Ingredient Animal — secretion (动物分泌物 dòng wù fēn mì wù)

She Xiang

Musk · 麝香

Moschus berezovskii Flerov, Moschus sifanicus Przewalski, Moschus moschiferus Linnaeus · Moschus

Also known as: Dāng Mén Zǐ (当门子), Qí Xiāng (脐香), Shè Qí Xiāng (麝脐香),

She Xiang (Musk) plant

Images shown are for educational purposes only

She Xiang (Musk) is one of the most intensely aromatic and penetrating substances in Chinese medicine, prized for its ability to restore consciousness in emergencies such as stroke and high-fever delirium. It also powerfully moves stagnant Blood and relieves pain, making it useful for traumatic injuries, chronic headaches, and abscesses. Because of its strong action, it is used in tiny doses (0.03 to 0.1 grams) and is strictly forbidden during pregnancy.

Category Aromatic substances that open the orifices (开窍药)
Therapeutic focus Neurological Emergencies Injury and Trauma Recovery Cardiovascular Health Abscess Support

TCM Properties

Temperature

Warm

Taste

Acrid / Pungent (辛 xīn), Aromatic (芳香 fāng xiāng)

Channels entered

Heart, Liver, Spleen

Parts used

Animal — secretion (动物分泌物 dòng wù fēn mì wù)

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 She Xiang does in the body, explained in both everyday and TCM terms

Therapeutic focus

In practical terms, She Xiang is primarily used to support these areas of health:

Neurological Emergencies Injury and Trauma Recovery Cardiovascular Health Abscess Support

TCM Actions

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

Opens the Orifices and Revives Consciousness Invigorates Blood and Unblocks the Channels and Collaterals Reduces Swelling and Alleviates Pain Resolves Toxicity and Dissipates Nodules Facilitates delivery and expels stillbirth

How these actions work

'Opens the orifices and revives consciousness' is the primary and most celebrated action of She Xiang. In TCM, when pathogenic factors such as Heat, Phlegm, or Cold block the Heart orifices, the person loses consciousness or becomes delirious. She Xiang's intensely aromatic, penetrating nature can cut through this blockage and restore awareness. It is considered the strongest orifice-opening substance in the entire materia medica, and is the key ingredient in famous emergency formulas for both heat-type and cold-type loss of consciousness (such as stroke, high fever with delirium, or sudden collapse).

'Invigorates Blood and unblocks the channels' means She Xiang can powerfully move stagnant Blood and open blocked meridian pathways. This makes it useful for conditions caused by Blood stasis, including missed periods (amenorrhea), chronic headaches, chest pain resembling angina, abdominal masses, and traumatic injuries with pain and swelling. Its penetrating nature allows it to reach areas that other Blood-moving herbs cannot easily access, especially the fine vessels of the head, face, and sensory organs.

'Reduces swelling and alleviates pain' refers to She Xiang's ability to disperse accumulations of Blood and toxic material at sites of infection or injury. It is used both internally and applied externally for abscesses, carbuncles, swollen sore throat, and traumatic swelling. It also helps promote healing of damaged tissues and can reduce inflammation around fractures and sprains.

'Dissipates nodules and toxins' describes its action against hard lumps, swollen lymph nodes (scrofula), and Phlegm nodules. Its strongly mobile, scattering nature breaks up stagnation that has solidified into palpable masses.

'Facilitates delivery and expels stillbirth' reflects its traditional use in obstetric emergencies where labour has stalled or the fetus has died in the womb. Its powerful moving action on the uterus can restart contractions. For this same reason, She Xiang is strictly contraindicated during pregnancy, as it can induce miscarriage.

Patterns Addressed

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

Why She Xiang addresses this pattern

When Heat and Phlegm combine to block the Heart orifices (the Pericardium acting as the Heart's protective envelope), the person falls into unconsciousness with high fever and delirium. She Xiang's acrid, warm, intensely aromatic nature gives it the strongest orifice-opening power in the materia medica. It cuts directly through the Phlegm and turbidity that are sealing off the Heart's connection to consciousness. Although She Xiang is warm, its primary mechanism here is aromatic penetration rather than thermal warming, so it can be combined with cold, Heat-clearing herbs (like Niu Huang and Huang Lian) to address heat-type closed disorders. It enters the Heart channel directly, making it the ideal substance to reach and unblock the seat of consciousness.

