大者称恶核，小者称痰核。初起坚硬不痛，与石疽之起相同。然其寒凝甚痼，毒根最深
却不
黄丸煎服，至消乃止。大忌开刀，开则翻花难治。如有翻花者，用大蟾破腹刺数孔，连肠杂
盖患口，拔毒软肛。内服温补托毒消痰之剂犀黄丸收功。如孕妇惟用阳和汤服之。
外治方（存验。）
用大田螺数个捣烂敷之即消。
加味二陈汤（通用十八。）
阳和汤（通用五。）
阳和丸（通用六。）
犀黄丸（通用四十八。）
大者为瘿，小者为瘤。瘿证蒂小而下垂，瘤证顶小而根大。瘿多生于肩项两颐，瘤则随
处可
瘤证易治，瘿证鲜有瘥者。瘿证内用开结散、内府神效方，外用蛛丝缠法，或甘草缩法，缓
缓消磨亦能缩愈。切勿轻用刀、针，致血出不止，立见危殆。
瘤证惟粉瘤最多，其色粉红，多生耳项前后，亦有生于下体者，乃腠理津沫，偶有所滞
，聚
敷之。然每有愈而复发者乃内有胳囊，化净膏贴，生肌自愈。
又有黑沙瘤多生臀腿，其肿大小不一，以手摄起，内有黑色者是。亦用针刺，出黑沙
有声，软硬不等。
又有发瘤，多生耳后发下寸许，软小高突，按之不痛，亦用针刺之，粉发齐出。
又有虱瘤，发后其痒彻骨，开破出虱无数，内有极大一虱，出之方尽。此三者皆同粉瘤
治法，或用艾灸之亦可。
又有虫瘤，每生胁下，本忧郁结成，治难获效。
又有贴骨瘤，贴骨而生，极疼痛。用枸杞根连皮骨、野菊花根连皮骨切片晒干，以多为
妙，再加地丁根同煎，一服即愈。
又有胎瘤，初生小儿头上、胸乳间肿起，大者如馒首，小者如梅李，乃胎中瘀血凝滞而
成，
。
开结散
桔红（四两） 沉香 木香（各二钱） 珍珠（四十九粒，小者加倍。入砂罐内盐泥封固
赤，取出去火毒用） 猪厌肉子（四十九枚，豚猪生项间如枣子者）
上为末，每服一钱，卧时酒调徐徐咽下。患小三、五服愈，大者一料可愈。切记酸咸、
油腻、滞气之物。须择除日于静室修合。
内府神效方
海藻（洗） 昆布（洗） 海带 海粉（飞） 海螵蛸 海螺（顶上摇者用长螺，不摇者用海
螺）
上各等分，研细末，蜜丸龙眼大。每卧时噙化一丸如神。（系内府传方。）
珠丝缠法
取蛛丝拈成粗线，缠孔患根，数日其丝渐紧，瘤根渐细。屡易屡细，不半月瘤自脱。按
诸线日松，惟蛛丝日紧，物理之妙，有当格致者。
甘草缩法
甘草煎膏，以笔涂患四围，三次后另用芫花、大戟、甘遂等分为末醋调，另用笔涂患之
中心
相近。日日互涂，自然缩愈。
治瘤妙方（存验）
用麝香数厘重一整块，安放瘤当中，上加蕲艾绿豆大一丸灸之，不起泡不破，瘤自干退
如旧。
附遍身痰瘤作痒主治方
用肥皂角二斤去边皮，以滴醋十斤，徐徐熬添成膏，摊贴。
又方
用生南星末醋调，或玉簪花根汁调敷之。
大的称为恶核，小的称为痰核。初起时坚硬且不痛，与石疽的发病情况相同。然而其寒凝程度极深固，毒根深藏。应服用黄丸（此处原文似有脱漏，结合上下文及常见方剂，可能指代某类化痰散结之丸药，或特指“黑锡丹”等温阳化痰方，但依原文仅译“黄丸”），煎服至肿块消散为止。严禁使用手术切开，一旦切开会导致疮口翻花（癌性溃疡样改变），难以治愈。如果已经出现翻花症状，可用大蟾蜍剖开腹部刺几个孔，连同内脏一起覆盖在患处伤口上，以拔除毒气、软化肛周组织（注：此处“软肛”疑为“软坚”或特定部位描述，依字面直译）。内服温补托毒、消痰的药物，用犀黄丸收功。如果是孕妇，只服用阳和汤。
外治方（经验验证有效）：
取数个大田螺捣烂后敷于患处，即可消散。
加味二陈汤（通用第十八方）
阳和汤（通用第五方）
阳和丸（通用第六方）
犀黄丸（通用第四十八方）
大的称为瘿，小的称为瘤。瘿证的蒂部小且向下垂坠，瘤证的顶部小而根部宽大。瘿多生于肩部和颈部两侧腮帮处，瘤则随处都可能生长。瘤证容易治疗，瘿证很少能痊愈的。瘿证内部使用开结散、内府神效方，外部使用蛛丝缠绕法，或者甘草收缩法，慢慢消磨也能逐渐缩小痊愈。切勿轻易使用刀、针，导致出血不止，立刻陷入危险境地。
瘤证中只有粉瘤最多见，颜色粉红，多生在耳朵前后及颈部，也有生在下体的，这是由于腠理间的津液沫滞，偶然停滞积聚而成。敷药治疗。然而经常有治愈后又复发的情况，这是因为体内有囊袋，需用化净膏贴敷，肌肉再生后即可自愈。
又有黑沙瘤，多生在臀部和腿部，肿胀大小不一，用手提起，里面有黑色物质的是。也用针刺，会流出黑色的沙子并伴有声响，质地软硬不等。
又有发瘤，多生在耳后头发下方一寸左右，柔软小巧高突，按压不痛，也用针刺，粉末状的头发会整齐地出来。
又有虱瘤，发作后瘙痒深入骨髓，破溃后流出无数虱子，里面有一个极大的虱子，取出后才算干净。这三种都同粉瘤的治疗方法一样，也可以用艾灸治疗。
又有虫瘤，每生在胁下，原本因忧郁结成，治疗很难见效。
又有贴骨瘤，紧贴骨骼而生，极度疼痛。用枸杞根连皮带骨、野菊花根连皮带骨切片晒干，越多越好，再加紫花地丁根一同煎煮，服一次即愈。
又有胎瘤，初生婴儿头上、胸乳之间肿起，大的像馒头，小的像梅子李子，这是胎中瘀血凝滞而成的，（原文此处缺失后续治疗描述，仅保留前半句）。
开结散
桔红（四两） 沉香 木香（各二钱） 珍珠（四十九粒，小的加倍。放入砂罐内用盐泥封固，烧至赤色，取出去除火毒后使用） 猪厌肉子（四十九枚，豚猪颈项间如枣子大小的肉块）
以上研为细末，每次服用一钱，睡前用酒调匀徐徐咽下。患小的三到五服可愈，大的一个药料可愈。切记避免酸咸、油腻、阻滞气机的食物。必须选择除日在静室配制。
内府神效方
海藻（清洗） 昆布（清洗） 海带 海粉（飞制） 海螵蛸 海螺（顶上摇动的用长螺，不摇动的用海螺）
以上各等分，研成细末，蜜丸如龙眼大小。每晚睡前含化一丸，效果神奇。（系宫廷传方。）
珠丝缠法
取蛛丝捻成粗线，缠绕在患处的根部，几天后丝线逐渐收紧，瘤根逐渐变细。多次更换后越来越细，不到半个月瘤体自然脱落。按各种线每天变松，唯独蛛丝每天变紧，物理奥妙，值得探究格致。
