Ingredient Animal — whole (全虫 quán chóng)

Qi Cao

White grub · 蛴螬

Holotrichia diomphalia bates · Larva Holotrichiae

Also known as: Qi Cao, Di Can (地蚕), Tu Can (土蚕),

Qi Cao (White grub) plant

Images shown are for educational purposes only

Qí Cáo is the dried larva of a scarab beetle, used in Chinese medicine as a powerful Blood stasis breaker. It is primarily found in formulas that treat long-standing Blood stasis with masses, pain from trauma, and conditions where old, stuck Blood prevents the body from healing properly. Because of its strong action, it is typically used in carefully composed formulas rather than on its own.

Category Blood-invigorating and stasis-dispelling herbs (活血化瘀药)
Therapeutic focus Injury and Trauma Recovery Menstrual Health Liver Health Skin Conditions

TCM Properties

Temperature

Slightly Warm

Taste

Salty (咸 xián)

Channels entered

Liver

Parts used

Animal — whole (全虫 quán chóng)

Educational content • Consult qualified TCM practitioners for diagnosis and treatment

What This Ingredient Does

Every ingredient has a specific set of actions — here's what Qi Cao does in the body, explained in both everyday and TCM terms

Therapeutic focus

In practical terms, Qi Cao is primarily used to support these areas of health:

Injury and Trauma Recovery Menstrual Health Liver Health Skin Conditions

TCM Actions

In TCM terminology, these are the specific therapeutic actions that Qi Cao performs to restore balance in the body:

Breaks Blood and Dispels Stasis Disperses Swelling and Dissipates Nodules Alleviates Pain Resolves Toxicity Promotes Lactation

How these actions work

'Breaks Blood and dispels stasis' means Qí Cáo has a powerful ability to move and clear stuck, old Blood (what TCM calls Blood stasis or stagnant Blood). This is its primary action. It is used when chronic Blood stasis has become deeply lodged in the body, causing fixed pain, visible masses, or dark discoloration of the skin and eyes. Its salty taste gives it the ability to soften hardness and enter the Blood level, while its slightly warm nature helps mobilize stagnant material.

'Dissipates masses and reduces swelling' refers to Qí Cáo's ability to break apart solid accumulations in the body, such as abdominal lumps or swollen lymph nodes. In classical texts, this includes what TCM calls zhēng jiǎ (abdominal masses formed by accumulated stagnant Blood). It is also applied externally for abscesses and toxic swellings.

'Relieves pain' follows directly from its Blood-moving action. In TCM, pain often arises because "where there is blockage, there is pain." By forcefully breaking through Blood stasis, Qí Cáo alleviates pain from traumatic injuries, fractures with internal bleeding, and joint pain from gout-like conditions.

'Promotes lactation' is a secondary action recorded in classical sources. When insufficient milk production is caused by Blood stasis obstructing the channels that supply the breast, Qí Cáo can help restore flow.

Patterns Addressed

In TCM, symptoms cluster into recognizable patterns of disharmony. Qi Cao is used to help correct these specific patterns.

Why Qi Cao addresses this pattern

Qí Cáo is one of the strongest Blood stasis-breaking substances in the Chinese materia medica. Its salty taste allows it to enter the Blood level and soften hardened accumulations, while its slightly warm nature gives it the momentum to actively push through stagnation. In Blood Stagnation, the free flow of Blood is obstructed, leading to fixed pain, dark complexion, and palpable masses. Qí Cáo's ability to "break Blood" (pò xuè) is more forceful than simply "invigorating Blood" (huó xuè), making it appropriate for chronic, deeply lodged stasis rather than mild or recent cases.

