一九五八年，领导上派我参加全国第一次肿瘤会议，听了首长和到会代表的发言，深感攻克肿瘤的重要性和迫切性，使我感到重任在肩，义不容辞。于是，从一九五九年开始，在我院附属医院开设了第一个用中医中药治疗肿瘤的专科门诊。那时前来诊治的病人很多，有本地的，也有外地专程来上海的。在与这些病员的广泛接触中，我不仅体验到肿瘤患者的痛苦，也看到了一个人生癌肿，往往一家人都得不到安宁的悲痛情景。作为一个医学工作者，怎能不闻不问，袖手旁观呢!有一次我遇到一个四十多岁的肿瘤患者，剧烈头痛，呕吐频繁，瞳孔不对等(左侧大于右侧)，舌尖歪斜，经神经科检查，确诊为脑干病变(脑干肿瘤)。这个病目前在世界上还是个难题，手术及放疗均有危险。怎么办呢?难道能看着病人被活活地折磨死吗?当然不能。我连夜查阅了有关资料，细致地分析了患者的病情，经过三个多月的治疗，呕吐渐渐停止，头痛也明显好转，这样接连治疗两年多，患者已恢复了工作。这一瘸侧，使我增加了用中医中药治疗肿瘤的信心。
由于肿瘤是一种危害人类健康和生命的常见病，且至今缺乏特效的治疗方法，成千上万的病员在期待着我们能够早日探索出一个防治肿瘤的规律。
祖国医学对于肿瘤的防治已有悠久的历史，并有其独特的理论和方法，在历代的文献中，都有关于这方面的记载和描述，只是名称不同而已。如《内经》中所述的「肠覃」、「石瘕」以及《难经》中的「积聚」，隋代《诸病源候论》中的「症疲」、「石痈」等等，有些就是属于胃肠、子宫、肝、肤等肿瘤。宋代东轩居士所著的《卫济宝：持》中，就使用了「瘟」字，并对癌作了朴素的描述。还有汉、唐医学家所论述的「噎膈」、「反胃」，很像现代的食道瘟和胃癌}「茧唇」和「舌菌」则很像现代所说的「唇癌」和「舌癌」。由此可见，肿瘤并非近世才为人们所认识，发掘祖国医学在防治肿瘤方面的经验，对医治肿瘤和筛选抗癌中草药，均可提供一些线索。
可是正当进一步搞好肿瘤研究工作的时候，十年浩劫开始了，我也受到了冲击。但我仍怀着攻克肿瘤的信念，二面被批斗，一面仍然考虑着攻克肿瘤的设计方案。在安徽干校劳动时，晚上躲在帐子里，或查阅资料，寻找有关的抗癌药物，或书写笔记，记录自己在白天所考虑的设想，探索治癌的规律。粉碎了「四人帮」之后，我才又有了安定的环境，继续从事肿瘤防治工作的研究。
临证心得
近来，趁养病休息之时，把多年来治疗肿瘤的一些体会写出来，供同志们参考。
(一)对肿瘤病因病机的探讨和认识肿瘤的病因，不外乎外因和内因两个方面；外因是由于毒邪(致癌因素)的侵入，蕴聚于脏腑经络，内因是正气不足，情志抑郁，阴阳长期失调(体内某些化学元素失去相对的平衡)，气血运行失常(免疫机能降低)，致气滞血瘀，痰湿凝聚，郁结壅塞，而逐渐形成为肿物。
祖国医学非常重视内因的作用。如《内经》中说：「邪气居其间，久而内着」；《医宗必读·积聚篇》中说：「积之成者，正气不足，而后邪气居之。」《外证医汇编》中说；「正气虚则成岩。」等等。其中所说的积就是积块肿物，说明正气虚弱(自身免疫机能低)邪气(致癌因索)侵入，导致机体某一局部组织的破坏或增生，渐渐形成肿物肿瘤。
(二)扶正与祛邪的辩证运用肿瘤是一种全身性疾病的局部表现，与整体有着极其密切的关系。因此，对肿瘤的治疗，必须注意辨别阴阳气血的盛衰和脏腑经络的虚实以及邪正双方力量的对比，权衡扶正与祛邪的轻重缓急。不能片面地强调用有毒的峻烈攻逐的药物，企图一下子消除肿瘤，因为那样势必损伤正气，影响人体的抗病机能。反之，如果片面地强调扶正，不用攻逐，那就舍姑息养奸。因此，在治疗中既要扶助正气，增强患者自身的抗病机能，又要祛除病_邪，使癌肿在体内逐渐缩小和消失。一般地讲，癌肿病人在正虚为主的时候，治法应以扶正为主，辅以祛邪；反之，在正气不很虚弱时，则应以祛邪为主，辅以扶正。
有一患结肠癌的病人，手术后不到半年复发，右下腹有一坚硬肿块似鸡蛋大，经常腹痛，便溏，胃纳很差，形体消瘦，面色觥白，舌苔薄白，质淡，脉象细而无力，两尺尤虚。由于患者已不适宜二次手术，所以采用中药治疗。分析症候属脾肾亏损，气虚血衰，气滞血瘀等。哪一方面为主呢?从咏证偏于正虚，初步认为上述症候是由干脾肾阳虚所致，治宜温补脾肾、益气助阳(党参、白朮、黄芪、附块、肉挂、补骨脂、仙灵脾、锁阳等)，同时适当加用一些理气活血、祛除病邪的药物(八月札、枸橘、木香、丹参、当归等)。经过一段时间，病人症状有所减轻，体力也有所增加，但肿块未见缩小。于是根据患者的体质情况，调整治疗方案，侧重于攻，以理气、活血，消肿的药物(香附，木香、枳壳、枸橘，归尾、赤芍、三被、乳香、没药、白花蛇舌草、天龙丸等)为主，由积极的防御，转为积极的进攻。在积极进攻，祛除病邪(消除肿块)的同时，再适当地加用一些益气补肾的药物(党参、黄芪、熟地、仙灵脾、桑寄生等)，攻补兼施，这样就可避免攻伐太过而损伤正气。运用这个方案经过三个多月治疗，肿块慢慢缩小，再经过一年多时间的治疗，渐至肿块消失，恢复工作。
(三)调整脾肾功能的重要性祖国医学认为，人体复杂的生命活动是与脏腑密切相关的，无论消化、循环、视听等活动，都是脏腑功能活动的表现。
