Appreciating Xiong Kuowu's Combined Internal and External Treatment of Thyroid Cancer

Professor Xiong Kuowu was a native of Tongcheng, Hubei. Born in 1919, he was a disciple of Xie Renzai, a famous physician of the Republican era. Professor Xiong once served as director of the Internal Medicine Teaching and Research Office of Hubei TCM College (now Hubei University of Chinese Medicine) and authored Zhongyi Rebing Lun; he had outstanding achievements in febrile diseases, acute diseases, and difficult, complicated diseases.

On September 20, 1977, Professor Xiong saw a patient with a yingliu (thyroid papilloma). This patient had undergone surgical resection for thyroid papilloma in November 1970; in 1978 thyroid papillary carcinoma was again found, and in August of the same year she underwent two operations: total right thyroidectomy, partial left thyroidectomy, and right cervical lymph node dissection. Postoperative pathology of the resected tissue confirmed thyroid papillary adenocarcinoma with cervical lymph-node metastasis. Because the operative area was large, she developed severe hoarseness, with the neck extremely swollen and hard, and impaired function. Given the patient's extremely weak constitution, the attending Western physicians dared not treat her and suggested TCM; she then came to Professor Xiong.

Examination found the patient's neck swollen to the point she could not turn it, emotionally unstable, irritable, and heavily burdened; her face was gaunt and her body thin; she felt occasional palpitations; her voice was hoarse and weak; the surgical scar was hard and tender to touch. The tongue was red with little moisture, coating thin yellow, and the pulse weak. Note that emotionally unstable people often have thyroid problems, especially women, and should pay attention to this ordinarily.

Professor Xiong planned to treat with combined internal and external therapy.

Internal prescription: Mudanpi (Moutan Cortex) 9 g, Zhizi (Gardeniae Fructus) 6 g, Chaihu (Bupleuri Radix) 9 g, Beimu (Fritillariae Bulbus) 12 g (ground powder, infused), Danggui (Angelicae Sinensis Radix) 12 g, Baishao (Paeoniae Radix Alba) 12 g, Xuanshen (Scrophulariae Radix) 15 g, Muli (Ostrea Concha) 15 g, Xiakucao (Prunellae Spica) 15 g, Haizao (Sargassum) 15 g, Kunbu (Eckloniae Thallus) 15 g, Ruxiang (Olibanum) 9 g, Moyao (Myrrha) 9 g, Banzhilian (Scutellariae Barbatae Herba) 30 g, Baihuasheshecao (Hedyotidis Diffusae Herba) 30 g.

External prescription: Honghua (Carthami Flos) 6 g, Taoren (Persicae Semen) 15 g, Dahuang (Rhei Radix et Rhizoma) 30 g, Tianhuafen (Trichosantinis Radix) 18 g, Ruxiang (Olibanum) 12 g, Moyao (Myrrha) 12 g, Huangqin (Scutellariae Radix) 12 g, Zhizi (Gardeniae Fructus) 15 g, Jianghuang (Curcumae Longae Rhizoma) 26 g, Zhangnao (Camphora) 12 g, Sanqi (Notoginseng Radix) 6 g. Grind all the above together into powder, mix with equal parts wine and vinegar, and apply to the affected area.

The patient followed this plan, taking one internal dose and applying one external dose daily. After 50 consecutive doses, her spirit improved, her emotions stabilized, her appetite normalized, her strength steadily recovered, and the wound swelling subsided, though her voice remained hoarse. The internal formula was unchanged; in the external formula, Jianghuang was removed, Mudanpi added, and Tianhuafen increased to 24 g. She was also told daily to drink a pulp made from half a jin of black beans, continued for one month. After over 70 days of such consolidating treatment, the medication was stopped for observation. Half a year later, re-examination at five Beijing hospitals showed the thyroid cancer had disappeared and not recurred; her spirit was good and the prognosis favorable.

The distinctive feature of Professor Xiong's method was using both internal and external medication simultaneously. The internal formula mainly clears heat and resolves toxin, resolves phlegm and scatters nodules, cools blood and disperses swelling, and activates blood and resolves stasis. In the formula, Mudanpi, Zhizi, and Xuanshen cool blood and disperse swelling; Chaihu soothes the liver and scatters nodules; Danggui and Baishao supplement and invigorate blood; Xiakucao disperses swelling and nodules; Haizao, Kunbu, and Beimu resolve phlegm and scatter nodules; Ruxiang and Moyao activate blood and disperse swelling; Banzhilian and Baihuasheshecao clear heat, resolve toxin, and fight cancer. Combined, these herbs jointly exert an anti-cancer, swelling-dispersing action.

The external formula emphasized activating blood and dispersing swelling, and clearing heat and dispersing swelling. Honghua, Taoren, Dahuang, Ruxiang, Moyao, Jianghuang, and Sanqi are all blood-activating, swelling-dispersing herbs; Tianhuafen, Huangqin, Zhizi, and Zhangnao all clear heat, resolve toxin, and disperse swelling and nodules. Administered transdermally, these herbs reach the cancer directly without passing through hepatic metabolism, so they act more quickly.

Professor Xiong's method reflects a major feature of traditional TCM: for sores, abscesses, and carbuncles, traditional TCM usually used combined internal and external treatment; only gradually has modern TCM stopped doing so, mostly using internal medication alone. For superficially palpable cancer, this amounts to losing a more direct therapeutic means.

Therefore this case is well worth learning from; even the formulas in the case can be used directly. Thyroid cancer has a relatively good prognosis; patients generally survive a long time and the disease progresses slowly, giving TCM treatment enough time, which is one factor behind the success of Professor Xiong's cases.