Soshikokito
Quick Facts
- What it is: Soshikokito is an approved Japanese Kampo herbal formula used for a long-standing phlegmy cough and breathlessness.
- Main uses: Long-standing cough with phlegm, Wheezing and breathlessness, Chest fullness with cold legs, a Kampo pattern
- Best for: An older or run-down person with a wet, rattling cough, Use for a few weeks, under guidance, with blood pressure checks
- Active ingredients: Perilla fruit (soshi), Pinellia tuber (hange), Magnolia bark (koboku), Citrus peel (chimpi), Hog fennel root (zenko), Japanese angelica root (toki), Cinnamon bark (keihi), Licorice root (kanzo), source of glycyrrhizin
- Forms: Extract granules in sachets, Tablets, Loose powder, Traditional water decoction
- Time to effect: Some people feel easier breathing in a few days; judge it by two to four weeks.
- Side effects: Licorice can cause low potassium, fluid swelling and higher blood pressure, and rarely severe muscle breakdown.
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What is Soshikokito?
Soshikokito is a Kampo herbal formula taken for a long-standing cough with phlegm and for breathlessness. In Japan it is a Ministry-approved Kampo formula, made by firms such as Tsumura. Its name is often given in English as Perilla Fruit Decoction for Directing Qi Downward.
It is chosen by pattern, not by test result. Kampo practice points it at a person whose chest feels full and tight while the legs and feet feel cold. It is used most in older or run-down people with a wet, rattling cough.
Here is the plain verdict. The formula has centuries of recorded use behind it. Good human trials of the formula itself are lacking, and traditional use is not proof that it works.
How does Soshikokito work?
How it works in the body has not been shown clearly in people. Kampo theory says it turns rising qi (vital energy) back downward and clears phlegm. That is a traditional idea, not a measured effect.
Some single herbs in it have been studied alone. In lab and animal tests, perilla fruit and magnolia bark appear to relax airway muscle. Whether that happens in a person taking the whole formula is not known.
One effect is well established in people, and it is unwanted. Licorice root (kanzo) contains glycyrrhizin. Glycyrrhizin blocks a kidney enzyme called 11-beta-hydroxysteroid dehydrogenase type 2.
Blocking that enzyme lets the body hold salt and water and lose potassium. Blood pressure can rise as a result. This is a drug-like effect, and it is the reason the formula needs care.
What forms does Soshikokito come in?
The usual form is a dried extract granule in a sealed sachet. Tablets and loose powders are also sold.
A traditional decoction is another option. You simmer the raw herbs in water and drink the strained liquid. Granules are far more common now, because the dose is fixed and easier to check.
Where it comes from:
The recipe comes from a Chinese state pharmacy text of the Song era, the Taiping Huimin Heji Ju Fang, printed in the early 1100s. It is known in Chinese medicine as su zi jiang qi tang.
Japanese doctors took it up and kept it in use for centuries. Today it sits on Japan's approved list of Kampo prescriptions. So it has classical standing in two linked traditions.
If this is an emergency
Some reactions to Soshikokito need urgent care. Call your local emergency number or go to an emergency department straight away — do not wait to see whether it passes.
Who should avoid Soshikokito?
- Do not use if you have low potassium in your blood (hypokalaemia).
- Do not use if you have aldosteronism (a hormone disorder that raises blood pressure and lowers potassium).
- Do not use if you have a muscle disease (myopathy) or have ever had rhabdomyolysis (severe muscle breakdown).
- Do not use if you take any other product containing licorice, kanzo or glycyrrhizin.
- Do not use if you take a water pill (diuretic), a steroid tablet or digoxin, unless your doctor is checking your potassium.
- Do not use if you have heart failure, kidney disease or high blood pressure that is not well controlled.
- Do not use if you are pregnant or breastfeeding.
- Never give it to a child except under a doctor's care.
- Do not use if you have had an allergic reaction to any herb in the mix.
- Never use it in place of an asthma inhaler or other prescribed lung treatment.
When should you see a doctor?
Stop taking it and get medical help the same day if you notice muscle pain, cramps or weakness, especially in your legs. Dark or cola-coloured urine with muscle pain needs emergency care now.
See your doctor soon if your ankles or face swell, if you gain weight fast over a few days, or if your blood pressure climbs. A pounding or uneven heartbeat also needs checking.
Get urgent help for severe breathlessness, chest pain or lips turning blue. Do not wait to see if the herbs help.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
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