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Parasitic Plant Widely Used in Traditional Medicine

by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon


Cynomorium is known in Chinese as suoyang, which is based on the herb's medicinal effects, "locking the yang." It is obtained mainly from the East Asian species, Cynomorium songaricum, though the similar C. coccineum is sometimes utilized as a substitute (and is used in other countries, from Europe to Central Asia, where it is the native species). The plant harvested for Chinese medicine grows at high altitude, mainly in Inner Mongolia, Qinghai, Gansu, and Tibet. It is used to tonify the yang (treat impotence and backache), strengthen the tendons, and nourish the blood to alleviate the blood-deficiency type of constipation (typically occurring with old age).

The value of cynomorium was depicted similarly in many cultures. In 16th century Europe, it was known as the Maltese mushroom, though it is not a true fungus. The plant was so highly regarded that the Knights of Malta often sent samples of it to European monarchs as presents. To protect the so-called Fungus Rock, where cynomorium was abundant, the grandmaster posted guards around the area and ordered the sides of the outcropping to be rendered smooth to eliminate any footholds and prevent access from the sea. The rock, rising to a sheer height of 60 meters (200 feet) from the rough sea, became virtually inaccessible.


As an explanation of its uses by the doctrine of signatures, since the plant appears reddish-brown, and becomes darker upon drying, herbalists thought it would be useful to treat ailments of the blood. On top of that, the phallic shape indicated the plant could also be used to treat sexual problems. The dried spikes were used by the Crusader Knights after their battles to recover strength. In Saudi Arabia, the plant is called tarthuth, and is recognized to have the same properties mentioned above, as well as many others, including treatment of digestive disorders and ulcers (see Appendix for story).

Cynomorium is parasitic on the roots of salt-tolerant plants, mainly species of Atriplex, the "saltbushes" (for C. coccineum) and on Nitraria sibirica (for C. songaricum). The plant has no chlorophyll; the fleshy red stems or spikes have tiny scarlet flowers. Its active constituents have not been fully analyzed, but cynomorium is known to contain anthocyanic glycosides, triterpene saponins, and lignans. Pharmacology experiments are in the early stage, with attempts to demonstrate a hormonal effect that would explain its use in impotence (its current main application in commercial products), as well as findings that the herb extracts inhibits HIV, lower blood pressure, and improve blood flow in laboratory experiments.

Cynomorium, which has a pleasant, sweet taste when raw, has long been known as a "famine food," that is, something not frequently eaten, but nourishing enough to help people survive when the standard foods are insufficient. In fact, a city in China is named for cynomorium because of this benefit. The city is near Anxi (in today's Gansu Province), which lies at the center of the ancient Silk Road, and was long considered as the key to the West. During the Tang Dynasty, Anxi was established as a military base to gain control over Middle Asia. About 40 miles away was an old Han Dynasty town called Kugucheng, also of strategic military importance. Numerous walls and gates were set up to form a line of defense. During the Tang dynasty, the famous general Xue Rengui and his army were besieged in the Anxi area while on the way to conquer the West. The soldiers had used up all their supplies and they had no hope of assistance. Yet, they were able to survive by eating suoyang, and after that the city was renamed as Suoyang.

Cynomorium didn't enter into the Materia Medica until Zhu Danxi of the Yuan Dynasty period mentioned it in his Bencao Yanyi Buyi (Supplement and Expansion of Materia Medica, 1347). The Yuan Dynasty, which was the time of Mongolian rule, introduced several plants from the Mongolian area, including this one. Zhu Danxi also offered a formula with cynomorium that became quite famous, Huqian Wan (Hidden Tiger Pills), used for impotence and/or for weakness and atrophy of the legs. The formula is named for the tiger in crouched position, ready to spring. In order to attain that position (which is also replicated in Gong Fu with the "crouching tiger" technique), one must have great strength in the tendons, ligaments, and muscles of the legs. This strengthening is sometimes referred to as "hardening" of yin (substance of the body); but that doesn't necessarily indicate lack of flexibility. The weak leg disorders were first described in the Neijing Suwen (ca. 100 A.D.), in the chapter on wei syndrome, which is translated as atrophy or wilting syndrome. There were five types of atrophy listed, associated with each of the five organs. The disorder was thought to derive from heat or damp-heat damaging the yin.