同时，脏腑功能活动决不是各不相关孤立地进行的，而是相互制约，相互依存的，其中脾、肾的功能在祖国医学体系中处于十分重要的地位。李东垣说：「内伤脾胃，百病由生。」强调「治脾胃叩所以安五脏」。健脾法不仅适用于脾胃虚弱，改善营养障碍}而且还适用于心、肝、肾的虚衰病症。补后天之本，充实气血生化之源，以扶助人体的正气和增强卫外功能。在动物实验中，也证明了应用健脾益气药物，有刺激网状内皮系统吞噬活性的作用，可以增强人体的免疫功能。
肾的作用较为复杂，人体的生长、发育、衰老，都与肾气的盛衰有关。结合现代临床来看，肾是一个复杂的功能单位，它的内容涉及生殖、泌尿、内分泌以及神经系统等。古人认为五脏六腑之阴都由肾胡来供有，五脏六腑之{；日都由肾阳来温养。肾在病机上涉及的范围也较广，往往各脏患病日久都会影响到肾，所谓「久病及肾」。由此可见，肾是人体各脏器的调节中心，所以前人在治疗上以肾立论的也很多，如《景岳全书》、《医贯》等文献中，都有详细的记载。从现代的研究来看，补肾法可提高机体的免疫力，改善机体免疫状态，而且能调节体内免疫功能的相对稳定。任何疾病对全身都有一定影响。全身机能好转，可促使局部病变加快恢复；而局部病变的恢复，反过来也影响到全身状态的好转。我在治疗肿瘤时，应用补肾为主的中药，不仅使虚象减轻，症状改善，而且对放疗、化疗病人的恢复有一定的作用。
总之，调整脾肾功能在治疗上有很重要的现实意义。如有一例食管癌的患者：高年体虚，吞咽困难(仅能吃半流质)，胸前医及背部闷胀隐痛，咳嗽不爽，痰多粘腻，大便干燥，苔腻舌质偏红，脉弦细而滑。
曾用5一氟尿嘧啶，因恶心呕吐等副作用剧烈而停止化疗，要求服中药。辨证分析以痰气凝滞为主，并根
据「食入即出是无水也，无水者，壮水之主」的理论，确定了「健脾化痰、理气散结、佐以灌阴补肾」的治则。在使用复方(青皮，枸橘、杏仁、橘叶、术香、槟榔、桃仁、石见穿、石打穿、象牙屑、山豆根、生地、茯苓、生熟苡仁等)加减出入的同时，加用六昧地黄丸、移山参片等，连续服药一年左右，吞咽困难基本消失，二年后完全康复。服药期间，x线摄片复查逐渐好转；最后一次摄片食道已无异常。在这个病案的治疗中，由于患者脾虚生湿，湿能生痰，痰气凝滞而为肿块，叉加高年肾气不足，肾阴亏损，因此，治疗上采用标本兼顾的方法，一面化痰、理气、散结以祛邪(消除肿块)，一面调整脾肾功能以扶正，所以获得了比较满意的效果。
(四)药物的配伍和剂量中医中药治疗肿瘤副作用小，改善症状比较明显，疗效取得后比较持久和稳定。其中有一些中草药对癌细胞有一定的抑制作用，有部分中草药虽然本身对癌细胞无直接抑制作用，但它能帮助抗癌药物透达病所或促进药物的吸收}有的中草药通过扶助正气，提高机体的免疫功能等环节，同样能起到治疗肿瘤的作用。
在选用药物时要注意配伍。从中药的发展史来看，先由单味药逐渐发展到几种药配合应用，再进一步组成方剂，这样可发挥药物的协同作用，而更好地取得预期的疗效。有些药物相互配合后，可以减少原有药物的毒性，如冶疗肿瘤时常用的马钱子有毒，配甘草可以减轻毒性。可是有些药物的配合如甘草与芜花、人参与五灵脂、乌头与贝母等，不仅会使作用减弱，甚至还会发生不良反应。因此，在临床用药上应尽可能取其相须、相使，避其相恶、相反，这样才能取得比较满意的效果。
在掌握配伍知识的同时，还要注意药物的用量大小，只有这样才能真正发挥药物的作用。在临床用药时，若应大而小，就要贻误病情；如应小而大，就会克伐正气。我在剐当医生时，也有急于求成的情况，喜用大剂量，其结果往往是欲速不达，引起了相反的作用。现在临床上有些药物虽是常用的，但用量也不能太大，知龙葵超过30克并长期应用，就会降低自细胞，莪术大剂量长期应用会对肝功能有影响。即使常用的桔梗和山豆根，如剂量掌握不妥，也会产生不良反应。有一次，治疗一声带肿瘤患者，用药后病情进步不大。当时一位青年医生想使药物迅速发挥作用，就把处方中桔梗增加到12克，山豆根增加到18克。结果服药后即出现恶心呕吐、胃纳呆滞等副作用。后来把剂量调整下来，病人才得以重新接受治疗。
(五)辨证与辨病相结合的应用辨证与辨病相结合，在辨证的基础上适当地加一些对肿瘤细胞有抑制作用的药物(如喜树、山豆根、肿节风、天南星等)，效果更好一些。例如一例胃癌患者，根据辨证属于胃阳虚及忧郁痰阻所致。按辨证用药，症状虽有减轻，但效果不明显。后来我们在辨证基础上加了石见穿、石打穿、天龙等之后，症状就有显著好转，后经x线钡餐胃肠摄片检查，病灶亦有缩小。
(六)取得病人的信任和支持要取得疗效，一方面要有扎实的理论基础和丰富的临床经验，另一方面还要取得病人的信任和支持。我们在治疗中，不可能都是一次辨证就正确的，有时需要反复辨证才能找到规律，这样就需要有一个过程。只有病人和医者密切配合，才可使治疗方案顺利进行，且可以获得详细的第一手数据。在平时常遇到一些病员，把自己以往治疗中，吃过那些药，用过那些治疗方法而没有见效的情况，或吃了那种药引起了怎样的副作用，原原本本地告诉我们。这些反面经验，往往是书本上没有详载。只有取得病人的信任和支持，才能在辨证论治中少走弯路，不断提高医疗水平。
