( Tải về vẫn đủ trang - Sự tích hợp của lý thuyết Phù chính cố bản và thuật châm cứu Đổng thị nâng cao trong điều trị ung thư

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The Integration of Fu Zheng Gu Ben Theory and Master Tung’s Acupuncture in Advanced-Stage
Oncology Patients Undergoing Metronomic-Dosed Chemotherapy
Darin J. Bunch, MTCM, L.Ac.


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Contents
Foreword

3

Introduction to Fu Zheng Gu Ben Theory and Its Application in Oncology

3

General Pattern Differentiation Guidelines of Fu Zheng Gu Ben Theory

4

Introduction to Master Tung

6

Advantages of Master Tung’s Acupuncture

7

Master Tung’s Location of Extra Points and Naming of the Points

8

Body Correspondence, Angle and Depth of Needle Insertion, and Needle Retention

10

Master Tung’s and Dr. Wei-Chieh Young’s Essential Needling Methods

12

Traditional Chinese Medicine and the Etiology and Pathology of Tumors

15

The Seven Emotions Damaging the Body’s Internal Environment

23

Zang-Fu Organ Deficiency

23

Dietary Irregularities, Toxic Foods, and Inappropriate Diet Regimen

25

Metronomic-Dosed Chemotherapy

27

Master Tung’s Acupuncture in Advanced-Stage Oncology Patients Undergoing MetronomicDosed Chemotherapy

29

Chinese Herbal Medicine in Fu Zheng Gu Ben Theory

39

Chinese Herbal Formulas Used in Fu Zheng Gu Ben Theory

52

Congees That Help Strengthen and Support Advanced-Stage Oncology Patients Undergoing
Metronomic-Dosed Chemotherapy

57

Lifestyle, Qigong, Meditation, and Nutrition for Advanced-Stage Oncology Patients Undergoing
Metronomic-Dosed Chemotherapy

64

Support Networks, Patient’s Mental Attitude and Conclusion

67

References

69

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Foreword
Cancer is certainly a complex disease and no individual is untouched in the Western
world without knowing someone—a friend, loved one, family member—who has not been
diagnosed with some type of cancer. Certainly it is a disease not fully understood even with all
the technology that we have available today and all the brilliant scientists working to eradicate
the disease. I have always noted that the disease is brilliant in one way in keeping our scientists
still guessing about the origins, mechanisms and pathways of the disease process while also
being not so intelligent as to inevitably (in most circumstances) terminate its host which will end
even cancer’s proliferation.
This paper will address my decade of experience as an acupuncturist and Chinese
medicine practitioner for the Seattle Cancer Treatment & Wellness Center/Cancer Treatment
Centers of America known to specialize in managing advanced-stage oncology patients receiving
metronomic-dosed chemotherapy utilizing Fu Zheng Gu Ben Theory and Master Tung’s style of
acupuncture in an integrated clinical setting.

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Introduction to Fu Zheng Gu Ben Theory and Its Application in Oncology
In what is commonly referred to as traditional Chinese medicine (TCM), Fu Zheng Gu

Ben or alternately, Fu Zheng Pei Ben refers to supporting the healthy Qi and optimizing the
body’s innate natural resistance to disease. In this paper, I will use Fu Zheng Gu Ben (FZGB).
Broken down, Fu Zheng translates as “support the upright” Qi of the body and Gu Ben translates
as “consolidate the root” to strengthen the resistance to illness (Pan, Cai, Chen, Webb, & Chen,
1992).

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Chinese medicine and allopathic medicine agree that cancerous tumors are a localized
manifestation of a pathology that exists in the entire body. This pathology can result from
exposure to toxins such as radiation or carcinogenic chemicals, or owing to exogenous
pathogens, a malfunctioning immune system or immunodeficiency, poor nutrition, hereditary
tendencies, weakness or damage to the organs, prolonged Qi and/or Blood stagnation, prolonged
Blood or Yin deficiency, emotional factors and more. Combinations of these factors may be
involved as well, such as hereditary tendencies combined with poor nutrition, or immune
deficiency with sufficient exposure to carcinogenic toxins. When applying FZGB theory, it is
essential to properly evaluate the patient’s constitution and differentiate the syndrome so that the
proper support can be executed. Treatment of symptoms should be subordinate to accurate
pattern identification in order to provide the best care to the patients in counteracting adverse
reactions to harsh allopathic treatment modalities and increase a patient’s quality of life before,
during and after such therapies—predominantly therapies such as, chemotherapy, radiation, and
surgery (Heuertz, 2006).

General Pattern Differentiation Guidelines of Fu Zheng Gu Ben Theory
FZGB theory when applied therapeutically to advanced-stage oncology patients should
be adjunct to primary allopathic oncology treatments. Firstly, it should address the underlying
constitutional root of the pathology. Secondly, it should address the clinical manifestations

directly or compensating for the imbalances and the clinical adverse reactions caused by
aggressive allopathic treatments (Heuertz, 2006).

