Scrofula, Lymphatic Swellings, Goiter

This section covers various forms of Lumps and Tumors, usually associated with Lymphatic swellings, but also including Goiter. It includes Lymphatic Swellings (in the neck, armpit or groin), as well as solitary Nodes in the flesh.

Goiter and Lymphatic swellings are often treated with similar medicines as they are both classed as Phlegmatic Swellings or Masses. Goiter in particular requires medicines from the Sea such as Sponge, Sea Weed, Kelp etc. due to their Iodine content. However, these same medicines were also commonly used for Scrofula in the West, as they are in TCM.

Types of Phlegm Swellings:

• Scrofula: Lymphatic swellings of the Neck (in severe cases Tuberculosis of the Lymph nodes)
• King’s Evil: another name for Scrofula
• Struma: swelling in the Neck, usually Goiter but also Scrofula
• Goiter: enlarged Thyroid
• Glandules: small lump, nodes or glands, usually lymphatic swellings
• Kernels: enlarged, swollen, or hardened lymph glands/nodes, often in the neck, armpit, or groin

Differential Diagnosis

Scrofula, Goiter and similar Nodes are classed as Phlegm-Masses in Traditional Medicine. The Phlegm may be associated with Cold or Heat. The former are usually softer, cold to touch with other general signs of Cold. Phlegm-Heat manifests with red, swollen, hot or painful swellings, red tongue with a greasy or thick coating and a rapid or big pulse.

• Phlegm-Heat: red, hot, swollen and painful lumps
• Phlegm-Cold: cold, pale and soft Swellings
• Toxic Heat: red, hard, swollen, painful with Fever; feels unwell

Treatment:

Several types of Medicine are used:

Phlegm-clearing: Both Hot and Cold types require Phlegm-clearing and mass-dispersing (attenuant or resolvent) medicines.
Cold Phlegm: Radish (root, juice or seed), Arum, Turbith, Agaric, Pinellia Ban Xia
Hot Phlegm: Sponge, Kelp, Pumice, Cuttlefish Bone, Oyster shell and Fritillaria Zhe Bei Mu.
Clear Heat: Figwort, Cleavers, Dandelion, Plantain, Self Heal
Heat-Toxin: Figwort, Bittersweet, Rhubarb, Self Heal, Plantain or Black Nightshade.
Melancholy: When chronic or in Melancholic constitutions, the Lumps become hard and fibrotic. Such cases require medicines for the Melancholy Humor (Dodder, Agaric, Polypody, Hellebore etc).
Blood Moving: chronic cases may require Blood moving medicines such as Myrrh, Bitter Almond, Madder or Paeonia Mu Dan Pi.

In all systems, the importance of medicines from the Sea was long realised as important for Scrofula, and in particular, Goiter. In the Western Tradition, Sponge, Sponge Stone, Burnt Sponge, Pumice, Cuttlefish Bone, Sea Balls etc. were used. In TCM, Kelp, Laminaria, and Pumice etc. are used. The importance of their trace minerals especially in relation to Iodine is most relevant.

Special mention can also be made of Figwort (Scrophularia spa.). This herb has been widely used in East and West for Tumors and Swellings, particularly Scrofula (Lymphatic Swellings). Its use in the West and in TCM is very similar in this respect. Likewise Black Nightshade is another herb commonly used in several traditions for Toxic Swellings and Tumors, including Lymphatic Swellings.

By extrapolation, other Nodes, Kernels and Lymphatic swellings in other parts of the body can usually be treated with similar formulas. If these lumps become very hard, they may be treated as Fibroid (hard swellings).

See also:

Treatment of Goiter (Wirtzung)
Fibroids
Tumors

Special Formula

Research:

1. Goiter in Tibetan Medicine