Professor Zhu Chenyu's Empirical Formulas for Treating Goiter
Goiter is a common condition. In mild cases, only an enlargement of the thyroid gland in the neck is noticed; the swelling is soft rather than hard, and may be accompanied by nodules. When the goiter is very large, symptoms such as a sensation of throat blockage, breathlessness, difficulty swallowing, chest oppression, and hoarseness may appear.Professor Zhu Chenyu held that the disease mechanism of goiter is long-standing liver qi stagnation, impaired qi movement, and the condensation of body fluids into phlegm nodules. Treatment should therefore regulate qi and resolve phlegm, soften hardness and dissipate nodules, and activate blood and resolve stasis.Professor Zhu Chenyu had two empirical formulas for treating goiter, one in decoction form and one in pill form. Either may be selected; they need not be taken together. Patients who cannot tolerate herbal decoctions may have the pill formula prepared by a pharmacy as a batch of honey pills.Decoction formula: Juling (Citrus Reticulatae Semen) 10g, Lizhihe (Litchi Chinensis Semen) 15g, Chuanshanjia (Manis Squama, now banned; see substitution below) 10g, Zaojiaoci (Gleditsiae Spina) 10g, Chaihu (Bupleurum Radix) 10g, Danshen (Salviae Miltiorrhizae Radix) 30g, Sheng Yiyiren (Coicis Semen, raw) 30g, Sheng Muli (Ostreae Concha, raw, decocted first) 30g, Xiakucao (Prunellae Spica) 15g, Zhe Beimu (Fritillariae Thunbergii Bulbus) 10g, Chenpi (Citri Reticulatae Pericarpium) 10g. One dose daily, decocted in water.Pill formula: Hupo (Succinum) 30g, Sheng Shanzha (Crataegi Fructus, raw) 30g, Juling 60g, Lizhihe 60g, Sheng Muli 90g, Sheng Yiyiren 60g, Chuanshanjia 30g, Zaojiaoci 30g, Xiakucao 30g, Wumei (Mume Fructus) 30g, Guijia (Testudinis Carapax) 60g, Kunbu (Eckloniae/Thallus Laminariae) 60g, Zhi Ruxiang (Olibanum, processed) 15g, Zhi Moyao (Myrrha, processed) 15g, Sanleng (Sparganii Rhizoma) 30g, Chenpi 70g. Grind all herbs into a fine powder, bind with refined honey into pills, each pill weighing 10g. Take one pill after each meal.Both of Professor Zhu's formulas originally used Chuanshanjia (pangolin scales). The pangolin is now a first-class protected animal in China and may no longer be used as a medicinal material. It may be replaced here by Wangbuliuxing (Vaccariae Semen) and Wubeizi (Galla Chinensis), and the substitute may even work better. Wubeizi in particular is a highly specific herb for treating goiter. Use Wangbuliuxing in the same dose as the original Chuanshanjia; at the same time, grind Wubeizi into a fine powder, moisten it with vinegar paste or honey, and apply it externally to the swollen lesion.Professor Zhu's formula may be used to treat simple goiter, nodular or cystic goiter, and thyroid fibroma as diagnosed by Western medicine, and may also be used as an adjuvant in thyroid cancer. When used for thyroid cancer, it is best combined with anti-tumor medicines such as Xihuang Wan (Yellow Stone Pill).The course of treatment for thyroid tumors is long. Pills are more convenient than decoctions, and pills also have fewer side effects than decoctions, so the author recommends that patients consider the pill form first. Professor Zhu's pills are large honey pills weighing 10g each; many people find such large pills difficult to swallow. A pharmacy may be asked to process them into small soybean-sized pills, and 6-10g may be taken each time.Patients with thyroid cancer who are surgical candidates should prioritize surgery; those who are not surgical candidates may then consider conservative treatment. This formula has a certain adjuvant therapeutic effect on thyroid cancer, but it cannot cure thyroid cancer. It can only improve the clinical symptoms of some patients and prolong their survival. Thyroid cancer patients should consider integrated traditional Chinese and Western medicine comprehensive treatment to improve the success rate.