Bai Zhi (白芷) — TCM Herb for Headache, Sinusitis & Yang Ming Pain

At a Glance

Herb: Bai Zhi
Chinese name: 白芷 (Bái Zhǐ)
Latin name: Angelicae Dahuricae Radix
Nature: Warm
Taste: Acrid
Meridian: Lung / Stomach / Large Intestine
Category: Herbs that Release the Exterior — Warm, Acrid
Introduction: 白芷 (Bái Zhǐ, Dahurian Angelica Root) is the dried root of Angelica dahurica or A. dahurica var. formosana, a large perennial herb in the Apiaceae family cultivated in Sichuan (川白芷), Zhejiang (杭白芷), Henan, and other provinces. Harvested in summer or autumn when the leaves begin to wither, the roots are dried in the sun and sliced for use. The fragrant white cross-section and powerful aromatic scent distinguish it from other Angelica species.
In TCM theory, Bai Zhi expels wind and relieves pain, opens the nasal orifices, reduces swellings and expels pus, and dispels dampness and stops leukorrhea. It is the foremost herb for headache along the Yang Ming channel (forehead, supraorbital region, teeth, jaw), sinusitis, and nasal congestion. Its warm-acrid nature disperses wind-cold from the exterior while its drying action resolves dampness.

Modern pharmacological research confirms significant analgesic, anti-inflammatory, antibacterial, and antispasmodic properties. Furanocoumarins including byakangelicol and isoimperatorin are principal active constituents contributing to the anti-inflammatory and light-sensitizing effects, the latter historically exploited in treating vitiligo.

Expels wind and relieves pain (祛风止痛): For Yang Ming channel headache (frontal, supraorbital, dental), migraine, trigeminal neuralgia, and wind-cold body aches.
Opens the nasal orifices (通鼻窍): For sinusitis, nasal congestion, and rhinitis — clears turbid damp from nose; reduces nasal discharge.
Reduces swellings and expels pus (消肿排脓): For early-stage carbuncles and toxic swellings — disperses and reduces before pus forms; once pus forms, promotes drainage.
Dispels dampness and stops leukorrhea (燥湿止带): For damp-cold or damp-heat leukorrhea from spleen-stomach damp descending.

Clinical Application:
Frontal headache and sinusitis: Key herb; with Cang Er Zi, Xin Yi Hua, Bo He (Cang Er Zi San)
Wind-cold exterior syndrome: With Fang Feng, Qiang Huo, Chuan Xiong
Toothache (Yang Ming): With Xi Xin, Shi Gao, Sheng Di Huang
Carbuncles and toxic swellings: With Jin Yin Hua, Zhe Bei Mu, Tian Hua Fen (Xian Fang Huo Ming Yin)
Leukorrhea from cold-damp: With Long Gu, Mu Li, Shan Yao (Wan Dai Tang)
Leukorrhea from damp-heat: With Huang Bai, Che Qian Zi
Dosage: 3–10g in decoction. Larger doses may be used for pain (up to 15g). Not appropriate for yin-deficiency heat patterns — drying nature may injure fluids.

Contraindicated in yin deficiency with hyperactive fire — warm-drying nature injures fluids. Use cautiously in blood deficiency headache without wind-cold. Avoid excessive sun exposure after large doses — furanocoumarins may cause photosensitivity. Large doses may cause convulsions in sensitive individuals (due to furanocoumarins). Not appropriate for heat-type sinusitis without wind-cold component — combine with cool herbs.

Cang Er Zi San (苍耳子散): Cang Er Zi, Xin Yi Hua, Bai Zhi, Bo He — for sinusitis, nasal congestion, frontal headache.
Chuan Xiong Cha Tiao San (川芎茶调散): Chuan Xiong, Bai Zhi, Qiang Huo, Xi Xin, Fang Feng, Bo He, Jing Jie, Gan Cao — for wind-cold headache.
Xian Fang Huo Ming Yin (仙方活命饮): Jin Yin Hua, Fang Feng, Bai Zhi, Tian Hua Fen, Zhe Bei Mu, Lian Qiao, Chuan Shan Jia, Zao Jiao Ci — for carbuncles and abscesses.

Bai Zhi + Cang Er Zi: Opens nasal orifices, expels wind, reduces nasal discharge; for sinusitis and allergic rhinitis. Source: Cang Er Zi San (苍耳子散).
Bai Zhi + Chuan Xiong: Expels wind, activates blood, relieves head pain; for frontal and temporal headache from wind-cold or blood stasis. Source: Chuan Xiong Cha Tiao San (川芎茶调散).
Bai Zhi + Jin Yin Hua: Clears heat-toxin, disperses swelling, promotes pus drainage; for early-stage carbuncles. Source: Xian Fang Huo Ming Yin (仙方活命饮).
Bai Zhi + Xi Xin: Expels wind-cold, stops pain, opens orifices; for severe wind-cold headache and toothache. Source: Jiu Wei Qiang Huo Tang (九味羌活汤) modifications.
Bai Zhi + Shan Yao: Stops leukorrhea while tonifying spleen; for cold-damp leukorrhea with spleen deficiency. Source: Wan Dai Tang (完带汤).

Shen Nong Ben Cao Jing (《神农本草经》): ‘Governs women’s red and white vaginal discharge, blood obstruction and vulvar swelling, chills and fever, wind headache invading the eyes with lacrimation; grows flesh and skin, moistens and beautifies, and can be made into facial cream.’
Ben Cao Gang Mu (《本草纲目》): ‘Resolves and relieves Hand Yang Ming headache, wind stroke with chills and fever, and Lung channel wind-heat, head and face skin wind impediment with dryness and itching.’
Ben Cao Bei Yao (《本草备要》): ‘Stops headache, brightens vision, removes excessive lacrimation, and opens nasal obstruction.’