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Traditional Chinese medicine

PinelliaPinellia ternata

Pinellia (ban xia) is used processed because the raw tuber irritates the mouth; 57 trials of Ban Xia Xie Xin Tang in dyspepsia (5,525 people) favored it over drugs.

Botanical name
Pinellia ternata
Part used
tuber, used processed (zhi ban xia), never raw
Also called
pinyin Ban xia (Fa ban xia, Jiang ban xia and Qing ban xia are the processed forms) (半夏 / 法半夏 / 姜半夏 / 清半夏); Pinelliae rhizoma, Pinellia tuber, Hange (Japanese), Banha (Korean)
Used in
Traditional Chinese medicine
Taken for
Nausea, Indigestion, Bloating, Reflux and heartburn
Sold as
decoction, granule extract, pills, oral liquid, syrup

Pinellia, the plant and the part used

Pinellia is the dried tuber of Pinellia ternata, a small plant of the arum family. In Chinese medicine it is called ban xia, and it is one of the herbs the tradition treats as toxic when raw. Raw tuber (sheng ban xia) causes acrid irritation of the mouth and throat if swallowed, and a review of the plant in the Journal of Ethnopharmacology says the toxicity and side effects can be dramatically reduced by proper processing. In a laboratory study of the Chinese Pharmacopoeia method, soaking in an alum solution or an alkaline solution removed the irritant crystals. Three processed products are traded in the market, named Qing ban xia, Jiang ban xia and Fa ban xia.

Raw pinellia is therefore not a gut supplement. Processed tuber goes into water decoctions, granule extracts, pills and patent medicines. It appears in Liu Jun Zi Tang, Ban Xia Xie Xin Tang and Huo Xiang Zheng Qi San, all of which are used for nausea and fullness in the tradition.

Traditional uses, in their own terms

Traditional Chinese medicine (about TCM)

Ban xia appears in the materia medica as acrid and warm, with some toxicity, entering the spleen, stomach and lung channels. Its actions are drying dampness, transforming phlegm, directing rebellious qi downward to stop vomiting, and dissipating nodules and focal distention. For the gut the texts use it for nausea and vomiting, epigastric fullness and a sense of obstruction in the middle, which is the picture Ban Xia Xie Xin Tang is built for: pinellia with coptis, scutellaria, dried ginger, ginseng, licorice and jujube, for what the tradition calls a mixture of cold and heat in the middle with fullness, nausea and loose stools. The tradition also lists ban xia among the herbs that must not be used with aconite (wu tou). This is the texts’ account, and the cold and heat in it are pattern terms and not temperatures.

Compounds, and what the laboratory says about them

A Journal of Ethnopharmacology review counts 233 compounds in the tuber, including alkaloids, nucleosides, organic acids, polysaccharides, volatile oils, amino acids and starch. Laboratory studies report antiemetic, antitussive, sedative and anti-inflammatory effects. The irritant principle in raw tuber is attributed to needle-shaped calcium oxalate crystals (raphides): in a Chinese laboratory study, soaking the tuber in an 8 percent alum solution or a sodium carbonate solution (pH above 12) dissolved the crystals’ barbs, dropped crystal content from over 1 percent to under 0.5 percent, and removed the irritation in a rabbit eye test. These are laboratory findings.

Trials in people, with the numbers

We could not find a controlled trial of processed pinellia on its own for a gut outcome. The human data are formulas that contain it, mostly Ban Xia Xie Xin Tang.

A meta-analysis of 57 trials with 5,525 people who had functional dyspepsia found that Ban Xia Xie Xin Tang, or the formula plus Western medicine, had a higher total clinical efficacy rate than Western medicine alone and fewer adverse events than Western medicine or placebo, but its comparison with placebo on a visual analog scale showed no significant difference. A small placebo-controlled trial of the Korean version (Banha-sasim-tang) syrup, 50 people randomized to 10 g twice a day for 4 weeks, found no significant gain on its primary dyspepsia score but a lower fullness-after-eating score at follow-up (2.88 vs 4.78, p = 0.0081). In a network analysis of 15 placebo-controlled trials covering 12 herbal formulas, modified Ban Xia Xie Xin Tang ranked as probably having a large effect on postprandial fullness (SMD -0.93, 95% credible interval -1.61 to -0.06).

Pinellia also sits in rikkunshito. A multicenter placebo-controlled trial of 247 people gave 33.6 percent responders against 23.8 percent on placebo, not significant (p = 0.09). In Huo Xiang Zheng Qi, which also contains it, a 212-person trial in diarrhea-predominant IBS found a response-rate difference of 0.29 (95% CI 0.14 to 0.43) over placebo.

Not tested: processed pinellia alone, and any dose of raw tuber.

