Gansui Root is the dried tuberous root of the plant Gansui Root from the Peking Euphorbia Root family. It is mainly produced in Shaanxi, Shanxi, Henan, and other regions. The original plant grows on grassy slopes, farmland ridges, and roadsides. It prefers cool climates, is cold-resistant, and can grow in various soils, but thrives best in deep, loose, fertile, well-drained, humus-rich sandy loam or clay loam. It has a bitter taste, cold nature, and is toxic. It belongs to the lung, kidney, and large intestine meridians. Its efficacy is to purge water and expel fluids. Clinical names include Gansui Root and vinegar Gansui Root.
bubble_chart Compendium of Materia Medica
Shennong Bencao Jing: Bitter in taste, cold in nature. It treats abdominal hernia, abdominal distension and fullness, facial edema, persistent fluid retention, retained food, breaks hard abdominal masses, and benefits the water and grain passages.
Mingyi Bielu: Sweet in taste, Great Cold (24th solar term), toxic. It expels five types of water, disperses bladder-retained heat, chest and abdominal masses, and heat-induced swelling. Yaoxing Lun: Bitter in taste. It can purge twelve types of water diseases, treat heart and abdominal hardness and fullness, expel water and phlegm, and primarily treats skin and muscle edema.
Kaibao Bencao: Bitter and sweet in taste, Great Cold (24th solar term), toxic. It expels five types of water, disperses bladder-retained heat, chest and abdominal masses, and heat-induced swelling.
Bencao Yanyi: This medicine is specifically used for water expulsion and decisive action, and must be carefully considered when used in medicine.
Tangye Bencao: Great Cold (24th solar term) in qi, bitter and sweet in taste. Sweet, pure yang, toxic.
《materia medica》states: It treats abdominal hernia, abdominal pain, facial edema, persistent fluid retention, retained food. It breaks hardness, eliminates accumulation, and benefits the water and grain passages. It expels five types of water, disperses bladder-retained heat, chest and abdominal masses, and heat-induced hardness and fullness. Muskmelon Base is its adjuvant. It is incompatible with Milkwort Root and antagonistic to Liquorice Root.《液》states: It can unblock water, and its qi directly penetrates to the site of obstruction.
《衍義》states: This medicine is specifically used for water expulsion and decisive action, and must be carefully considered when used in medicine.
《珍》states: If there is thoracic accumulation of water, it cannot be removed without this.
Bencao Yanyi Buyi: Sweet and cold, toxic. Only the connected beads are used, but this is not mentioned in the classics. This medicine is specifically used for water expulsion and decisive action, and must be carefully considered when used in medicine.
Bencao Fahui: Jiegu states: Sweet and cold in taste. Toxic, thoracic accumulation of water cannot be removed without this.
Bencao Gangmu: The kidney governs water; when it congeals, it forms phlegm-fluid retention; when it overflows, it causes swelling. Gansui Root can drain dampness from the kidney meridian, treating the root of phlegm. It should not be overused, but should be stopped once the disease is cured. Zhang Zhongjing used it with Liquorice Root to treat persistent fluid retention below the heart, utilizing their antagonism to achieve efficacy. Hejian's "Life-Saving Collection" states: For edema that is not completely resolved by medication, apply Gansui Root powder around the navel and take Liquorice Root water internally, and the swelling will subside. Bai Yi Xuanfang states: For foot qi rising, forming swollen nodules, and all types of swelling and toxicity. Use Gansui Root powder mixed with water and apply to the swollen area, then take a concentrated decoction of Liquorice Root juice, and the swelling will disperse. The two substances are antagonistic, and their interaction is remarkable. Han Yong of Qingliu suffered from foot disease and used this remedy once, curing 70-80% of the disease, and was completely cured after a second dose.
