On February 12, 2023, I published an article on my public account and personal website titled “Asplenium ruprechtii (Ma Deng Cao): A Treatment for Thromboangiitis Obliterans and Lower Extremity Ulcers.” In that article, I introduced Asplenium ruprechtii (Ma Deng Cao), a rare folk herbal medicine.

In folk medicine in Northeast China, as well as in Henan and Shandong provinces, Asplenium ruprechtii has been used to treat thromboangiitis obliterans, post-stroke hemiplegia, uterine bleeding, traumatic hemorrhage, neurodermatitis, and lower extremity ulcers. I have already explained the mechanism of action of this folk herbal medicine in detail in that article and will not repeat it here.

In December 2023, an 84-year-old elderly patient was admitted for the treatment of lower extremity pain and edema. The diagnoses were: 1. Erysipelas of the left lower extremity; 2. Hemiplegia, sequelae of cerebral infarction; 3. Cerebral infarction; 4. Right middle lobe syndrome; 5. Nodule in the anterior segment of the left upper lung, nature to be determined; 6. Grade 3 hypertension (very high-risk group); 7. Coronary heart disease (myocardial ischemia type), cardiac function Grade II; 8. Chronic gastritis; 9. Lumbar disc herniation; 10. Chronic tracheitis; 11. Sciatica; 12. Left hepatic cyst; 13. Right renal cyst; 14. Post-cholecystectomy; 15. Hypokalemia; 16. Bilateral carotid arteriosclerosis with partial vascular plaque formation; 17. Incompetence of the saphenofemoral valve in both lower extremities; 18. Arteriosclerosis of both lower extremities with multiple plaque formations; 19. Segmental occlusion of the left superficial femoral artery with collateral circulation formation.

Such a diagnostic report indicates that this elderly patient is a complex case with multiple comorbidities. Due to the patient’s advanced age and numerous underlying diseases, doctors at the local hospital did not dare to perform surgery. Pharmacological treatment was administered, but the effect was not obvious; the patient’s leg swelling and pain worsened and became intolerable. Some doctors suggested vascular stenting, but the family was afraid of the surgical risks for an elderly patient of such an advanced age.

Coincidentally, this patient’s niece was a breast cancer patient I had previously treated. She had been reading my articles for a long time, and after seeing my introduction to Asplenium ruprechtii, she felt her grandmother’s condition was worth trying. She purchased Asplenium ruprechtii online (this herb is rarely used by traditional Chinese medicine practitioners, so it cannot be bought in conventional pharmacies or hospital dispensaries) and instructed the caregiver looking after her grandmother to boil a small handful of the herb in water for the elderly patient to drink each time. The elderly patient was also taking the lipid-lowering drug Probucol Tablets, one tablet daily.

After three months of this treatment, the elderly patient’s lower extremity edema disappeared, and the pain ceased. The doctors at the local hospital were very surprised and inquired with the patient’s family about the herbal medicine used by the elderly patient.

According to traditional Chinese medicine herbal texts, Asplenium ruprechtii has the effects of promoting blood circulation and removing blood stasis, stopping bleeding and detoxifying, and promoting diuresis and reducing swelling. Studies have shown that in the treatment of 63 cases of thromboangiitis obliterans with injections made from Asplenium ruprechtii, 34 cases were clinically cured, 27 cases improved, and only 2 cases were ineffective.

Modern pharmacological research shows that the total flavonoids of Asplenium ruprechtii have a significant peripheral vasodilatory effect on the coronary vessels of experimental rabbits and guinea pigs, and have an inhibitory effect on ADP-induced platelet aggregation. This indicates that this herb has a good thrombolytic effect, which may be the reason why Asplenium ruprechtii can treat obliterans vasculitis.

Local edema and pain caused by obliterans vasculitis (mostly in the extremities) are relatively common in clinical practice, especially in elderly patients with slow mobility. Patients with fractures or tumors will also frequently experience these symptoms after the formation of local tumor emboli or lymphatic return obstruction. Asplenium ruprechtii is inexpensive and has obvious efficacy, making it highly worthy of recommendation to patients.

Asplenium ruprechtii (Ma Deng Cao): A Treatment for Thromboangiitis Obliterans and Lower Extremity Ulcers

Asplenium ruprechtii (Ma Deng Cao) is the whole plant of Asplenium ruprechtii (family Aspleniaceae). It is a highly effective medicine for treating thromboangiitis obliterans discovered from folk remedies by the contemporary traditional Chinese medicine community. Because this medicine is not widely used, most pharmacies do not sell Asplenium ruprechtii; however, I have seen some herb gatherers or medicinal material wholesalers selling Asplenium ruprechtii on websites such as Taobao.

Asplenium ruprechtii has the effects of promoting blood circulation and removing blood stasis, stopping bleeding, and detoxifying. In Northeast China, as well as in Henan and Shandong provinces, it is used in folk medicine to treat thromboangiitis obliterans, post-stroke hemiplegia, uterine bleeding, traumatic hemorrhage, neurodermatitis, and lower extremity ulcers.

The Flora of Medicinal Plants of Changbai Mountain includes folk prescriptions using Asplenium ruprechtii to treat neurodermatitis and hemiplegia caused by cerebral vascular embolism. The daily dosage is 6g of Asplenium ruprechtii decocted in water for oral administration.

This medicine has a special effect on thromboangiitis obliterans and the lower extremity ulcers caused by it. Studies have shown that in the treatment of 63 cases of thromboangiitis obliterans with injections made from Asplenium ruprechtii, 34 cases were clinically cured, 27 cases improved, and only 2 cases were ineffective.

In addition to being formulated into injections, Asplenium ruprechtii can also be decocted for internal and external use. The general daily dosage for oral decoction is 3-6g. It can also be ground into powder and swallowed, 1g each time, 2-3 times a day.

Dried Asplenium ruprechtii ground into powder and applied externally to the affected area can be used to treat lower extremity ulcers and traumatic hemorrhage.

The reason why Asplenium ruprechtii can treat thromboangiitis obliterans and the lower extremity ulcers induced by it is related to its vasodilatory and platelet aggregation-inhibiting effects.

Animal experiments have shown that 100% aqueous-alcoholic extract of Asplenium ruprechtii has a significant dilatory effect on isolated rabbit ear blood vessels, toad hindlimb blood vessels, and rabbit hindlimb blood vessels. The total flavonoids of Asplenium ruprechtii have a significant peripheral vasodilatory effect on the coronary vessels of experimental rabbits and guinea pigs, and have an inhibitory effect on ADP-induced platelet aggregation.

Asplenium ruprechtii has very low toxicity, and aqueous decoctions are basically non-toxic when taken orally. However, when injections made from Asplenium ruprechtii total flavonoids extracted from Asplenium ruprechtii are administered via intravenous injection to mice, excessive dosage can cause intermittent convulsions in mice, and in severe cases, can lead to paralysis and death.

In Henan folk medicine, Asplenium ruprechtii is also used to treat uterine bleeding and traumatic hemorrhage. For uterine bleeding, 3-7 leaves of Asplenium ruprechtii can be decocted in water and mixed with beaten egg for consumption. For traumatic hemorrhage, Asplenium ruprechtii can be ground into powder and applied to the wound.

Uterine bleeding treated with Asplenium ruprechtii may be caused by uterine fibroids; this is a speculation based on the main efficacy of Asplenium ruprechtii, but there is a lack of literature and clinical data regarding the treatment of uterine fibroids with Asplenium ruprechtii.