Huqian Wan is comprised of anemarrhena, phellodendron, cooked rehmannia, tortoise shell, tiger's bone (no longer used), peony, citrus, and dry ginger; sometimes cistanche (another parasitic desert plant) is added. The formula was recently described by Kong Lingqi (Resolutely Upholding the Concept of Hardening the Kidneys Method, by Kong Lingqi, Sichuan Chinese Medicine, 1998 (6): 8-9, translated by Bob Flaws, and edited here):

The Suwen chapter titled Treatise on Wilting says, 'The ancestral sinews rule the binding of the bones and the disinhibition of the joints.' If damp heat invades and assails the muscles and flesh and sinews and bones, the qi and blood will not move. The sinews will become slack and not pulled together and, hence, will be useless. If severe, the liver and kidneys will become debilitated and consumed and the ancestral sinews will cease their duty. Master Ye Tianshi, in his Guide to Clinical Conditions & Case Histories chapter titled Vacuity Taxation highly praised Zhu Danxi's Huqian Wan for their effect of subduing yang and hardening yin. These pills use phellodendron and anemarrhena's bitterness to harden yin. This causes the source to be cleared and flow to be cleaned. Atractylodes (cangzhu) and coix (yiyiren) dispel dampness. Cistanche (roucongrong), cynomorium (suoyang), achyranthes (niuxi), and tiger bone (hugu) strengthen the sinews and bones. Peony (baishao) and chaenomeles (mugua) emolliate the sinews and relax tension. Cooked rehmannia (shudi) and tortoise shell (guiban) enrich yin and boost the marrow. Thus damp heat is discharged and transformed, yin essence is subdued and astringed, the ancestral sinews are hardened and strengthened, and the feet are able to walk.

Because of these uses, the formula has been suggested by Chinese clinicians as a possible therapy for paralytic disorders, such as multiple sclerosis and ALS.

APPENDIX: Cynomorium Review

Following is a story about cynomorium written by Robert W. Lebling, Jr., which appeared in the March/April 2003 issue of Saudi Aramco World. Lebling, a graduate of Princeton, is a writer/editor and corporate communications specialist. He has lived in both Arab and Hispanic countries, and has worked as a journalist. He has compiled an online handbook of Arabian medicinal herbs, which can be viewed at, and is currently collaborating on a book about natural remedies of Saudi Arabia. Saudi Aramco, an oil company, distributes Saudi Aramco World to increase cross-cultural understanding. The bimonthly magazine's goal is to broaden knowledge of the cultures, history, and geography of the Arab and Muslim worlds and their connections with the West. Saudi Aramco World is distributed without charge, upon request (

The Treasure of Tarthuth

by R.W. Lebling, Jr.

It is early spring in the Dahna, Saudi Arabia's northeastern sand desert. The winter rains have been over for several weeks, leaving a legacy of green foliage that spots the dunes and valleys-scattered arta shrubs, patches of grasses, low saltbushes. The clumps of vegetation provide forage for the occasional flocks of sheep and goats and for small herds of camels.

Where there is livestock, there is always a person to tend the animals, keep them safe and prevent them from straying. On the slope of a dune, a Saudi youth named Ahmad settles down beside a stand of bushes and trains his eye on his father's camels, about 100 meters off, grazing on the spring bounty. He is particularly watchful of the young ones. It has been a long morning, and he now waits for the return of his brother's white pickup truck.