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Two pairs of opposing principles, representing four of the “eight principles” of TCM
diagnosis are commonly used to determine underlying constitutional root in cancer patients. The
first category distinguishes between the opposing but interdependent principles of Yin and Yang;
the second between excess and deficiency. It is of utmost importance to make appropriate
distinctions. For example, deficient Yin is treated by nourishing the Yin using herbs of Yin
nature. Alternately, excessive Yin is treated with herbs of a Yang nature which either boost the
Qi, actively drain or dry, warm or invigorate the circulatory system—all of which are Yang
actions. Failure to distinguish between the Yin or Yang nature of the patient’s condition can
result in the selection of herbs that are counter-productive. This can be extended to acupuncture,
though typically it is considered by TCM practitioners that acupuncture is far more forgiving
than Chinese herbal medicine in that it is not putting a supplement into the body with complex
chemistry. This can be determined used as what is commonly referred to as the “four
examination techniques” used in TCM. They are as follows: (a) looking/inspection, (b) listening
and smelling, (c) asking/inquiring, and (d) touching/palpation. For example, if there is only
excess in the pulse, if the cancer is in the early stages, and the constitution is otherwise strong
with sufficient, smooth-flowing Qi, a focused, localized intervention is recommended. However,
if the pulse reveals some underlying weakness, such as Yin, Qi, or Blood deficiency, if the cancer
has already progressed beyond the early stages, or if the constitution shows immunodeficiency,
then it is best to include a formula and acupuncture treatment strategy that boosts or nourishes
the weakened energy in order to attempt to bring the body into equilibrium (Heuertz, 2006).
In addition to the underlying root of the patient, there is often a particular clinical
manifestation or several manifestations involved. These manifestations may be caused by the

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toxicity of the tumor, a malfunctioning immune system, the physical blockage resulting from the
tumor, or they can arise as an adverse reaction of the allopathic treatment. Often, a patient may
experience depression from the chemotherapy or diagnoses of cancer, loss of appetite, or the
physical location of the tumor may interfere with breathing, swallowing, or urination. These are
all considered branch symptoms. Adjunct FZGB can help alleviate the patient’s symptoms,
strengthen their body, enhance the effects of chemotherapy, radiotherapy, and speed healing after
surgery. In my own clinical experience I have found that both acupuncture and Chinese herbal
medicine can greatly offset the adverse reactions of allopathic treatment modalities in patients
diagnosed with advanced-stage cancer (Heuertz, 2006).

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Introduction to Master Tung
The Tung family lineage of acupuncture can be traced back to the Han Dynasty (206
BCE - 220 CE). It was passed orally always from the father to the eldest son and never to a
daughter residing in the Tung family due to the implications that if she possessed the Tung style
of acupuncture and married, her new family would be taught the Tung’s style of acupuncture,
thus breaking the lineage. Not until the 20th century where the last Master Tung, Tung Ching
Ch’ang, then residing in Taiwan decided to train outside of his family in order to preserve his
family’s acupuncture lineage to benefit future generations. The world was changing and so did
Master Tung Ching Ch’ang. It is documented that through the rest of his life from July 1,
1962-1975, he trained 73 students (McCann & Ross, 2012, p. 11).

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Advantages of Master Tung’s Acupuncture
Those that pursue the ongoing didactic and clinical training and practice of Master Tung’s
acupuncture techniques know that the needling is conducted away from the diseased area(s).
One advantage of this needling approach is that local areas, which may be quite sensitive, do not
need to be needled directly. For example, often in the case of advanced-stage oncology patients,
the tissue may be inflamed and painful, or necrotic. TCM acupuncturists would not typically
needle the breasts either. However, they may surround the breast, adjacent to the necrotic tissue
which can be both painful and emotionally traumatic to the patient due to the erosive effects
tumors can have. Additionally from my experience, often the oncologist and nursing staff needs
access to the port placed below the clavicle, and the clinicians may need to palpate and examine
the site of disease during their acupuncture session. Acupuncture needles inserted away from the
site of disease is very logical for this reason when working in a multidisciplinary facility.
Various scholars of Master Tung have repeatedly enforced that contralateral needling from the
area of the disorder is done based on classical TCM channel theory. A general rule of thumb and
written in Dr. Wei-Chieh Young’s book, Lectures On Tung’s Acupuncture Points Study states in
Biao You Fu’s poetry on Cross Channel Needling: “Treat problems on the left with points on the
right. Treat local problems with distal points (to drain away the problem). Treat disorders on the
head with points on the feet” (2008, p. 12).
“Never underestimate the power of one needle!” One of my mentors repeatedly said this
in various seminars I had throughout the years and I continuously remind myself of this
important lesson. Master Tung and his acupuncture points strategy uses fewer needles that have
often profound and quick results when done correctly. It is less invasive to the patient when

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using fewer needles away from the site of pain or disharmony and far less traumatic both from a
psychological as well as physical perspectives. For the acupuncturist, as one becomes more
skilled, they are able to select a treatment strategy that requires only a few needles to be
punctured on the body which will have a more focused treatment with greater therapeutic results.
Furthermore, many problems can be addressed by needling only one point. Having an extensive
understanding of Channel theory, classical acupuncture texts, and Master Tung’s applications of
points will allow for the selection of less points to be used with a far more extensive and potent
acupuncture treatment.