It drains dampness from the kidney meridian and water passages, treats beriberi, scrotal swelling and sagging, phlegm-induced epilepsy, dysphagia, and obstruction.Bencao Jingshu: Gansui Root is born from the pudendal coldness of heaven and earth, hence its bitter taste, cold nature, and toxicity, making it a yin herb. Water belongs to yin, and each follows its kind, hence it is good at expelling water. It treats abdominal distension, known as water tympanites. It also treats hernia, abdominal distension and fullness, facial edema, persistent fluid retention, benefits the water and grain passages, expels five types of water, disperses bladder-retained heat, and treats chest and abdominal masses and swelling due to qi stagnation. All these diseases arise from water-dampness; when water is expelled, fluids are reduced, and dampness is eliminated, thus addressing the root. Jiegu states it is bitter and cold in nature. Bitterness purges, cold dominates heat, directly reaching the site of water accumulation, making it a sage medicine for water expulsion. Thoracic accumulation of water cannot be removed without this, hence Zhang Zhongjing used it in Major Chest Bind Decoction. However, it is toxic and should not be used lightly, and its adverse nature is evident.
Caution: Gansui Root is yin and toxic. Although it is effective in draining water and eliminating dampness, it can deplete vital qi and exhaust body fluids. Except for cases of cold-damage disease with water thoracic accumulation where it is indispensable, in other cases of edema and distension, it is often due to spleen yin deficiency, where the spleen is too weak to control water, leading to water qi overflow. As Liu Hejian stated: "All dampness, swelling, and fullness belong to the spleen earth." The method should be to tonify the spleen and strengthen the earth, while also promoting urination. Instead of doing this, using Gansui Root for purgation will further deplete what is already deficient. Once the water is temporarily removed, the swelling will return, and death is certain. It is essential to determine whether the disease is due to dampness-heat, with retained fluids and water, and that the original qi is still strong, before considering its use. Otherwise, disaster will follow swiftly.
Bencao Mengquan: Bitter and sweet in taste, associated with the Great Cold (24th solar term). It is toxic. It is best used with Muskmelon Base. It is incompatible with Liquorice Root and antagonistic to Milkwort Root. It is highly effective in breaking down abdominal masses and reducing facial and body swelling. It can expel food stagnation in the stomach and resolve thoracic fluid accumulation. It penetrates directly to the site of the blockage, specializing in promoting water movement and facilitating excretion through the intestinal tract. Use with caution and avoid indiscriminate application.Bencao Chengya: Extremely bitter in taste, known as Gansui Root, it is said to bring relief and satisfaction as described in ancient texts. It is used for its strong and rapid effects, acting as a potent purgative and diuretic. It is particularly effective for abdominal masses, hernias, persistent fluid retention, and food stagnation, which obstruct the water and food pathways, leading to severe abdominal distension and facial swelling. It works by unblocking and purging, fulfilling the body's needs. However, due to its bitter and cold nature, it is not suitable for conditions caused by cold.
Yaojian: Bitter in taste, cold in nature, and toxic. Incompatible with Liquorice Root. It specializes in promoting water movement, directly reaching areas of water accumulation, such as thoracic fluid retention. It can expel phlegm, resolve abdominal masses, and treat swelling in the abdomen, feet, and scrotum, as well as reduce facial swelling, promote urination and defecation, clear bladder dampness-heat, and address phlegm-induced epilepsy and dysphagia. However, due to its strong and yin-damaging properties, it should not be used indiscriminately.
Bencao Beiyao: Strongly promotes urination and purges water-dampness from the meridians.
