Weilingxian (Clematis Root): An Analgesic and Cholagogic Herb

During the Zhenyuan reign of the Tang Dynasty, a man named Songyangzi wrote a Biography of Weilingxian: “Previously in Shangzhou (present-day Shangxian, Shaanxi), someone fell seriously ill and could not walk for decades. Excellent doctors exhausted their skills without cure, and his relatives placed him by the roadside seeking help. A monk from Silla (Korea) happened upon him and said, 'This illness can be cured by one herb, but I do not know whether it exists here.' He went into the mountains to search for it and indeed found it—it was Weilingxian. The patient was made to take it and could walk after several days. Later, a mountain dweller Deng Siqi learned of this and passed the story on.”

I quote this story because it vividly describes the efficacy of Weilingxian. The patient in Shangzhou likely had what we today call rheumatic disease; some severe rheumatism patients can barely walk. Weilingxian's main action is treating rheumatic arthralgia, joint immobility, and numbness of the limbs. It got the name Weilingxian (“mighty and miraculous immortal”) because its effect on such diseases was so remarkable that the ancients named it with a name highlighting its potency.

Modern pharmacological research confirms that Weilingxian mainly has analgesic, cholagogic, labor-inducing, antimicrobial, and anti-histaminic effects on smooth muscle. But the protoanemonin contained in Weilingxian also has certain side effects; protoanemonin can polymerize into anemonin, and prolonged contact can cause skin blistering and mucosal congestion in humans, while excessive ingestion causes poisoning. So TCM also notes that pregnant women and those with qi and blood deficiency should use Weilingxian cautiously.

Traditional TCM holds that Weilingxian is pungent, salty, and slightly bitter, warm in nature, slightly toxic, entering the Bladder and Liver meridians. It has the effects of dispelling wind and dampness, unblocking collaterals and relieving pain. It is mainly used for rheumatic arthralgia, limb numbness, muscle-tendon contraction and spasm, difficulty in flexion and extension, beriberi swelling and pain, malaria, fish-bone stuck in the throat, and can also treat phlegm-rheum accumulations.

Modern research has found that Weilingxian works very well for gallstones. Using 60 g of Weilingxian decocted in water twice daily to treat 120 gallstone patients, after treatment 60 patients had disappearance of clinical symptoms, gallstones found in stool, and no recurrence for over one year; 44 had disappearance of clinical symptoms but gallstones still visible by B-ultrasound; only 16 had no improvement in symptoms. The total effective rate was as high as 87%.

Related research shows Weilingxian is most effective for gallbladder stones smaller than 15 mm, especially sandy gallstones. For gallstones larger than 15 mm, it can also improve symptoms. This is related to Weilingxian's effect of promoting bile secretion and lowering cholesterol; it may be more effective for cholesterol-type gallstones. There are also reports that Weilingxian has marked efficacy for urinary stones; used together with Jinqiancao (Desmodium), it can treat urinary stones.

Historically there was controversy over which plant Weilingxian actually refers to. The Weilingxian recognized by the Silla monk recorded in Songyangzi's Biography of Weilingxian was likely the Weilingxian used in Korea; historically Korea used Clematis plants of the Ranunculaceae family. The Weilingxian used in the Song Dynasty included the Scrophulariaceae herb Weilingxian, and the Weilingxian in the Bencao Gangmu (Compendium of Materia Medica) was the iron-foot Weilingxian.

Nowadays the roots and rhizomes of several Ranunculaceae plants—Weilingxian (Clematis chinensis), Shanliao, Laliao Tielingxian, Maozhu Tielingxian, and Zhuguo Tielingxian—are all used as Weilingxian. So many TCM experts point out that because the Weilingxian material used in ancient and modern times is not entirely the same, clinical efficacy differs; Weilingxian is neither mighty nor miraculous nor immortal.

However, the basic components of these congeneric plants are similar. Weilingxian roots mainly contain protoanemonin, hederagenin, and oleanolic-acid-based saponins: Weilingxian 23-O-arabinoside saponin, Weilingxian monosaccharide saponin, and various Weilingxian polysaccharide saponins.

Records of Weilingxian treating rheumatic arthralgia, joint immobility, limb numbness, and even post-stroke facial deviation, speech difficulty, and paralysis of the hands and feet are abundant in ancient TCM texts.

Weilingxian combined with Cangzhu (Atractylodes) treats rheumatic arthralgia caused by dampness; combined with Fangfeng (Saposhnikovia), it treats bi syndrome caused by wind; combined with Fangji (Stephania) and Huangbai (Phellodendron), it treats rheumatic arthralgia caused by damp-heat; combined with Guizhi (Cinnamon twig), it warms the meridians and disperses cold, and for severe cold pain, Fuzi (prepared aconite) and Wutou (aconite) can be added; combined with Qianghuo (Notopterygium), it treats numbness and pain of the upper limbs; combined with Niuxi (Achyranthes) and Duhuo (Angelica pubescens), it treats lower-body bi pain; combined with Mugua (Chaenomeles), Shenjincao (Lycopodium), and Baihuashe (silver snake), it treats tendon-muscle spasm and joint deformity.

I often use Weilingxian combined with Shexiang (musk), Gegen (Pueraria), Baizhi (Angelica dahurica), and Dilong (earthworm) to treat stroke sequelae, often with effect. Why Weilingxian has a good effect on nervous system diseases remains to be further studied.

Weilingxian is also an important herb for treating esophageal and cardiac cancer obstruction. It also has a laxative effect, not only useful for senile constipation but also relieving the constipation common in esophageal cancer. The Runchang Gao (Intestine-Moistening Paste) recorded in the Yixue Zhengzhi (Orthodox Medicine) for treating dysphagia and dry bound stool (i.e., what we call esophageal cancer today) is made from 120 g of fresh Weilingxian and 120 g of fresh ginger, pounded together for juice, then mixed with 60 g of sesame oil and 120 g of white honey, simmered slowly into a paste and taken by holding in the mouth from time to time. This paste can improve symptoms such as dysphagia and constipation in esophageal cancer patients.

In folk use, Weilingxian is most often soaked in liquor to treat various pain conditions, though such medicinal wines usually contain more than just Weilingxian as an analgesic. Weilingxian can also be one of the drugs for cancer pain, used together with fellow cancer-pain herbs such as Ruxiang (frankincense), Moyao (myrrh), Yuanhu (Corydalis), Shifu (woodlouse), Maqianzi (nux vomica), Jishiteng (Paederia), and Hanfangji (Han Stephania). There are also modern injections of Weilingxian for spinal hypertrophy.