The Application of Yanghe Decoction in Cancer Treatment
The five zang and six fu should be free-flowing; the exterior and interior, and the nutritive and defensive qi, should be harmonized. When zang-fu are free, there are no accumulations; when exterior-interior and nutritive-defensive are harmonized, phlegm-dampness is scant. Tangible cancer, in TCM view, mostly arises from phlegm-dampness and accumulations. At the root, it can be explained by when righteous qi is stored within, pathogen cannot invade: when the body's righteous qi is weak and metabolism dysregulated, external thief-pathogens easily invade and cause trouble; over time they accumulate into a tangible tumor.
Once a tumor forms, cold and heat intermingle, and phlegm-nodules gather and disperse not; as they grow larger they press on normal organs and become a fatal threat. The key to treating cancer therefore lies in resolving phlegm, dispersing nodules, and expelling the pathogen outward. I hold that the safest way to expel pathogen outward is the slight sweating method and the slight urination method. Slight sweating does not necessarily mean visible sweat; feeling the pores open or a faint moistness suffices. Slight urination does not necessarily mean dozens of times a day; a moderate increase in urine volume suffices. Over-discharge of body fluids is not beneficial; modern medicine has proven that dehydration causes endless later troubles. Powerful diaphoretics or purgatives may bring momentary relief but easily damage the righteous. Robust young adults may use them briefly, but chronic cancer patients or frail elderly are harmed by long use.
In Suwen's Liu Weizhi Dalun it is said: when there is excess, there is harm; what follows restrains it; with restraint there is generation and transformation. All diseases originally arise from excess—excess means going too far. The Qian hexagram of the Zhouyi warns: at the top line, the overbearing dragon has cause for regret. Everything has a measure; overshooting brings harm, and things at their extreme decline. To respond to the harm of excess, what follows must restrain it, so that generation and transformation may proceed.
Zhang Jingyue said: In the way of yin-yang and the five phases, when excess reaches its peak, disharmony arises, and strong and weak harm each other. Thus whenever there is preponderance, there must be deficiency; if the strong has nothing to restrain it, the strong grows stronger and the weaker weaker, and disorder daily worsens. Therefore when excess goes too far, it harms what it overcomes, and what follows beneath must in turn restrain it. The key to treating disease therefore lies in activating the body's own restraint mechanism and suppressing excessive excess.
Tumor disease arises from weakness of the body's righteous qi, disorder of discharging and spreading, and excess of phlegm-dampness; over time these gather into nodules. To treat it, one must begin by supporting the righteous and expelling pathogen, resolving phlegm and dispersing nodules, opening the couli (skin and interstices), and driving out pathogen. At the present stage, trying to defeat tumors with anti-cancer drugs can hardly achieve a root cure, because so far the world has not invented a truly efficient, long-acting anti-cancer drug. Perhaps future scientific progress will find better ones, but for now it is utterly unrealistic. The ancients said, within the body there originally is a great medicine; the body's own metabolism and immune system are that great medicine within us. After cancer strikes, actively seeking this great medicine within the body may offer the only chance of life.
Yanghe Tang comes from the Waike Zhengzhi Quansheng Ji of the Qing medical family Wang Weide (courtesy name Hongxu). It was the Wang family's ancestral secret formula for treating various yin nodules, shirong (what modern medicine calls lymphoma-like conditions), ruyan (modern breast cancer), bone-rot wind, and crane's-knee wind.
Wang Weide, pitying the suffering of the people and carrying out a great vow to deliver them, gave his family's whole series of secret formulas to the public. To this day, among both TCM hospital physicians and folk doctors, many still follow Wang Weide's Quansheng school approach. The various patent medicines he transmitted remain widely used in TCM external clinical practice.
Suwen's Wuchang Zheng Dalun says: when the harmonious yang breeze spreads its transformation, yin qi follows; the generating qi becomes rich, and the ten thousand things flourish. The yang-he qi arises in mid-spring, the season when all things are born and transformed. Hence Yanghe Tang carries the meaning of removing rot and generating the new, of vigorous flourishing.
