San Qi (Notoginseng, Panax notoginseng dried root and rhizome), also known as Tian Qi, Shan Qi, and most famously Jin Bu Huan (“Cannot be Exchanged for Gold”), is the premier haemostasis and Blood-Stasis-dissolving drug in the TCM repertoire. It belongs to the Araliaceae family — the same family as Ren Shen (Ginseng) — and shares the Panax genus, which is why the Ben Cao Gang Mu Shi Yi could make the landmark comparison: “Ren Shen supplements Qi as the foremost; San Qi supplements Blood as the foremost; their flavours are the same and their actions are equivalent.” San Qi’s defining pharmacological paradox: it simultaneously stops bleeding and dissolves Blood-Stasis. The classical formulation: “stops bleeding without retaining Stasis; dissolves Stasis without injuring constitutional Qi.” Li Shizhen in the Ben Cao Gang Mu: “San Qi stops blood, disperses Blood, settles pain; for metal-weapon arrow-wounds, falls and injuries, ulcerations with unceasing haemorrhage — chew and apply to the wound, and the bleeding immediately stops” — calling it Jin Bu Huan.

I. Classical Records and Historical Status

Four classical benchmarks:

• Ben Cao Gang Mu: “San Qi stops blood, disperses Blood, settles pain; for metal-weapon wounds, falls and injuries, ulcerations with unceasing haemorrhage — chew and apply, the bleeding immediately stops”; designates it Jin Bu Huan
• Ben Cao Gang Mu Shi Yi: “Ren Shen supplements Qi as the foremost; San Qi supplements Blood as the foremost; their flavours are the same and their actions are equivalent” — establishing the Bei Shen Nan Qi (“Northern Ginseng Southern San Qi”) dual-axis of Chinese tonic medicine
• Ben Cao Cong Xin: “can damage new Blood; those without Stasis should not use it” — establishing the important contraindication for patients without Blood-Stasis
• Zhongguo Yao Dian (Chinese Pharmacopoeia): disperses Stasis and stops bleeding, reduces swelling and settles pain; governs: haemoptysis, haematemesis, epistaxis, haematochezia, uterine bleeding, traumatic bleeding, chest-abdominal stabbing pain, falls and swelling pain

II. TCM Properties and Identification

TCM properties: Sweet, mildly bitter, warm; enters Liver and Stomach channels. The sweet-warm combination supports the supplementing (Blood-tonifying) action; the mildly bitter quality drives Blood movement and dissolves Stasis. This combination produces the paradoxical dual action: haemostatic (via the diosgenin-type saponin Dencichine / Sanqi Prime) simultaneously with anti-coagulant and Blood-Stasis-dissolving (via the ginsenoside-type saponins PNS).

Regional origin: Primary production in Yunnan Wenshan and Guangxi Jingxi; Yunnan Wenshan San Qi is the dao di (authentic regional standard) drug. Two seasonal grades: Chun Qi (Spring San Qi, harvested before flowering in autumn — higher quality, higher active compound content); Dong Qi (Winter San Qi, post-flowering harvest — lower quality). Harvest: autumn before flowering; wash, separate main root, lateral roots, and rhizome; dry.

Appearance and identification: Main root near-conical to cylindrical; surface grey-brown to grey-yellow with discontinuous longitudinal wrinkles and lateral root scars. Apex has stem-scar; periphery has nodular protuberances. Heavy, hard, and solid. Cross-section: grey-green, yellow-green, or grey-white, with faintly radiating wood pattern. Faint odour; bitter taste with sweet aftertaste. Quality: large size, heavy, hard, solid, grey-green cross-section, no fissures.

