The Anti-Cancer Herb Xuanshen (Scrophularia): Clearing Heat and Cooling Blood, Nourishing Yin and Downbearing Fire, Resolving Toxins and Dissipating Nodules

Xuanshen is the dried root of Scrophularia ningpoensis (Scrophulariaceae), produced mainly in Zhejiang. It is sweet, bitter and salty in taste and slightly cold in nature, entering the lung, stomach and kidney meridians. Its functions are to clear heat and cool blood, nourish yin and downbear fire, and resolve toxins and dissipate nodules. It Indicates warm-disease heat entering the ying and blood levels, feverish body, vexed thirst, crimson tongue, eruption of macules, vomiting of blood and nosebleed, steaming-bone consumption cough, vacuity vexation and insomnia, fluid-injury constipation, dry, dim eyes, swelling and pain of the throat, scrofula and phlegm nodules, and welling-abscess and sores. Xuanshen is a bitter-cold herb; it may cause loose stools and diarrhea, so patients with spleen deficiency and loose stool, or with excessive dampness, are forbidden to take it.

Xuanshen is one of the most commonly used herbs in oncology. The famous anti-cancer formula Xiaoluo Wan uses xuanshen; the yin-nourishing, fluid-enriching Zengye Tang uses xuanshen; the heat-clearing, blood-cooling Qingying Tang uses xuanshen; and the macule-resolving Huaiban Tang also uses xuanshen. These are all commonly used oncology formulas. Xiaoluo Wan in particular is a famous formula for dissipating swelling and nodules; physicians through the ages have continuously modified it, until it became a renowned anti-cancer formula.

Although modern pharmacological research has not credited xuanshen with an anti-tumor action, the symptoms common among tumor patients—fever, constipation, dry mouth, red swelling and pain, hematemesis, epistaxis, irritability—all require xuanshen-centered formulas to resolve. For example, constipation in advanced cancer patients responds well to modified Zengye Tang (xuanshen, maidong, shengdi, baishao, danggui, roucongrong, huomaren, etc.); cancer fever, dry mouth, night sweats and purpura due to yin deficiency with internal heat in leukemia or lymphoma patients also require xuanshen-containing Qingying Tang (water buffalo horn, shengdi, jinyinhua, lianqiao, xuanshen, huanglian, bamboo leaf heart, danshen, maidong, etc.); Xiaoluo Wan (xuanshen, beimu, muli) modified with haizao, kunbu, xiakucao, banzhilian, baihuasheshecao, xianhecao, shijianchuan, etc., has become a mainstay of contemporary anti-cancer formulas.

Thus xuanshen is one of the herbs every oncology TCM physician must know; we must be familiar with its indications and contraindications and use it accurately in clinical practice.

Xuanshen clears heat and cools blood, and dissipates swelling and nodules. Modern pharmacological research confirms that xuanshen reduces fever and has antibacterial action, increases coronary blood flow, and lowers blood glucose and blood pressure. Traditional TCM mostly uses xuanshen for warm-disease heat entering the ying-blood level, for yin deficiency with fire effulgence, and for scrofula, phlegm nodules and welling-abscesses due to heat-toxin.

Using xuanshen to treat heat entering the ying-blood level, combine it with shengdi, mudanpi, jinyinhua and lianqiao; combining xuanshen with shigao, zhimu and shengdi clears both qi-level and blood-level heat at once. If heat-toxin congests the blood level and causes macules (purpura on the skin), xuanshen may be combined with shengma, daqingye, huaihua, baiwei and fuping. These symptoms are commonly seen in patients with hematological and lymphatic tumors.

The scrofula and phlegm nodules recorded in TCM classics are also often associated with lymphoma or lymph-node enlargement. The very name Xiaoluo Wan indicates its function of eliminating “scrofula”—a visible, surface lymph-node enlargement, whether inflammatory or cancerous. Xiaoluo Wan heavily uses xuanshen, paired with beimu and muli, which dissipate phlegm and scatter nodules; the three together indeed have good blood-cooling, swelling-dissolving and anti-cancer effects. If one further adds xiakucao, haizao, kunbu, huangyaozi, shancigu, banzhilian, banbianlian, baihuasheshecao, shijianchuan, xianhecao, pugongying, diding, yejuhua, sanleng and ezhu to form a large compound, with appropriate supplementation with zhengqi-supporting herbs such as dangshen, huangjing and yuzhu, the result will be very effective for benign and malignant tumors of the heat-toxin-bounding type. Patients of means may also pair it with equally heat-clearing, toxin-resolving, swelling-dissolving costly herbs such as Xihuang Wan and Liushen Wan.

In advanced cancer patients, tumor consumption depletes body fluids, producing dry mouth and constipation; Zengye Tang or Zengye Chengqi Tang work well. I have my own empirical formula: xuanshen 30 g, shengdi 24 g, maidong 24 g, danggui 12 g, baishao 12 g, muxiang 12 g, huomaren 15–30 g, roucongrong 15–30 g; for severe constipation, add mangxiao 10–30 g and sheng dahuang 3–30 g. This formula has some efficacy for dry mouth, constipation and abdominal pain of various causes in advanced cancer patients.