Bai Ji
StarBletilla striata (Thunb.) Rchb.f.
Traditionally used for
- Cough & breathing
- Digestion
- Skin
Cautions & contraindications
- Heart conditions
☯ TCM Properties
Astringes and Stops Bleeding; Reduces Swelling and Promotes Tissue Regeneration; Promotes Tissue Regeneration and Heals Sores
Traditional Chinese Uses
Bai Ji (bletilla rhizome) is an astringent, cool herb used in Chinese medicine primarily to stop bleeding from the Lungs and Stomach and to promote wound healing. It is a key herb for coughing up blood from Lung conditions, stomach hemorrhage from ulcers, and external traumatic bleeding. Its tissue-regenerating action reduces swellings, facilitates the healing of chronic sores, and promotes the closure of wounds. Modern applications include its use in injectable preparations for gastrointestinal bleeding and wound management formulas.
Western Herbalism Properties
Pharmacological Effects
- Hemostatic: Topical powder hemostatic, causing leukocyte aggregation and artificial thrombi at capillary ends; shortened coagulation and prothrombin times in rabbits.
- Antimicrobial: The phenanthrene/bibenzyl compounds were mainly active against gram-positive bacteria, weakly against some fungi; two bibenzyls most active.
Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 421.
Relationships
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Botanical Description
Bletilla striata (Orchidaceae), the hyacinth orchid or Bai Ji, is a hardy terrestrial orchid 30-70 cm tall arising from compressed, flattened, fleshy pseudobulbs (corms) that bear concentric leaf scars and grow in chains beneath the soil. Three to six lanceolate, pleated, parallel-veined leaves 8-30 cm long clasp the lower stem. A terminal raceme bears 3-10 showy magenta to purplish-pink flowers 3-5 cm across in late spring, each with a fringed, ruffled lip. Native to wooded slopes, valleys, and rocky grasslands of central and southern China, Japan, and Korea. The pseudobulbs are harvested in summer or autumn, the fibrous rootlets removed, then briefly boiled and sun-dried into yellowish-white, translucent, gummy slices. (Sources: POWO; Wikipedia; Bensky)
Active Constituents
Bletilla striata polysaccharide (BSP)
Glucomannan polysaccharideConcentration: the principal bulk constituent of the tuber; a high-molecular-weight, viscous glucomannan of D-glucose and D-mannose, with no single agreed content figure across the reviews
The main pharmacologically active fraction and the reason the drug behaves as it does clinically. It is immunomodulatory, antioxidant, antifibrotic and haemostatic, and its viscosity is not incidental: it is what lets the drug form a protective film over damaged mucosa and what makes it usable as a vascular embolising agent. Twenty-two distinct polysaccharides have been characterised from the tuber.
Militarine
Glucosyloxybenzyl 2-isobutylmalateConcentration: abundant in the tuber; designated the HPLC quality-control marker for the drug by the Chinese Pharmacopoeia Commission
The compound the Pharmacopoeia uses to decide whether a lot of Bai Ji is up to standard, quantified by HPLC. A militarine assay is therefore the most practical single check that a sample is genuine Bletilla striata rather than a substitute or a depleted lot.
Dactylorhin A
Glucosyloxybenzyl malate glycosideConcentration: not quantified
One of the characteristic glucosyloxybenzyl glycosides of the tuber, structurally close to militarine and reported across the phytochemical surveys of this species.
Gymnosides I, II, V, IX and X
Glucosyloxybenzyl glycosidesConcentration: not quantified
A further series of glucosyloxybenzyl glycosides from the tuber, part of the same biosynthetic family as militarine and dactylorhin A.
Bibenzyls
Bibenzyl (dihydrostilbene) phenolicsConcentration: 28 distinct bibenzyls have been characterised from the tuber
The largest phenolic class in the drug. Bibenzyls and the related phenanthrenes carry much of its anti-inflammatory and antimicrobial activity, several suppressing nitric oxide production in LPS-stimulated macrophages.
Phenanthrenes and 9,10-dihydrophenanthrenes
Phenanthrene and dihydrophenanthrene phenolicsConcentration: not quantified; multiple substituted variants and biphenanthrene dimers reported
An orchid-characteristic phenolic class. Zhou and colleagues isolated and optically resolved a series of these from the tuber and demonstrated antineuroinflammatory activity, with the two enantiomers of a resolved pair behaving differently, which is a reminder that stereochemistry matters here.
