She Xiang
StarMoschus berezovskii Flerov, Moschus sifanicus Przewalski, Moschus moschiferus Linnaeus
Traditionally used for
- Cough & breathing
- Heart & circulation
Cautions & contraindications
- Pregnancy
☯ TCM Properties
Opens the Orifices and Revives Consciousness; Invigorates Blood and Unblocks the Channels and Collaterals; Reduces Swelling and Alleviates Pain; Resolves Toxicity and Dissipates Nodules; Facilitates delivery and expels stillbirth
Traditional Chinese Uses
She Xiang (musk, moschus) is one of the most intensely aromatic and penetrating substances in Chinese medicine, used to open the orifices, revive consciousness, and invigorate Blood in emergency situations. It is applied for sudden loss of consciousness, coma from stroke, and cardiac events from Phlegm-Blood obstruction. Its Blood-activating and channel-opening properties address pain from traumatic injury and Blood stasis. It is also used topically for localized pain and carbuncles, and plays a role in calming the fetus. Due to musk deer's endangered status, synthetic alternatives are now commonly used.
Pharmacological Effects
- CNS (biphasic): In rats, low-dose muscone had no effect on conditioned reflexes, medium doses altered them and 1 mg/kg was toxic; low doses of musk or muscone shortened barbiturate sleep in mice/rats while high doses prolonged it (stimulation at low, inhibition at high dose).
- Cardiotonic: Musk extract/solution increased contractility of toad, frog and isolated rabbit hearts; perfused muscone at 0.04 mg/ml reduced contractility dose-dependently.
- Antiinflammatory and antibacterial: Aqueous extract inhibited acetic-acid vascular permeability in mice and croton-oil ear inflammation, and leukocyte migration in vitro; less effective against late-stage granuloma; dilute tincture inhibited S. aureus, E. coli and Salmonella suipestifer.
- Uterotonic: 5% ethanolic extract stimulated isolated and in-situ uteri of several species, more so in late pregnancy; muscone (10-50 μg/ml) also stimulated rat/mouse uteri.
- Androgenic: Ether extract, muscone and several androstane constituents given s.c. increased prostate and seminal vesicle weight in castrated rats.
Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 537.
Relationships
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Botanical Description
She Xiang is musk, the dried secretion of the preputial musk gland of mature male musk deer (genus Moschus, especially M. moschiferus, M. berezovskii, and M. chrysogaster), small solitary nocturnal ungulates inhabiting forested mountains across the Himalayas, Tibetan Plateau, and northern East Asia. Adult males possess a unique sac-like gland located between the navel and the genitals which fills with a reddish-brown waxy secretion during the rutting season; once dried this hardens into dark brown-black granules with an intensely penetrating, animalic-sweet aroma owing chiefly to the macrocyclic ketone muscone. Musk-deer species are CITES Appendix I or II listed and are critically threatened by poaching. Synthetic muscone and cultured-gland musk now substitute in most contemporary preparations. This is an animal product, not a plant.
Active Constituents
Muscone (3-methylcyclopentadecan-1-one)
Macrocyclic ketoneConcentration: Chinese Pharmacopoeia requires >=2.0% (typically ~1-3%); principal active
The chief odour-bearing and pharmacologically active compound of musk. Muscone shows neuroprotective, anti-inflammatory, antioxidant and cardioprotective effects and is central to the orifice-opening and channel-invigorating actions of the drug.
Normuscone (cyclopentadecanone)
Macrocyclic ketoneConcentration: Minor macrocyclic ketone
A structurally related macrocyclic ketone contributing to the aromatic and bioactive ketone fraction of musk.
Muscopyridine
Pyridine alkaloidConcentration: Minor nitrogenous constituent
A characteristic pyridine base of musk that forms part of its distinctive chemical signature and contributes to biological activity.
Steroids (cholesterol, androstane/testosterone-type)
Steroids / sterolsConcentration: Present as a notable lipophilic fraction
Cholesterol and androstane-type steroids of glandular origin; androgenic steroids may relate to the reputed circulation-invigorating and tissue-stimulating effects.
Peptides and proteins (musk protein, 'musclide')
Peptides / proteinsConcentration: Large proportion of the crude drug by mass
Proteinaceous and peptide material that carries anti-inflammatory activity and has been linked in laboratory studies to the immunomodulatory effects of musk.
Fatty acids
LipidsConcentration: Minor lipophilic constituents
Free fatty acids of the glandular secretion contributing to the lipid matrix that carries the volatile ketones.
Amino acids
Amino acidsConcentration: Present (free amino-acid fraction)
Free amino acids identified in musk that form part of the water-soluble, potentially bioactive fraction.
