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HE SHOU WU
WHAT'S IN AN HERB NAME?
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
He Shou Wu (pinyin: heshouwu) is derived from the roots of Polygonum multiflorum. The herb was first recorded (1,2,16) in the Ri Huazi Bencao (Tang Dynasty, 713 A.D.) and then incorporated into the well-known Kaibao Bencao (Song Dynasty; 973 A.D.). The herb was originally called jiaoteng, referring to its form: an intertwining vine (jiao = intersecting, teng = creepers). The newer name came from a story that is typically related something like this: Mr. Ho (full name, in pinyin, is He Tianer) from Hebei Province, at age 58, had not been able to father a child. A monk advised him to eatjiaoteng gathered from a mountain, which Ho then did, and consumed regularly. Soon after, he was able to father several children, his hair turned from gray to black, his vision improved, and his body became more youthful. He lived to age 130 (some say 160), still with black hair. Since then, the herb has been called Mr. Ho's hair is black (shou = head; wu = black). Ho's son is also reputed to have lived to be 130 years (3, 4). This short version is derived from the following story, which is related in the Heshouwu Lun (Notes on He shou wu) by Li Ao, written around 813 A.D. (16):
The Buddhist priest Wenxiang was devoted to the art of nourishing life [this refers to the Taoist immortality practices]. On the 18th day of the 3rd month in the 7th year of the governmental period yun he [thus, in 812 A.D.], he was on Maoshan early in the morning, and there, in the vicinity of Huayang cave, he met an old man who said to him: "You have the appearance of an immortal. I will reveal to you a secret formula [as suggested by the following story].
An ancestor of He Shouwu, who lived in the district of Nanhe in Xunzhou, was originally named He Tianer and was later called Nengzi. He was born impotent [meaning, he couldn't bear children] and had turned to drinking wine. At the age of 58, he returned home drunk one night and was overcome by sleep while still outside. When he awoke again, he noticed on the field two shoots of climbing plants, which stood about 3 feet apart. The sprouts of these shoots were twisted around each other [thus, the original name of the plant, jiaoteng] and then separated, three or four times.
Tiener considered this to be strange and, therefore, dug out the root of the plant and asked all the people in the village and the wilderness, but no one was able to tell him its name. Thereupon he dried the plant in the sun. A man living nearby was an excellent jester and said to Tiener: "You are impotent, you are old and childless. This climbing plant struck you as peculiar, now surely it is supposed to serve you as a divine drug. Why don't you take it?"
Thereupon, Tiener sifted out a fine powder of the drug and took it with wine. After 7 days, he suddenly recognized clearly the principles of human life. After several tens of days had passed, he felt unburdened and strong, and he could barely control his sexual desire. He married a widow named Cen and continued to take the drug regularly after that. He then increased the individual dose to 2 qian [about 6.2 grams]. After over 700 days, all of his previous complaints had disappeared, he regained his youthful appearance and begot a son. The people in the neighborhood were very astonished at this. During the following 10 years, Tiener became the father of several sons. He ascribed all this to the drug and said: "This was caused by the climbing plant. When one takes it, one can live to be 160 years old, and yet it is neither listed in the old prescriptions nor in the materia medicas [bencao].
I [the old man at the beginning of this story] have received this from my teacher [the Buddhist priest] who was told about it in Nanhe. Taking it helped me, also, to father children. Originally, I preferred peace of mind, and under no circumstances did I want to take this drug, because it is harmful to peace of mind [this refers to its stimulation of sexual desire]. My spouse took it accidentally and we attained the greatest happiness. Subsequently, I recorded all the effects of the drug for Tiener, and I changed his name to Nengzi [capable of begetting]. He died at the age of 160 and left 19 sons and daughters. His son He Yen, who also took the drug, reached the age of 160 as well, and left 30 sons and daughters. Yen's son, He Shouwu lived to the age of 130 by means of this drug, and fathered 21 children.
