Fumigation Therapy in TCM External Treatment
Fumigation therapy (xunliao fa) is a treatment method commonly used in TCM external medicine. Generally, ignited mulberry wood, chaff, or herbal powder (the powder rolled into a medicinal roll in thick straw paper) is used to fumigate the skin over the lesion, so as to achieve therapeutic effect.
I once wrote an article introducing the Divine Lamp Illumination method of TCM external medicine (click the link to read the original and see the Divine Lamp prescriptions). This Divine Lamp method is one form of TCM fumigation therapy. The late famous surgeon Professor Fang Mingqian once cured a melanoma patient with the Divine Lamp method; I compiled the case records of his use of the method into the article Six Case Records of Professor Fang Mingqian Treating Cancer, which can be read by clicking the title link.
TCM fumigation is not limited to the Divine Lamp method. The most commonly used fumigation methods are mulberry-wood moxibustion and the herbal paper-roll fumigation (the Divine Lamp method is one kind of herbal paper-roll fumigation, but paper-roll fumigation is far broader than just the Divine Lamp method).
Fumigation with mulberry wood is also called mulberry-wood moxibustion; it uses ignited mulberry wood to fumigate and moxibust the affected area, generally for treating visible sores, welling-abscesses and swellings. For example, the Orthodox Manual of External Medicine (Waike Zhengzong) by the Ming-dynasty physician Chen Shigong records: "For various sores and toxins that are hard and do not ulcerate, ulcerate but do not putrefy, where new flesh does not grow and pain is incessant, use fresh mulberry wood seven cun long, split to finger thickness; ignite one end and moxibust toward the lesion. When the fire is spent, change to another; use five or six pieces of wood each time, stopping when the flesh putrefies." The Shenjing Jinglun (Canon of Divine Moxibustion) records: "Burn mulberry wood into red charcoal, hold it in a perforated ladle, suspend it over the lesion, and bake from the circumference toward the sore mouth; whether high or low, stop when the sore feels heat."
Mulberry-wood moxibustion is a form of thermal therapy. The sores treated this way may be benign tumors or furuncles/abscesses, or they may be malignant tumors. Thermal therapy can indeed burn tumors to death; radiofrequency ablation and microwave ablation in modern medicine work precisely on the principle of using heat to treat tumors. The smoke produced by mulberry wood is basically non-toxic and harmless to the body, so mulberry-wood moxibustion is a safe and reliable therapy.
However, an external method such as mulberry-wood moxibustion is limited to treating visible surface tumors, and during treatment the heat must be carefully controlled; excessive fumigation may instead bring about mishaps. The Shenjing Jinglun says fumigation should stop when "the sore feels heat," indicating that ancient surgeons stopped as soon as the mass became warm. The virtue of this method lies in perseverance, not in rushing; stop each time once the mass is heated. It may be done once a day, or several times.
Herbal paper-roll fumigation is also widely used among the people; the prescriptions vary greatly, with different formulas for different diseases.
In his early years of practice, Professor Zhao Bingnan saw an elderly woman using straw paper to fumigate stubborn lichen (neurodermatitis) with excellent results. Drawing on his reading of ancient texts, he then organized a set of fumigation therapies for skin diseases; his experience is recorded in the chapter "Fumigation Therapy" of the Zhao Bingnan Clinical Experience Collection (Zhao Bingnan Linchuang Jingyan Ji), which interested readers may consult.
Professor Zhao recorded three fumigation formulas. The first is the Lichen Fumigation Formula: Atractylodes lancea (cangzhu), Phellodendron (huangbai), Sophora flavescens (kushen) and Saposhnikovia (fangfeng), three qian each; Hydnocarpus seed (dafengzi) and Dictamnus bark (baixianpi), one liang each; pine resin (songxiang) and Carpesium (heshi), four qian each; Chinese gall (wubeizi), five qian. This formula eliminates dampness and dispels wind, kills parasites and stops itching, and is indicated for neurodermatitis (lichen), chronic eczema, cutaneous amyloidosis and pruritus cutis. The second is the Ziyou Fumigation Formula: Hydnocarpus seed (dafengzi), Kochia fruit (difuzi), castor bean (bimazi), Cnidium fruit (shechuangzi) and premium Artemisia (qi'ai), one liang each; Perilla seed (suzi) and bitter apricot kernel (kuxingren), five qian each; ginkgo nut (yinxing) and Sophora seed (kushenzi), four qian each. This formula softens hard masses and moistens the skin, kills parasites and stops itching, and is indicated for psoriasis, ichthyosis and cutaneous amyloidosis. The third is the Huiyang (Yang-Restoring) Fumigation Formula: cinnamon bark (rougui), blast ginger (paojiang), ginseng reed (renshen lu), Ligusticum (chuanxiong) and Angelica (danggui), three qian each; white mustard seed (baijiezi) and Qi mugwort (qi'ai), one liang each; Ampelopsis (bailian) and Astragalus (huangqi), five qian each. This formula restores yang and generates flesh, boosts qi and nourishes blood, and is indicated for chronic non-healing yin sores of cold type, intractable fistulae, intractable ulcers, fistulae from chronic hidradenitis, tuberculous ulcers and ankle-joint tuberculosis.
The operation of all the above fumigation therapies is the same: grind the herbs together into coarse fragments, roll them in thick straw paper into a medicinal roll, light it, and use the smoke to fumigate the affected area, once or twice daily for 15–30 minutes each time. The smoke produced is not heavy; although inhaling it is somewhat irritating, the harm is very small. During fumigation, the patient and the family member or medical staff assisting can wear an N95 mask and medical goggles, after which the harm is negligible.
Fumigation therapy can treat not only ordinary skin diseases but also cancer. It also has some analgesic effect, and mulberry-wood moxibustion is the safest for pain relief. The herbs used in fumigation for cancer often contain highly toxic substances such as realgar (xionghuang), cinnabar (zhusha), arsenic trioxide (pishuang) and Huechys sanguinea (hongniangzi), so there are certain safety hazards in operation. Patients are advised to use such drugs under a doctor's guidance and monitoring, so that any toxic side effects can be promptly handled.
During fumigation, a layer of black soot forms on the treated lesion. Do not rush to wipe it off after each session; leaving it for a while gives better results. Fumigation usually works quickly, often showing effect after a few applications, but for chronic skin lesions and tumors, long-term persistence is needed to achieve a radical cure. Giving up halfway often wastes all previous effort, although resuming fumigation after a break still works. After chronic symptoms disappear, fumigation should still be continued for half a month to a month to eradicate the root, otherwise relapse is likely.
In addition, cancer is a systemic disease that only forms local lesions; relying on fumigation alone can only exert some control over the local lesion and is difficult to achieve long-term control. Therefore, when fumigation is used for surface tumors, it should also be combined with internal oral treatment.