⚠ Drug Interactions
Aconitum preparations (Chuan Wu, Cao Wu, Fu Zi; Aconitum carmichaelii and Aconitum kusnezoffii)
This is the classical Eighteen Incompatibilities pairing, and its source text is unusually explicit. The Shen Nong Ben Cao Jing's supplement on restrainers and envoys states that Wu Tou clashes with Ban Xia, Gua Lou, Bei Mu, Bai Lian and Bai Ji, so the prohibition is not a later gloss. On the modern side, Xu and colleagues report that Bletilla striata cannot be combined with Aconitum carmichaelii because the combination enhances hypaconitine content and may produce an abnormal heart rate. Aconitum alkaloid pharmacokinetics are demonstrably altered by co-decocted herbs, so the direction of the claim is plausible, but a controlled pharmacokinetic study of this specific pair has not been published, which is why this is graded possible rather than established.
Clinical note: Do not combine. Aconite's therapeutic window is narrow enough that a plausible mechanism for increased alkaloid exposure is sufficient reason to keep the pair apart, and both the classical prohibition and modern regulatory practice in China treat it as absolute. Check patent formulas and granule blends for hidden aconite before adding Bai Ji.
Warfarin, direct oral anticoagulants and antiplatelet agents
Bai Ji's defining action is haemostasis, and its polysaccharide fraction participates in multiple haemostatic processes; it is used clinically as a vascular embolising agent precisely because it occludes vessels. Combining a haemostatic drug with therapeutic anticoagulation is a pharmacodynamic opposition on its face. No clinical case of anticoagulant failure attributable to Bai Ji has been published, so this is an inference from mechanism, not a documented event.
Clinical note: In a patient anticoagulated for a thrombotic indication, prefer a different haemostatic strategy or monitor INR after starting. There is no evidence for a metabolic interaction, so INR is a screening measure rather than an expected finding.
Co-administered oral drugs with narrow therapeutic windows (e.g. levothyroxine, digoxin)
The active fraction is a high-molecular-weight viscous glucomannan whose therapeutic mechanism in gastric and duodenal ulcer is the formation of a protective film over the mucosa. A gel-forming mucosal coat is the same physical arrangement that reduces the absorption of co-ingested drugs for other viscous soluble fibres. No absorption study has been done for this drug, so the concern is mechanistic only.
Clinical note: Separate Bai Ji from narrow-therapeutic-index oral drugs by about two hours, as one would for any mucilaginous herb. This costs nothing and removes the question.
Wild-collected Bletilla rhizome and internationally traded raw material (CITES Appendix II)
Bletilla striata is an orchid, and the whole of Orchidaceae is listed in CITES Appendix II, so international trade in the rhizome requires permits and a non-detriment finding. The Chinese Scientific Authority reviewed the harvest and trade of this species in 2019 in response to wild-collection pressure. At CoP19 in Panama City in 2022 the Parties amended annotation #4 to exempt finished products, packaged and ready for retail, containing parts of artificially propagated Bletilla striata, alongside Gastrodia elata, Cycnoches cooperi, Phalaenopsis amabilis and Phalaenopsis lobbii; Decisions 19.268 to 19.271 were adopted at the same meeting to monitor whether wild material leaks into trade through that exemption. The exemption covers finished retail cosmetic products only. Raw and bulk medicinal rhizome, which is what a dispensary buys, is not exempt.
