *Triticum aestivum* (boiled in wine, each 3 fen).
Grind into powder, make honey pills the size of small bullets. Wrap one pill in silk, constantly hold in mouth and swallow saliva.
**Shenxiao Kaijie San** (Divine Efficacy Unbinding Powder): For Ying disease, highly effective regardless of age.
*Aquilaria sinensis*; *Costus root*; *Citrus reticulata* peel (4 liang); *Sus domesticus testis* (from wild boar neck); *Margarita* (40 grains, sealed in clay pot, calcined, thread through, one date-sized piece, take 49).
Grind into powder. Take 1 qian before sleep, mix with cold wine, apply and swallow slowly. Mild cases: 3-5 doses; severe cases: one batch for full recovery. Best prepared on "Removal Day". Avoid salty, sour, greasy, and astringent foods.
The Six Liu follow Qi stagnation in the skin, suddenly swelling like plums or peaches, soft and smooth skin, gradually enlarging like cups or eggs. If swelling is entirely soft and painless, it is Blood Liu. If swelling grows daily without significant heat, with occasional pulling pain, it is Qi Liu. Qi knot causes slight swelling, persisting without resolving, eventually suppurating. Various Long Liu, warts, etc., naturally ulcerate internally in old age; treating in youth prevents future worries. If movable upon pressing and pushing, removal methods can be used; if immovable, do not remove. Regardless of size, arbitrary removal without assessment endangers life. Folk saying: "Liu means staying," advising against light removal is not without reason.
Treatment: First apply Tie Guan Gao (Iron Pot Ointment) to the top of the Liu to blacken and necrotize the flesh without pain. Then use knife/scissors to remove blackened necrotic tissue, apply medicine to induce further necrosis, cut again, repeat until root is gone. If afraid of needles/knives, apply Jingjin San to blacken flesh completely until fully rotten, then cut/scrape. If any flesh is not fully blackened, fear flesh/blood is not dead; cutting/scraping may cause hemorrhage and syncope. When flesh is fully blackened and rotten, and movable, muscle is dead, thus blood is dead. Once blood is dead, cutting/scraping is safe, even for Blood/Flesh Liu. Small Liu heal immediately; large Liu may cause half-year muscle paralysis; take Qi-Blood nourishing medicines, self-heals over time.
[Xue Ji] *Nei Jing* states: The Liver governs tendons and stores blood; the Heart envelops blood and governs vessels; the Spleen governs flesh and controls blood; the Lung governs Qi and regulates interstices; the Kidney governs bones and controls water. If anger stirs Liver Fire, drying blood and causing tendon spasm, swelling arises from tendons, firm like a chopstick, with blood threads appearing later, named Tendon Liu; use Liujun Dihuang Wan, Siwu Tang, Gardenia, Quince. If labor stirs fire, boiling Yin blood, external evil combats causing swelling, arising from muscle, with red threads or red skin appearing later, named Blood Liu; use Siwu Tang, Poria, Polygala. If depression injures Spleen, thinning muscle, external evil combats causing swelling, arising from muscle, firm yet soft upon pressure, named Flesh Liu; use Guipi Tang, Yiqi Tang. If labor injures Lung Qi, loose interstices, external evil combats causing swelling, arising from skin, floating and soft upon pressure, named Qi Liu; use Buzhong Yiqi Tang. If labor injures Kidney Water, failing to nourish bones causing swelling, arising from bone, hard upon pressure, named Bone Liu; use Dihuang Wan and Buzhong Yiqi Tang. Liu means staying. Following Qi stagnation, all result from organ injury and Qi-Blood disharmony; seek the root to treat. Generally, nodules in Liver/Gallbladder channels: Bazhen Tang plus Gardenia, Gentiana to nourish Qi-Blood, clear Liver Fire; Liujun Wan to nourish Lung Metal, generate Kidney Water. If Liver Fire/Blood Dryness, generate and cool blood using Siwu Tang, Er Di, Moutan, wine-blackened Gentiana, Gardenia. For Middle Qi deficiency, take Buzhong Yiqi concurrently. If treatment fails, Spleen/Stomach damaged, Ying Qi weak, unable to moisten lesion, or Cold Qi congeals at wound, Ying Qi unable to nourish, leading to non-healing fistula, regulate and tonify Spleen/Stomach, then Qi-Blood strengthens and flesh regenerates. If neglecting diet/lifestyle, Six Evils, Seven Emotions, or using cold/caustic medicines, spider web wrapping, Kadsura vine methods externally, it is erroneous.
