Professor Shen Yannan's Empirical Formula for Cervical Lymphoma: Xiahua Longbei Decoction
Professor Shen Yannan (1920-1992) was formerly a professor at Guangzhou University of Chinese Medicine. During his lifetime he treated many cancer patients and accumulated rich experience in treating cervical lymphoma. He combined Xiaoluo Wan (Scrofula-Dissolving Pill) from Cheng Zhongling's Yixue Xinwu (Medical Mind Awakening) of the Qing dynasty with Zengye Tang (Fluid-Engendering Decoction) from the great warm-disease physician Wu Jutong's Wenbing Tiaobian (Systematized Identification of Warm Diseases), and, based on his own clinical experience, made modifications and additions to form his own Xiahua Longbei Decoction for treating cervical lymphoma.
The formula is composed as follows: Xiakucao (Spica Prunellae) 15 g, Tianhuafen (Trichosanthes Root) 15 g, Shengdihuang (Raw Rehmannia) 15 g, Shengmuli (Raw Oyster Shell) 15 g, Xuanshen (Scrophularia) 9 g, Maidong (Ophiopogon) 9 g, Beimu (Fritillaria) 9 g, gecko (壁虎, Gekko) 2 pieces (eviscerated, dry-fried, ground into powder and swallowed). Decoct the above medicines with 3 bowls of water down to 1 bowl; take orally twice daily, one dose per day.
Modifications: if heat-toxin is exuberant, add Qingtiankui 9 g, Banzhilian (Scutellaria barbata), Baihuasheshecao (Oldenlandia), and Qiyeyizhihua (Paris polyphylla) each 30 g; if yin damage is severe, add Beishashen (Glehnia) 15 g, Baishao (White Peony) 12 g, Sheng Gancao (Raw Licorice) 6 g; if accompanied by qi deficiency presenting as dual deficiency of qi and yin, add Sheng Huangqi (Raw Astragalus) and Dangshen (Codonopsis) each 15 g; if the mass is large and very hard, add Sanleng (Sparganium) and Ezhu (Curcuma) each 9 g.
Professor Shen used this formula to treat cervical lymphoma with frequent success: patients' symptoms eased, tumors shrank, and some even disappeared.
This formula can also be regarded as an extension of Zhang Xichun's Jiawei Xiaoluo Wan (Modified Scrofula-Dissolving Pill). Xiaoluo Wan is a classic Chinese medicine formula for sores and abscess-type diseases, composed of Xuanshen (Scrophularia), Beimu (Fritillaria), and Shengmuli (Raw Oyster Shell); it cools blood, reduces swelling, softens hardness, and disperses nodules. Zhang Xichun added Sanleng and Ezhu to this formula to strengthen its hardness-softening and nodule-dispersing action. This line of formula construction has a certain effect in treating cancer; the empirical formulas of many contemporary famous TCM oncologists are derived from it.
Modern pharmacological research has confirmed that Tianhuafen, Xiakucao, Banzhilian, Baihuasheshecao, Qiyeyizhihua, Qingtiankui, and gecko all possess certain anticancer effects. Thus Professor Shen's formula further developed the approaches of Cheng Zhongling and Zhang Xichun. His composition integrates the findings of contemporary Chinese materia medica research; it is a formula combining pattern differentiation and treatment with disease differentiation and treatment.
Cervical lymphoma was called "shirong" (withered flesh, or scrofula) in ancient times. This disease may be primary lymphoma, or it may represent cervical lymphatic metastasis from other cancers; physicians through the ages have recorded it as very difficult to treat. Chen Shigong of the Ming dynasty described it in Waike Zhengzong (Orthodox External Medicine) as follows: "At first it is slightly swollen, the skin color unchanged; over time it gradually enlarges, hard as stone, immovable when pushed, unmoving when pressed." It cannot be moved because the cervical lymph nodes have adhered to the surrounding tissues; benign lymph-node enlargement, by contrast, has a regular shape and is movable.
Chen Shigong stated frankly: "Those who contract this all die"—meaning that at the time it was a terminal, fatal disease. Contemporary TCM has in fact made considerable progress over ancient TCM in treating this disease. Drawing on knowledge from modern medicine and pharmacology, contemporary TCM has improved its approach to formulating for lymphoma and can now save some patients. Professor Shen's formula precisely embodies the progress of contemporary TCM in treating lymphoma.