Zhang Nao

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Cinnamomum camphora (L.) Presl.

Genus: Cinnamomum Species: camphora Pinyin: Zhang Nao
Camphor樟脑

☯ TCM Properties

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

Clears Heat and Resolves Phlegm from the Orifices; Moves Qi and Resolves Stagnation; Kills Parasites and Stops Itching; Reduces Swelling and Alleviates Pain; Warms the Middle Burner and Stops Pain; Drains Dampness

Traditional Chinese Uses

Zhang Nao (camphor) is a warm, pungent aromatic substance used in Chinese medicine primarily as an external remedy to open the orifices, relieve pain, kill parasites, and stop itching. It is applied topically for scabies, ringworm, skin sores, joint pain, and traumatic injuries. Its penetrating, aromatic nature allows it to disperse cold and obstruction from the channels and sinew when used externally. Internal use is limited, as camphor is toxic if ingested in significant amounts, and its primary role is firmly in external applications.

Western Herbalism Properties

Actions:
analgesicantimicrobialstimulantcarminative

Botanical Description

Cinnamomum camphora, the camphor tree, is a large evergreen tree in the family Lauraceae, native to East Asia, particularly southern China, Taiwan, southern Japan, and Vietnam, and widely planted in subtropical regions worldwide. Mature specimens commonly reach 20-30 meters in height with broad, dome-shaped crowns and stout, deeply furrowed grayish-brown trunks. The alternate, ovate to elliptic leaves are leathery and glossy, with three prominent veins from the base, and emit a strong camphor scent when crushed. Small, six-tepalled, pale yellow-green flowers are borne in axillary panicles in spring, developing into round, dark-purple to black drupes about 1 cm across. All tissues, especially the wood and leaves, contain volatile oil rich in camphor crystals that are distilled and harvested commercially.

Active Constituents

(+)-Camphor

Bicyclic monoterpene ketone

Concentration: Principal component; up to ~95% of the crystalline sublimate and of camphor-chemotype essential oil

The characteristic active principle. Acts as a rubefacient and counterirritant on skin and mucosa, producing local warmth followed by a cooling, analgesic and antipruritic sensation via TRPV1/TRPV3 and TRPM8 channel modulation. It is aromatic, antiseptic and insecticidal, and at toxic systemic doses it is a CNS stimulant that lowers the seizure threshold.

Safrole

Phenylpropanoid (methylenedioxy)

Concentration: Dominant in the safrole ("brown camphor") chemotype, trace to minor in the camphor chemotype

A fragrant phenylpropanoid contributing to antimicrobial and insecticidal activity. It is hepatotoxic and a recognized genotoxic carcinogen, and its abundance varies markedly between chemotypes, which is a key safety consideration for the raw material.

1,8-Cineole (eucalyptol)

Monoterpene ether (oxide)

Concentration: Major in the cineole chemotype; minor in others

Contributes expectorant, mucolytic, anti-inflammatory and antimicrobial properties, and reinforces the penetrating, decongestant aroma used in topical liniments.

Linalool

Acyclic monoterpene alcohol

Concentration: Dominant in the linalool chemotype ("ho wood/ho leaf" oil); minor elsewhere

A floral monoterpene alcohol with sedative, anxiolytic and antimicrobial activity; contributes to the aroma and to mild anti-inflammatory effects.

Camphene

Bicyclic monoterpene hydrocarbon

Concentration: Minor constituent of the volatile oil

A lipophilic terpene with antioxidant and antimicrobial activity; contributes to skin penetration of the topical preparation.

alpha-Pinene

Bicyclic monoterpene hydrocarbon

Concentration: Minor constituent of the volatile oil

Volatile terpene with anti-inflammatory, bronchodilatory and antimicrobial activity; enhances aromatic and counterirritant qualities.

Limonene

Monocyclic monoterpene hydrocarbon

Concentration: Minor constituent of the volatile oil

Citrus-scented terpene with antioxidant, anti-inflammatory and mild antimicrobial activity; aids solubilization and skin penetration.