Wang Tianjue from Changzhou, Spring of Xinchou year, suffered near Huantiao on left leg, shaped like large peach, soft upon pressure. Strictly took damp-draining, Qi-moving, phlegm-resolving agents, with chills/fever, poor appetite, fatigue, empty/Qi deficiency, pulse large/empty. This is Qi Liu, governed by Lung. Gallbladder is Wood, Lung is Metal; occurring in Gallbladder channel, Lung Metal insults Liver Wood, Yuan Qi depleted, pus internally ulcerated. Used Shiquan Dabu Tang for several doses, discharged much clear thin pus, suddenly worsened chills/fever, thirst/headache, resembling Taiyang syndrome. I said this is due to pus discharge increasing Qi-Blood deficiency. Continued previous formula, condition worsened, pulse rapid/large, empty on pressure. Added 1 qian Fuzi, condition worsened, pulse returned to previous, indicating extreme deficiency where medicine could not reach. Added 2 qian Fuzi, three doses, symptoms receded. Morning: Buzhong Yiqi Tang; Evening: Shiquan Shibu Tang, each 30+ doses, discharged 5 pieces of necrotic bone, wound nearly healed. Later, careless lifestyle caused recurrence. Symptoms worsened, throat burning, tongue/lack of skin. Took Shiquan Dabu Tang plus 1 qian Fuzi, all symptoms resolved. Stopped for two days, internal illness returned, wound re-ulcerated. Two years later, relapsed, previous meds ineffective. Pulse Chi fine as silk, indicates Mingmen Fire decline. Mainly used Jiwei Wan, assisted by Shiquan Dabu Tang, slightly improved. In Yisi year, died of deficiency-cold syndrome.
One man, left leg outer side near buttock, swollen mass, three years of red threads like chicken spur or sheep horn, wrist stiff, looking bright like peach gum, husband's family wanted to discard him. Dairen saw and said: On hand back is Glue Liu, on face is Powder Liu. This is Glue Liu. Puncture crosswise with needle, press out 2-3 spoons of yellow glue-like pus, flattened immediately. Nodule did not recur, marriage restored. Only experts dare use this method.
**Qingshang Xiaoyu Tang** (Clear Upper Resolve Depression Decoction): For Phlegm-Fire, Qi-Blood stagnation forming nodules/Liu, pulse string-slippery in upper part.
*Ecklonia stolonifera* (washed); *Mirabilite*; *Citrus reticulata* peel; *Pinellia ternata* (ginger-processed); *Coptis chinensis*; *Sargassum pallidum*; *Curcuma zedoaria*; *Ligusticum chuanxiong*; *Cyperi Rhizoma*; *Indigo naturalis*; *Sinapis alba* seed.
Decoct with *Mentha haplocalyx* and take.
**Xiexia Chushi Tang** (Drain Lower Remove Dampness Decoction): For Damp-Heat stagnation, Qi-Blood congealing forming nodules/Liu in lower part.
*Sargassum pallidum* (washed); *Phellodendron amurense*; *Sparganium stoloniferum*; *Cyperi Rhizoma*; *Citrus reticulata* green peel; *Gardenia jasminoides* (stir-fried); *Forsythia suspensa*; *Areca catechu* seed; *Akebia quinata* stem.
Decoct with *Mentha haplocalyx* and take.
**Nanxing San** (Arisaema Powder): For skin, neck, facial Liu, large as fist, small as chestnut, soft or hard, no itch/pain. Use this medicine, strictly avoid acupuncture/moxibustion, often leading to untreatable outcomes.
Raw *Arisaema erubescens* (large, 1 piece).
Grind finely, add 5-7 drops of good vinegar, pound into paste. First prick lesion with fine needle to let Qi penetrate, then apply paste. Change frequently if itching occurs, for efficacy.
**Kuliu Gao** (Withered Liu Ointment): For Six Liu, Scrofula, Hemorrhoids/Fistula. (If unavailable, use Tie Guan Gao, more expedient.)
*Aconitum carmichaelii* lateral root (raw) (4 liang); *Aconitum carmichaelii* lateral root (raw) (2 liang); *Dryaulus*; *Rotting mulberry wood* (each 1.5 liang); *Calcined mineral stone*; *Mulberry branch ash*; *Buckwheat straw ash* (each 1 bowl).
Burn *Aconitum* and mulberry wood to ash, mix with mineral stone and ashes, pack together.