Da-Ji and Xiao-Ji (Thistles): Common TCM Herbs for Hemostasis, Detumescence and Reducing Ascites in Cancer Patients
Da-Ji and Xiao-Ji (Thistles): Common TCM Herbs for Hemostasis, Detumescence and Reducing Ascites in Cancer Patients
Da-ji (Cirsium japonicum, Japanese thistle) and xiao-ji (Cirsium setosum, field thistle) are two of the most commonly used TCM herbs for cooling blood, detumescence, hemostasis and pain relief. In clinical practice I have also found that they reduce ascites.
Both belong to the Asteraceae family, look similar, and are inexpensive, easily obtainable herbs. Wild da-ji and xiao-ji are widely distributed across the provinces of China, and are easily gathered in rural fields and mountain forests.
One ovarian-cancer patient had followed my writing for a long time. One day she told me that after a fellow patient's ovarian tumor recurred with ascites, a local folk herbalist advised her to dig up a certain herbal root, stew it with pork ribs, and eat the meat and drink the soup. After six days the ascites vanished and the tumor marker CA125 fell into the normal range.
This patient was examined at Fujian Provincial Cancer Hospital on December 29, 2016 (outpatient No. 0636214). The findings showed pelvic peritoneal and mesenteric metastasis with a large amount of ascites; the tumor remained partly active; enlarged lymph nodes in the left supraclavicular region with increased metabolism, metastasis pending exclusion; scattered low-metabolic retroperitoneal lymph nodes; and scattered linear opacities in both lung fields, most likely inflammatory.
After stewing the herbal root with pork ribs at home, the patient felt the ascites disappear. An ultrasound at the Affiliated Hospital of Putian University on March 5, 2017 showed that all ascites had resolved and no obvious recurrent lesion was seen.
Of course, I did not continue to follow up on this patient, and it is unknown whether her condition later recurred. But judged solely by the resolution of ovarian-tumor-related ascites and the drop of CA125 from over 1000 into the normal range, this was already a very good outcome.
Although the patient used the herb, she did not know its formal name, and the folk herbalist who recommended it did not know either. She photographed the root she had dug, and her fellow patient asked me about it. After consulting a doctoral supervisor expert in Chinese materia medica, I confirmed the herb was xiao-ji (field thistle).
From then on, I began including da-ji and xiao-ji in my prescriptions for cancer patients with ascites and internal bleeding.
In April 2017, invited by a patient's family for a house call in Yiwu, Zhejiang, I saw another ovarian-tumor patient also suffering from severe ascites. On the basis of the commonly used Huangqi Fangji Decoction (Astragalus and Stephania Decoction), I added 50 g each of da-ji and xiao-ji; after half a month of treatment the ascites resolved.
In several other patients with ascites accompanied by bleeding, I likewise added 15-50 g each of da-ji and xiao-ji, with good results. The reason for adding appropriate amounts of both is that among commonly used hemostatic and detumescent TCM herbs, da-ji and xiao-ji are themselves the most classic herb pair; used together they work better than either alone.
According to TCM classics, da-ji and xiao-ji have a broad blood-cooling and hemostatic action, suitable for various bleeding syndromes caused by reckless blood movement due to blood heat. In the upper body they treat hematemesis, hemoptysis and epistaxis (nosebleed); in the lower body they treat hematuria, hematochezia and uterine bleeding (benglou).
Beyond this, da-ji also moves stasis and reduces swelling, and can treat heat-toxin sores and various swellings and pain caused by heat toxin. Xiao-ji additionally lowers blood pressure and treats nephritic edema.
When the two are combined, their hemostatic, stasis-resolving, detumescent and analgesic actions are enhanced. In addition, ancient bencao materia medica works record that da-ji treats scrofula (lymph-node enlargement caused by tuberculous lymphadenitis, lymphatic tumors, or metastatic tumors).
These are the oncology applications of da-ji and xiao-ji. Their other effects are broad—they may even treat rhinitis and asthma. Interested readers can consult more literature on their pharmacology to deepen their knowledge.