TCM Properties

Traditional Use

Clears Heart Fire and drains heat through the Small Intestine — used for mouth and tongue sores, irritability, and scanty dark urine from Heart Fire transferring to the Small Intestine
Promotes urination and drains damp-heat — used for Lin syndrome (painful, burning, scanty urination), edema, and damp-heat accumulation in the Lower Jiao
Promotes lactation and unblocks the blood vessels — used for insufficient milk secretion from blocked collaterals after delivery
Stimulates menstrual flow — used for amenorrhea from blood stasis with heat

Expels damp-heat from the joints — secondary application for hot, painful joint bi-syndrome
Guides heart fire downward through urination to relieve inflammation of the mouth and tongue

Ba Zheng San (八正散) — Eight-Herb Powder for Rectification; treats damp-heat Lin syndrome with painful, difficult urination, and urinary tract inflammation
Dao Chi San (导赤散) — Guide Out the Red Powder; treats Heart Fire transferring to Small Intestine with tongue sores, irritability, and scanty dark urine

Oleanolic acid — primary triterpenoid; anti-inflammatory, antinociceptive, and cytotoxic against liver cancer cell lines
Hederagenin — triterpenoid sapogenin; anti-inflammatory and antinociceptive
Triterpenoid saponins (akequintoside F, pulsatilla saponin A, asperosaponin C) — anti-inflammatory and diuretic
Phenylethanoid glycosides — antioxidant secondary metabolites
Megastigmane glycosides — additional bioactive terpenoid derivatives

Anti-inflammatory and antinociceptive — saponin and sapogenin (oleanolic acid, hederagenin) fractions demonstrate significant pain-relieving and anti-inflammatory effects in rodent models (PMID 15857214)
Neuroprotective — oleanane triterpenoids inhibit Aβ42-induced fibrillogenesis; potential application in Alzheimer's prevention (PMID 28054176)
Diuretic — aqueous extract increases urinary output in preclinical models, supporting traditional Lin syndrome use

Pregnancy — contraindicated; stimulates uterine activity and menstrual flow
Qi deficiency with spermatorrhea — bitter, cold, draining action depletes Qi and Essence
Aristolochic acid adulteration — CRITICAL: stub Latin 'Caulis Aristolochiae' refers to Guan Mu Tong (Aristolochia manshuriensis), a Group 1 IARC carcinogen causing irreversible progressive renal fibrosis and urothelial carcinoma; only authenticated Caulis Akebiae is safe

Adulteration risk is high — dried stems of Akebia and Aristolochia manshuriensis (Guan Mu Tong) are morphologically similar; verify botanical identity by DNA testing or authenticated supplier
Caulis Aristolochiae Manshuriensis is banned in many countries and removed from the Chinese Pharmacopoeia (2005 edition); Caulis Akebiae is the officially approved substitute
Not for long-term use — cold draining nature depletes Yang and Qi
MSK page not found — drug interaction data not available from Memorial Sloan Kettering integrative medicine database