Xiao Luo Wan (消瘰丸) — Reduce Scrofula Pill

Xiao Luo Wan (Reduce Scrofula Pill) is a compact three-herb Chinese formula for Phlegm-Fire nodules — classically scrofula (cervical tuberculous lymphadenopathy) and today more commonly used for thyroid nodules, benign lymphadenopathy and firm subcutaneous cysts of a Phlegm-Fire pattern.

On this page

Overview
TCM pattern
Ingredients
Actions and indications
Dosing
Cautions and contraindications
Related formulas
Treatment at my clinic

1. Overview

Xiao Luo Wan (消瘰丸) — Reduce Scrofula Pill — is a classical Chinese herbal formula in the Transform Phlegm (soften nodules) category. Source: Yi Xue Xin Wu (Medical Revelations), 1732 CE, by Cheng Guopeng. I prescribe it as bespoke pharmaceutical-grade granules from Sun Ten in Taiwan at my clinic in Wokingham, Berkshire and via online herbal consultations.

2. TCM pattern

Phlegm-Fire congealing into nodules: firm palpable neck or subcutaneous nodules that are not tender at rest but may enlarge on stress, red tongue with a thin yellow coat, wiry rapid pulse. May coexist with a thyroid-nodular picture, benign lymphadenopathy or fibroadenoma.

3. Ingredients

Xuan Shen — Scrophularia ningpoensis (12g) — chief; clears Heat, nourishes Yin, softens hard nodules
Zhe Bei Mu — Fritillaria thunbergii (6g) — transforms Phlegm-Heat, softens hard nodules
Mu Li — Ostrea (calcined oyster shell) (12g) — softens hard nodules, calms Liver Yang, restrains sweating

4. Actions and indications

Principal actions

Clears Heat and transforms Phlegm
Softens hard nodules
Nourishes Yin

Indications

Cervical lymphadenopathy of Phlegm-Fire type (traditional scrofula pattern)
Benign thyroid nodules with Phlegm-Fire signs
Fibroadenoma of the breast with Phlegm-Fire
Subcutaneous cysts with a warm, dry constitutional background
Neck lipomas in Phlegm-Fire types

5. Dosing

As pills or granule 6–9g/day. Long course: 3–6 months typical, with adjustment based on nodule change on ultrasound and clinical assessment.

6. Cautions and contraindications

Any thyroid, lymph node or breast lump requires conventional investigation first — this formula is a complementary adjunct once malignancy has been excluded.
Contraindicated in Spleen-Cold-Damp patterns.
Add Xia Ku Cao, Kun Bu and Hai Zao for stronger softening in resistant cases.

8. Treatment at my clinic

I prescribe Xiao Luo Wan where the TCM pattern above matches the patient’s presentation, typically as part of a wider prescription tailored to the individual. Return to the Chinese herbal formulas directory or the Chinese herbal medicine main page.