轻微易治者，痰子也。迟重难愈者，瘰 也。有风痰、热痰、气痰，由外感之不同；瘰
、
筋、痰 ，因内伤之各异。其表面形状，大致相类，故总名曰痰子。而瘰 者，尤痰子中
之重症，治之久而难愈也。
风痰者，风湿之毒，伏于经络，先寒后热，结核浮肿。二三日内，即发起于颈项间，治
宜祛风散湿化痰消坚之类。
热痰者，天时亢热，暑中三阳，及内食煎炒浓味，酿结为患。色红发热，结核坚肿，治
宜清脾泻热之类。
气痰者，由感触四时杀厉之气，于耳项胸腋，骤成肿核。患者寒热交作，头眩项强，治
宜调气和血之类。
瘰 者，累累如贯珠，连接三五枚，有数月数年，或十余年始发者。初则核小不痛，亦
不作
寒热，久方知痛，由误食虫蚁鼠残不洁之物，及宿水陈茶内有汗液所致，治宜散坚解毒和血
之类。
筋 者，忧愁抑闷，暴怒伤肝，盖肝主筋，故令筋缩，结蓄成核。生项侧筋间，形如棋
子，大小不一，或陷或起，久则虚羸，多生寒热，劳怒则甚，治宜清肝解郁之类。
痰 者，饮食冷热不调，饥饱喜怒不常，致脾气不能运输，遂成结核，初起如梅如李，
生及遍身，久则微红，后必溃破，收敛亦易，治宜豁痰行气之类。
又有婺妇尼僧，室女庶外家，或男患失荣失精，皆志不得伸，思不得遂，积想在心，思虑
伤脾
，脾败血亏，遍身结核，最为难治，宜先养心血，次开郁结，益肾安神疏肝快膈，如逍遥散
、归脾汤、益气养荣汤，俱加香附、青皮、山栀、贝母、木香之类是也。
病情轻微且容易治疗的，是痰核（皮下结节）。病程迁延、病情沉重且难以痊愈的，是瘰疬（颈部淋巴结结核）。风痰、热痰、气痰，是由于外感邪气不同所致；瘰疬、筋瘤（肌肉或筋膜间的肿块）、痰癭（颈部肿块），则是由于内伤病因各异。这些病症在表面形态上大致相似，所以统称为痰核。而瘰疬，更是痰核中的重症，治疗时间长且难以痊愈。
风痰，是由风湿毒邪潜伏于经络之中，先出现恶寒后发热，局部形成结核并伴有浮肿。通常在发病两三天内，就会出现在颈项部位，治疗应当采用祛风、散湿、化痰、消坚的方法。
热痰，是由于天气酷热，暑邪侵犯三阳经，加上体内食用了煎炸浓味食物，酝酿结聚而成患。表现为局部色红、发热，结核坚硬肿胀，治疗应当采用清脾泻热的方法。
气痰，是由于感触四时疫厉之气，在耳部、项部、胸部、腋下突然形成肿核。患者出现寒热交替发作，头晕目眩，颈项强直，治疗应当采用调气和血的方法。
瘰疬，像串珠一样累累相连，连接三五枚，有的数月或数年才发作，甚至有十余年才发病的。初期核小且不痛，也不出现恶寒发热，很久之后才知道疼痛，这是由于误食虫蚁鼠类残留的不洁之物，以及宿水陈茶中含有汗液杂质所导致，治疗应当采用散坚解毒、和血的方法。
筋瘤，是由于忧愁压抑、暴怒伤肝，因为肝主筋，所以导致筋脉收缩，结聚蓄积形成肿块。生长在颈部侧面筋脉之间，形状像棋子，大小不一，有时凹陷有时隆起，日久则身体虚弱消瘦，多伴有寒热症状，劳累或发怒时加重，治疗应当采用清肝解郁的方法。
痰癭，是由于饮食冷热不调，饥饱喜怒无常，导致脾气不能正常运化输布，从而形成结核。初起时像梅子或李子，生长遍布全身，日久微微发红，随后必然溃破，但愈合收敛也容易，治疗应当采用豁痰行气的方法。
又有寡妇尼姑、未婚女子及庶出或外家出身的女子，或者男性患有失荣症、遗精等病，都是因为志向无法伸展，思愿无法实现，积想在心中，思虑损伤脾气，导致脾败血亏，全身出现结核，最为难治。应当先滋养心血，其次开通郁结，补益肾气、安神、疏肝、宽胸理气，如使用逍遥散、归脾汤、益气养荣汤，都加入香附、青皮、山栀、贝母、木香之类的药物。
Mild cases that are easy to treat are Tan He (subcutaneous nodules). Cases that are severe, difficult to cure, and have a protracted course are Luo Li (cervical lymphatic tuberculosis). Wind Phlegm, Heat Phlegm, and Qi Phlegm arise from different external pathogenic invasions; Luo Li, Jin Liu (masses between muscles or fascia), and Tan Ying (neck masses) result from various internal injuries. Their surface appearances are generally similar, hence they are collectively named Tan He. Among them, Luo Li is particularly a severe type of Tan He, characterized by a long treatment duration and difficulty in curing.
