Empirical Tincture Formulas for Cancer Pain
A tincture is an external preparation made with alcohol or wine; its processing is similar to medicinal wine but different from it, because tinctures are for external use only and must not be taken orally. Many Chinese medicines are soluble in ethanol (the main component of alcohol or wine) but insoluble in water, so water cannot extract their active constituents; making them into a tincture allows their therapeutic effect to be fully exerted.
For example, the commonly used analgesic Bingpian (Borneol) has a solubility in water that is negligible, yet it dissolves in alcohol. Making such herbs into tinctures gives them greater clinical value. Ancient Chinese physicians already discovered this property, so the use of tinctures did not begin in modern times but has existed since antiquity.
This article introduces several tinctures for relieving cancerous pain, for readers' reference.
Formula 1: Shabing Ezhu Ding (Cinnabar-Borneol-Zedoaria Tincture, from Chinese Journal of Integrated Liver Disease, 1994, 4)
Formula: Zhusha (Cinnabar), Ruxiang (Olibanum), Moyao (Myrrh), Danggui (Angelica sinensis), Dilong (earthworm), Taoren (Peach kernel), Honghua (Carthamus), Muxiang (Aucklandia), Danshen (Salvia), and Yuanhu (Corydalis), 15 g each; Bingpian (Borneol) and Ezhu (Curcuma zedoaria), 30 g each. Crush the above herbs and steep them in 500 ml of rice wine to make the tincture; seal for 2 days before use. This formula has the actions of clearing heat and detoxifying, sedating and calming the spirit, activating blood and unblocking collaterals, and reducing swelling and relieving pain; it mainly treats cancerous pain of advanced primary liver cancer. When using, dip a cotton swab or gauze in a small amount of the liquid and gently apply it externally to the painful body surface over the tumor; once slightly dry, repeat the application 3-5 more times.
Zhusha (Cinnabar) in this formula is a mercury preparation. TCM holds that cinnabar has a sedating, spirit-calming effect; in reality, cinnabar paralyzes nerves through its neurotoxic effect to reduce pain. Cinnabar is quite toxic, and taking it orally is dangerous. Ruxiang, Moyao, Danggui, Dilong, Taoren, Honghua, Danshen and Ezhu all belong to blood-activating stasis-resolving herbs with a stasis-resolving analgesic effect. Yuanhu (Corydalis) is a commonly used analgesic in Chinese medicine; Corydalis belongs to the same botanical family as the opium poppy, but its analgesic effect is only about half that of opium, and it is not addictive. Bingpian (Borneol) clears heat and relieves pain; it takes effect very rapidly, essentially on use, but its duration is short, so borneol alone cannot provide lasting pain relief.
This formula combines the above herbs, using wine to extract their active constituents while also taking advantage of wine's easier penetration of epithelial tissue, making transdermal delivery more effective. As an external analgesic tincture, it can reduce pain and decrease the frequency of oral opioid use.
Formula 2: Aitongning (Cancer-Pain-Relaxing, from Journal of External Therapy of TCM, 1995, 4)
Formula: Sheng Dahuang (raw Rhubarb), Chuan Huangbo (Sichuan Phellodendron), Chuan Huanglian (Sichuan Coptis), Sumu (Sappanwood), Sanqi (Panax notoginseng), Xixin (Asarum), and Sheng Maqianzi (raw Strychnos), 20 g each; Bingpian (Borneol) 10 g. The above herbs need not be powdered; place them directly in 75% medical alcohol and steep for one week before use. When using, soak gauze in this preparation and apply as a wet compress to the painful area, once every 2-4 hours.
This formula has the actions of clearing heat and detoxifying, cooling blood and activating blood, removing stasis and promoting new tissue, and reducing swelling and relieving pain; it mainly treats various kinds of cancerous pain. When using, one may also load an appropriate amount into a small alcohol spray bottle and spray it directly on the painful area.
In this formula, Sheng Dahuang, Chuan Huangbo and Chuan Huanglian have broad-spectrum antibacterial and disinfectant effects; TCM says they clear heat and detoxify. Sumu is a blood-activating analgesic commonly used in orthopedics and traumatology. Xixin and Sheng Maqianzi warm yang, unblock the meridians and relieve pain; the action of Bingpian has already been described.
This herbal combination focuses on clearing heat and detoxifying and reducing swelling and relieving pain, so it has a certain therapeutic effect on tumor patients of the heat-toxin type.
Formula 3: Shifu-1 (Wet Compress No.1, from Liaoning Journal of Traditional Chinese Medicine, 1996, 23)
Formula: Banzhilian (Scutellaria barbata) and Qingpi (tangerine peel), 30 g each; Longkui (Solanum nigrum) 15 g; Banmao (Lytta/Mylabris) 6 g; Sanleng (Sparganium), Ezhu (Curcuma zedoaria), and Bingpian (Borneol), 12 g each. The above herbs need not be powdered; steep them directly in 60-proof baijiu (white liquor) and seal for 9 days before use. When using, first clean the skin of the painful area, soak gauze in this preparation, apply the gauze to the painful site, and then soak more gauze in the above liquid and apply it to the painful body surface.
This formula has the actions of moving qi and breaking blood stasis, resolving stasis and relieving pain, attacking and expelling cancer toxin, and dispersing nodules and reducing swelling; it mainly treats mild to moderate cancerous pain.
Banmao (Mylabris) in this formula is highly toxic and is now a State-Council-controlled drug, hard to obtain. Mylabris is strongly corrosive; externally it not only relieves pain but also fights cancer and shrinks tumors. Banzhilian and Longkui clear heat, detoxify and fight cancer; Sanleng, Ezhu and Qingpi activate blood and resolve stasis; Bingpian clears heat and relieves pain. Used together, they comprehensively relieve cancer pain. In the past, tinctures were mostly applied externally with gauze, but in recent years, with the popularization of alcohol spray bottles, tinctures can be sprayed directly onto the lesion surface, which may be even more effective.