Professor Chen Chishu's Empirical Formula for Esophageal and Gastric Cancer

Professor Chen Chishu (1913-1983) was a professor at the former Guiyang College of Traditional Chinese Medicine. He had rich teaching experience and excellent clinical results, and was skilled in treating intermediate and advanced gastric and esophageal cancer with TCM.

Professor Chen held that in the development of esophageal and gastric cancer, besides the vicious cycle of mutual causation among deficiency, phlegm, toxin and stasis, failure of the stomach (including esophagus) to downbear and conduct is also of great importance. TCM compares the stomach to a great granary, responsible for receiving food and drink and transmitting and transforming waste; thus the stomach favors downward movement and unobstructed passage. When qi stagnation, phlegm obstruction, blood stasis or toxic heat block the esophagus and stomach, the middle jiao glomus and closes, the stomach loses its downbearing function, and the alternating fullness and emptiness of the fu-organs is disrupted: upward it cannot receive food, downward it cannot conduct waste. Over time, gastric cancer forms.

Professor Chen therefore held that treatment of gastric and esophageal cancer should specifically address the patient's qi stagnation, phlegm obstruction, blood stasis and toxic-heat blockage, using strategies such as moving qi and unblocking the fu-organs, activating blood and resolving stasis, resolving phlegm and dissipating nodules, and detoxifying and anti-cancer action.

Through long practice he worked out an effective approach and his own empirical formula. His base formula is: Xuan Fu Hua (Inulae Flos) 10 g (wrapped for decocting), Dai Zhe Shi (Hematitum) 15 g (wrapped for decocting), Fa Ban Xia (prepared Pinelliae Rhizoma) 15 g, Fu Ling (Poria) 15 g, Chen Pi (Citri Reticulatae Pericarpium) 10 g, Gua Lou Pi (Trichosanthis pericarpium) 10 g, Xie Bai (Allii macrostemi Bulbus) 10 g, Dan Shen (Salviae Miltiorrhizae Radix) 10 g, Tao Ren (Persicae Semen) 10 g, Hong Hua (Carthami Flos) 10 g, Huo Ma Ren (Cannabis Semen) 15 g, Wu Gong (Scolopendra, ground and swallowed) 3 pieces, Bi Hu (Gecko, ground and swallowed) 5 g, Chong Lou (Paridis Rhizoma) 10 g, Bai Hua She She Cao (Hedyotidis Herba) 20 g, Ban Zhi Lian (Scutellariae barbatae Herba) 20 g.

In the above formula, Wu Gong and Bi Hu may alternatively be prepared as follows: 20 gecko and 20 g centipede soaked in 500 ml of white liquor for 7 days, then diluted with water to 2000 ml; take 50 ml three times daily.

Modifications of this formula:

For vomiting, ye-ge and obstruction of eating: add Ding Xiang (Caryophylli Flos) 3 g, Shi Di (Kaki Calyx) 9 g, Dao Dou (Canavaliae Semen) 10 g.

For dry stool and abdominal distension: add Mang Xiao (Natrii Sulfas) 5 g (taken dissolved), Rou Cong Rong (Cistanches Herba) 15 g.

For fatigue, listlessness and low spirits: add Dang Shen (Codonopsis Radix) 15 g, Tai Zi Shen (Pseudostellariae Radix) 20 g, Huang Qi (Astragali Radix) 15 g.

For tidal fever, night sweating, dry mouth and tongue: add Sha Shen (Glehniae/Adenophorae Radix) 15 g, Mai Dong (Ophiopogonis Radix) 15 g, Sheng Di Huang (raw Rehmanniae Radix) 15 g, Xuan Shen (Scrophulariae Radix) 15 g, Yin Chai Hu (Stellariae Radix) 10 g.

For dull epigastric pain that likes warmth and pressure, eating in the morning and vomiting in the evening (or vice versa), vomiting clear water, sallow complexion and loose stool: add Gan Jiang (Zingiberis Rhizoma) 6 g, Ding Xiang 3 g, Wu Zhu Yu (Evodiae Fructus) 6 g, Fu Pian (processed Aconiti Radix lateralis) 6 g, Gao Liang Jiang (Alpiniae officinari Rhizoma) 10 g, Dang Shen 15 g.