Inorganic salts and trace elements
Inorganic constituentsConcentration: Present as ash/mineral fraction
Mineral salts of the secretion; part of the overall composition though not primary to the therapeutic action.
⚠ Drug Interactions
Oxytocin and other uterotonic/oxytocic drugs
Musk is a potent uterine stimulant that markedly increases the frequency and intensity of uterine contractions, particularly in the pregnant uterus. Combined with oxytocic drugs it could additively provoke uterine hyperstimulation.
Clinical note: Absolutely contraindicated in pregnancy (internal and topical). Do not combine with uterotonic agents outside a controlled obstetric setting.
Anticoagulant and antiplatelet drugs (e.g. warfarin, aspirin, clopidogrel)
Musk strongly invigorates blood and unblocks the channels, and muscone has vascular/antithrombotic-type activity in experimental models, so co-use with anticoagulants or antiplatelets could theoretically increase bleeding tendency.
Clinical note: Use cautiously with anticoagulant/antiplatelet therapy and monitor for bruising or bleeding.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction, or powder/pills | 0.03–0.1 g | Daily | — | — | 中国药典 2020 【用法与用量】0.03~0.1g，多入丸散用。外用适量。 【注意】孕妇禁用。 【性味与归经】辛，温。归心、脾经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Preparation Methods
Powder taken directly (chong fu), added to pills or formulas
Parts: Dried glandular secretion (musk grains)
Because the active ketones are volatile, musk is never boiled. A very small dose (about 0.03-0.1 g) of the powder is swallowed directly with liquid or incorporated into pills and powders, as in classic orifice-opening formulas.
Topical application
Parts: Dried glandular secretion (musk grains)
Incorporated into plasters, ointments and medicated preparations applied over sores, swellings, trauma and painful obstruction to reduce swelling, move blood and relieve pain. Not to be applied in pregnancy.
Dui Yao — Herb Pairs
The classical two-herb combinations this herb appears in, each with an action neither herb has alone.
Mutually reinforce aromatic opening of the orifices to revive consciousness; also used together topically to reduce swelling and stop pain.
Contraindicated in pregnancy; for closed (bi) patterns only, not collapse (tuo).
Named pairing — Zhong Yao Xue national textbook, pei wu discussion
Clearing heat, transforming phlegm and resolving toxin combines with aromatic opening of the orifices, so heat-phlegm blocking the pericardium is both cleared and opened.
For high fever with delirium or loss of consciousness from heat entering the pericardium. Contraindicated in pregnancy.
Core pair of a classical formula — An Gong Niu Huang Wan, Wen Bing Tiao Bian (Wu Jutang)
Warm aromatic opening of the orifices combined, dispelling cold and turbidity to revive consciousness in cold closed patterns.
Cold closed pattern; not for hot closed patterns or collapse.
Core pair of a classical formula — Su He Xiang Wan, Tai Ping Hui Min He Ji Ju Fang
Evidence Tier
Moderate evidence · 1 studyRecorded 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
1
1 verified · 0 unverified
Other clinical trial
0
Observational / case report
0
In vitro / animal
0
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
Efficacy and safety of Shexiang Baoxin pill (MUSKARDIA) in patients with stable coronary artery disease: a multicenter, double-blind, placebo-controlled phase IV randomized clinical trial
The MUSKARDIA (MUST) trial evaluated the musk-containing compound Shexiang Baoxin Pill added to standard therapy in patients with stable coronary artery disease. The trial assessed major adverse cardiovascular events and reported an acceptable safety profile, providing controlled clinical evidence for a musk-based preparation in cardiovascular disease.
⚠ Safety & Contraindications
- Pregnancy
Contraindications
Shouldn’t be decocted with water. And its use is prohibited in pregnant women.
Source: Xi S, Gong Y. Essentials of Chinese Materia Medica and Medical Formulas. Academic Press/Elsevier, 2017, pp. 323–326.
⚠ 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.
Pregnancy
Avoid uterine stimulant
Historical Texts
Shen Nong Ben Cao Jing (Divine Farmer's Materia Medica)
Han dynasty (c. 200 CE)Ben Cao Gang Mu (Compendium of Materia Medica)
Ming dynasty (1596), Li ShizhenReferences
- Liu K, Xie L, Deng M, et al.. Zoology, chemical composition, pharmacology, quality control and future perspective of Musk (Moschus): a review . Chinese Medicine (2021) [DOI]
- Ge J, et al.. Efficacy and safety of Shexiang Baoxin pill (MUSKARDIA) in patients with stable coronary artery disease: a phase IV randomized clinical trial . Chinese Medical Journal (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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