An Qi [a legendary herbalist from the Qin Dynasty who specialized in miraculous herbs] reports the following about this climbing plant: It has a sweet taste, warm nature, and belongs to the category of herbs without markedly curative power [that is, it has a slow and moderate action]. It masters the five hemorrhoidal complaints as well as all hidden illnesses and emaciating influences in the loins and abdomen. It expands the muscles and helps people to have many children because it increases one's semen [jing]. Taken as a food, this substance supplements the body's influences [qi] and strength, nourishes the skin, and prolongs life. Other names of the plant are yemiao [wild sprout], jiaojing [joining stalks; same basic meaning as jiaoteng],yehe [meeting at night], dijing [earth essence], and daoliu [peach and willow, meaning sexual joy; see also, below, the relation to the shape of the trees]. This climbing plant grows on the fields of Xunzhou, in the district of Nanhe. It is also frequently found in all regions of Lingnan. The sprouts of the plant are of the same size as those of mugao [the identity of this herb is not certain] and have a moist shimmer. They resemble the shape of peach and willow trees. The leaves are bent, grow individually with their backs facing, and are not opposite. There are male and female types of the plant. The sprouts of the male plant are yellow-white, those of the female are yellow-red. They grow at a distance from each other and unite at night. Some then become invisible. The female and male specimens should be gathered on cloudless days at the end of spring, in midsummer, or at the beginning of fall, and they should be dried in the hot sun. The herb is taken pulverized, together with wine. When gathering, one ought to make sure that the whole root is obtained. The root must not be washed, must be protected from moisture, and is rubbed clean of sand and soil by means of a piece of cloth; the rind must not be damaged. It is stored in a tightly closed container. Every month, the herb should again be dried in the sun. It must be taken only on even days, that is, on the second, fourth, sixth, and eighth day [etc.], and its use must be discontinued as soon as the clothes are soaked with perspiration, indicating that one's qi was brought into motion. While taking the herb, the consumption of meat and blood from pork and lamb are to be avoided.
Here [after relating this information], the old man ended and left. His walk resembled a swift wind. Censor Meng from the Provision Distribution Office in East Chekiang, was acquainted with Mr. He Shouwu. After he had tasted his herb, he said: "Its effects correspond to the tradition. It comes from Niudou Mountain in Bingzhou. The sprouts grow in a crawling fashion similar to that of bijie [Dioscorea sativa or Dioscorea tokoro]. The root resembles a threatening fist. The herb is taken fresh, after removal of the black rind. Because of the story related above, the people of the south call the herb heshouwu."
In a book written around 1638 A.D., the Beigao Shiwu Bencao Gang Mu, the short version of the story of Mr. Ho is relayed, along with the following statement (16):
Both of my eyes still were jade-green;
I was not very old, my hair was already white;
hunger and anxious thoughts often distressed me.
Shou-wu stilled the hunger and cured the pain;
returned my youth and banished old age.
Its effect to provide relief in times of pressing need
seems to be especially good.
PROCESSING OF HE SHOU WU
During the Tang Dynasty, Lin Daoren wrote the book The Secret Recipes of the Immortals for Treating Wounds and Fractures (Xian Shou Li Shang Xu Duan Mi Fang, 846 A.D.). In that book, he described the processing of He Shou Wu to enhance its tonic properties (processed He Shou Wu is sometimes called zhi heshouwu to distinguish it from the unprocessed form, which may be designatedsheng shouwu). The processing method is to stew or steam the He Shou Wu in black soybean (heidou) juice for several hours (up to three days, depending on the devotion of the processor to this method) and then dry the roots. This is a technique that is still used today. The black soy bean juice is prepared by boiling black soybeans in water for about 4 hours; the liquid that is left after the cooking is poured off and the beans are cooked again with less water for 3 hours; the resulting extract is combined with the former extract to make the juice. About 10 kg of black beans are used to process 100 kg of He Shou Wu roots. Black beans are traditionally attributed with the property of supplementing blood and essence, and prolonged cooking or steaming of the herb is associated with enhancing its enriching and warming nature. The alchemical version of this processing, which is similar to the recommended method for making processed rehmannia, is to repeat the stewing or steaming 9 times. Thus, after preparing with the black soybean (overnight) and drying, it is again prepared with black soybean on the next day, and so on, until nine cycles have been completed. This repetition of processing was questioned by Chen Shiduo in his book New Compilation of Herbs (Qing Dynasty), in which he felt that the repeated processing would destroy the quality of the herb. Today, the single processing is relied upon (5, 6).
According to the English-Chinese Rare Chinese Materia Medica (7), raw he shou wu, that is, the dried root that has not been prepared with soybeans, is used to treat toxicosis (infections yielding abscess, swellings beneath the skin, sores, carbuncles, and eruptive diseases like rubella), inflammation, constipation, and hyperlipidemia. The soybean-prepared He Shou Wu is used as a tonic for yin and blood, nourishing the hair, strengthening the bones and muscles, and used to treat pale complexion, dizziness, tinnitus, premature greying of hair, weakness of loins and knees, numbness of extremities, metrorrhagia, metrostaxis, profuse leukorrhea, weakness due to lingering diseases (e.g., malaria), and hyperlipemia. According to evaluations done with raw and processed He Shou Wu , the processed version does have different properties, and is the one with the most dramatic effects on preserving the immune system functions (5). Processed He Shou Wu is currently the only one that is regularly exported from China. During the past thousand years in China, processed He Shou Wu has been used to nourish the liver and kidney, promote the growth of hair (see the following section on alopecia), and treat premature greying of hair.
