Professor Fang Yaozhong's Case: Treating Liver Cancer with Shenqi Danji Tang Plus Xiaozhang San

Professor Fang Yaozhong (1921-1995) was a famous contemporary TCM master in China. Before his passing, he worked at the China Academy of Chinese Medical Sciences, the predecessor of which was the China Institute of Traditional Chinese Medicine. Professor Fang Yaozhong was one of the great contemporary masters of warm-disease (wenbing) theory in China. He had profound theoretical attainments and a high clinical level, and was especially skilled in treating liver and kidney diseases. This article introduces a liver cancer patient case treated by Professor Fang Yaozhong.

The patient in this case, surnamed Yin, was 41 years old at the time of the first visit on a certain day in August 1972. Since 1964, the patient had frequently experienced pain in the liver area, sometimes accompanied by low fever (37.5-38 °C), with normal liver function. In May 1972, after a cold with fever, the liver-area pain worsened and became unbearable. After examination at several hospitals, he was diagnosed with liver cancer. He was continuously hospitalized without significant improvement, and his condition kept deteriorating, so he sought treatment from Professor Fang.

At the first visit, the patient's chief complaints were liver-area pain, gastric and epigastric fullness, low fever, loose stools, and poor appetite. He was emaciated, with a bluish-dark complexion, fatigue and lack of strength, and shortness of breath. The pulse was deep, fine, wiry, and rapid; the tongue was bluish-red with petechiae and a thin white coating. The liver was palpable 5 cm below the costal margin, with a somewhat uneven surface, medium hardness, and marked tenderness. After analysis, Professor Fang established the treatment principles of enriching the kidney and nourishing the liver, strengthening the spleen and harmonizing the stomach, soothing the liver and benefiting the lung, and supplementing both qi and yin, deciding to treat mainly with Shenqi Danji Tang plus Xiaozhang San.

First-visit prescription: Dangshen (Codonopsis Radix) 15 g, Huangqi (Astragali Radix) 30 g, Danshen (Salviae Miltiorrhizae Radix) 30 g, Jixueteng (Spatholobi Caulis) 30 g, Huangjing (Polygonati Rhizoma) 30 g, Danggui (Angelicae Sinensis Radix) 12 g, Xi Shengdi (unprocessed Rehmanniae Radix) 30 g, Jiaoteng (Polygoni Multiflori Caulis) 30 g, Cangzhu (Atractylodis Rhizoma) 12 g, Baizhu (Atractylodis Macrocephalae Rhizoma) 12 g, Qingpi (Citri Reticulatae Pericarpium Viride) 10 g, Chenpi (Citri Reticulatae Pericarpium) 10 g, Gancao (Glycyrrhizae Radix) 6 g, Chaihu (Bupleuri Radix) 12 g, Jianghuang (Curcumae Longae Rhizoma) 12 g, Yujin (Curcumae Radix) 12 g, Bohe (Menthae Folium) 3 g, Sharen (Amomi Fructus) 6 g, Laifuzi (Raphani Semen) 12 g. One decoction per day, taken in water-decocted form.

After two weeks of taking the medicine, the patient's subjective symptoms gradually eased. The patient was simultaneously hospitalized for treatment at another hospital for half a year; the treatment protocol used there was not described in Fang Yaozhong's case record, but it was probably routine liver cancer treatment. During this period he occasionally caught cold, with fever reaching 40 °C; Professor Fang Yaozhong treated him with Chai Ge Jie Ji Tang (Bupleurum and Kudzu Decoction to Release the Muscle Layer), which brought down the fever. In early 1973, the patient was discharged; before discharge, his spirit, diet, sleep, urination, and defecation were basically normal, and the liver-area pain had basically disappeared. Alpha-fetoprotein was normal, and transaminase and lactate dehydrogenase were also normal.

After discharge, the patient rested for one year and then returned to work. Thereafter, in July 1976, liver-area pain and poor appetite recurred, and he again sought treatment from Professor Fang Yaozhong. Professor Fang again used mainly the first-visit prescription with slight modifications; after taking the medicine, symptoms rapidly eased. In 1977, the patient sought out Professor Fang Yaozhong again for a sprain; this allowed Professor Fang to learn of his subsequent condition, and there had been no sign of liver cancer recurrence. Follow-up to 1985 showed no recurrence; the patient survived 13 years after cancer in a tumor-free, symptom-free state, essentially clinically cured.

In this case, Professor Fang Yaozhong did not detail the treatments the patient received at other hospitals. Given the conditions at the time and the fact that the patient was hospitalized for half a year, he may have undergone interventional therapy or chemotherapy. This patient's liver cancer was likely treated with integrated Chinese and Western medicine.

In treating this patient, Professor Fang Yaozhong adopted a treatment principle combining support of the healthy root with elimination of the pathogen. His formula was relatively simple, with few herbs. After treatment by Professor Fang, the patient's symptoms eased, showing that this symptomatic treatment regimen at least effectively improved the patient's quality of life and created conditions for the patient to receive other treatments.

In this prescription of Professor Fang Yaozhong, Jianghuang, Yujin, and others are modern commonly used anti-tumor Chinese herbs. The patient's disease in this case did not progress rapidly and was sensitive to medication, which was an important reason for such good efficacy. In addition, at the time of consultation, apart from fever and abdominal distension, the patient had no serious complications (such as ascites or portal hypertension). Such cancer patients are also easier to treat. These objective conditions allowed Professor Fang Yaozhong's treatment to take effect and secured the best possible outcome for the patient.

I have always advocated that cancer should, as far as possible, be treated through multidisciplinary collaboration, and that TCM adjuvant treatment should be introduced as early as possible. But in reality, many cancer patients, for various reasons, do not trust TCM in the early stage of treatment and only seek TCM after developing terminal symptoms such as ascites, pleural effusion, or cachexia. In fact, by then, the role TCM can play is already very limited.