(张存义整理)
中医瑰宝苑
名老中医之路四
名老中医之路一
名老中医之路二
名老中医之路三
名老中医之路四
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习医、临床回首录
黑龙江中医学院教授韩百灵
【作者筒介】韩百灵(1909～)，辽宁省台安县人。一九二五年始随兄韩秀实习医，一九三。年始行医于哈尔滨审。从事中医临床和教学工作迄今已五十余年，擅长妇科，着有《百灵妇科》、《中医妇科学》等。现任黑龙江省政协委员，中华金国中医学会理事，中华全国中医学会黑龙江分会副理事长，黑龙江中医学院妇科主任，黑龙江省卫生局中医考试委员等职。
一九五八年，上级指派我参加全国第一次肿瘤会议。听了领导讲话和与会代表的发言后，我深感攻克肿瘤的重要性和紧迫性，感到重任在肩，义不容辞。于是，从一九五九年开始，在我院附属医院开设了第一个用中医中药治疗肿瘤的专科门诊。那时前来诊治的病人很多，有本地的，也有外地专程来上海的。在与这些病员的广泛接触中，我不仅体验到肿瘤患者的痛苦，也看到了一个人患癌肿，往往一家人都得不到安宁的悲痛情景。作为一个医学工作者，怎能不闻不问，袖手旁观呢！有一次我遇到一个四十多岁的肿瘤患者，剧烈头痛，呕吐频繁，瞳孔不对等（左侧大于右侧），舌尖歪斜，经神经科检查，确诊为脑干病变（脑干肿瘤）。这个病目前在世界上还是个难题，手术及放疗均有危险。怎么办呢？难道能看着病人被活活地折磨死吗？当然不能。我连夜查阅了有关资料，细致地分析了患者的病情，经过三个多月的治疗，呕吐渐渐停止，头痛也明显好转，这样接连治疗两年多，患者已恢复了工作。这一病例，使我增加了用中医中药治疗肿瘤的信心。
由于肿瘤是一种危害人类健康和生命的常见病，且至今缺乏特效的治疗方法，成千上万的病员在期待着我们能够早日探索出一个防治肿瘤的规律。
祖国医学对于肿瘤的防治已有悠久的历史，并有其独特的理论和方法，在历代的文献中，都有关于这方面的记载和描述，只是名称不同而已。如《内经》中所述的「肠覃」（changtan，肠道息肉或肿瘤）、「石瘕」（shijia，子宫肿块）以及《难经》中的「积聚」（jiju，腹内结块），隋代《诸病源候论》中的「症瘕」（zhengjia，腹部肿块）、「石痈」（shiying，坚硬之痈疽）等等，有些就是属于胃肠、子宫、肝、肤等肿瘤。宋代东轩居士所著的《卫济宝书》中，就使用了「癌」字，并对癌作了朴素的描述。还有汉、唐医学家所论述的「噎膈」（yige，吞咽困难）、「反胃」（fanwei，食入即吐），很像现代的食道癌和胃癌；「茧唇」（jianchun，唇部肿块）和「舌菌」（shejun，舌部肿瘤）则很像现代所说的「唇癌」和「舌癌」。由此可见，肿瘤并非近世才为人们所认识，发掘祖国医学在防治肿瘤方面的经验，对医治肿瘤和筛选抗癌中草药，均可提供一些线索。
可是正当进一步搞好肿瘤研究工作的时候，十年浩劫开始了，我也受到了冲击。但我仍怀着攻克肿瘤的信念，一面被批斗，一面仍然考虑着攻克肿瘤的设计方案。在安徽干校劳动时，晚上躲在帐子里，或查阅资料，寻找有关的抗癌药物，或书写笔记，记录自己在白天所考虑的设想，探索治癌的规律。粉碎了「四人帮」之后，我才又有了安定的环境，继续从事肿瘤防治工作的研究。
临证心得
近来，趁养病休息之时，把多年来治疗肿瘤的一些体会写出来，供同志们参考。
(一)对肿瘤病因病机的探讨和认识 肿瘤的病因，不外乎外因和内因两个方面；外因是由于毒邪（致癌因素）的侵入，蕴聚于脏腑经络，内因是正气不足，情志抑郁，阴阳长期失调（体内某些化学元素失去相对的平衡），气血运行失常（免疫机能降低），致气滞血瘀，痰湿凝聚，郁结壅塞，而逐渐形成为肿物。
祖国医学非常重视内因的作用。如《内经》中说：「邪气居其间，久而内着」；《医宗必读·积聚篇》中说：「积之成者，正气不足，而后邪气居之。」《外证医汇编》中说：「正气虚则成岩。」等等。其中所说的积就是积块肿物，说明正气虚弱（自身免疫机能低）邪气（致癌因素）侵入，导致机体某一局部组织的破坏或增生，渐渐形成肿物肿瘤。
(二)扶正与祛邪的辩证运用 肿瘤是一种全身性疾病的局部表现，与整体有着极其密切的关系。因此，对肿瘤的治疗，必须注意辨别阴阳气血的盛衰和脏腑经络的虚实以及邪正双方力量的对比，权衡扶正与祛邪的轻重缓急。不能片面地强调用有毒的峻烈攻逐的药物，企图一下子消除肿瘤，因为那样势必损伤正气，影响人体的抗病机能。反之，如果片面地强调扶正，不用攻逐，那就舍姑息养奸。因此，在治疗中既要扶助正气，增强患者自身的抗病机能，又要祛除病邪，使癌肿在体内逐渐缩小和消失。一般地讲，癌肿病人在正虚为主的时候，治法应以扶正为主，辅以祛邪；反之，在正气不很虚弱时，则应以祛邪为主，辅以扶正。
