Shi Hui San

What is Shi Hui San?

Shi Hui San, also called Ten Partially-Charred Substances Powder, is a traditional Chinese herbal powder used for sudden bleeding from the upper body, such as coughing up or vomiting blood. It is listed here as a single drug, although it is a formula built from ten herbs that are partly charred over heat before use.

It is a rescue-style remedy in classical Chinese medicine, not a daily tonic. In practice a trained practitioner gives it for a short time, often with other treatment, and never as a substitute for urgent care.

The honest verdict: it has a long record of use in one tradition, but we could find no published human trials that test it. Traditional use tells you what people have done for centuries; it does not prove the remedy works.

How does Shi Hui San work?

The traditional idea is that heat pushes blood out of the vessels, and that these cooling, charred herbs help settle that heat and hold the blood in place.

Charring plant material raises its tannin content. Tannins are plant compounds that make tissue tighten and can slow oozing from a raw surface. Some herbs in the formula also contain substances studied in the lab for effects on clotting.

All of this is theory and laboratory work. Nobody has shown in a proper human trial that the finished powder stops bleeding in people.

What forms does Shi Hui San come in?

Loose powder is the classical form. The charred herbs are ground fine and mixed just before use.

You may also see it as small pills, capsules or granules sold as a patent formula. Quality varies a lot between makers, and some imported herbal powders have been found to contain heavy metals or hidden drugs.

Buy only from a supplier who tests each batch, and show the label to your doctor.

Where it comes from:

The formula is credited to Ge Kejiu, who recorded it in Shi Yao Shen Shu (Ten Remedies) in the Yuan dynasty, around 1348.

It has stayed in Chinese herbal practice ever since as a short-term answer to sudden bleeding. It is a recognised staple of that one tradition, and it does not appear in other classical systems.

What does Shi Hui San help with?

• Coughing up blood (haemoptysis): This is the classical use. In Chinese medicine the formula is given for sudden bright-red blood from the chest. We found no human trials testing it for this. Coughing up blood can mean a serious lung problem, a clot or a cancer, so it needs a doctor the same day, not a home remedy.
• Vomiting blood (haematemesis): Traditionally used for sudden vomiting of blood thought to come from 'heat'. There is no trial evidence here either. Vomiting blood is a medical emergency, because it can mean a bleeding ulcer or a torn vein in the gullet. Call emergency services.
• Nosebleed that keeps coming back: Practitioners have used it for repeated nosebleeds along with local pressure. No published human trial supports this. Repeat nosebleeds can come from high blood pressure, blood thinners or a clotting problem, and those need testing.
• Blood in the urine: Traditional texts list this among the bleeding patterns the formula addresses. Evidence in people is absent. Blood in the urine can signal infection, stones or bladder cancer, so it always needs checking first.
• Heavy or breakthrough bleeding from the womb: Some practitioners use it short term for heavy bleeding outside pregnancy. We found no trials. It must never be used during pregnancy, and heavy bleeding with dizziness or fainting is an emergency.

What are the side effects of Shi Hui San?

• Loose stools or diarrhoea, mainly from the rhubarb root
• Stomach cramps or griping pain
• Nausea
• Urine that looks darker or reddish, which rhubarb can cause
• Loss of body fluid and salts if diarrhoea keeps going
• Skin rash or itching from an allergy
• Yellow skin or eyes, which can mean liver harm (rare but serious)

Good to know:

Bowel upset is the common problem, and it comes mostly from the rhubarb root.

The serious risks are rarer but real: liver strain from gardenia fruit in large or long-term doses, salt and fluid loss from ongoing diarrhoea, and harm in pregnancy.

The biggest danger is not the herbs. It is using a home remedy for bleeding that needs a hospital.

Options to discuss with a clinician

Every symptom this formula is reached for — blood in the urine, blood coughed up, blood vomited, heavy or breakthrough bleeding from the womb, nosebleeds that keep returning — is a signal that something underneath needs identifying. Better-studied routes exist for all of them, and each is a conversation with a doctor, pharmacist or qualified herbalist rather than a swap you make at home.

- **Any visible bleeding:** the first route is diagnosis, not a remedy. Vomited blood, coughed-up blood, or blood in urine warrants same-day medical assessment; a clinician can arrange urine tests, imaging or endoscopy (a camera test) to find the source. - **Heavy or breakthrough womb bleeding:** a GP or gynaecology clinic can check hormone causes, fibroids and ferritin (your stored iron), and talk through the standard treatments that have been properly trialled. - **Repeated nosebleeds:** once a clinician has examined the nose and ruled out clotting problems, dryness and crusting are often part of the picture — **Saline Nasal Rinse** or a **Neti Pot (Jala Neti)** are reasonable things to raise with them. - **An irritated, lingering cough once the cause is known:** **Honey** is well studied for throat irritation and is worth asking a pharmacist about.

Tell whoever you see about every herbal product you are taking.

Graded pages for the options named above:

• Neti Pot (Jala Neti) — evidence grade A, traditional tier T3
• Saline Nasal Rinse — evidence grade A, traditional tier T3
• Honey — evidence grade A, traditional tier T3