CERVICAL LYMPHADENOPATHY, CERVICAL LYMPHADENITIS (LUO LI)

Clinical Manifestations
  • Cervical lymphadenopathy refers to lymphadenopathy of the cervical lymph nodes (the glands in the neck). The term lymphadenopathy strictly speaking refers to disease of the lymph nodes, often however the term refers to enlargement of the lymph nodes. Similarly, the term lymphadenitis refers to inflammation of a lymph node, but often it is used as a synonym of lymphadenopathy.
    Cervical lymphadenopathy is a sign or a symptom, not a diagnosis. The causes are varied, and may be inflammatory, degenerative, or neoplastic. In adults, healthy lymph nodes can be palpable, in the axilla, neck and groin. In children up to the age of 12 cervical nodes up to 1 cm in size may be palpable and this may not signify any disease. If nodes heal by resolution or scarring after being inflamed, they may remain palpable thereafter. In children, most palpable cervical lymphadenopathy is reactive or infective. In individuals over the age of 50, metastatic enlargement from cancers (most commonly squamous cell carcinomas) of the aerodigestive tract should be considered.
  • Initial Stage:
    The swollen gland, usually on the neck or behind the ear is often painless and usually found by accident.
    The gland is hard and can easily be moved.
    There is no sensation of Heat or Cold.
    The color and skin texture is normal.
    In some cases the onset may be marked by signs of Wind-Heat:
    Fever
    Headache
    Aches and pains of the bones
    Redness and pain of the eyes
    TC: Thin and yellow
    P: Floating and rapid
  • Middle Stage:
    The gland enlarges slowly over a period of weeks
    Adjacent glands become involved
    Often several glands join together to form one mass
    The nodules begin to feel painful
    The nodules become hard and not easily moved
    Mild fever
    Slightly reduced appetite
  • Final Stage:
    Abscess formation
    Discharge of pus
    1. Thick, purulent pus
        Surrounding tissue is red
        After a while the lesion closes and heals
    2. A slow discharge of purulent fluid
        The surrounding area turns a dark purple
        The lesion remains open and an empty shell remains
        There may be symptoms of Lung and Kidney Yin Deficiency or
        Qi and Blood Deficiency

Treatment Principle
Herb Formulas
  • Topical:
    Initial stage: Tan He Gao
    Middle stage: Qian Chui Gao
    Final stage: Wu Wu Dan
    When the abscess continues to discharge thin pus for a long time and shows no signs of closing: Hb. Euphorbiae Helioscopiae Mao Yan Cao
Points
Clinical Manifestations
  • Abrupt onset
  • The glands enlarge more rapidly and attain greater size
  • The pain is minimal
  • Fever
  • Headache
  • Pains in the bones
  • Redness and pain of the eyes
  • A sore, dry throat
  • T: Red tip
  • C: Yellow
  • P: Floating and rapid
Treatment Principle
  • Release the Exterior
  • Expel Wind-Heat
Herb Formulas
Points
Clinical Manifestations
  • Cervical lymphadenopathy
  • Night sweats
  • Dry mouth and tongue
  • Lower back and knee pain
  • Urinary difficulty
  • Weakness of the lower back, knees and extremities
  • Steaming bones
  • Light-headedness
  • Vertigo
  • Tinnitus
  • Diminished hearing
  • Five sole Heat
  • Chronic dry, sore throat
  • Toothache
  • Wasting and thirsting disorder (Xiao Ke)
  • Dizziness
  • Muscular weakness
  • Irritability
  • Dry skin
  • Deafness
  • Spontaneous and nocturnal emissions
  • Tidal fevers
  • Loose teeth
  • Dripping urine
  • Thirst
  • Swollen gums, painful and light red in color
  • Numbness and weakness at the waist and knees
  • Heel pain
  • Scanty urination
  • Frequent, scanty, yellow urination
  • Pain at midline
  • Lower back and knee pain
  • Sore throat
  • T: Red
  • C: Little or None
  • P: Thready and rapid (large at the Kidney positions)
Treatment Principle
  • Enrich Yin
  • Nourish the Essence of the Liver and Kidneys
  • Reduce Deficiency Fire
Herb Formulas
Points
Clinical Manifestations
  • Cervical lymphadenopathy
  • Thin exudate
  • The nodule ulcerates, turning a dark purple color
  • An empty shell is left which does not close up
  • Unsightly red scars remain when the shell finally closes
  • Fatigue
  • Loose stools
  • Poor appetite
  • Dizziness
  • Pale face
  • Weak voice
  • Reluctance to speak
  • Sweating with little or no exertion
  • Palpitations
  • Insomnia
  • Dry skin
  • Dry hair
  • Poor memory
  • Paleness
  • Scanty periods
  • T: Pale or Pale, thin and dry
  • C: Thin and white
  • P: Weak or Thin and choppy
Treatment Principle
  • Strongly tonify Qi and Blood
Herb Formulas
Points
Clinical Manifestations
  • The gland enlarges slowly over a period of weeks
  • Adjacent glands become involved
  • Often several glands join together to form one mass
  • The nodules begin to feel painful
  • The nodules become hard and not easily moved
  • Mild fever
  • Slightly reduced appetite
  • Feeling of obstruction in throat as if a slice of roast meat were stuck there which cannot be coughed up nor swallowed down. This sensation becomes more prominent during emotional upset and subsides when relaxed
  • Distention and pain in the sides or flanks
  • Suffocating sensation in the chest
  • Tendency to sigh
  • Melancholy
  • Depression
  • Irritability
  • Inappropriate anger
  • Irregular menses
  • Dysmenorrhea
  • Breast distention and pain before and during menses
  • T: Pink
  • C: Thin and white
  • P: Slippery and wiry (slippery due to Phlegm)
Treatment Principle
  • Spread Qi
  • Resolve Phlegm
Herb Formulas
Points
Clinical Manifestations
  • Noxious swellings
  • Abscesses
  • Flat abscesses
  • Red face
  • Chest pain
  • Ulceration of the tumor
  • Maybe a bloody secretion
  • Foul odor
  • Short urine
  • T: Reddish purple
  • C: Little or Yellow
  • P: Wiry and rapid or Flooding or Tight or Thin
Treatment Principle
  • Tonify Qi
  • Nourish the Blood
  • Promote the movement of Qi and Blood
  • Disperse Stagnation
  • Expel pus
  • Dissipate swelling
Herb Formulas
Points
Clinical Manifestations
  • Swollen, painful glands that have not suppurated
  • Cough with sticky, yellow, difficult to expectorate sputum
  • Rapid breathing with a harsh voice
  • Restless fever
  • Sore throat
  • Constipation
  • Dry stools
  • Mania
  • Shortness of breath
  • Dyspnea
  • Nausea
  • Vomiting
  • Chest and/or epigastric fullness
  • Pain in the ribs
  • T: Scarlet
  • C: Yellow or Yellow and greasy or Yellow and smooth
  • P: Rapid and smooth or Slippery and rapid
Treatment Principle
  • Clear Heat
  • Resolve Phlegm
  • dissipate nodules
Herb Formulas
Points
Clinical Manifestations
  • Hard, painful swellings
  • Swelling of the affected area
  • Hardening of the affected area
  • Stomach ache with tenderness
  • Pain in the affected area
  • Hematemesis with purplish discharge
  • No change in skin color in the early stages
  • T: Dark
  • C: White and smooth
  • P: Choppy
Treatment Principle
  • Warm Cold
  • Dissolve Phlegm
  • Disperse Dampness
  • Dispel Stagnation
  • Open the channels and collaterals
Herb Formulas
Points