Shi Jun Zi
StarQuisqualis indica L.
Traditionally used for
- Digestion
Cautions & contraindications
- Young children
- Heart conditions
- Seizure disorders
- Toxic — professional use only
☯ TCM Properties
Expels Parasites; Resolves Accumulation; Strengthens the Spleen to relieve childhood nutritional impairment
Traditional Chinese Uses
Shi Jun Zi (quisqualis fruit, rangoon creeper fruit) is a sweet, warm herb used in Chinese medicine primarily as a gentle, safe antiparasitic for children. It expels roundworms and other intestinal parasites without harming the child's digestive Qi. As one of the most palatable antiparasitic herbs — often described as tasting like fried seeds — it has been a preferred remedy for intestinal parasites in pediatric Chinese medicine for centuries.
Western Herbalism Properties
Relationships
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Botanical Description
Combretum indicum (L.) DeFilipps (syn. Quisqualis indica L., Combretaceae), the Rangoon creeper, is a woody perennial climbing vine native to tropical Asia, reaching 4-8 m on supports, with opposite ovate leaves and showy fragrant tubular flowers that open white and turn pink then deep red. It produces ellipsoid five-angled fruits about 3 cm long, brown when ripe, each containing a single seed. The medicinal Shi Jun Zi is the dried mature fruit, harvested in autumn, brown-black externally with longitudinal ridges, enclosing the oily seed used internally for the active constituents. The seeds contain quisqualic acid (an excitatory amino acid analogue), fatty oil, trigonelline, and sucrose. In traditional Chinese medicine, Shi Jun Zi is sweet and warm, entering the spleen and stomach channels; it kills parasites, particularly roundworm (Ascaris) and pinworm, and strengthens the spleen to reduce childhood food accumulation, used especially in pediatric formulas. Overdose causes hiccups, nausea, and dizziness.
Active Constituents
Quisqualic acid, largely present as its potassium salt
Non-protein excitatory amino acid (3-amino-3-carboxypropyl oxadiazolidinedione)Concentration: Concentrated in the seed kernel; reported content varies with geographical origin and no single reliable figure applies to the commercial drug
The anthelmintic principle and the toxic principle are the same molecule. Its structure mimics L-glutamate, and it acts as an agonist at AMPA receptors and at group I metabotropic glutamate receptors. In helminths this disrupts glutamatergic neuromuscular transmission, producing the paralysis that underlies the drug's activity against Ascaris and pinworm. In mammals the same activity makes it a potent excitotoxin, used experimentally to produce excitotoxic lesions and limbic seizures. Chinese sources name quisqualic acid explicitly as the toxic constituent responsible for the hiccup, nausea, vomiting, diarrhoea and dizziness of overdose. Its structure was determined by Takemoto and colleagues in 1975.
Fixed oil of the kernel (oleic, linoleic, palmitic, stearic and arachidic acids)
Triacylglycerol fatty acid mixtureConcentration: The kernel is oil-rich; quantitative figures in the literature are inconsistent and are not reproduced here
Bulk lipid of the seed. It contributes to the laxative tendency of larger doses but has no anthelmintic activity of its own.
Trigonelline
Pyridine alkaloid (N-methylnicotinic acid betaine)Concentration: Reported as a constituent of Quisqualis fructus; not quantified consistently
A minor alkaloid reported in the fruit. It is not established as contributing to the anthelmintic effect and is best treated as a marker rather than an active.
Betulinic acid
Lupane-type pentacyclic triterpeneConcentration: Isolated from the methanol extract of the fruit; not quantified
Isolated from Quisqualis fructus alongside clerosterol and methyl ursolate. A widely distributed triterpene with in vitro cytotoxic and anti-inflammatory activity, it plays no established part in the anthelmintic action of the drug.
Clerosterol and its 3-O-acylglucoside
Sterol and acylglycosyl sterolConcentration: Isolated from the fruit; not quantified
Structural sterols of the fruit, one of which, 3-O-[6'-O-(8Z-octadecenoyl)-beta-D-glucopyranosyl]-clerosterol, was described as new from this species in 2003. No pharmacological role is established.
⚠ Drug Interactions
Hot or strong tea (Camellia sinensis), taken with or shortly after the dose
This is a specific and well documented incompatibility recorded consistently across the Chinese materia medica: taking Shi Jun Zi with hot tea provokes hiccup and diarrhoea, and standard practice is to avoid strong tea for the duration of treatment. The reaction is attributed to the same quisqualic acid that carries the anthelmintic effect, whose adverse-effect profile of hiccup, dizziness, vomiting and diarrhoea is dose-related, so the practical reading is that tea increases either the extraction or the systemic delivery of the toxic principle. The exact pharmacological basis has not been established experimentally and should not be asserted more precisely than that.
Clinical note: Instruct the patient explicitly to avoid hot and strong tea while taking Shi Jun Zi. If persistent hiccup develops, stop the herb; the reaction is self-limiting. Do not counter the hiccup by increasing the dose or by re-dosing.
Areca nut (Bing Lang, Areca catechu) in combined anthelmintic prescriptions
Shi Jun Zi and areca nut are classically combined for intestinal worms, and both irritate the gut. Quisqualic acid produces nausea, vomiting and diarrhoea in overdose while arecoline is a muscarinic agonist that increases gut motility and secretion, so the two adverse-effect profiles overlap and add. There is no pharmacokinetic study of the pairing; this is an additive pharmacodynamic interaction.