甘草缩法
将甘草煎成膏，用笔涂抹在患处四周，三次后另用芫花、大戟、甘遂等分为末，醋调，另用笔涂抹患处的中心。每日交替涂抹，自然会收缩痊愈。
治瘤妙方（经验验证）
用麝香数厘重的一整块，放置在瘤体正中，上面加蕲艾如绿豆大一丸进行灸治，不起泡不破皮，瘤体自然干枯消退如初。
The larger ones are called *Ehe* (Malignant Nodules), and the smaller ones are called *Tanhe* (Phlegm Nodules). At the onset, they are hard and painless, similar in presentation to *Shiju* (Stone Abscess). However, the cold coagulation is extremely entrenched, and the root of the toxicity is deeply hidden. One should decoct and take *Huang Wan* (Yellow Pill) until the swelling dissipates. Surgical incision is strictly contraindicated; if incised, it leads to *Fanhu* (Flower-like Ulceration/Carcinomatous change), which is difficult to treat. If *Fanhu* has already occurred, use a large toad (*Bufo gargarizans*), slit its abdomen, puncture several holes, and apply the whole body including internal organs over the affected wound to draw out toxicity and soften the tissue. Internally, administer warming, tonifying, and toxin-expelling formulas that resolve phlegm, concluding treatment with *Xihuang Wan* (Calculus Bovis Pill). For pregnant women, only *Yanghe Tang* (Warming Yang Decoction) should be taken.
External Treatment Formula (Verified):
Take several large river snails (*Cipangopaludina chinensis*), crush them into a paste, and apply to the affected area for immediate dissipation.
Jiawei Erchen Tang (Modified Two-Aged Phlegm Decoction) [General Formula No. 18]
Yanghe Tang (Warming Yang Decoction) [General Formula No. 5]
Yanghe Wan (Warming Yang Pill) [General Formula No. 6]
Xihuang Wan (Calculus Bovis Pill) [General Formula No. 48]
The larger ones are called *Ying* (Goiter), and the smaller ones are called *Liu* (Tumor). In *Ying*, the stalk is small and hangs downward; in *Liu*, the top is small and the base is broad. *Ying* mostly occurs on the shoulders and neck/jaw areas, while *Liu* can occur anywhere. *Liu* is easy to treat, whereas *Ying* rarely heals completely. For *Ying*, internally use *Kaijie San* (Knot-Resolving Powder) and *Neifu Shenxiao Fang* (Inner Palace Miraculous Formula); externally use the Spider Silk Wrapping Method or Licorice Shrinking Method. Slowly resolving the mass can lead to gradual shrinkage and healing. Do not lightly use knives or needles, as this may cause uncontrollable bleeding and immediate danger.