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Master Tung’s Location of Extra Points and Naming of the Points
In the Master Tung acupuncture system, there are over 740 points located on the hands,
arms, feet, legs, ears, head and face. A system was developed to help organize and locate the
points. Points on the fingers are defined as “11.00,” point on the hand are “22.00,” points on the
forearm “33.00,” points on the upper arm “44.00,” points on the plantar side of the foot “55.00,”
points on the medial and dorsal side of the foot “66.00,” points on the leg “77.00,” points on the
thigh “88.00,” points on the ear “99.00,” points on the head and face “1010.00,” points on the
back “DT.00,” and points on the chest “VT.00” (Wang & Vasilakis, 2013, p. 20).
Master Tung’s points have never been named using their own name by any of the Tung
lineage nor senior practitioners of Tung-style acupuncture. For example, Master Tung did not
name point FuKe (11.24) as “Tung’s Gynecology Point.” It is named “Female Gynecology”
because of the profound effects it has in treating gynecological issues. Points are named
according to their locations such as CeSanLi (77.22) which means “beside-sanli” in reference to

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it being lateral to Zusanli (ST-36). Some points are named according to their actions or after the
five elements such as ShuiJin (1010.20). ShuiJin’s (1010.20) name “implies the connection
between the Water (Kidney) and Metal (Lung). It strengthens both the Lung and Kidney,
promoting the descending function of the Lungs and the receiving function of the Kidney. This
has excellent outcomes for treating and regulating respiration. So it has very good effect in
regulating respiration” (Young, 2008a, p. 240).
Others are named after the Zang-Fu such as Dan (11.13) which means “Gallbladder.”
The indications for this two-point unit is for palpitations and morbid night crying of babies.
“With the extraordinary connection of the Heart and Gallbladder, it is also effective for infantile
night crying and fright due to deficiency of the Gallbladder. This point is located on the
Pericardium channel. Since the Pericardium has the connection with the Stomach, and
disharmony of the Stomach may disturb the sleep, and therefore the point can treat the above
disease. This is the same reason for the indications related to the Gallbladder” (Young, 2008a, p.
54).
Some are named after indications that they treat such as GanMen (33.11) which translates
to “Liver Gate.” This point is most effective for acute hepatitis. Some are named after the
location and action like ZhiShen (11.15) which translates to “Finger Kidney” as it is located on
the fourth metacarpal which is the San Jiao channel. The San Jiao connects to the Kidney so
therefore this point is indicated for treating dry mouth, Kidney deficiency and back pain. Some
are named according to number such as SanZhong (77.07) which is named “Third Weight” after
YiZhong (First Weight, 77.05) and ErZhong (Second Weight, 77.06). These points are frequently

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needled simultaneously to treat hyperthyroidism due to heart diseases or for lumps and cranial

tumors (Young, 2008a).

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Body Correspondence, Angle and Depth of Needle Insertion, and Needle Retention
Body correspondence that Master Tung employed corresponds to the following:

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• Skin to treat skin
• Muscle to treat muscle
• Tendon to treat tendon
• Vessel to treat vessel
• Bone to treat bone (Young, 2008a, pp. 15-16).

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This can be applied in theory to any acupuncture points, including those on the 14
channels to enhance therapeutic effects. Examples are: When a disease such as urticaria, which
has a component of Wind lodged in the skin, superficial shallow needling at XueHai (SP-10) can
be performed. If it is deeper lodged in the muscle, the same point can be needled to a depth that
reaches the muscle layer. Needling YangLingQuan (GB-34) close to the tendon or into the
tendon has a more profound effect on the sinews and tendons than needling in its common
location just slightly anterior and inferior to the head of the fibula. Another example is in the
case of whiplash where a patient cannot extend or flex the neck, needling both ZhengJin (77.01)
and ZhengZong (77.02) through the tendon has profound and immediate relief. TaiYuan (LU-9)
is proximal to the radial artery and is the “Influential Point of Vessels” which treats vascular