The defining raw-vs-processed distinction:

• Raw San Qi (sheng san qi): disperses Stasis, stops bleeding, reduces swelling, settles pain; strong action; primary form for haemorrhage, Blood-Stasis pain, and traumatic injury. “Raw use: break Stasis”
• Processed San Qi (shu san qi, steamed or dry-fried): shifts predominantly toward supplementing Blood and harmonising Blood; the Blood-activating and Stasis-breaking action decreases while the supplementing-Blood action emerges. Used for anaemia, post-partum Blood deficiency, chronic-illness constitutional weakness. “Cooked use: supplement deficiency”

Core chemical constituents: San Qi total saponins (PNS — including notoginsenoside R1, ginsenoside Rg1, Rb1, Rd) — the primary cardiovascular-protective, anti-thrombotic, and Blood-Stasis-dissolving components; Dencichine (san qi su) — the primary haemostatic component; flavonoids, volatile oils, and amino acids.

III. Four Core Actions

1. Disperse Stasis and stop bleeding — the defining dual action:
San Qi’s most clinically remarkable property: it stops bleeding (haemostatic mechanism via Dencichine shortening clotting time and promoting platelet aggregation) while simultaneously dissolving pre-existing Blood-Stasis (anti-coagulant and fibrinolytic mechanism via PNS saponins). Most haemostatic herbs only stop bleeding; in doing so they risk retaining Stasis. Most Blood-activating herbs dissolve Stasis but cannot stop bleeding; they risk worsening haemorrhage. San Qi does both simultaneously. The critical clinical implication: San Qi is specifically indicated when bleeding is accompanied by Blood-Stasis (e.g. traumatic haemorrhage with haematoma, uterine haemorrhage with clotting, or gastrointestinal bleeding with xue yu signs). It is not indicated for bleeding without Stasis (see contraindications).

2. Reduce swelling and settle pain:
Specifically addresses traumatic injury: dissolves Blood-Stasis producing the swelling; reduces swelling; settles stabbing-type (ci tong) Blood-Stasis pain. The essential herb of traditional Chinese traumatology (shang ke). Indicated for: traumatic swelling and pain (external injury haematoma, contusion, sinew-bone pain); chest-abdominal stabbing pain from internal Blood-Stasis; dysmenorrhoea from Blood-Stasis; Wind-Damp bi-syndrome pain. Can be used orally and topically. The classical topical application: chew fresh San Qi and apply to wound — simultaneously haemostatic and analgesic.

3. Activate Blood, unblock vessels, and protect the cardiovascular system:
PNS saponins dilate coronary arteries, improve myocardial blood supply, inhibit platelet aggregation, reduce blood viscosity, and resist thrombosis. Modern pharmacology provides a comprehensive cardiovascular-protective molecular mechanism directly corresponding to the classical huo xue tong mai (activate Blood and unblock vessels) action. Clinical applications: coronary artery disease, angina pectoris, myocardial ischaemia, post-cerebral infarction sequelae, hypertension adjunctive management.

4. Supplement Blood and benefit deficiency (processed form):
Shu San Qi (processed): benefits Qi and nourishes Blood; addresses constitutional Blood deficiency from anaemia, post-partum Blood loss, and chronic-illness weakness. Dull-yellow complexion, dizziness and fatigue, palpitations. The Ben Cao Gang Mu Shi Yi comparison with Ren Shen directly references this supplementing action of the processed form.

IV. Clinical Applications

• Various haemorrhage patterns: haemoptysis, haematemesis, haematochezia, uterine bleeding, traumatic bleeding; powder for oral use or topical application alone is effective; most appropriate when bleeding accompanies Blood-Stasis signs
• Traumatic injury and Blood-Stasis swelling-pain: external injury haematoma, sinew-bone pain, chest-abdominal stabbing pain; both oral and topical use effective
• Cardiovascular disease: coronary artery disease, angina pectoris, myocardial ischaemia, post-cerebral infarction sequelae, hypertension adjunctive management
• Blood-Stasis dysmenorrhoea and post-partum abdominal pain: Blood-Stasis amenorrhoea, dysmenorrhoea, post-partum lochia retention, small-abdominal stabbing pain
• Deficiency and anaemia (processed San Qi): dull-yellow complexion, dizziness and fatigue, post-partum and chronic-illness weakness

V. Four Classical Formulas

1. Qi Li San “Seven-Li Powder” (classical traumatology formula)
Composition: San Qi · Xue Jie · Ru Xiang · Mo Yao · Hong Hua and others. Action: dissolve Stasis and reduce swelling, settle pain and stop bleeding. Indication: traumatic injury, Blood-Stasis pain, traumatic bleeding. San Qi’s dual haemostatic and Stasis-dissolving action is the formula’s core; the others amplify pain-relief and swelling-reduction.

