Bai Dou Kou
StarAmomum kravanh Pierre ex Gagnep.
Traditionally used for
- Digestion
☯ TCM Properties
Transforms Dampness and Moves Qi; Warms the Middle Burner and Stops Vomiting; Opens the Stomach and promotes digestion; Transforms Turbidity
Traditional Chinese Uses
Bai Dou Kou (round cardamom, white cardamom) is a warm, aromatic herb used to move Qi and transform Dampness in the middle burner. It relieves bloating, nausea, poor appetite, and abdominal fullness from Dampness obstructing the middle burner, and its aromatic warming nature allows it to dissolve cold-Dampness stagnation in the Stomach and Spleen. It also helps open and revive the Stomach when Dampness has suppressed appetite and digestive function.
Western Herbalism Properties
Used In Formulas (1)
Relationships
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Botanical Description
Amomum kravanh is a perennial rhizomatous herb in the Zingiberaceae family native to mainland Southeast Asia, especially Cambodia, Thailand and southern China. It forms dense clumps of erect leafy pseudostems 2-3 m tall arising from a stout aromatic rhizome. The lanceolate leaves are smooth, 25-50 cm long, with a prominent midrib and a sheathing base. Inflorescences emerge directly from the rhizome at ground level as short scaly spikes bearing pale yellow flowers with a striped lip. The fruit is a nearly spherical pale straw-coloured capsule about 1.5-2 cm across, splitting into three valves to reveal clusters of small, hard, dark brown seeds with a strong camphoraceous, cineole-rich aroma. The dried unopened capsules are the trade article known as round or Thai cardamom.
Active Constituents
1,8-Cineole (eucalyptol)
Monoterpenoid cyclic ether (essential oil)Concentration: The dominant volatile: 68.42% of the hydrodistilled fruit oil in one Chinese sample and 74.07% by GC-MS in another
The marker constituent of the drug and the compound that carries most of its measured activity. It is absorbed intact, being detected unchanged in rat plasma after dosing with the fruit oil, and in a rat chronic kidney disease model it reproduced the whole oil's effect on renal function and fibrosis by blocking TGF-beta/Smad and NF-kB signalling and inhibiting ferroptosis via Nrf2/HO-1. It is also the reason this drug is added late in decoction: prolonged boiling drives it off.
alpha-Pinene
Bicyclic monoterpene hydrocarbon (essential oil)Concentration: 5.71% of the fruit essential oil in the analysed Chinese material
Second most abundant volatile of the fruit oil. It contributes to the aroma and to the oil's antibacterial activity but has no separately demonstrated role in this drug.
alpha-Terpinene
Monoterpene hydrocarbon (essential oil)Concentration: 2.63% of the fruit essential oil
A minor volatile of the fruit oil, reported among the 34 components identified by GC-MS. No individual pharmacology has been established for it in this drug.
beta-Pinene
Bicyclic monoterpene hydrocarbon (essential oil)Concentration: 2.41% of the fruit essential oil
A minor volatile constituent contributing to the aromatic profile that TCM practice associates with the drug's ability to transform dampness and open the stomach.
Kravanhols C-I
Diarylheptanoids (diphenylheptanes)Concentration: Minor isolated constituents of the fruit
Seven diarylheptanoids isolated from the fruit. Four of the compounds tested inhibited LPS-induced nitric oxide production in murine macrophages with IC50 values of 17.4-26.5 µM, more potent in that assay than the dexamethasone control at 32.5 µM. This is in vitro activity of isolated compounds, not of the decoction.
Kravanhins A-D
Tetracyclic diterpenoids with isomerised isospongian skeletonConcentration: Minor isolated constituents of the fruit
Structurally unusual diterpenoids with a trans-anti-cis fused ring system, described as unprecedented skeletons when first reported from this fruit. One of them inhibited nitric oxide production in LPS-stimulated macrophages with an IC50 of 36.2 µM. They are of chemotaxonomic value for authenticating the drug.
