Case Histories of Ye-Ge Disease Recorded by Zhang Xichun
Zhang Xichun's works include 8 case histories of ye-ge (dysphagia); all 8 were treated with Zhang Xichun's empirical formulas Shenzhen Peiqi Tang, Shenzhen Zhenqi Tang, or a combination of the two.
Shenzhen Peiqi Tang formula: Lu Dangshen (Codonopsis) 6 qian, Tianmendong (Asparagi Radix) 4 qian, Sheng Zheshi (Hematitum, crushed fine) 8 qian, Fabanxia (prepared Pinellia) 3 qian, Roucongrong (Cistanches Herba) 4 qian, Zhimu (Anemarrhenae Rhizoma) 5 qian, Dangguishen (Angelicae Radix body) 3 qian, Shishuangbing (persimmon frost cake) 5 qian - to be slowly dissolved in the mouth and swallowed after taking the decoction. Here Lu Dangshen is Dangshen, Tianmendong is Tiandong, Sheng Zheshi is Daizheshi or Zheshi, Roucongrong is the mild Cistanche, and Shishuangbing may need to be bought online since pharmacies may not stock it.
Some of the case histories recorded by Zhang Xichun are as follows:
Case One: An old man over sixty developed ye-ge and came to me for a formula. He said he could still chew crisply roasted food and wash it down slowly with soup, but if one mouthful went down unevenly, he would vomit and could not eat further; and when he vomited, sputum-saliva was brought up with it. On taking the pulse, the position after guan was weak and fine, while before guan it seemed slippery and replete; I knew the upper jiao was congested with phlegm-saliva. I used this Tang plus 2 qian of Xuanfuhua (Inulae Flos) produced at Wu Emperor Terrace in my home county, and after four consecutive doses he was cured.
Case Two: A man of forty-six, who had long been devoted to leaf-card games, to the point of neglecting sleep and meals. At first he felt qi surging up to the throat; gradually it obstructed eating, and sometimes he vomited and could not swallow down. His pulse was wiry, long and hard on both sides. I knew it was chong qi surging upward along the stomach. I treated with this Tang, adding 2 qian of Xuanfuhua from Wu Emperor Terrace and 4 qian of Sheng Qianshi (raw Euryales Semen), to descend the surging counterflow qi and astringe it; after ten consecutive doses he recovered.
Case Three: An aunt of mine in the clan, age fifty-six, at first felt obstruction to eating, which gradually worsened until she could only take thin congee. Her pulse was wiry, fine and weak. She had been frugal and hardworking all her life, living very sparingly for herself and overtaxing both heart and body. Her fine pulse was due to scant food causing decline of qi and blood; her wiry pulse was due to overtaxed thinking causing phlegm-rheum excess. She had two elder sisters who both died of this disease; those of the same constitution get the same disease, and she anxiously feared she would not recover. I firmly believed it was treatable and gave her this Tang plus 2 qian of Baizhu and 3 qian of Longyanrou (Longan Arillus); after more than ten consecutive doses she was fully cured.
Case Four: A niece of mine in the same clan, age forty-eight, chronically frail and often ill. Through managing household affairs she overtaxed her mind and often stayed awake all night; in the summer of the Guimao year she developed ye-ge. At the time I was far in the mountains, so other doctors were called to treat her, repeatedly without effect. By the time I returned home, the illness had become severe. Her pulse was somewhat slippery and replete but weak on deep pressure. I treated with this Tang plus 5 qian of Longyanrou; two doses brought relief, and after more than ten further doses she was cured.
The remaining cases are much the same and I will not recount them one by one. Those wishing to study Zhang Xichun's cases in depth may read his work Yixue Zhongzhong Canxilu (Records of Integrating Chinese and Western Medicine), where all these cases are collected.
It should be noted that the "Xuanfuhua produced at Wu Emperor Terrace" mentioned in Zhang Xichun's cases refers to the authentic daodi medicinal material of Inulae Flos, produced at the place called Wu Emperor Terrace. Zhang Xichun noted that the Xuanfuhua produced there was twice as large as that from elsewhere and more potent. The concept of authentic (daodi) medicinal materials really exists in Chinese medicine, so everyone should pay attention to this when using herbs.
I have used Zhang Xichun's empirical formula myself, and it does indeed help improve the symptoms of ye-ge patients. But, as the Qing-Dynasty physician Xu Lingtai said, most ye-ge that can be cured are not "true ge syndrome"; Xu Lingtai once said that true ge syndrome is almost never curable.
What Xu Lingtai called true ge syndrome roughly corresponds to cardiac cancer or esophageal cancer in modern medicine. The ye-ge treated by Zhang Xichun, although its symptoms resemble those of esophageal cancer - some patients' symptoms even closely resemble middle-to-late-stage esophageal cancer - was in fact probably not true esophageal cancer, and may mostly have been gastroesophageal reflux disease. True esophageal cancer or cardiac cancer is by no means curable with just over ten doses of Chinese medicine. Even if lucky patients are cured of their esophageal cancer with Chinese medicine, the treatment course is at least three months.
But in practice, when we treat esophageal cancer today, using Shenzhen Peiqi Tang as the base formula plus Donglingcao (Rabdosiae Herba), Xihuang Wan, Compound Banmao Capsules, Pingxiao Pian and similar herbs is also feasible. One simply should not expect true esophageal cancer to be cured so easily; such a therapeutic picture is too lightly drawn, out of touch with reality, and easily raises unrealistic, overly high expectations in patients and their families.