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diseases very effectively. RenZong (44.08) is supplied by the cephalic vein and radial collateral
artery and DiZong (44.09) is supplied by the post-humoral circumflex artery and the Axillary
nerve. Both points are close to large vessels and can effectively regulate blood circulation and
help with those patients suffering from arteriosclerosis and heart disease with excellent results.
Puncturing ZuSanLi (ST-36) alongside the bone with deep insertion and ShenGuan (77.18)
touching the periosteum can tonify the Kidney and treat bone pain (Young, 2008b, pp. 18-20).
Attention to needle angle, depth, and location of the points is also necessary to have
desired therapeutic efficacy when applying Master Tung’s principles. Again, let’s use the
acupuncture point ZuSanLi (ST-36) as an example. Needling it to a fairly shallow depth of 0.5 to
1 cun treats pain and diseases of the leg. When you needle to a depth of approximately 1.25 to
1.5 cun (depending on the size of the patient’s leg), it will treat diseases in the Middle Jiao. With
needling to a deeper depth of approximately 2 cun, with long needle retention of 45 minutes or
greater, it is effecting for asthmatic breathing and heart diseases. When you needle to a depth of
2.5 to 3 cun, you can treat headache. Alternately, when you needle to a depth of 2 cun needled
obliquely against the Foot Yangming Stomach channel upward, the point is more effective for
facial paralysis. Additionally, when you needle this point closer to the bone and to a deeper
level, you effect the Kidney more as “bone to treat bone.” When you needle ZuSanLi (ST-36)
three cun below DuBi (ST-35) and one finger breadth lateral to the tibial bone, it primarily
affects the Spleen and Stomach channels. Lateral to the standard location, you affect not only
the Spleen and Stomach, but additionally, the Gallbladder as well. Master Tung employed
different applications of needle insertion theory, but one of the most important and useful

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clinically is needle shallowly for acute or localized diseases and deeply for chronic, stubborn or
distal diseases (Young, 2008b, pp. 18-20).
In Lectures on Tung’s Acupuncture Points Study, Dr. Young describes that acupuncture

needle retention should be at least 30 minutes based on the Ling Shu, Ying Wei Sheng Hui (The
Origin of the Nutrient and Defensive Systems and Qi Circulation in Them, Miraculous Pivot)
which describes one whole circulation of Qi and Blood in the body takes 28 min, 48 sec to make
its way throughout all the channels. Rounding up, typically retention is at least 30 minutes.
Master Tung usually retained the needles for 45 minutes for greater therapeutic effects (2008a, p.
26). In general, it is suggested the needle retention should be for 45 minutes or longer for
stubborn and chronic conditions, cold syndromes, acute abdominal pain and severe diseases (pp.
18-20). In modern times, people and many acupuncture practices are busy. Therefore, in these
circumstances or a lack of additional space and treatment rooms, needle retention should at least
be for at least 30 minutes.

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Master Tung’s and Dr. Wei-Chieh Young’s Essential Needling Methods
Dr. Chuan-Min Wang so easily explains Master Tung’s usage of Dao Ma needle
technique in his book, Introduction to Tung’s Acupuncture. Dao Ma is the usage of typically two
and sometimes three needles spaced 1 to 2 cun depending on the anatomical region and zone the
practitioner is working (note: this can also be a smaller space depending on smaller areas such as
the thumb and fingers and the desirable therapeutic effects and acupuncture treatment strategy).
When utilizing the Dao Ma technique, there is increased therapeutic results as the De Qi
sensation is frequently enhanced and the free flow of Qi is more readily mobilized through the

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San Jiao channel to allow for the regulation of all the bowels and viscera, thereby strengthening
the overall efficacy of the acupuncture treatment strategy by treating the whole body (Wang et
al., 2013, p. 226). For example, if you needle HuoZhu (66.04) and then HuoYing (66.03) which
is one cun distal from HuoZhu (66.04) this will have greater therapeutic effects and is just one

illustration of Master Tung’s Dao Ma technique.
In Dr. Young’s (Young, 2008a) book, Lectures on Tung’s Acupuncture Points Study, he
explains the use of Master Tung’s mobilizing Qi technique which is referred to as Dong Qi
technique. An example of this technique when treating with Foot Taiyang Urinary Bladder and/
or Foot Shaoyang Gallbladder sciatic leg pain is after inserting LingGu (22.05) and DaBai
(22.04) once the desired De Qi sensation has been obtained, ask the patient to move the affected
leg which is generally in most instances on the contralateral side to the acupuncture needles.
When possible, it is best to rotate the needle with the movement of the affected area being
treated. When the pain decreases or entirely ameliorates, this is indicative that the union of the
acupuncture point(s) and technique and the affected area have been balanced. For chronic cases,
the needle should be retained for longer periods of time typically 30-45 minutes (and in some
cases even longer such as stubborn migraines) and rotated at 10-15 minute intervals repeating the
Dong Qi application described above. If the patient is having chest pain for example needle
NeiGuan (PE-6), using the Dao Ma technique, Neiguan (PE-6) and DaLing (PE-7) and ask them
to take several deep breaths. The pain or discomfort will diminish within seconds as it helps
circulate and bring the Qi to the area of concern thus, another Dong Qi treatment strategy. A
third example: for abdominal and stomach pain needle NeiGuan (PE-6) and JianShi (PE-5) or
MenJin (66.05) with NeiTing (ST-44) another two point Dao Ma technique then ask the patient

