Chou Wu Tong

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Clerodendrum trichotomum

Not yet clinically reviewed

Family: Lamiaceae Genus: Clerodendrum Species: trichotomum Pinyin: Chou Wu Tong

Synonyms: Clerodendrum trichotomum var. ferrugineum, Clerodendrum fargesii, Siphonanthus trichotomus, Siphonanthus trichotomus var. ferrugineus, Siphonanthus yakusimensis, Clerodendrum trichotomum var. yakusimense, Clerodendrum trichotomum f. ferrugineum, Clerodendrum trichotomum var. tomentosum, Clerodendrum koshunense, Clerodendrum serotinum, Siphonanthus trichotomus var. esculentus, Siphonanthus trichotomus var. fargesii, Clerodendrum trichotomum var. villosum, Clerodendrum trichotomum f. albicarpum, Clerodendrum trichotomum var. fargesii, Clerodendrum yakusimense, Ovieda trichotoma, Clerodendrum trichotomum var. esculentum

Harlequin GlorybowerPeanut Butter TreeStinking TreeChou Wu Tong臭梧桐
Chou Wu Tong

Traditionally used for

  • Headaches
  • Dizziness
  • Ears & hearing
  • Nerves & recovery
  • Pain & joints
  • Blood pressure

Cautions & contraindications

  • Heart conditions
Moderate evidence · 5 studies

☯ TCM Properties

Category: wind-damp dispelling
Temperature: cool
Taste: pungent, bitter, sweet
Meridians: liver, spleen, heart, lung
Functions:

Dispels Wind-Dampness; Calms Liver Yang and lowers Blood pressure

Traditional Chinese Uses

Chou Wu Tong (臭梧桐) is the leaf and young twig of Clerodendrum trichotomum Thunb. (Lamiaceae), Folium Clerodendri — the name, "stinking parasol tree", records the unpleasant smell of the fresh leaf. It is acrid, bitter and sweet and cool, entering the Liver channel. It dispels Wind-Dampness, and calms Liver Yang and lowers blood pressure.

It is used for Wind-Damp painful obstruction with aching, swollen joints, numbness of the limbs and lower back and knee pain, and for hemiplegia following windstroke. Its second and now more prominent use is ascendant Liver Yang with hypertension, headache, dizziness and tinnitus, where it is classically paired with Xi Xian Cao — the two together forming the traditional pairing for raised blood pressure.

The leaf is held to be most effective gathered before the plant flowers, and prolonged high heat in preparation is said to weaken its blood-pressure-lowering action.

Western Herbalism Properties

Actions:
anti-inflammatoryantihypertensiveanalgesic

Pharmacological Effects

  • Analgesic and antiinflammatory: Analgesic in mice (tail electrical stimulation); i.p. clerodendronin B 400-800 mg/kg outperformed morphine 10-20 mg/kg. Antiinflammatory only in combination with Xi Xian Cao or Gui Zhen Cao, none active alone.
  • Sedative: Sedative and prolonged pentobarbital anesthesia without hypnotic or anticonvulsant action; clerodendronin A had a sedative index greater than reserpine.
  • Hypotensive: Consistent in acute and chronic animal studies; oral hot-water extract lowered BP 16-57% in renal hypertensive rats; i.v. gave biphasic fall in dogs/rats. Mechanism mainly vasomotor-center inhibition and baroreceptor reflex, minor ganglionic block.

Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 267.

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Botanical Description

Clerodendrum trichotomum is a large deciduous shrub or small tree reaching 3-6 m tall, with a spreading habit. Leaves are broadly ovate, 8-20 cm long, opposite, with an unpleasant odor when crushed (giving rise to the Chinese name meaning "stinking parasol tree"). Fragrant, white tubular flowers are borne in lax terminal cymes in late summer. Each flower has a prominent, inflated, reddish-pink calyx that persists and enlarges in fruit. The fleshy, bright blue-turquoise berries (4-8 mm) are nestled within the star-shaped red calyx, creating a striking ornamental display.

Habitat:

Hillsides, thickets, forest margins, and roadsides; native to China, Japan, and Korea, widely cultivated as an ornamental shrub in temperate regions worldwide.

Native Region: China North-Central, China South-Central, China Southeast, Hainan, Japan, Korea, Manchuria, Philippines, Qinghai, Taiwan
Conservation Notes:

Clerodendrum trichotomum is common throughout its native range in East Asia and is widely cultivated as an ornamental. It has naturalized in some areas of North America. No conservation concerns.

