Su He Xiang Wan (Liquid Styrax Pill)

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Indications

Western Uses:

• What is Su He Xiang Wan used for in modern practice?

  In modern Chinese practice, Su He Xiang Wan (marketed as the Suhexiang pill / Suhexiang Wan) is a licensed patent medicine studied mainly as an adjunct for acute ischemic stroke, and it is traditionally correlated with cold-pattern coma, syncope, and cold-type chest pain. A large multicenter real-world registry (SUNRISE, ClinicalTrials.gov NCT05833932) is currently following patients given the pill within seven days of acute ischemic stroke onset to assess functional recovery at three months.

  These biomedical correlates describe how the formula’s traditional cold-closed-orifice pattern maps to conditions Western medicine recognizes — they are not a claim that the formula treats any diagnosed disease. Direct clinical trial evidence remains limited (see research). Any use for a diagnosed condition belongs with a qualified practitioner and appropriate medical care.

  Source: traditional-use correlates summarized from Bensky & Barolet, Formulas & Strategies; modern-use context from PubMed 39875901. Reference only, not a treatment claim.

Originally Appeared In:

• Imperial Grace Formulary of the Tai Ping Era (Tai Ping Hui Min He Ji Ju Fang)

Notes:

• How is Su He Xiang Wan different from An Gong Niu Huang Wan?

  Su He Xiang Wan and An Gong Niu Huang Wan are the two classic emergency orifice-opening formulas, distinguished by temperature: Su He Xiang Wan treats the cold-type closed disorder, while An Gong Niu Huang Wan (together with Zhi Bao Dan and Zi Xue Dan) treats the heat-type closed disorder. Confusing the two patterns is a recognized clinical hazard — the warming aromatics of Su He Xiang Wan can aggravate a heat-type collapse, and vice versa.

  • vs An Gong Niu Huang Wan: An Gong Niu Huang Wan clears heat and toxin (Niu Huang, Huang Lian, and historically Xi Jiao/Shui Niu Jiao) for a feverish, flushed, agitated collapse; Su He Xiang Wan warms and moves qi for a pale, cold, quiet collapse.
  • Shared ingredient history: both formulas historically used Xi Jiao (Rhinoceros Horn) and Zhu Sha (Cinnabar) as restraining, spirit-settling substances — a reminder that the orifice-opening category as a whole was built around materials now largely toxic-restricted or substituted in modern manufacture.

  Source: Bensky & Barolet, Formulas & Strategies (orifice-opening formula category: warm vs cool subtypes).

Clinical Studies & Research:

• Is there modern research on Su He Xiang Wan?

  Yes — research concentrates on ischemic stroke, ranging from a large real-world clinical registry to preclinical mechanism studies, on either the whole patent-medicine pill (Suhexiang Wan) or Su He Xiang (storax) as a single ingredient. Direct randomized-trial evidence for the full 15-ingredient formula remains limited; most mechanistic work is preclinical.

  • Acute ischemic stroke (clinical registry): the SUNRISE registry protocol describes a multicenter, prospective, 1,000-patient observational study of the Suhexiang pill given within 7 days of stroke onset, tracking functional independence at 3 months (PMID 39875901).
  • Stroke mechanism (preclinical): in-silico screening combined with an oxygen-glucose-deprivation cell model identified cirsiliol as a candidate active compound with neuroprotective, anti-oxidative effects (PMID 41389492).
  • Post-stroke recovery (preclinical, single ingredient): in rats, post-stroke administration of Su He Xiang (storax) alone reduced neurological deficits and lesion size through day 28, associated with reduced brain TNF-alpha and IL-1beta expression (PMID 34343648).

  Sources: PubMed 39875901; PubMed 41389492; PubMed 34343648. Research context, not a therapeutic claim; clinical trial evidence for the full formula remains limited.