A practitioner would look for one or more of these signs

Loss Of Consciousness

Sudden loss of consciousness with high fever

Delirium

Delirious speech and restlessness

Seizures

Convulsions or seizures in febrile disease

Excessive Phlegm

Rattling phlegm sound in throat

Commonly Used For

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

Arises from: Phlegm Fire harassing the Pericardium Phlegm

TCM Interpretation

TCM understands acute stroke primarily as a 'closed disorder' (bì zhèng) where Wind, Phlegm, Fire, or stagnant Blood suddenly block the orifices of the Heart, cutting off the spirit's connection to the body and causing loss of consciousness. Depending on the patient's constitution and the nature of the pathogenic factors, this can present as a 'heat-closed' pattern (with high fever, red face, and agitation) or a 'cold-closed' pattern (with pallor, cold limbs, and quiet collapse). The underlying organ systems involved are typically the Heart (governing consciousness), the Liver (where internal Wind arises), and the Spleen (which generates Phlegm when dysfunctional). Blood stasis in the brain's vessels is also a key factor.

Why She Xiang Helps

She Xiang is considered the most powerful orifice-opening substance in the Chinese materia medica. Its intensely aromatic, acrid, and penetrating nature allows it to cut through the Phlegm, Blood stasis, and turbidity that seal off the Heart's orifices during a stroke, helping restore consciousness. It enters the Heart, Liver, and Spleen channels, directly targeting the organs most implicated in stroke pathology. For heat-type stroke, it is combined with cold, Heat-clearing substances (as in An Gong Niu Huang Wan); for cold-type stroke, with warm aromatics (as in Su He Xiang Wan). Its additional Blood-invigorating action helps address the Blood stasis component that is present in most stroke presentations. Modern research has shown that muscone, the primary active compound in musk, can increase blood-brain barrier permeability and promote drug delivery to brain tissue.

Also commonly used for

Loss Of Consciousness

From various causes including high fever, Phlegm obstruction, and sudden collapse

Seizures

Febrile seizures and epilepsy in the acute phase

Amenorrhea

Missed periods caused by Blood stasis

Periappendiceal Abscess

Deep abscesses, carbuncles, and boils

Sore Throat

Severe swelling and pain of the throat

Chronic Headache

Stubborn headaches unresponsive to other treatments, especially from Blood stasis in the head

Encephalitis

Viral encephalitis with high fever and impaired consciousness

Ingredient Properties

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

Temperature

Warm

Taste

Acrid / Pungent (辛 xīn), Aromatic (芳香 fāng xiāng)

Channels Entered

Heart Liver Spleen

Parts Used

Animal — secretion (动物分泌物 dòng wù fēn mì wù)

Dosage & Preparation

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

Standard dosage

0.03–0.1g (30–100mg)

Maximum dosage

Do not exceed 0.1g (100mg) per dose in pills or powder. Some sources cite up to 1g as an absolute ceiling in extreme emergency situations, but standard practice should not exceed 100mg.

Dosage notes

She Xiang is extremely potent and is always used in very small quantities. The standard range of 0.03–0.1g (30–100mg) is for inclusion in pills and powders. It should NOT be decocted in standard herbal formulas, as its aromatic volatile compounds would be destroyed by prolonged boiling. For opening orifices and reviving consciousness in emergencies, it is typically dissolved in warm water or wine for rapid administration. For chronic conditions involving Blood stasis (e.g. stubborn headaches, channel obstruction), it is used at the lower end of the dosage range as a 'guide drug' (引经药) within pill formulas. External use (in plasters, ointments, or powders applied to sores and abscesses) has no fixed dosage limit but should use appropriate amounts.

Preparation

She Xiang must NEVER be decocted in a standard herbal formula. Its therapeutic potency depends on volatile aromatic compounds (primarily muscone) that would be lost through boiling. It is always taken as pills (丸) or powder (散), or dissolved in a pre-strained decoction liquid or warm water/wine just before administration. For topical use, it can be blended into ointments, plasters, or insufflated (blown) into the nose or throat. When used alongside a decoction formula, the strained liquid should be prepared first, and the musk powder stirred in at the end (冲服, chong fu). Store in airtight, light-proof containers to preserve the aromatic compounds.