The roots of He Shou Wu are reddish brown. The taste is starchy, astringent and slightly bitter. The highest quality roots are those that have a high density and firm quality. In Hong Kong, the highest quality roots are sliced very thin and packaged carefully to display the color, shape, and luster of the slices; the ordinary quality roots are sliced thicker and sold in bulk packages.
To make a tea of He Shou Wu , 9-15 grams of the sliced root (dried or processed root, as indicated for the application) is simmered in water (in a non-metallic pot) for 45 minutes (30 minutes is adequate for the thin slices). Aside from oral ingestion, the herb decoction can be applied locally: 1 concentrated tea can be used in a douche for leukorrhea (vaginal discharge), and He Shou Wu tea is useful too as a gargle for pyorrhea (inflammation of the gums) or loose teeth.
HE SHOU WU ARRIVES IN AMERICA, VIA HAWAII AND OREGON
He Shou Wu came to the attention of Americans through a circuitous route (the story was first revealed by the current author in an article that appeared in Health Foods Business magazine, April 1981). The herb was first known to many Westerners under the name "fo-ti," a designation which still appears, on occasion, today. No one in China ever used that name for He Shou Wu or any other herb. The way in which this name came about is rather enlightening. A Hawaiian entrepreneur had seen an article that was originally published in a newspaper, which claimed that a recluse in China had lived to a very old, surviving on local plants in the mountains. This Hawaiian abstracted the marketable concept from the story and made an "elixir" of three herbs that, he claimed, were the ones that conveyed longevity to this long-lived individual, as well as several other recluses that had, purportedly, attained a long life by the same means. These three herbs were gotu kola from India, meadowsweet from Europe, and kola nut (an African herb, which has also be cultivated throughout the tropics). He gave it an exotic Chinese sounding name, Fo-Ti-Tieng. It was an instant hit in the naive world of health foods and herbs that had emerged during the 1970's in the U.S.
Jeanne Rose, author of the pop herb book of the 1970's, Herbs & Things (written when she was bed-ridden for several months with not much else to do after a car accident) listed fo-ti-tieng in the book. Under that heading, she told the story of Li Chung Yun (his actual name was Li Ch'ing Yuen; see Figure 2.), a Chinese herbalist who lived to the age of 256 years (he is the one in the newspaper article), presumably because he drank a daily tea made from, as she describes it, "an herb called Fo-Ti-Tieng." Thus, the sales pitch for a newly devised, caffeine-containing herb mixture becomes a part of modern herbal lore: the strange formulation invented just a couple of years earlier is ignored, and a new herb is invented. In the story of Li Ch'ing Yuen related by Da Liu (17), his longevity is attributed, primarily, to consuming lycium fruits and, especially, to practicing certain exercises of a type similar to Tai Ch'i Ch'uan.
Not to be outdone, those who were becoming involved with Chinese herbs at around the same time also ignored the history and content of the commercial product and, instead, made a search of the Chinese literature, seeking Fo-Ti-Tieng. Their search was unsuccessful, but that didn't stop those who wanted to sell something successfully by gliding on the reputation fashioned for Fo-Ti-Tieng by an extensive advertising campaign.
A Westerner importing Chinese herb products into the U.S. apparently reasoned as follows: the product that is being sold as fo-ti-tieng is reputed to prolong life; a Chinese herb that is reputed to prolong life is He Shou Wu . Therefore, fo-ti-tieng, the herb that purportedly caused Li to live so long, is probably nothing other than He Shou Wu. It is reasonable to sell He Shou Wu to people seeking Fo-Ti-Tieng, but, since Fo-Ti-Tieng is someone else's trademarked name, I will just call it Fo-ti.