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to take deep abdominal breaths and massage the area to reduce or entirely relieve the discomfort
(pp. 20-21).
Dr. Wei-Chieh Young developed a technique which he refers to as Qian Yin (Guiding)
needle method after many years of observing Master Tung’s Dong Qi techniques and based on
his own clinical experience. In his book, Lectures On Tung’s Acupuncture Therapeutic System,
he explains this in detail. For example, we can use the above example of LingGu (22.05) and

DaBai (22.04) needled contralateral to the site of pain. The Shu-Stream points are needled on
the diseased side as a way to help guide or attract the Qi to the diseased channel. For example, if
the pain is along the Foot Taiyang Urinary Bladder channel, you would use ShuGu (BL-65).
Alternately, if the pain is along the Foot Shaoyang Gallbladder channel, you would needle
ZuLinQi (GB-41). If the pain were to occur in both channels simultaneously, you would use
both Shu-Stream points to attract or guide the Qi (2008b, pp. 16-17).
Dr. Young (Young, 2008b) explains in his book, Lectures on Tung’s Acupuncture
Therapeutic System:
It is a needing method that is used to attract the Qi flowing to the desired
area. It is based on the theory of “attracting effect.” If we needle two
points at the same time and then withdraw one needle, the Qi of the other
point will be attracted and flows towards and finally arrives at the area of
the withdrawn needle. If you give a short stimulation to one of the two
points, the Qi will flow towards the retained needle. This is the basic
mechanism of the attracting needling technique. (p. 16)

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Bloodletting was commonly used as a part of Master Tung’s techniques and treatments
strategies. The Nei Jing refers to this method of treatment throughout its chapters in treating
chronic, recalcitrant diseases. In Tung’s acupuncture point strategies, most of the points on the
Back (DT.00) and Chest (VT.00) are bled using a three-edged needle. Other very important
areas to bleed are ChiZe (LU-5) for all diseases in the upper body and WeiZhong (BL-40) for all
diseases of the lower body and lower extremities, head and back (McCann & Ross, 2012, p.
209).

Traditional Chinese Medicine and the Etiology and Pathology of Tumors

It is imperative to understand the fundamental etiologies and pathologies from a
traditional Chinese medicine (TCM) perspective before delving into FZGB’s role integrating
Master Tung’s acupuncture treatment strategies with oncology patients undergoing metronomicdosed chemotherapies.
The six exogenous excesses in TCM are considered to play a major role in tumor
formation. In TCM theory, invasion by any exogenous pathogens, including man-made in
modern day such as chemicals and environmental pollutants, can impede the Zang-Fu organs,
and obstruct the circulation of Qi and Blood, leading to Qi stagnation and Blood stasis. In doing
so, if the Wei Qi is weak or deficient, this can create accumulation and congeal non-pathologic
fluids into Phlegm-Damp which in turn can lead to the formation of tumors (Li, 2003, pp. 19-27).

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Exogenous Wind Invading the Lungs
Exogenous Wind is a external pathogenic factor. The reason for this is it can invade the
body on its own or combine with other pathogenic factors such as Cold, Heat, Dampness,
Summerheat and Dryness (Li, 2003, pp. 19-27).
Exogenous Wind is a Yang pathogenic factor. It penetrates the skin and impairs the
movement of Wei Qi. It has a tendency to move upward and outward. Often it invades the upper
portions of the body obstructing the Lung channel and then with no predictable course, it can
spread to many other regions of the body (Li, 2003, pp. 19-27).
Exogenous Wind can combine with Heat and assault the body. If the Heat becomes
extreme, it will inevitably generate internal Wind so the two pathogenic factors have a
concomitant relationship with one another. If the body is unable to extinguish these pathogenic
factors due to Wei Qi deficiency or the endogenous factors are too robust, Heat Toxins will ensue
and attack the Zang-Fu as well as the channels and network vessels. This may propagate various

pathological mutations within the organism (Li, 2003, pp. 19-27).

