15 g of bupleurum root, 10 g of magnolia bark, 10 g of coptis chinensis, 3 g of evodia rutaecarpa, and 6 g of licorice. Decoct in water and take one dose daily.

6 g of fragrant incense, 10 g of spiculated atractylodes rhizome, 10 g of curcuma zedoary rhizome, 6 g of amomum villosum (added later), 6 g of sandalwood, 10 g of salvia miltiorrhiza,
15 g of bupleurum root, 10 g of magnolia bark, 10 g of coptis chinensis, 3 g of evodia rutaecarpa, and 6 g of licorice. Decoct in water and take one dose daily. 2. Deficiency of stomach yin with fluid deficiency and heat accumulation Symptoms: Most cases of mid-stage esophageal cancer fall into this category, with patients experiencing significant food obstruction. Symptoms include chest and back pain, difficulty swallowing both solid and liquid foods, dry mouth and throat, low-grade fever, bone-steaming hot flushes, vexing heat in the five centers, night sweats, dry and hard stools, a red or dark-red tongue, and a greasy yellow coating or no coating at all. Treatment should focus on tonifying qi and nourishing yin while resolving blood stasis and eliminating accumulation. Prescription: Modified Liuwei Dihuang Tang, Tuoli Tounong San, and Qige San. Prescription: 12 g of rehmannia root, 30 g of cornus fruit, 10 g of Chinese yam, 6 g of cortex moutan, 12 g of poria, 10 g of alisma, 10 g of anemarrhena, 15 g of prunella vulgaris, 10 g of psoralea corylifolia, 6 g of polygala tenuifolia, 30 g of astragalus, 10 g of angelica sinensis, 3 g of pangolin scales, 15 g of soapberry thorns, 10 g of dried lotus leaves, 6 g of curcuma, 15 g of fritillaria, 6 g of cortex moutan, and 10 g of salvia miltiorrhiza. Decoct in water and take one dose daily. 3. Phlegm-stasis interlocking type Symptoms: Most cases of late-stage esophageal cancer fall into this category, with patients experiencing obvious dysphagia and being able to consume only liquids or tea. Treatment should focus on transforming phlegm and regulating qi, as well as activating blood circulation and unblocking stagnation. Prescription: Modified Xuanfu Daizhe Tang and Shengzhe Bei Qi Tang. Prescription: 15 g of codonopsis pilosula, 15 g of xuanfuhua, 15 g of raw zheshi (decocted first), 10 g of cloves, 6 g of agarwood, 6 g of curcuma, 10 g of bamboo shavings, 10 g of magnolia bark, 10 g of angelica sinensis, 10 g of acorus calamus, 15 g of calcined oyster shell, 6 g of licorice, 6 g of processed frankincense, 6 g of processed myrrh, 10 g of anemarrhena, 15 g of fritillaria, 6 g of rhubarb, 15 g of cistanche, 10 g of pinellia, 10 g of gastrodia elata, and 10 g of safflower. Decoct in water and take one dose daily. 4. Qi and blood deficiency Symptoms: Difficulty swallowing, vomiting phlegm and saliva, generalized edema, bedridden status, and cancer metastasis to adjacent organs. Patients are emaciated, anemic, cachectic, with pale complexion and pale-red tongue, and a weak, fine pulse. Treatment principle: Warm yang and tonify qi, transform phlegm and resolve depression. Prescription: Modified Lanzhou Fang and Banxia Xiexin Tang. 15 g of northern ginseng, 15 g of Lu dangshen, 15 g of ginseng roots, 15 g of prince ginseng, 12 g of rehmannia root, 30 g of cornus fruit, 10 g of Chinese yam, 10 g of ophiopogon, 6 g of schisandra, 12 g of cinnamon twig, 15 g of white peony, 30 g of floating wheat, 10 g of pinellia, 6 g of coptis, 10 g of scutellaria, and 6 g of licorice. Decoct in water and take one dose daily. 5. Professor Pei Zhengxue’s analysis of prescriptions for esophageal cancer Basic formula: Liuwei Xia Po Yuan Fang: 12 g of rehmannia root, 3 g of cornus fruit, 10 g of Chinese yam, 6 g of cortex moutan, 12 g of poria, 10 g of alisma, 10 g of anemarrhena, 15 g of prunella vulgaris, 10 g of psoralea corylifolia, 6 g of polygala tenuifolia, 30 g of astragalus, 10 g of angelica sinensis, 3 g of pangolin scales, 15 g of soapberry thorns, 10 g of dried lotus leaves, 6 g of curcuma, 15 g of fritillaria, 6 g of cortex moutan, and 10 g of salvia miltiorrhiza. This formula is derived by modifying Liuwei Dihuang Wan, Qige San, and Tuoli Tounong San. Liuwei Dihuang Wan nourishes yin and tonifies the kidneys; Qige San opens up depression, transforms phlegm, and moistens dryness; Tuoli Tounong San tonifies qi and blood, draws out toxins, and promotes drainage—originating from “The Authentic Records of Surgery,” it has the effect of tonifying qi and blood while drawing out toxins, primarily used for treating carbuncles and abscesses that have not yet ruptured, making it a famous formula in surgical detoxification methods; raw astragalus tonifies qi and supports righteous energy, with the function of drawing out toxins as the chief herb; pangolin scales and soapberry thorns disperse and penetrate, softening hard masses and breaking down pus as the minister herbs; angelica sinensis and chuanxiong tonify blood and activate blood circulation as the assistant herbs. Professor Pei Zhengxue believes that deep-seated inflammation cannot reach its source without pangolin scales and soapberry thorns. The combined use of these three formulas works together to support righteous energy and dispel evil, nourish yin and moisten dryness, transform phlegm, regulate qi, and disperse stagnation. 