Bitter, cold, and toxic, it purges water-dampness from the kidney meridian and the body's pathways, directly reaching areas of water accumulation. It is a highly effective diuretic and is used in Zhang Zhongjing's Major Chest Bind Decoction. It treats twelve types of water retention, including severe abdominal swelling, known as water tympanites. Yu Jia-yan said: The stomach is the sea of water and grain, the source of the five zang and six fu organs. If the spleen cannot disperse the stomach's essence to the lungs, disease occurs in the middle; if the lungs cannot regulate the stomach's water pathways to the bladder, disease occurs in the upper body; if the kidneys cannot control the stomach's gate, regulating storage and excretion, disease occurs in the lower body. This leads to uncontrolled water accumulation. The kidneys are the gate of the stomach. The external genitalia promote water excretion, and the anus promotes grain excretion. Wang Hao-gu said: Water is governed by the spleen, lungs, and kidneys. It affects the five zang and six fu organs, the twelve meridians, the head and face, limbs, waist and feet, skin, muscles, and bones. The pulse varies in depth and strength, and one must not purge indiscriminately. The disease's location in the meridians and organs must be identified before use. Note: Edema can be caused by phlegm obstruction, food accumulation, or static blood preventing the rise of clear and descent of turbid substances; by dampness-heat interaction blocking the pathways; or by dryness-heat impact causing constipation. These are excess conditions. It can also result from cold damage to the diet, middle qi deficiency, post-illness weakness, or uncontrolled fluid excretion due to spleen failure. These are deficiency conditions. Treatment should be differentiated, but the root cause is often middle qi deficiency. Danxi said: Water diseases should focus on strengthening the spleen, as spleen excess promotes water movement. Ginseng and Poria are the main herbs, adjusted based on accompanying symptoms. Relying solely on diuretics can be fatal. Abdominal masses, persistent fluid retention, and phlegm-induced epilepsy should be avoided in deficiency conditions. Muskmelon Base is the guiding herb, antagonistic to Milkwort Root, and incompatible with Liquorice Root. Zhang Zhongjing used it with Liquorice Root to treat persistent fluid retention, leveraging their antagonism for therapeutic effect. For edema and swelling, apply Gansui Root powder to the swollen area and drink a strong decoction of Liquorice Root. The swelling will quickly subside. The antagonism between these two substances produces such effects.
Benjing Fengyuan: Gansui Root is white in color and bitter in taste, first ascending and then descending, being a potent medicine for purging water. Benjing treats conditions such as large abdominal hernia, facial edema, persistent fluid retention, and retained food. It takes advantage of its bitter and cold nature to swiftly and effectively unblock the twelve meridians, break through hard accumulations, and directly reach the areas where water and qi are congealed. Zhang Zhongjing's Major Chest Bind Decoction and the "Golden Chamber" Liquorice Root Pinellia Decoction use it, but it greatly drains original qi and is toxic, so it should not be used lightly. The kidneys govern water; when it congeals, it becomes phlegm-fluid retention, and when it overflows, it causes swelling. Gansui Root can drain dampness from the kidney meridian and treat the root of phlegm, but it should not be overused—stop once the disease is cured. Zhang Zhongjing treated persistent fluid retention below the heart by using it with Liquorice Root, taking advantage of their antagonism to achieve results. Zhouhou Fang treats body and facial edema by using two qian of Gansui Root powder mixed with one sliced male pig kidney, wrapped in wet paper and roasted until cooked. One slice is taken daily, and after four to five doses, abdominal rumbling and increased urination indicate its efficacy. However, edema and tympanites are often due to spleen yin deficiency, where the earth is too weak to control water. The method should be to warm and tonify the spleen to expel water while promoting urination. Misusing Gansui Root, Peking Euphorbia Root, Pokeberry Root, or lobedleaf pharbitis seed can lead to immediate disaster. For epilepsy, heart wind, and blood evil, two qian of Gansui Root powder is mixed with pig heart blood, stuffed into the heart, wrapped in wet paper, and roasted. The medicine is then mixed with one qian of cinnabar powder and divided into four pills. One pill is taken with pig heart decoction, and the expulsion of foul substances indicates efficacy. If not expelled, take another pill. For incomplete edema, apply Gansui Root powder around the navel and take Liquorice Root decoction internally to reduce swelling. The antagonism between the two substances produces such effects, and applying it to toxic swellings in the same way can also disperse them. It also treats sudden deafness in obese individuals by inserting a piece of Gansui Root wrapped in cotton into the ear while chewing Liquorice Root, which can suddenly restore hearing.
Bencao Chongyuan: The taste of earth is sweet, and the direct path is called "sui". Gansui Root tastes bitter, as it drains earth qi and travels through the tunnels, hence it is named "sui". When earth qi is disharmonious, it causes abdominal distension. When the tunnels are obstructed, it leads to hernia and abdominal masses. Abdominal distension and fullness are due to earth failing to overcome water, externally manifesting as facial and eye swelling, and internally as persistent fluid retention and retained food. Gansui Root treats this by draining earth qi. For hernia and masses, which are hard abdominal masses, Gansui Root breaks them up by clearing the tunnels. When the water passages are clear, water qi disperses; when the grain passages are clear, old accumulations are removed. Gansui Root moves water qi and clears old accumulations, thus benefiting the water and grain passages.
