病
结核者，火因痰注而不散，郁结坚硬，如果中核也。或在颈胁，
或在手足，或在头额，或在臂，或在腋。如肿毒不红不痛，不作脓，不必溃发，但令热气散则核自消。
治
大法宜二陈汤加竹沥，多服为妙。
方
开气消痰汤 治胸中胃脘至咽门窄狭如线疼痛，及手足俱有核如胡桃者。
陈皮（一钱） 半夏（七分，泡） 枯芩（一钱） 前胡（八分） 桔梗（一钱二分） 枳
壳（一钱） 枳实（七分） 香附（一钱二，童便炒） 木香（五分） 僵蚕（一钱二分） 羌活
（七分） 荆芥（七分） 槟榔（八分） 射干（七分） 威灵仙（七分） 甘草（六分）
上锉一剂，生姜三片，水煎服。
治颈项下生痰核。
二陈汤加酒炒大黄、黄连、连翘、桔梗、柴胡、生姜，煎服。
治臂核作痛。
二陈汤加连翘、川芎、防风、黄芩、酒炒苍术、皂角刺。
治耳后项各一块。
牛胆南星 白僵蚕 大黄（酒炒） 青黛
上为末，炼蜜丸，噙化。
治一身俱是块。
二陈汤加白芥子炒、黄连姜汁炒。
治颈项结核或肿痛（李小陉传）
夏枯草不拘多少，水煎频频服之，即愈。
〔批〕（按此方治结核内消之剂） 一妇人遍身痰核，不红肿，不疼痛。
陈皮 半夏 茯苓 当归 川芎 白芍药 枳实 黄连 香附
桔梗 连翘 防风 羌活 柴胡 龙胆草 甘草（各等分）
上锉一剂，生姜煎服。
治痰核
用南星、淮乌各等分，共为细末，姜汁调如膏，敷核上，立消。
〔批〕（按此方治结核，外敷之剂） 治项后侧少阳经中，瘩瘩不变肉色，不
问大小及年深月久，或亦赤硬肿痛。
生山药（去皮，一块） 蓖麻子（三个，去壳，共研匀HT 帛上贴之即消）
【病机论述】
所谓结核，是由于火邪因痰浊停滞而不得消散，郁结形成坚硬肿块，就像果实中的核一样。这种肿块可能出现在颈部和胁部，也可能出现在手足、头额、手臂或腋下。如果表现为肿毒状但不红不痛，不化脓，也不需要溃破排脓，只要使体内的热气散除，肿块自然就会消退。
【治疗原则】
治疗的大法适宜使用二陈汤（燥湿化痰的基础方）加入竹沥（竹子经火烤流出的汁液，清热化痰），长期服用效果更佳。
【方剂与治法】
1. 开气消痰汤：主治胸中及胃脘部直至咽门狭窄如线般疼痛，以及手足部位出现像胡桃大小的肿块。
药材组成：陈皮（一钱）、半夏（七分，浸泡后使用）、黄芩（去心枯干者，一钱）、前胡（八分）、桔梗（一钱二分）、枳壳（一钱）、枳实（七分）、香附（一钱二分，用童便炒制）、木香（五分）、僵蚕（一钱二分）、羌活（七分）、荆芥（七分）、槟榔（八分）、射干（七分）、威灵仙（七分）、甘草（六分）。
用法：将上述药材锉碎为一剂，加生姜三片，用水煎煮后服用。
2. 治疗颈项下部生痰核：
在二陈汤基础上，加入酒炒大黄、黄连、连翘、桔梗、柴胡、生姜，煎煮后服用。
3. 治疗手臂上的肿块并伴有疼痛：
在二陈汤基础上，加入连翘、川芎、防风、黄芩、酒炒苍术、皂角刺。
4. 治疗耳后及颈部各有一块肿块：
牛胆南星、白僵蚕、大黄（酒炒）、青黛。
用法：将上述药材研为细末，用炼蜜制成丸药，含服使其慢慢化开。
5. 治疗全身各处都有肿块：
在二陈汤基础上，加入炒白芥子、姜汁炒黄连。
6. 治疗颈项部结核或伴有肿痛（由李小陉传授）：
夏枯草不限数量，用水煎煮，频繁服用，即可痊愈。
【批注】（按：此方为治疗结核内消的方剂）
7. 案例：一位妇人全身遍布痰核，不红肿，不疼痛。
药材组成：陈皮、半夏、茯苓、当归、川芎、白芍药、枳实、黄连、香附、桔梗、连翘、防风、羌活、柴胡、龙胆草、甘草（以上药材各等分）。
用法：将上述药材锉碎为一剂，加生姜煎煮后服用。
8. 治疗痰核：
使用南星、淮乌（即制川乌或制草乌，此处指代有毒性的乌头类药材，需炮制）各等分，共同研为细末，用姜汁调成膏状，敷于肿块上，立即消退。
【批注】（按：此方为治疗结核的外敷剂）
9. 治疗项后侧少阳经区域出现的瘩瘩（小疙瘩），颜色不变，无论大小及病程长短，或者已经变红、坚硬、肿痛。
药材组成：生山药（去皮，一块）、蓖麻子（三个，去壳，共同研磨均匀）。
用法：涂于帛布上贴敷患处，即可消退。
[Pathogenesis Discussion]
Tubercles (Jiehe, nodular swellings) refer to hard masses formed by the stagnation and accumulation of fire-heat due to phlegm-dampness, resembling the pit of a fruit. These masses may occur in the neck and hypochondrium, or on the hands, feet, forehead, arms, or axillae. If presenting as a swelling without redness or pain, without suppuration, and requiring no ulceration or discharge, the mass will naturally dissipate once the internal heat is cleared.