Fo-ti, thus interpreted as a single herb rather than a proprietary formula, became an integral part of many major herb capsule lines that were found in herb and health food stores across the U.S. The herb (riding on the popularity of the enigmatic Fo-Ti-Tieng) could virtually sell itself without promotion and without mention in any but the most recent of the popular herb books. In fact, purchasers of Fo-ti assumed that they were getting Fo-Ti-Tieng, the item in the advertisements. It may be worth mentioning that a trademark infringement case was attempted by the originator of Fo-Ti-Tieng, to no avail. Further, as a protection for the original formula, in case someone should wish to copy it, its originator claimed that the ingredient from India was Hydrocotyle asiatica minor, for which he had the exclusive supply, while everyone else had access to the less effective Hydrocotyle asiatica major. No botanist could be found to support this distinction between varieties of gotu kola (Hydrocotyle asiatica is the old botanical designation for gotu kola; it is now known as Centella asiatica, there never was a minor and major variety). Gotu kola is known in India as brahmi; a more commonly used herb collected for brahmi is bacopa, which, extracted into black sesame oil (yielding Brahmi Oil), is applied to the scalp to aid hair growth.
To illustrate how far the situation with herb names can get out of hand, yet another herb company sought out fo-ti (rather than Fo-Ti-Tieng, now that the new name was available) from the Chinese herb books. The closest spelling was fo-tse, which is one of the unorthodox English spellings of fuzi (the pinyin name): aconite. This herb was on the market for some time, sold as fo-ti, until the nature of the raw material was finally realized. Luckily, the naive herb company that marketed this item had purchased processed aconite rather than raw aconite, so that it didn't threaten the health of the consumer; raw fuzi is highly toxic.
For a further look at the real herbal lore behind He Shou Wu , the herb is described in the following passage in Li Shizhen's famous compendium of 1578 (published posthumously in 1596), Bencao Gang Mu (8):
The root of the 50-year-old plant is called "mountain slave:" taken for a year, it will preserve the black color of the hair. The root of the 100-year-old plant is called "mountain brother:" taken for a year, it will bring a glowing complexion and a cheerful disposition. The root of the 150-year-old plant is called "mountain uncle:" taken for a year, it will rejuvenate the teeth. The root of the 200-year-old plant is called "mountain father:" taken for a year it will banish old age and give the power to run like a deer. The root of the 300-year-old plant is called "mountain spirit:" taken for a year, one becomes an earthly immortal.
With this dramatic vision provided by Taoists seeking immortality, He Shou Wu has retained its reputation in China as a reliable safeguard against old age. The herb is now cultivated and collected after 3-4 years growth (50-year-old wild plants are impossible to find these days). Perhaps the most frequently repeated claim is that the herb "keeps the hair black" (the only color of Chinese hair except when it's turning grey). The ability of He Shou Wu to prevent premature greying-and hair loss-is attributed, in part, to its tonic effects on the kidneys and liver. According to traditional Chinese medicine theory, the condition of hair (on the head) is governed by the kidneys and nourished by the liver blood (in fact; the hair is often said to be the excess of the liver blood). For the more complete analysis, here is what Bensky reports about liver and kidney deficiency (9):
Healthy hair depends on the sufficiency of blood stored in the liver. When the liver blood is deficient, it is unable to rise and nourish the head; the hair then turns gray or falls out. The health of the kidneys is expressed in the hair of the head, and graying or loss of hair is a sign of kidney deficiency. The teeth depend on the sufficiency of bone matter, which is governed by the kidneys. The kidneys also generate marrow, which is thought to keep the teeth in place; if the kidneys are deficient, the teeth will become loose and easily fall out.
Regarding He Shou Wu , he also indicates that: "Its bitterness enables it to strengthen the sinews and bones, and its astringent properties enable it to stabilize the essence [jing] and, thus, the kidneys.
HE SHOU WU IN TRADITIONAL FORMULAS
Perhaps because it belonged to the realm of Taoist immortality recipes, He Shou Wu has not entered into many of the well-known traditional Chinese herb prescriptions. However, its use as medicine has been widely adopted in the modern era in China. This same situation applies to another remedy of the immortals, ganoderma (lingzhi), which rarely appears in traditional prescriptions but is widely used in modern formulations.
One of the oldest recorded prescriptions with He Shou Wu that is still utilized today (10) is Danggui Yin Zi (Tang-kuei and Tribulus Combination), recorded in a Song Dynasty text (Ji Sheng Tang, 1253 A.D.). This formula is used to treat skin disorders associated with blood deficiency, including itching, eczema, and dry skin. Another old formula (2, 9) is called He Ren Yin (He Shou Wu and Ginseng Combination); it contains a large dose of He Shou Wu (at least 15 grams), with moderate amounts of ginseng, tang-kuei, citrus, and fresh ginger. This formula is intended to nourish the blood and reinforce the qi to treat a person with chronic malaria, which yields cycles of feverish attacks; the decoction is to be taken two hours before the next expected cyclic attack is to begin. This formula was recorded in Jing Yue Quan Shu (Collected Works of Zhang Jingyue), published in 1624, though it had been used for a century before then. A formula for treating premature greying of hair appeared in the book Analytic Collection of Medical Formulas (Yi Fang Ji Jie), published in 1682: processed ho-shou wu is combined with hoelen, achyranthes, tang-kuei, lycium fruit, cuscuta, and psoralea, which is made into a 9 gram pill (6 grams herbs, 3 grams honey); two pills per day is the standard dosage. The formula is called Qibao Meiran Dan, or "The Seven Treasure Special Pill for Beautiful Whiskers (9)."
