Experience in Treating Malignant Tumors with Modified Xiaoluo Wan

Xiaoluo Wan (Scrofula-Dispersing Pill) is a famous formula from Yixue Xinwu (Medical Mind-Awakening) for treating phlegm-nodules and scrofula (various benign and malignant tumors and tuberculous lesions). It consists of three herbs—Xuanshen (Scrophularia), Zhebeimu (Zhejiang Fritillary), and Shengmuli (raw Oyster shell)—and treats scrofula and phlegm-nodules due to congealed phlegm-fire, clearing and moistening to resolve phlegm, and softening hardness to scatter nodules. In the formula, Xuanshen nourishes yin and lowers fire, cools blood and disperses stasis, and its bitter-salty nature dissipates scrofula; Beimu resolves phlegm and reduces swelling, and loosens stagnation to scatter nodules; Muli is salty-cold, nourishes yin and subdues yang, softens hardness and dissipates scrofula. Used together, they can dissipate early scrofula; they can also be applied to long-standing cases that have ulcerated.

The Republican-era physician Zhang Xichun further expanded this formula to:

Muli (Oyster) 10 liang, Sheng Huangqi (raw Astragalus) 4 liang, Sanleng (Sparganium) 2 liang, Ezhu (Curcuma) 2 liang, Zhuxuejie (cinnabar-processed Dragon's Blood) 1 liang, Shengruxiang (raw Olibanum) 1 liang, Shengmoyao (raw Myrrh) 1 liang, Longdancao (Gentiana) 2 liang, Xuanshen (Scrophularia) 3 liang, Zhebeimu (Zhejiang Fritillary) 2 liang. Grind these ten herbs into fine powder, make honey pills the size of a paulownia seed. Take 3 qian each time, washed down with a decoction of 5 qian of Haidai (Kombu), washed and shredded; take twice a day.

When I myself use Xiaoluo Wan for cancer patients with heat and yang patterns, I like to extend it further into the following pair-based set: Xuanshen, Zhebeimu, Shengmuli, Haizao (Sargassum), Kunbu (Ecklonia), Haifushi (Pumice), Walengzi (Corbula shell), Sanleng, Ezhu, Ruxiang (Olibanum), Moyao (Myrrh), Xuejie (Dragon's Blood), Baizhi (Angelica dahurica), Chuanshanjia (Pangolin scales), Zaojiaoci (Gleditsia thorns), Lufengfang (wasp nest), Danshen (Salvia), Fuling (Poria), Tubiechong (Eupolyphaga), Taoren (Peach kernel), Dahuang (Rheum). I combine this with Xiaxia Yuxue Tang (Lower-Stasis Blood-Purging Decoction) as my standard pair-set for heat- and excess-pattern tumor patients, assisted by appropriate vital-qi-supporting herbs. If the patient is a cold pattern, I remove Xuanshen, Zhebeimu, Shengmuli, and the like, and substitute Chenpi (tangerine peel), Fabanxia (processed Pinellia), Zhinanxing (processed Arisaema).

In choosing supporting herbs, I used to favor cold-cooling drugs; now I like to combine cold and heat, following the idea of Yinyang Jiji Wan (Yin-Yang Attack-Accumulation Pill), balancing yin, yang, cold, and heat. Because when attacking accumulation the purgatives chosen are mostly bitter-cold and easily damage the spleen-stomach and consume healthy qi; using only cold-cooling drugs leads to damaged spleen-stomach, loose stools, weight loss, and anxiety. So now, when attacking accumulation, I always support yang as well—spleen yang, kidney yang, and heart yang all together.

After seeing cancer treated by famous physicians of many schools, I gradually realized that pattern-differentiation treatment of cancer is a dead end; at most it brings brief constitutional improvement and ultimately cannot save the patient. In particular, some famous professors irresponsibly tout on TV and in print the fallacy that TCM can, by improving the patient's constitution, make cancer cells "return to the right path." Such TCM doctors' actual results are mediocre, yet their consultation fees and herb costs are exorbitant, and they delay the patient's best treatment window—truly harmful.

In cancer treatment: if there is a tumor, attack the tumor; if there is no tumor, attack the cancer toxin. At every moment one must not forget to attack. The modified Xiaoluo Wan I commonly use contains not a single tonic; it is purely tumor-attacking. In actual use, it must always be assisted by appropriate vital-qi-supporting herbs chosen according to the patient's constitution, with some lean.

But this lean should not be an obsessive adherence to yin or yang pattern: regardless of yin or yang, yin-herbs and yang-herbs must both be used. While nourishing yin do not forget to support yang; while supporting yang do not forget to nourish yin—there should only be a lean according to the patient's specific condition. Otherwise excessive yin-nourishment obstructs the distribution of yang qi, and excessive yang-supporting risks drying up yin fluids.

This is exactly the Ming physician Li Zhongzi's intention in creating the Xinyin Yinyang Gongji Wan (newly made yin-yang attack-accumulation pill), and the intention of Zhang Jingyue, who advocated that "yang is always insufficient, yin is not excessive"—balancing yin and yang, with yin and yang generating each other. Cancer patients, after long illness, are deficient in both yin and yang; whether yin-deficient or yang-deficient is only a matter of degree, not of kind.

This therapeutic idea has played a large role in shrinking tumors. Even so, it is not enough to withstand the rampant advance of the cancer. I believe TCM cancer treatment must go further—using poison to attack poison, moderately employing harshly toxic Chinese herbs to kill the patient's cancer cells. When using the poison-to-attack-poison method, one must closely watch the patient's urination and defecation; if either shows signs of obstruction, immediately pause or reduce the attack.

Cancer treatment should be mainly disease-differentiation treatment, secondarily pattern-differentiation treatment. Disease-differentiation treats the root; pattern differentiation treats the branch. Do not listen to the so-called TCM masters who claim pattern differentiation treats the root; that is empty talk of no practical value. If disease-differentiation treatment is done properly, even if pattern differentiation is wrong, a cancer patient may still be cured.

So Western surgery, radiotherapy, and chemotherapy are sometimes far less complicated than TCM makes them out to be, yet many cancer patients are cured by them. Is this disease-differentiation model of Western medicine—utterly unlike TCM pattern differentiation—not also treating the root?

For TCM disease-differentiation treatment of tangible tumors, I sum it up in eight characters: "detoxify and scatter nodules, reduce swelling and remove the tumor." Between two points the straight line is shortest. TCM cancer treatment should go straight for the tumor with the most direct means, and not detour around pattern differentiation. Once the patient's tumor shrinks or even disappears, regardless of whether remaining cancer cells can later be exterminated, the patient's survival is at least prolonged.

Certainly, if a TCM doctor is skilled enough to combine pattern differentiation with disease differentiation—correctly differentiating while shrinking the tumor and supporting the patient's constitution—he can without doubt improve the patient's condition and ensure that, while on the attacking regimen, the patient does not collapse under the assault and die before the tumor is gone.