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Exogenous Invasion of Pathogenic Cold
Exogenous pathogenic Cold primarily injures the skin and flesh but can also affect the
Zang-Fu, bypassing the skin and flesh. Cold is a Yin pathogenic factor and impairs Yang Qi.
Accumulation of Cold leads to Yin abundance with Yang debilitation. The body’s Wei Qi is
responsible for warming and protecting and the Spleen Qi’s role is that of transforming and
transporting. When they become impaired, a Yin-Cold pattern will manifest. Cold symptoms
associated with cancers of the digestive system are commonly pain in the Middle Jiao and emesis

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or diarrhea caused from exogenous Cold injuring the Yang Qi of the Spleen and Stomach.
Additionally, if Cold injures the functions of the Kidney, Kidney Yang will become impaired and
its ability to contribute in assisting the Wei Qi is further debilitated as the Ministerial Fire is
unable to warm the body at its optimal level (Li, 2003, pp. 19-27).
Furthermore, patients will present with cold and pain in the lower back and spine. With
complications of cancerous tumors or otherwise, patients may also have ascites, and edema
typically in the lower extremities but can be elsewhere such as the face or upper extremities as
well (Li, 2003, pp. 19-27).
Cold is congealing and stagnant in nature; it causes constriction and tension, leading to
discomfort and pain. Cold is sluggish in movement by its very nature. It obstructs and blocks
the movement of Qi and Blood. Tumor-induced pain is similar to the mechanism of pain caused
by Cold in clinical practice. Therefore, warming Cold and ensuing the free flow of Qi while
invigorating Blood concomitantly helps to reduce or ameliorate tumor-related pain (Li, 2003, pp.
19-27).

Exogenous Cold invading the skin and muscles directly causes the hair follicles to
contract trapping Cold which in turn obstructs the Wei Qi resulting in aversion to Cold and fever.
Recalcitrant fever in patients with advanced-stage cancers can often be effectively managed by
treating Cold. If Cold affects the joints, stiffness in the channels and network vessels will occur.
Numbness, coldness, and a hypertonicity can be observed and palpated with a decrease in
flexibility and range of motion to the affected areas of the body. Often the extremities and low
back will be cold to the touch and the patient will report that they are experiencing stiffness in
the joints and numbness in the extremities, trunk, and/or face and head (Li, 2003, pp. 19-27).

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Exogenous Summerheat Damaging Qi
Summerheat is a Yang pathogenic factor. Its very nature is hot and it scorches the Yinfluids within the body causing them to congeal due to the drying nature of Summerheat. With
the congelation of the fluids, Qi and Blood are again obstructed. Stagnation of Qi and Stasis of
Blood may occur with severe damage to the Yin-fluids of the body and can propagate the
formation of tumors (Li, 2003, pp. 19-27).
Additionally, Summerheat and Damp often amalgamate particularly in humid climates all
over the world. When this happens, Summerheat and Damp intertwine. When extreme, it
transforms into Fire and Fire Toxins will attack the body causing a vast variety of clinical
pathologies and presentations. Blood cancers such as leukemia patients often present with
profuse sweating and high intermittent fevers (Li, 2003, pp. 19-27).

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Exogenous Damp Generating Phlegm-Heat Toxins
When Damp penetrates the body, the functional activities of Qi are obstructed as well as
the Yang Qi is impaired. A Yin pathogenic factor, Damp is heavy, sticky, and viscous. It has a
tendency to linger and is difficult to transform and expel from the body. Damp, when it invades

the body, frequently obstructs the Zang-Fu, channels and network vessels. Damp is oppressive
and can cause shortness of breath and labored breathing in the chest, distention in the abdomen,
and problems with a feeling of complete evacuation with the bowel or difficult urination. When
Damp settles and lingers, Heat and Phlegm are generated and this can give rise to Phlegm-Heat
Toxins in the body (Li, 2003, pp. 19-27).

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The Spleen loathes Damp. When Damp invades, the Spleen Yang Qi is handicapped;
impairing its transportive and transformative abilities. Accumulation will result and ascites in
the peritoneum, edema in the extremities and face, and/or diarrhea may occur. Unfortunately,
when the skin and tissues are edematous or especially when there is ascites, the prognosis is very
poor for advanced-stage cancer patients. Typically, this is observed clinically at the most latentstage of neoplasms and Phlegm-Damp-Heat Toxins are prevailing while the patient’s Zheng Qi is
very debilitated. Palliative care is typically the best Eastern medicine can do in this scenario (Li,
2003, pp. 19-27).

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Dryness-Heat Damaging Lung Yin and Body Fluids
Dryness is a Yang pathogenic factor. It depletes the body fluids and inevitably leads to
Deficiency of the Yin. Dryness has a tendency to attack the Lung Yin which impairs the
dispersing and diffusing functions of the Lungs. Lung cancer is often presents with bloody,
scanty sputum which is Dryness and Heat smolder the lungs. Additionally, radiation therapy to
the head and neck, breast or lungs is an external form of concentrated Dryness-Heat, albeit manmade, it causes the Yin body fluids to become depleted often with permanent dryness issues such
as dry mouth and Xerostomia with reduced capacity for mastication (Li, 2003, pp. 19-27).

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Fire Toxins Scorching Yin

Fire can attack exogenously and is generally thought of as a more severe form of Heat.
Fire blazes upwards. Symptoms of profuse epistaxis, irritability, mental instability, mania,
incoherent speech, and high fever with profuse sweating can often present with Fire.