6. Clinical case examples by Professor Pei Zhengxue Case 1: Patient Xu, male, 50 years old. He had experienced gastric distension and difficulty swallowing for over a month. After barium meal and gastroscopy, he was diagnosed with mid-esophageal adenocarcinoma. Due to financial difficulties, he requested to take traditional Chinese medicine and return to his rural home for recuperation. Examination revealed a red tongue, thick greasy coating, weak chi pulse, and tense guan pulse. [Prescription] 12 g of rehmannia root, 10 g of Chinese yam, 30 g of cornus fruit, 6 g of cortex moutan, 10 g of poria, 10 g of alisma, 6 g of coptis, 10 g of scutellaria, 10 g of astragalus, 10 g of angelica sinensis, 10 g of pangolin scales, 15 g of soapberry thorns, 10 g of dried lotus leaves, 6 g of curcuma, 15 g of fritillaria, 6 g of cortex moutan, and 10 g of salvia miltiorrhiza. Decoct in water, extract 800 ml of juice, take twice daily, 200 ml each time, after breakfast and dinner. After a year, the patient returned for follow-up, stating that he had consistently taken over 300 doses of the above prescription and now felt completely well, with a rosy complexion, robust physique, no more difficulty swallowing or gastric discomfort, and no positive findings on barium meal. Gastroscopy showed no abnormalities in the mid-esophagus, only chronic superficial and atrophic gastritis. This cure can truly be considered a miracle. When Professor Pei Zhengxue asked the patient how he managed to stick to the medication for so many years, he replied: “After taking just over ten doses, I felt much better and could eat a bit more. A year later, my condition improved significantly, which boosted my confidence, so I kept taking the medicine ever since.” Note: The above prescription combines Liuwei Dihuang Tang, Banxia Xiexin Tang, and Tuoli Tounong San. Liuwei Dihuang Tang supports righteous energy and strengthens the foundation; Banxia Xiexin Tang clears heat and dampness while regulating qi and expanding the middle burner; Tuoli Tounong San softens hard masses, activates blood circulation, supports righteous energy, and disperses blood stasis. Together, these formulas work to treat stubborn cancers effectively, and long-term continuous use yields great results. Case 2: Patient Zhang, male, 56 years old. He had been experiencing difficulty swallowing for three months, accompanied by gastric distension. After barium meal and gastroscopy, he was diagnosed with upper-esophageal squamous cell carcinoma, atrophic gastritis with intestinal metaplasia, and Helicobacter pylori positivity. He had previously undergone 20 sessions of cobalt irradiation, totaling 6,000 milliroentgens, which slightly improved his swallowing function, allowing him to consume milk and tea, but his gastric distension worsened compared to before, prompting him to seek treatment. At the time of consultation, in addition to the aforementioned symptoms, he also presented with severe constipation, reddish and bitter urine, a red tongue, thick greasy coating, and a deep, tense, rapid pulse. [Prescription] Combination of Dachengqi Tang, Sanhuang Xiexin Tang, and Qige San with modifications: 10 g of rhubarb, 3 g of coptis, 10 g of astragalus, 10 g of polygonatum, 10 g of magnolia bark, 10 g of poria, 6 g of curcuma, 10 g of salvia miltiorrhiza, 10 g of cortex moutan, 10 g of psoralea corylifolia, 6 g of amomum villosum (added later), 20 g of rice bran, and 10 g of lotus leaves. Decoct in water and take one dose daily. After taking 10 doses, the patient’s swallowing function improved markedly, allowing him to eat noodles, bread, and cookies. His bowel movements became regular, his urine turned clear, and his gastric distension and pain significantly eased. The tongue coating became thinner, so the original prescription removed the rhubarb and added 12 g of rehmannia root, 10 g of Chinese yam, and 10 g of alisma, continuing