The "Chengyalun" states: Gansui Root is used in formulas for major and urgent conditions. In prescriptions, it is used for clearing and draining. However, its bitter and cold nature is biased towards heat, making it unsuitable for conditions caused by cold.
Bencao Qiuzhen: [Comment] Greatly purges water-dampness from the channels and tunnels.
Gansui Root specifically enters the spleen, stomach, lungs, kidneys, and bladder. Its skin is red and flesh white, with a bitter taste and cold, toxic qi. Its nature is purely yin. Therefore, texts record its ability to rush directly to the water qi accumulation in the kidney channel and the tunnels, causing it to be expelled through the grain passages, making it the foremost medicinal for draining water-dampness. Element says: In thoracic accumulation of water, this cannot be dispensed with, hence Zhang Zhongjing used it in Major Chest Bind Decoction. However, it is toxic and should not be used lightly. Yu Jia-yan said: The stomach is the level of water and grain, the source of the five zang and six fu organs. If the spleen does not disperse the stomach's water essence to the lungs, it causes illness in the middle; if the lungs cannot connect the stomach's water passages to the bladder, it causes illness above; if the kidneys cannot regulate the stomach's gate, timing its storage and discharge, it causes illness below, leading to water accumulation spreading without end. Edema has five types: wind edema, skin edema, typical edema, stony edema, and yellow sweat. Water stagnation in the heart causes vexation, shortness of breath, and inability to sleep peacefully; in the lungs, it causes fullness, panting, and cough; in the liver, it causes rib-side fullness and pain extending to the lower abdomen; in the spleen, it causes vexation in the limbs, heaviness, and inability to wear clothes; in the kidneys, it causes abdominal pain extending to the back and pain in the waist and thighs. Edema differs from qi swelling: edema is bright and moist, with thin, smooth skin, swelling slowly from the bottom up, flesh pressing like mud, with defined swelling boundaries. Qi swelling is pale yellow, with thick skin, sudden swelling without boundaries, distension possibly extending to the chest and ribs, pain possibly affecting the zang-fu organs, or sudden swelling, swelling from top to bottom, or whole-body swelling, pressing causes it to rise. However, Zhang Zhongjing's discussions on edema mainly focus on external pathogens, with internal damage also considered. Ultimately, water is extreme yin, its root in the kidneys; if kidney qi is deficient, water has no master and runs wild. Without warming the kidneys and supplementing the spleen, merely moving qi to drain water is not the principle of guiding water back to the kidneys, like earth in rain becoming mud, requiring gentle wind and warm sun to turn damp qi into yang harmony, naturally allowing all things to grow. Therefore, only when excess pathogens and original qi are strong should Gansui Root be used. For tunnel blockages manifesting as edema, tympanites, hernia, and abdominal pain, none can do without this swift and sharp medicinal to open and clear the water passages, as in Zhang Zhongjing's Major Chest Bind Decoction. However, if the condition is not one of excess but due to middle qi weakness, with blocked urination and wild water movement that the spleen cannot control, mistakenly using draining medicinals further depletes the deficiency; though water may temporarily recede, life will surely follow. Liquorice Root is said to antagonize this, yet why do the two used together show such efficacy? It is because the sweet action enhances the downward urgency. Also, according to Liu Hejian: For edema not fully resolved by medication, applying Gansui Root powder around the navel and taking Liquorice Root water can disperse the swelling. The two antagonize yet respond thus. Only those deeply versed in this path can speak of this.
Depei Bencao: Muskmelon Base is its envoy. It is averse to Milkwort Root and Liquorice Root.
Sweet, bitter, cold. Toxic. Enters the foot shaoyin channel qi aspect. Directly reaches water accumulation sites. Attacks and clears tunnel water. Moves water through the twelve channels, expelling it through the grain passages.
