A Brief Introduction To The Medical Thought Of Wang Hongxu, Qing-Dong Master Of The Quansheng School Of External Medicine

Wang Hongxu (1669–1749), given name Weide, literary name Linwu Sanren and also Dingdingzi, was a native of Wu County, Jiangsu. His family had practiced medicine for generations; his great-grandfather Wang Ruogu was renowned as an ulcer physician and compiled Jingyan Yanfang (Proven Effective Formulas), treasured as a family heirloom. Wang Hongxu was a famous Qing-dynasty TCM surgeon and the author of Waike Zhengzhi Quansheng Ji (Quansheng Compendium on the Pattern and Treatment of External Conditions). The ancestral secret formulas he contributed—Xihuang Wan (today called Xihuang Wan, originally Xiniu Huang Wan) and Xiaojin Dan (now made as Xiaojin Wan and Xiaojin Capsules)—remain widely used anti-cancer patent medicines in clinical practice today. Yanghe Tang (Yang-Harmonizing Decoction) is also a famous anti-cancer formula.

The family's TCM external medicine had distinctive features. Wang founded a pattern-differentiation and treatment system based on yin and yang, emphasizing yin-yang differentiation of sores and ulcers; it was simple and practical, with outstanding efficacy. In treatment he advocated the principle that "dispersing is prized, and supporting/propping is feared." He boasted of having "treated illness for over forty years without a single error in medication," and wrote: "I reflected that treating carbuncles and ulcers according to channels has long been widespread throughout the land, but treating them separately by differentiating yin and yang is my school alone. I therefore lay out fully the ancestral secrets, my own clinical experience, and the formulas that cured the illness at the dose, along with refined methods of preparing minerals and herbs." He compiled these into a book, carved and published in the 5th year of the Kangxi reign (1740), titled Waike Zhengzhi Quansheng Ji, also known as Waike Quansheng Ji.

After Wang Hongxu's Quansheng Compendium was published, it was warmly welcomed by the medical community, especially in TCM external medicine, where its influence was enormous. It formed a school represented by Wang Hongxu's academic thought—the Quansheng ("Whole Life") School—which occupies an important place in the history of TCM external surgery.

Wang Hongxu held that carbuncle (yong) and deep ulcer (ju) arise through different mechanisms: yong is a yang, excess, heat syndrome, while ju is a yin deficiency, cold syndrome. He proposed differentiating them by the red and white colors of the tumor skin and treating them separately. A yong is red, a yang-excess condition in which qi and blood are hot and toxin congested; a white ju is a yin-deficiency condition in which qi and blood are cold and congealed. Their treatment principles are utterly different. Treating yong-toxin requires clearing heat and resolving toxin, while treating white ju requires "warming yang to free the interstices, and warmly supplementing qi and blood." The Yanghe Tang created by Wang Hongxu is the representative formula for treating yin-ju; it has excellent efficacy for early-stage breast cancer, osteosarcoma, vasculitis and lymphoma belonging to the yin pattern.

The Xihuang Wan (Xihuang Wan—because rhinoceros bezoar is no longer available, modern versions use cow bezoar instead of rhinoceros bezoar, hence the name was changed) created by him mainly treats breast cancer, inguinal bubo, scrofula, lung abscess and small-intestine abscess. In modern times it is commonly used for cancer, lymphadenitis and multiple abscesses.

The family's Xingxiao Wan is also a famous formula, but because it contains realgar and other arsenic compounds, modern pharmaceutical companies mostly no longer produce it, and Xingxiao Wan is no longer sold on the market. Xingxiao Wan's action is to invigorate blood and dissipate nodules, resolve toxin and dispel carbuncle; it treats all red, swollen carbuncles and toxins.

Another ancestral pill formula, Xiaojin Dan, resolves phlegm and dispels dampness, and removes stasis and unblocks the collaterals. It mainly treats wandering abscess (liuzhu), phlegm nodule, scrofula, breast cancer, inguinal bubo, and bone-deep ulcer. In modern times it is also commonly used for various cancers, especially gynecological cancers such as breast cancer.

Wang Hongxu's Yanghe Jie Ning Gao is a plaster formula applied externally to treat mammary hyperplasia and ruyan (breast cancer). Its medicinal philosophy fully embodies the family tradition of warming yang, dispersing nodules and dissipating cold to treat yin-ju. However, it is not much used in modern clinical practice and is hard to buy.

TCM external surgery has always had two major treatment methods: the dispersing method (xiao fa) and the supporting/propping method (tuo fa). Wang Hongxu favored the dispersing method, holding that the supporting method easily worsens the condition. He proposed that treating carbuncles and ulcers should "prize dispersing and fear supporting"; "even for wandering abscess, scrofula and evil nodules, if any have ulcerated, one still dares not support. For though supporting may heal the ulcerated part, what of new lesions that arise? Therefore dispersing is prized."

By the Qing dynasty, TCM external surgery already had surgical and other treatment methods, but Wang Hongxu opposed the abusive use of the knife and needle on patients, and was also strongly opposed to the then-current practice of externally applying sheng-jiang dan (升降丹) corrosive preparations to eat away tumors. Wang's attitude toward surgery seems somewhat out of place today, but his opposition to external corrosive tumor treatment is worth learning from. In 2012 I saw a penile cancer patient in Hangzhou who, after receiving external application of sheng-jiang dan and similar medicines from a TCM physician in Shanghai, developed ulceration at the site and several new tumors grew from the ulcer. Blood poured out incessantly day and night, and the ulcer would not heal; the sight was appalling, sheer hell on earth. Treating tumor patients with corrosive methods cannot root out the cancer; once an ulcer forms, neither Chinese nor Western medicine can do anything about it. This is a warning.

Wang Hongxu emphasized that the formulas in his book "all cure the illness the moment the medicine reaches it; do not add or subtract." However, according to Ma Peizhi, a famous late-Qing surgical physician, after the Quansheng School became influential, surgeons using Yanghe Tang found that patients with poor prognoses were everywhere—not at all the instant cures Wang claimed. Ma Peizhi's observation is probably accurate, so later generations had the warning that yang-pattern patients should not let Yanghe Tang "touch their lips."

Wang Hongxu's contribution to TCM cancer treatment is enormous; even today, many of the patent medicines we use to treat cancer are still made from Wang's ancestral secret formulas or are additions to them.