[Treatment Principles]
The general treatment principle involves using Erchen Tang (Two-Aged Decoction, a basic formula for drying dampness and resolving phlegm) with added Zhuli (Bamboo Sap, used to clear heat and resolve phlegm). Long-term administration is considered optimal.
[Formulas and Therapies]
1. Kaixi Xiaotan Tang (Qi-Opening and Phlegm-Resolving Decoction): Indicated for pain described as narrow like a thread from the chest and epigastrium up to the throat gate, and for nodules the size of walnuts appearing on the hands and feet.
Ingredients: Chenpi (Citri Reticulatae Pericarpium, 1 qian), Banxia (Pinelliae Rhizoma, processed, 0.7 qian), Huangqin (Scutellariae Radix, dried/cored, 1 qian), Qianhu (Peucedani Radix, 0.8 qian), Jiegeng (Platycodonis Radix, 1.2 qian), Zhike (Aurantii Fructus Immaturus, 1 qian), Zhishi (Aurantii Fructus Immaturus, 0.7 qian), Xiangfu (Cyperī Rhizoma, stir-fried with child's urine, 1.2 qian), Muxiang (Aucklandiae Radix, 0.5 qian), Jiangcan (Bombyx Batryticatus, 1.2 qian), Qianghuo (Notopterygii Rhizoma et Radix, 0.7 qian), Jingjie (Schizonepetae Spica, 0.7 qian), Binglang (Arecae Semen, 0.8 qian), Shegan (Belamcandae Rhizoma, 0.7 qian), Weilingxian (Salviae Miltiorrhizae Radix et Rhizoma? Note: Traditionally Notopterygii or Clematidis, here likely Clematidis Radix et Rhizoma, 0.7 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.6 qian).
Administration: Coarsely crush the above ingredients for one dose. Add three slices of Shengjiang (Zingiberis Rhizoma Recens) and decoct with water for oral administration.
2. Treatment for phlegm nodules occurring below the neck:
Modify Erchen Tang (Two-Aged Decoction) by adding Dahuang (Rhei Radix et Rhizoma, wine-fried), Huanglian (Coptidis Rhizoma), Lianqiao (Forsythiae Fructum), Jiegeng (Platycodonis Radix), Chaihu (Bupleuri Radix), and Shengjiang (Zingiberis Rhizoma Recens). Decoct and administer orally.
3. Treatment for painful nodules on the arm:
Modify Erchen Tang (Two-Aged Decoction) by adding Lianqiao (Forsythiae Fructum), Chuanxiong (Ligustici Chuanxiong Rhizoma), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix), Cangzhu (Atractylodis Rhizoma, wine-fried), and Zaojiaoci (Gleditsiae Sinensis Spina).
4. Treatment for single lumps behind the ear and on the neck:
Niudan Nanxing (Arisaema cum Bile, prepared with ox gall), Baijiangcan (Bombyx Batryticatus), Dahuang (Rhei Radix et Rhizoma, wine-fried), Qingdai (Indicum).
Administration: Grind the above ingredients into fine powder. Form pills with refined honey. Administer by holding in the mouth to dissolve slowly.
5. Treatment for lumps throughout the entire body:
Modify Erchen Tang (Two-Aged Decoction) by adding Baijiezi (Sinapis Semen, stir-fried) and Huanglian (Coptidis Rhizoma, stir-fried with ginger juice).
6. Treatment for tubercles in the neck or accompanied by swelling and pain (Transmitted by Li Xiaoxing):
Xiakucao (Prunellae Spica), quantity unrestricted. Decoct with water and take frequently until cured.
[Commentary]: This formula is for the internal resolution of tubercles.
7. Case Study: A woman presented with phlegm nodules all over her body, without redness, swelling, or pain.
Ingredients: Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Fuling (Poria), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Zhishi (Aurantii Fructus Immaturus), Huanglian (Coptidis Rhizoma), Xiangfu (Cyperī Rhizoma), Jiegeng (Platycodonis Radix), Lianqiao (Forsythiae Fructum), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Chaihu (Bupleuri Radix), Longdancao (Gentianae Radix), Gancao (Glycyrrhizae Radix et Rhizoma). All ingredients in equal proportions.
Administration: Coarsely crush for one dose. Decoct with Shengjiang (Zingiberis Rhizoma Recens) and administer orally.
8. Treatment for phlegm nodules:
Use Nanxing (Arisaematis Rhizoma) and Huaiwu (Aconiti Lateralis Radix Praeparata or similar prepared Aconite root, equal parts). Grind into fine powder. Mix with Jiangzhi (Ginger Juice) to form a paste. Apply externally to the nodule; it will dissipate immediately.
[Commentary]: This is an external application formula for tubercles.
9. Treatment for small lumps in the Shaoyang meridian region on the side/back of the neck, which do not change skin color, regardless of size or duration, or if they become red, hard, swollen, and painful.
Ingredients: Shengshanyao (Dioscoreae Rhizoma, peeled, one piece), Bamazi (Ricini Semen, three seeds, shelled, ground together evenly).
Administration: Apply onto a silk cloth and patch the affected area; it will dissipate.