Hualiu Gao and Shengrou Gao from the Qianjin Yaofang for Ying-Liu (Goiter/Thyroid Nodules)
The Qianjin Yaofang (Essential Prescriptions Worth a Thousand Gold) contains a plaster formula named Hualiu Gao (Nodule-Resolving Plaster). Its composition is: fan-shi (alunite/ alum stone), chuanxiong (Sichuan lovage rhizome), danggui (angelica root), dahuang (rhubarb), huanglian (coptis), chishao (red peony root), bailian (ampelopsis root) and huangqin (scutellaria root), each 5 qian (15 g); plus wuzhuyu (evodia fruit) 2 qian 5 fen (7.5 g). Preparation: grind the above herbs into a powder, blend with egg yolk into a paste, spread on fine old cloth (today one may use medical non-woven gauze), and apply externally according to the size of the nodule. Change it as soon as the plaster dries. If, after applying, pus and fat slowly ooze out from the opening, wipe it away with cloth, continuing until the pus is exhausted. Once the pus is exhausted, then apply Shengrou Gao externally.
Shengrou Gao (Flesh-Generating Plaster) is composed of: shengdihuang (fresh rehmannia) 1 jin (240 g), xinyi (magnolia flower bud) 2 liang; duhuo (angelica pubescens root), danggui, dahuang, huangqi (astragalus root), chuanxiong, baizhi (angelica dahurica root), shaoyao (baishao, white peony), huangqin and xuduan (teasel root), each 1 liang (30 g); plus xiebai (Chinese scallion) 5 liang (150 g). Slice the above herbs, use four sheng of twelfth-month lard, and decoct until the angelica dahurica turns yellow; strain out the dregs, and apply the oily plaster externally to the affected area. Shengrou Gao is indicated for welling abscesses and carbuncles, and for non-healing ulcer openings after back-abscess ulceration.
Hualiu Gao has the actions of clearing heat and resolving phlegm, and of moving stasis and dissipating nodules. It is indicated for phlegm-fire and blood stasis congealing and binding to cause ying-liu (goiter/thyroid nodules). Ying-liu are today's thyroid tumors; some are benign and some malignant. In ancient times it was difficult to distinguish benign from malignant ying-liu; judging from the medicinal properties of this formula, it should mainly treat benign goiter, and may also be tried on malignant thyroid tumors belonging to the heat-toxin pattern.
Both Hualiu Gao and Shengrou Gao are externally applied local plasters. Hualiu Gao is derived from Sanhuang Xiexin Tang and Siwu Tang, with the addition of alunite, ampelopsis and evodia, and the reduction of fresh rehmannia. Sanhuang Xiexin Tang has the action of clearing heat, cooling the blood and dispersing swelling; the main action of Siwu Tang is to activate blood and resolve stasis to disperse swelling. Fan-shi (alunite) is the raw ore of alum; applied externally it disperses swelling and stops pain, and also stops bleeding. Bailian (ampelopsis) has the action of clearing heat and resolving toxicity, and of dispersing swelling and nodules. Wuzhuyu (evodia) dispels cold and stops pain. Thus this formula addresses the condition from multiple angles to achieve the goal of dispersing swelling and dissipating nodules.
Shengrou Gao is a modified version of Siwu Tang. In ancient times this formula was mostly used as an external plaster for bone-setting and trauma healing. Siwu Tang plus huangqi and xuduan has the action of activating blood and generating flesh; xinyi, duhuo and xiebai expel wind, activate blood and stop pain; huangqin clears heat and stops pain; dahuang resolves stasis.
The ancients used these two formulas together to treat ying-liu externally, and they should have had a certain effect. Today's patients, when preparing the plaster, can themselves go to the pharmacy to buy the medicinal materials and process them according to the method. When applying externally, one may buy empty plaster patches online, spread the plaster flat in the center ring of the patch, and then apply it to the affected area. This way of applying the medicine is more convenient.
This plaster has very little toxicity, and the side effects of external application are even fewer. Perhaps only a small number of people with sensitive skin will have adverse reactions during external application. If, during external application, the patient experiences skin allergy or similar phenomena, use should be stopped promptly.