The application of the law of unity of opposites in the treatment of tumors by Professor Lin Lizhu Wang Shumei1,2 Directed by Lin Lizhu2 Wang Shumei, Department of Oncology, Second Hospital of Chongqing Medical University, Chongqing 401331, China; 2 Department of Oncology, First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China) [Abstract] Professor Lin Lizhu focuses on the application of the law of unity of opposites in the treatment of tumors, and her method is widely reflected in His method is widely reflected in various aspects such as balancing yin and yang, treating both the symptoms and the root cause, taking the upper disease down, attacking and supplementing at the same time, and supporting earth and suppressing wood. The “yin ping yang secret”. [Keywords] tumor; Chinese medicine treatment; Lin Lizhu; famous doctor’s experience Professor Lin Lizhu is the great director of the Department of Oncology of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, the supervisor of doctoral students, and the supervisor of the third batch of famous old Chinese medicine academic experience succession work in China. She has been engaged in clinical, teaching and scientific research work for more than 2O years. She has deeply applied Chinese medicine theories to the treatment of tumors, and deeply understood the contradiction between the essence of the specimen and the reality, and the machine is round and the method is active, and has made a lot of achievements. I had the honor to study with my mentor and was deeply enlightened by his profound understanding of the dialectic of the law of unity of opposites embedded in Chinese medicine. The occurrence of disease is a series of disorders of the unity of opposites, such as the disorders of the body’s yin and yang, Ying, Wei, Qi and blood, the movement in and out of the body, the cause of the positive and the evil, the subject and the essence, the disorder of birth and gram, and the disorder of movement and static. Now, we will summarize the application of the law of unity of opposites in his theory and prescriptions, such as balancing yin and yang, treating the symptoms together, taking the disease from above, attacking and supplementing at the same time, and supporting earth and suppressing wood, and try to introduce his experience as follows. Professor Lin believes that tumors are closely related to “phlegm stagnation”. Phlegm and dampness are both the causative factors of many cancers and the pathological products in the process of cancer development. Phlegm is a yin evil, which is sticky and easily injures yang qi, resulting in qi deficiency and yang weakness and loss of transportation. In turn, the deficiency of qi and the loss of transportation will further aggravate phlegm stagnation, which will affect biochemistry, congestion of qi, block blood flow, and cause all kinds of diseases. Eventually, old phlegm will be formed and become tumor due to agglutination and condensation. “The spleen is the source of phlegm production and the lung is the reservoir of phlegm”, phlegm and dampness are closely related to the lung and spleen. According to the dialectical relationship between phlegm-dampness and spleen deficiency, elimination of phlegm and strengthening of spleen are the key to treatment, and clinical practice should focus on the organic combination of the two, taking into account both the symptoms and the root cause. Take lung cancer as an example, the treatment of lung cancer is inseparable from the treatment of phlegm, and the root of phlegm in lung cancer lies in spleen deficiency. Patients often have cough and phlegm, chest tightness and shortness of breath, fatigue and laziness, dullness and emaciation, abdominal distension and loose stools, teeth marks on the edge of the tongue, white and greasy tongue coating, moist, slow and slippery pulse, and other symptoms of spleen deficiency and phlegm-dampness. The treatment is to tonify the middle and strengthen the spleen, promote the lung and remove phlegm. According to this treatment method, we give Yi Qi and eliminate phlegm soup (Prof. Zhou Daihan’s prescription: Dang Shen, Fu Ling, Semen, Beehive, etc.) plus and minus treatment, using Dang Shen, Atractylodes Macrocephala, Poria, Fu Ling, Coix Seed and other herbs to play the function of strengthening the spleen and dissolving dampness, and selecting raw Tian Nan Xing, raw Semen, Radix Platycodon, Quan Gua Lou, Zhe Bei Mu and other herbs to build the effect of dissolving phlegm and dispersing knots. The spleen is strengthened by the use of Radix Codonopsis every time, as it is the ruling herb of Si Jun Zi Tang, which benefits the qi and strengthens the spleen, protects the middle jiao, and helps the source of blood and vitality. The basic treatment of strengthening the spleen and dispelling dampness, removing phlegm and dispersing nodules reflects the opposing and unifying ideas of balancing the symptoms and the root cause, and complementing and dipping in parallel. [Yin deficiency and heat stasis are another pair of contradictions in the identification and treatment of tumors. Yin deficiency is the root of the disease. Yin deficiency leads to internal heat deficiency, which in turn decays the fluid, and fluid