Today, He Shou Wu is often combined with other herbs that are tonics for the blood, such as tang-kuei, lycium fruit, and rehmannia. The combinations are used to treat anemia and weakness due to old age, injury or debilitating illness, as well as for alopecia.
SUBSTITUTES AND ALTERNATIVES, AND POTENTIAL MISTAKES IN IDENTITY
He Shou Wu is prepared from the roots of Polygonum multiflorum, and there are dozens of related species of Polygonum used in Oriental medicine. Some of the same species of polygonum are recognized in Western herbalism as well, notably bistort (Polygonum bistorta), also used in China. All the Polygonum species used in medicine have in common a very starchy root (He Shou Wu is about 40-50 percent starch) that is rich in tannins (up to 20 percent by weight); tannins produce the astringent effect.
According to Grieve's Herbal (1939), a British compendium of herbal lore:
Bistort root is one of the strongest astringent medicines -and may be used for all bleedings, whether external or internal, and wherever astringency is required. It is of proven excellence in diarrhea, dysentery, cholera and all bowel complaints; in hemorrhages from the lungs and stomach; (it is a most effectual remedy for bleeding from the nose and exceedingly useful in dealing with hemorrhoids. It is a useful wash in ulcerated mouth and gums, and as a gargle. It is also used as a lotion for ulcers attended with a discharge. Bistort is considered valuable for diabetes, given in conjunction with tonics, and has itself tonic action.
It is interesting to see the report that it is "exceedingly useful in dealing with hemorrhoids," in light of the ancient Chinese commentary that "it masters the five hemorrhoidal complaints." Similarly, the value of the herb in treating diabetes (which referred to early-onset diabetes, a wasting disease, in the days when this commentary was presented) compares with the ancient Chinese comment that it treats "emaciating" illnesses. So, there can be overlapping therapeutic properties among the different species of Polygonum.
Polygonum multiflorum is known as an imported garden plant, by the name of fleeceflower. Many modern books on Chinese herbs utilize this name in an attempt to approach Western readers in a more user friendly manner; unfortunately, almost no one knows it by this name. Another common name that has been applied is "flowery knotweed."
There is an herb known as baishouwu, which is the white-colored (bai) root used as a substitute for He Shou Wu , derived from an unrelated plant, Cynanchum bungei. It is reported to have properties that are similar to He Shou Wu , with similar taste and uses.
Labeling He Shou Wu simply as "polygonum," is fraught with problems, since there are so many Polygonum species in standard usage, that it can easily be confused. In fact, in the common naming system adopted in 1976 by the Oriental Healing Arts Institute (see On the common names for Chinese herbs), polygonum is the designated common name for Polygonum aviculares (Chinese: bianxu), which is mainly used for urinary tract infections. Most of the other polygonum species are to be named, in accordance with this system, by their transliterated designations, such as He Shou Wu and hu-chang.
One of the commonly used Polygonum species in modern medicine is Polygonum cuspidatum (hu-chang; huzhang). Originally, it was described as having uses similar to He Shou Wu . For example (11), the Compiled Essence of All Medical Works commented: "the herb is sweet, bitter, and acrid in flavor and warm in nature; it tonifies the muscles and bones and increases strength." In Prescriptions Worth a Thousand Gold, it is said that "mixing the decoction of the herb with aged wine is effective for treating abdominal mass, tinnitus, heaviness of the limbs, irregular menstruation, and impotence." While other ancient texts mention its ability to invigorate blood circulation and resolve abdominal masses, today, hu-chang is described differently. In Oriental Materia Medica (3), this is said: "taste is sour, bitter, mildly pungent [acrid], cold property; clears up heat, invigorates blood, detoxifies, and disperses swelling." It would seem that a different species of Polygonum was used as the original source of hu-chang. Still, hu-chang is being used in a manner that is similar to He Shou Wu in modern clinical practice. As an example, it was reported (12) that hu-chang could significantly inhibit leukopenia (low white-blood-cell count) caused by the immunosuppressive drug cyclophosphamide. Hu-chang was found to be more potent in this regard than a mixture in which it was only one-third of the combination (with astragalus and millettia, two herbs commonly employed to treat leukopenia induced by drugs). Both He Shou Wu and hu-chang are today used in formulas to treat tinnitus (see Treatment of tinnitus, vertigo, and Meniere's disease with Chinese herbs).
