Ting Li Zi (葶苈子) — TCM Peppergrass Seed for Severe Lung Dyspnea, Edema & Heart Failure

At a Glance

Herb: Ting Li Zi
Chinese name: 葶苈子 (Tíng Lì Zǐ)
Latin name: Lepidii/Descurainiae Semen
Nature: Very Cold
Taste: Bitter / Acrid
Meridian: Lung / Bladder
Category: Herbs that Transform Phlegm and Stop Coughing
Introduction: Ting Li Zi (葶苈子) is the dried ripe seed of Lepidium apetalum Willd. (peppergrass) or Descurainia sophia (L.) Webb ex Prantl (flixweed), small annual herbs in the mustard family (Brassicaceae) found as common weeds in fields and roadsides throughout China. Documented in the Shennong Bencao Jing as a lower-grade herb due to its potency, Ting Li Zi is one of the most powerful downward-draining herbs for the Lung — used when Phlegm-fluid accumulation is severe enough to cause life-threatening dyspnea, and when gentler approaches have failed. Sinigrin glucosinolates, cardiac glycoside-like compounds, and fatty acids contribute to strong bronchodilating, expectorant, diuretic, and cardiac-strengthening effects; modern studies confirm positive inotropic action similar to cardiac glycosides, supporting classical use in cor pulmonale and cardiac edema. Its potency necessitates careful dosing and pattern-specific use — always combined with Da Zao to protect the Stomach and buffer its harsh draining action.

Drains the Lung and calms wheezing — severe Phlegm-fluid obstruction with dyspnea, orthopnea
Promotes urination and reduces edema — lung-origin edema, pleural effusion, ascites
Strengthens cardiac function — cor pulmonale, heart failure edema (modern integrative)
Purges Phlegm-fluid accumulations — severe Phlegm retention when gentler herbs are insufficient

Lung Phlegm-fluid obstruction with severe dyspnea (不得卧): primary use — combined with Da Zao in Ting Li Da Zao Xie Fei Tang
Pleural effusion and cardiac edema: combined with Fang Ji, Huang Qi for deficiency background
Pulmonary hypertension and cor pulmonale: modern evidence-based integrative use
Ascites from Liver disease with concurrent Lung involvement
Phlegm-fluid palpitations: Phlegm water accumulating around the Heart

Dosage: 5–10 g in decoction; stir-fry (炒葶苈子) to moderate harshness; wrap in cloth for decoction
Always combine with Da Zao (3–5 dates) to protect Stomach Qi from harsh draining action
Contraindicated in Lung deficiency without excess — powerful draining action depletes Lung Qi rapidly
Use with extreme caution in frail or elderly patients — reduce dose and monitor closely
Cardiac glycoside-like compounds may interact with digoxin — monitor in patients on cardiac glycosides
Not for long-term use — a powerful acute intervention for excess accumulation patterns

Ting Li Da Zao Xie Fei Tang (葶苈大枣泻肺汤) — Ting Li Zi + Da Zao; severe Lung Phlegm-fluid with dyspnea unable to lie flat; Zhang Zhongjing classic
Ji Jiao Li Huang Wan (己椒苈黄丸) — Ting Li Zi + Fang Ji + Jiao Mu + Da Huang; Phlegm-fluid with constipation and edema
Combined with Sang Bai Pi and Ma Huang for severe bronchial asthma with fluid retention
Modern cardiac formulas: Ting Li Zi + Dan Shen + Ze Xie for congestive heart failure

Lepidium Seed (葶苈子) + Jujube Fruit (大枣) → Ting Li Da Zao Xie Fei Tang (葶苈大枣泻肺汤) — forcefully drain lung phlegm and water; Jujube Fruit (大枣) protects stomach from harshness
Lepidium Seed (葶苈子) + Stephania Root (防己) + Zanthoxylum Seed (椒目) + Rhubarb Root (大黄) → Ji Jiao Li Huang Wan (己椒苈黄丸) — drain water and heat from chest and abdomen, treat ascites and pleural effusion
Lepidium Seed (葶苈子) + Mulberry Root Bark (桑白皮) + Apricot Kernel (杏仁) → drain lung qi, stop severe dyspnea and wheezing from phlegm flooding
Lepidium Seed (葶苈子) + Bitter Sophora Root (苦参) + Plantain Seed (车前子) → clear heat, drain damp, reduce pulmonary edema
Lepidium Seed (葶苈子) + Ginseng (人参) + Aconite Root (附子) → cardiac failure with phlegm-water — drain excess while supporting deficiency; clinical note: one of the most powerful lung-draining herbs in TCM — indicated only for strong excess patterns (full pulse, dyspnea, unable to lie flat); stir-fried Lepidium Seed (炒葶苈子) slightly reduces harsh cold nature; two sources: Northern Lepidium Seed (北葶苈) (Lepidium apetalum — stronger) vs Southern Descurainia Seed (南葶苈) (Descurainia sophia — milder)

Cardiotonic / positive inotropic
- helveticoside, erysimoside — cardiac glycosides similar to digitalis
- inhibit Na+/K+-ATPase
- increase intracellular Ca²⁺
- strengthen myocardial contraction
- clinical use for congestive heart failure with pulmonary edema
- increases cardiac output, reduces pulmonary congestion
- 狭窄治疗窗 — narrow therapeutic window, monitor closely
Diuretic
- cardiac glycosides + flavonoids — improve renal perfusion
- increase GFR
- reduce body fluid accumulation
- treat pleural effusion and ascites
Antiasthmatic
- isothiocyanates — relax bronchial smooth muscle
- reduce airway resistance
- reduce mucus hypersecretion
Expectorant
- isothiocyanates — stimulate bronchial secretion, thin mucus
Anti-inflammatory
- quercetin, kaempferol — inhibit COX-2, 5-LOX
Antibacterial
- isothiocyanates — broad spectrum
Antitumor
- quercetin, glucosinolate metabolites — anti-proliferative
caution: overdose causes cardiac arrhythmia — monitor heart rate; contraindicated in deficiency

Shen Nong Ben Cao Jing: ‘Governs abdominal masses and accumulations, bound qi, alternating chills and heat from food retention; breaks up hardness and expels evil; opens and benefits the water passages.’
Ming Yi Bie Lu: ‘Drains water from the bladder and lurking heat qi; draws out pathogenic water from between skin layers and disperses facial and bodily edema; treats sudden wind-stroke; relieves heat rash and itching; promotes urination; long-term use causes deficiency.’
Ben Cao Gang Mu: ‘For water-qi accumulation in the lung with fullness, urgency, and wheezing counterflow with upward-surging qi, use bitter Lepidium Seed and add Jujube Fruit to dredge and open the lung.’
Yao Xing Lun: ‘Promotes urination; withdraws upward-surging lung qi causing rapid wheezing; stops cough. Sweet Lepidium Seed treats lung obstruction with upward-surging cough, settles accelerated wheezing, and eliminates phlegm-fluid in the chest.’