Tongyou Decoction for Gastric and Esophageal Cancer
Tongyou Tang is a classic formula by the Jin-Yuan physician Li Dongyuan. It moistens dryness and unblocks obstruction, nourishes yin and blood, resolves stasis and breaks concretions. It is indicated for gastrointestinal dryness-heat with damaged yin fluids and failure of downbearing, presenting as dysphagia, constipation, and distention. Li used it for spleen-stomach heat, blocked pylorus with upward rushing, failure of the cardia to open, choking, qi that cannot pass up or down, and difficult defecation. These symptoms resemble those of chronic gastritis, esophageal cancer, gastric cancer, reflux esophagitis, and habitual constipation in modern medicine; today it is mainly used for such diseases with the pattern of static blood blocking the pylorus and blood dryness failing to moisten.
Tongyou Tang consists of Taoren (peach kernel), Honghua (safflower), Shengdihuang (raw Rehmannia), Shudihuang (processed Rehmannia), Dangguishen (Angelica body), Heshouwu (Fo-ti), Gouteng (Uncaria), Shuizhi (leech), Tianma (Gastrodia), and Zhi Gancao (honey-fried licorice). Modern use is as a decoction; typical adult dose: Shengdihuang 20 g, Shudihuang 20 g, Danggui 20 g, Heshouwu 30 g, Taoren 15 g, Honghua 15 g, Gouteng 15 g, Shuizhi 10 g, Tianma 10 g, Zhi Gancao 3 g, decocted in water, taken twice daily.
In the formula, Taoren, Honghua, Shuizhi, and Danggui activate blood and resolve stasis; Shengdihuang, Shudihuang, Heshouwu, and Danggui nourish yin and blood; Shengma (Cimicifuga) clears heat, resolves toxin, and lifts yang to raise the fallen; Gouteng pacifies the liver and extinguishes wind; Zhi Gancao fortifies the spleen and harmonizes the other herbs; Taoren, Shengdihuang, Shudihuang, Danggui, and Heshouwu all moisten the intestines and unblock the stool.
Together, the herbs benefit patients with digestive disease presenting as pain in the chest and diaphragm, inability to swallow food followed by vomiting, even difficulty swallowing water, hard pellet-like stools, vomit like red-bean juice, emaciation, withered skin, a red or purple-blue tongue, and a wiry, fine, rough pulse. These symptoms are typical of gastritis and reflux esophagitis at an advanced stage and of gastric and esophageal cancer.
If the tongue coating is thick and greasy, add Chenpi (tangerine peel) and Fabanxia (processed Pinellia) to dry dampness and transform phlegm; for qi deficiency, add raw Huangqi (Astragalus) to supplement qi; for frequent hiccup, add Daizheshi (hematite) and Xuanfuhua (inula) to downbear counterflow and stop hiccup; for severe epigastric pain, combine with Danshen Yin or Shixiao San. For gastric and esophageal cancer, folk remedies such as white goose blood may be used concurrently, plus anticancer herbs such as Sanleng (Sparganium), Ezhu (Curcuma), Ruxiang (frankincense), Moyao (myrrh), Shandougen (Sophora tonkinensis), Banzhilian, and Baihua Sheshengcao.
This formula strongly activates blood and resolves stasis, so it should be used cautiously in the frail, the elderly, and those with bleeding tendency. Modern pharmacology confirms it lowers blood viscosity, inhibits red-cell aggregation, anticoagulates, and promotes fibrinolysis—effects similar to many anti-angiogenic targeted anticancer drugs.