Polygonum multiflorum should not be confused with Polygonatum sibiricum, another precious Chinese herb tonic which has been called "the food of the immortals." Its Chinese name is huangjing, and ancient Chinese people thought that consuming it enabled them to increase their jing, the essence associated with health and longevity; because the unprocessed root is yellow (huang), it was so named (3). There are numerous Polygonatum species used in Chinese medicine, but it is important, especially, to keep in mind that the extra "at" in the name (Polygonatum) designates herbs from an entirely different plant family (Lilacea) than the Polygonum species (Polygonacea). To make matters worse, one of the sources of huangjing is Polygonatum multiflorum. Interestingly, He Shou Wu and polygonatum are both used in treating hyperlipidemia (see Obesity and Hyperlipidemia).
Finally, it is important to recognize that the stem of Polygonum multiflorum, sometimes called shouwu stem or polygonum stem, is also used in Chinese medicine. The material, which appeared in theKaibao Bencao along with the root material, is called yejiaoteng, thus retaining the original term jiaoteng (ye = night; recall the story of the stems intertwining at night). Like the root, the stem is used to nourish the blood, but this part of the plant is also said to tranquilize the spirit and invigorate the meridians. It is used for weakness, palpitation, and internal wind associated with blood deficiency.
ALOPECIA
The treatment of premature graying of hair is not considered a medical necessity, so He Shou Wu has not been subjected to critical analysis in relation to this claim. However, another problem with hair, alopecia, has been investigated. The treatments often contain He Shou Wu.
Alopecia may arise from numerous causes, including stress reactions, hypothyroidism, local exposure to chemicals, therapies used for cancer, and genetic male-pattern balding. The disorder is often classified by its specific manifestation, such as patchy balding (alopecia areata), total loss of head hair (alopecia totalis), or total loss of body hair (alopecia universalis). Alopecia areata and alopecia totalis frequently affect women, and the disorder may persist for several months to about a year, sometimes longer.
According to the English-Chinese Encyclopedia of Practical Traditional Chinese Medicine, "alopecia is mostly caused by deficiency of liver and kidney with subsequent failure of [blood to go up and nourish] the hair. The hair pores are open when the hair is poorly nourished, and wind invades the pores on the occasion. Therefore, deficient blood with wind [invasion] leads to hair loss. However, stagnation of liver qi and impaired qi mechanism will also result in hair loss because of the malnutrition of hair due to stagnation of qi and stasis of blood."
In addition to He Shou Wu , the nourishing herbs ligustrum and eclipta have the long-standing reputation of preventing the premature graying of hair and restoring gray hair to black; they have been applied as well for correcting hair loss following the theory that both graying of hair and hair loss may be due to lack of essential essences. Black sesame seed, taken internally or applied topically, has these qualities. Biota twig, used internally to stop bleeding, is also deemed valuable in treating alopecia; the twigs or the root bark are powdered and prepared as an ointment to cure burns and scalds and to make hair grow back on the scarred tissues. A wine made from drynaria is said to treat baldness when applied topically.
An example of a tonic preparation claimed useful for alopecia was reported in the Sichuan Journal of Traditional Chinese Medicine (1987). Shengfa Wan (literally, pill to generate hair), containing He Shou Wu , ligustrum, eclipta, lycium fruit, cuscuta, tang-kuei, achyranthes, psoralea, and hoelen was made as large honey pills, 10 grams each. These were given three times per day (a total of about 20 grams per day of herb powders), before meals, unless digestive disturbance occurred, in which case the pill was given after meals instead. Treatment time was 1-3 months, with an effective rate reported to be 62%. A similar formula Shengfa Yin, comprised of He Shou Wu , eclipta, ligustrum, rehmannia, tang-kuei, schizandra, morus fruit, and biota twig, was reported to cure 30 of 36 persons affected by alopecia areata, with 4 others improved. According to a report in the Hunan Journal of Traditional Chinese Medicine (1987), all of 50 cases of alopecia areata treated could be cured with daily ingestion for 1-3 months of a decoction of He Shou Wu , black sesame, soja (black soy bean), astragalus, gelatin, atractylodes, longan, and jujube, taken along with cystine (100 mg, three times daily), and topically applying an extract of morus bark.