有一患结肠癌的病人，手术后不到半年复发，右下腹有一坚硬肿块似鸡蛋大，经常腹痛，便溏，胃纳很差，形体消瘦，面色苍白，舌苔薄白，质淡，脉象细而无力，两尺尤虚。由于患者已不适宜二次手术，所以采用中药治疗。分析症候属脾肾亏损，气虚血衰，气滞血瘀等。哪一方面为主呢？从脉证偏于正虚，初步认为上述症候是由于脾肾阳虚所致，治宜温补脾肾、益气助阳（党参、白术、黄芪、附块、肉桂、补骨脂、仙灵脾、锁阳等），同时适当加用一些理气活血、祛除病邪的药物（八月札、枸橘、木香、丹参、当归等）。经过一段时间，病人症状有所减轻，体力也有所增加，但肿块未见缩小。于是根据患者的体质情况，调整治疗方案，侧重于攻，以理气、活血，消肿的药物（香附、木香、枳壳、枸橘、归尾、赤芍、三棱、乳香、没药、白花蛇舌草、天龙丸等）为主，由积极的防御，转为积极的进攻。在积极进攻，祛除病邪（消除肿块）的同时，再适当地加用一些益气补肾的药物（党参、黄芪、熟地、仙灵脾、桑寄生等），攻补兼施，这样就可避免攻伐太过而损伤正气。运用这个方案经过三个多月治疗，肿块慢慢缩小，再经过一年多时间的治疗，渐至肿块消失，恢复工作。
(三)调整脾肾功能的重要性 祖国医学认为，人体复杂的生命活动是与脏腑密切相关的，无论消化、循环、视听等活动，都是脏腑功能活动的表现。
同时，脏腑功能活动决不是各不相关孤立地进行的，而是相互制约，相互依存的，其中脾、肾的功能在祖国医学体系中处于十分重要的地位。李东垣说：「内伤脾胃，百病由生。」强调「治脾胃即所以安五脏」。健脾法不仅适用于脾胃虚弱，改善营养障碍；而且还适用于心、肝、肾的虚衰病症。补后天之本，充实气血生化之源，以扶助人体的正气和增强卫外功能。在动物实验中，也证明了应用健脾益气药物，有刺激网状内皮系统吞噬活性的作用，可以增强人体的免疫功能。
肾的作用较为复杂，人体的生长、发育、衰老，都与肾气的盛衰有关。结合现代临床来看，肾是一个复杂的功能单位，它的内容涉及生殖、泌尿、内分泌以及神经系统等。古人认为五脏六腑之阴都由肾阴来供养，五脏六腑之阳都由肾阳来温养。肾在病机上涉及的范围也较广，往往各脏患病日久都会影响到肾，所谓「久病及肾」。由此可见，肾是人体各脏器的调节中心，所以前人在治疗上以肾立论的也很多，如《景岳全书》、《医贯》等文献中，都有详细的记载。从现代的研究来看，补肾法可提高机体的免疫力，改善机体免疫状态，而且能调节体内免疫功能的相对稳定。任何疾病对全身都有一定影响。全身机能好转，可促使局部病变加快恢复；而局部病变的恢复，反过来也影响到全身状态的好转。我在治疗肿瘤时，应用补肾为主的中药，不仅使虚象减轻，症状改善，而且对放疗、化疗病人的恢复有一定的作用。
总之，调整脾肾功能在治疗上有很重要的现实意义。如有一例食管癌的患者：高年体虚，吞咽困难（仅能吃半流质），胸前区及背部闷胀隐痛，咳嗽不爽，痰多粘腻，大便干燥，苔腻舌质偏红，脉弦细而滑。
曾用5-氟尿嘧啶，因恶心呕吐等副作用剧烈而停止化疗，要求服中药。辨证分析以痰气凝滞为主，并根据「食入即出是无水也，无水者，壮水之主」的理论，确定了「健脾化痰、理气散结、佐以滋阴补肾」的治则。在使用复方（青皮、枸橘、杏仁、橘叶、木香、槟榔、桃仁、石见穿、石打穿、象牙屑、山豆根、生地、茯苓、生熟苡仁等）加减出入的同时，加用六味地黄丸、移山参片等，连续服药一年左右，吞咽困难基本消失，二年后完全康复。服药期间，X线摄片复查逐渐好转；最后一次摄片食道已无异常。在这个病案的治疗中，由于患者脾虚生湿，湿能生痰，痰气凝滞而为肿块，又加高年肾气不足，肾阴亏损，因此，治疗上采用标本兼顾的方法，一面化痰、理气、散结以祛邪（消除肿块），一面调整脾肾功能以扶正，所以获得了比较满意的效果。
(四)药物的配伍和剂量 中医中药治疗肿瘤副作用小，改善症状比较明显，疗效取得后比较持久和稳定。其中有一些中草药对癌细胞有一定的抑制作用，有部分中草药虽然本身对癌细胞无直接抑制作用，但它能帮助抗癌药物透达病所或促进药物的吸收；有的中草药通过扶助正气，提高机体的免疫功能等环节，同样能起到治疗肿瘤的作用。
在选用药物时要注意配伍。从中药的发展史来看，先由单味药逐渐发展到几种药配合应用，再进一步组成方剂，这样可发挥药物的协同作用，而更好地取得预期的疗效。有些药物相互配合后，可以减少原有药物的毒性，如治疗肿瘤时常用的马钱子有毒，配甘草可以减轻毒性。可是有些药物的配合如甘草与芜花、人参与五灵脂、乌头与贝母等，不仅会使作用减弱，甚至还会发生不良反应。因此，在临床用药上应尽可能取其相须、相使，避其相恶、相反，这样才能取得比较满意的效果。
在掌握配伍知识的同时，还要注意药物的用量大小，只有这样才能真正发挥药物的作用。在临床用药时，若应大而小，就要贻误病情；如应小而大，就会克伐正气。我刚当医生时，也有急于求成的情况，喜用大剂量，其结果往往是欲速不达，引起了相反的作用。现在临床上有些药物虽是常用的，但用量也不能太大，知龙葵超过30克并长期应用，就会降低白细胞，莪术大剂量长期应用会对肝功能有影响。即使常用的桔梗和山豆根，如剂量掌握不妥，也会产生不良反应。有一次，治疗一声带肿瘤患者，用药后病情进步不大。当时一位青年医生想使药物迅速发挥作用，就把处方中桔梗增加到12克，山豆根增加到18克。结果服药后即出现恶心呕吐、胃纳呆滞等副作用。后来把剂量调整下来，病人才得以重新接受治疗。