Wang's Yanghe Tang is extremely simple, composed of seven herbs: Shudihuang (1 liang), Lujiaojiao (3 qian), Mahuang (5 fen), Rougui (1 qian, bark removed, ground), Jiangtan (ginger charcoal, 5 fen), Baijiezi (2 qian), and Sheng Gancao (1 qian). It is a formula that warms and supplements while resolving phlegm, dispersing nodules, ventilating the lung, and promoting urination. Shudihuang and Lujiaojiao supplement kidney yin and yang and generate blood; Mahuang and Baijiezi resolve phlegm and disperse nodules while inducing sweating to release the exterior; Rougui and Jiangtan warm the middle and scatter cold, and lead fire back to its origin; Sheng Gancao supplements qi, harmonizes the other herbs, and at the same time plays an important role in repairing mucous membranes (ancient materia medica mostly called licorice a flavor-correcting and harmonizing agent; modern scientific research has found licorice has a strong anti-ulcer effect. I believe licorice may not literally moderate the other herbs, but most strongly acting herbs greatly irritate the gastrointestinal mucosa; pairing them with licorice does protect the mucosa from ulceration.)
Yanghe Tang uses herbs in a balanced, central way: the exterior-releasing Mahuang and the warming herbs Jiangtan and Rougui are used in extremely small doses—as little as 1 qian, about 3.72 g today; 5 fen is half of 1 qian, about 1.86 g; 1 liang is about 37.2 g. Today many convert 1 liang to 30 g, which is wrong; I think converting 1 liang to 40 g, 1 qian to 4 g, and 5 fen to 2 g is more appropriate.
The clinical effect of Wang's Yanghe Tang is very clear. According to the records of physicians after Wang, using Yanghe Tang for yin nodules (i.e., tumors described in medical texts as unchanged in skin color, diffuse swelling without a head; if the tumor is already red, swollen, purulent, or ulcerated, it is a yang pattern, and past physicians warned that yang patterns should not touch the lips of Yanghe Tang—using it in yang patterns is very dangerous) gives ideal results. Hence Yanghe Tang is called the life-saving elixir for yin nodules and ranks among the eight great famous formulas of TCM. According to Wang Weide's own account, using Yanghe Tang together with Xiaojin Dan and Xihuang Wan to treat ruyan (today's breast cancer) had a cure rate of 30-40%; in fact the efficacy is not that high.
Modern clinicians have used Yanghe Tang to treat various cancers with marked effect, especially where cancer has metastasized to bone. In Shijin Maiyao (Shijin's Paired Herbs), compiled by disciples of the four great Beijing physicians of old, there is an herb pair of Shudihuang and Mahuang for phlegm nodules; this pair derives from Yanghe Tang.
Past physicians have all discussed the pairing features of Yanghe Tang. In my view, its main actions are: boosting qi, nourishing blood, invigorating yang, inducing slight sweating, promoting slight urination, dispersing nodules, and repairing mucosa.
Both Shudihuang and Lujiaojiao in Yanghe Tang have clear blood-nourishing effects, and cancer patients often show qi-blood deficiency. Because qi-blood deficiency lowers immunity, various digestive and discharging functions decline: some present gastric and abdominal fullness, some aversion to cold with no sweating, some difficult or unsatisfactory urination and defecation. Hence Wang Weide first prioritized blood nourishment for such patients. Modern physicians Shi Jinmo and Guan Youbo created ten-pattern differentiation, adding qi and blood to the traditional eight principles—a very scientific advance in TCM. The ancient saying long illness necessarily involves deficiency is borne out in today's patients: those with chronic illness commonly show anemia, malnutrition, and other qi-blood insufficiency. Thus Yanghe Tang's heavy supplementation is exactly appropriate.