Suddenly a rare flash of dark red color catches his eye. Down under the saltbushes to his left, he spies three little dark red club-like shapes poking up from the sand. Tarthuth! Ahmad is hungry and thirsty, and nature has furnished him with one of its tastiest snacks. Taking his pocketknife, he digs into the sand at the base of one of the stalks and cuts it off at the root. The pungent smell brings a smile to his face. Ahmad cuts away the reddish skin-tightly covered with tiny button flowers-and exposes the succulent white flesh beneath. He slices off a wet piece and pops it into his mouth. It's sweet and juicy, refreshing, like ripe fruit. He chews contentedly.

Ahmad is lucky: Tarthuth emerges from the sands only for a brief period each year, following the rains of winter. After he has finished his snack, he cuts off the remaining red clubs to take back to his family. The people of the desert have been harvesting tarthuth like this for thousands of years. It has pleased the palates of passing Bedouins and their camels, filled grocers' baskets in local markets and served as survival food in times of dire famine. It is traditionally known for a wide range of medicinal properties as well-properties now being studied seriously by researchers in the Middle East.

Tarthuth today is barely known outside the region, though it was once harvested around the Mediterranean and was bestowed as a special gift on European royalty in the 16th century. In those days it was known to Arabs and Europeans alike as a wonder drug-a heritage largely forgotten in the rush of modern medicine. But things may be changing. Now, as pharmaceutical companies and medical researchers take a closer look at traditional remedies derived from plants and herbs, tarthuth may once again have an opportunity to rise to prominence.

Tarthuth (pronounced tar-thooth) is the popular Arabic name for the parasitic plant Cyno-morium coccineum. Medieval Europeans called it fungus melitensis-"Maltese mushroom" or "Malta fungus," names by which it is still known today. Sometimes it's called "desert thumb" or "red thumb." The plant is found growing-usually ignored nowadays-in a wide swath that extends from southern Portugal and Spain across the Mediterranean region, including North Africa. Tarthuth even pokes above the remote sands of the Sahara. Botanists have identified it as far south as the central Hoggar range of Southern Algeria. It latches onto salt-loving bushes on Mediterranean islands like Ibiza, Sicily and, of course, Malta. Its range passes through the Levant to the northern and eastern regions of the Arabian Peninsula and vaults across the Gulf into Iran-and perhaps beyond.

Well known in Saudi Arabia-its burgundy spikes emerged this year in late January near the colossal Ghawar oil field and at Lake Lanhardt in Dhahran-tarthuth also makes its home in Kuwait, Bahrain, Qatar, the United Arab Emirates and Oman. In February 1999, Canadian explorer Jamie Clarke spotted the bright red flowering stems growing on a rocky shelf nearly five meters (16') up a cliff wall in Wadi Ghadun, in Oman's southern province of Dhofar. 'Traditionally the Bedu...ate it during long camel caravans across the Empty Quarter,' Clarke reports in his book Everest to Arabia. 'The entire plant is only ten inches [25 cm] high and has an awkward appeal, much like a mushroom's....[C]amels love to eat it and I gather this particular plant has been spared that fate by its lofty perch. In a tropical forest it would go unnoticed. Here, its vivid color and unique character make it stand out against the starkly barren wadi cliff.'

Tarthuth is a highly specialized parasite with some fungus-like properties. It grows underground for most of the year, feeding on the roots of saltbushes and other salt-tolerant plants. When the winter rains come, its extensive root system shoots fleshy red stems up through the sand and into the open air. The plant has no green color because it's a parasite and thus needs no chlorophyll to feed itself. The leafless red stems or spikes, fully grown, range in height from about 15 to 30 centimeters (6-12"). The spikes have tiny scarlet flowers so small that they can hardly be seen individually. Tightly packed and scale-like, they look somewhat like coarse fur. Pollinated by flies attracted by the plant's sweetish, somewhat cabbage-like aroma, the flowers eventually wither and the spike turns black.

