Herb Resin / Sap (树脂 shù zhī / 汁 zhī)

Su He Xiang

Storax resin · 苏合香

Liquidambar orientalis Mill. · Styrax Liquidus

Also known as: Su He You (苏合油), Storesin

Su He Xiang (Storax resin) plant

Images shown are for educational purposes only

Su He Xiang is an intensely aromatic resin historically used as an emergency remedy for loss of consciousness caused by cold or phlegm blocking the mind. It works by powerfully opening the body's sensory pathways and dispersing cold, turbid substances that cloud awareness. It is also used for sudden chest or abdominal pain associated with cold and stagnation.

Category Aromatic substances that open the orifices (开窍药)
Therapeutic focus Emergency Resuscitation Cardiovascular Health Pain Management Neurological Health

TCM Properties

Temperature

Warm

Taste

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

Channels entered

Heart, Spleen

Parts used

Resin / Sap (树脂 shù zhī / 汁 zhī)

Educational content • Consult qualified TCM practitioners for diagnosis and treatment

What This Herb Does

Every herb has a specific set of actions — here's what Su He Xiang does in the body, explained in both everyday and TCM terms

Therapeutic focus

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

Emergency Resuscitation Cardiovascular Health Pain Management Neurological Health

TCM Actions

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

Opens the Orifices and Revives Consciousness Dispels Turbidity and Filth Dispels Cold and Alleviates Pain Scours Phlegm and Opens the Orifices

How these actions work

'Opens the orifices and revives consciousness' means Su He Xiang's intensely aromatic nature can penetrate through blockages that cloud the mind, helping restore awareness in emergency situations such as sudden collapse or coma. In TCM, when cold phlegm or turbid substances block the Heart (which houses the mind and consciousness), the person may lose consciousness, clench their jaw, and become unresponsive. Su He Xiang's warm, piercing fragrance breaks through this blockage. It is specifically suited for 'cold-type' closed disorders where the face is pale, the limbs cold, the tongue coating white, and the pulse slow.

'Dispels filth and turbidity' refers to its ability to counteract noxious environmental influences. Historically, it was carried in sachets or burned to ward off pestilential or miasmic vapors. In a clinical context, this means using it when foul, turbid pathogenic factors obstruct the Qi pathways and sensory orifices.

'Disperses Cold and alleviates pain' reflects its warm nature. It is used for sudden chest pain (as in angina) or abdominal cold pain where the mechanism involves cold congealing and Qi stagnating in the chest or abdomen. The warmth of the herb moves Qi, disperses Cold, and relieves pain.

'Resolves phlegm and opens depression' means it can cut through thick, sticky phlegm and relieve Qi that has become knotted or stuck. This action supports both its resuscitative and pain-relieving effects, since phlegm and Qi stagnation are common root causes of the conditions it treats.

Patterns Addressed

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

Why Su He Xiang addresses this pattern

When cold phlegm or turbid dampness accumulates and veils the Heart orifice, consciousness becomes clouded or lost entirely. Su He Xiang directly addresses this through its warm, aromatic nature that penetrates the Heart channel, breaking through the phlegm obstruction to restore awareness. Its pungent taste disperses and moves stagnation, while its warmth counters the cold nature of the phlegm. This is the herb's primary and most important clinical application, specifically for cold-type closed disorders (as opposed to heat-type, where cooling aromatic openers like An Gong Niu Huang Wan would be used instead).

A practitioner would look for one or more of these signs

Loss Of Consciousness

Sudden collapse with loss of consciousness

Lockjaw

Clenched jaw, inability to open the mouth

Cold Limbs

Pale face and cold extremities indicating cold-type closure

Excessive Phlegm

Copious phlegm with white, greasy tongue coating

Commonly Used For

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

Arises from: Phlegm Misting the Heart

TCM Interpretation

In TCM, stroke (zhong feng) can manifest as an 'open' or 'closed' disorder. The closed type involves wind and phlegm surging upward and blocking the clear orifices, causing sudden collapse, unconsciousness, clenched jaw, and clenched fists. Within the closed type, there is a critical distinction between 'cold closure' and 'hot closure.' Cold closure presents with a pale or bluish face, cold limbs, white tongue coating, and slow pulse, indicating that cold-natured phlegm-turbidity has sealed off the sensory pathways. Hot closure shows a flushed face, fever, and yellow tongue coating. This distinction determines whether a warming or cooling aromatic opener is used.

