Compound Zaofan Pills: A Chinese Patent Medicine with Adjunctive Radiotherapy/Chemotherapy and Anti-Leukemia Effects
Zaofan (black alum, ferrous sulfate) is the mineral goslarite (a sulfate mineral) or a chemically synthesized product, whose main component is ferrous sulfate heptahydrate; its aliases are green alum and blue alum. It has been used as a medicinal in China since antiquity. Traditional TCM holds that zaofan is sour and astringent in taste and cool in nature, entering the liver and spleen meridians. It resolves toxicity and engenders sores, dissipates accumulation and kills parasites, dries dampness and resolves phlegm, and stops bleeding and nourishes blood. It is used mainly for jaundice with distension, gan accumulation with chronic dysentery, intestinal wind with blood in stool, blood deficiency with sallow complexion, damp sores and scabies, and throat impediment and mouth ulcers.
The "Green Alum Pill" in Taiping Shenghui Fang combines zaofan with plant soot (Baicaoshuang) and cuttlefish bone (Wuzeigu) to treat intestinal bleeding, blood-deficiency sallowness, and persistent red/white vaginal discharge in women over years. These conditions mostly involve chronic bleeding leading to anemia; this method of using zaofan pills to nourish blood predates the modern use of ferrous sulfate by a great margin.
Compound Zaofan Wan is a Chinese patent medicine based on zaofan, composed of zaofan, American ginseng, seahorse, cinnamon, jujube, and walnut. According to traditional TCM theory, it warms yang and tonifies the kidney, benefits the marrow and fills essence, nourishes yin and boosts qi, and generates blood and stops bleeding.
Compound Zaofan Wan is a common oncology patent medicine used as an adjunct to radiotherapy and chemotherapy; it is also used for aplastic anemia, leukopenia, thrombocytopenia, and myelodysplastic syndrome. It has few side effects; a small number of patients experience mild gastrointestinal discomfort, which resolves after reducing the dose for a few days.
Used alongside radiotherapy and chemotherapy, Compound Zaofan Wan protects cancer patients' bone marrow from damage. It promotes proliferation of the granulocytic, erythroid, and megakaryocytic lineages of the bone marrow, raising patients' tolerance to chemoradiotherapy. Controlled trials show that during chemoradiotherapy, cancer patients taking Compound Zaofan Wan had markedly higher white blood cell and platelet counts than controls not using it or using leucogen; with Compound Zaofan Wan, patients tolerated chemoradiotherapy better and completed it more smoothly.
Because iron chemically reacts with tannic acid in tea to form a precipitate that impairs iron absorption, ancient Chinese already knew that iron-containing medicines such as zaofan should not be taken with tea; tea and other tannin-containing drinks are also incompatible with iron utensils when decocting Chinese medicine. Therefore, do not drink tea while taking Compound Zaofan Wan.
In addition, although TCM considers zaofan non-toxic, modern scientific research finds that ferrous sulfate heptahydrate has a certain toxicity, irritating the respiratory tract, eyes, mucous membranes, and skin, and can cause cough and shortness of breath. Therefore patients with respiratory disease should take care when using Compound Zaofan Wan, and protect their eyes and skin when handling the drug. Pregnant women should use it cautiously.