Hua Ying Dan for Treating Thyroid Tumors (Nodules)
In Rumen Shiqin (Confucian Duties to Parents) by Zhang Zihe, one of the four great masters of the Jin-Yuan period, there is a formula called “Hua Ying Dan” (Nodule-Transforming Elixir). Its composition is: Haidai (kelp), Haizao (Sargassum), Haige (clam shell), and Kunbu (thallus Eckloniae—the above four all toasted), Zexie (Alisma, fried), and Lianqiao (Forsythia), each in equal amounts (30g); plus 10 pig thyroid glands (Zhu Ye) and 10 sheep thyroid glands (Yang Ye). Grind all the above into a fine powder, refine with honey into pills the size of a chicken-head seed. Each time take 1–2 pills, held in the mouth to dissolve at bedtime.
This formula has the actions of clearing heat and resolving phlegm, and dissipating nodules and scattering goiter. It is indicated for ying liu (thyroid nodules/goiter). Ying liu is what modern medicine calls thyroid enlargement; it includes both benign goiter and malignant thyroid tumors.
The less common herbs in this formula are Zhu Ye and Yang Ye. “Ye” is actually animal thyroid tissue: Zhu Ye is the pig's thyroid gland, and Yang Ye is the sheep's thyroid gland. This shows that as early as the Jin-Yuan period, ancient Chinese physicians had already discovered that using pig and sheep thyroid tissue as medicine has a therapeutic effect on human thyroid nodules.
Zhu Ye is also called Zhu Qi Zi. Bencao Gangmu (Compendium of Materia Medica) records: “It treats goiter of the neck; bake it on a tile, grind into powder, and take one qian with wine each night.” “Goiter of the neck” is thyroid enlargement. TCM also has a formula called “Er Ye San,” which is likewise composed mainly of pig and sheep thyroid glands to treat thyroid tumors or nodules. However, that formula requires expensive musk and pearl, and musk is now hard to obtain, so its use is not recommended.
Haidai, Haizao, Haige, and Kunbu are all seafoods rich in iodine; in ancient times, seafoods like these were the main treatment for iodine-deficiency goiter. TCM holds that they soften hardness and dissipate nodules; not only do they have a certain effect on iodine-deficiency goiter, but they also have some anticancer action. However, the iodine content of the formula is too high, which is very bad for hyperthyroid patients; therefore the various thyroid problems caused by hyperthyroidism cannot be treated with such a formula.
Zexie promotes diuresis and reduces edema, while Lianqiao clears heat and reduces swelling. Zexie and Lianqiao are added because TCM holds that thyroid enlargement is accompanied by damp-heat toxin, so one must clear heat and resolve toxins, reduce swelling and dissipate nodules, while also draining dampness and reducing edema, giving the pathogen an outlet. Used together in this way, the effect is better.