Ku Hu Lu
StarLagenaria siceraria (Molina) Standl. var. gourda (Ser.) Hara
Traditionally used for
- Cough & breathing
- Digestion
- Bowel health
- Urinary & fluids
- Skin
- Liver & jaundice
Cautions & contraindications
- Bleeding disorders
- Toxic — professional use only
☯ TCM Properties
Promotes urination and reduces swelling
Traditional Chinese Uses
Ku Hu Lu is the bitter-fruited form of the bottle gourd/calabash, Lagenaria siceraria var. gourda. Bitter and sweet with a cold nature, entering the Spleen, Lung and Kidney channels, its chief action is to promote urination and reduce swelling, draining accumulated water. It is used for water-retention patterns: generalized edema, ascites and abdominal fullness, and for difficult, scanty urination. Its detoxifying, purgative quality is also applied to jaundice and skin sores, and topically to ulcers.
It is typically decocted around 15-30 g. It is unsuited to Spleen-Stomach deficiency-cold. A genuine safety caution: intensely bitter bottle-gourd fruit contains high levels of cucurbitacins, and ingestion of the bitter juice has caused severe gastroenteritis with vomiting, bloody diarrhea, and in reported cases shock or death — so the bitter form must be used strictly in controlled medicinal amounts, never as food.
Western Herbalism Properties
Relationships
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Botanical Description
Ku Hu Lu is the bitter-fruited form of Lagenaria siceraria (Molina) Standl. (Cucurbitaceae), the bottle gourd or calabash, an annual climbing vine cultivated throughout China and tropical/subtropical regions worldwide. Stems are long, soft-hairy, and bear branched tendrils. Leaves are alternate, broadly cordate-ovate, shallowly 5-lobed, 10–25 cm wide, with soft pubescence and small glands at the petiole apex. Plants are monoecious with solitary, large, white, nocturnal flowers opening at dusk. The fruit is a pepo of highly variable shape (bottle, dipper, club, or globose) 10–50 cm long; the wild and certain cultivar forms produce a sharply bitter fruit owing to cucurbitacin accumulation. Mature fruits have a hard, woody, pale-tan rind enclosing white spongy flesh and many flat, oblong seeds. Bitter-fruited gourds are used cautiously in TCM to promote urination and reduce edema; they are mildly toxic and contraindicated in deficiency patterns and in large doses.
Active Constituents
Cucurbitacin B
Tetracyclic triterpenoid (cucurbitacin)The principal toxic bitter principle of bitter-tasting bottle gourd, and the analyte targeted by the published methods for screening commercial bottle gourd juice. It is intensely bitter and causes gastric erosion and increased capillary permeability, producing vomiting, diarrhoea, gastrointestinal haemorrhage and hypotension. The bitterness is the practitioner's only bedside warning that a given fruit is dangerous.
Cucurbitacin D
Tetracyclic triterpenoid (cucurbitacin)One of the cucurbitacin congeners quantified alongside cucurbitacin B in Lagenaria and related cucurbits. It contributes to the same bitter, cytotoxic and gastrointestinally corrosive profile.
Cucurbitacin E
Tetracyclic triterpenoid (cucurbitacin)Quantified together with cucurbitacins B and I in cucurbit tissue by HPLC-MS. Like the other cucurbitacins it is an actin-binding cytotoxin, which is why the poisoning is a mucosal injury rather than a simple irritant diarrhoea.
Cucurbitacin I
Tetracyclic triterpenoid (cucurbitacin)Another cucurbitacin measured in cucurbit tissue. Cucurbitacin content is not fixed by cultivar alone: it rises in fruit grown under drought, temperature extremes or poor soil, so a normally edible variety can produce a toxic fruit.
Cucurbitane-type triterpenoid saponins
Triterpenoid saponinReported among the constituents of the fruit alongside flavonoids and sterols. These are the non-cucurbitacin fraction responsible for much of the traditional diuretic reputation, and they are present in the non-bitter fruit as well.
Flavonoids and phytosterols
Flavonoid and sterol mixtureThe fruit contains flavonoids, sterols, saponins and terpenoids together with vitamins and minerals, at roughly 14 kilocalories per 100 g. These account for the food use of the sweet form and are not the source of the toxicity.
⚠ Drug Interactions
Bitter fruit of the same species substituted for the sweet bottle gourd (Hu Lu, Lagenaria siceraria)
The single most important safety fact about this drug is that Ku Hu Lu and the edible bottle gourd Hu Lu are the same botanical species, separated only by cucurbitacin content, and cucurbitacin content varies with growing conditions rather than being fixed by the label on the sack. The Indian Council of Medical Research investigation of bitter bottle gourd juice recorded 26 hospital admissions with abdominal pain and vomiting, diarrhoea in 69 percent and haematemesis in 73 percent, and three deaths, all in people over 59 with long-standing diabetes. A separate case series of 15 patients described onset within 15 minutes to 6 hours of drinking the juice, with hypotension and gastrointestinal bleeding; those patients recovered in 1 to 4 days. This is a documented fatal poisoning, not a theoretical concern.
