Hard Lumps in the Belly or Gynecological Masses? San Leng and E Zhu — the Pair That Dissolves Stubborn Blood-Stasis Lumps
Opening: answering everyone’s question first — can Li Chong Tang treat breast nodules?
Many friends have written in, and the single most-asked question is: can Li Chong Tang (Regulating the Thoroughfare Decoction) treat breast nodules? Doctor Luo Dalun answers this right at the start of today’s lecture.
💬 Note from Doctor Luo: Dear friends, here’s the thing — breast nodules are mostly caused by liver qi constraint (gan qi bu shu): stress, difficult emotions, and that leads to blood stasis. So what’s usually needed is to soothe the liver and regulate qi, then invigorate blood and resolve stasis — that’s the proper treatment. Doctor Zhang Xichun’s Li Chong Tang, on the other hand, is supporting the upright and dissolving stasis; its liver-soothing power is insufficient. So in my view, breast problems have their own way of being treated.
So what is Li Chong Tang for? The “zheng jia” Doctor Zhang spoke of refers to lumps inside the abdomen — in the belly, and especially in women, gynecological masses.
What exactly is zheng jia? Many of today’s benign lumps count as one
💬 Note from Doctor Luo: What is this zheng jia, exactly? It’s like this: nowadays we can regard a good many benign tumors and lumps as zheng jia.
With that positioning clear, today we go on to the next question: what exactly did Doctor Zhang Xichun put in Li Chong Tang? The most distinctive — and most misunderstood — pair in the formula is san leng (Sparganium rhizome) and e zhu (zedoary, Curcuma rhizome). What are these two for?
The structure of Li Chong Tang: a base that supports the upright, a vanguard that dissolves stasis
First, look at the formula: raw huang qi (astragalus), three qian, and dang shen (Codonopsis), two qian — what are these two for? Supporting the upright. San leng, e zhu, plus ji nei jin (chicken gizzard lining) — these three are the stasis-dissolving team. Doctor Zhang Xichun believed that san leng, e zhu and ji nei jin must always be paired with some herbs that support the upright.
💬 Note from Doctor Luo: Why? Because when you invigorate blood and break blood, Doctor Zhang worried about injuring the upright qi. So with supporting herbs added, Doctor Zhang said: the blood-invigorating power becomes even stronger, and the upright qi is not harmed.
So what did he add? Raw huang qi and dang shen — to tonify qi; then bai zhu (white atractylodes) and sheng shan yao (dried Chinese yam) — these build the spleen and also add upright qi; and what are tian hua fen (Trichosanthes root) and zhi mu (Anemarrhena) doing? They’re there because the tonics above could run too warm — so a little yin-nourishing, heat-clearing medicine is added to keep the whole formula warm, moist and not drying.
The main event at the end: san leng, e zhu and raw ji nei jin, three qian each
At the very end come san leng, e zhu and raw ji nei jin, three qian each — these three herbs are extremely important.
💬 Note from Doctor Luo: What kind of herbs are san leng and e zhu? In Chinese medicine we consider them both blood-invigorating and stasis-resolving, with a blood-breaking action — their ability to invigorate blood and resolve stasis is especially strong. Doctor Zhang pointed out: ordinary doctors, when regulating qi and moving blood, habitually use xiang fu (nutgrass flatsedge rhizome) rather than san leng and e zhu. Why did Doctor Zhang use these instead? Because they can dissolve zheng jia — san leng and e zhu are the specific herbs for dissolving those masses formed when qi and blood knot together.
Everyone suspects they’re too fierce, and so doesn’t realize: breaking up zheng jia is precisely the job of san leng and e zhu — their function is to break accumulations and dissolve masses, and that is their special strength. It is not that the herbs are violent and therefore able to dissolve lumps — they are not violent at all.
The bold verdict: ten times as much xiang fu cannot match san leng and e zhu at dissolving zheng jia
Doctor Zhang Xichun himself said something that can fairly be called startling.
💬 Note from Doctor Luo: Doctor Zhang said — based on my years of experience, my own understanding: once you know the true nature of san leng and e zhu, then if we’re talking about scattering and draining qi and blood, xiang fu may actually be harsher than san leng and e zhu; but if we’re talking about dissolving zheng jia lumps, ten times as much xiang fu cannot match san leng and e zhu.
So, he said, why do I use san leng and e zhu in this formula? Precisely to eliminate stasis and break zheng jia — and then I add dang shen and huang qi to protect the qi and blood: the stasis goes, and the upright qi is not wounded. When you use ren shen and huang qi to support the upright, and add san leng and e zhu on top, the result is that you tonify without creating stagnation — qi and blood circulate freely, and the primordial qi grows stronger and stronger. In Doctor Zhang’s experience, this combination works superbly.
The herbs in detail: faint taste, slight acrid note, warm nature — and excellent for blocked menstruation
In the materia medica section of his Yi Xue Zhong Zhong Can Xi Lu (Records of Chinese Medicine with Reference to Western Medicine), Doctor Zhang Xichun wrote specifically about san leng and e zhu.
💬 Note from Doctor Luo: What did he say? San leng has a faint taste, with just a hint of acridity in it; e zhu is slightly bitter, faintly fragrant, and also carries a touch of acridity. Both are warm in nature — warm herbs that resolve blood stasis. He said these treat blocked menstruation and amenorrhea in women, and so on, extremely effectively — they are absolutely not violent, fierce medicines.
We generally assume they must be ferocious, but Doctor Zhang had his own experience — and what was Doctor Zhang’s greatest strength? He examined every single herb in minute detail, and after testing it himself, he told you exactly what the herb was really like.
