A Case of Treating Thromboangiitis Obliterans with Madengcao (Hippuris Grass)
On February 12, 2023, I published an article on my official account and personal website titled "Madengcao: A Folk Herb for Thromboangiitis Obliterans and Lower-Leg Ulcers." In it I introduced this uncommon folk remedy.
In Northeast China and the folk traditions of Henan and Shandong, Madengcao is used for thromboangiitis obliterans (Buerger's disease), stroke hemiplegia, uterine bleeding, traumatic bleeding, neurodermatitis, and lower-limb ulcers. I detailed the herb's mechanism in that article, so I will not repeat it here.
In December 2023, this 84-year-old patient was admitted for lower-limb pain and edema. Diagnoses: 1) left lower-leg erysipelas; 2) hemiplegia and sequelae of cerebral infarction; 3) cerebral infarction; 4) right middle-lobe syndrome; 5) left upper-lung anterior-segment nodule, nature pending; 6) grade-3 hypertension (very-high-risk); 7) coronary heart disease (myocardial-ischemic type), cardiac function grade II; 8) chronic gastritis; 9) lumbar intervertebral disc herniation; 10) chronic bronchitis; 11) sciatica; 12) left hepatic cyst; 13) right renal cyst; 14) post-cholecystectomy; 15) hypokalemia; 16) bilateral carotid arteriosclerosis with partial plaque formation; 17) bilateral great saphenous–femoral venous valvular insufficiency; 18) bilateral lower-limb arteriosclerosis with multiple plaques; 19) segmental occlusion of the left superficial femoral artery with collateral circulation.
Such a diagnostic list shows this elderly patient is a disease complex. In clinical practice we see many such complex cases; conditions are intricate and treatment must consider every dimension. This also shows that the large-formula multi-target therapy I advocate is practically meaningful.
Local doctors, noting his advanced age and many comorbidities, dared not operate. Drug treatment produced little effect, and the leg swelling and pain worsened and became unbearable. One doctor suggested vascular stenting, but the family feared surgical risk in such an elderly patient.
It so happened that the patient's niece was a breast-cancer patient I had treated. A long-time reader of my articles, after reading my introduction to Madengcao, felt her grandmother might benefit. She bought Madengcao online herself (this herb is rarely used by TCM physicians, so it is unavailable at ordinary pharmacies or hospital dispensaries) and had the home caregiver boil a small handful for the grandmother to drink. The patient was also taking the lipid-lowering drug probucol, one tablet daily.
After three months of this, the elderly patient's lower-limb edema and pain had resolved. Local doctors were astonished and asked the family what herb she had taken.
According to TCM materia medica, Madengcao activates blood and resolves stasis, stops bleeding and detoxifies, and promotes diuresis and reduces swelling. One study reported that an injection made from Madengcao treated 63 cases of thromboangiitis obliterans: 34 clinically cured, 27 improved, and only 2 ineffective.
Modern pharmacology shows that total flavonoids of Madengcao markedly dilate coronary vessels in experimental rabbits and guinea pigs and inhibit ADP-induced platelet aggregation. This suggests the herb has good thrombolytic action—possibly why it works in occlusive vasculitis.
Local edema and pain (mostly in the limbs) caused by occlusive vasculitis is common clinically, especially in elderly patients with limited mobility. Fracture or cancer patients may also develop these symptoms after tumor emboli or lymphatic obstruction. Madengcao is cheap and effective; I warmly recommend it to patients.
Appendix: my 2023 article on Madengcao
Madengcao: A Folk Herb for Thromboangiitis Obliterans and Lower-Leg Ulcers
Madengcao is the whole herb of Caulophyllum (Camptosorus) sibiricus of the Aspleniaceae family, a specific remedy for thromboangiitis obliterans discovered in folk prescriptions by contemporary TCM. Because it is not widely used, most pharmacies do not carry it, though I have seen foragers or herbal wholesalers selling it on Taobao and similar sites.
Madengcao activates blood and resolves stasis, stops bleeding, and detoxifies. In Northeast China and the folk traditions of Henan and Shandong it is used for thromboangiitis obliterans, stroke hemiplegia, uterine bleeding, traumatic bleeding, neurodermatitis, and lower-limb ulcers.
Changbaishan Plant Materia Medica records folk prescriptions using Madengcao for neurodermatitis and hemiplegia from cerebral vascular embolism: 6 g daily, decocted in water.
This herb is specific for thromboangiitis obliterans and the lower-limb ulcers it causes. One study reports that a Madengcao injection treated 63 cases, with 34 cured, 27 improved, and only 2 ineffective.
Besides injection, Madengcao may be decocted for oral or external use. Oral decoction is generally 3–6 g daily; it may also be ground to powder, 1 g per dose, 2–3 times daily.
Dried Madengcao ground and applied topically treats lower-limb ulcers and traumatic bleeding.
Madengcao's efficacy in thromboangiitis obliterans and induced lower-limb ulcers is related to its vasodilatory and platelet-aggregation-inhibiting effects.
Animal experiments show that a 100% water-alcohol extract of Madengcao markedly dilates isolated rabbit-ear vessels, toad hind-limb vessels, and rabbit hind-limb vessels. Its total flavonoids dilate coronary vessels in rabbits and guinea pigs and inhibit ADP-induced platelet aggregation.
Madengcao has very low toxicity; oral decoction is essentially non-toxic. But intravenous injection of its total flavonoids in mice, at excessive doses, causes intermittent convulsions and, in severe cases, paralytic death.
Henan folk also uses Madengcao for uterine and traumatic bleeding. For uterine bleeding, 3–7 leaves are decocted and mixed with a beaten egg. For traumatic bleeding, the powdered herb is sprinkled on the wound.
The uterine bleeding treated by Madengcao may be caused by uterine fibroids—this is my inference from the herb's main actions—but literature and clinical data on Madengcao for fibroids are lacking.