Common Ingredient Pairs

These ingredients are traditionally combined with She Xiang for enhanced therapeutic effect

Niu Huang
Niu Huang She Xiang 7.5g : Niu Huang 30g (as in An Gong Niu Huang Wan)

She Xiang opens the orifices and revives consciousness with its intensely aromatic, penetrating action, while Niu Huang clears Heart Heat, resolves toxins, and calms the spirit. Together they form the core orifice-opening and Heat-clearing pair: She Xiang breaks through the blockage, and Niu Huang clears the Heat that caused it. This pairing is the heart of the 'cool opening' (liáng kāi) strategy.

When to use: Heat-type closed disorders with loss of consciousness, high fever, delirium, and convulsions, such as in encephalitis, meningitis, or heat-type stroke.

Bing Pian
Bing Pian 1:1 (equal parts, typically 7.5g each in classical pill formulas)

Both are acrid, aromatic orifice-openers, but She Xiang is warm and more powerful at opening orifices and moving Blood, while Bing Pian is cool and better at clearing Heat constraint and relieving pain. Combined, they open the orifices from both warm and cool angles, creating a balanced penetrating action that is effective for both heat-closed and cold-closed presentations.

When to use: Loss of consciousness and delirium in febrile diseases, Wind-Stroke, swollen sores due to Heat toxin, and severe sore throat.

Su He Xiang
Su He Xiang She Xiang 60g : Su He Xiang 30g (as in Su He Xiang Wan)

Both are acrid, warm, and aromatic orifice-openers. She Xiang is stronger at opening the orifices and moving Blood and Qi stagnation, while Su He Xiang is better at expelling turbid Phlegm and warming the interior. Combined, they create the most powerful warm-opening pair for cold-type closed disorders where thick Phlegm and Cold have sealed off consciousness.

When to use: Cold-type closed disorders: sudden collapse with loss of consciousness, clenched jaw, cold limbs, and pale face caused by Cold-Phlegm obstruction, as well as chest impediment (angina) from Cold stagnation.

Ru Xiang
Ru Xiang She Xiang 0.4g : Ru Xiang 4g (as in Qi Li San, where She Xiang is used in very small amounts)

She Xiang powerfully penetrates and moves stagnant Blood while Ru Xiang (Frankincense) invigorates Blood, moves Qi, relaxes the sinews, and relieves pain. Together they create a synergistic pain-relieving and swelling-reducing combination for traumatic injuries, reaching deep into damaged tissues to disperse stagnation and promote healing.

When to use: Traumatic injuries with swelling and pain, fractures, sprains, contusions, and abscesses or carbuncles.

Key Formulas

These well-known formulas feature She Xiang in a prominent role

An Gong Niu Huang Wan 安宮牛黃丸 King

The most famous emergency formula in Chinese medicine for heat-type stroke and febrile delirium. She Xiang serves as co-King alongside Niu Huang, showcasing its primary action of opening the orifices and reviving consciousness. The formula's entire strategy of 'cool opening' depends on She Xiang's unmatched penetrating power to break through Heat-Phlegm blockage of the Heart.

Su He Xiang Wan 蘇合香丸 King

The counterpart to An Gong Niu Huang Wan, this formula treats cold-type closed disorders. She Xiang is a principal ingredient at 60g, the largest dose in the formula, demonstrating its power to open blocked orifices when Cold-Phlegm has sealed off consciousness. It also showcases how She Xiang's warm nature makes it especially suitable for cold-closed patterns.

Tong Qiao Huo Xue Tang 通竅活血湯 King

Wang Qing Ren's signature formula for Blood stasis in the head and face, demonstrating She Xiang's second major action: invigorating Blood and unblocking the channels. She Xiang's intensely aromatic nature guides the Blood-moving herbs upward to penetrate the fine vessels and orifices of the head, treating conditions like chronic headache, hair loss, tinnitus, and alopecia that other formulas cannot reach.