Active Constituents

Acteoside (verbascoside)

Phenylethanoid (phenylpropanoid) glycoside

Concentration: Phenylpropanoids make up about 4.6 per cent of the bark and about 0.6 per cent of the leaves

The dominant phenolic of the plant and the compound most often credited with its hypotensive reputation, inhibiting angiotensin converting enzyme in vitro with an IC50 of 373.3 micrograms per millilitre. It was also identified by HPLC as the active antiviral component of the leaf extract against respiratory syncytial virus in cell culture and in mice.

Isoacteoside

Phenylethanoid (phenylpropanoid) glycoside

Concentration: Isolated from the stem alongside acteoside in bioassay-guided fractionation

An acteoside positional isomer with essentially the same angiotensin converting enzyme inhibition, IC50 376.0 micrograms per millilitre. It is one of five phenylpropanoid glycosides isolated by activity-guided fractionation of the stem extract.

Leucosceptoside A

Phenylethanoid (phenylpropanoid) glycoside

Concentration: Isolated from the ethyl acetate soluble stem extract

Inhibits angiotensin converting enzyme in vitro with an IC50 of 423.7 micrograms per millilitre, in the same weak range as the other glycosides of the group.

Martynoside

Phenylethanoid (phenylpropanoid) glycoside

Concentration: Isolated from the ethyl acetate soluble stem extract

The least potent of the five phenylpropanoid glycosides tested for angiotensin converting enzyme inhibition, IC50 524.4 micrograms per millilitre; its isomer isomartynoside gave 505.9 micrograms per millilitre.

Trichotomoside

Phenylethanoid (phenylpropanoid) glycoside

A phenylpropanoid glycoside described from this species and named after it, isolated and characterised as an antioxidant. It has no cardiovascular data of its own.

Clerodendronin B

Crystalline acid-soluble leaf principle of undetermined structural class

Concentration: Isolated as granular crystals from the leaves and twigs; 1 gram corresponds to roughly 170 grams of crude drug on the reported equivalence

Given intraperitoneally to mice at 400 to 800 mg/kg it produced hot-plate analgesia reported as stronger and longer-lasting than morphine at 10 to 20 mg/kg, with an intraperitoneal LD50 of 3.21 g/kg. Its companion clerodendronin A has an intraperitoneal LD50 of 1.84 g/kg. These are 1960 Chinese isolations whose structures were never fully settled, and the doses are parenteral and enormous relative to any oral use.

Clerodendrin A

Neoclerodane diterpene

Concentration: Isolated from the leaves by hexane-acetone extraction

One of a series of neoclerodane diterpenes, clerodendrins A, B and D through H, described from the leaves by Japanese workers. They are best known as insect feeding and oviposition stimulants for Athalia sawflies rather than for any mammalian pharmacology, and they are not the compounds behind the blood pressure effect.

Trichotomine

Bis-indole alkaloid

Concentration: Isolated from the ethanol extract of the fruits

The blue pigment of the ripe fruit, isolated with its congener trichotomine G1. It is a fruit constituent and does not belong to the leaf and twig drug used as Chou Wu Tong.

⚠ Drug Interactions

Antihypertensive drugs (ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, beta-blockers)

Moderate Evidence: Possible

The hypotensive effect of the leaf and twig water extract is one of the better-replicated findings in the Chinese pharmacology of the 1950s and 1960s: it lowered blood pressure in anaesthetised and conscious rats and dogs and in renal hypertensive rats and dogs, by oral and by parenteral routes. The mechanism has been attributed variously to central and vascular receptor effects, to direct vasodilatation with ganglionic blockade, and to increased renal blood flow with natriuresis. The candidate molecular explanation is angiotensin converting enzyme inhibition by the phenylpropanoid glycosides, but the measured IC50 values sit between 373 and 524 micrograms per millilitre, which is far too weak to be reached in plasma, so the animal effect is probably not mediated that way and the true mechanism is unsettled.

Clinical note: The herb is used in China precisely for hypertension, so a treated hypertensive patient is exactly who will be taking it. Check blood pressure at the start of treatment and after any dose change, and warn about postural symptoms. There are no human trials, so do not adjust conventional antihypertensives in anticipation of an effect.

Diuretics

Moderate Evidence: Possible

Extracts given to rats at 0.1 and 0.5 g/kg and to dogs at 0.24 g/kg lowered blood pressure by increasing renal blood flow and promoting urinary water and sodium excretion. Adding that to a loop or thiazide diuretic would be expected to compound both the volume loss and the sodium loss.

Clinical note: Watch for dehydration, postural dizziness and low sodium in older patients on a diuretic, particularly in hot weather.

Alpha-blockers, nitrates and phosphodiesterase type 5 inhibitors

Moderate Evidence: Possible

Part of the antihypertensive action reported in dogs, rabbits, cats and rats at 0.5 to 1 g/kg was attributed to direct vasodilatation together with blockade of autonomic ganglia. Ganglionic blockade abolishes the reflex vasoconstriction that defends standing blood pressure, so it stacks badly with any drug that also causes vasodilatation or blunts the reflex.

