Zhang Xichun's Shiquan Yuzhen Tang Has a Role in Treating Cancer
In Zhang Xichun's *Lvshi Lvxiao Fang (Repeatedly Tested and Repeatedly Effective Formulas)* there is a formula called "Shiquan Yuzhen Tang" (Ten-Complete Truth-Nourishing Decoction), which Zhang Xichun used to treat what TCM calls "xu lao" (deficiency-tax) and "lao zhai" (consumptive phthisis; the character zhai is pronounced zhai, fourth tone). "Xu lao" and "lao zhai" are TCM disease names belonging to deficiency-exhaustion-type disorders. Some people think "lao zhai" is pulmonary tuberculosis; actually lao zhai is not necessarily pulmonary tuberculosis, and the late-stage symptoms of many chronic diseases closely resemble "lao zhai." In the past, without today's advanced medical equipment, a clear cause could not be detected, so diseases could only be named according to their symptoms, and patients given symptomatic treatment.
The composition of Shiquan Yuzhen Tang is: Yeshen (wild Taishan Ginseng) four qian; Sheng Huangqi (raw Astragalus) four qian; Sheng Shanyao (raw Dioscorea) four qian; Zhimu (Anemarrhena) four qian; Xuanshen (Scrophularia) four qian; Sheng Longgu (raw Dragon Bone, crushed) four qian; Sheng Muli (raw Oyster Shell, crushed) four qian; Danshen (Salvia) two qian; Sanleng (Sparganium) one and a half qian; Ezhu (Curcuma Rhizome) one and a half qian. Zhang Xichun lived in the late Qing and early Republican period; by the conversion between the weights and measures of that time and the modern standard, one qian here is best converted to 3–4g today, and I lean toward 4g.
Zhang Xichun's formula is taken as a decoction, one dose a day; the above dosage is for an adult. When decocting, Longgu and Muli need to be decocted first for about half an hour, because these two herbs are mineral and shell-type herbs; decocting them first for half an hour allows them to dissolve more fully.
But the herb Longgu is now not much recommended; the author suggests replacing it with Fuhaishi (Pumice) or Biejia (Turtle Shell). The Chinese medicinal Longgu is the fossil of ancient animals; these are all precious cultural-relic resources protected by law. The Longgu on the current Chinese medicinal market is no longer the traditional Longgu but a substitute.
In Zhang Xichun's original work he says that Shiquan Yuzhen Tang treats "deficiency-tax, with the pulse wiry, rapid, fine, and faint; skin and muscles like fish scales (jia cuo); the body emaciated; food not building sinew and strength; or spontaneous sweating; or cough with counterflow; or intermittent cold and heat; or many confused dreams; essence and spirit not secured." He also notes the modifications for this formula: "For those with extreme qi deficiency, remove Sanleng and Ezhu, and add Sheng Jineijin (raw Chicken Gizzard Lining) three qian; for those with panting, double the Shanyao (meaning double the dose of Dioscorea, the same below) and add Niubangzi (Burdock) three qian; for those with much sweating, replace Huangqi with Baizhu (Atractylodes), double Longgu and Muli, and add Shanzhuyu (Cornus, pitted clean) and Sheng Baishao (raw White Peony) each six qian. If the sweating is too profuse and does not stop after taking the medicine, one may use large doses of Longgu, Muli, and Shanzhuyu, each one liang, to decoct and take; in no more than two doses the sweat will stop, and after the sweat stops, take the original formula again. If there is cold first and then heat with sweating, and the pulse is perhaps also weak and faint, this is mostly the great qi of the chest falling down; read carefully the colophon to my proposed Shengxian Tang (Rising the Sunken Decoction), and you will know the treatment."
Most late-stage cancer patients have the TCM symptoms of "skin and muscles like fish scales; the body emaciated; food not building sinew and strength; or spontaneous sweating; or cough with counterflow; or intermittent cold and heat; or many confused dreams; essence and spirit not secured"; so this formula can be used to treat late-stage cancer. Moreover, most of the herbs used in Zhang Xichun's Shiquan Yuzhen Tang are commonly used in modern TCM anti-cancer treatment, and the approach Zhang Xichun used to compose "Shiquan Yuzhen Tang" is also followed by contemporary TCM; Shiquan Yuzhen Tang is a comprehensive formula that balances supporting the righteous with expelling the evil.
The Yeshent in the formula (now rare, a precious medicinal), Sheng Huangqi, and Sheng Shanyao all belong to the righteous-supporting herbs, with the function of supplementing qi and blood and fortifying the spleen and kidneys; Zhimu nourishes yin and clears heat, Xuanshen cools blood and dissipates swelling, Longgu and Muli soften hardness and disperse nodules, while Danshen, Sanleng, and Ezhu have the action of activating blood, resolving stasis, and breaking up accumulations. Used together, these herbs are well matched to the symptoms of cancer patients, especially suitable for late-stage cancer patients with the pattern of qi deficiency and blood stasis, and yin depletion with fluid exhaustion.
In modern TCM, quite a few physicians take Zhang Xichun's empirical formula as a base formula and, according to the patient's specific condition, add some herbs or subtract some in treatment—the professional TCM term is "modification and adjustment (jia jian hua cai)." This process of modification and adjustment is very important; it is actually a process of using basically the same therapeutic approach to deliver personalized treatment to different patients.
Shiquan Yuzhen Tang indeed has a certain anti-cancer effect; the Sanleng and Ezhu used in it are now a classic anti-cancer herb pair (TCM calls using two or more herbs together that exert a synergistic therapeutic effect a "herb pair" or paired herbs; the disciples of Mr. Shi Jinmo even compiled a book specifically called *Shi Jinmo's Paired Herbs*). The zedoary oil extracted from Ezhu is now made into a Western drug, commonly used in interventional treatment of cancer. The alcoholic extract of Ezhu is also made into elemene injection, mostly used in treating late-stage lung cancer, gastric cancer, and brain metastatic tumors, and also commonly used in treating the cancer complications of pleural effusion and ascites. If this formula is viewed from the perspective of modern pharmacology, it achieves its anti-tumor effect by inhibiting tumor angiogenesis and destroying the tumor's blood-supply system.
Because a tumor is a disease of root deficiency and branch excess, one needs both to support the righteous and secure the root and to expel the evil and disperse the tumor. An experienced clinical TCM physician will, when treating, carefully assess the patient's bodily condition and control the intensity of supporting the righteous and expelling the evil accordingly. When Zhang Xichun said, "For those with qi deficiency, remove Sanleng and Ezhu, and add Sheng Jineijin three qian," he meant exactly this; but raw Jineijin, when decocted into a formula, has a chicken-droppings taste that often makes people nauseous, so the author himself still recommends using stir-fried Jineijin or taking Jineijin tablets separately.
Some late-stage cancer patients whose bodies are already especially frail often cannot tolerate the assault of harsh qi-and-blood-breaking herbs like Sanleng and Ezhu, so when prescribing, the physician must take care not to damage the patient's body's righteous qi. But cancer is a very fatal disease; if the physician is timid and hesitates, often the patient will miss the chance of being saved, so this requires the clinician to carefully and cautiously grasp the measure of medication.
In TCM treatment of late-stage cancer patients, the ideal state is for the physician to be like the patient's nanny, constantly watching the changes in the patient's bodily condition. When the patient's condition improves, one should seize the moment to increase the intensity of the assault; when the condition is a bit worse, one should increase the intensity of supporting the righteous and reduce the amount of attacking herbs. But this requires the patient's trust and cooperation.