Qi Li San 七厘散 King

The classic trauma formula for fractures, sprains, and contusions. She Xiang's ability to penetrate deeply, move stagnant Blood, reduce swelling, and relieve pain is the driving force of this formula. It demonstrates the herb's important role in external medicine and traumatology, where it is used both internally and applied topically.

Comparable Ingredients

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

Bing Pian
She Xiang vs Bing Pian

Both She Xiang and Bing Pian are acrid, aromatic substances that open the orifices and restore consciousness. However, She Xiang is warm and far more powerful at opening blocked orifices, moving Blood, and unblocking channels, making it the first choice for severe closed disorders and Blood stasis conditions. Bing Pian is cool in nature and has additional actions of clearing Heat, reducing fire constraint, and promoting tissue regeneration, making it more suitable for topical use on red, swollen eyes, mouth sores, and sore throat. She Xiang is the stronger orifice-opener; Bing Pian is milder and used more broadly in external medicine.

Su He Xiang
She Xiang vs Su He Xiang

Both are acrid, warm, aromatic orifice-opening substances used for loss of consciousness. She Xiang is significantly stronger in orifice-opening power and also has potent Blood-invigorating and channel-unblocking actions, making it effective for both closed disorders and Blood stasis conditions like trauma and amenorrhea. Su He Xiang is weaker at opening orifices but better at clearing turbid Phlegm and warming the interior, making it more specifically suited for cold-closed patterns caused by Wind-Stroke with profuse Phlegm. Su He Xiang cannot match She Xiang's Blood-moving ability.

Shi Chang Pu
She Xiang vs Shi Chang Pu

Both open the orifices and are used for impaired consciousness and cognitive disorders. She Xiang is far more potent and acts as an emergency substance for acute closed disorders with complete loss of consciousness. Shi Chang Pu is much milder, warm, and aromatic but primarily transforms Phlegm-Dampness and harmonizes the Middle Burner, making it suited for chronic conditions like mild cognitive impairment, poor memory, or dullness caused by Phlegm-Damp clouding the Heart orifices. Shi Chang Pu can be used in daily decoctions; She Xiang cannot be boiled and is reserved for acute, severe situations.

Common Substitutes & Adulterants

Related species and common adulterations to be aware of when sourcing She Xiang

Due to the extreme rarity and high cost of natural musk (one of the most expensive medicinal substances in TCM), adulteration is a significant problem. Common adulterants and substitutes include: 1. Artificial musk (人工麝香): Developed in China in 1994 and now used in over 99% of musk-containing patent medicines. It contains synthetic muscone and other bioactive compounds but lacks muscopyridine and 3-methylcyclotridecanone found in natural musk, and does not show the microscopic structure of gland tissue. It is a legitimate substitute, not a fraudulent one. 2. Adulterated musk pods: Pods may be injected with foreign materials such as dried blood, ground meat, plant powders, mineral oil, or lead shot to increase weight. Authentic musk should pass the hand-rolling, mounding, and fire tests described in quality indicators. 3. Synthetic muscone alone: Since muscone can be chemically synthesized, some products may contain only synthetic muscone mixed with fillers, lacking the full spectrum of peptides, steroids, and other components present in genuine musk. 4. Other animal musks: Muskrat secretions or civet (灵猫香) secretions are sometimes fraudulently sold as musk deer musk. These lack the same chemical composition and therapeutic profile. DNA barcoding and electronic nose technology are emerging methods for authenticating genuine musk.

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

Toxicity Classification

Classical Chinese pharmacopoeia toxicity rating for She Xiang

Non-toxic

She Xiang and its principal active compound muscone both have very low acute toxicity. In animal studies, the LD50 of musk water extract via intraperitoneal injection in mice is approximately 331 mg/kg, and via intravenous injection approximately 848 mg/kg. Rats given oral musk at 60 mg/kg daily for 15 days showed no abnormalities in body weight, blood, liver, or kidney function. Dogs injected intramuscularly with synthetic muscone at 400–800 mg/kg daily for 14 days showed no adverse effects. At very high doses, muscone can cause tremors, limb weakness, eye closure, and respiratory depression in mice. It also has well-documented uterine-stimulating effects that increase with the dose and stage of pregnancy, which is the basis for its absolute prohibition in pregnancy rather than classical toxicity. The Chinese Pharmacopoeia does not assign a toxicity classification to She Xiang, effectively treating it as non-toxic at standard dosages. However, the extremely potent aromatic and penetrating nature of the substance means it should always be used in very small amounts and only for appropriate indications.