Why Su He Xiang Helps

Su He Xiang is warm, pungent, and powerfully aromatic, making it specifically suited for cold-type closed stroke. Its intense fragrance penetrates through cold phlegm-turbidity that blocks the Heart orifice and sensory pathways. By warming the interior and dispersing cold, it helps restore Qi circulation and reopen the pathways to consciousness. It enters the Heart channel (which houses the mind) directly, acting as an emergency resuscitative agent. This is why it is the namesake herb of Su He Xiang Wan, the classical formula specifically designated for cold-closure emergencies. It is not appropriate for hot-type closure, where cooling openers like An Gong Niu Huang Wan are used instead.

Also commonly used for

Epilepsy

Seizures with phlegm obstruction

Loss Of Consciousness

Sudden collapse from phlegm-turbidity blocking the orifices

Coronary Artery Disease

Chest tightness and pain from phlegm-turbidity and Qi stagnation

Abdominal Pain

Sudden cold pain in the chest or abdomen

Convulsions

Childhood convulsions from wind-phlegm

Chilblains

Applied externally dissolved in alcohol

Herb Properties

Every herb 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), Sweet (甘 gān), Aromatic (芳香 fāng xiāng)

Channels Entered

Heart Spleen

Parts Used

Resin / Sap (树脂 shù zhī / 汁 zhī)

Dosage & Preparation

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

Standard dosage

0.3-1g

Maximum dosage

Do not exceed 1g per dose. This is already the upper end of the standard range. Su He Xiang is used in pills and powders, never in decoctions.

Dosage notes

Su He Xiang is never used in decoctions (煎剂) because its volatile aromatic compounds would be destroyed by prolonged boiling. It is exclusively administered in pill or powder form, or dissolved in alcohol for external application. The standard internal dose is 0.3 to 1g, incorporated into pill formulations. For acute emergencies such as cold-type stroke or sudden loss of consciousness, it is typically given as part of Su He Xiang Wan rather than as a single herb. For external use in frostbite or skin conditions, it is dissolved in ethanol and applied topically, with no fixed dose. The lower end of the dosage range (0.3g) is used for milder chest tightness and cold pain, while the upper range (1g) is reserved for acute loss of consciousness with cold-type presentation.

Preparation

Su He Xiang must NOT be added to decoctions. Its volatile aromatic compounds are destroyed by prolonged boiling. It is only used in pill (wan) or powder (san) formulations. When preparing pills, the resin is gently warmed until fluid, then mixed with honey and the other powdered ingredients. For external application, dissolve in ethanol (alcohol) and apply to the affected area. Store in a tightly sealed container submerged under a thin layer of clean water in a cool place to prevent loss of aromatic compounds.

Common Herb Pairs

These ingredients are traditionally combined with Su He Xiang for enhanced therapeutic effect

Bing Pian
Bing Pian Su He Xiang 50g : Bing Pian 105g (approximately 1:2)

Su He Xiang is warm and opens orifices by dispersing cold-turbidity, while Bing Pian (borneol) is cool and opens orifices by clearing heat. Together they create a balanced aromatic opening effect that strongly unblocks the sensory pathways and alleviates chest pain without being excessively warming or cooling. This pairing forms the core of the modern Su Bing Di Wan (Storax-Borneol Drops) used for angina.

When to use: Acute chest pain from coronary heart disease or angina where both cold stagnation and turbid obstruction are present. Also used for loss of consciousness when the cold-heat balance is unclear.

Yu Jin
Yu Jin 1:2 to 1:3 (Su He Xiang is used in small amounts)

Su He Xiang aromatically opens the Heart orifice and disperses cold phlegm-turbidity, while Yu Jin (turmeric tuber) moves Qi, resolves depression, clears Heart heat, and transforms phlegm. Together they powerfully open the orifices, resolve both phlegm and Qi stagnation, and address a broader spectrum of orifice-blocking mechanisms.

When to use: Phlegm-turbidity or emotional stagnation blocking the Heart orifice causing confusion, delirium, or epileptic seizures. Also for chest and flank pain from Qi stagnation and Blood stasis.