to decoct in water and take one dose daily. After another 10 doses, his swallowing function improved further, his gastric distension disappeared, his tongue remained red with a thin, slightly greasy coating, and he was treated with a combination of Liuwei Dihuang Tang, Sanhuang Xiexin Tang, salvia miltiorrhiza drink, and Qige San: 6 g of rhubarb, 3 g of coptis, 10 g of astragalus, 6 g of ginger, 6 g of pinellia, 10 g of salvia miltiorrhiza, 6 g of curcuma, 6 g of amomum villosum (added later), 12 g of rehmannia root, 10 g of Chinese yam, 10 g of cortex moutan, 10 g of alisma, 10 g of psoralea corylifolia, 10 g of fritillaria, 10 g of lotus leaves, and 20 g of japonica rice. Decoct in water and take one dose daily. In March 2001, the patient returned for follow-up, stating that he had taken over 90 doses of the above prescription, all symptoms had completely disappeared, and local barium meal and gastroscopy showed no lesions remaining. He was advised to grind the above prescription into pills, 6 g per pill, take three times daily after meals with warm boiled water, to ensure better efficacy going forward. Note: This cure can also be considered a miracle. The combination of Sanhuang Xiexin Tang and Dachengqi Tang addresses symptomatic treatment, while the combination of Liuwei, Qige, and salvia miltiorrhiza drink focuses on supporting righteous energy and treating the root cause. Using traditional Chinese medicine alongside radiotherapy yields far better results than radiotherapy alone. Case 3: Patient Pei, male, 58 years old. He had experienced esophageal obstruction for half a month, accompanied by nausea, vomiting phlegm and saliva, fatigue, chest pain, dry mouth, dry and hard stools, a dark-red tongue, white and greasy coating, and a tense, slippery pulse. Upper gastrointestinal radiography showed a filling defect in the upper esophagus, about 4 cm long, with irregular narrowing and mucosal damage, poor dilation, and obstruction of barium passage. Gastroscopy revealed congestion and erosion of the esophageal wall 25 cm from the incisors, prone to bleeding, with biopsy confirming squamous cell carcinoma. Diagnosis: Upper-esophageal squamous cell carcinoma, TCM differentiation: Qi stagnation and phlegm blockage, qi stagnation and blood stasis. Treatment principle: Transform phlegm and regulate qi, activate blood circulation and dissolve blood stasis. [Prescription] Qige San, Xuanfu Daizhe Tang, and modified Liuwei Dihuang Tang. 10 g of poria, 10 g of curcuma, 10 g of ginseng, 10 g of salvia miltiorrhiza, 10 g of fritillaria, 30 g of coix seed, 10 g of dried lotus leaves, 3 g of amomum villosum, 12 g of rehmannia root, 10 g of Chinese yam, 10 g of cornus fruit, 6 g of cortex moutan, 10 g of alisma, 10 g of prunella vulgaris, 10 g of psoralea corylifolia, 10 g of ageratum, 10 g of polygala tenuifolia, 10 g of xuanfuhua, 15 g of daizhe stone (added later), 6 g of pinellia, 6 g of ginger, 6 g of cloves, and 10 g of persimmon stem. After two rounds of treatment, taking 14 doses, the choking sensation during swallowing lessened, vomiting stopped, but chest pain, back pain, and fatigue persisted, indicating qi deficiency and blood stasis. The original prescription was then supplemented with Tuoli Tounong San, 15 g of astragalus, 10 g of angelica sinensis, 6 g of processed frankincense, 6 g of processed myrrh, 15 g of pangolin scales (decocted first), and 30 g of soapberry thorns. After persisting with the prescription for over six months, the condition improved, eating became smoother, and weight increased. He received radiotherapy at the Gansu Provincial Cancer Hospital, with a total radiation dose of 60 Gy. Subsequently, he continued taking the prescription for over 400 doses, maintaining stable condition and surviving healthily for two years of follow-up. Note: The treatment of esophageal cancer prioritizes regulating qi and opening up depression, transforming phlegm and dispersing stagnation. Qige San moisturizes dryness and generates fluids, regulating qi and clearing phlegm. Salvia miltiorrhiza, curcuma, and amomum villosum dissolve blood stasis and open up depression, while ginseng, fritillaria, and poria moisten dryness and disperse stagnation. Lotus leaves and rice bran humidify the stomach and reverse upward flow. Detoxification, blood activation, and blood stasis resolution are used in conjunction, with Qige San, Tuoli Tounong San, and Liuwei Dihuang Tang forming an effective prescription for treating esophageal cancer. This formula integrates regulating qi and opening up depression, activating blood circulation and dissolving blood stasis, transforming phlegm and dispersing stagnation, supporting righteous energy and strengthening the foundation—all at once, addressing both symptoms and root causes, combining attack and support, embodying the characteristics of TCM treatment for tumors. 