Contraindications

Situations where She Xiang should not be used or requires extra caution

Avoid

Pregnancy: She Xiang strongly stimulates the uterus, increasing contraction frequency and strength. It has demonstrated anti-implantation and anti-early pregnancy effects in animal studies, with these effects becoming more pronounced as pregnancy progresses. Both internal and topical use are absolutely prohibited during pregnancy.

Caution

Qi or Blood deficiency without excess patterns: She Xiang is a strongly dispersing aromatic substance. Zhu Danxi (朱丹溪) warned that in women with Blood deficiency, and in cases of nosebleed from Yin excess and Yang deficiency, dispersing aromatic agents like musk should not be used as they further scatter the already depleted Qi and Blood.

Caution

Yin deficiency with internal Heat: The warm, dispersing, and penetrating nature of She Xiang can further damage Yin fluids and aggravate deficiency Heat. Use with caution in Yin-deficient patients.

Avoid

Collapse syndromes (tuo zheng / 'abandoned disorder'): She Xiang opens orifices and is indicated for excess-type closure syndromes (bi zheng). In deficiency-type loss of consciousness where Qi is collapsing and escaping, its dispersing action can worsen the condition.

Caution

Absence of Blood stasis or orifice obstruction: As a strongly penetrating and Blood-invigorating substance, She Xiang should not be used when there are no signs of blockage or stasis. Li Gao (李杲) cautioned that using it for wind conditions in the superficial muscle layer could paradoxically draw pathogenic wind deeper into the bone.

Classical Incompatibilities

Traditional Chinese pharmacological incompatibilities — herbs or substances to avoid combining with She Xiang

She Xiang does not appear on the classical Eighteen Incompatibilities (十八反) or Nineteen Mutual Fears (十九畏) lists.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

Absolutely contraindicated during pregnancy, both for internal and topical use. She Xiang has a powerful stimulating effect on the uterus, markedly increasing contraction frequency and intensity. The pregnant uterus is particularly sensitive to this effect. Pharmacological research has demonstrated that muscone (the primary active compound) possesses anti-implantation and anti-early pregnancy activity, with these effects becoming more pronounced as pregnancy progresses. Zebrafish embryo studies have also shown concentration-dependent embryotoxicity. Classically, She Xiang was intentionally used to expel dead fetuses and retained placenta, precisely because of its ability to stimulate uterine contractions. The Chinese Pharmacopoeia explicitly states: "Pregnant women prohibited" (孕妇禁用).

Breastfeeding

She Xiang should be used with great caution during breastfeeding. Its strongly penetrating, aromatic, and Blood-invigorating properties mean active compounds including muscone (which is highly lipophilic) could potentially transfer into breast milk. While specific clinical data on breast milk transfer is lacking, given the substance's powerful pharmacological effects on the central nervous system, cardiovascular system, and uterus, and its extremely low therapeutic dosage (which reflects high potency), it is generally advised to avoid use during lactation. If use is clinically essential, breastfeeding should be temporarily suspended.

Children

She Xiang has been used historically in pediatric emergency formulas, particularly for childhood convulsions and seizures. Classical texts record using a single grain (当门子, 'dang men zi') dissolved in warm water for infantile fright and convulsions. Dosage should be proportionally reduced based on age and body weight, and use should be limited to acute episodes under the guidance of a qualified practitioner. Prolonged use in children is not recommended due to its strongly dispersing nature and the vulnerability of children's immature Qi. She Xiang appears in several established pediatric patent medicines (e.g. within An Gong Niu Huang Wan for high fever with impaired consciousness).

Drug Interactions

If you are taking pharmaceutical medications, be aware of these potential interactions with She Xiang

Anticoagulants and antiplatelet agents: She Xiang has demonstrated Blood-invigorating and anti-thrombotic properties. Concurrent use with warfarin, heparin, clopidogrel, aspirin, or other anticoagulant/antiplatelet medications may increase the risk of bleeding. Close monitoring of coagulation parameters is advised if combined use is clinically necessary.