When the January and February rains are good, the young fleshy stems of tarthuth can be "sweet tasting and edible raw, with a pleasant crisp, succulent texture," reports botanist and former Aramco professional James P. Mandaville in his Flora of Eastern Saudi Arabia. The flesh is apple-like, with an astringent quality that freshens the mouth. Just picked, tarthuth can be very sweet; left to sit for a few days, it can be somewhat bitter on first taste, but stays tartly refreshing. The Bedouins clean the just-picked spikes, peel off the outer skin and eat the flavorful white interior. The mature, blackened spikes are sometimes ground and made into a sweetened infusion used hot or cold to treat colic and stomach ulcers.

Botanist James Duke cites tarthuth's traditional use as a medicinal tea in Qatar. Botanist Loutfi Boulos says North African medical tradition regards the entire plant as an 'aphrodisiac, spermatopoietic, tonic, [and] astringent.' In traditional medicine, it is mixed with butter and consumed to treat obstructions of the bile duct. Maltese mushroom has a close relative in the East Asia, C. songaricum or suoyang, whose brownish spikes have long been regarded as an effective medicinal agent in Chinese medicine, used to treat kidney problems, intestinal ailments and impotence. Recent studies in China show that Cynomorium, like green tea, has 'very strong antioxidant effects.'

As recently as the 1920s, villagers from the Saudi coastal oasis of Qatif would head into the desert in early spring and return with their donkeys loaded with sacks of tarthuth for sale in the local suqs, or markets, Mandaville notes. The plants are still a popular treat for Bedouins and other desert travelers, according to Saudi Aramco wellsite inspector and desert expert Geraiyan M. Al-Hajri. He says tarthuth can be found in springtime in the suqs of al-Hasa in the kingdom's Eastern Province. In the Maghrib, Arab North Africa, the dried and pulverized plant is used as a spice or condiment with meat dishes.

The red pigment in the plants provides another benefit: It has been used as an effective fabric dye by the women of at least one Arabian tribe, the Manasir, many of whom now live in the United Arab Emirates. The dye produces a rich, colorfast crimson hue known as dami or 'blood-red.'

Maltese mushroom's use as both foodstuff and medicine goes back thousands of years. The ancient Hebrews ate the spikes in times of famine. In the Book of Job (30:4), starving Israelites consume a plant called 'juniper root'-and modern botanists say this is C. coccineum rather than the inedible root of the juniper bush. (The use of Maltese mushroom as a famine food was most recently reported in the Canary Islands in the 19th century.)

Arab physicians of the Middle Ages considered tarthuth 'the treasure of drugs' because it had a wealth of traditional therapeutic uses, particularly as a remedy for blood disorders, digestive ailments and reproductive problems, including impotence and infertility. The great early philosopher of the Arabs, the polymath Al-Kindi (800-870), compiled a medical formulary, or aqrabadhin, that mentions tarthuth as the main ingredient of a salve used to relieve acute itching caused by foreign matter under the skin. Al-Razi (865-925), known to Europeans as Rhazes and one of the most influential of all Islamic physicians, prescribed tarthuth as a remedy for hemorrhoids as well as for nasal and uterine bleeding.

The medicinal uses of tarthuth are also cited by Ibn Masawayh (777-857), a Persian Christian who directed a hospital and served as personal physician to four caliphs at Baghdad, and by Maimonides, the celebrated 12th-century Hispanic Jewish doctor and philosopher who was court physician to Saladin in Egypt. Ninth-century Chaldean scholar Ibn Wahshiya, best known for his work Nabataean Agriculture, wrote a toxicological treatise called the Book on Poisons which includes tarthuth as a key ingredient in several antidotes.

Knowledge of the medicinal value of tarthuth was eventually passed to the Europeans-and here the plant's history takes an unusual turn. In the 16th century, the 'treasure of drugs"' became the closely guarded treasure of the Knights Hospitaller in Malta. The Hospitallers, or Knights Hospitaller of St. John of Jerusalem, were a fighting order formed at Jerusalem during the First Crusade, some four centuries earlier. They had a dual military and medical mission, and operated a 1000-bed hospital in Jerusalem, providing care for the sick and injured. It was there, in Palestine, that Hospitaller physicians first learned of tarthuth from their Muslim counterparts and began using the plant in their treatments.