A special talent: blocks as hard as iron, it can still pare them away
Doctor Zhang Xichun held that the qi-moving power of san leng and e zhu can treat pain in the heart and abdomen, distending pain under the ribs, and all patterns of congealed blood and stagnant qi. When combined with dang shen, bai zhu and huang qi used together, they greatly open the appetite, harmonize blood and regulate blood — the same herbs.
💬 Note from Doctor Luo: If you compare the two: for resolving blood, san leng seems a little stronger than e zhu; for regulating qi, e zhu seems a little stronger than san leng. In Chinese medicine we very often use these two as a pair. Each herb, Doctor Zhang said, has its own abilities.
San leng and e zhu are close to neutral in nature, yet they can treat blood-stasis zheng jia in women — even lumps as hard as iron, they can pare them right down. So Doctor Zhang said: you might say the herbs are not fierce, and yet they can achieve remarkable results — that too is their special skill, their special gift.
The misunderstanding of the “ear-eaters”: not daring to use the herbs means not knowing what they can do
💬 Note from Doctor Luo: The “ear-eaters” — what are ear-eaters? People who only know things by hearsay. They hear that it can pare away such a big lump, so the medicine must be fierce — don’t use it lightly. Doctor Zhang said: what is this? This is not understanding what the herb can do, and therefore not daring to use it.
That’s why, in many of his formulas, whenever there is blood stasis — especially severe stasis forming lumps — Doctor Zhang excelled at using san leng and e zhu, and often paired them with ji nei jin. These three herbs are all stasis-dissolvers.
A lump is never the work of a day: keep at it long-term, and don’t forget to support the upright
Doctor Zhang Xichun had another piece of experience, very down-to-earth.
💬 Note from Doctor Luo: He believed that any blood stasis capable of forming a lump is almost never a matter of a day or two — it’s always been building for a long time. So at that point you have to persist long-term, keep using it long-term. When you invigorate blood and resolve stasis every single day, the upright qi can sometimes get wounded — which is why Doctor Zhang advocated adding dang shen, huang qi, bai zhu and the like as support. That’s Doctor Zhang’s experience.
Flexible use: three situations, three additions
If we meet this kind of situation today, how can we use it? Doctor Luo Dalun offers three approaches.
💬 Note from Doctor Luo: First, for example, liver qi constraint — you can soothe the liver and regulate qi while supporting the upright, and add san leng and e zhu to dissolve stasis. Second, for yin deficiency — increase the yin-nourishing herbs a bit, then add the stasis-dissolvers. Third, for qi deficiency — follow Doctor Zhang’s approach: ren shen, huang qi, bai zhu, plus san leng, e zhu and ji nei jin. These are all flexible applications of Doctor Zhang’s experience and methods. But if all we’ve learned is the one formula Li Chong Tang, and we throw it at any lump regardless of cause, that won’t work either.
Because the causes of illness are many. The patients Doctor Zhang Xichun met were all like this: ill for a long time, their bellies already filled with lumps, the upright qi often insufficient. What we see a lot of today is people whose illness comes from difficult emotions — soothing the liver and dissolving stasis is one approach too.
Closing: knowing this pair of herbs matters more than memorizing a formula
💬 Note from Doctor Luo: Nowadays doctors may not use san leng and e zhu all that often. If you see these herbs in a prescription your doctor gives you, now you know what they’re for — san leng and e zhu are not as fierce as people imagine; in fact Doctor Zhang considered them very gentle in nature, yet they can dissolve stasis. So with some upright-supporting herbs assisting them, they go after those stasis accumulations — the lumpy, knotted stasis — and very often can dissolve it. That is the special efficacy of san leng and e zhu.
If you have a similar condition, you can also ask a physician to weigh whether san leng and e zhu might suit you. And for those studying medicine: when you use them from now on, remember — Doctor Zhang Xichun believed that dissolving stasis and zheng jia does not necessarily require violent medicines; gentle herbs paired with upright-supporting tonics can still pare away lumps as hard as iron. That is the distinctive medicinal insight of this modern master.
What to take away
- Li Chong Tang is for abdominal zheng jia, not breast nodules. Breast nodules mostly come from liver qi constraint plus blood stasis — soothe the liver, regulate qi, then invigorate blood and resolve stasis. Li Chong Tang supports the upright and dissolves stasis; it is aimed at lumps inside the belly, especially gynecological ones.
- San leng and e zhu are not the violent drugs people fear. Both are warm, blood-resolving herbs with a faint taste and a slight acrid note — excellent for amenorrhea and blocked menstruation. They are close to neutral in nature, yet can pare away lumps “as hard as iron.”
- The bold comparison: for scattering and draining qi and blood, xiang fu is harsher than san leng and e zhu; for dissolving zheng jia, ten times as much xiang fu cannot match them.
- Always pair them with upright-supporting herbs — huang qi, dang shen, bai zhu, shan yao — so that “you tonify without stagnation,” the stasis goes, and the upright qi is unharmed.
- A formed lump is never the work of a day or two — keep at the treatment long-term, and protect the upright qi while dissolving stasis.
- Three flexible patterns: liver qi constraint — soothe the liver plus dissolve stasis; yin deficiency — nourish yin more heavily plus dissolve stasis; qi deficiency — ren shen, huang qi, bai zhu plus san leng, e zhu, ji nei jin.
Compiled from Doctor Luo Dalun’s Chinese medicine lecture series on Doctor Zhang Xichun’s cases and medicinal insights, drawn from the Yi Xue Zhong Zhong Can Xi Lu (Records of Chinese Medicine with Reference to Western Medicine, published in installments 1918–1934).