Clinical note: Advise rising slowly. Be cautious in men taking an alpha-blocker for prostatic symptoms and in anyone on a nitrate.

Dichroa febrifuga (Chang Shan, and its leaf Shu Qi)

Major Evidence: Established

This species carries the Chinese name Haizhou Changshan precisely because material from the Haizhou area of Lianyungang was once dispensed as Changshan, and Su Song described it in the Ben Cao Tu Jing under the head entry for Shu Qi, the sprout of Changshan. Changshan is Dichroa febrifuga, whose febrifugine alkaloids are powerfully emetic and have a narrow margin between antimalarial and toxic dose. The two drugs share nothing pharmacologically; the confusion is one of name and provenance, and it is baked into the classical record rather than being a modern market problem.

Clinical note: Confirm you have been supplied Clerodendrum leaf and twig and not Dichroa. Severe vomiting after a dose intended as Chou Wu Tong should raise immediate suspicion of Changshan substitution.

Sedatives, hypnotics and other central nervous system depressants

Moderate Evidence: Theoretical

Sedative activity of the decoction is a consistent finding in the same body of mid-century Chinese animal work that produced the hypotensive and analgesic data, and both recent reviews list sedation among the reproducible effects. No target has been identified and no human data exist.

Clinical note: Mention possible drowsiness, especially alongside a benzodiazepine, a Z-drug or a sedating antihistamine.

Analgesics and opioids

Minor Evidence: Theoretical

Intraperitoneal decoction above 1.65 g/kg produced measurable analgesia in mice, peaking 20 to 40 minutes after dosing and lasting about two hours, and the isolated principle clerodendronin B outperformed morphine in the hot-plate test at the doses used. Nothing is known about the receptor involved, and nothing about oral human exposure, so this is a plausibility rather than a documented interaction.

Clinical note: No action required. If a patient reports unexpectedly good pain control after adding the herb to an opioid, review the opioid dose rather than assuming tolerance has changed.

Dosage

Form Amount Frequency Duration Population Notes
decoction 4.5–15 g daily — adult Bensky, Clavey & Stöger, Chinese Herbal Medicine: Materia Medica, 3rd ed. (2004): 4.5–15 g. Add later when treating hypertension to preserve antihypertensive effect.

Dui Yao — Herb Pairs

The classical two-herb combinations this herb appears in, each with an action neither herb has alone.

with Xi Xian Cao 豨莶草

The pair dispels wind-damp and unblocks the channels, relieving joint pain and numbness; it is also used to calm hyperactive liver yang.

Wind-damp painful obstruction with aching and weak lower limbs.

Core pair of a classical formula — Xi Tong Wan, Ji Yan Liang Fang Ba Cui

Evidence Tier

Moderate evidence · 5 studies

Recorded 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.

Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description

Clinical Studies

Angiotensin converting enzyme inhibitory phenylpropanoid glycosides from Clerodendron trichotomum

Kang DG; Lee YS; Kim HJ; Lee YM; Lee HS (2003) Journal of Ethnopharmacology in vitro Verified: In vitro / animal

Bioassay-guided fractionation of the ethyl acetate soluble stem extract yielded acteoside, leucosceptoside A, martynoside, an acteoside isomer and isomartynoside. All five inhibited angiotensin converting enzyme dose-dependently, with IC50 values of 373, 423, 524, 376 and 505 micrograms per millilitre respectively. The authors propose this as at least part of the antihypertensive mechanism. The caveat a practitioner needs is that these are microgram-per-millilitre potencies, orders of magnitude weaker than a pharmaceutical ACE inhibitor, and are unlikely to be reached in plasma from an oral decoction.

Anti-Respiratory Syncytial Virus Activity of Plantago asiatica and Clerodendrum trichotomum Extracts In Vitro and In Vivo

Chathuranga K; Kim MS; Lee HC; Kim TH; Kim JH; Gayan Chathuranga WA; Ekanayaka P; Wijerathne HMSM (2019) Viruses animal

Non-cytotoxic concentrations of the extract reduced respiratory syncytial virus replication, virus-induced cell death, viral transcription and protein synthesis and syncytium formation in HEp2 and A549 cells, and oral dosing improved viral clearance from the lungs of BALB/c mice. HPLC identified acteoside as the active component of both herb extracts, and purified acteoside reproduced the effect in vitro and in vivo. Combined in vitro and animal work; there is no human antiviral data.

Trichotomoside: A New Antioxidative Phenylpropanoid Glycoside from Clerodendron trichotomum

Chae S; Kang KA; Kim JS; Hyun JW; Kang SS (2006) Chemistry & Biodiversity in vitro Verified: In vitro / animal

Isolation and structure elucidation of a new phenylpropanoid glycoside from the plant, characterised as an antioxidant. It documents the chemistry rather than any therapeutic effect.

