Experience with Danzhuru Decoction for Profuse Sweating in a Cancer Patient

Danzhuru Decoction (Light Bamboo-shavings Decoction) first appeared in the Qianjin Fang (Essential Prescriptions Worth a Thousand Gold). It is a derivative of Gancao Xiaomai Dazao Tang (Licorice-Wheat-Jujube Decoction) from Zhang Zhongjing's Jingui Yaolüe (Essentials from the Golden Cabinet), and was later further developed by Chen Yan of the Song dynasty, becoming a classic famous formula for treating zang-zao (organ restlessness) in women and postpartum depression.

Danzhuru Decoction has the actions of nourishing the heart and calming the spirit, and clearing the heart and eliminating vexation. It treats heart-vacuity vexation and oppression, headache and shortness of breath, internal heat that does not resolve, chest turmoil, as well as postpartum heart-vacuity palpitations, oppressive near-collapse, zang-zao, and incessant sadness and weeping.

Gancao Xiaomai Dazao Tang has only three herbs: Gancao (Licorice) 3 liang, Xiaomai (Wheat) 1 sheng, Dazao (Jujube) 10 (broken up). This formula was originally for treating women's zang-zao, sadness and propensity to weep; it is a famous formula among TCM spirit-calming prescriptions. The Tangtou Gejue (Prescription Songs) says: "The Jingui's Gan-Mai-Dazao Tang, for women's zang-zao who love sadness; spirit distracted, always wanting to weep; nourishing the heart and calming the spirit, its efficacy is manifest."

Gancao Xiaomai Dazao Tang has the actions of nourishing the heart and calming the spirit, harmonizing the middle and moderating urgency. It treats zang-zao, presenting as mental distraction, constant sadness and weeping beyond self-control, heart vexation and turmoil, restless sleep, even abnormal speech and behavior, frequent yawning, a pale-red tongue with little coating, and a fine, rapid pulse. Modern clinical use commonly covers hysteria, menopausal syndrome, neurasthenia, and infantile night crying, in patterns of heart-yin insufficiency and liver-qi losing harmony.

Danzhuru Decoction is built on Gancao Xiaomai Dazao Tang by adding Zhuru (Bamboo shavings) and Maidong (Ophiopogon); Chen Yan's Danzhuru Decoction further adds Fabanxia (processed Pinellia) on this basis. In the classic TCM gynecology text Jingxiao Chanbao (Effective Obstetrical Treasures), one removes the Dazao from Gancao Xiaomai Dazao Tang and adds Gange (Kudzu root), Maidong, Danzhuru, and Sheng Shigao (raw Gypsum), for treating postpartum vacuity vexation, headache, shortness of breath near collapse, and unresolving heart turmoil in women.

Historically, this formula was chiefly used for postpartum depression in women, and I have previously written about it. But recently I used this formula, modified with Fuxiaomai (light/immature wheat), to treat a triple-negative breast-cancer patient's uncontrollable sweating, with very good results.

This patient had no other obvious symptoms; she simply sweated very easily, breaking out in a whole-body sweat each time. The moment her emotions tightened, the sweating would not stop; later it even reached the point that merely thinking about sweating would immediately bring on a heavy sweat all over. I had previously tried several common prescriptions for sweating, to no effect.

Then one day I heard the patient say that whenever she thought about sweating, she immediately broke out in a sweat. I felt that her treatment should still prioritize calming the spirit, with stopping sweating as secondary. So I prescribed Danzhuru Decoction plus Fuxiaomai, which has a sweat-stopping action. The formula was as follows:

Maidong 15g, Xiaomai (Wheat) 30g, Fuxiaomai (light wheat) 30g, Zhi Gancao (honey-fried Licorice) 10g, Dangshen (Codonopsis) 15g, Fulin (Poria) 15g, Fabanxia (processed Pinellia) 10g, Danzhuru (light bamboo shavings) 10g, Shengjiang (Fresh Ginger) 7 slices.

Because the patient happened to be about to travel and it was inconvenient to decoct herbs, I told her to get the medicine immediately that day, decoct it, and take it. I also told her to bring some Gancao, Xiaomai, and Dazao with her on the trip, steeping them in boiling water as a tea.

The patient bought and took the medicine that very day. One dose brought immediate effect; after two doses, the sweating was controlled. I offer this small experience for everyone's reference.

According to TCM theory, the main indication treated by Danzhuru Decoction arises from zang-yin insufficiency, heart-vacuity failing to nourish, and the spirit not dwelling in its abode; this pattern should be treated by nourishing the heart and calming the spirit.

In this formula, Xiaomai is sweet and cold, nourishing the heart and boosting the kidney, eliminating vexation and quenching thirst to calm the spirit; Maidong is sweet and cold, generating fluids and enriching moisture. Together they clear the heart and eliminate vexation. Gancao harmonizes the middle and moderates urgency, supplementing heart qi; Renshen and Fulin supplement heart qi and nourish heart yin; Zhuru clears deficiency heat and eliminates heart vexation, and also has the function of washing away phlegm. With heart-yin deficiency and heart-fire effulgence, fluids may easily be scorched into phlegm and block the orifices; fearing that Zhuru's phlegm-washing force is insufficient, Banxia is added to transform phlegm and Shengjiang to scatter fluid retention. Dazao is used to boost qi and regulate the middle. The combined herbs jointly achieve the effect of clearing and nourishing the heart, calming the spirit and settling fright.

Not only postpartum-depression patients show zang-zao; some cancer patients, or menopausal women, also have similar zang-zao symptoms—the spirit restless, heart vexed and hot, so that sweating is hard to control. Hence this formula also works well for them. When I treat such patients, on the basis of pattern differentiation I add Fuxiaomai for its sweat-stopping action, and so achieved immediate results. Hence one should not be rigidly bound to a fixed formula; it must be adapted flexibly to the patient's specific symptoms.

Special note: the Xiaomai in this formula is ordinary wheat, which is generally unavailable in ordinary TCM pharmacies or supermarkets, but can be bought online on sites such as Taobao, or obtained from farmers who grow wheat in the countryside. Fuxiaomai is immature wheat, sold in TCM pharmacies. The actions of Xiaomai and Fuxiaomai are not the same: Xiaomai fortifies the spleen and calms the spirit, while Fuxiaomai's main action is to stop sweating.