A practitioner would look for one or more of these signs

Abdominal Pain

Fixed, stabbing pain in the abdomen that worsens with pressure

Amenorrhea

Absent menstruation due to Blood stasis blocking the uterine vessels

Dark Circles Under Eyes

Dark, blackish discoloration around the eye sockets

Dark Skin

Rough, scaly skin resembling fish scales (肌肤甲错)

Commonly Used For

These are conditions where Qi Cao is frequently used — but only when they arise from the specific patterns it addresses, not in all cases

Arises from: Blood Stagnation

TCM Interpretation

In TCM, amenorrhea (absence of menstruation) can arise from several causes, but one of the most stubborn types is caused by Blood stasis. When old, stagnant Blood accumulates in the lower abdomen and uterus, it physically blocks the outflow of menstrual Blood. Over time, the stagnation becomes more deeply entrenched. The Liver, which governs the smooth flow of Qi and stores Blood, is the primary organ involved. When Liver Blood flow is obstructed, the Directing (Ren) and Penetrating (Chong) vessels that govern menstruation cannot function properly.

Why Qi Cao Helps

Qí Cáo enters the Liver channel and has a powerful Blood stasis-breaking action that can address deep, chronic stagnation. Where milder Blood-invigorating herbs might be insufficient for long-standing amenorrhea, Qí Cáo's forceful "breaking" action can help dislodge old, dried Blood. Classical sources such as the Shén Nóng Běn Cǎo Jīng specifically list "yuè bì" (menstrual blockage) among its indications. In clinical use, it is typically combined with other Blood movers in formula form rather than used alone, ensuring the stasis is cleared without excessive damage to healthy Blood.

Also commonly used for

Trauma

Fractures and contusions with internal bleeding and pain

Cirrhosis

Through the Da Huang Zhe Chong Wan formula

Chronic Hepatitis

Especially chronic hepatitis B with Blood stasis signs

Gout

Joint pain with Blood stasis component, classically called 'white tiger wind'

Hemorrhoids

With Blood stasis and swelling

Tetanus

Traditional topical and internal use for tetanus-related spasm

Lactation Insufficiency

When caused by Blood stasis blocking the breast channels

Eye Disorders

Corneal opacity and visual obstruction from Blood stasis

Ingredient Properties

Every ingredient has an inherent temperature, taste, and affinity for specific channels — these properties determine how it interacts with the body

Temperature

Slightly Warm

Taste

Salty (咸 xián)

Channels Entered

Liver

Parts Used

Animal — whole (全虫 quán chóng)

Dosage & Preparation

These are general dosage guidelines for Qi Cao — always follow your practitioner's recommendation, as dosages vary based on the formula and your individual condition

Standard dosage

2–5g (as powder or in pills)

Maximum dosage

Do not exceed 5g internally. This is a toxic substance with strong Blood-breaking properties; exceeding the standard dose risks gastrointestinal distress and cardiovascular effects.

Dosage notes

Qi Cao is rarely used in standard decoctions. It is most commonly ground into fine powder and taken directly (2–5g per dose), or incorporated into pill and powder formulations. In the classical formula Da Huang Zhe Chong Wan, it is processed separately before being combined with the other ground ingredients and formed into honey pills taken in small doses (3g per pill). For external use, fresh grubs can be crushed and applied directly to affected areas, or the juice can be extracted and used topically for eye conditions or wound treatment. When used internally, the traditional processing method of stir-frying with glutinous rice (as described in Lei Gong Pao Zhi Lun) is recommended to reduce toxicity.

Preparation

Qi Cao is not typically decocted in water. It is most often ground into powder for internal use or incorporated into pill formulations. Traditional processing: blanch fresh grubs in boiling water, then sun-dry. Classical method from Lei Gong Pao Zhi Lun: after shade-drying, stir-fry with glutinous rice until the rice turns scorched black, then remove the mouthparts and body hairs, cut into 3–4 pieces, and grind to powder. For external use, fresh grubs may be crushed directly for topical application.

Processing Methods

In TCM, the same ingredient can be prepared in different ways to change its effects — here's how processing alters what Qi Cao does

Processing method

Stir-fried with glutinous rice (糯米) until the rice turns charred black. The mouth parts and body hairs are then removed, the body is cut into 3-4 sections, and ground into powder.