Labdane diterpenoids
Diterpenoid (labdane class)Concentration: Minor constituents of the fruit, reported alongside the kravanhins
Three new labdane diterpenes were isolated from the fruit in the same study that described the kravanhins. Diterpenoids, together with diarylheptanoids and lignans, are considered the main non-volatile bioactive class of this drug group.
Amomumols A-J
Mixed terpenoids and neolignans (four sesquiterpenoids, three monoterpene derivatives, two neolignans, one nor-bisabolane norsesquiterpenoid)Concentration: Minor constituents isolated by activity-guided fractionation of the fruit
Ten new compounds isolated during a search for the basis of the traditional use of this fruit against hangover. In the same study eight of the isolated compounds significantly activated alcohol dehydrogenase in vitro at 50 µM, which gives the traditional anti-hangover use a plausible, though purely enzymatic and in vitro, correlate.
⚠ Drug Interactions
Myristica fragrans (Rou Dou Kou, nutmeg) substituted as a dou kou drug
In Chinese practice Amomum kravanh (Bai Dou Kou), Alpinia galanga (Hong Dou Kou), Alpinia katsumadai (Cao Dou Kou) and Myristica fragrans (Rou Dou Kou) are grouped together as cardamom drugs sharing the name dou kou, and bencaological review has shown that the name dou kou referred to different plants in different historical periods, with no settled agreement on the botanical source even now. The species are not interchangeable: Myristica fragrans seed contains myristicin and elemicin and produces psychoactive and anticholinergic toxicity at doses of a few grams, which is within the range at which an aromatic Zingiberaceae fruit would be dosed. Bai Dou Kou has no comparable toxicity.
Clinical note: Verify that a dou kou drug is Amomi Fructus Rotundus and not Semen Myristicae before dispensing, especially where a prescription is written with the bare name dou kou. Do not substitute one for another on the basis of the shared Chinese name.
Other Zingiberaceae cardamom fruits (Amomum compactum, Amomum subulatum, Amomum tsao-ko, Elettaria cardamomum, Alpinia species)
A comparative anatomy study of Alpinia galanga, Alpinia katsumadai, Alpinia zerumbet, Amomum kravanh, Amomum subulatum, Amomum tsao-ko and Elettaria cardamomum found that the seeds of these three genera could not be told apart to species level on macroscopic features, and required transverse-section microscopy of the seed coat. The Chinese Pharmacopoeia itself accepts two source species for Amomi Fructus Rotundus, Amomum kravanh and Amomum compactum, and a 1982 quality comparison of Chinese Bai Dou Kou against Java Bai Dou Kou (A. compactum) and Thai xiao bai dou kou treated them as distinguishable in quality. Essentially all of the modern chemistry cited in this monograph, including the kravanhins, kravanhols and amomumols, was generated on material identified as Amomum kravanh.
Clinical note: Buy on microscopic or chromatographic authentication rather than appearance. Where a study is cited in support of this drug, check which of the cardamom species it actually used.
CYP3A4 substrates (for example ciclosporin, midazolam, statins, calcium channel blockers)
1,8-Cineole, which makes up roughly 70% of this drug's essential oil, is a high-turnover substrate of human CYP3A4: in human liver microsomes its 2-hydroxylation correlated with CYP3A4 content, was strongly inhibited by ketoconazole and anti-CYP3A4 IgG, and was fastest with recombinant CYP3A4. In rats, oral 1,8-cineole at 200-800 mg/kg for three days dose-dependently induced CYP2B1/2 and CYP3A1/2, and pretreatment at 800 mg/kg potentiated thioacetamide hepatotoxicity by increasing metabolic activation. Older work also found 1,8-cineole raised rat CYP2B1 and 3A2 levels. These are rodent doses far above the cineole a patient receives from a decoction of a few grams of fruit, and no human interaction study exists.
Clinical note: No dose adjustment is indicated for ordinary decoction use. Flag only where a concentrated essential-oil preparation is being taken alongside a narrow-therapeutic-index CYP3A4 substrate, and monitor rather than pre-emptively adjust.
Ethanol
The traditional use of this fruit to relieve hangover prompted an activity-guided isolation study in which eight constituents significantly activated alcohol dehydrogenase in vitro at 50 µM. Activation of an isolated enzyme is a long way from an effect on blood alcohol in a person, and no pharmacokinetic study in animals or humans has followed it up.
