What is Xiao Xu Ming Tang?

Xiao Xu Ming Tang is an old Chinese herb formula. The name means "minor prolong life decoction". Healers gave it after a stroke, for weak or stiff limbs and a drooping face.

It is a mix of about ten herbs, boiled into a tea. Two of them act like strong drugs. Ma huang (ephedra) speeds up the heart, and fu zi (aconite) can upset the heart's rhythm.

Long use in China is not proof that a remedy works. The human trial evidence here is thin and weak, so read this page as background only. This is a multi-herb formula, so drug clashes and risks in pregnancy are real and are set out below.

How does Xiao Xu Ming Tang work?

In Chinese medicine, the old idea is that "wind" enters a weak body and stiffens one side. The formula is meant to push that wind out, warm the body and open the flow of blood.

That is a traditional idea, not a tested one. Modern lab work shows that some parts of the mix change blood vessel width and calm swelling in animal tissue.

No one has shown that these lab effects help a person recover after a stroke. Treat the way it works as unproven.

What forms does Xiao Xu Ming Tang come in?

The classic form is a decoction. You boil the raw herbs in water and drink the strained liquid.

You may also see it as granules that melt in hot water, as pills, or as a bottled liquid. Products vary a lot in strength and in which herbs they use.

In several countries, ephedra and aconite are banned or limited in over-the-counter products. Some sold blends leave them out, which makes the product a different thing from the classic formula.

Where it comes from:

The formula appears in Chinese medical books from around the 5th to 7th century. Sun Si-miao lists it in his Qian Jin Yao Fang.

For centuries it was a main choice for what Chinese doctors called "wind stroke". Later doctors argued about it, and many dropped the strong warming herbs.

Today it is still taught and still used in parts of China, mostly under close watch by a trained prescriber.

What does Xiao Xu Ming Tang help with?

• Weakness or stiffness on one side after a stroke: This is the main traditional use, and it has been for well over a thousand years. Small trials in China have tested it beside standard stroke care. They were mostly poorly run, so we cannot tell if the herbs helped. Stroke care needs a hospital, not a herb shop.
• Facial palsy (a drooping face from a weak nerve): Old texts list a drooping face as a target sign. We found no good human trials for this use. A sudden drooping face can mean a stroke, so treat it as an emergency and call for help.
• Numb or heavy limbs: Traditional writers used the formula when limbs felt numb, heavy or hard to move. There is no trial evidence for this on its own. New numbness needs a doctor first, since it can point to nerve or blood vessel trouble.
• Joint pain that feels worse in cold, damp weather: Some prescribers use it for cold, achy joints. This rests on tradition, not on trials. Safer and better tested options exist for joint pain.

Which foods are rich in Xiao Xu Ming Tang?

Skip coffee, energy drinks and alcohol while taking it, since they add to the strain on your heart.

What are the side effects of Xiao Xu Ming Tang?

• Fast or pounding heartbeat
• Uneven heartbeat
• Higher blood pressure
• Feeling jumpy or shaky, or not being able to sleep
• Heavy sweating
• Numb or tingling lips, tongue or fingers (an early sign of aconite poisoning)
• Nausea, vomiting or loose stools
• Headache or dizziness
• Swollen ankles, and low potassium from the licorice in the mix
• Rash, itching or other allergy signs
• Kidney damage, if the wrong plant is sold as fang ji

Good to know:

Mild effects are common. Many people feel warm, sweaty and wired.

The serious risks are not rare enough to ignore. Ephedra has been linked to stroke, heart attack and sudden death. Badly prepared aconite has killed people.

Stop the herbs and get help fast if your lips or tongue go numb, your heart races, or you feel faint. These are warning signs, not side effects to wait out.

How much Xiao Xu Ming Tang should you take?

• Recommended daily: There is no safe dose you can set on your own. This formula holds ephedra and aconite, and both can harm the heart. It should only be used, if at all, under a trained prescriber who checks your heart and your other medicines. In classic practice, a day's dose of raw herbs is boiled and split into two or three drinks. Granule doses differ by brand. Never copy a dose from a book or a website.
• Best time of day: Traditionally taken warm in the morning and early afternoon. Avoid the evening dose, since ephedra can keep you awake.
• With or without food: Usually taken warm, after food, to be easier on the stomach.
• Time to effect: Old texts describe sweating and a change in symptoms within hours to a few days. Trial evidence does not back any time frame.
• How long to take it: Traditional use is short, often a few days to two weeks. Longer use raises the risk from licorice and ephedra. If you see no change within two weeks, stop and go back to your doctor.