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Additionally, the pulse will be flooding and rapid frequently felt in all three positions. When
Fire Toxins are present, the Blood moves in a reckless fashion and damage to the vessels and Yin
can no longer contain the Blood causing hemorrhaging or profuse festering tumorous sores such
as in the case of certain types of breast cancer presentations. When this happens the Fire
scorches the Yin fluids causing congelation and Phlegm-Fire and Toxins are pathologically
abundant (Li, 2003, pp. 19-27).

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Additional Exogenous Factors
Our world with all its technological advances is not without imperfections. Biological
agents, exposure to toxic industrial chemicals or too many chemical agents that have a collective
effect, and wreak havoc in our bodies. The air that we breathe unfortunately has pollutants that
can cause unequivocal damage often irreversible to our internal environment ("Support PSR!,"
n.d.). Many laborers and tradespeople that worked around asbestos primarily in the late 19th
century inhaled small asbestos fibers. Over the course of a decade or two, a very high
percentage developed malignant Mesothelioma, a type of lung cancer (Peto, Seidman, &
Selikoff, 2005). Consumption of alcohol especially when in excess can increase our risks of
oral, pharynx, esophagus, breast, colorectal, and liver cancers ("Alcohol Use and Cancer," n.d.).

Phlegm-Damp Stagnation not Transformed
Phlegm and Fluids can collect and manifest in many ways. If not transformed by the

body, it pools and collects and may lead to serious pathogenic health complications. Phlegm, a
pathogenic substance, can obstruct the Lungs (known as Substantial Phlegm) causing cough and

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wheezing. Often, the phlegm may be able to be expectorated from the lungs; however, if the
phlegm is deep and stuck, it can be difficult to expectorate. Phlegm can block the orifices of the
Heart and leads to chest oppression and fullness, heart palpitations, metal confusion or muddled
thinking, or withdrawal from the external environment and regular social behavioral patterns.
When Phlegm collects in the middle Jiao and Stomach Fu, it can manifest as nausea and/or
vomiting accompanied by focal distention, fullness, and abdominal discomfort. When Phlegm
and Fluids combine with pathogenic Wind, they have a tendency to ascend leading to dizziness
or impairment of vision. Dampness and Fluids can spread beneath the skin and flesh resulting in
edematous tissue. Fluids that collect in the chest and hypochondrium will cause local pain that is
worse with coughing. Fluids above the diaphragm will present symptomatically with coughing
and the patient will not be able to lie in a supine position comfortably. Fluids in the Intestines
will manifest as abdominal dissension, decreased appetite, and borborygmus (Li, 2003, pp.
19-27).
Phlegm-Fluids stagnating internally manifests as various diseases. Yang Ke Xin De Ji (A
Collection of Experiences in the Treatment of Sores) says, “Cancers and tumors are not formed
by binding of Yin, Yang or Vital Qi (Zheng Qi), but by Blood stasis in the five Zang organs and
stagnation of turbid Qi or Phlegm” (Li, 2003, p. 24). Phlegm, coughing and wheezing, lumps
and accumulation of liquids in the body and many solid masses and tumors are frequently treated
according to the principles of transforming, dispersing, flushing out, or dislodging Phlegm (Li,
2003, pp. 19-27).

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Phlegm Invading the Channels, Interstices and Network Vessels
Over a long period of time if Phlegm accumulates, it will flow into the channels,
interstices and network vessels. When this happens and if it is not dispersed properly, it will
inevitably transform into Toxic accumulations, resulting in a condition of congealing of Phlegm
and accumulation of Toxins that blocks the channels, interstices and network vessels and inhibits
the Qi transformation in the San Jiao. Furthermore, congealing of Phlegm due to stagnation can
give rise to Heat and combine transforming into Phlegm-Heat Toxic accumulations. This can
affect any part of the body and manifest as malignant tumors. The primary methods in dealing
with this presentation is addressing Phlegm, dissipating Heat, and resolving Toxins. This has
been discussed in the prior section of transforming, dispersing, flushing out, or dislodging
according to TCM principles (Li, 2003, pp. 19-27).

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Qi and Blood Stagnation & Stasis
Many types of solid cancerous tumors are due to Qi stagnation and Blood stasis. The
Liver Channel spans over the entire breast(s) and the Stomach channel goes to the nipple and has
an external/internal relationship with the Spleen. When the Liver is affected by irritability and
depression, Liver Qi becomes stagnated and constrained damaging the Liver and its functions.
Likewise, the Spleen’s ability to transform and transport is impaired by excessive worrying and
preoccupation or poor dietary practices giving rise to Phlegm and Damp. These two pathological
states of the Liver and Spleen allow for Qi stagnation and Blood stasis to combine with Phlegm
and Damp to form masses and tumors. Beginning stage of breast cancer is treated by dredging

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the Liver and regulating Qi. As the tumor becomes firmer, Chinese herbal medicine is often
utilized to invigorate the Blood and transform Blood stasis (Li, 2003, pp. 19-27).