When the Muslims recaptured Palestine from the Crusaders, the Knights Hospitaller moved their headquarters to the island of Rhodes and eventually to Malta, the strategically vital island group south of Sicily, where they were pleased to find tarthuth growing on a tiny islet.

Off the west coast of Gozo, the smaller of the two main Maltese islands, there is an irregular block of limestone rising from the sea, some 180 meters long and about 60 meters high (600 by 200') with a flattish, sloping top and sheer cliffs on all sides. Today this islet is called Fungus Rock. It is also known to the Maltese as Gebla tal-General, General's Rock, after a Hospitaller naval squadron commander credited with discovering it. Here, on the tabletop islet, C. coccineum, Maltese mushroom, grew in abundance.

On orders from their grand master, the knights quickly took control of Fungus Rock, placed guards on the mainland and barred access to any but their own. They hacked all ledges from the sides of the islet to keep people from climbing the cliffs. Trespassers who tried anyway were imprisoned and made galley slaves. Thieves who managed to steal Maltese mushroom were reportedly put to death. The only way to reach the island's top was by a primitive and precarious 'cable car' rigged on ropes and pulleys and connected to poles on the mainland. A version of that cable car, a wooden box, survived into the early 19th century, and English traveler Claudius Shaw made the dangerous crossing in 1815:

It is not a very pleasant sensation to be suspended some hundred feet above the water, and if there is any wind, the movement of the box is anything but agreeable, and all that can be obtained are a few pieces of fungus. I was well pleased to be back again, and made a determination never to risk my precious carcass in that conveyance again.

Maltese mushroom was under the personal control of the Hospitaller grand master. His knights harvested the precious plant each year and stored it in a watchtower on the mainland. This structure, Dwejra Tower, was built in 1651 to guard Fungus Rock and protect the island of Gozo from pirate raids. Once harvested, the Maltese mushroom spikes were dried, pulverized and preserved in various liquids. Hospitaller doctors used it to cure dysentery and ulcers, to stop hemorrhages and prevent infection. The plant was a favored treatment for apoplexy and venereal disease, and was used as a contraceptive, as a toothpaste and as a dye to color textiles. It was also prescribed in Malta to treat high blood pressure, vomiting and irregular menstrual periods. Precious as it was, the grand master sent it as an appropriate special present to the kings, queens and nobility of European countries.

In 1565, the most famous of the Hospitallers' grand masters, Jean de la Vallette-eponym of Malta's present-day capital, Valetta-was wounded by a grenade blast during a siege by Ottoman Turkish forces. Historians say his wound was dressed with Maltese mushroom, and that the grand master recovered and returned to battle. The Knights Hospitaller held Malta until 1798, when they surrendered to Napoleon and lost their last territorial base in the Mediterranean. Their military role had come to an end, though they survive today as the Knights of Malta, an international non-governmental medical-service organization recognized by the United Nations. As the order lost its military mission, so did the Maltese mushroom fade from therapeutic use in Europe. By the 1800s, the old herbal remedies of the Middle East-plant extracts known as galenicals-were largely eclipsed in the West by new, mineral-based 'drug' treatments.

Today Maltese mushroom survives atop Fungus Rock, drawing its nourishment from the roots of tamarisk or sea lavender. The Maltese call it gherq is-sinjur, which may derive from the Arabic 'irq al-sinja, 'bayonet root.' A species of reptile found nowhere else-the Fungus Rock wall lizard, Podarcis filfolensis generalensis-seems to have a special affinity for the plant and can often be found climbing the succulent red spikes. But biologists say it is attracted not by the sweet juice but by the flies that help pollinate the plants. (Lizards in Saudi Arabia seem similarly drawn to tarthuth.)