In another study, the internal treatment for alopecia included ligustrum, He Shou Wu , rehmannia, biota twig, salvia, schizandra, peony, tang-kuei, carthamus, cnidium, and chiang-huo. This formula combines kidney and liver tonics with blood-circulating agents (chiang-huo opens the meridians in the upper body and dispels wind). In the clinical study in which it was used, patients also applied Monoxidil topically. Treatment time was 2-12 months, with a reported effective rate of 80%. Formulas such as this are often prescribed as powders, with a total dosage of 20 grams per day.
A similar prescription has been produced in more convenient form for export as the "Alopecia Areata Pill," following successful clinical testing during the 1970's. The main ingredients are He Shou Wu , rehmannia (cooked and raw), tang-kuei, salvia, red peony, schizandra, codonopsis, chaenomeles, and chiang-huo. The small pills are recommended to be taken 6 each time, three times per day (total of 4.5 grams of herb extract per day) for 3-4 months. This pill is readily available from Chinese herb shops in the U.S. The dosage for Americans should probably be higher, about 8 pills each time, since American body weight is considerably higher than Chinese body weight on average.
The same basic formula, but in decoction form, was described in the English-Chinese Encyclopedia of Practical Traditional Chinese Medicine (Volume 4: Simple and Proved Recipes). The formula presented was 30 grams astragalus, 15 grams each of He Shou Wu , raw and cooked rehmannia, millettia, morus fruit, and peony; 9 grams each of eclipta and cnidium, and 6 grams each of gastrodia and chaenomeles. This is to be decocted, and taken in two divided doses each day. In one sample case report, it was mentioned that a woman, who suffered from alopecia, menstrual irregularity, poor appetite, and insomnia, took the decoction for one month and had symptoms improved, with hair growth started. She continued to take the herbs for two more months, with the result of having dense, thick hair that was blacker than before.
A double-blind placebo-controlled study of an anti-aging mixture containing astragalus, salvia, and He Shou Wu was conducted with 507 persons and reported in the Chinese Journal of Integrated Traditional and Western Medicine (1986). A number of symptoms and signs associated with aging were monitored. The power of the placebo and the rate of spontaneous remission was here demonstrated, with nearly 35% of the control group showing some improvements in both subjective and objective measures. However, the herb treatment group had nearly 77% of patients showing improvements, including a reduction in alopecia during a 3 month trial.
He Shou Wu is also applied in topical applications. In a recent large-scale clinical evaluation, with results published in the Hubei Journal of Traditional Chinese Medicine (1991), 822 patients suffering from alopecia areata or alopecia totalis were treated with the topical formula, Suxiao Ketuling Shengfa Jing. The ingredients, extracted in alcohol, include capsicum, eclipta, He Shou Wu , biota twig, drynaria, ginseng, carthamus, and cnidium. According to the report, 630 patients were cured and others had partial regrowth of hair; only 48 patients (less than 6%) showed no response.
For most cases of alopecia, depending on the actual causes and the extent to which hair follicles have been inhibited, the treatment time is expected to range from about 1-3 months. Often, this requires taking an adequate dosage of an internal remedy and applying a topical remedy; or use of a topical remedy alone. Longer treatment may be necessary: in some evaluations treatment times of 4-12 months were used to assure higher total rates of success. The formulas to be used in the internal treatment of alopecia may have numerous beneficial effects, as demonstrated through the use of similar formulas for anti-aging actions (improving immune functions, increasing energy, improving sleep, etc.) so that one might experience some positive changes even before noticing any new hair growth. Based on the Chinese clinical evaluations, at least 60% of those treated can expect a substantial degree of hair growth within 3 months.
ANTIAGING EFFECTS
The story of Mr. Ho seems a bit exaggerated, but the many centuries of use of the herb for antiaging effects has led Chinese researchers to investigate further. The most desirable study, one in which humans would take He Shou Wu regularly in an effort to extend the lifespan, is beyond the capability of modern science, as there are too many factors that would need to be taken into account in evaluating the outcomes were it possible to recruit a large enough group to participate for years. The alternatives that have been attempted, such as monitoring the lifespan of insects fed He Shou Wu extract (or other herbs) really aren't very informative, since the conveniently short lifespans, measured in weeks, can't be meaningfully compared to the human lifespan and processes of aging that occur.