An Xi Xiang
An Xi Xiang 1:2 (Su He Xiang 30g : An Xi Xiang 60g in Su He Xiang Wan)

Both are aromatic resins that open the orifices and dispel turbidity. Su He Xiang is more warming and better at dispersing cold, while An Xi Xiang (benzoin) also invigorates Blood and alleviates pain. Combined, they create a powerful aromatic penetrating force that breaks through phlegm-turbidity obstructing consciousness and opens closed sensory pathways.

When to use: Cold-type closed disorders with loss of consciousness, especially when accompanied by Qi and Blood stagnation. This pairing is the core of Su He Xiang Wan.

Ding Xiang
Ding Xiang 1:4 (Su He Xiang in small amounts, Ding Xiang in standard dosage)

Su He Xiang opens orifices and transforms turbidity, while Ding Xiang (clove) warms the middle burner, directs rebellious Qi downward, and stops pain. Together they enhance warming, Qi-moving, and pain-relieving effects in both the chest and abdomen.

When to use: Cold pain in the stomach and abdomen with nausea, vomiting, or Qi stagnation. Also for cold-type chest pain where both orifice-opening and middle-warming actions are needed.

Key Formulas

These well-known formulas feature Su He Xiang in a prominent role

Su He Xiang Wan 苏合香丸 King

The definitive formula for Su He Xiang, and the one named after it. Su He Xiang serves as King herb, showcasing its core function of aromatically opening the orifices, dispelling cold-turbidity, and restoring consciousness. This is the classical emergency formula for cold-type closed disorders (sudden collapse with pale face, cold limbs, clenched jaw) and also for cold chest and abdominal pain. Originally from the Tang dynasty Guang Ji Fang as 'Chi Li Jia Wan,' it was later codified in the Tai Ping Hui Min He Ji Ju Fang.

Comparable Ingredients

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

She Xiang
Su He Xiang vs She Xiang

Both She Xiang (musk) and Su He Xiang are warm, pungent, aromatic substances that open the orifices and revive consciousness. However, She Xiang is significantly stronger at opening orifices, awakening the spirit, and unblocking channels and collaterals, making it more effective for severe Qi and Blood stagnation with swelling and pain. Su He Xiang is milder in its orifice-opening action but has a stronger warming quality that makes it more specifically suited for cold-type closed disorders. She Xiang is also used to invigorate Blood and reduce swelling in sores and trauma, which Su He Xiang does not do.

An Xi Xiang
Su He Xiang vs An Xi Xiang

Both are aromatic tree resins used to open the orifices and dispel turbidity. An Xi Xiang (benzoin) has a stronger Blood-invigorating action and is better for pain from Blood stasis, while Su He Xiang is more warming and better at dispersing cold-phlegm. In practice, they are frequently combined together (as in Su He Xiang Wan) rather than used as substitutes, because their complementary actions enhance the overall formula.

Bing Pian
Su He Xiang vs Bing Pian

Both open the orifices and revive consciousness, but their thermal natures are opposite. Bing Pian (borneol) is slightly cold and is better suited for heat-type closed disorders where there is fever, flushed face, and delirium. Su He Xiang is warm and is specifically indicated for cold-type closure with pale face, cold limbs, and white tongue coating. This distinction is clinically critical: using the wrong one can worsen the condition.

Common Substitutes & Adulterants

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

Su He Xiang has historically been subject to confusion and adulteration. Notably, the Tang dynasty Ben Cao describes a solid, reddish, wood-like form of "su he xiang" that differs significantly from the semi-liquid resin used today, suggesting that the ancient solid form may have been a different product entirely (possibly the bark residue after resin extraction, known as Cortex Thymiamatis). The American sweetgum (Liquidambar styraciflua) produces a similar resin sometimes marketed as "storax" or "liquid storax," but it has different chemical composition and is not an accepted substitute in Chinese medicine. An Xi Xiang (安息香, benzoin resin from Styrax species) is a related but distinct aromatic orifice-opening medicinal that is sometimes confused with Su He Xiang. While both are warm, aromatic, and orifice-opening, they come from entirely different plant families and have different clinical strengths. Due to the endangered status of L. orientalis and severely limited supply, commercial adulteration with cheaper resins, synthetic fragrances, or pine-derived products is a significant concern.

