Neixiao Luoli Wan: A Chinese Patent Medicine for Swollen Lymph Nodes
Neixiao Luoli Wan (Interior-Dissolving Scrofula Pill) is a Chinese patent medicine made according to an ancient formula in *Yixue Qimeng (Medical Enlightenment)*. Its composition is: Xiakucao (Prunella) 8 liang; Xuanshen (Scrophularia) and roasted Qingyan (green salt) each 5 liang; Haizao (Sargassum), Beimu (Fritillary), Bohe (Mentha), Tianhuafen (Trichosanthes Root), Haigeifen (clam powder), Bailian (Ampelopsis), Lianqiao (Forsythia), wine-treated Dahuang (Rheum), Sheng Gancao (raw Licorice), Sheng Dihuang (raw Rehmannia), Jiegeng (Platycodon), Zhiqiao (Bitter Orange), Danggui (Angelica), and Xiaoshi (Niter) each 1 liang. This formula is not decocted into a decoction but made into pills.
When using it, grind the above herbs together into a fine powder; melt the mirabilite (Mangxiao) in water, use Prunus extract to roll into pills the size of mung beans, and take 6–9g each time, 2–3 times daily, washed down with warm water. But nowadays there is no need to make it yourself; many manufacturers produce this patent medicine, which can be bought directly at pharmacies.
According to *Yixue Qimeng*, this formula can be used to treat scrofula and phlegm nodules caused by phlegm congelation and qi stagnation, and goiter of the neck and nape, presenting with unchanged skin color, or swelling or pain. Nowadays this formula is commonly used for cervical lymph node tuberculosis, chronic lymphadenitis, simple goiter, thyroiditis, or thyroid tumor and other patterns belonging to qi stagnation transforming into fire, with phlegm congelation and stasis stagnation. The swollen lymph nodes treated by this formula are mostly benign; in the case of malignant lymphoma, this formula can also be used as an adjuvant treatment, but treating malignant lymphoma solely with this formula yields poor results.
In clinical use, note that this formula is suitable for patients with relatively dry, hard stools. If the patient has loose stools, this formula is not suitable. Because Dahuang and Mangxiao in this formula both belong to the purgative herbs, if a patient with loose stools then takes Neixiao Luoli Wan, the condition will be aggravated. During use, this formula may also produce the side effect of causing diarrhea, so patients with spleen deficiency should not use it for long.
Luoli (scrofula) is an ancient TCM disease name; the disease mainly presents as swollen lymph nodes in the neck or under the armpits. Scrofula that lasts a long time may also ulcerate; patients who have ulcerated can also take this formula as long as, by TCM pattern differentiation, they belong to the pattern of qi stagnation transforming into fire with phlegm congelation and stasis stagnation.
Before the condition is cured, the patient should refrain from anger and avoid spicy and irritating foods, fried and grilled foods, and even various gas-producing foods, such as beans, tubers, and radishes.