Somewhat more satisfying results are obtained by pharmacology studies that show that He Shou Wu extract improves the cardiovascular system, enhances immune functions, slows the degeneration of glands, increases antioxidant activity, and reduces the accumulation of lipid peroxidation (13). Such findings suggest that He Shou Wu is helpful in combating some of the processes that lead to conditions characteristic of old age, thereby also reducing the risk of fatal diseases (e.g., cancer) and incidents (e.g., heart attack, stroke). Processed He Shou Wu was shown to have effects on the antioxidant system superoxide dismutase (SOD), accumulation of lipid peroxidase, and enhancement of cell-mediated immune responses, while the unprocessed He Shou Wu showed much less effect (5, 14). Other antiaging substances studied extensively include ginseng, astragalus, tang-kuei, epimedium, cordyceps, ganoderma, eleuthero ginseng, and polygonatum (huangjing).
Among the Chinese herbal prescriptions tested and shown useful for lowering the risk factors associated with aging and death, were (15):
Shou Xing Bu Zhi: with main components He Shou Wu , dioscorea, rehmannia, codonopsis (or ginseng)
Essence Restoring Decoction: with main components He Shou Wu , rehmannia, cuscuta, astragalus, achyranthes, and cynomorium.
Rejuvenating Decoction: with main ingredients He Shou Wu , astragalus, and salvia.
SIDE EFFECTS, ADVERSE REACTIONS
He Shou Wu is essentially non-toxic and without any serious side-effects. However, it contains anthraquinones which tend to cause soft stool and may even cause slight diarrhea in some users. The processed He Shou Wu has less of this effect than the dried He Shou Wu . Because of this effect, it is recommended that persons who already suffer from loose stool use this herb cautiously. There is a very slight chance of liver hypersensitivity to intestinal metabolites of the He Shou Wu active ingredients. Recently, a clinical report of one such case was published (18). However, given the very wide-spread use of this herb, it is reasonable to assume that the chances of such an adverse response are quite small.
REFERENCES
1. Bensky D, and Gamble A, Chinese Herbal Medicine: Materia Medica, 1993 rev. ed., Eastland Press, Seattle, WA.
2. Huang Bingshan and Wang Yuxia, Thousand Formulas and Thousand Herbs of Traditional Chinese Medicine, vol. 1, 1993 Heilongjiang Education Press, Harbin.
3. Hong-Yen Hsu, et al., Oriental Materia Medica: A Concise Guide, 1986 Oriental Healing Arts Institute, Long Beach, CA.
4. Liu Zheng Cai, The Mystery of Longevity, 1990 Foreign Language Press, Beijing.
5. Ye Dingjiang, et al., Immunopharmacological studies of He Shou Wu and its preparations, 1987 Bulletin of Chinese Materia Medica 12(3): 21-24.
6. Pharmacopoeia Commission of PRC, Pharmacopoeia of the PRC, (English edition) 1988 People's Medical Publishing House, Beijing.
7. Zhang Enquin (ed. in chief), English-Chinese Rare Chinese Materia Medica, 1990 Publishing House of Shanghai College of Traditional Chinese Medicine, Shanghai.
8. Smith FP and Stuart GA, Chinese Medicinal Herbs, 1973 Georgetown Press, San Francisco, CA.
9. Bensky D and Barolet R, Chinese Herbal Medicine: Formulas and Strategies, 1990 rev. ed., Eastland Press, Seattle, WA.
10. Hong-Yen Hsu and Chau-Shin Hsu, Commonly Used Chinese Herb Formulas with Illustrations, 1980 rev. ed., Oriental Healing Arts Institute, Long Beach, CA.
11. Chang Minyi, Anticancer Medicinal Herbs, 1992 Hunan Science and Technology Publishing House, Changsha.
12. Pang Minxiang and He Xioahui, Studies on the leukopoietic actions of Polygonum cuspidatum and Huanghuji Mixture, Xinjiang Journal of Materia Medica 1989; 2: 33-35.
13. Chen Keji and Zhang Wenpeng, Advances on antiaging herbal medicines in China, Abstracts of Chinese Medicine 1987; 1(2): 309-330.
14. Pan Hongping, Wang Hong, and He Tingcai, Processed root tuber of Polygonum multiflorum on SOD and LPO levels in mice, China Journal of Chinese Materia Medica 1993; 18(6): 344.
15. Lien EJ, et al., Longevity-promoting agents: a survey, International Journal of Oriental Medicine 1992; 17(4): 177-186.
16. Unschuld PU, Medicine in China: History of Pharmaceutics, 1986 University of California Press, Berkeley, CA.
17. Da Liu, Taoist Health Exercise Book, 1983 Putnam Publishing Group, New York.
18. But PPH, Tomlinson B, and Lee KL, Hepatitis related to the Chinese medicine Shou-wu-pian manufactured from Polygonum multiflorum, Veterinary and Human Toxicology 1996; 38(4): 280-282.