Clinical note: Do not present this herb as a treatment for alcohol intoxication or as protective against drink-driving impairment. The evidence supports the traditional indication only at the level of an enzyme assay.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction (added late) | 3–6 g | Daily | — | — | 中国药典 2020 monograph 【豆蔻】【用法与用量】3～6g，后下。 【性味与归经】辛，温。归肺、脾、胃经。 — Matched by hand: Amomum kravanh is the ChP source of 豆蔻; 白豆蔻 is the same article. Chinese Pharmacopoeia 2020, quoted verbatim. |
Dui Yao — Herb Pairs
The classical two-herb combinations this herb appears in, each with an action neither herb has alone.
Aromatic, warming herbs that together transform dampness, move qi and warm the middle, stopping nausea and vomiting.
Damp obstruction of the middle burner with poor appetite, nausea and distention.
Named pairing — Lü Jingshan, Shi Jinmo Dui Yao
Evidence Tier
Moderate evidence · 8 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
0
Randomized controlled trial
0
Other clinical trial
0
Observational / case report
0
In vitro / animal
8
4 verified · 4 unverified
Show 8 studies
- Nephroprotective effects of Amomum kravanh essential oil by inhibition of ferroptosis regulated by Nrf2/HO-1 signaling pathway
- Chemical Composition, Antibacterial Activity, and Mechanism of Action of the Essential Oil from Amomum kravanh
- Chemical Constituents from the Fruits of Amomum kravanh and Their Role in Activating Alcohol Dehydrogenase
- Diarylheptanoids with NO production inhibitory activity from Amomum kravanh
- Tetracyclic Diterpenoids with Isomerized Isospongian Skeleton and Labdane Diterpenoids from the Fruits of Amomum kravanh
- Identification of seven Zingiberaceous species based on comparative anatomy of microscopic characteristics of seeds
- Antioxidant, DNA damage protective, antibacterial activities and nitrite scavenging ability of essential oil of Amomum kravanh from China
- Pretreatment with 1,8-cineole potentiates thioacetamide-induced hepatotoxicity and immunosuppression
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Nephroprotective effects of Amomum kravanh essential oil by inhibition of ferroptosis regulated by Nrf2/HO-1 signaling pathway
Rats with chronic kidney disease induced by adenine and 5/6 nephrectomy were treated with the fruit essential oil, which improved renal biochemistry and reduced fibrosis on H and E and Masson staining. GC-MS identified 33 oil components with eucalyptol predominant at 74.07%, and eucalyptol was detected unchanged in blood. Eucalyptol alone reproduced the effect, acting through TGF-beta/Smad and NF-kB blockade and inhibition of ferroptosis via Nrf2/HO-1. This supports the Mongolian and Tibetan use of the drug for kidney disorders, in rats only.
Chemical Composition, Antibacterial Activity, and Mechanism of Action of the Essential Oil from Amomum kravanh
GC-MS of hydrodistilled fruit oil identified 34 components, with 1,8-cineole at 68.42%, alpha-pinene 5.71%, alpha-terpinene 2.63% and beta-pinene 2.41%. The oil was bacteriostatic against Bacillus subtilis and Escherichia coli after 12 h at the MIC, and membrane permeability, constituent-release and electron microscopy work indicated disruption of the cell wall and membrane. This is the reference composition analysis for Chinese-sourced material.
Chemical Constituents from the Fruits of Amomum kravanh and Their Role in Activating Alcohol Dehydrogenase
Activity-guided separation of the fruits yielded ten new compounds (amomumols A-J: four sesquiterpenoids, three monoterpene derivatives, two neolignans and a nor-bisabolane norsesquiterpenoid) plus thirty-five known compounds. Eight of the isolates significantly activated alcohol dehydrogenase at 50 µM in vitro. The study was framed explicitly as testing whether the traditional anti-hangover use has a chemical basis.
