Appreciation of a Case: Hong Ziyun Treating Bladder Epithelial Tumor
Hong Ziyun (1916-1986), given name Yuankai, was from Honggang Village, Xinmiao Township, Ezhou City, Hubei Province. During his lifetime he served as director of the Shanghan (Cold-Damage) teaching and research office at Hubei College of Traditional Chinese Medicine (now Hubei University of Chinese Medicine), as well as professor and vice-president of the college. He authored monographs such as The TCM Treatment of Epidemic Cerebrospinal Meningitis. On October 20, 1982, Professor Hong treated a patient with a bladder epithelial tumor.
In April 1982, the patient was diagnosed with a bladder epithelial tumor after hematuria; several papillomas of varying sizes were found on the bladder wall, and biopsy showed an epithelial tumor. After radiotherapy and chemotherapy, symptoms did not improve; hematuria worsened, with dysuria, pain at the end of urination, and left-sided lumbar pain. At the visit the tongue was red with little coating and the pulse was fine and rapid. Professor Hong differentiated the patient as having evil heat in the lower burner that had penetrated deeply into the blood portion, damaging the yin collaterals and obstructing blood stasis, giving rise to the tumor. He planned first to clear heat and detoxify, cool blood and scatter blood to relieve symptoms, and then to treat with the principle of clearing heat and detoxifying, cooling blood and stopping bleeding, while simultaneously tonifying the spleen and stomach.
The first prescription: dry Shengdihuang (raw Rehmannia), Jixueteng (Spatholobus stem), Dahongteng (Sargentodoxa stem), Rendongteng (Lonicera stem), and Baijiangcao (patrinia), 15 g each; Mudanpi (Moutan bark), Chishao (red peony), Sheng Gancao (raw licorice), Huainiuxi (Achyranthes), Sheng Cebaiye (biota leaf), Shengdihuang (raw Rehmannia), Diyu (Sanguisorba), and Sangjisheng (mistletoe), 10 g each. Decocted in water, one dose daily, taken in two divided doses.
By the second visit on November 3, after taking 3 doses of the above, the patient passed large clumps in the urine (microscopy showed blood clots and connective tissue); urination was smoother but still bloody, with left lumbar pain. The treatment was then changed to clearing heat and detoxifying, cooling blood and stopping bleeding, while simultaneously tonifying the spleen and kidney.
Second-visit prescription: dry Shengdihuang (raw Rehmannia), Rendongteng (Lonicera stem), Huaishanyao (Chinese yam), Sangjisheng (mistletoe), and Fuling (Poria), 15 g each; Mudanpi (Moutan bark), Baijiangcao (patrinia), Xuduan (Dipsacus), Chao Cebai (dry-fried biota), Chao Diyu (dry-fried Sanguisorba), and Zhigancao (honey-fried licorice), 10 g each; Yiyiren (Coix seed) 30 g. Decocted in water, one dose daily, taken in two divided doses.
After taking the second prescription, hematuria improved and lumbar pain lessened. Following the principle of not changing an effective formula, Professor Hong Ziyun had the patient continue the original prescription. After more than 6 months of medication, the hematuria stopped and lumbar pain ceased. Although hematuria occasionally recurred thereafter, treating with the above was still effective. By the end of 1983, the patient had survived with the tumor for over 2 years.
Commentary: In Professor Hong Ziyun's case, clumps appeared in the urine after only three doses, which is relatively rare clinically. There may be an element of coincidence, because the herbs in Professor Hong's first prescription were not strong in dosage and would not usually make a patient pass clumps so quickly.
But after the clumps were passed, Professor Hong's prescriptions gradually improved the hematuria and lumbar pain, and this effect is reasonable. The herbs used in the first and second visits were all common blood-cooling, hemostatic, heat-clearing, and detoxifying herbs; adding Sangjisheng and Xuduan for lumbar pain was routine symptom-targeted treatment. Such a formula seems unremarkable, but because the pattern differentiation was correct and the patient persisted long-term, it ultimately achieved a good therapeutic effect. This shows the importance of steadfastly upholding correct treatment when TCM treats cancer. To be able to hold the course, the physician must keep composure and the patient must cooperate; neither can be lacking.