7. A synthesis of theories from ancient and modern schools “The Plain Questions · On the Distinction Between Yin and Yang”: “When the three yang energies become blocked, it is called ‘ge’.” “The Plain Questions · On the Evaluation of Deficiency and Excess”: “If the ‘ge’ is completely blocked, with no communication between top and bottom, it leads to sudden anxiety.” “The Plain Questions · On Wind”: “The symptoms of stomach wind include excessive sweating around the neck, aversion to wind, inability to eat or drink, resulting in blockage and fullness of the abdomen. If one wears too little clothing, the stomach expands; if one eats cold food, diarrhea occurs. The body appears thin but the abdomen is large.” “The Treatise on Cold Damage · On Pulse Diagnosis”: “Food suddenly fails to pass through, with qi filling the area above the ‘ge’.” “The Essential Compendium of the Golden Cabinet · On Vomiting and Diarrhea”: “For all types of vomiting where grain cannot pass through, the Small Pinellia Decoction is the primary remedy.” “The Complete Book of Jing Yue · On Miscellaneous Syndromes of ‘Ge’”: “The ‘ge’ syndrome invariably arises from accumulated worries, thoughts, labor, and depression, or from excessive indulgence in alcohol and sexual activity.” “The Heart Method of Danxi · On ‘Fan Wei’”: “‘Fan Wei’ is essentially ‘ge,’ and ‘ge’ is the gradual manifestation of ‘fan wei’... ... Elderly people, if left untreated, will produce feces like sheep droppings, which are also untreatable...” “The Standard Manual of Diagnosis and Treatment · On ‘Ge’”: “‘Ge’ refers to food entering the throat but being obstructed and unable to pass through—some can swallow, some cannot, some vomit, some cannot vomit. Therefore, a separate category is established... . When there is a lump in the throat causing food to be stuck, use two liang of kelp.” “The Treatise on the Origins and Symptoms of Various Diseases · On ‘Ge’ Symptoms”: “This is caused by cold internal organs and lack of proper regulation, leading to insufficient fluid and inability to transmit food. Thus, when food enters, it gets stuck and cannot pass through, hence the term ‘food choke.’ There is chest pain, difficulty breathing, and inability to eat, which is why it’s called ‘ge.’” “The Golden Mirror of Medical Classics · Key Principles of the Heart Method for Treating Miscellaneous Diseases”: “When the three yang energies become excessively hot and deplete the body fluids, the spirit becomes dry and unable to circulate properly, leading to blockage of the gate and inability to accept food. The gate does not release the ‘fan wei,’ and the two conditions remain linked, causing the spirit to become increasingly rigid and inflexible. Chest pain, hard stools like sheep droppings, and vomiting blood make survival difficult.” Zhang Zesheng: Treatment for ‘ge’ should be divided into early, middle, and late stages. In the early stage, the pathological change lies in qi; generally, liver-soothing, qi-regulating, and depression-relieving methods are used. In the middle stage, due to liver qi depression and prolonged stagnation, qi turns into fire, burning the body fluids and turning them into phlegm. Phlegm and qi combine, hindering the smooth flow of qi and blood, so treatment focuses on transforming phlegm and removing blood stasis. In the late stage, righteous energy declines, the body becomes emaciated, yin deficiency and yang excess occur, or the vital gate fire weakens, or the fire fails to warm the earth, resulting in spleen-kidney yang deficiency. Treatment should focus on warming yang and tonifying qi. Wang Jemin: Through observation of the tongue, he believes that esophageal cancer often involves blood stasis. From the perspective of syndrome differentiation, treatment can be divided into qi stagnation, blood stasis, and deficiency of righteous energy. In the early stage, qi stagnation and blood stasis are most common, while in the middle and late stages, blood stasis and deficiency of righteous energy are more prevalent. Generally, qi stagnation and blood stasis coexist, so qi-regulating drugs and blood-activating drugs are used together. Zhang Daizhao: Emphasizes the integrated treatment of esophageal cancer using both traditional Chinese medicine and Western