Medicinal Value and Side Effects of Baijili (Cijili, Tribulus Fruit)

Baijili (also called Cijili) is the dried ripe fruit of Tribulus terrestris (family Zygophyllaceae); full, firm, yellowish-green fruits are best. Because TCM holds that Baijili dispels wind and invigorates blood, brightens the eyes, and stops itching, it is a commonly used dermatological herb and appears in most formulas for common skin diseases such as vitiligo, flat warts, and melanoma. Some clinical reports show that Baijili can make flat warts and melanoma on the skin slough off entirely.

Traditional TCM holds that Baijili is pungent and bitter, slightly warm in nature, and slightly toxic, entering the liver channel. It calms the liver and resolves depression, invigorates blood and dispels wind, brightens the eyes, and stops itching. Modern pharmacology has found that Baijili lowers blood pressure, counteracts atherosclerosis and platelet aggregation, and has tonic, anti-aging, aphrodisiac, and mild-to-moderate diuretic actions.

Baijili is somewhat toxic. After poisoning, common symptoms include fatigue, drowsiness, dizziness, nausea and vomiting, diarrhea, palpitations, cyanosis of the lips, nails, and mucous membranes, and a scarlet-fever-like drug rash; severe cases may develop pulmonary edema and respiratory failure, and it can cause methemoglobinemia leading to asphyxiation. This herb should therefore not be taken in excess; the adult daily dose is 6–10 g. Within this range it is safe; should the above side effects appear, the dose must be reduced or the herb stopped.

Modern use mostly employs Baijili as an antihypertensive and for dermatological disease, and also for eye conditions such as cataract and glaucoma. Baijili is an important dermatological herb, with some effect on wind-rash itching, vitiligo, flat warts, and related skin diseases. Bencao Gangmu (Compendium of Materia Medica) records that a single herb of Baijili ground into powder and taken twice daily, two qian each time washed down with water, treats vitiligo. Modern pharmacological experiments using Baijili alone for vitiligo show an effective rate of up to 81.5%; after patients took a Baijili extract, the white skin patches disappeared completely or partially.

Baijili is also an important herb for external sores, boils, and swellings; for example, Qianjin Yaofang (Essential Prescriptions Worth a Thousand Gold) records taking one sheng of Baijili, burning it to ash, mixing it with vinegar, and applying it externally to treat boils and swellings. In addition, there were ancient formulas using Baijili alone for breast distending pain and ruyan (roughly corresponding to modern breast cancer and breast nodules): one jin of Baijili (stir-fried with thorns) ground to a fine powder, four qian taken morning and evening with water. Bencao Huiyan records a formula of “one jin of Cijili (stir-fried with thorns), two liang of Ganqi (dry lacquer, stir-fried), both ground to powder, made into mung-bean-sized pills with water, two qian taken after dinner and before bed,” to treat accumulation of evil blood and abdominal masses. The same book also records using “five liang of Baijili (stir-fried with thorns), one liang each of Baihe (lily bulb) and Chuanbei (Sichuan fritillary, stir-fried), ground together to a fine powder, three qian taken morning and evening” for fetid pus and blood coughed up in lung abscess and lung atrophy; and using “eight liang of Cijili (stir-fried with thorns), three liang of Mudanpi (moutan bark, stir-fried), four liang of Dangguishen (Angelica body, stir-fried), ground together and made into honey pills, taken morning and evening,” for “scrofula with discharging pus that will not dry.” These records fully show that ancient TCM commonly used Baijili (Cijili) for various tumor-like diseases.

Baijili can also treat ascites; ancient TCM held that it “governs water-bound edema, wind-puffing panting and fullness, jaundice, beriberi, and other disorders.” Modern research confirms that Baijili is indeed diuretic and has some effect on ascites. I recently treated a melanoma patient with edema of the lower limbs; after using Baijili, the leg edema also subsided markedly. The Mongols have an empirical formula, “Three-Ingredient Tribulus Powder,” made from 250 g Baijili, 150 g Dongkuigu (Malva verticillata fruit), and 150 g Fanghai (a macroalgal diuretic), ground together to a fine powder; 3–4.5 g is decocted in water or taken directly, 2–3 times daily, for hot, painful urination due to damp-heat pouring downward.

Because Baijili lowers blood pressure and is somewhat toxic, those with low blood pressure and pregnant women should use it cautiously. Other patients should also monitor their blood pressure and watch for side effects while using it; if blood pressure drops or other intolerable side effects appear, the dose should be reduced or Baijili discontinued.