How it changes properties

Stir-frying reduces the raw, somewhat toxic and offensive nature of the fresh larva. It makes the material drier and easier to grind into powder for pill or powder formulations. The thermal nature remains slightly warm, but the processing moderates its intensity and reduces potential gastrointestinal irritation.

When to use this form

This is the standard processed form used in most internal formulations, including Da Huang Zhe Chong Wan. The raw form is primarily reserved for external application (crushed fresh larvae applied to wounds or abscesses).

Common Ingredient Pairs

These ingredients are traditionally combined with Qi Cao for enhanced therapeutic effect

Tu Bie Chong
Tu Bie Chong 1:1

Both are animal-derived substances that strongly break Blood stasis. Tǔ Biē Chóng (ground beetle) is especially effective at breaking up fixed masses and coursing through the channels, while Qí Cáo adds additional stasis-breaking power and helps dissipate swelling. Together they form a potent pair for chronic, deeply lodged Blood stasis with palpable masses.

When to use: Chronic Blood stasis with abdominal masses, amenorrhea from stasis, or the 'dry blood' pattern described in the Jin Gui Yao Lue with skin changes and dark eye sockets.

Tao Ren
Tao Ren 1:1

Táo Rén (peach kernel) invigorates Blood and moistens dryness, while Qí Cáo forcefully breaks through stasis. Together, Táo Rén provides a gentler, moistening Blood-moving action that complements Qí Cáo's more aggressive stasis-breaking power. The combination addresses both the dryness and the obstruction that characterize chronic Blood stasis.

When to use: Blood stasis causing amenorrhea, traumatic injury with internal bleeding, or abdominal masses with dry skin.

Ru Xiang
Ru Xiang 1:1

Rǔ Xiāng (frankincense) invigorates Blood, promotes Qi movement, and is particularly effective at relieving pain. Combined with Qí Cáo's Blood-breaking action, the pair addresses traumatic injuries where Blood stasis causes severe pain and swelling. Rǔ Xiāng moves Qi to support Blood movement, while Qí Cáo directly attacks the stagnant Blood.

When to use: Traumatic injuries with fractures, severe bruising, and pain from Blood stasis. Also applicable to gout-like joint pain with a stasis component.

Key Formulas

These well-known formulas feature Qi Cao in a prominent role

Da Huang Zhe Chong Wan 大黃蟅蟲丸 Deputy

This is the most important formula containing Qí Cáo. From Zhang Zhongjing's Jin Gui Yao Lue, it treats the 'dry blood' (gān xuè) pattern of chronic Blood stasis with emaciation, scaly skin, and dark eye sockets. Qí Cáo serves as one of several Deputy-level Blood stasis-breakers alongside Water Leech, Horsefly, and Lacquer, showcasing its core action of forcefully breaking through deep, chronic stasis. The formula perfectly illustrates how Qí Cáo's powerful Blood-breaking nature is balanced by nourishing herbs to prevent harm to healthy Blood.

Comparable Ingredients

These ingredients have overlapping uses — here's how to tell them apart

Tu Bie Chong
Qi Cao vs Tu Bie Chong

Both are insect-derived Blood stasis-breakers used in the same classical formula (Da Huang Zhe Chong Wan). However, Tǔ Biē Chóng (ground beetle) is salty and cold, making it more suitable when Blood stasis generates Heat. It is also more commonly used as a standalone herb and has stronger mass-dissolving action. Qí Cáo is slightly warm and has a somewhat broader traditional application including promoting lactation and treating eye opacities.

Shui Zhi
Qi Cao vs Shui Zhi

Both are animal-derived substances that forcefully break Blood stasis. Shuǐ Zhì (leech) is salty, bitter, and neutral, and is considered one of the strongest Blood stasis-breakers available, particularly for breaking apart clotted Blood in the vessels. Qí Cáo is slightly milder in comparison and has additional applications for trauma pain, eye conditions, and lactation that Shuǐ Zhì lacks.

