Wang Xiru's Case: Using Ye's Stomach-Nourishing Decoction to Relieve Hiccups in Late-Stage Gastric Cancer
The veteran TCM physician Wang Xiru, former chief physician of internal medicine at the Chongqing Institute of Traditional Chinese Medicine, once treated a patient with late-stage gastric cancer suffering from persistent hiccups using Ye's Stomach-Nourishing Decoction (Ye's Yangwei Tang), an empirical formula of the Qing-dynasty master physician Ye Tianshi. The patient, unable to eat or drink because of vomiting, was diagnosed by Western medicine as having late-stage gastric cancer. Always frail, she could not tolerate surgery, radiotherapy, or chemotherapy, so she was transferred to the Chongqing Institute of TCM to request purely TCM treatment.
At the visit, the patient had frequent dry heaving and hiccups, a dry mouth with thirst for cold drinks, vomiting immediately after drinking, no bowel movement for several days, and a wasted physique. The tongue was red with cracks, lacking coating and moisture; the pulse was fine and rapid. Dr. Wang differentiated the pattern as stomach-yin depletion, and planned to treat with modified Ye's Stomach-Nourishing Decoction.
The first prescription was: white ginseng (bai ganshen) 30 g; Glehnia (bei shashen) 15 g; Ophiopogon (maidong) 30 g; Solomon's Seal (yuzhu) 15 g; hyacinth bean (biandou) 12 g; Licorice (gancao) 10 g; Trichosanthes root (tianhuafen) 15 g; Huai Shan yam (huaishanyao) 30 g; raw rice sprout (sheng guyya) 30 g; Mume (wumei) 8 g.
The herbs were decocted and taken as a tea, frequently in small amounts. After a week of continuous use, vomiting and hiccups stopped; she could take liquid and occasionally semi-liquid food, and had a bowel movement every 1–2 days. Since the formula was effective, it was not changed; at the follow-up, Dr. Wang made only slight adjustments and advised the patient to use tremella (yin'er) and mussel (dancai) stewed in duck soup as dietary therapy. After three months of treatment, the patient no longer vomited. Ultimately, however, she died from gastrointestinal bleeding.
Dr. Wang's case has merit. Following the principle of pattern differentiation and treatment, he used Ye's Stomach-Nourishing Decoction and ultimately stopped the patient's vomiting—an effect that was not easy to achieve, because from a modern-medicine perspective the vomiting was caused by pyloric obstruction; such hiccupping and vomiting are extremely hard to relieve without surgery.
But Dr. Wang's prescription also had shortcomings. Perhaps because he placed too much weight on medication safety, he essentially did not use antitumor drugs such as Xihuang Wan, Compound Cantharidin Capsules, or Sophora tablets. The decoction also lacked antitumor herbs, avoiding all toxic ones. The formula was safe, but it had no targeted treatment for the tumor; as a result, although symptoms were relieved, the tumor was not controlled. As the disease progressed, the patient ultimately died of gastric bleeding, with a survival of only three months.
Had Dr. Wang combined pattern-based treatment with disease-based treatment, or combined Chinese and Western medicine—using Chinese herbs together with chemotherapy—this patient's survival might have been extended considerably.