Treating Tumors as Yang-Fire and Yin-Poison: An Exploration of TCM Thought

The thought of yang-fire and yin-poison originated with Zhang Jingyue of the Ming dynasty and matured under Wang Weide of the Qing dynasty. This school held that the yang pattern of tumors is caused by fire, while the yin pattern is caused by poison; therefore yang patterns are treated chiefly by clearing heat, and yin patterns chiefly by warming yang to dissolve the mass. As for half-yin-half-yang patterns, they must be treated by a method of moderation. In reality, tumors presenting as yang patterns are uncommon; most belong to yin patterns or half-yin-half-yang patterns.

The Nan Jing, in the 55th difficult issue, discusses ji-ju (the various benign and malignant abdominal tumors or inflammatory lesions of today) as follows: “The accumulation of qi is called ji; the gathering of qi is called ju. Thus ji is engendered by the five zang, and ju is produced by the six fu. Ji belongs to yin qi: its onset has a fixed location, its pain does not leave its region, it has ends and beginnings above and below, and bounds on the left and right. Ju belongs to yang qi: its onset has no root, it stays nowhere above or below, and its pain has no fixed place; this is called ju.” In fact, ju here does not belong to neoplastic disease; only ji counts as neoplastic, because the pain of ji is fixed, which matches the characteristic of abdominal tumors causing fixed, unchanging pain. The pain of ju has no fixed location, resembling wandering neuralgia. The ancients considered ji a disease of yin qi, and therefore treated it chiefly as a yin pattern.

Later, Zhang Jingyue, in his work Waike Qian, differentiated the causes of tumors according to yin and yang. Wang Hongxu inherited this thought and further refined the yin-yang differentiation of tumors. He opposed the Shanghan school's channel-following approach, emphasized differentiation of yin/yang and deficiency/excess, and for yin-pattern patients invariably used Mahuang (Ephedrae Herba), Paojiang (Zingiberis Rhizoma Praeparatum), and Rougui (Cinnamomi Cortex) as the chief herbs, modifying them according to the patient's condition—with outstanding results. Wang Hongxu's understanding of tumor pathogenesis was profound, and his clinical experience was rich; hence he held that dispersion should be prized and support/drainage feared.

Through many years of clinical exploration, I believe that in TCM external medicine's understanding of tumor causation, yin/yang and deficiency/excess are the primary considerations; all the so-called six-channel symptoms are minor, secondary contradictions. The real principal contradiction lies in the patient's imbalance of yin and yang, with righteous qi deficient and evil qi excess, requiring support of the righteous and expulsion of evil, and regulation of yin and yang. Moreover, among tumor patients, most present yin patterns or half-yin-half-yang patterns; the currently widespread TCM approach of clearing heat and detoxifying is quite unsuitable for treating tumors. This clearing-heat-and-detoxifying idea is based only on modern pharmacology and anti-cancer trials in animals; its clinical efficacy is deeply disappointing and cannot resolve the root problems of tumor patients. I myself chiefly use Yanghe Tang, which has remarkable effects on yin patterns, and Zhonghe Tang, which addresses half-yin-half-yang patterns; treatment usually works very rapidly.

Seeking tumor causation within the six channels usually fails to reach the root; but seeking the cause through the patient's imbalance of yin/yang and deficiency/excess usually reveals the fundamental reason. TCM stresses that in treating disease one must seek the root. Treating tumors according to six-channel pattern differentiation is treating the branch, not the root; treating tumors according to yin/yang and deficiency/excess is treating the root. This method may not attend to every concomitant symptom and complication, but it can dissolve the tumor from its root—somewhat similar to hyperthermia in modern medicine. Yet it is superior to hyperthermia, because modern hyperthermia is limited to local heating of the tumor, whereas TCM regulation of yin and yang is whole-body. In fact, once a tumor arises, cancer cells exist throughout the patient's body; mere local hyperthermia is of no avail and only solves a temporary problem.

Regulating yin and yang is the root method; on this basis, combining it with some branch methods targeting the tumor to attack the established mass holds out hope of curing the patient's tumor.