In recent decades, Maltese mushroom has been found growing elsewhere in Malta, but it has been declared an endangered species throughout the island group and is legally protected. Since 1992, Fungus Rock itself has been designated as a nature reserve, and the curious and adventurous are prohibited from intruding on the craggy rock-just as they were back in the 16th and 17th centuries.

Sir David Attenborough, the well-known British filmmaker and author who wrote The Private Life of Plants, finds Maltese mushroom a fascinating plant parasite, but he is skeptical about its medicinal value. He suggests that apothecaries may have inferred the plant's therapeutic properties from its appearance, applying the 'doctrine of the signatures,' a belief going back to the ancient Greeks that a plant's external appearance indicated what its effects might be. Thus, for example, a plant with kidney-shaped leaves was good for breaking up kidney stones, and tarthuth was presumed to cure blood diseases because of its dark red, blood-like color. But Attenborough's suggestion does not explain the range of medical uses found for the plant that had no connection with its appearance-such as its role as a treatment for ulcers and other gastrointestinal ailments-and it underestimates the Knights of Malta, who were not practitioners of magic and whose doctors employed the latest clinical and therapeutic practices, including those of Arab and Islamic medicine.

The Arabs and other Muslims of the Middle Ages were the most sophisticated medical practitioners of their time and well acquainted with experimental methods. Clinical and therapeutic works written in Arabic and translated into Latin found their way into Europe's best medical schools. The massive and authoritative Canon of Medicine by Ibn Sina (Avicenna) was translated in the 12th century and served as the standard textbook for medical training in European universities even well into the 18th century. Given their medical expertise, the Arabs may well have been correct in calling Cynomorium coccineum 'the treasure of drugs.'

With the growing popularity of alternative and holistic medicine in recent decades-a trend now taken seriously by pharmaceutical companies and government health institutes-researchers have been exploring the claims of traditional therapies and herbal medicines, looking for new, scientifically supported treatments and applications.

'Interest in medicinal plants as a re-emerging health aid has been fueled by the rising costs of prescription drugs in the maintenance of personal health and well-being, and the bioprospecting of new plant-derived drugs,' report Lucy Hoareau and Edgar J. DaSilva of UNESCO's Division of Life Sciences. 'Developed countries, in recent times, are turning to the use of traditional medicinal systems that involve the use of herbal drugs and remedies,' they note in the Electronic Journal of Biotechnology (1999). 'About 1400 herbal preparations are used widely, according to a recent survey in Member States of the European Union.'

So it is not surprising to learn that scientists have been testing the properties of tarthuth. In 1978, researchers reported in an Iranian medical journal that Cynomorium coccineum harvested in Iran was 'found to possess significant blood pressure lowering activity' when tested on dogs. The strong hypotensive effect occurred chiefly in tests involving the fresh juice of the plant, or juice dissolved in water. Dried, powdered tarthuth was also tested but without so significant an effect. The researchers suspected the fresh samples enjoyed a 'special molecular arrangement' that caused the reduction in blood pressure. This study suggests that the traditional belief in tarthuth's value as a remedy for blood ailments warrants further investigation.

Saudi researchers have also worked on some of the plant's reputed health properties. Based on their initial findings, the traditional claims that Maltese mushroom improves fertility and reproductive vigor may have a basis in truth as well. Three recent studies at King Saud University found that extracts of Cynomorium coccineum, administered orally, had significant positive effects on the reproductive development and fertility levels of male and female rats. The results were published in the international journals Phytotherapy Research (1999 and 2000) and Ethnopharmacology (2001).

Modern scientific studies of this strange parasitic plant are clearly in their early stages. But they seem to be worth pursuing. Ethnopharmacology-the study of traditional plant and herbal remedies-is a burgeoning field with great social and commercial promise, and further research may indeed show there is much more to Maltese mushroom than a delightful desert treat