Ji Xue Cao

Anticoagulant and antiplatelet medications (e.g. warfarin, aspirin): Animal studies have shown that asiaticoside at high doses can prolong bleeding time and cause haemorrhage. Ji Xue Cao may therefore potentiate the effects of blood-thinning medications, increasing the risk of bleeding. Patients on anticoagulant therapy should use this herb with caution and under medical supervision.

Sedative and CNS-depressant medications (e.g. benzodiazepines, barbiturates): The glycoside fraction of Centella asiatica has demonstrated sedative and anxiolytic effects in animal studies. Concurrent use with pharmaceutical sedatives may produce additive central nervous system depression and increased drowsiness.

Hepatotoxic drugs: Since prolonged high-dose use of Centella asiatica has been associated with potential liver injury, caution is advised when combining it with other hepatotoxic medications (e.g. acetaminophen at high doses, certain statins, or anti-tuberculosis drugs). Liver function should be monitored.

Diabetes medications: Some preliminary evidence suggests Centella asiatica may influence blood glucose levels. Patients on hypoglycaemic medications should monitor blood sugar more closely when using this herb.

Centella asiatica (L.) Urban is a low-growing perennial herb in the Apiaceae (Umbelliferae) family. It has slender, creeping stolons that root at the nodes, allowing the plant to spread rapidly across the ground in a mat-like fashion. The stems are green to reddish-green, smooth or slightly hairy. The leaves are kidney-shaped (reniform) to nearly circular, 1–5 cm wide, with bluntly toothed margins and a broad heart-shaped base. They arise on long petioles (1.5–27 cm) from the nodes. Palmate venation with 5–7 veins is visible on both surfaces.

The flowers are tiny (less than 3 mm), purplish-red to white, arranged in small axillary umbels of 3–4 flowers each, partly enclosed in two green bracts. Flowering and fruiting occur from April through October. The fruit is a flattened schizocarp with prominent ribs and a net-like surface texture, which distinguishes it from the smooth fruits of Hydrocotyle species that are commonly confused with it. The plant has a faint aromatic scent and prefers moist, shady habitats such as stream banks, ditches, paddy field margins, and damp grasslands, from lowlands up to about 1,900 metres elevation.

Ji Xue Cao has over two thousand years of documented medicinal use in China. It was first recorded in the Shen Nong Ben Cao Jing (Divine Farmer's Classic of Materia Medica), where it was classified as a middle-grade (中品) herb for clearing Heat and treating sores. The name 'Ji Xue Cao' (积雪草, literally 'accumulated snow herb') is thought to evoke the cool, cold nature of the plant. The great physician Tao Hongjing (陶弘景) of the Liang dynasty noted that the herb was not commonly used in formulas in his era, commenting simply that it must be quite cold in nature. The Tang dynasty Xin Xiu Ben Cao provided the first clear botanical description of its coin-shaped leaves and creeping habit.

Interestingly, there has been longstanding confusion in Chinese herbalism between Ji Xue Cao (Centella asiatica, Apiaceae) and Lian Qian Cao (Glechoma longituba, Lamiaceae), as both plants share common names like 'Lian Qian Cao' (连钱草, 'linked-coins herb') and 'Di Qian Cao' (地钱草). Even the illustration in some editions of the Ben Cao Gang Mu appears to depict the wrong plant. The modern Chinese Pharmacopoeia distinguishes them as separate medicinal substances. Beyond China, Ji Xue Cao holds a central place in Indian Ayurvedic medicine (known as Brahmi or Mandookaparni), where it has been used for wound healing, cognitive enhancement, and skin diseases. In the West, known as Gotu Kola, it has appeared in the pharmacopoeias of Britain, France, and Germany, and has gained recent popularity in the cosmetics industry for its skin-repair properties.