Nei Xiao Luo Li Wan — Internal Dispersing Pill for Scrofula

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

Overview

Nei Xiao Luo Li Wan — the “Internal Dispersing Pill for Scrofula” (luo li = scrofula = chronic cervical lymphadenopathy) — is a long-established Chinese patent formula widely used for Phlegm-Fire and Blood-stasis nodules in the neck. The traditional TCM diagnosis “luo li” historically referred to scrofula (cervical lymph node tuberculosis); modern use covers benign cervical lymph node enlargement of various causes including chronic infection, reactive lymphadenopathy and lipomas with Phlegm-stasis pattern. The formula combines Phlegm-softening herbs (Xuan Shen, Hai Zao, Kun Bu, Bei Mu), Heat-clearing herbs (Lian Qiao, Tian Hua Fen), Blood-movers (Dang Gui, Bai Shao) and Qi-movers (Qing Pi, Chen Pi).

I prescribe Nei Xiao Luo Li Wan as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Nei Xiao Luo Li Wan is prescribed for Phlegm-Fire with Blood-stasis nodules:

• Hard or rubbery lymph nodes in the neck, single or in chains
• Generally non-tender
• Slow-growing over months
• May feel like “a string of beads”
• Possibly mild low-grade afternoon Heat
• Tongue — possibly slightly red, thin yellow coat
• Pulse — wiry, slippery

Key herbs

1. Xuan Shen — nourishes Yin; clears Heat; softens hardness
2. Hai Zao, Kun Bu — soften hardness; dissolve nodules
3. Zhe Bei Mu — transforms Phlegm-Heat; dissipates nodules
4. Lian Qiao, Tian Hua Fen — clear Heat; resolve toxin; dissipate masses
5. Xia Ku Cao (prunella) — clears Liver Heat; dissipates nodules; specifically for cervical lymphadenopathy
6. Dang Gui, Bai Shao — nourish and move Blood
7. Qing Pi, Chen Pi — move Liver Qi; transform Phlegm
8. Gan Cao — harmonises and resolves toxin

Formula actions

1. Softens hardness and dissolves nodules
2. Transforms Phlegm-Heat
3. Moves Blood and Qi
4. Nourishes Yin

Conditions treated

1. Benign chronic cervical lymphadenopathy (after exclusion of malignancy and TB)
2. Reactive lymphadenopathy with chronic recurrent neck nodes
3. Sebaceous cysts in the neck with Phlegm-stasis pattern
4. Lipomas with Phlegm-stasis pattern
5. Subacute thyroiditis with neck swelling (adjunctive)
6. Branchial cleft cysts (not surgical case)
7. Persistent post-infective lymph node enlargement

Cautions

Persistent, growing or hard fixed cervical lymph nodes (especially over 1.5 cm, painless, supraclavicular, multiple) always need urgent ENT/general surgery assessment to exclude lymphoma, head & neck cancer or tuberculosis — herbs are NOT a substitute for malignancy work-up.

Contains iodine-rich seaweeds — caution in thyroid disease without monitoring.

Contraindicated in pregnancy — contains strong Blood-movers and softening herbs.

Not appropriate for cold-deficient patterns — the cold and dispersing herbs aggravate Cold.

For longer-term use under regular review.

Always consult a qualified Chinese herbalist registered with the RCHM.

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