Wind Phlegm is caused by the accumulation of toxic pathogens of wind-dampness lurking in the meridians, presenting initially with aversion to cold followed by fever, and local formation of nodules accompanied by edema. Within two to three days, it typically appears in the neck region. Treatment should focus on dispelling wind, scattering dampness, resolving phlegm, and dissipating hardness.
Heat Phlegm results from extreme heat weather, where summer-heat pathogens invade the Three Yang channels, combined with the consumption of fried and rich-flavored foods internally, leading to fermentation and accumulation. It presents with redness, heat, and hard, swollen nodules. Treatment should focus on clearing the spleen and draining heat.
Qi Phlegm is caused by contracting epidemic toxins of the four seasons, resulting in the sudden formation of swollen nodules in the ears, neck, chest, and axillae. Patients experience alternating chills and fever, dizziness, and stiffness of the neck. Treatment should focus on regulating qi and harmonizing blood.
Luo Li appears as beads strung together, connecting three to five nodes. Onset may occur after several months or years, or even more than ten years. Initially, the nodes are small, painless, and without chills or fever; pain develops only after a long period. This condition is caused by accidentally consuming unclean residues of insects, ants, rats, etc., or impurities such as sweat contained in stored water and aged tea. Treatment should focus on dissipating hardness, detoxifying, and harmonizing blood.
Jin Liu arises from sorrow, depression, and violent anger injuring the liver. Since the liver governs the sinews, this leads to contraction of the sinews, resulting in accumulated knots forming masses. These grow between the sinuses on the side of the neck, resembling chess pieces in shape, varying in size, sometimes depressed and sometimes protruding. Over time, the patient becomes emaciated and weak, often experiencing chills and fever, which worsen with fatigue or anger. Treatment should focus on clearing the liver and relieving depression.
Tan Ying is caused by irregular diet temperature, irregular eating habits, and inconsistent emotions of hunger, fullness, joy, and anger, leading to the spleen's failure in transportation and transformation. This results in the formation of nodules. Initially resembling plums or peaches, they appear all over the body. After a long time, they become slightly red and eventually ulcerate, but heal relatively easily. Treatment should focus on resolving phlegm and promoting qi movement.
Additionally, widows, nuns, unmarried women, and women from concubine or maternal families, as well as men suffering from Shi Reng (loss of prosperity/cachexia) or spermatorrhea, often suffer because their ambitions are unfulfilled and desires unmet. Accumulated thoughts in the heart damage the spleen through excessive worry, leading to spleen deficiency and blood depletion, manifesting as systemic nodules. This is the most difficult to treat. One should first nourish heart blood, then resolve stagnation, tonify kidney qi, calm the spirit, soothe the liver, and open the diaphragm. Formulas such as Xiao Yao San (Free and Easy Wanderer Powder), Gui Pi Tang (Spleen-Restoring Decoction), and Yi Qi Yang Rong Tang (Benefit Qi and Nourish Blood Decoction) can be used, added with herbs like Xiang Fu (Cyperus Rhizome), Qing Pi (Aurantium Peel), Shan Zhi (Gardeniae Fructus), Bei Mu (Fritillariae Bulbus), and Mu Xiang (Aucklandiae Radix).