Borneol

Bicyclic monoterpene alcohol

Concentration: Minor constituent (biosynthetic relative of camphor)

Aromatic "orifice-opening" alcohol that promotes penetration of co-administered agents across skin and mucosa; mild analgesic and antimicrobial.

⚠ Drug Interactions

Anticonvulsants / antiepileptic drugs (e.g., phenobarbital, valproate)

Major Evidence: Probable

Absorbed camphor is a CNS stimulant that lowers the seizure threshold; even topical or inhaled exposure has produced convulsions, particularly in children. This can counteract anticonvulsant therapy and precipitate breakthrough seizures in predisposed patients.

Clinical note: Avoid in patients with epilepsy or seizure history; keep away from children. Use only externally on intact skin and never on broken skin or the face of infants.

Hepatotoxic drugs / agents metabolized by hepatic conjugation (e.g., acetaminophen, isoniazid)

Moderate Evidence: Theoretical

Camphor is metabolized in the liver by cytochrome P450 oxidation and glucuronide conjugation. Safrole, a variable co-constituent, is hepatotoxic and genotoxic. Concurrent hepatotoxic drugs may compound the load on hepatic detoxification pathways with excessive or prolonged use.

Clinical note: Limit dose and duration; avoid in hepatic impairment. Systemic (oral) use is discouraged given the narrow margin of safety.

Dosage

FormAmount Frequency Duration Population Notes
powder 0.3-1g Daily

Preparation Methods

Topical application (powder, medicated oil, liniment or plaster)

Parts: Refined crystalline camphor (sublimate of wood/leaf distillate)

The principal traditional and modern use. Finely powdered camphor is dissolved in oil or alcohol, or incorporated into ointments and plasters, and applied externally to affected skin for itching, ringworm, scabies, sores and localized pain and swelling. It is a warming counterirritant. Do not apply to broken skin, mucous membranes, or the face of infants and young children.

Small-dose internal use in pills/powders (specialist use only)

Parts: Refined crystalline camphor

Historically incorporated in tiny amounts (roughly 0.1-0.2 g) into pills or powders to open the orifices and revive consciousness or warm the middle and stop pain. Camphor is never decocted because it sublimes and volatilizes on heating. Because of its narrow toxic margin this internal route is now rarely used and requires expert supervision; it is contraindicated in pregnancy and in the deficient or heat-pattern patient.

Clinical Studies

A cluster of children with seizures caused by camphor poisoning

Khine H, Weiss D, Graber N, Hoffman RS, Esteban-Cruciani N, Avner JR (2009) Pediatrics Case series

Report of three young children (15-36 months) who developed seizures after ingestion or repeated dermal application of camphor-containing products, all requiring pharmacologic intervention. The series underscores the low toxic threshold of camphor and the neurotoxic (pro-convulsant) hazard that governs its safe, external-only, low-dose use.

Historical Texts

Ben Cao Pin Hui Jing Yao (Collected Essentials of Materia Medica)

Ming dynasty, 1505
One of the early Chinese materia medica references to Zhang Nao (camphor) as a distinct crystalline drug distilled from the camphor tree, used externally for itch and parasites.

Ben Cao Gang Mu (Compendium of Materia Medica), Li Shizhen

Ming dynasty, 1596
Provides a detailed account of Zhang Nao, distinguishing it from Bing Pian (borneol), describing its preparation by distillation and sublimation and its external use for sores, scabies, toothache and pain, with cautions on its toxicity.

References

  1. Chen W, Vermaak I, Viljoen A. Camphor - A Fumigant during the Black Death and a Coveted Fragrant Wood in Ancient Egypt and Babylon - A Review . Molecules (2013) [DOI]
  2. Khine H, Weiss D, Graber N, Hoffman RS, Esteban-Cruciani N, Avner JR. A cluster of children with seizures caused by camphor poisoning . Pediatrics (2009) [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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