Wu Ye San: A Formula for Relieving Pyloric Obstruction Caused by Esophageal or Cardiac Cancer

Wu Ye San (“Five-Block Powder”) comes from Jisheng Fang (in the Jingyue Quanshu it is also called Wu Ge San, “Five-Diaphragm Powder”). It treats “five types of Ye (dysphagia): food that will not go down, vomiting and reverse flow with profuse phlegm, obstruction in the throat, and fullness and pain in the chest and back.” This disease resembles modern pyloric obstruction, mostly caused by esophagitis, cardiac cancer or esophageal cancer.

Wu Ye San is composed of: Renshen (Ginseng), Banxia (Pinellia, soaked seven times in boiling water), Jiegeng (Platycodon, rootlets removed, filed and stir-fried), Baidoukouren (White Cardamom kernel), Muxiang (Aucklandia, not fired), Mipikang (rice bran), Baizhu (Atractylodes), Bichengqie (Litsea cubeba), Chenxiang (Aquilaria, not fired), Pipaye (Loquat leaf, wiped free of hairs), Ganjiang (Dried Ginger) — each one liang (30 g); and Gancao (Honey-fried Licorice) five qian (15 g). Preparation: grind all the above into a fine powder. Each dose: take 2 qian (6 g), boil with one zhan (about 300 ml) of water down to six-tenths (180 ml), and take warm after meals, twice daily.

Wu Ye San is named “Five-Block Powder” or “Five-Diaphragm Powder” because it treats the TCM disease of Ye-Ge (dysphagia and diaphragmatic obstruction). Its main symptoms are obstruction to swallowing food, immediate vomiting after eating, or vomiting in the evening of food eaten in the morning, or vomiting in the morning of food eaten in the evening. Ye and Ge differ in severity: Ye is a sticking, unsmooth sensation during swallowing, food going down with difficulty; Ge is blockage in the chest-diaphragm, food being vomited as soon as it is swallowed. Ye is milder than Ge; in the early stage there is often only Ye without Ge. Ge develops from Ye, and clinically the two are usually referred to together as Ye-Ge. In modern medicine, esophagitis, esophageal stricture, esophageal ulcer, esophageal cancer, cardiac cancer and cardiac spasm all fall within this category.

Wu Ye San warms the middle and transforms phlegm, descends reverse flow and harmonizes the stomach. TCM holds that Ye-Ge mostly results from qi stagnation and blood stasis with congealed cold-phlegm. The formula therefore uses many middle-warming herbs (Litsea, Dried Ginger, etc.), qi-regulating herbs (Platycodon, White Cardamom, Aucklandia, Aquilaria, Loquat leaf, etc.) and spleen-strengthening, phlegm-transforming herbs (Pinellia, Atractylodes, rice bran, etc.); combined, these exert the effect of warming the middle, transforming phlegm and descending reverse flow.

This formula can relieve the symptoms of Ye-Ge. In cardiac or esophageal cancer, although the formula can reduce the patient’s clinical symptoms and improve quality of life, such relief lasts only a relatively short time, and the effect is not significant in severe cases. For most patients with cardiac or esophageal cancer, the formula provides only symptomatic supportive treatment and is difficult to control tumor progression. Therefore, while using this formula, it should be combined with other anti-cancer treatments in a multidisciplinary effort to jointly suppress tumor progression.