Clinical note: Never dispense or recommend raw bottle gourd juice. Instruct any patient who tastes intense bitterness in a gourd preparation to spit it out, stop immediately and seek emergency care, and never to mask the bitterness by mixing it with other juice. Treatment is supportive: fluid resuscitation, endoscopy where there is bleeding.
Anticoagulants and antiplatelet drugs (warfarin, direct oral anticoagulants, aspirin, clopidogrel)
Cucurbitacin poisoning from bitter bottle gourd causes gastric erosions and frank gastrointestinal bleeding, with haematemesis in the large majority of hospitalised cases. A patient who is anticoagulated or antiplatelet-treated when that mucosal injury occurs has far less margin. There is no pharmacokinetic interaction; the interaction is between a bleeding lesion and impaired haemostasis.
Clinical note: Regard bitter gourd preparations as contraindicated in anticoagulated patients, and lower the threshold for endoscopy in any such patient presenting after gourd juice ingestion.
Antihypertensives, diuretics and drugs requiring stable renal perfusion (ACE inhibitors, ARBs, NSAIDs, metformin)
Cucurbitacin toxicity produces rapid vomiting, diarrhoea and hypotension through increased capillary permeability. In a patient already on antihypertensives or diuretics that hypotension is deeper; in one on an ACE inhibitor, ARB or NSAID the kidney loses its autoregulatory reserve; and metformin should be withheld in shock because of lactic acidosis risk. The deaths in the Indian investigation were all in elderly long-standing diabetics, exactly the group carrying these drugs.
Clinical note: Withhold antihypertensives, diuretics, NSAIDs, ACE inhibitors, ARBs and metformin during an episode of gourd-juice gastroenteritis, resuscitate with fluid, and check renal function.
Any oral medication taken during acute cucurbitacin gastroenteritis
Vomiting and profuse diarrhoea beginning within 15 minutes to 6 hours of ingestion make oral drug absorption unreliable, which matters most for antiepileptics, antiretrovirals, immunosuppressants and anticoagulants. This is a straightforward consequence of the documented clinical syndrome rather than a studied interaction.
Clinical note: Review whether critical oral medication has been retained, and use parenteral routes while vomiting persists.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 15–30 g | Daily | — | — | Standard oral dose per Xi S, Gong Y. Essentials of Chinese Materia Medica and Medical Formulas. Academic Press/Elsevier, 2017, pp. 139–143. Exact wording: Normally, 15–30 g is decocted with water as an oral |
Evidence Tier
Limited evidence · 2 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
0
Randomized controlled trial
0
Other clinical trial
0
Observational / case report
2
1 verified · 1 unverified
In vitro / animal
0
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Assessment of effects on health due to consumption of bitter bottle gourd (Lagenaria siceraria) juice
The Indian Council of Medical Research investigation of reported toxicity after drinking bitter bottle gourd juice. Twenty-six people were admitted with abdominal pain and vomiting, with diarrhoea in 18 of 26 and haematemesis in 19 of 26, and three people died, all aged over 59 with about 20 years of diabetes. The toxicity is attributed to cucurbitacins, the bitter tetracyclic triterpenoids of the Cucurbitaceae. This is the study that establishes bitter bottle gourd juice as a cause of human death.
Gastrointestinal toxicity due to bitter bottle gourd (Lagenaria siceraria)—a report of 15 cases
Fifteen patients who developed toxicity after drinking bitter bottle gourd juice, presenting with abdominal pain, vomiting, haematemesis, diarrhoea and hypotension between 15 minutes and 6 hours after ingestion. All recovered within 1 to 4 days with supportive care. Together with the ICMR report this defines the clinical syndrome and its time course.
⚠ Safety & Contraindications
- Bleeding disorders
- Toxic — professional use only
Contraindications
Its use is prohibited in patients with deficiency-cold of the spleen and stomach.
Source: Xi S, Gong Y. Essentials of Chinese Materia Medica and Medical Formulas. Academic Press/Elsevier, 2017, pp. 139–143.
Historical Texts
Shen Nong Ben Cao Jing
Han dynastyBen Cao Gang Mu (Compendium of Materia Medica), Li Shizhen
Ming dynasty, 1596References
- Muhammad Saeed, Muhammad Sajjad Khan, Kinza Amir, Jannat Bi Bi, Muhammad Asif, Asadullah Madni, Asghar Ali Kamboh, Zahid Manzoor, Umair Younas, Sun Chao. Lagenaria siceraria fruit: A review of its phytochemistry, pharmacology, and promising traditional uses . Frontiers in Nutrition (2022) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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