Appreciation of Yu Tianmin's Case History of Treating Ye-Ge (Esophageal or Gastric Cancer)

Yu Tuan (1438–1517), courtesy name Tianmin, self-styled Old Man Hengde of Huaxi, was from Huaci Village, Ershisanli Town, Yiwu City, Zhejiang Province. He was a renowned physician of the mid-Ming Dynasty. The Jin Hua Fu Zhi (Gazetteer of Jinhua Prefecture) records: "In Yiwu, those famous for medicine have not been lacking through the generations; after Danxi, Tuan alone stands supreme."

The Gu Jin Yi An An (Case Records of Past and Present, Annotated) contains one case of Yu Tianmin treating ye-ge (dysphagia). Its content is as follows:

"Yu Tianmin treated a man over fifty years of age who, in summer–autumn, developed ye-ge: epigastric pain, inability to swallow food, or food returning up long after being eaten, dry and bound stools, and the man had become very dark and emaciated. The pulse on the right, before the guan position, was wiry, slippery and flooding; after the guan position, it was slightly deep and small; all three positions on the left were deep and wiry; the chi position carried a drum-like (kou) quality. This was insufficiency of central qi, wood insulting earth, damp-heat in the upper jiao congealing into phlegm, and scant blood in the lower jiao, hence dry bound stools; yin fire surged upward to the swallowing gate, hence inability to swallow food. He used Siwu Tang to engender blood, Sijunzi Tang to supplement qi, and Erchen Tang to resolve phlegm, combining the three into one prescription. He added ginger-fried Huanglian, Zhishi and Gualouren, with a small amount of Sharen; he also alternately used Runchang Wan, or Danxi's Zhuitan Wan. After taking more than a hundred decocted doses over half a year, the patient was fully cured."

According to this account, this was a patient in his fifties with a relatively severe condition, presenting with epigastric pain, dysphagia, vomiting, constipation, a darkish complexion and progressive wasting — symptoms commonly seen in the middle to late stages of esophageal cancer or cardiac cancer. Yet, strictly speaking, the formula Yu Tianmin used contained few of the anticancer Chinese herbs identified by modern pharmacological research.

Yu Tianmin simply based the prescription on the patient's clinical symptoms: using Siwu Tang and Sijunzi Tang (which together are in fact Bazhen Tang) to enrich blood and supplement qi, plus Erchen Tang to resolve phlegm and stop vomiting, with appropriate additions of Huanglian, Zhishi, Gualouren, Sharen and so on. The approximate prescription components were: Shengdihuang, Baishao, Danggui, Chuanxiong, Dangshen or Renshen, Baizhu, Fuling, Zhi Gancao, Chenpi, Fabanxia, Wumei, Shengjiang, Huanglian, Zhishi, Gualouren, Sharen. The patent medicine used was Huomaren Runchang Wan, used to relieve constipation.

These were all composed according to the TCM approach of pattern differentiation and treatment. After taking more than a hundred doses, the patient's symptoms gradually disappeared. It looks unremarkable, yet it had excellent efficacy. Of course, the success rate of such medication would not be very high. From this case we can see the hope of treating cancer by composing formulas according to the TCM approach of pattern differentiation and treatment.