Combined with Rhubarb Rhizoma and Donkey-hide Gelatin, it treats blood stasis; with Polyporus and Alisma, it treats bladder inversion; with Liquorice Root, it treats persistent fluid retention below the heart. The kidneys govern water; congealed, it becomes phlegm-fluid retention; overflowing, it becomes swelling. Draining kidney channel dampness treats the root of phlegm-fluid retention. Powder mixed into roasted pig kidney, taken daily, treats severe edema and distension.
Misuse greatly damages original qi, leading to abdominal distension and fullness and death.
Benjing Shuzheng: The skin of the Gansui Root is red, the flesh is white, metal meets fire, why worry about not flowing? Its bitter taste descends, its cold nature aligns with water, and its substantial weight makes its nature deeply penetrating like a string of pearls, thus clearing blockages section by section. Even if there are constraints, it can still open and release, hence it specifically targets deep-seated water retention, regardless of how stubborn it is. The chapter on water heat points in the discussion of water states: Water diseases manifest as swelling in the lower limbs and abdominal distension, and as panting and wheezing in the upper body. Thus, the kidney is the root, and the lung is the branch. Abdominal distension and fullness, and swelling of the face and eyes indicate that both the root and branch are diseased. You Zai-jing's discussion on the chest congestion syndrome states: The stomach is like a metropolis where food and water coexist, and the clear and turbid are not yet separated. When pathogenic qi persists, mixed with phlegm and food, it becomes unresolved thoracic accumulation. The large and small intestines, having lost their essence, retain only the dregs. When pathogenic qi persists, it only forms dry feces with the foul matter. The major purgative formula mainly targets dry feces in the intestines, while the major chest congestion formula also targets water and food below the heart. Feces in the intestines must be expelled, hence the need for Zhiqiao and Magnolia bark. Water and food in the stomach must also break up fluid retention, hence the need for Gansui Root. When persistent fluid retention and retained food are removed, the pathways for water and grain are cleared. Jingui Yaolue uses Gansui and Pinellia Decoction to treat persistent hardness and fullness below the heart even after diarrhea. It also uses Rhubarb and Gansui Decoction to treat water and blood accumulation in the blood chamber. Here we see that water can be the root of abdominal masses such as hernias and tumors, and it is also evident that in cases of diarrhea, Rhubarb Rhizoma cannot be used, but Gansui Root can still be used. Its nature is straightforward and direct, without lingering, thus it is not only capable of moving stagnant and overflowing water but also excels in dealing with water that hesitates and lingers, wanting to move but not moving.
Bencao Xinbian: Gansui Root, bitter and sweet in taste, with a Great Cold (24th solar term) nature, toxic, and incompatible with Liquorice Root. It enters the stomach, spleen, bladder, and large and small intestines. It is highly effective in breaking abdominal masses, reducing facial and body edema, and resolving water accumulation in the chest, particularly excelling in promoting diuresis. This herb expels water and dampness slowly, while lobedleaf pharbitis seed does so quickly. When used together, the slow becomes less slow, and the fast becomes less fast. However, Gansui Root should not be used lightly. It can only treat true dampness, not false dampness. True dampness arises when water invades from below, while false dampness occurs when water invades from above. Gansui Root can be used for true dampness to open the water pathways, but not for false dampness, as it would exacerbate the condition. True dampness is a substantial water pathogen, while false dampness stems from a deficiency of original qi. Treating a deficiency syndrome with a method for excess would violate the principle of not depleting the already deficient. Thus, using it recklessly can lead to rapid decline. Caution is essential!
