A Case: Treating Lymphoma Edema Based on the Patient's Physiological Responses
After summer began, He, a lymphoma patient I had long treated, developed difficult urination and edema of the lower abdomen and lower limbs. The patient went to the hospital for liver and kidney function tests and a tumor-marker panel of five, and all values were normal. After her period ended, she still occasionally had sudden pain somewhere in the chest. Her lower abdomen was protruding and her bladder distended; because of the abdominal fullness, her appetite was poor, and she also occasionally felt pain in the liver area and kidneys. Her bladder was distended and painful, with urgent, inhibited urination and scanty urine; during her period, when menstrual flow was heaviest, her urine volume was large, and her abdomen was somewhat flatter during the days of her period.
The patient repeatedly emphasized that she felt better during her period. I had previously tried other summer-heat-clearing and water-draining herbs, with poor results. On careful reflection, since this patient's symptoms eased during menstruation, and since, alongside her difficult urination, she also had chest and hypochondriac pain caused by liver-qi stagnation, I could try combining the approach of activating blood and unblocking menstruation with that of soothing the liver and regulating qi.
So I decided to treat her with the Tao Hong Siwu Tang (Peach Pit and Safflower Four Substances Decoction), which activates blood and unblocks menstruation, combined and modified with the Chaihu Shugan San, which soothes the liver and regulates qi. The prescription was as follows: raw rehmannia (Shengdi) 15 g, red peony (Chishao) 12 g, moutan (Mudanpi) 12 g, chuanxiong 12 g, Chinese angelica (Danggui) 12 g, bupleurum (Chaihu) 10 g, cyperus (Xiangfu) 10 g, stir-fried aurantium (Zhiqiao) 10 g, tangerine peel (Chenpi) 10 g, green tangerine peel (Qingpi) 10 g, eupolyphaga (Diebichong) 15 g, salvia (Danshen) 30 g, leonurus (Yimucao) 30 g, lycopus (Zelan) 30 g, honey-fried licorice (Zhi Gancao) 10 g, safflower (Honghua) 3 g, peach pit (Taoren) 6 g (added later), leech (Shuizhi) 10 g, earthworm (Dilong) 10 g, cattail pollen (Puhuang) 10 g, thistle (Xiaoji) 50 g, and glabrous greenbrier (Tufuling) 50 g.
I told the patient to buy two doses and report back after taking them for two days. After she took the medicine, I followed up once; the patient reported that after taking this formula, the dysuria and scanty urine had improved a great deal, her chest and hypochondria were no longer distended and painful, her appetite was much better, and the heavy, body-weight sensation caused by the edema had eased. I then told her to continue taking this formula until all symptoms disappeared before adjusting the prescription.
This patient is a lymphoma patient whom I have treated for nearly four years; her treatment case can be found in the medical cases I have written in the past. When she was first diagnosed with lymphoma, a local oncology department director thought her survival might be only three years. But up to now, her physical condition is still very good, living a normal life and caring for her family.
This patient's difficult urination came on rather suddenly this time, but her body also gave me many hints. The patient repeatedly emphasized that during menstruation her urination was smooth and her physical state better, which gave me a very important hint. I formulated the prescription based on her body's responses; in a sense, her own body was teaching me how to treat her.