She Xiang

Star

Moschus berezovskii Flerov, Moschus sifanicus Przewalski, Moschus moschiferus Linnaeus

Genus: Moschus Species: berezovskii Pinyin: She Xiang
Musk麝香

☯ TCM Properties

Category: opening orifices
Temperature: warm
Taste: pungent
Meridians: heart, liver, spleen
Functions:

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.

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 ketone

Concentration: 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 ketone

Concentration: Minor macrocyclic ketone

A structurally related macrocyclic ketone contributing to the aromatic and bioactive ketone fraction of musk.

Muscopyridine

Pyridine alkaloid

Concentration: 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 / sterols

Concentration: 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 / proteins

Concentration: 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

Lipids

Concentration: Minor lipophilic constituents

Free fatty acids of the glandular secretion contributing to the lipid matrix that carries the volatile ketones.

Amino acids

Amino acids

Concentration: 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 constituents

Concentration: 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

Major Evidence: Probable

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)

Moderate Evidence: Theoretical

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

FormAmount Frequency Duration Population Notes
powder 0.3-1g Daily

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.

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

Ge J, et al. (2021) Chinese Medical Journal Multicenter double-blind placebo-controlled phase IV RCT

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.

Historical Texts

Shen Nong Ben Cao Jing (Divine Farmer's Materia Medica)

Han dynasty (c. 200 CE)
Lists musk (She Xiang) in the upper (superior) class of drugs, noting its ability to open the orifices, dispel malign influences and revive consciousness.

Ben Cao Gang Mu (Compendium of Materia Medica)

Ming dynasty (1596), Li Shizhen
Gives a detailed account of musk's origin, grades and uses for opening the orifices, moving blood, reducing swelling and its strong action on the uterus.

References

  1. 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]
  2. 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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