Antioxidant Activity of Jionoside D from Clerodendron trichotomum

Chae S; Kim JS; Kang KA; Bu HD; Lee Y; Hyun JW; Kang SS (2004) Biological and Pharmaceutical Bulletin in vitro Verified: In vitro / animal

Jionoside D isolated from the plant showed antioxidant activity in cell-free and cellular assays. One of a series of Korean papers establishing the phenylpropanoid glycoside fraction as the antioxidant principle of the leaf.

Two novel polyketones from the leaves and twigs of Clerodendrum trichotomum

Gao YN; Wei JC; Qi ZB; Gao XX; Wang AH (2021) Journal of Asian Natural Products Research in vitro

Clerodendruketones A and B were isolated from the leaves and twigs, the part used as Chou Wu Tong, alongside four known compounds. Both new polyketones showed antibacterial activity against Escherichia coli and Staphylococcus aureus by turbidimetry, and one ecdysanol showed moderate DPPH radical scavenging. Chemistry paper on the correct plant part.

⚠ Safety & Contraindications

  • Heart conditions

Contraindications

When using for high blood pressure, it should not be decocted for a long time.

Source: Xi S, Gong Y. Essentials of Chinese Materia Medica and Medical Formulas. Academic Press/Elsevier, 2017, pp. 117–121.

Side Effects

  • Rats given 0.25 and 2.5 g/kg extract orally for 60 days showed no abnormalities apart from increased water intake and watery stool in a few
  • Dogs: 10 g/kg decoction orally had no effect on liver, blood or ECG; 20 g/kg caused vomiting

Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 267.

Historical Texts

Ben Cao Tu Jing (Illustrated Classic of the Materia Medica), Su Song

Northern Song dynasty, 1061 CE
The earliest description of this plant, and it appears not under its own name but under the entry for Shu Qi, the sprout of Chang Shan. Su Song writes that the material coming out of Haizhou has leaves like a catalpa, flowers red and white in the eighth month, and blue-green fruits like small chinaberries. This is the origin of the Chinese name Haizhou Chang Shan and of a conflation with Dichroa febrifuga that the drug has never entirely shaken off.

Ben Cao Gang Mu Shi Yi (Supplement to the Compendium of Materia Medica), Zhao Xuemin

Qing dynasty, 1765
The first entry under the name Chou Wu Tong, drawn from folk practice. The uses recorded are overwhelmingly external or in wine: washes for tinea of the palms and for all manner of sores and scabies, a decoction wash for tinea versicolor, soaking in wine with An Lu Zi for long-standing damp-heat swelling of the leg, taken in wine for wind-damp generally and for haemorrhoidal swelling, and pounded into a cake with tung oil for shin ulcers. The internal antihypertensive use is not classical; it dates from Chinese pharmacological work of the 1950s and 1960s.

Zhong Hua Ben Cao (Chinese Materia Medica)

Modern, 1999
Records the drug under the synonyms Chou Wu Tong, Di Wu Tong and Ai Tong Zi, and defines its modern actions as dispelling wind-damp, freeing the channels and calming the Liver, indicated for wind-damp painful obstruction, wind rash, damp sores, headache and dizziness. It also notes that the young leaves are eaten as a wild vegetable in Guizhou, Hubei, Sichuan and Yunnan, so dietary exposure is ordinary in parts of China.

Chinese pharmacological reports on Chou Wu Tong, Xu and colleagues

Modern, 1957 to 1962
The body of work that created the modern indication. It established the hypotensive effect across rats, dogs, cats and rabbits, the analgesic effect of the decoction and of clerodendronin B, and the acute toxicity figures still quoted: intraperitoneal LD50 of the water extract 20.6 g/kg in mice, intravenous LD50 19.4 g/kg in rats, and no deaths in rats given 150 g/kg by gavage within 72 hours. The same workers reported that material collected before flowering was more active than material collected after it, a harvest-timing distinction that has never been explained chemically.

References

  1. Li L; Tang Z; Xiao S; Dai X; Wang Y; Wei X. Clerodendrum trichotomum Thunb.: a review on phytochemical composition and pharmacological activities . Frontiers in Pharmacology (2025) [DOI]
  2. Gomulski J; Grzegorczyk-Karolak I. Clerodendrum trichotomum Thunberg—An Ornamental Shrub with Medical Properties . Molecules (2024) [DOI]
  3. Wang JH; Luan F; He XD; Wang Y; Li MX. Traditional uses and pharmacological properties of Clerodendrum phytochemicals . Journal of Traditional and Complementary Medicine (2018) [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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