CNS-active medications: She Xiang and muscone have bidirectional effects on the central nervous system (stimulatory at low doses, inhibitory at high doses). One study suggested that muscone may affect the anesthetic effect of ketamine. Caution is warranted when combining with sedatives, anesthetics, or other CNS depressants/stimulants.

Oxytocics and uterine-stimulating drugs: Given its powerful uterine-stimulating effects, She Xiang could theoretically potentiate the action of oxytocin or other uterotonic medications, increasing the risk of uterine hyperstimulation.

Cardiovascular medications: She Xiang has demonstrated cardiac-stimulating and blood-pressure-raising effects. Caution is advised in patients taking antihypertensives, cardiac glycosides, or anti-arrhythmics, as unpredictable interactions are possible.

Note: Formal clinical drug interaction studies on She Xiang are very limited. The above interactions are inferred from its known pharmacological properties. More research is needed.

Dietary Advice

Foods and dietary considerations when taking She Xiang

No specific strict dietary restrictions apply to She Xiang use. However, since it is typically employed for acute emergency or Blood-stasis conditions, general TCM principles apply: avoid cold and raw foods that could impede circulation, and avoid greasy, heavy foods that generate Dampness and Phlegm. When used for opening orifices in acute conditions, dietary considerations are generally secondary to the clinical emergency. Alcohol was traditionally used as a vehicle for She Xiang administration (to enhance its dispersing action), but this should only be done under practitioner guidance.

Botanical Description

Physical characteristics and morphology of the She Xiang source animal

She Xiang is not a plant-based herb but an animal-derived medicinal substance. It is the dried secretion from the musk gland (香囊, xiāng náng) located between the navel and genitals of mature male musk deer. Three species are recognized as official sources in the Chinese Pharmacopoeia (2020 edition): the Forest Musk Deer (Moschus berezovskii Flerov), the Alpine Musk Deer (Moschus sifanicus Przewalski), and the Siberian Musk Deer (Moschus moschiferus Linnaeus).

These small, solitary, crepuscular animals resemble small deer without antlers, standing about 50–55 cm at the shoulder and weighing 8–15 kg. Males possess elongated upper canine teeth (tusks) that protrude below the lip. Their coats are dark brown to greyish-brown, with lighter spotted patterns along the back. They inhabit mountainous forests, typically in coniferous or mixed forest zones at elevations of 2,000–4,000 metres, and are agile climbers on steep, rocky terrain. The male's musk gland is a pouch-like structure about 3–7 cm in diameter that produces a strongly aromatic secretion used to attract mates.

Sourcing & Harvesting

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

Harvesting season

Winter through early spring (冬季至次春). Farmed musk deer are typically harvested once annually in winter-spring, though some facilities harvest twice per year (March–April and July–August).

Primary growing regions

The primary producing regions in China are Sichuan, Tibet (Xizang), Yunnan, Shaanxi, and Gansu provinces. Inner Mongolia also produces significant quantities. Additional production comes from parts of the northeast (Heilongjiang, Jilin), as well as Hubei, Guizhou, Guangxi, Qinghai, Henan, and Anhui. Historically, four famous regional musk types were recognized: Shaanxi (陕南) musk, Tibetan musk, Qinghai musk, and Sichuan musk. Sichuan's mountainous forests, particularly in the western highlands, have traditionally been considered the premier terroir (道地产区) for musk deer, producing the Forest Musk Deer variety highly valued for its muscone content. Today, most commercial musk comes from farmed deer, with Sichuan and Shaanxi being leading centres of captive breeding programs.

