Ru Xiang (乳香) — Frankincense Resin: TCM Uses, Pain Relief & Formulas

At a Glance

Herb: Ru Xiang
Chinese name: 乳香 (Rǔ Xiāng)
Latin name: Boswellia carterii Birdw.
Nature: Warm
Taste: Acrid / Bitter
Meridian: Heart / Liver / Spleen
Category: Herbs that Invigorate Blood
Introduction: Ru Xiang (乳香), the dried oleo-gum resin obtained from Boswellia sacra Flueck. or Boswellia carterii Birdw. (frankincense), is one of the world’s oldest medicines, used across Egyptian, Ayurvedic, and Chinese medical traditions. Recorded in the Ming Yi Bie Lu, it is prized for simultaneously moving both qi and blood, making it superior to pure blood-activating herbs for pain that involves both qi and blood stagnation. Modern pharmacology has confirmed that boswellic acids — particularly AKBA — potently inhibit 5-lipoxygenase, producing anti-inflammatory, analgesic, anticancer, and neuroprotective effects that rival some NSAIDs without gastric side effects.

Activates blood and moves qi — addresses both blood stasis and qi stagnation simultaneously
Relieves pain — the primary resin for musculoskeletal pain, trauma, and surgical pain
Reduces swelling and generates flesh — promotes wound healing, reduces post-injury swelling
Relaxes sinews and unblocks the channels — treats bi syndrome and joint stiffness

Standard dose: 3–5 g internally; larger amounts used in topical preparations
Contraindicated in pregnancy — strongly activates blood and may cause miscarriage
Use with caution in patients without blood stasis — prolonged use may injure blood
May cause nausea in some patients — take after meals or reduce dose
Process to remove oil (去油制乳香) for internal use to reduce nausea
Almost always combined with Mo Yao — they are considered inseparable partners

Huo Luo Xiao Ling Dan (活络效灵丹): Ru Xiang, Mo Yao, Dan Shen, Dang Gui — activates blood, moves qi, and relieves pain; used for trauma, angina, and dysmenorrhea
Qi Li San (七厘散): Ru Xiang, Mo Yao, Xue Jie, Hong Hua, She Xiang, Bing Pian, Zhu Sha, Er Cha — classic topical and internal trauma formula for fractures and acute injury
Juan Bi Tang (蠲痹汤) and other bi-syndrome formulas: Ru Xiang added for joint pain and stiffness
Topical plasters (膏药): Ru Xiang + Mo Yao form the base of most Chinese analgesic plasters

For traumatic injury with pain and swelling — classical pairing: combine with Mo Yao (Ru Xiang and Mo Yao are almost always used together).
For non-healing ulcers and carbuncles: combine with Mo Yao, Dan Shen, Jin Yin Hua.
For blood stasis pain in chest, abdomen, or limbs: combine with Mo Yao, Yan Hu Suo, Dan Shen.
For bi syndrome with joint pain: combine with Du Huo, Qin Jiao, Mo Yao.
For dysmenorrhea from blood stasis: combine with Mo Yao, Dang Gui, Hong Hua.
For postpartum pain and lochia retention: combine with Yi Mu Cao, Mo Yao, Dang Gui.
For fracture healing: combine with Mo Yao, Gu Sui Bu, Xu Duan.

AKBA specifically
- Anti-inflammatory: inhibits 5-lipoxygenase (5-LOX), reducing leukotriene B4 — without gastric side effects of NSAIDs
Analgesic
- reduces pain in osteoarthritis, rheumatoid arthritis, and sports injuries
Wound healing
- promotes fibroblast proliferation and collagen synthesis
AKBA
- Antitumor: induces apoptosis in colon, brain, and breast cancer cells
Anti-inflammatory bowel disease
- reduces mucosal inflammation in Crohn’s, UC
Neuroprotective
- reduces neuroinflammation in Alzheimer’s and MS models
Antibacterial
- volatile oils active against Staphylococcus and oral pathogens

Ming Yi Bie Lu (《名医别录》): ‘Treats wind-water toxin swelling, expels pathogenic qi.’
Ben Cao Gang Mu (《本草纲目》): ‘Dissolves all carbuncle and abscess toxins, supports the interior and protects the Heart, activates blood and settles pain, relaxes sinews, treats difficult labor in women and fracture injuries.’
Ben Cao Jing Shu (《本草经疏》): ‘Frankincense is warm in qi, enters the Hand Shao Yin and Foot Jue Yin blood aspect; can expel pathogenic qi, settle pain in all channels, dissolve toxic swelling, and generate flesh — functioning the same as Myrrh (没药), frequently used together with it.’
Ben Cao Zheng (《本草正》): ‘Frankincense is a medicinal for activating blood, expelling wind, relaxing sinews, and stopping pain; hence it excels at treating all blood stagnation, wind pain, carbuncles and abscesses, traumatic injury from falls, and postpartum afterbirth pain.’