medicine. Integrated treatment of esophageal cancer is a characteristic of Chinese oncology research. Starting from syndrome differentiation, it adjusts bodily functions, improves symptoms, reduces side effects of radiotherapy and chemotherapy, combines overall and local treatments, supports righteous energy while dispelling evil, attacks and supports simultaneously, leverages strengths and compensates for weaknesses, thereby improving therapeutic efficacy. Combining traditional Chinese medicine with radiotherapy for esophageal cancer not only reduces toxicity but also enhances effectiveness; combining traditional Chinese medicine with chemotherapy can alleviate chemotherapy side effects and boost patients’ immunity; combining traditional Chinese medicine with surgery, using righteous-energy-supporting TCM before surgery can improve patients’ nutritional status, facilitating smoother operations; consolidating treatment effects and maintaining therapeutic action, after radiotherapy, to prevent local recurrence and stenosis, in addition to providing qi-tonifying, blood-nourishing, heat-clearing, detoxifying, spleen-strengthening, and stomach-soothing agents, also supplement with softening-hardening, blood-stasis-dissolving, and hemostatic anticancer drugs. Anatomical, physiological, and pathological aspects The stomach is a sac-like organ located in the left hypochondriac region and the epigastric region of the upper abdomen. It has two openings—one for entry and one for exit—and two walls, front and back, as well as two edges, left and right, convex and concave. The entrance is called the cardia, and the exit is called the pylorus. The shorter concave edge is the lesser curvature, while the longer convex edge is the greater curvature. The stomach’s physiological functions include secreting gastric juice, mixing and stirring food through movement, emptying food, and preparing and transporting food for digestion and absorption in the small intestine. The most common sites for gastric cancer are the gastric antrum (58%), the cardia (20%), the gastric body (15%), and the entire stomach or most of it (7%). Broadly speaking, there are mass-type, ulcer-type, and infiltrative-type cancers; tissue classification is based on gland formation and mucus secretion ability, dividing into tubular adenocarcinoma, mucinous adenocarcinoma, medullary carcinoma, and diffuse carcinoma; according to the degree of cancer cell differentiation, there are low-differentiation and high-differentiation cancers. Gastric cancer cells can originate from the columnar epithelium of the gastric mucosa, or from intestinal metaplastic epithelium. The former is more common among women and young adults, with a poorer prognosis; the latter is more common among elderly men and patients with atrophic gastritis. According to the depth of gastric cancer invasion into the stomach wall, there are superficial and non-superficial types. The former refers to gastric cancer cells invading only the mucosal layer and submucosal layer, typically early-stage gastric cancer; the latter invades the mucosa, submucosa, muscular layer, serosa, as well as adjacent tissues and distant metastases, usually mid- to late-stage gastric cancer. 2. Diagnosis and treatment (---) Clinical diagnosis The symptoms of gastric cancer include upper abdominal pain, distension, emaciation, loss of appetite, black stools, vomiting, and hematemesis. Abdominal pain initially occurs in the gastric region, sometimes mild, sometimes severe, similar to ulcer disease. If there is metastasis to nearby tissues or mesenteric lymph nodes, it can spread throughout the abdomen. Peritoneal metastasis may result in ascites; liver metastasis may cause hepatomegaly and jaundice; lung metastasis may manifest as cough, blood in sputum, and difficulty breathing; bone metastasis may cause pain in the lower back, limbs, and other areas; brain metastasis may present with symptoms of intracranial hypertension; pelvic metastasis may lead to constipation and gynecological symptoms. Some gastric cancers may show metastatic symptoms first, with primary symptoms appearing later. Early-stage gastric cancer often lacks obvious physical signs, while advanced-stage gastric cancer may present with lumps in the upper abdomen, hard texture, uneven surface, nodular appearance, tenderness upon palpation, and widespread infiltration, with a higher detection rate. Gastric antrum cancer ranks second, while cardia cancer is harder to detect. Late-stage gastric cancer is often accompanied by emaciation, anemia, and exhaustion.