StudyDoseWhat it found
Meta-analysis of 57 RCTs, 5,525 people with functional dyspepsia (Ban Xia Xie Xin Tang, alone or with Western medicine) PMID 37274096Decoction or granules; doses variedHigher total clinical efficacy than Western medicine; no significant VAS difference vs placebo; fewer adverse events
Placebo-controlled RCT, 50 randomized people with functional dyspepsia (Banha-sasim-tang, the Korean version) PMID 3451233410 g syrup twice a day for 4 weeksPrimary dyspepsia score not significant; fullness after eating 2.88 vs 4.78 at follow-up, p = 0.0081
Network meta-analysis of 15 placebo-controlled RCTs, 12 formulas, functional dyspepsia PMID 34592339Formulas; doses variedModified Ban Xia Xie Xin Tang: postprandial fullness SMD -0.93 (95% credible interval -1.61 to -0.06)
Multicenter placebo-controlled RCT, 247 people with functional dyspepsia (rikkunshito, contains pinellia) PMID 247662952.5 g three times a day for 8 weeksResponders 33.6% vs 23.8%, p = 0.09 (not significant); epigastric pain improved, p = 0.04
Double-blind RCT, 212 adults with IBS-D (Huo Xiang Zheng Qi oral liquid, contains pinellia) PMID 4129732120 ml twice a day for 4 weeksResponse rate difference 0.29 (95% CI 0.14 to 0.43) vs placebo; no serious adverse events

The doses on record

No trial gives a dose of pinellia alone. Banha-sasim-tang syrup was given as 10 g twice a day for 4 weeks in the 50-person trial, rikkunshito as 2.5 g three times a day for 8 weeks, and Huo Xiang Zheng Qi oral liquid as 20 ml twice a day for 4 weeks. The traditional preparation is a water decoction using the processed tuber. Granule extracts, pills and oral liquids of the named formulas are sold ready-made, and their pinellia content is not tied to a trial-based dose.

None of this is a dose recommendation. It is what the literature used, set down so a label can be compared with it; a pharmacist or clinician decides what applies to you.

The safety record

The main hazard is raw tuber, which a Journal of Ethnopharmacology review says irritates the mouth and throat when taken by mistake; proper processing greatly reduces that. The Huo Xiang Zheng Qi trial reported no serious adverse events, and the Ban Xia Xie Xin Tang meta-analysis found fewer adverse events than Western medicine or placebo. Controlled safety data for pregnancy or breastfeeding were not found. On product quality, the authors of a survey of 334 raw Chinese herb samples advised further monitoring of cadmium and chromium and of chlorpyrifos residues, while rating 95 percent of the samples as posing negligible concern under a likely scenario of use; the survey did not single out pinellia.

Medicines it can interact with

Nothing in the sources we read reports an interaction between processed pinellia and a medicine, and we found no study built to test one. The tradition separately warns against combining ban xia with aconite (wu tou). Formulas that contain it also contain ginseng, licorice, ginger and, in Ban Xia Xie Xin Tang, coptis (a berberine source), so the interaction notes for those herbs apply to the finished product and not to pinellia alone.

Where pinellia turns up in the catalog

Pinellia appears on the labels below, alone or inside a blend; each product page gives the printed amount, the evidence for that product and the review picture.

Snap Dynasty Stomach Chi 4.5 out of 5 from 162 ratings from Amazon · $1.50 per day at two capsules three times a day ($29.99 for 120 on the brand site, $29.98 on Amazon, a 20-day bottle); the 60-capsule bottle is $17.99

Want to know which products fit your symptoms?

The quiz weighs your symptoms and medicines against every product researched here, pinellia products included, and shows its working.

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What people want to know

Why is pinellia always processed?

The raw tuber irritates the mouth and throat. A review says processing greatly reduces that, and a laboratory study found that alum or alkaline soaking cut the irritant calcium oxalate crystals from over 1 percent to under 0.5 percent.

What are Qing, Jiang and Fa ban xia?

They are the three processed forms of the tuber traded in the Chinese market, made with different processing methods. The raw tuber is the form that irritates the mouth and throat.

Does Ban Xia Xie Xin Tang work for dyspepsia?

A meta-analysis of 57 trials with 5,525 people found it better than Western medicine on total efficacy, but its comparison with placebo on a visual scale showed no significant difference, and the quality of the trials is mixed.

Is the hange of Kampo the same plant?

Yes, the same plant is called hange in Kampo and appears in rikkunshito and hangekobokuto. In a mouse model of postoperative ileus, hangekobokuto reduced inflammation and improved transit.

Can pinellia be taken with aconite?

The tradition lists ban xia among the herbs not to be used together with aconite (wu tou). That is an old incompatibility from the texts and not a modern clinical finding.

Sources