Neixiao Lianqiao Wan (Inner-Resolving Forsythia Pill) for Resolving Swelling, Scattering Nodules, and Relieving Pain
"Neixiao Lianqiao Wan" is recorded in Yiji Weiwei (Subtle Meanings of Medical Orthedies). It is a swelling-resolving, nodule-scattering formula, an empirical formula beloved by the late Master Zhao Bingnan. After Master Zhao modified it, it became a proprietary preparation of the Beijing Hospital of TCM for treating thyroid nodules and similar conditions.
The composition is: Lianqiao (Forsythiae Fructus) one jin, Xiakucao (Prunellae Spica) one jin, Shegan (Belamcandae Rhizoma) eight liang, Zelan (Lycopi Herba) eight liang, Tianhuafen (Trichosanthis Radix) eight liang, Baiji (Bletillae Rhizoma) eight liang, Shashen (Glehniae/Adenophorae Radix) eight liang, Lulu (Rhapontici seu Echinopsis Radix) eight liang, Hetaoren (Juglandis Semen) eight liang. Preparation: grind all the above into a fine powder, form into water-pasted pills, and coat with Huashi (Talcum).
If it is not yet certain whether this formula suits the pattern, making pills may not be worthwhile; it can be converted to a decoction. Dosage: Lianqiao 10 g, Xiakucao 10 g, Shegan 8 g, Zelan 8 g, Tianhuafen 8 g, Baiji 8 g, Shashen 8 g, Lulu 8 g, Hetaoren (i.e., walnut meat) 8 g, decoct in water, twice daily. Treating nodules generally requires a long course, and using a decoction long-term is inconvenient. If after three to five days of taking this formula you feel it is effective, it is still best to have a pharmacy process it into pills, taking 10 g of the pills each time, twice daily.
In this formula, Lianqiao, Xiakucao, Lulu, and Tianhuafen all clear heat and resolve swelling; Zelan activates blood and promotes diuresis to reduce swelling; Baiji resolves swelling and promotes tissue regeneration; Shashen nourishes yin and moistens dryness; walnut meat tonifies the kidney and moistens the intestines. Combined, these herbs clear heat and resolve toxin, resolve swelling and scatter nodules, nourish yin and downbear fire. So this is a formula for fire-toxin-type masses, not suitable for patients with yin-type welling-abscess. Clinically, the indication is a mass that is red, swollen, hot, and painful; some patients also have scanty dark urine, constipation, and a red tongue.