(五)辨证与辨病相结合的应用 辨证与辨病相结合，在辨证的基础上适当地加一些对肿瘤细胞有抑制作用的药物（如喜树、山豆根、肿节风、天南星等），效果更好一些。例如一例胃癌患者，根据辨证属于胃阳虚及忧郁痰阻所致。按辨证用药，症状虽有减轻，但效果不明显。后来我们在辨证基础上加了石见穿、石打穿、天龙等之后，症状就有显著好转，后经X线钡餐胃肠摄片检查，病灶亦有缩小。
(六)取得病人的信任和支持 要取得疗效，一方面要有扎实的理论基础和丰富的临床经验，另一方面还要取得病人的信任和支持。我们在治疗中，不可能都是一次辨证就正确的，有时需要反复辨证才能找到规律，这样就需要有一个过程。只有病人和医者密切配合，才可使治疗方案顺利进行，且可以获得详细的第一手数据。在平时常遇到一些病员，把自己以往治疗中，吃过那些药，用过那些治疗方法而没有见效的情况，或吃了那种药引起了怎样的副作用，原原本本地告诉我们。这些反面经验，往往是书本上没有详载。只有取得病人的信任和支持，才能在辨证论治中少走弯路，不断提高医疗水平。
(张存义整理)
In 1958, I was assigned by the authorities to attend the first National Tumor Conference. After listening to the speeches of leaders and delegates, I deeply felt the importance and urgency of conquering tumors, feeling that the heavy responsibility was on my shoulders and that I could not shirk it. Thus, starting from 1959, I opened the first specialized outpatient clinic for treating tumors with Traditional Chinese Medicine (TCM) herbs at the affiliated hospital of our institute. At that time, many patients came for diagnosis and treatment, both locals and those who traveled specifically to Shanghai. Through extensive contact with these patients, I not only experienced the suffering of tumor patients but also witnessed the heartbreaking scenes where one person’s cancer often brought no peace to the whole family. As a medical worker, how could one ignore this and stand by idly! Once, I encountered a tumor patient in his forties with severe headache, frequent vomiting, unequal pupils (left larger than right), and deviation of the tongue tip. Neurological examination confirmed brainstem lesions (brainstem tumor). This disease remains a difficult problem worldwide today, with both surgery and radiotherapy posing risks. What should be done? Could we just watch the patient suffer to death? Of course not. I consulted relevant materials overnight and carefully analyzed the patient's condition. After more than three months of treatment, the vomiting gradually stopped, and the headache improved significantly. Following continuous treatment for over two years, the patient resumed work. This case increased my confidence in using TCM herbs to treat tumors.