Clinical note: Keep both components at conservative doses when combined rather than dosing each to its own ceiling. Avoid in asthma, bradyarrhythmia or peptic ulcer, and with beta-blockers or cholinesterase inhibitors.
Albendazole, mebendazole, pyrantel and other conventional anthelmintics
No human interaction data exist. Conventional benzimidazoles are considerably more effective and better characterised against Ascaris and Enterobius than Shi Jun Zi is, and adding the herb offers no established incremental benefit while adding its own nausea, hiccup and diarrhoea.
Clinical note: Where a licensed anthelmintic is being used, do not add Shi Jun Zi on top of it.
Drugs that lower the seizure threshold, and glutamatergic agents
Quisqualic acid is an established experimental excitotoxin acting at AMPA and group I metabotropic glutamate receptors, and it produces limbic seizures and neuronal necrosis when introduced centrally. Chinese toxicology descriptions of severe Shi Jun Zi overdose list cold extremities, cold sweat, dyspnoea, falling blood pressure and convulsions. Whether orally administered quisqualic acid reaches the central nervous system in quantities relevant to a drug interaction has not been demonstrated, so this is flagged as theoretical rather than established. It is nonetheless a reason for caution in epilepsy.
Clinical note: Avoid in patients with epilepsy or on drugs known to lower the seizure threshold, and adhere strictly to the classical paediatric ceiling.
Overdose by exceeding the classical paediatric dose ceiling
Toxicity is dose-related and attributable to quisqualic acid. Chinese practice fixes the paediatric dose at 1 to 1.5 roasted seeds per year of age with a daily total not exceeding 20 seeds, and the adult range at roughly 4.5 to 12 g of the fruit. Adverse reactions cluster where these limits are exceeded, and the drug is graded slightly toxic. Because the medicine is sweet and pleasant-tasting and is given to children, accidental excess is a realistic scenario rather than a theoretical one.
Clinical note: Count the seeds. Do not exceed 1 to 1.5 seeds per year of age or 20 seeds in a day, keep the material out of children's reach, and do not use where there is no confirmed parasitic infection or where there is spleen and stomach deficiency cold.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction, or powder/pills | 9–12 g | Daily | — | — | 中国药典 2020 【用法与用量】使君子9～12g，捣碎入煎剂；使君子仁6～9g，多入丸散或单用，作1～2次分服。小儿每岁1～1.5粒，炒香嚼服，1日总量不超过20粒。 【注意】服药时忌饮浓茶。 【性味与归经】甘，温。归脾、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
1 verified · 0 unverified
In vitro / animal
0
Other / unclassified
2
0 verified · 2 unverified
Show 2 studies
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Determination of Quisqualic Acid in quisqualis fructus by Pre-column Derivatization and High Performance Liquid Chromatography
Describes an analytical method for quantifying quisqualic acid in Quisqualis fructus using pre-column derivatisation followed by HPLC. Its relevance to this record is that the marker being measured is simultaneously the anthelmintic principle and the toxic principle, so batch-to-batch variation in quisqualic acid content translates directly into variation in both efficacy and adverse-effect risk. The paper is methodological and reports no clinical outcome.
Origin differentiation based on volatile constituents of genuine medicinal materials Quisqualis indica L. via HS-GC-MS, response surface methodology, and chemometrics
Headspace GC-MS with response surface optimisation was applied to Quisqualis indica from four principal production areas in southwest China. Thirty-one volatile components were identified, comprising fatty acids, aldehydes, alcohols and alkyl pyrazines, with 26 common to all samples at differing levels. Principal component analysis, hierarchical clustering and OPLS-DA separated the four origins, and seven differential components were proposed as quality markers. The study confirms that material sold under this name varies measurably by geographical source, which matters for a drug whose therapeutic and toxic doses are close together.
Photoallergic contact dermatitis caused by Quisqualis indica (Combretum indicum)
A documented case of photoallergic contact dermatitis attributed to Quisqualis indica, confirming that cutaneous sensitisation to this plant occurs. This is directly relevant given that the corpus places this record in the external applications category: topical contact with the plant is not innocuous, and the reaction described is photoallergic, meaning it requires light exposure as well as contact.
⚠ Safety & Contraindications
- Young children
- Heart conditions
- Seizure disorders
- Toxic — professional use only
Contraindications
When taking orally, avoid drinking strong tea. Overdose can cause hiccup, dizziness, and vomiting.
Source: Xi S, Gong Y. Essentials of Chinese Materia Medica and Medical Formulas. Academic Press/Elsevier, 2017, pp. 199–202.
Historical Texts
Kai Bao Ben Cao
Song dynasty (973)Ben Cao Gang Mu
Ming dynasty (1596)Standing dosing caution across the Chinese materia medica
Song dynasty to the presentReferences
- Takemoto T, Nakajima T, Arihara S, Koike K. Studies on the Constituents of Quisqualis Fructus. II. Structure of Quisqualic Acid . Yakugaku Zasshi (1975) [DOI]
- Kwon HC, Min YD, Kim KR, Bang EJ, Lee CS, Lee KR. A new acylglycosyl sterol from quisqualis fructus . Archives of Pharmacal Research (2003) [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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