The Application of Gexia Zhuyu Decoction in Cancer Treatment
Gexia Zhuyu Tang (Blood-Stasis-Dispersing Decoction from Below the Diaphragm) comes from Wang Qingren's Yilin Gaicuo (Correction of Errors in Medical Works) of the Qing dynasty.
In Yilin Gaicuo, Wang Qingren defined the indications of Gexia Zhuyu Decoction as: abdominal masses, pediatric pi masses, pain at a fixed location, abdominal drooping sensation when lying down, kidney diarrhea, and chronic diarrhea. Abdominal masses and pediatric pi masses often correspond to tumors, and pain at a fixed location can also be caused by tumors.
The formula composition of Gexia Zhuyu Decoction is: Wulingzhi (Trogopterorus, 2 qian, fried), Danggui (Angelicae Sinensis Radix) 3 qian, Chuanxiong (Chuanxiong Rhizoma) 3 qian, Taoren (Persicae Semen) 3 qian (pounded into a paste), Mudanpi (Moutan Cortex) 2 qian, Chishao (Paeoniae Radix Rubra) 2 qian, Wuyao (Linderae Radix) 2 qian, Gancao (Glycyrrhizae Radix) 3 qian, Xiangfu (Cyperi Rhizoma) 1.5 qian, Honghua (Carthami Flos) 3 qian, Zhiqiao (Aurantii Fructus) 1.5 qian.
This formula is composed of large doses of blood-activating, stasis-resolving herbs and qi-moving herbs, so its effect is to resolve stasis and move qi. Modern pharmacology confirms that Gexia Zhuyu Decoction can inhibit tumor angiogenesis and can also destroy vessels already formed within a tumor; it therefore has the effect of cutting off the tumor's own blood supply and can be used to treat tumors.
In Yilin Gaicuo, Wang Qingren especially recommended Gexia Zhuyu Decoction for treating jiju (accumulations and gatherings—many of which correspond in Western medicine to gastrointestinal and gynecological tumors).
Wang Qingren wrote: "For the condition of jiju, we need not discuss the ancient names of five ji, six ju, seven zheng, or eight jia, nor need we debate and refute their errors; refuting them would be unnecessarily troublesome. Now I ask: what is it that can form a lump in the abdomen? If it forms in the stomach, it must be food; if it forms in the intestine, it is dry feces. If the mass has persisted for a long time and eating and drinking remain as usual, it is naturally not within the stomach or intestines, but must lie outside them. Outside the stomach and intestines, in whatever place, there is qi and blood. Qi has its tracts, blood has its vessels; qi is formless and cannot form a lump—whatever forms a lump must be formless blood that has congealed. When blood meets cold it congeals into a mass; when blood meets heat it is scorched into a mass. When vertical vessels congeal they form vertical strips; when horizontal vessels congeal they form horizontal strips; when both vertical and horizontal vessels congeal they necessarily join into sheets, and sheets that congeal for long grow thick and become lumps. Since it is a clot of blood, fever should be present. One must know that blood stasis in the blood mansion (xuefu) necessarily causes fever; the blood mansion is the root of blood, and stasis there is life-threatening. Blood stasis in the abdomen does not cause fever, for the abdomen is the periphery of the blood; though stasis occurs there, it does not endanger life. Whether the accumulated mass lies below the left rib, below the right rib, to the left of the navel, to the right of the navel, above or below the navel, or pulsates when pressed, treat it all with this formula (Gexia Zhuyu Decoction), and it will invariably respond. If the disease is mild, take less; if severe, take more; the rule is: once the disease is gone, stop the medicine—do not take more than necessary. If the patient is weak in qi and cannot withstand the attacking and dispersing herbs, add 3 to 5 qian of Dangshen (Codonopsis); there is no need to be rigid about this."
This passage of Wang Qingren gives a fairly comprehensive description of the characteristics of tumors. Though, limited by his era, he could not recognize the true cause of tumors, his grasp of their clinical features is remarkably accurate. When a tumor grows to a certain size, vessels interlace within it; in TCM this is seen as a product of blood stasis. Wang Qingren also raised the issue of tumor fever, a point rarely summarized so accurately in earlier TCM works.
Thus, in treating such diseases, Wang Qingren's attitude was to use large doses of qi-moving and blood-activating, stasis-resolving herbs. He also noted that some patients may not tolerate such herbs, and specifically mentioned that qi-weak patients should add Dangshen.
Under the entry "pain at a fixed location," Wang Qingren states: "Whenever abdominal pain does not shift, it is blood stasis. Treating it with this formula is extremely effective." Such fixed abdominal pain closely resembles the cancer pain caused by modern gastrointestinal tumors.
Under the entry "pediatric pi mass," Wang Qingren says: "Pediatric pi masses, with a swollen belly and raised blue veins, are throughout always caused by blood stasis. Take this formula alternately with the earlier Tongqiao Huoxiang Decoction and Xuefu Zhuyu Decoction; after a month or more, there has never been a case that did not succeed." The symptoms of pediatric pi masses he describes also resemble those seen in some pediatric tumor patients. For such diseases, Wang Qingren uniformly applied the method of activating blood and resolving stasis, rotating through the three famous blood-activating formulas he himself created.
Of course, using Gexia Zhuyu Decoction to treat cancer will not produce results as good as Wang Qingren describes; treating ordinary blood-stasis syndromes rather than cancer may well yield such fine results. Gexia Zhuyu Decoction does help in some cancer cases, but the effective rate is relatively lower.
Professor Yin Huihe once used a modified Gexia Zhuyu Decoction to treat esophageal cancer. Professor Yin's empirical formula was: Taoren 9g, Danshen (Salviae Miltiorrhizae Radix) 30g, Mudanpi 9g, Chishao 9g, Yanhusuo (Corydalidis Rhizoma) 9g, Danggui 9g, Wulingzhi 9g, Honghua 6g, Zhiqiao 9g, Wumei (Mume Fructus) 15g, Naosha (sal ammoniac/halitum) 0.3g (taken infused). (Formula from Yin Huihe's Zhongyi Neike Xinlun [New Discourse on TCM Internal Medicine].)
Professor Yin's formula heavily emphasizes blood-activating, stasis-resolving herbs, and its blood-activating force surpasses even Wang Qingren's. Wang Qingren used Wuyao and Xiangfu to move qi and stop pain; Yin replaced them with Yanhusuo, which also moves qi and stops pain, though Yanhusuo's analgesic effect may be even better. Naosha is a mineral drug with a specific effect on the dysphagia caused by esophageal cancer. However, Naosha should not be decocted; it is best made into a powder and taken infused, so Professor Yin took it as a infused powder.
The author has also used this formula alternately with Qige San (Qi-Decorticating Powder) to treat gastrointestinal and gynecological tumors, with some effect. Adding Jianghuang (Curcumae Longae Rhizoma), Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), together with certain phlegm-resolving herbs (such as Banxia, Beimu, Tiannanxing, Zhuru) and heat-clearing, toxin-resolving herbs (such as Pugongying, Zihu Diding, Banzhilian, Baihua Sheshicao), seems to yield even better results.
When using this formula to treat cancer, the patient's general condition must still be fair, and special care must be taken that the patient does not have a bleeding tendency. If the patient has a bleeding tendency, using this formula is very dangerous.