Since tumors are common diseases that endanger human health and life, and effective specific treatments are still lacking, thousands of patients are waiting for us to explore laws for the prevention and treatment of tumors as soon as possible.
Traditional Chinese Medicine has a long history in the prevention and treatment of tumors, possessing unique theories and methods. Historical documents contain records and descriptions of this, merely under different names. For example, "Changtan" (Intestinal Polyp/Tumor) and "Shijia" (Uterine Mass) mentioned in *Neijing* (The Yellow Emperor's Inner Canon), and "Jiju" (Accumulation and Gathering) in *Nanjing* (Classic of Difficult Issues); "Zhengjia" (Abdominal Mass) and "Shiyong" (Hard Carbuncle) in Sui Dynasty's *Zhubing Yuanhou Lun* (Source Book of All Diseases and Syndromes), etc., some of which belong to tumors of the gastrointestinal tract, uterus, liver, skin, etc. In the Song Dynasty, Dongxuan Jushi's *Weiji Baoshu* (Precious Book of Weiji) used the character "Cancer" (Ai) and made a naive description of it. Furthermore, "Yige" (Dysphagia/Regurgitation) and "Fanwei" (Regurgitation/Vomiting after eating) discussed by Han and Tang physicians resemble modern esophageal cancer and gastric cancer; "Jianchun" (Silkworm Lip) and "Shejun" (Tongue Fungus) resemble modern "Lip Cancer" and "Tongue Cancer." Thus, tumors were not recognized only in recent times. Excavating the experience of Traditional Chinese Medicine in preventing and treating tumors can provide clues for curing tumors and screening anti-cancer Chinese herbal medicines.
However, just as research on tumors was being further advanced, the Cultural Revolution began, and I was also impacted. But holding onto the belief in conquering tumors, while being criticized and struggled against, I continued to consider design plans for tackling tumors. During labor at the Anhui Cadre School, I hid in my tent at night, either consulting materials to find relevant anti-cancer drugs or writing notes to record ideas considered during the day, exploring laws for treating cancer. Only after the downfall of the "Gang of Four" did I have a stable environment to continue researching tumor prevention and treatment.
Clinical Insights
Recently, taking advantage of rest during convalescence, I have written down some experiences gained from treating tumors over the years for reference by comrades.
(I) Exploration and Understanding of Etiology and Pathogenesis of Tumors The etiology of tumors lies in external and internal factors. External factors involve the invasion of toxic pathogens (carcinogenic factors) accumulating in Zang-Fu organs and meridians. Internal factors include deficiency of Zhengqi (Vital Qi), emotional depression, long-term imbalance of Yin and Yang (loss of relative balance of certain chemical elements in the body), and abnormal circulation of Qi and Blood (reduced immune function), leading to Qi stagnation and Blood stasis, condensation of Phlegm and Dampness, and gradual formation of masses.
Traditional Chinese Medicine attaches great importance to internal factors. As stated in *Neijing*: "When pathogenic factors reside within, they penetrate internally over time." In *Yizong Bidu · Accumulation Chapter*: "The formation of accumulation is due to deficiency of Zhengqi, after which pathogenic factors take residence." In *Wai Zheng Yi Huibian*: "Deficiency of Zhengqi leads to rock-like growths." The "accumulation" mentioned refers to mass formations, indicating that weakness of Zhengqi (low autoimmune function) combined with invasion of pathogenic factors (carcinogens) leads to destruction or hyperplasia of local tissues, gradually forming tumor masses.