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

Toxicity Classification

Classical Chinese pharmacopoeia toxicity rating for Su He Xiang

Non-toxic

Su He Xiang is classified as non-toxic in the classical texts. The Ming Yi Bie Lu records it as "sweet, warm, and non-toxic" (味甘，温，无毒). Modern pharmacological studies confirm that even relatively large doses do not produce proteinuria or obvious organ toxicity. However, one in vitro study on human lymphocytes found that concentrated storax extract could increase sister chromatid exchange frequency at higher concentrations (1.6 and 4.0 micrograms/mL), suggesting some genotoxic potential at supra-therapeutic levels. This is not considered clinically significant at standard medicinal doses, but reinforces the classical teaching that aromatic orifice-openers should only be used short-term for acute conditions and never taken long-term.

Contraindications

Situations where Su He Xiang should not be used or requires extra caution

Avoid

Yin deficiency with internal Heat or Fire. The Ben Jing Feng Yuan (本经逢原) explicitly states that Su He Xiang is prohibited for those with Yin deficiency and excessive Fire, as its warm, aromatic, and dispersing nature will further injure Yin fluids and fan internal Heat.

Avoid

Hot-type closed patterns (re bi, 热闭). Su He Xiang is a warm orifice-opening substance suited only for cold-type closed patterns (han bi). In cases of high fever, red face, flushed complexion, rapid pulse, and delirium (heat closing the orifices), it is contraindicated as it would worsen the condition. An Gong Niu Huang Wan is indicated instead.

Avoid

Collapse patterns (tuo zheng, 脱证). In prostration with profuse sweating, open mouth, relaxed hands, and loss of consciousness from Qi or Yang collapse, aromatic orifice-opening herbs like Su He Xiang are inappropriate as their dispersing nature would further scatter the already depleted Qi.

Caution

Prolonged or continuous use. As an aromatic orifice-opener, Su He Xiang is strictly an emergency or short-term remedy. Extended use depletes the body's Qi (zheng qi), potentially worsening fatigue, dry mouth, irritability, and shortness of breath.

Caution

Patients with bleeding disorders or those on anticoagulant therapy. Pharmacological research indicates Su He Xiang has antiplatelet aggregation and anticoagulant activity, which may increase bleeding risk.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

Contraindicated during pregnancy. Su He Xiang is a strongly aromatic, penetrating, and Qi-moving substance. Classical sources warn that aromatic orifice-opening herbs with strong dispersing properties can disturb fetal Qi (损胎气) and may potentially stimulate uterine activity. The herb's ability to powerfully move Qi and penetrate through all channels and orifices poses a theoretical risk of miscarriage or premature labor. All formulas containing Su He Xiang (such as Su He Xiang Wan) carry pregnancy cautions.

Breastfeeding

Not recommended during breastfeeding. Su He Xiang contains volatile aromatic compounds including cinnamic acid, cinnamaldehyde, and styrene that could theoretically transfer into breast milk. No specific studies on lactation safety exist. Its strongly dispersing nature and the classical caution against long-term use of aromatic orifice-opening herbs suggest avoiding it while nursing unless absolutely necessary for an acute emergency, and even then only as a single dose under practitioner guidance.

Children

Su He Xiang may be used in children for acute emergencies (cold-type closed patterns) at reduced doses. The classical Su He Xiang Wan formula specifies that elderly and children may take one pill (approximately 2g of the pill, containing a small fraction of Su He Xiang), compared to four pills for adults. Dosage should be proportionally reduced based on age and body weight. As with adults, use should be strictly short-term for acute situations only, never as a long-term treatment. The pill form can be dissolved in warm water or administered via nasogastric tube if the child cannot swallow.

Drug Interactions

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

Anticoagulants and antiplatelet agents (warfarin, heparin, aspirin, clopidogrel): Pharmacological studies have demonstrated that Su He Xiang has significant antiplatelet aggregation and anticoagulant activity, with cis-cinnamic acid identified as the primary active component for inhibiting platelet aggregation. Concurrent use with blood-thinning medications may increase the risk of bleeding. Close monitoring is advised if combined use is unavoidable.

Cardiovascular medications: Su He Xiang has demonstrated effects on coronary blood flow, heart rate reduction, and decreased myocardial oxygen consumption in animal studies. Patients taking beta-blockers, calcium channel blockers, or nitrates should use Su He Xiang-containing formulas with caution, as additive cardiovascular effects are theoretically possible.