2. San Qi Dan Shen San (modern experiential formula)
Composition: San Qi · Dan Shen. Action: activate Blood and dissolve Stasis, unblock vessels and settle pain. Indication: coronary artery disease, angina pectoris, chest stuffiness and chest pain. The combination of San Qi’s haemostatic-plus-Stasis-dissolving action with Dan Shen’s Blood-activating and cooling action covers both the acute pain (Stasis) and the underlying vessel obstruction comprehensively.

3. Yun Nan Bai Yao (San Qi as core active component)
Action: dissolve Stasis and stop bleeding, activate Blood and settle pain, detoxify and reduce swelling. Indication: traumatic injury, Blood-Stasis swelling-pain, haemoptysis, haematemesis, haematochezia, uterine bleeding. San Qi’s dual haemostatic and Stasis-dissolving pharmacology is the molecular basis for the entire Yun Nan Bai Yao formula’s legendary action.

4. Shu San Qi Bu Xue Tang “Processed San Qi Blood-Supplementing Decoction” (experiential formula)
Composition: Shu San Qi · Dang Gui · Huang Qi. Action: supplement Qi and nourish Blood. Indication: anaemia, post-partum Blood deficiency, chronic-illness constitutional weakness. The processed form (Shu San Qi) here contributes supplementing-Blood action rather than Stasis-breaking; Dang Gui and Huang Qi complete the Qi-Blood supplementing framework.

VI. Three-Herb Differential

VII. Modern Pharmacology

Two-component pharmacological basis:

• Dencichine (san qi su): shortens clotting time; promotes platelet aggregation — haemostatic mechanism
• San Qi total saponins (PNS): inhibit platelet aggregation; reduce blood viscosity; anti-thrombotic; dilate coronary arteries; improve myocardial ischaemia; anti-arrhythmic; increase coronary blood flow — cardiovascular protective and Blood-Stasis-dissolving mechanism

Additional documented actions: anti-inflammatory, analgesic, accelerated tissue repair; immune enhancement, antioxidant, anti-ageing; adjunctive blood lipid and glucose regulation.

Modern clinical applications: Cardiovascular (coronary artery disease, angina pectoris, post-cerebral infarction, hypertension, hyperlipidaemia adjunctive); orthopaedic and traumatology (traumatic injury, soft tissue contusion, fracture recovery); gastroenterology (gastric bleeding, duodenal ulcer bleeding recovery); gynaecology (uterine haemorrhage, dysmenorrhoea, post-partum Blood-Stasis abdominal pain); health maintenance (elderly thrombosis prevention, microcirculation improvement, constitutional Blood supplementation).

VIII. Dosage and Safety

Dosage: powder for oral use 1–3g per dose, 1–2 times daily; decoction 3–9g; topical: appropriate amount. Do not use in excessive doses or over prolonged periods.

Contraindications:

• Pregnancy: Blood-activating and Stasis-dispersing force may disturb foetal Qi; use with caution; do not self-administer
• Bleeding without Blood-Stasis: Ben Cao Cong Xin: “can damage new Blood; those without Stasis should not use it.” Blood-Heat haemorrhage or Yin deficiency-Fire haemorrhage without accompanying Stasis signs should not use San Qi alone; inappropriate use may worsen bleeding
• Bleeding tendency disorders: thrombocytopenia, coagulopathy, severe menorrhagia, acute phase cerebral haemorrhage — do not use San Qi alone without medical supervision
• Drug interactions: avoid simultaneous use with anticoagulants (warfarin, aspirin) — risk of amplified anticoagulant effect and increased bleeding
• Diet during treatment: reduce spicy and oily foods