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The Seven Emotions Damaging the Body’s Internal Environment
The seven emotions can lead to internal damage and contribute to the formation of
malignant tumors. Grief, anxiety and irritability, excessive thought and neurotic behaviors
damage the Spleen and Stomach, consume the Blood and Body Fluids and cause Qi to stagnate
transforming to a more viscous substance in the body known as Phlegm. Once Phlegm is formed
anywhere in the body it is stubborn and resistant to transform back to a more fluid state. In the
case of breast tumors, Phlegm may lie dormant for several years until tumors gradually develop.
These tumors combine with heat toxins and eventually will invade others tissues and organs
within the body. Fu Ren Da Quan Liang Fang (Complete Effective Prescriptions for Women’s
Diseases) says: “Ru yan (mammary rock) is due to depression and anger in the Liver and Spleen,
and depletion of and damage to Qi and Blood.” Dan Xi Xin Fa [Danxi’s Experiential Therapy]
says: “A woman who has been in a state of anxiety and depression for a long period will have
obstruction of Spleen Qi and transverse counterflow of Liver Qi. This will gradually give rise to
dormant nodes” (Li, 2003, pp. 19-27).

Zang-Fu Organ Deficiency
The five Zang Yin organs and the six Fu Yang organs denote a functional relationship in
that the Zang are paired with the Fu in both a Yin/Yang polarity and an internal/external
relationship. The Zang-Fu along with the Extraordinary Vessels, Essence, Qi, Blood and Body

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Fluids forming the material basis via the channels and network vessels functioning as pathways
of communication (Li, 2003, pp. 19-27).
Zang-Fu deficiency not only means insufficiency of the congenital Pre-Heaven
constitution or deficiency of the acquired Post-Heaven constitution due to lack of nourishment, it
also includes depletion and damage to the organs’ functions due to the Six Excesses, internal
damage caused by the seven emotions and dietary irregularities (Li, 2003, pp. 19-27).
During optimal conditions, the functions of the five Zang organs promote and control
each other—keeping one another in a state of balance with each Yin Zang paired with its Yang
Fu organs with an internal-external organizational relationship. The Zang organs govern the
limbs, the five sense organs and the nine orifices. Under normal conditions, this keeps bodily
functions harmonious and healthy—making a person’s body resistant to external pathogenic
factors. When the body system is compromised becoming depleted, pathological factors can lay
the foundation for tumor formation (Li, 2003, pp. 19-27).
As we age, the Kidney Qi gradually becomes more debilitated and the Zang-Fu organs
inevitably become more vulnerable and weakened giving rise to the increased ability of tumor
formation. The Wai Ke Qi Xuan (Revelations of the Mystery of External Diseases) clearly states
that: “cancers occur in persons aged 40 and older with depletion of Blood and debilitation of Qi,
and a predilection for rich foods” (Li, 2003, p. 11).
Likewise, gender also plays a role of the location of tumors. Women are more prone
towards tumor formation in the breasts and uterus. Men are more prone to cancers affecting the
Spleen such as gastrointestinal tumors and prostate cancer. In the Ling Shu: Shui Zhong (The
Miraculous Pivot: On Edema) it was recorded that Qi Bo said, “Shi jia (a stone-like mass) occurs

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in the uterus and therefor only affects women.” Ren Zhai Zhi Zhi Fang (Direct Indications of
Ren Zhai’s Formula) says, “In men, cancer is more likely to affect the spleen; in women the
breast.” When observing the causes of cancer, consideration should be given to the person’s
constitution, age and gender tot eh extent that these may be a factor to deficiency and depletion
of the Zang and Fu (Li, 2003, p. 26).

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Summary
The expansive scope of Chinese medicine considers that the complex development of
cancer is closely related to external pathogenic factors, dietary and emotional irregularities and
factors, Phlegm-Damp accumulations, and consumption and deficiency of the Zang-Fu organs.
In isolated circumstances, these etiological factors are not typically the cause of extensive
disease—being the sole cause of cancerous malignant tumors. However, when combined with
the appropriate external and internal factors affecting the body, they can propagate significant
Yin and Yang imbalance, disharmony of the Qi and Blood, dis-regulation to the Zang and Fu
organs, and local toxic pathogenic components that can lead to malignancies. Therefore, it is
essential to apply the methods of FZGB theory in patients diagnosed with cancer to help restore
the functions of the Zang-Fu and restore balance of the Yin-Yang relationship in the body.

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Dietary Irregularities, Toxic Foods, and Inappropriate Diet Regimen
Food and drink are an essential aspect in helping to maintain optimum health. The old
adage, “you are what you eat” is partially true however, the frequency, duration between meals,
portion size, variances of the types of foods and beverages, and food and beverage quality all

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