Quality indicators

Whole musk pods (毛壳麝香): Should be round or slightly flattened, 3–7 cm in diameter, weighing about 30 g. The outer surface should be brownish with greyish-white fur and show an opening pore about 3 mm in diameter. The pod should feel elastic when pressed. Musk grains (麝香仁/当门子): The highest quality form. Grains should be irregular round or granular, purplish-black in colour, smooth, oily, and lustrous, with a fine network pattern (麻纹) visible on the surface. The cross-section should be deep brown to yellowish-brown. Key authentication tests: (1) 'Mounding test' (冒槽): When a probe is inserted into the pod and grains are scooped out, they should visibly swell and rise above the probe's surface. (2) 'Hand-rolling test': Moistened musk powder, when rolled between the palms, should form a ball, then easily crumble when rubbed with fingers, without sticking, staining the hand, or resisting pressure. (3) 'Fire test': When sprinkled on a hot crucible, authentic musk should first crackle, then melt and swell into bead-like bubbles releasing intensely fragrant smoke, with no smell of burnt hair or meat, no flame or sparks. Ash residue should be white to greyish-white. The Chinese Pharmacopoeia (2020 edition) requires that the muscone content must be no less than 2.0% by dry weight. The aroma should be intensely fragrant, distinctive, and lingering. The taste should be slightly spicy, slightly bitter, and somewhat salty.

Classical Texts

Key passages from the classical Chinese medical texts that describe She Xiang and its therapeutic uses

Shen Nong Ben Cao Jing (《神农本草经》)

Original Chinese: 麝香，味辛，温。主辟恶气，杀鬼精物，温疟，蛊毒，痫痉，去三虫。久服除邪，不梦寤魇寐。

English translation: Musk is pungent in flavour and warm in nature. It mainly dispels foul Qi, kills ghostly essences, treats warm malaria, gu-poison, epilepsy and spasms, and eliminates the three types of parasites. Long-term use expels pathogenic influences and prevents nightmares and oppressive sleep.

Ming Yi Bie Lu (《名医别录》)

Original Chinese: 疗中恶，心腹暴痛，胀急痞满，风毒，妇人产难，堕胎，去面黔，目中肤翳。

English translation: It treats malignant strike, sudden acute pain of the Heart and abdomen, distension and fullness, wind-toxin, difficult labour in women, expulsion of dead fetus, removes facial darkening, and corneal opacities.

Ben Cao Gang Mu (《本草纲目》) — Li Shizhen

Original Chinese: 通诸窍，开经络，透肌骨，解酒毒，消瓜果食积。治中风、中气、中恶，痰厥，积聚症瘕。

English translation: It opens all the orifices, unblocks the channels and collaterals, penetrates through muscle and bone, resolves alcohol toxicity, and disperses food stagnation from fruits. It treats wind-stroke, Qi-strike, malignant strike, phlegm-collapse, and accumulations and masses.

Ben Cao Gang Mu (《本草纲目》) — Li Shizhen's commentary

Original Chinese: 盖麝香走窜，能通诸窍之不利，开经络之壅遏。若诸风、诸气、诸血、诸痛、惊痫、症瘕诸病，经络壅闭，孔窍不利者，安得不用为引导以开之、通之耶？非不可用也，但不可过耳。

English translation: Musk is penetrating and mobile in nature, able to open all blocked orifices and unblock obstructed channels. For conditions involving wind, Qi, Blood, or pain, seizures, and masses where the channels are blocked and orifices obstructed, how could one not use it as a guide to open and clear them? It is not that it cannot be used, only that it should not be used in excess.

Historical Context

The history and evolution of She Xiang's use in Chinese medicine over the centuries

She Xiang is one of the most storied medicinal substances in Chinese history. The character '麝' (shè) appears in oracle bone inscriptions dating back over 3,000 years, and the animal is mentioned in the Shan Hai Jing (Classic of Mountains and Seas) and Er Ya (earliest Chinese dictionary). The Eastern Han scholar Xu Shen wrote in Shuowen Jiezi: "The musk deer is like a small elk, with fragrance at its navel." Li Shizhen explained the etymology in the Ben Cao Gang Mu: "The musk deer's fragrance shoots far, hence it is called 'she' (射, to shoot). Or perhaps it means that the musk father's fragrance comes shooting forth."

The Shen Nong Ben Cao Jing classified She Xiang as an 'upper grade' medicine, indicating early recognition of its safety and therapeutic value. However, notably, it does not appear in any surviving Han-dynasty medical texts such as Zhang Zhongjing's works or the Mawangdui medical manuscripts. It was Tao Hongjing (陶弘景, 456–536 CE) during the Wei-Jin period who significantly expanded understanding of its medicinal uses through his annotations on the Ben Cao Jing, adding indications for difficult labour, abdominal pain, and wind-toxin. By the Tang and Song dynasties, musk had become an important ingredient in famous formulas such as Su He Xiang Wan, An Gong Niu Huang Wan, and Zi Xue Dan, and was a major commodity on the Silk Road, exported in large quantities to Persia and the Arabian world. The Qing-dynasty Ben Cao Shu Gou Yuan declared it "the foremost medicine for opening the orifices," effective for both cold-closure and heat-closure patterns.