Diarylheptanoids with NO production inhibitory activity from Amomum kravanh
Seven new diarylheptanoids, kravanhols C-I, were isolated from the fruits along with two known analogues. Four compounds inhibited LPS-induced nitric oxide production in RAW264.7 macrophages with IC50 values of 17.4-26.5 µM, better than the dexamethasone positive control at 32.5 µM. Isolated-compound in vitro data.
Tetracyclic Diterpenoids with Isomerized Isospongian Skeleton and Labdane Diterpenoids from the Fruits of Amomum kravanh
Four novel diterpenoids (kravanhins A-D, three of them tetracyclic with an isomerised isospongian skeleton) and three new labdane diterpenes were isolated from the fruits, with structures settled by NMR, CD and X-ray crystallography. One compound inhibited nitric oxide production in LPS-induced RAW264.7 macrophages with an IC50 of 36.2 µM.
Identification of seven Zingiberaceous species based on comparative anatomy of microscopic characteristics of seeds
Comparative seed-coat anatomy of Alpinia galanga, Alpinia katsumadai, Alpinia zerumbet, Amomum kravanh, Amomum subulatum, Amomum tsao-ko and Elettaria cardamomum. The authors found that the seeds could not be identified to species from macroscopic features but could be separated by a dichotomous key built on transverse-section microscopy. Directly relevant to the substitution risk that attaches to this drug.
Antioxidant, DNA damage protective, antibacterial activities and nitrite scavenging ability of essential oil of Amomum kravanh from China
Characterisation of the antioxidant, DNA-damage-protective, antibacterial and nitrite-scavenging properties of the fruit essential oil from Chinese material. Adds to the in vitro profile of the volatile fraction; no in vivo or human component.
Pretreatment with 1,8-cineole potentiates thioacetamide-induced hepatotoxicity and immunosuppression
Oral 1,8-cineole at 200, 400 and 800 mg/kg for three days dose-dependently induced rat liver CYP2B1/2 and CYP3A1/2. Cineole alone caused no hepatotoxicity, but pretreatment at 800 mg/kg significantly potentiated thioacetamide hepatotoxicity in rats and the antibody response in mice, by increasing metabolic activation. Included here because 1,8-cineole is the dominant constituent of this drug's oil, with the caveat that these doses far exceed decoction exposure.
Historical Texts
Kai Bao Ben Cao (Materia Medica of the Kaibao Era)
Northern Song, 973-974 CEBencaological (materia medica philology) review of the drugs named dou kou, Wu Menghua and colleagues, Hong Kong Baptist University
Historical range surveyed from the classical bencao literature to modern market material; published 2012Pharmacopoeia of the People's Republic of China, monograph on Amomi Fructus Rotundus (Dou Kou / Bai Dou Kou)
Modern standard, current editionReferences
- Yang X; Xie J; Zhang Q; Su S; Wang T; Gao H; Zhao L; Renzhen W; Su J; Zhang Y. Fructus Amomi Rotundus, Fructus Galangae, Semen Alpiniae Katsumadai and Semen Myristicae comparison of traditional medicinal uses, phytoconstituents, bioactivities . Journal of Ethnopharmacology (2026) [DOI]
- Luo JG; Yin H; Kong LY. Monoterpenes from the fruits of Amomum kravanh . Journal of Asian Natural Products Research (2014) [DOI]
- Miyazawa M; Shindo M; Shimada T. Oxidation of 1,8-cineole, the monoterpene cyclic ether originated from eucalyptus polybractea, by cytochrome P450 3A enzymes in rat and human liver microsomes . Drug Metabolism and Disposition (2001)
- Hiroi T; Miyazaki Y; Kobayashi Y; Imaoka S; Funae Y. Induction of hepatic P450s in rat by essential wood and leaf oils . Xenobiotica (1995) [DOI]
- Menghua W. New bencaological studies of traditional Chinese medicine after name "Doukou" . China Journal of Chinese Materia Medica (2012) [DOI]
- Jia ZC. Quality comparison of Bai-Dou-Kou (Amomum kravanh) Java Bai-Dou-Kou (A. compactum) and Thailand Xiao-Bai-Dou-Kou . Zhong Yao Tong Bao (Bulletin of Chinese Materia Medica) (1982)
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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