Meng Chong
Qi Cao vs Meng Chong

Méng Chóng (horsefly/gadfly) is another insect Blood-breaker, bitter and slightly cold. It is particularly strong at breaking stasis in the channels and collaterals and is more specifically indicated for amenorrhea and abdominal masses. Qí Cáo has a broader range of traditional uses including external application for abscesses, tetanus, and eye disorders.

Common Substitutes & Adulterants

Related species and common adulterations to be aware of when sourcing Qi Cao

Multiple species of scarab beetle larvae are used interchangeably as Qi Cao in different regions of China. Besides the primary species Holotrichia diomphalia, commonly substituted source species include Anomala corpulenta (铜绿金龟甲), Holotrichia oblita (华北大黑鳃金龟), Holotrichia morosa (暗黑鳃金龟), and Mimela lucidula (used in northeastern China). While these are generally considered acceptable substitutes within the same pharmacological category, their chemical compositions may vary somewhat. The dried grubs should not be confused with other insect larvae sometimes found in soil, such as mole cricket nymphs or moth larvae, which have different morphology and medicinal properties.

Educational content — always consult a qualified healthcare provider or TCM practitioner before using any ingredient.

Toxicity Classification

Classical Chinese pharmacopoeia toxicity rating for Qi Cao

Toxic

Qi Cao is classified as toxic (有毒) in classical and modern Chinese pharmacological literature. The grub contains proteins and fats that, if improperly prepared or taken in excessive doses, can cause gastrointestinal irritation including nausea, vomiting, and diarrhea. Pharmacological studies show that Qi Cao water extracts at high concentrations (1:1000 and above) can excite uterine smooth muscle and affect cardiovascular function, including vasoconstriction and cardiac excitation that at very high concentrations can lead to cardiac arrest in diastole. Proper processing (cleaning, blanching in boiling water, drying, and traditionally stir-frying with glutinous rice) reduces toxicity. The substance is typically used in small doses (2–5g as powder) or as a component of pill formulations where the small per-dose amount limits toxic exposure. Oral administration of the decoction in animal studies showed much lower toxicity than injection, suggesting that gastrointestinal processing significantly reduces systemic toxicity.

Contraindications

Situations where Qi Cao should not be used or requires extra caution

Avoid

Pregnancy. Qi Cao is a potent Blood-breaking substance that strongly invigorates Blood circulation and can stimulate uterine contractions, posing serious risk to the fetus.

Avoid

Active bleeding or hemorrhagic conditions. As a powerful Blood-moving agent, Qi Cao can worsen bleeding in patients with hemorrhagic tendencies, heavy menstrual bleeding, or active internal bleeding.

Caution

Qi and Blood deficiency without Blood stasis. Qi Cao's forceful Blood-breaking action can further deplete weakened patients who do not have true Blood stasis as the underlying pathology.

Caution

Known allergy to beetle larvae or insect-derived medicines. Some individuals may develop allergic reactions including skin rash or gastrointestinal distress.

Caution

Use with caution in patients with Spleen and Stomach weakness, as the substance can be difficult to digest and may cause nausea or gastrointestinal discomfort.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

Absolutely contraindicated during pregnancy. Pharmacological studies demonstrate that Qi Cao water extracts can excite uterine smooth muscle in isolated rabbit uterus preparations at concentrations of 1:1000 and above. This uterotonic effect, combined with its powerful Blood-breaking and stasis-dispersing properties, poses a significant risk of miscarriage, premature labor, or fetal harm. All classical and modern sources agree on this prohibition, and the famous formula Da Huang Zhe Chong Wan that contains Qi Cao is likewise explicitly contraindicated in pregnancy.