Musk deer are now endangered. All musk deer species are listed under CITES, and China has classified the Forest Musk Deer as a Class I protected animal. Since 1994, China has used an artificial musk substitute (人工麝香) in over 99% of musk-containing patent medicines, reserving natural musk for only six specially designated formulas. Modern captive breeding programs also allow non-lethal harvesting by extracting secretions from living animals.

Modern Research

5 published studies investigating the pharmacological effects or clinical outcomes of She Xiang

1

Comprehensive review: Zoology, chemical composition, pharmacology, quality control and future perspective of Musk (Moschus) (2021)

Liu K, Xie L, Deng M, Zhang X, Luo J, Li X. Chinese Medicine. 2021;16(1):46.

This review covered the zoology of musk deer, the chemical composition of musk (macrocyclic ketones, pyridines, steroids, fatty acids, amino acids, peptides), and summarized its pharmacological effects including anti-inflammatory, neuroprotective, anti-cancer, and antioxidant activities. Muscone was confirmed as the main active ingredient with multiple mechanisms of action.

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Protective effect of muscone on acute cerebral ischemia-reperfusion injury in rats (Preclinical study, 2023)

Zhang P, You S, Ding X, Luan P, Xu J, Cui Q, Wang F, Li R, Zhu Y, Zhang J. Journal of Ethnopharmacology. 2023;308:116287.

In a rat model of transient middle cerebral artery occlusion, muscone significantly reduced infarct size and tissue damage. It also elevated expression of neurotrophic and angiogenesis-related factors. In cell models, muscone increased cell viability and inhibited apoptosis via the Bax/Bcl-2/Caspase-3 pathway, suggesting potential as a neuroprotective and pro-angiogenic agent for ischemic stroke.

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Beneficial effects of muscone on cardiac remodeling in a mouse model of myocardial infarction (Preclinical study, 2014)

Wang X, Meng H, Chen P, Yang N, Lu X, Wang ZM, Gao W, Zhou N, Zhang M, Xu Z, Chen B, Tao Z, Wang L, Yang Z, Zhu T. International Journal of Molecular Medicine. 2014;34(1):103-111.

In mice with experimentally induced myocardial infarction, 3 weeks of muscone treatment (2 mg/kg/day) significantly improved cardiac function and exercise tolerance, reduced myocardial fibrosis and collagen deposition, and attenuated inflammation and apoptosis through the Akt/eNOS signaling pathway.

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Chemical compositions and pharmacological activities of natural musk (Moschus) and artificial musk: A review (2022)

Lv S, Lei Z, Yan G, Shah SA, Ahmed S, Sun T. Journal of Ethnopharmacology. 2022;284:114799.

This review compared the chemical ingredients, pharmacological activities, and mechanisms of action of natural versus artificial musk. Key active constituents including polypeptides, muscone, steroids, and muscopyridine demonstrated therapeutic properties against inflammation, immune disorders, neurological conditions, and cardiovascular disease.

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Muscone ameliorates LPS-induced depressive-like behaviors and inhibits neuroinflammation in prefrontal cortex of mice (Preclinical study, 2020)

He MC, Shi Z, Qin M, Sha NN, Li Y, Liao DF, Lin FH, Shu B, Sun YL, Yuan TF, Wang YJ, Zhang Y. American Journal of Chinese Medicine. 2020;48(3):559-577.

Pre-treatment with muscone reversed LPS-induced body weight loss and depressive-like behaviors in mice. The mechanism involved suppression of microglial activation and reduction of inflammatory cytokines in the prefrontal cortex via the TLR4 pathway and renin-angiotensin system cascade.

Research on individual TCM herbs is growing but still limited by Western clinical trial standards. These studies provide emerging evidence and should be considered alongside practitioner expertise.