deficiency leads to sticky blood, thus forming stasis. The tumor itself is the microscopic evidence of stasis of blood. Yin deficiency produces internal heat, which is called deficiency heat. Qi stagnation does not ease the flow of blood, and the stagnation turns into heat, which is real heat. The deficiency heat and the real heat lead each other to incite and combine with the stagnant blood to form stagnant heat, which in turn leads to heat toxicity, and heat toxicity and stagnant blood in turn aggravate the dark depletion of Yin and Blood. Regarding the location of Yin deficiency, the instructor believes that it is most often seen in the lung, liver and kidney. The liver and kidney are of the same origin. If the kidney yin is insufficient, it cannot nourish the liver yin, which means that “water does not contain wood”, and clinically, it is obvious that the liver and kidney are not nourished and the yin deficiency is internally hot. Lung Yin deficiency is also valued by Lin Shi, as stated by former sage Gong Juzhong: “The essence of human life is based on the two organs of gold and water, then one water is deficient, five fires follow the incandescence, the upper inflammation scorches gold, injuring its source of transformation, then the opportunity of life has been rested.” Therefore, Yin deficiency and heat stasis is one of the common etiologies of tumors, and the treatment of this evidence of deficiency should be based on nurturing Yin and dispersing nodules, resolving blood stasis and clearing heat. Take liver cancer as an example, many patients with liver cancer suffer from congenital loss of nourishment and emotional depression, resulting in liver qi stagnation, which leads to blood stasis. Clinical symptoms include hot flashes and night sweats, dry throat, lack of fluid, soreness of the waist and knees, abdominal pain and refusal to press, palpable lumps, cyanosis, red tongue with yellow fur, and thin pulse, all of which are based on the identification of liver and kidney yin deficiency and internal obstruction of blood stasis. Nourishing kidney water and nourishing liver yin is the fundamental treatment. In clinical practice, we often use herbs to nourish the liver and kidney, such as chasteberry, dried lotus grass, raw groundnut, rehmannia, white peony, cornelian, sage, American ginseng, maidenhair and schisandra. Herb Jing Shu” said: “Female chasteberry smell all Yin, is into the kidney to remove heat and nourish the essence of the key products, the kidney can be tonic, then the five organs since the peace, the spirit of self-sufficiency, a hundred diseases go and body fat and healthy.” The above-mentioned herbs have the function of improving the immune function of body cells and humors and inducing a variety of cytokines, thus inhibiting tumor growth. The herbs are also used to clear heat stasis, such as turtle, peach kernel, August zha, half-branch lotus, Xihuangcao, longan grass, Mian Yin Chen, mountain gardenia and Baiying grass. This formula combines attack with tonicity, and achieves the effect of expelling evil without harming the righteousness and nourishing without hindering evil, which facilitates the healing of patients. [The physiopathological relationship between liver and spleen is close, and in digestive tumors, they are a pair of opposite contradictions. The spleen lives in the middle jiao and is an earth organ, which is responsible for transportation and transformation; the liver is a wood organ, which is responsible for drainage. Wood and earth are moderately mutually supportive of the normal physiological functions of the two organs. However, the liver is the general’s official, the main ascending and active, and its nature is fierce, which is incompetent by the spleen. Clinically, it is common for liver qi to be too much draining and then to violate the spleen, which is “wood flourishing multiplied by earth”. The clinical practice should correctly grasp the relationship between the two opposites and unity, so that diarrhea of the liver is conducive to strengthening the spleen and supporting the earth so as to suppress the wood. Clinical patients with liver cancer mostly belong to the evidence of deficiency of liver and spleen, because of the weakness of the patient’s body and the depression of emotion, resulting in the stagnation of liver qi, which leads to blood stasis, and the stagnation of blood in the abdomen, resulting in lumps over time. Liver stagnation multiplies the spleen, coupled with careless diet, resulting in loss of spleen health, so patients with liver cancer often show signs of depression, abdominal distension and pain, such as abnormal drainage of liver qi and weakness of spleen qi, such as dullness and loose stools, lassitude and fatigue, etc. The pale tongue, white fur and sunken string veins are also signs of liver deficiency and spleen deficiency. This disease is a deficiency of the origin and a symptom of the symptoms, so the prescriptions of Ginseng Peach Soft Liver Pill and Jianshuangdian Liver Decoction (prescribed by Prof. Zhou Daihan) all hit the right spot. The formula is based on Dangjian Ginseng, Huai Shan, Yun Ling, Coix Seed and Atractylodes Macrocephalae to strengthen the spleen and benefit the qi, and