The Lung-Draining, Wheeze-Quelling and Diuretic, Swelling-Reducing Actions of Tinglizi (Descurainia Seed)
The TCM herb Tinglizi is the seed of Lepidium apetalum, Lepidium virginicum and Descurainia sophia of the Brassicaceae. In the market, northern Tinglizi is the seed of Lepidium apetalum, and southern Tinglizi is the seed of Descurainia sophia.By convention, northern Tinglizi is called sweet Tinglizi and southern Tinglizi bitter Tinglizi. The ancients considered Tinglizi a bitter-draining herb, and believed that sweet Tinglizi damages the healthy qi less than bitter Tinglizi, but that bitter Tinglizi water-draining and swelling-reducing action is better than sweet Tinglizi.Tinglizi has some toxicity; southern Tinglizi is more toxic than northern Tinglizi. Tinglizi poisoning causes nausea, vomiting and loss of appetite, and overdose causes diarrhea. When used as a medicine, Tinglizi should be stir-fried over low heat until it slightly puffs up and an aroma emerges; stir-frying reduces its toxicity. It may also be mixed with refined honey and stir-fried until the honey is absorbed, or mixed with refined honey and a small amount of water and stir-fried until it no longer sticks to the hands.Tinglizi has a long history of medicinal use; it appears in both the Shennong Bencao Jing and Zhang Zhongjing Jingui Yaolue (Essentials from the Golden Cabinet). The Shennong Bencao Jing holds that Tinglizi is pungent in flavor and cold in nature; it chiefly treats abdominal masses and accumulations with binding qi, dietary cold and heat, breaks hardness and expels evil, and frees the waterways. The Tingli Dazao Xiefei Tang (Descurainia and Jujube Lung-Draining Decoction) in the Jingui Yaolue uses Tinglizi and jujube together to treat wheezing and inability to lie down caused by lung abscess.TCM holds that Tinglizi drains the lung and calms wheezing, and promotes diuresis to reduce swelling. It chiefly treats dyspneic cough with abundant phlegm from phlegm-saliva obstructing the lung, lung abscess, chest and abdominal fluid accumulation, edema, deep sores and scrofulous nodules. In traditional TCM view, Tinglizi is an evil-expelling herb that consumes qi; it can be used for lung abscess and phlegm-wheezing of excess pattern, but is not suitable for deficiency wheezing. If used for deficiency wheezing, it must be combined with qi-tonifying herbs, and honey-processed Tinglizi should be used to reduce its toxicity.Modern pharmacology has found that Tinglizi strengthens the heart and regulates blood lipids. Tinglizi enhances myocardial contractility and pumping function, increases coronary flow, but does not increase myocardial oxygen consumption. Tinglizi can slow the heart rate and raise blood pressure. Tinglizi extract lowers total cholesterol, triglycerides and LDL, and raises HDL levels in hyperlipidemic rats, regulating blood lipids in experimental animals.Therefore modern TCM commonly uses Tinglizi to treat heart failure. Taking Tinglizi powder alone (3-6 g daily, swallowed in three divided doses) treats heart failure (whether cardiac, pulmonary, viral, hypertrophic, rheumatic, endocrine, hypertensive or renal in origin), or Tinglizi can be combined with Danshen (Salvia) and Zhishi (Immature Bitter Orange) to treat heart failure; both work well. Tinglizi can also treat uremic pericarditis. After Tinglizi treatment, edema in heart failure or pericarditis patients subsides, and heart failure symptoms markedly lessen or disappear.Synthesizing literature through the ages, we can see that Tinglizi has a marked effect on wheezing and edema caused by cor pulmonale; in the past it was often used as an emergency medicine for such diseases.Zhang Zhongjing Tingli Dazao Xiefei Tang combines Tinglizi (roasted yellow and crushed) with jujube; this use is very safe. TCM holds that jujube tonifies qi and is a healthy-qi-supporting herb, preventing excessive use of Tinglizi from damaging the upright qi. At the same time, jujube itself promotes diuresis and reduces swelling, and combining it with Tinglizi enhances Tinglizi efficacy. Today we commonly use this formula for heart failure, edema, pleural effusion and pericardial effusion caused by cardiopulmonary disease.The San Yin Ji Yi Bing Zheng Fang Lun contains the Tingli Da Wan (Large Descurainia Pill) formula. It combines equal parts of Tinglizi (stir-fried over paper, which absorbs oil and reduces Tinglizi toxicity) and shepherd purse root, ground together into powder, then formed with refined honey into pills the size of a bullet (about 6-10 g each). Take one pill each time, chewed and washed down with tangerine peel decoction. Tingli Da Wan treats abdominal fullness and distension from retained fluid, with emaciated limbs and scanty, turbid, difficult urination; this is what modern medicine calls ascites, mostly caused by late-stage liver cirrhosis or cancer.The Taiping Shenghui Fang also contains a Tingli Wan formula composed of Tinglizi, Xingren (Apricot kernel), Qianniuzi (Morning Glory seed), Hanfangji (Han Stephania), aged tangerine peel and others, made into pills and washed down with mulberry bark decoction. It treats chest and abdominal fullness and oppression, cough and dyspnea, large-intestine qi stagnation and constipation caused by lung qi excess. Judging from the nature of the herbs in this formula, it is very powerful at promoting diuresis and reducing swelling, but the Qianniuzi in this formula is quite toxic and is mostly not used today.Besides internal use, Tinglizi can also be applied externally, generally for scrofulous nodules and deep sores; diseases that today we call skin diseases and subcutaneous tuberculosis or tumors.The Shenghui Fang uses two ge of Tinglizi and half a jin of fermented soybean, pounded and twisted into cakes. When used, the medicinal cake is placed on the skin lesion, and a moxa cone the size of a little finger is lit and burned on it; treat once every five days, seven cones each time, for scrofulous tuberculosis of the skin. This is TCM herb-partition moxibustion, in which moxa heat penetrates the medicine cake into the lesion.The Shengji Zonglu records another formula for deep sores, combining equal parts of sweet Tinglizi, Mutong (Akebia), Dahuang (Rhubarb) and Mangcao, filed into powder, mixed with water into a thin paste and spread on the swelling; reapply when dry. This method reduces swelling and dissipates nodules.Modern TCM practitioners also combine equal parts of Tinglizi and Chuanjiao (Sichuan pepper), grind them into powder, mix with water or honey into a paste, and apply it externally on the patient umbilicus; through transdermal delivery it treats thoracic and abdominal effusion. This method can be used for late-stage cancer patients who cannot take medicine normally.External use of Tinglizi to reduce swelling is safe and effective, but these methods are now seldom used, and some valuable medication experience has been lost. The ancients ranked Tinglizi with rhubarb, considering it a fierce herb for purging and water-expelling; the weak should not use it heavily or for long, lest there be danger. Therefore the ancients were extremely cautious when taking it internally.But as an emergency medicine for edema and dyspnea, its efficacy cannot be ignored. As the Bencao Zhengyi (True Meaning of Materia Medica) says: When phlegm-fire blocks the lung, or cold-fluid floods the chest with urgent dyspnea or swelling, one must rely on this spearhead to break through the stronghold and storm the fortress.