SPARGANIUM AND ZEDOARIA
Herbs Combined to Treat Solid Masses
Solid masses, including uterine fibroids, thyroid adenomas, sclerodermic patches of tight skin, liver fibrosis, enlarged spleen, post-surgical adhesions, and other manifestations of blood stasis are frequently treated with formulas that include the herbs sparganium and zedoaria. Jiao Shude (1) specified the action of zedoaria in this combination as "dispersing strings, glomus, concretions, and aggregations." He elaborates:
Stasis of blood and qi in the abdomen can accumulate over time until it gathers and binds together to form lumps. When these are in the center of the stomach and abdomen, or slightly to the right, they are called glomus. When they are hidden in the rib-side, they are called aggregations. Those that are below or to either side of the umbilicus are called strings; they are shaped like a string and may be as taut as a bowstring or may resemble a child's arm. Lumps in the lower abdomen are called concretions; concretions that are not always palpable are called conglomerations.
To treat these various conditions, Jiao recommends using zedoaria with certain other herbs depending on the type and site of the lump. Zedoaria is known as pengezhu, or, more commonly, simply ezhu; it is a relative of turmeric, obtained from the rhizome of Curcuma zedoaria (Zingiberaceae). Sparganium is known as sanleng, which is the rhizome of Sparganium stoloniferum (Sparganiaceae), sometimes substituted by a botanically unrelated herb, Scirpus yagara (Cyperacea). Both ezhu and sanleng were first recorded in the Kaibao Bencao (973 A.D.). Sparganium was described there as being "mainly used for hypochondriac lump and mass in the abdomen," which accurately describes its current uses. The reliance on using zedoaria and sparganium together developed during the latter half of the 20th century, and primarily during the past 25 years. These two herbs have overlapping indications, but they can be differentiated, as has been explained by several modern authors. Thus, for example, Jiao states:
Zedoaria is better able to move qi and break blood, dissipate stasis, and disperse accumulations than sparganium, but sparganium has pronounced ability to soften hardness, dissipate binds, and eliminate old lumps. Sparganium and zedoaria are often used to disperse accumulations and eliminate concretions.
Yang Yifan, in her book Chinese Herbal Medicines: Comparisons and Characteristics (2), writes:
Sparganium and zedoaria are two important herbs that remove congealed blood and treat tumors. They can strongly promote the qi movement and blood circulation, and break up congealed blood. The two herbs are often used together to enhance their actions because sparganium is stronger in breaking up congealed blood and zedoaria is stronger in breaking up restraint of qi. They are used to treat severe blood stagnation. In clinical practice, they can be used to treat splenomegaly, liver cirrhosis, ectopic pregnancy, and cancer.
This description has some similarity to that of the pair myrrh and frankincense, where the former is said to be stronger at breaking up congealed blood and the latter is stronger at dispersing stagnant qi, while the pair treats severe blood stasis. There is more to this relationship: both myrrh and sparganium are basically bitter in nature, while both frankincense and zedoaria are acrid and aromatic as well as bitter. Phillip Sionneau (3) depicts the effects on qi and blood this way: zedoaria breaks the qi and quickens the blood, treats qi stagnation that causes blood stasis, and treats the blood within the qi; sparganium breaks the blood and moves the qi, treats blood stasis that causes qi stagnation, and treats the qi within the blood. Clearly, these are seen as completely complementary, one working from the qi to the blood, the other from the blood to the qi. In addition, both herbs are said to remove food stagnation. Another herb that vitalizes blood and regulates qi is cnidium (chuanxiong); it is common to combine cnidium with zedoaria and sparganium in treatment of abdominal masses.
Both sparganium and zedoaria are usually processed with vinegar to enhance their mass-softening effects (4). According to the Chinese herbal doctrines, the sour taste has a softening effect, and vinegar is considered the ideal sour substance. The processing method is to soak the herbs in vinegar (about 15 parts vinegar per 100 parts herbs); the soaked herbs are then stir fried over a low fire until they develop a golden color. If one wished to emphasize the blood vitalizing action of the herbs, but not the mass resolving effect, one would process them with wine instead of vinegar, as wine is said to enhance the blood circulation.
Sparganium contains flavonoids that are thought to be the main constituents reducing blood coagulation and enhancing circulation. Zedoaria contains essential oils with sesquiterpenoids that are thought to be among the main active constituents; they alleviate inflammation and pain, and may have antitumor activity.
Both sparganium and zedoaria are considered strong agents for dispersing stagnant qi and blood and resolving masses, and it is thought that high doses or prolonged use can be harmful to the qi in patients who suffer from deficiency. Yet, the theory is that abdominal masses usually form because of qi deficiency, which allows stagnation of qi and blood to progress to form masses. Therefore, sparganium and zedoaria are recommended to be administered along with qi tonic herbs (e.g., astragalus and codonopsis) for prolonged therapy. Also, sparganium (though not zedoaria) can reduce platelet aggregation; in cases where abdominal mass is accompanied by bleeding (e.g., heavy uterine bleeding due to fibroids), this herb is to be used in lower dosage and sanqi (tien-chi ginseng) may be added to the therapy to help inhibit bleeding. Sanqi will not interfere with, but will enhance, the main action of vitalizing blood circulation.