Depending on the patient's condition, the following herbs may be added as appropriate.

To soften hardness and dissipate nodules: add Hai Zao (Sargassum) and Kun Bu (Eckloniae/ Laminariae Thallus).

For anti-cancer and detoxifying action: add Ba Yue Zha (Akebiae Fructus), Qiang Lang Chong (Scarabaeus), San Leng (Sparganii Rhizoma), E Zhu (Curcumae Rhizoma), San Qi (Notoginseng Radix), Mu Man Tou (Fructus mali varii), Mi Hou Tao Gen (Actinidiae Root), and tender walnut branchlets.

To aid digestion: add Shen Qu (medicated leaven), Mai Ya (Hordei Fructus germinatus), Shan Zha (Crataegi Fructus), Ji Nei Jin (Gigeriae galli endothelium corneum).

Professor Chen used this empirical formula with modifications to treat more than 30 patients with gastric or esophageal cancer: 2 survived over 10 years; 5 had marked effect (symptoms basically disappeared, survived 3 years); 15 had effect (symptoms markedly reduced, weight and food intake increased, survived over 1 year). The total response rate was 73.3%.

Professor Chen's empirical formula derives from Xuanfu Daizhe Tang, Gualou Xiebai Banxia Tang and Er Chen Tang.

Xuanfu Daizhe Tang comes from Zhang Zhongjing's Shanghan Lun (Han dynasty), composed of Xuan Fu Hua, Dai Zhe Shi, Ren Shen (Ginseng), Sheng Jiang (fresh Ginger), Ban Xia, Gan Cao (honey-fried Licorice) and Da Zao (Jujube). It downbears counterflow and resolves phlegm, boosts qi and harmonizes the stomach; it treats belching, hiccups and vomiting due to stomach deficiency, phlegm obstruction and upward counterflow of qi. Modernly it is often used for gastritis, esophageal reflux and gastric cancer presenting with these symptoms.

Gualou Xiebai Banxia Tang comes from Zhang Zhongjing's Jinkui Yaolue, composed of Gua Lou (Trichosanthis Fructus), Xie Bai and Ban Xia. It unblocks yang, dissipates nodules, expels phlegm and widens the chest, treating chest impediment due to exuberant phlegm and stasis, with pain radiating through chest and back, shortness of breath, copious phlegm, purple-dark tongue and slow pulse. Modern pharmacology shows that Gualou Xiebai Banxia Tang has strong blood-activating and stasis-resolving effects; today it is used for coronary angina, intercostal neuralgia and mammary hyperplasia, as well as digestive-tract disease of the stasis-obstruction pattern.

Xie Bai in this formula is a vegetable similar to onion and garlic; its corm has strong blood-activating and stasis-resolving action and also a marked laxative effect. The modern Xizhitong capsule used for cardiovascular thrombotic disease is made from an extract of Xie Bai.

Er Chen Tang comes from the Taiping Huimin Hejiju Fang, composed of Chen Pi, Ban Xia, Fu Ling and Gan Cao. It is the representative TCM phlegm-resolving formula, drying dampness and resolving phlegm, moving qi and harmonizing the center, indicated for damp-phlegm syndrome: cough with copious white sputum that is easy to expectorate, nausea and vomiting, chest and diaphragmatic glomus, heavy limbs, or dizziness and palpitations, with white, slippery or greasy tongue coating and a slippery pulse.

Professor Chen's base formula builds on the combination of these three classic formulas, adding Dan Shen, Tao Ren and Hong Hua to strengthen blood activation and stasis resolution; adding Wu Gong and Bi Hu to use toxin against toxin; adding Chong Lou, Bai Hua She She Cao and Ban Zhi Lian to clear heat, detoxify and fight cancer; and adding Huo Ma Ren to moisten the intestines and free the stool.

His base formula integrates pattern differentiation and disease differentiation for treating gastric and esophageal cancer. Its logic is scientific, rational and well targeted, rapidly and markedly relieving clinical symptoms and helping build the patient's confidence. Most TCM-treated gastric and esophageal cancer patients are late or terminal patients whom Western medicine has given up on; the success rate was never high, so achieving these results with this formula was no small feat.