Dietary Advice

Foods and dietary considerations when taking Su He Xiang

During treatment with Su He Xiang or formulas containing it, avoid cold and raw foods, as the herb is used for cold-type conditions and cold foods would work against its warming action. Avoid alcohol in excess (small amounts of warm wine are traditionally used as a vehicle). Avoid spicy, greasy foods that may generate additional phlegm-Heat. Light, warm, easily digestible meals are preferred to support the recovery of Qi circulation.

Botanical Description

Physical characteristics and morphology of the Su He Xiang source plant

Liquidambar orientalis Mill. (Oriental sweetgum or Turkish sweetgum) is a slow-growing deciduous tree in the Altingiaceae (formerly Hamamelidaceae) family. It typically grows 10 to 15 metres tall, though specimens in favourable conditions can reach 30 to 35 metres with trunks up to 1 metre in diameter. The leaves are alternate, long-petioled, and palmately divided into 5 lobes (occasionally 3 or 7), with an ovate shape, pointed tips, heart-shaped base, and serrated margins. When crushed, they release a sweet, fruity fragrance.

The tree is monoecious, bearing separate male and female flowers on the same plant. The small yellowish-green flowers bloom in spring (March to April), arranged in round, head-like clusters. The fruit is a globular aggregate of capsules about 2.5 cm in diameter, armed with persistent spine-like styles. Seeds are narrow, oblong, flattened, and winged for wind dispersal, ripening in November to December.

The species is native to the floodplains and river valleys of southwestern Turkey and the Greek island of Rhodes, favouring rich, deep, moist soils at elevations of 0 to 400 metres. It is now classified as Endangered on the IUCN Red List, with pure stands in Turkey having declined from about 7,000 hectares in the 1940s to roughly 1,350 hectares today. The medicinal product is the aromatic balsam (resin) that exudes from the inner bark when the trunk is wounded.

Sourcing & Harvesting

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

Harvesting season

Bark is wounded in early summer to stimulate resin secretion. The resin-saturated bark is then stripped in autumn for processing.

Primary growing regions

Su He Xiang originates from southwestern Turkey and the eastern Mediterranean region (including parts of Syria, and the Greek island of Rhodes). Turkey, particularly the Mugla Province (Fethiye, Koycegiz, and Dalaman districts), has historically been the primary source of the highest quality resin. The resin is still primarily imported into China from Turkey. In recent decades, China has established small-scale cultivation of Liquidambar orientalis in Guangxi and Yunnan provinces to reduce dependence on imports, though the quantity remains limited. The species is now Endangered (IUCN), and wild harvest from Turkey has decreased dramatically from 180,000 kg in 1950 to under 200 kg by 2007.

Quality indicators

Good quality Su He Xiang is a semi-fluid, thick, viscous liquid resembling malt syrup. It should be brownish-yellow to yellowish-white in colour, semi-transparent, and have a strongly aromatic fragrance. When lifted with a stick or spatula, it should stretch into continuous, unbroken threads. It is heavier than water and sinks when placed in water. The taste should be slightly bitter and pungent, and it sticks to the teeth when chewed. It dissolves in 90% ethanol, chloroform, and glacial acetic acid. Per the Chinese Pharmacopoeia (2020 edition), cinnamic acid content must be no less than 5.0%. Avoid material that is excessively dark, gritty, contains visible impurities, or has a weak or rancid smell.

Classical Texts

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

Ming Yi Bie Lu (名医别录), attributed to Tao Hongjing

Chinese: 主辟恶，温疟，蛊毒，痫痉，去三虫，除邪，令人无梦魇。

English: It primarily dispels evil [pathogenic influences], treats warm malaria, gu-toxin poisoning, and epileptic convulsions. It eliminates three types of parasites, removes perverse influences, and prevents nightmares.

Ben Cao Bei Yao (本草备要), by Wang Ang

Chinese: 走窜，通窍开郁，辟一切不正之气。

English: It is dispersing and penetrating in nature. It opens the orifices and resolves stagnation, and dispels all manner of pathogenic or turbid Qi.

Ben Jing Feng Yuan (本经逢原), by Zhang Lu

Chinese: 苏合香，聚诸香之气而成，能透诸窍脏腑，辟一切不正之气，凡痰积气厥，必先以此开导，治痰以理气为本也。

English: Su He Xiang gathers the Qi of many fragrances. It can penetrate all the orifices and organ systems, dispelling every kind of pathogenic Qi. Whenever there is phlegm accumulation or Qi collapse with syncope, one must first use this substance to open and guide [the orifices]. Treating phlegm takes regulating Qi as its foundation.