Hanzhilian, Chai Hu, Bai Shao, Serpent’s Tongue Herb, Cat’s Claw Herb and Xihuangcao to relax the liver and diarrhea the liver, together with Turtle Worm, Di Long and Rhubarb to remove blood stasis and detoxify the liver to fight cancer. The decoction of rhubarb with all the herbs reduces the laxative effect and enhances the power of removing blood stasis, so as to avoid the risk of injuring the spleen and hindering the stomach. The purpose of draining the liver and dipping the liver is to eliminate evil, while strengthening the spleen and benefiting the qi is to support the righteousness. The organic combination of the two reflects the dialectical thinking of seeing the disease of the liver and knowing that the liver transmits the spleen. [In tumor treatment, tonifying and tonifying are a pair of opposite contradictions. On the one hand, Master Zhou emphasized tonifying the middle energy, strengthening the spleen, benefiting the lung, and protecting the gastric energy, and on the other hand, he also focused on the method of passages to find a way out for the diseased evil, and regarded “passages” as the most important physiological function of Chinese medicine. “The lung and the large intestine are in phase with each other, and they correspond to each other in the physiopathology. For the deficiency of lung cancer, the treatment is to cultivate earth and generate gold, to benefit qi and transform phlegm; while for the significant symptoms, it is appropriate to “treat the symptoms urgently”, to take the upper disease downward, and to use the method of internal circulation urgently. The lung heat moves to the large intestine, must make the internal qi pass down, the lung qi can be purified, water and liquid transmission, qi flow, then the stagnant heat and poisonous evil can get out and retreat. The common symptoms of colorectal cancer, such as dietary incontinence, abdominal pain and distension, constipation, etc., are also caused by the blockage of internal qi. For example, the treatment of abdominal pain and stagnation, dirty poison, pus and blood, intestinal obstruction, etc. are all based on “standard and urgent”, and “Tongli” is the priority, often treated with Muxiang Penang Pill. In addition, the decontamination of the toxin to get Sheng decoction (Professor Zhou Daihan prescription: rhubarb, cypress, gardenia, dandelion, silver flower, safflower, bitter ginseng) rectal drip injection to pass down the internal Qi, so that the dregs are removed, the evil has a way out. The proper use of the method, in turn, is conducive to the protection of the right qi, such as “Yangming internal organs real, heat knot side flow” of the evidence, through the internal organs to diarrhea heat, not only does not hurt the right, but also can play a “rush down to store yin” role, and because of the turbid poison to get down, so that the clear yang to ascend, yin and yang tend to calm. Clinical patients with rectal cancer often have stagnant toxins in the large intestine, and commonly have abdominal pain and bloating, constipation and other manifestations, while elderly patients often have deficiency of organs and weakness of lung and spleen. This is still a deficiency of the original organs and a deficiency of the symptoms, so “to treat the symptoms in an emergency”, the first priority is to clear the internal organs and disperse the nodules, taking into account the deficiency of the correct qi. The teacher often uses the combination of Xie Yu Blood Tang and Bai Tou Weng Tang, with Chuan Hou Pu, Fa Han Xia, Da Huang, Swollen Jiao Feng, Bai Tou Weng, etc., to move the Qi and remove heat from the internal organs, and Tao Ren, Tu Tu Chuan, Curcuma longa, Shan Ci Gu, etc., to remove blood stasis and soften the firmness, and use the flavors of Dang Shen and Bai Zhu to protect the positive Qi. [In the comprehensive treatment of tumor, the two major rules of treatment, namely, confrontation and reconciliation, are two opposing and unified aspects. In Western medicine, surgery, radiotherapy, chemotherapy, and even in Chinese medicine, the severe and fierce remedies focus on confrontation, while the confrontation treatment focuses on expelling the evil, reflecting the way to remove the evil, but all of them have certain risk of harming the righteousness. For example, surgery depletes qi and blood; chemotherapy drugs “do not distinguish between the enemy and me”, while killing cancer cells, they also damage normal cells of the body to varying degrees; radiation therapy kills tumor cells while inevitably irradiating part of the normal tissue and generating a series of toxic side effects, combined with the theory of warm disease in Chinese medicine to explore its pathogenesis. Considering that “radiation disease” has the clinical characteristics of heat and toxicity, and is prone to dryness and yin injury, it is consistent with the definition of “fire evil” and “heat toxicity”, and belongs to the category of “warm disease”. It belongs to the category of “warm disease”. On the one hand, it depletes Qi and blood, which is reflected in the decrease of blood cell count due to bone marrow suppression and the decrease of resistance due to immune suppression; on the other hand, it also leads to the disharmony