Breastfeeding

Qi Cao has traditionally been used to promote lactation (下乳汁), as noted in the Ming Yi Bie Lu. However, given its classification as toxic and its potent Blood-breaking properties, it should be used during breastfeeding only under strict practitioner supervision and at minimal effective doses. The potential transfer of bioactive compounds through breast milk has not been studied. If used, it should be for short durations only, and the infant should be monitored for any adverse signs.

Children

Qi Cao should be used with great caution in children due to its toxic classification and potent Blood-breaking properties. It is generally not recommended for young children. If used in older children for specific indications under practitioner supervision, the dosage should be reduced to approximately one-third to one-half of the adult dose. Historical folk use for childhood tetanus has been documented, but this should only be considered in emergency situations under qualified medical care.

Drug Interactions

If you are taking pharmaceutical medications, be aware of these potential interactions with Qi Cao

Anticoagulant and antiplatelet medications: Qi Cao has potent Blood-invigorating and stasis-breaking properties. Concurrent use with warfarin, heparin, aspirin, clopidogrel, or other anticoagulant/antiplatelet drugs may increase bleeding risk. Patients on such medications should avoid Qi Cao or use it only under close medical supervision with appropriate monitoring of coagulation parameters.

Uterotonic drugs: Given the demonstrated ability of Qi Cao extracts to excite uterine smooth muscle, concurrent use with oxytocin or prostaglandin-based medications could potentiate uterine contractions.

Cardiac medications: Pharmacological studies show that Qi Cao water extracts can affect cardiac function, exciting the heart at lower concentrations and potentially causing cardiac arrest at high concentrations. Caution is advised when combining with cardiac glycosides (e.g. digoxin) or antiarrhythmic drugs.

Dietary Advice

Foods and dietary considerations when taking Qi Cao

Avoid cold, raw foods and iced beverages while taking Qi Cao, as these can impede the Blood-moving action of the medicine. Moderate amounts of warm wine may be taken to enhance the herb's circulation-promoting effects, as traditionally recommended in the Jin Gui Yao Lue for Da Huang Zhe Chong Wan (taken with warm wine or rice wine). Avoid excessively greasy or heavy foods that may burden the Spleen and Stomach, as Qi Cao can already be taxing on digestion.

Botanical Description

Physical characteristics and morphology of the Qi Cao source animal

Qi Cao (蛴螬) is not a plant but an insect-derived medicinal substance. It is the dried larva (grub) of scarab beetles from the family Scarabaeidae (鳃金龟科), primarily Holotrichia diomphalia Bates (东北大黑鳃金龟) and related species such as Anomala corpulenta Motsch. (铜绿金龟甲).

The living grub is approximately 35mm long, milky white in colour, with a C-shaped curved body densely covered in yellowish-white fine hairs. It has three thoracic segments, each bearing a pair of well-developed legs covered in brownish fine hairs. The head is small and brownish. The adult beetle is a dark brown, oval-shaped insect measuring 16–21mm long and 8–11mm wide, with yellowish-brown antennae and raised striations on the wing cases.

The grubs live in soil at depths of 3–6 cm, feeding on plant roots. The adult beetles are nocturnal, active from mid-June to early October, and are commonly found in agricultural fields and grasslands across most regions of China.

Sourcing & Harvesting

Where Qi Cao is sourced, when it's harvested or collected, and how to assess quality

Harvesting season

May to August, when the grubs are actively feeding in shallow soil (3–6 cm depth) near plant roots

Primary growing regions

Qi Cao (蛴螬) is widely distributed across China, as the scarab beetle grubs are found throughout most of the country. Major production regions include Jiangsu, Anhui, Sichuan, Hebei, Shandong, Henan, and the northeastern provinces (Heilongjiang, Jilin, Liaoning), as well as Inner Mongolia and Shaanxi. There is no single 'daodi' terroir region for this insect-derived medicine, as the grubs are collected wherever scarab beetles are abundant in agricultural soils.