Ben Cao Zheng (本草正), by Zhang Jiebin

Chinese: 杀虫毒。疗癫痫，止气逆疼痛。

English: It kills parasites and toxins. It treats epilepsy and stops pain caused by rebellious Qi.

Historical Context

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

Su He Xiang has a rich history spanning nearly two millennia of trade along the Silk Road. The name "su he" (苏合) derives from its place of origin: Li Shizhen's Ben Cao Gang Mu cites the Guang Zhi (广志) by Guo Yigong, noting that "this fragrance comes from the Su He kingdom, and was thus named after it." The Han dynasty historian Ban Gu recorded in a letter to his brother Ban Chao that the general Dou Xian dispatched agents westward to trade silk for horses and Su He Xiang, documenting cross-continental commerce in this resin as early as the 1st century CE.

Su He Xiang first entered the Chinese medical literature in the Ming Yi Bie Lu (名医别录), compiled during the Southern Dynasties period (attributed to Tao Hongjing), where it was classified as a top-grade medicinal. Its use evolved from a luxury incense and fumigation agent in the Han and Tang periods into a critical emergency medicine. The Tang dynasty imperial formulary Guang Ji Kai Yuan Fang (广济开元方) included it in the "Chi Li Jia Wan" (吃力迦丸), which was later renamed Su He Xiang Wan in the Song dynasty's Tai Ping Hui Min He Ji Ju Fang (太平惠民和剂局方). This formula was originally restricted to the imperial court. The Song polymath Shen Kuo recorded in his Meng Xi Bi Tan (梦溪笔谈) that Emperor Zhenzong personally bestowed Su He Xiang wine upon the ailing Grand Preceptor Wang Wenzheng, whose health dramatically improved after drinking it. This event led to the formula spreading beyond the palace into widespread civilian use.

In modern times, derivatives such as Guan Xin Su He Wan (冠心苏合丸) have been developed from the classical formula for use in coronary heart disease and angina pectoris, representing one of the most successful examples of classical formulas being adapted for modern cardiovascular emergencies.

Modern Research

4 published studies investigating the pharmacological effects or clinical outcomes of Su He Xiang

1

Styrax promotes mitochondrial function and reduces cardiac damage following myocardial ischemic injury: the role of the AMPK-PGC1α signaling pathway (Animal study, 2023)

Mu F, Zhao J, Zhao M, et al. Journal of Pharmacy and Pharmacology, 2023, 75(12): 1496-1508.

This study investigated the effects of storax extract on myocardial ischemic injury in rats and cell models. The extract improved cardiac function, reduced cardiomyocyte death, and restored mitochondrial energy metabolism by activating the AMPK/PGC-1α signaling pathway, suggesting a mechanism for the traditional use of Su He Xiang in treating chest pain from heart blood stasis.

DOI
2

Inhibitory effects of Sığla tree (Liquidambar orientalis) storax against several bacteria (In vitro study, 2005)

Sağdiç O, Ozkan G, Ozcan M, Ozçelik S. Phytotherapy Research, 2005, 19(6): 549-551.

Storax resin dissolved in ethanol was tested against 20 bacterial species. The study found antibacterial activity against many bacteria at 10% concentration, and against some species at concentrations as low as 0.2%, supporting the traditional use of Su He Xiang for dispelling pathogenic influences.

DOI
3

Effects of oriental sweet gum storax on porcine wound healing (Animal study, 2012)

Ocsel H, Teke Z, Sacar M, et al. Journal of Investigative Surgery, 2012, 25(4): 262-270.

In a porcine wound model, topical application of storax enhanced both re-epithelialization and granulation tissue formation in full-thickness wounds compared to standard dressings. This provides evidence for the traditional external use of Su He Xiang dissolved in alcohol for frostbite and skin lesions.

DOI
4

Genotoxic and cytotoxic effects of storax in vitro (In vitro study, 2013)

Human & Experimental Toxicology, 2013, 29(2): 181-186.

This study evaluated storax balsam extract on human lymphocytes. At higher concentrations (1.6 and 4.0 micrograms/mL), storax increased sister chromatid exchange frequency and reduced cell viability, suggesting a dose-dependent genotoxic and cytotoxic potential in isolated cell systems. These findings underscore the importance of using Su He Xiang only at therapeutic doses for short durations.

DOI

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.