of the spleen and stomach, resulting in erratic rebellion, vomiting, and dietary incontinence, causing the patient to lose both body and spirit, and to lose all flesh and body weight. To counteract the damage, instructors paid special attention to the way of reconciliation. As advocated by Wu Jutong, “treating internal injuries is like a phase, sitting calmly, and the divine mechanism moves silently, no work can be said, no virtue can be seen, and the person will be able to live a long life”, thus manifesting the effect of half the result with twice the effort. The specific embodiment in the spleen and stomach protection, regulate the qi and blood, nourish Yin and protect the fluids and other aspects. Combined with Chinese medicine, radiotherapy patients mostly see deficiency of both qi and yin, especially yin deficiency and fire, and after chemotherapy, they mostly see spleen and stomach disharmony and deficiency of both spleen and kidney, and postoperative patients mostly see deficiency of both qi and blood. Since radiation is heat poisonous and injures yin, the method of nourishing yin and preserving fluid is always used in the treatment of tumor radiation disease, and it is believed that “if you keep a share of yin, you will have a share of vitality.” This is to nourish yin to harmonize the disadvantages of radiotherapy. In response to the effect of chemotherapy on the spleen and stomach, Zhou follows the doctrine of “the spleen is strong and free from evil” and believes that “nourishing the righteousness and accumulation will be removed” is the fundamental treatment. In his prescriptions, he does not forget to protect the stomach qi and to strengthen the spleen to help the tumor survive. In the treatment of tumor in Chinese medicine, the key lies in “harmony”, which is the way of reconciliation and pacification of the disadvantages of confrontation, in order to support the righteousness and eliminate the evil, taking into account both the symptoms and the root cause, in order to “pacify the yin and secret the yang”. [The patient was seen on July 15, 2004, with recurrent low-grade fever and shortness of breath and chest pain for more than 1 month. Pleural fluid biopsy showed: centrifugal sediment smear of pleural fluid showed a large number of mesothelial-like cells, some of which had an increased nucleoplasmic ratio with heterotypy. CA 125: 52.13 U/ml, pleural fluid LDH: 1172 U/L. Symptoms: low fever, chest pain on deep inspiration, occasional dry mouth and bitterness, sleep, stool regulation, cough and sputum, no night sweats, no significant weight loss since onset. The tongue is light and fat, the coating is slightly yellow and thick, and the pulse is thin and moist. The four diagnoses were combined, TCM diagnosis: lung accumulation; symptoms: spleen deficiency, phlegm and dampness; treatment: tonifying the middle and strengthening the spleen, dispelling dampness and removing phlegm; self-formulated formula: Xing Xia Jian Spleen Drink plus reduction; formula composition: Prince Ginseng 20g, Atractylodes Macrocephala 20g, Poria 25g, Coix Seed 30g, Shou Gong 6g, Zhe Bei 15g, Fa Xia 15g, Chen Pi 10g, Cat’s Claw 20g, August Zha 20g, Bile Star 10g, Licorice 6g, decoction with water Take 1 dose daily for 7 doses. At the second consultation, the patient’s cough, sputum and other phlegm-damp symptoms were alleviated, with pain in the right hypochondrium, dry mouth, bitterness, slight heat in the body, and lack of desire to eat and drink, etc. Therefore, the medication focused on harmonizing Shaoyang, soothing the liver and strengthening the spleen. At the third consultation, the patient’s cough and sputum continued to improve, and the shortness of breath worsened after activity, which showed that the lung qi was not promoted and lowered, so he added zhebei mu and mandrake to promote and lower the lung qi, scaphozoon and gypsum to drain the lung heat, and cat’s claw herb and dilong to disperse the knots. Thereafter, the main method was still to strengthen the spleen and remove phlegm. After taking more than 80 doses, all the symptoms disappeared and the clinical efficacy was evaluated to be in complete remission. He continued the outpatient treatment and is still alive today. The patient’s spleen deficiency and phlegm-dampness were the main line of the patient’s pathogenesis, and the treatment method of tonifying the spleen and removing phlegm from the dampness was used throughout the whole situation. References [1] Lin Lizhu. Professor Zhou Daihan’s experience in treating cancer from phlegm [J]. New Traditional Chinese Medicine, 2006, 38(3): 10-12. [2] Zhou Daihan. Clinical Chinese medical oncology [M]. Beijing: People’s Health Publishing House. 2003, 132-139. [3] Zhou Daihan. Tumor Treatment and Experimentation [M]. Guangdong: Guangdong Higher Education Publishing House, 1997,96-133. [4] Zhou Daihan. Chinese medical oncology [M]. Guangdong: Guangdong Higher Education Publishing House, 1997, 198-209. [5] Zhang Enxin. Zhou Daihan’s experience in the treatment of colorectal cancer [J]. Journal of Practical Chinese Medicine, 2OO6, 22(9): 562. [6] Zhou Daihan. Chinese health features derived from Chinese medicine life span [J]. New Chinese Medicine, 2010 ,42 (7):141-143.