Quality indicators

Good quality dried Qi Cao grubs should be intact and complete, not broken or fragmented. The preferred specimens are large in size (approximately 2 cm long, 1–1.2 cm wide), dry, and uniformly yellowish in colour (棕黄色). The body should show clear segmentation (ring-like joints), with a small brownish head. The outer shell should be relatively hard and brittle, and the interior should appear hollow and spongy when broken open. The smell should be only mildly fishy (气微臭), not putrid or strongly rotten. Avoid specimens that are darkened, mouldy, fragmented, or heavily contaminated with soil.

Classical Texts

Key passages from the classical Chinese medical texts that describe Qi Cao and its therapeutic uses

Shen Nong Ben Cao Jing (《神农本草经》)

Original: 主恶血血瘀痹气，破折血在胁下坚满痛，月闭，目中淫肤、青翳白膜。

Translation: Treats malignant Blood and Blood stasis with obstructive Qi, breaks accumulated Blood under the ribs causing hardness, fullness and pain, treats menstrual blockage, and eye conditions including fleshy growths, blue-green cataracts and white films over the eyes.

Ming Yi Bie Lu (《名医别录》)

Original: 疗吐血在胸腹不去及破骨踒折血结，金疮内塞，产后中寒，下乳汁。

Translation: Treats retained blood from vomiting that lodges in the chest and abdomen, breaks Blood clots from bone fractures and traumatic injuries, unblocks wounds sealed by internal congestion, treats postpartum Cold invasion, and promotes lactation.

Yao Xing Lun (《药性论》)

Original: 汁滴目中，去翳障，主血，止痛。

Translation: Its juice dropped into the eyes removes cataracts and visual obstructions; it governs Blood disorders and stops pain.

Chang Sha Yao Jie (《长沙药解》)

Original: 蛴螬，能化瘀血，最消癥块。《金匮》大黄蛰虫丸用之，治虚劳腹满，内有干血，以其破瘀而化积也。

Translation: Qi Cao can transform stasis Blood and is most effective at dissolving masses and lumps. The Jin Gui (Yao Lue) uses it in Da Huang Zhe Chong Wan to treat consumptive taxation with abdominal fullness and internal dried Blood, employing its ability to break stasis and dissolve accumulations.

Historical Context

The history and evolution of Qi Cao's use in Chinese medicine over the centuries

Qi Cao (蛴螬) is one of the oldest documented insect medicines in Chinese medicine, first recorded in the Shen Nong Ben Cao Jing (《神农本草经》), where it was classified among substances that treat Blood stasis and eye diseases. The Shen Nong Ben Cao Jing noted that specimens which crawl backwards (反行者) are considered superior in quality. The name 蛴螬 literally refers to the white, fleshy larva, and the substance has accumulated many regional folk names over the centuries, including 地蚕 (Earth Silkworm), 土蚕 (Soil Silkworm), 老母虫 (Old Mother Worm), and 核桃虫 (Walnut Worm).

The herb's most famous classical application is in Zhang Zhongjing's Da Huang Zhe Chong Wan (大黄蛰虫丸) from the Jin Gui Yao Lue (《金匮要略》), where it serves as one of several Blood-breaking insect medicines treating consumptive taxation (虚劳) with internal dried Blood. This formula exemplifies the classical strategy of using insect medicines for their powerful ability to penetrate and dissolve stubborn, long-standing Blood stasis that herbal medicines alone cannot address. The Lei Gong Pao Zhi Lun (《雷公炮炙论》) documented an early processing method of drying the grubs in shade and then stir-frying with glutinous rice until the rice turns scorched black, then removing the mouthparts and body hairs before grinding to powder.

Folk medical traditions across China have long used fresh Qi Cao juice topically for treating tetanus (破伤风), with historical case reports describing how the yellow liquid secreted from the grub's mouth, when applied to wound sites, could relieve muscle spasm and lockjaw within 15–30 minutes.