(II) Dialectical Application of Supporting Zhengqi and Expelling Pathogens A tumor is a local manifestation of a systemic disease, closely related to the whole body. Therefore, in treating tumors, one must distinguish the excess or deficiency of Yin, Yang, Qi, and Blood, the deficiency or excess of Zang-Fu organs and meridians, and the comparative strength of pathogens versus Zhengqi, weighing the priority and urgency of supporting Zhengqi versus expelling pathogens. One cannot unilaterally emphasize the use of toxic, harsh purgative drugs to eliminate tumors instantly, as this inevitably damages Zhengqi and affects the body's resistance. Conversely, if one unilaterally emphasizes supporting Zhengqi without expelling pathogens, it amounts to indulging evil. Therefore, in treatment, one must both support Zhengqi to enhance the patient's resistance and expel pathogens to cause the cancerous mass to gradually shrink and disappear. Generally speaking, when Zhengqi deficiency is predominant in cancer patients, the treatment should focus on supporting Zhengqi, assisted by expelling pathogens; conversely, when Zhengqi is not very weak, the treatment should focus on expelling pathogens, assisted by supporting Zhengqi.
A patient with colon cancer relapsed less than half a year after surgery, presenting with a hard egg-sized mass in the lower right abdomen, frequent abdominal pain, loose stools, poor appetite, emaciation, pale complexion, thin white tongue coating, pale tongue body, and fine, weak pulse, especially deficient at the Chi position. Since secondary surgery was unsuitable, Chinese herbal medicine was adopted. Syndrome analysis indicated Spleen-Kidney depletion, Qi deficiency and Blood decline, Qi stagnation, and Blood stasis. Which aspect was predominant? Given the pulse and symptoms leaning towards Zhengqi deficiency, it was preliminarily believed that these symptoms were caused by Spleen-Kidney Yang Deficiency. The treatment principle was to warm and tonify Spleen-Kidney, boost Qi and assist Yang (Codonopsis Root, Atractylodes Macrocephala Rhizome, Astragalus Root, Prepared Aconite Lateralis Radix, Cinnamon Twig, Psoralea Fruit, Epimedium Herba, Cynomorium Herb, etc.), while appropriately adding Qi-regulating and Blood-invigorating, pathogen-expelling drugs (Artemisia Argyi Fruit, Citrus Bigaradia Peel, Aucklandia Root, Salvia Miltiorrhiza Root, Angelica Sinensis Root, etc.). After a period, symptoms alleviated, and physical strength increased, but the mass did not shrink. Based on the patient's constitution, the treatment plan was adjusted to focus on attack, using Qi-regulating, Blood-invigorating, and swelling-reducing drugs (Cyperus Rotundus Rhizome, Aucklandia Root, Bitter Orange Pericarp, Citrus Bigaradia Peel, Angelica Sinensis Tail, Red Peony Root, Burreed Tuber, Frankincense Resin, Myrrh Resin, Hedyotis Diffusa Herb, Gekko, etc.), shifting from active defense to active offense. While actively attacking and expelling pathogens (eliminating the mass), appropriate Qi-boosting and Kidney-tonifying drugs (Codonopsis Root, Astragalus Root, Rehmannia Glutinosa Root, Epimedium Herba, Mulberry Root Bark, etc.) were added. This combination of attacking and tonifying avoided excessive damage to Zhengqi. Using this regimen for over three months, the mass slowly shrank; after another year of treatment, it gradually disappeared, and the patient resumed work.
(III) Importance of Regulating Spleen and Kidney Functions Traditional Chinese Medicine believes that complex life activities are closely related to Zang-Fu organs; digestion, circulation, vision, hearing, etc., are all manifestations of Zang-Fu functional activities.
Simultaneously, Zang-Fu functional activities do not occur in isolation but constrain and depend on each other. Among them, the functions of the Spleen and Kidney hold a very important position in the TCM system. Li Dongyuan said: "Internal injury to the Spleen and Stomach gives rise to hundreds of diseases," emphasizing "Treating the Spleen and Stomach is the way to pacify the Five Zang." Spleen-strengthening methods apply not only to Spleen-Stomach weakness and nutritional disorders but also to deficiency syndromes of the Heart, Liver, and Kidney. Tonifying the acquired foundation enriches the source of Qi and Blood generation, supporting the body's Zhengqi and enhancing defensive exterior functions. Animal experiments have proven that Spleen-strengthening and Qi-boosting drugs stimulate the phagocytic activity of the reticuloendothelial system, enhancing human immune function.
The role of the Kidney is complex; human growth, development, and aging are related to the prosperity or decline of Kidney Qi. Combining modern clinical perspectives, the Kidney is a complex functional unit involving reproduction, urination, endocrinology, and the nervous system. Ancients believed that Yin of the Five Zang and Six Fu organs is supplied by Kidney Yin, and Yang is warmed by Kidney Yang. The scope of Kidney involvement in pathogenesis is broad; chronic illness in any organ often affects the Kidney, known as "long-standing illness reaches the Kidney." Thus, the Kidney is the regulatory center of various organs, so predecessors frequently formulated treatments based on the Kidney, as detailed in *Jingyue Quanshu* and *Yiguan*. Modern research shows that Kidney-tonifying methods can improve organism immunity, improve immune status, and regulate the relative stability of internal immune functions. Any disease affects the whole body. Improvement in overall function accelerates local lesion recovery; conversely, local recovery affects overall improvement. In treating tumors, using Kidney-tonifying Chinese herbs not only alleviates deficiency signs and improves symptoms but also aids recovery in patients undergoing radiotherapy and chemotherapy.