Clinical note: Bulk rhizome crossing a border needs CITES paperwork; a finished retail cosmetic containing artificially propagated material does not. Prefer cultivated material, and where the Pharmacopoeia identity matters use the militarine HPLC assay rather than relying on appearance, since scarcity of wild material is exactly the condition under which substitution appears.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction, or powder/pills | 6–15 g | Daily | — | — | 中国药典 2020 【用法与用量】6～15g；研末吞服3～6g。外用适量。 【注意】不宜与川乌、制川乌、草乌、制草乌、附子同用。 【性味与归经】苦、甘、涩，微寒。归肺、肝、胃经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Evidence Tier
Moderate evidence · 3 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
1
0 verified · 1 unverified
In vitro / animal
2
1 verified · 1 unverified
Show 2 studies
- Isolation, Structural Elucidation, Optical Resolution, and Antineuroinflammatory Activity of Phenanthrene and 9,10-Dihydrophenanthrene Derivatives from Bletilla striata
- Structural characterization of a low molecular weight Bletilla striata polysaccharide and antitumor activity on H22 tumor-bearing mice
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
Bletilla striata as a vascular embolizing agent in interventional treatment of primary hepatic carcinoma
Between October 1991 and January 1995, 56 patients with primary hepatic carcinoma underwent hepatic arterial chemoembolisation using a Bletilla striata angioembolus, with 50 patients treated by conventional gelfoam embolisation as controls, followed for 10 to 48 months. The Bletilla powder produced extensive and permanent vascular obstruction with marked tumour shrinkage and a significant fall in serum alpha-fetoprotein, less subsequent collateral circulation, and a treatment interval extended to about 7 months. One-, two- and three-year survival was 81.9%, 44.9% and 33.6%, with mean survival 19.8 months. This is a controlled interventional-radiology application of the polysaccharide as a physical embolising material, not oral herbal therapy, and it is a non-randomised comparison.
Isolation, Structural Elucidation, Optical Resolution, and Antineuroinflammatory Activity of Phenanthrene and 9,10-Dihydrophenanthrene Derivatives from Bletilla striata
Phenanthrene and 9,10-dihydrophenanthrene derivatives were isolated from the tuber, their structures elucidated and enantiomers optically resolved, and their antineuroinflammatory activity assessed. The resolution step matters: it shows that activity in this class is stereochemistry-dependent, so a racemic total-extract figure understates what individual enantiomers do.
Structural characterization of a low molecular weight Bletilla striata polysaccharide and antitumor activity on H22 tumor-bearing mice
A low-molecular-weight polysaccharide was isolated from Bletilla striata, structurally characterised, and tested in H22 tumour-bearing mice, where it inhibited tumour growth with evidence of immune-mediated mechanism. Note that this is a deliberately depolymerised fraction: the high-molecular-weight native polysaccharide is the one responsible for the drug's mucosal-film and embolising behaviour, so the two are not interchangeable.
⚠ Safety & Contraindications
- Heart conditions
Contraindications
It is not suited to combine with Radix Aconiti ( chuan wu ), Radix Aconiti Kusnezoffii ( cao wu ) and Radix Aconiti Lateralis Praeparata ( fu zi ) to use.
Source: Xi S, Gong Y. Essentials of Chinese Materia Medica and Medical Formulas. Academic Press/Elsevier, 2017, pp. 219–222.
⚠ Rule-Based Cautions
These entries come from the deterministic rule tables that gate Verscienta's formula tools — classical pair prohibitions, pregnancy and lactation contraindications, and dose ceilings.
Incompatibilities (十八反 / 十九畏)
- 十八反: Wu Tou × Bai Ji — avoid combining with Fu Zi / Aconite / Aconitum / Chuan Wu / Cao Wu / Wu Tou / Shu Fu / Hei Shun Pian / Fu Pian / Guan Bai Fu / Xue Shang Yi Zhi Hao / Aconitum brachypodum
Historical Texts
Shen Nong Ben Cao Jing
Han dynastyReferences
- Delin Xu, Yinchi Pan, Jishuang Chen. Chemical Constituents, Pharmacologic Properties, and Clinical Applications of Bletilla striata . Frontiers in Pharmacology (2019) [DOI]
- Xiaolong Ji, Mingsong Yin, Hui Nie, Yanqi Liu. A Review of Isolation, Chemical Properties, and Bioactivities of Polysaccharides from Bletilla striata . BioMed Research International (2020) [DOI]
- Yi-Tong Sun, Fang Zhou, Hong-Xin Zheng, Jing-Dong Xiao. Clinical efficacy and mechanism of Bletilla striata and Chinese herbal compounds in treatment of peptic ulcer . World Journal of Gastroenterology (2025) [DOI]
- Yau-Tuen Chan, Ning Wang, Yibin Feng. The toxicology and detoxification of Aconitum: traditional and modern views . Chinese Medicine (2021) [DOI]
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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