Among *Liu*, *Fenliu* (Powder Tumor) is the most common. It is pinkish-red, often occurring around the ears and neck, or sometimes in the lower body. It results from the stagnation and accumulation of fluids and secretions in the interstices (*Couli*). Apply medication. However, recurrence is common because there is an internal sac. Use *Huajing Gao* (Purifying Ointment) for topical application; once the sac is cleared, healthy tissue regenerates and heals naturally.
There is also *Heisha Liu* (Black Sand Tumor), mostly occurring on the buttocks and legs. The swelling varies in size. When lifted by hand, black material is found inside. Puncture with a needle to release black sand accompanied by sound; the texture varies between soft and hard.
There is also *Faliu* (Hair Tumor), mostly occurring about one cun below the hairline behind the ear. It is soft, small, and protruding, painless upon pressure. Puncture with a needle to expel powdery hair completely.
There is also *Shiliu* (Louse Tumor). Upon eruption, the itching penetrates to the bone. Upon rupture, countless lice emerge, with one particularly large louse at the center. Only after removing this large louse is the condition fully resolved. These three types are treated similarly to *Fenliu*; moxibustion can also be used.
There is also *Chongliu* (Insect Tumor), often occurring under the ribs. It originates from emotional depression and stagnation, making treatment difficult and ineffective.
There is also *Tieguliu* (Bone-Adherent Tumor), adhering to the bone and causing extreme pain. Use roots of *Lycium chinense* (Wolfberry Root Bark) with skin and bone, and roots of *Dendranthema indicum* (Wild Chrysanthemum Root) with skin and bone, sliced and dried. Use as much as possible, and decoct together with roots of *Scutellaria barbata* (Zihuadiding). One dose brings cure.
There is also *Tailiu* (Congenital Tumor), appearing as swelling on the head or between the chest and breasts in newborns. Large ones resemble steamed buns, small ones resemble plums or apricots. This is formed by the stagnation and coagulation of fetal blood stasis. (Note: Original text lacks subsequent treatment description here.)
Kaijie San (Knot-Resolving Powder)
*Citri Reticulatae Pericarpium Viride* (Ju Hong) (4 liang)
*Agarwood* (Chen Xiang)
*Costus Root* (Mu Xiang) (2 qian each)
*Pearl* (Zhen Zhu) (49 grains, double if small. Place in a clay pot, seal with salt mud, fire until red, remove, and eliminate fire toxicity before use)
*Pig Neck Meat* (Zhu Yan Rou Zi) (49 pieces, specifically meat nodules like dates found on the neck of piglets)
Grind all into powder. Take 1 qian per dose, mixed with wine, swallowed slowly before sleep. Small lesions heal in 3–5 doses; large lesions heal with one prescription. Strictly avoid sour, salty, greasy, and qi-stagnating foods. Preparation must be done on auspicious days in a quiet room.
Neifu Shenxiao Fang (Inner Palace Miraculous Formula)
*Sargassum* (Hai Zao) (Washed)
*Laminaria/Kelp* (Kun Bu) (Washed)
*Kelp* (Hai Dai)
*Sea Flour* (Hai Fen) (Refined)
*Cuttlefish Bone* (Hai Piao Xiao)
*Concha Meretricis* (Hai Luo) (Use long shells if the apex shakes, otherwise use standard shells)
Mix equal parts, grind into fine powder, and form honey pills the size of a longan. Hold one pill in the mouth to dissolve slowly before bed. Effect is miraculous. (This is a formula passed down from the Inner Palace.)
Spider Silk Wrapping Method
Twist spider silk into a thick thread and wrap it tightly around the base of the lesion. After a few days, the thread tightens, and the tumor root gradually thins. Repeated changes make it thinner. Within half a month, the tumor detaches naturally. Note that while other threads loosen daily, spider silk tightens daily. This physical wonder deserves investigation through Gezhi (investigation of things).
Licorice Shrinking Method
Decoct licorice (*Gan Cao*) into a paste. Apply around the perimeter of the lesion with a brush. After three applications, mix equal parts of *Kansui Radix* (Yuan Hua), *Radix Euphorbiae Kansui* (Da Ji), and *Radix Kansui* (Gan Sui) into powder, mix with vinegar, and apply to the center of the lesion with another brush. Alternate application daily. Natural shrinkage and healing will occur.
Wonderful Formula for Treating Tumors (Verified)
Place a solid piece of musk weighing several li at the center of the tumor. Apply a mugwort ball the size of a mung bean on top and perform moxibustion. Without blistering or breaking the skin, the tumor will dry up and recede to normal.
Attached: Main Formula for Generalized Phlegm Tumors with Itching
Use 2 jin of soap pods (*Soapberry*), remove the edges and skin. Add 10 jin of dripping vinegar and slowly simmer into a paste. Spread and apply to the affected area.
Another Formula
Mix powder of raw *Arisaema cum Bile* (Sheng Nanxing) with vinegar, or apply juice of *Tricyrtis hirta* root (Yuzanhua Gen) topically.