In summary, regulating Spleen and Kidney functions has significant practical meaning in treatment. For instance, an esophageal cancer patient: elderly and weak, dysphagia (only semi-liquid diet), dull distending pain in the chest and back, unsatisfactory cough, sticky sputum, dry stool, greasy coating, reddish tongue body, wiry, fine, and slippery pulse.
Previously treated with 5-Fluorouracil, but chemotherapy was stopped due to severe side effects like nausea and vomiting; the patient requested Chinese medicine. Syndrome differentiation identified Phlegm-Qi stagnation as primary. Based on the theory "vomiting immediately after eating indicates lack of fluids; lack of fluids requires strengthening the master of fluids," the treatment principle was determined as "Strengthen Spleen, resolve Phlegm, regulate Qi, dissipate nodules, assisted by nourishing Yin and tonifying Kidney." While using a modified compound formula (Green Tangerine Peel, Citrus Bigaradia Peel, Apricot Seed, Mandarin Leaf, Aucklandia Root, Areca Seed, Peach Kernel, Vitex Trifolia Root, Oldenlandia diffusa Herb, Ivory Chips, Sophora Root, Rehmannia Root, Poria, Coix Seed Raw and Prepared, etc.) and adding Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) and Yishanshen Pian (Moved Mountain Ginseng Tablets), continuous medication for about one year led to the basic disappearance of dysphagia, with complete recovery after two years. X-ray film reviews during medication showed gradual improvement; the final film showed no abnormalities in the esophagus. In this case, due to Spleen deficiency generating Dampness, which generates Phlegm, causing Phlegm-Qi stagnation into a mass, compounded by elderly Kidney Qi insufficiency and Kidney Yin deficiency, the treatment adopted a method addressing both root and branch: resolving Phlegm, regulating Qi, dissipating nodules to expel pathogens (eliminate mass), while adjusting Spleen-Kidney functions to support Zhengqi, achieving satisfactory results.
(IV) Drug Compatibility and Dosage TCM treats tumors with fewer side effects, obvious symptom improvement, and durable, stable efficacy. Some Chinese herbs inhibit cancer cells; others, though lacking direct inhibition, help anti-cancer drugs reach the disease site or promote absorption; still others treat tumors by supporting Zhengqi and improving immune function.
Attention must be paid to compatibility when selecting drugs. Historically, single herbs evolved into combinations, then formulas, exerting synergistic effects for better efficacy. Some drug combinations reduce toxicity; for example, Strychnos Nux-Vomica Seed (Maqianzi), commonly used in tumor treatment, is toxic, but compatibility with Licorice Root reduces toxicity. However, some combinations, such as Licorice Root with Genkwa Flower, Ginseng Root with Trogopterus Dung, or Aconite Root with Fritillaria Bulb, not only weaken effects but may cause adverse reactions. Therefore, clinically, one should seek mutual enhancement (Xiangxu, Xiangshi) and avoid mutual aversion (Xiangwu) and incompatibility (Xiangfan) to achieve satisfactory results.
Along with compatibility knowledge, attention must be paid to dosage. Only then can drugs truly exert their effects. In clinical practice, under-dosing delays treatment; overdosing attacks Zhengqi. When I first started practicing, eager for quick results, I preferred large doses, often resulting in haste making waste and opposite effects. Even commonly used drugs now should not be overdosed; exceeding 30 grams of Solanum Nigrum Fruit (Longkui) for long periods lowers white blood cells; large doses of Curcuma Zedoary Rhizome (Ezhu) long-term affect liver function. Even commonly used Platycodon Root (Jiegeng) and Sophora Root (Shandougen) can cause adverse reactions if dosages are improper. Once, treating a vocal cord tumor patient, progress was slow. A young doctor wanted rapid effect, increasing Jiegeng to 12g and Shandougen to 18g. Result: nausea, vomiting, and anorexia occurred immediately after ingestion. Dosages were later adjusted, allowing the patient to resume treatment.
(V) Combined Application of Syndrome Differentiation and Disease Identification Combining syndrome differentiation with disease identification, adding drugs with inhibitory effects on tumor cells (such as Camptotheca Acuminata Fruit, Sophora Root, Panax Notoginseng Root/Stem, Pinellia Ternata Tuber, etc.) to the basis of syndrome differentiation yields better results. For example, a gastric cancer patient was differentiated as Stomach Yang Deficiency and Depression-Phlegm Obstruction. Medication based solely on syndrome differentiation alleviated symptoms but had insignificant effects. Later, adding Vitex Trifolia Root, Oldenlandia diffusa Herb, and Gekko to the syndrome-based prescription led to significant symptom improvement. Subsequent X-ray barium meal gastro-intestinal imaging showed lesion shrinkage.
(VI) Gaining Patient Trust and Support To achieve efficacy, one needs solid theoretical foundations and rich clinical experience, but also patient trust and support. Treatment does not always yield correct syndrome differentiation on the first attempt; sometimes repeated differentiation is needed to find patterns, requiring a process. Close cooperation between patient and physician ensures smooth implementation of treatment plans and acquisition of detailed primary data. Often, patients report previous ineffective treatments or side effects from specific drugs. These negative experiences are rarely detailed in books. Only with patient trust and support can one avoid detours in syndrome-based treatment and continuously improve medical standards.
(Compiled by Zhang Cunyi)