Some ask why lobedleaf pharbitis seed and Gansui Root are combined in Zhang Zhongjing's formula to treat edema tympanites with unparalleled efficacy. Since lobedleaf pharbitis seed is already highly effective in promoting diuresis, why add Gansui Root to slow it down? Alas, this is the brilliance of Zhang's medicinal strategy, beyond the grasp of superficial learners. Consider flood control: when a deluge engulfs the land, where does one begin? One must start upstream, dredging and clearing the source, so the downstream becomes manageable. If only the downstream is opened, water will indeed rush out, but the upstream water, still blocked and stored in lakes, will remain. If the coccyx qi is drained while the upstream surges, how can the people live in peace? Thus, flood control must address both upstream and downstream. The human body is no different. Zhang Zhongjing's inclusion of Gansui Root with lobedleaf pharbitis seed embodies this principle, harmonizing the draining of dampness. Lobedleaf pharbitis seed is swift, but its excessive force might expel water too quickly, leaving water in the limbs, skin, hair, head, face, and hands, while the intestines, stomach, and spleen are easily cleared. Adding the slower Gansui Root balances urgency and gentleness, ensuring that water is evenly dispersed during emetic therapy and swiftly expelled during purgation. Thus, water in the limbs, skin, hair, head, face, and hands is thoroughly expelled through the bladder, and water in the spleen, stomach, and intestines is completely eliminated through urination and defecation. Using only lobedleaf pharbitis seed would be too harsh, risking lower energizer dryness and upper energizer panting, leading to an incurable condition. Using only Gansui Root would be too slow, causing upper energizer relief but lower energizer blockage, resulting in an unmanageable illness. Zhang's combination achieves remarkable efficacy, reaping benefits without harm.
Some ask why lobedleaf pharbitis seed, being fast-acting, and Gansui Root, being slow, are combined for success. You have only discussed the benefits for the upper and lower energizers, but not the middle energizer. Does their combination not benefit the middle energizer? The combined use of lobedleaf pharbitis seed and Gansui Root, benefiting the upper and lower energizers, inherently supports the middle energizer. If the lower energizer is blocked, water will reflux into the middle energizer, causing obstruction. If the upper energizer is panting, water will flow into the middle energizer, causing distension. Using both herbs ensures the upper and lower energizers are balanced, and the middle energizer remains stable.
Some doubt that Gansui Root, though slow, is still potent in expelling water and dampness. Using it with lobedleaf pharbitis seed might exacerbate its harshness. However, Gansui Root targets true water and dampness, so there is no concern about harshness. If the condition is not due to water and dampness, using Gansui Root alone is inadvisable, let alone with lobedleaf pharbitis seed. Only when true water and dampness are present can they be used together without conflict.
Some ask whether the Bifeng Zaxing's method of treating bladder torsion with one qian of Gansui Root powder mixed with Polyporus Decoction for immediate relief is reliable. Bladder torsion often results from fire, and Gansui Root's Great Cold nature seems suitable for purging it. However, the fire in bladder torsion stems from kidney fire failing to reach the bladder, with deficient fire suppressed and unable to flow. True bladder torsion would be fatal; how could one survive long?
Bencao Fenjing: Bitter, cold. Drains water and dampness from the kidney meridian and tunnels, directly reaching areas of water accumulation. It acts by breaking through, treating abdominal distension, masses, and phlegm confusion. It is highly effective in removing water but rapidly depletes true qi. Use after roasting.
bubble_chart Modern Pharmacology
- Gansui Root has a purgative effect. Administering Gansui Root powder to dogs can cause intense contractions of the gastrointestinal tract. Its purgative active ingredients strongly irritate the intestinal mucosa, leading to inflammatory congestion and increased intestinal peristalsis, resulting in severe diarrhea. The active components may be resins present in the ethanol extract.
- Gansui Root has a diuretic effect. A water-decocted Gansui Root preparation did not induce a diuretic effect in rats, but clinical observations of patients with renal disease and edema who took Gansui Root or used Gansui Root applied to acupoints for treating dysuria showed a promoting urination effect, although no significant diuretic effect was observed in healthy individuals.
- Gansui Root has an antifertility effect. Peking Euphorbia Root dienol and Peking Euphorbia Root dienone isolated from Gansui Root have abortifacient effects. Gansui Root preparations administered intrauterinely to Yaodui mice and rabbits can terminate intermediate stage [second stage] pregnancy.
- Gansui Root has antileukemic effects. Kansuiporin A and B, two new diterpene ester components found in Gansui Root, are antileukemic agents.
- Gansui Root has cancer-promoting activity and mutagenic effects.
- Gansui Root terpene esters A and B have analgesic and anti-writhing effects.
- A small dose of Gansui Root can enhance the contractility of isolated frog hearts without changing their frequency; a large dose produces an inhibitory effect.
- In experimental peritonitis in mice, treatment with Gansui Root promotes the absorption of peritoneal blood.