A TCM External Surgery Formula: Xiong Fan Powder (Realgar-Alum Powder)
A powder made mainly from realgar (xionghuang) and dried alum (ku fan) (or white alum, mingfan), ground together with other herbs for external application, is generally named Xiong Fan Powder (Realgar-Alum Powder).
There are many formulas named Xiong Fan Powder; the main active ingredients are realgar and dried alum or white alum. Realgar is an arsenic sulfide, chemical formula As₄S₄; alum is a sulfate, chemical formula KAl(SO₄)₂·12H₂O; dried alum is the product obtained by heating alum. The greatest effect of combining realgar and alum is to reduce swelling and stop pain, remove putrid flesh and generate new tissue.
Xiong Fan Powder is a commonly used formula in TCM external medicine. It can be used to treat various benign and malignant tumors, and also to treat infectious diseases.
Realgar has a marked anticancer effect against leukemia and other cancers, and also good antimicrobial activity. Traditional TCM holds that realgar resolves toxicity and kills parasites, dries dampness and expels phlegm, and stops malaria; it is used for welling-abscesses and boils, snake and insect bites, abdominal pain from parasite accumulation, convulsions and epilepsy, and malaria. Classic TCM formulas for unnamed swelling toxins, such as Liushen Pills, Meihua Dianshe Dan and Xingxiao Pills, all use realgar.
Alum (or dried alum) has astringent, antidiarrheal, hemostatic, analgesic, expectorant, dampness-drying and antipruritic, antibacterial and anti-inflammatory effects; it is a commonly used external medicine in TCM dermatology. Alum was once used as a food-leavening agent in steamed buns, fried dough sticks and other foods, but because it has toxic side effects, legislation in China banned it as a food additive.
Xiong Fan Powder can treat many diseases. Wang Xingtang, Song Qing and others reported treating 10 cases of nape carbuncle (naoju) at the Zhuanghe TCM Hospital in Dalian with a self-made Xiong Fan Powder (realgar 15 g, dried alum 10 g, lead oxide/dan 5 g, silver 5 g, ground together into fine powder, mixed with an appropriate amount of petrolatum into an ointment applied to the affected area, changed every 2 days); all 10 cases were cured. Nape carbuncle is a surgical disease caused by acute purulent infection of several adjacent hair follicles and sebaceous glands; it looks like a tumor but is not one.
The Feng's Jin Nang Milu records another Xiong Fan Powder formula: one liang realgar, two liang white alum, five qian licorice, decocted in water; first fumigate, then wash. It treats "yin swelling" (a gynecological condition of painful, swollen vagina caused by infection), and is said to be divinely effective.
The Xiong Fan Powder in the Yang's Jia Cang Fang uses "white alum (ground separately), realgar (ground separately), frankincense (ruxiang, ground separately), Chinese gall powder (wubeizi), and cosmetic powder (ni fen, ground separately), in equal parts; ground into a fine powder. Each time, sprinkle according to the size of the sore mouth. Blood stops immediately, and the sore need not be bandaged; it dries and heals without pain." Here too it is used to treat surgical sores and ulcers.
The Xiong Fan Powder in the Pu Ji Fang combines realgar and alum stone into a powder to treat sores, ulcers, swellings and toxins, and snake and insect bites. In contemporary practice, Xiong Fan Powder is also used to treat herpes zoster, with good results. There are also powders of realgar, alum stone, blister beetle (banmao) and Ampelopsis (baiji) ground together and applied externally to treat surface tumors.
Whether alum, white alum or dried alum, all have some irritating effect on the skin. I once made an external analgesic for cancer pain from dried alum, borax and borneol; some patients got good pain relief after use, though the skin was somewhat irritated. I advise patients, after use, to protect the skin with some skin-care product (such as Vaseline or Dabao), which can reduce this kind of skin irritation.
Used appropriately, Xiong Fan Powder has a definite therapeutic effect: it can achieve a cure for infectious diseases and can also exert some control over malignant tumors.