Safflower

Hwalhwa (活花): Safflower, the flower that awakens stagnant blood

The Dongui Bogam (Principles and Practice of Eastern Medicine) records the following regarding safflower (Honghwa). “紅花入藥只二分, 則入心養血, 多用則破血. 又云, 多用破血, 少用養血.” It states that when used in small amounts in medicine, it enters the heart to nourish the blood, but when used in large amounts, it breaks the blood. The core characteristic of safflower is that the same flower can become a 'nourishing medicine' or a 'breaking medicine' depending on the dosage. According to OASIS (Traditional Medicine Information Portal), the effects of safflower are Saneo-jitong (dispersing blood stasis to stop pain) and Hwalhyeol-tonggyeong (promoting blood circulation to clear the meridians), serving to resolve stagnant blood stasis (Eo-hyeol) and open the meridians.

Many people remember safflower only as a 'red flower that stops bleeding.' This may be due to its association with the red color used in dyes or the strong image of it being applied to wounds. However, in pharmacognosy, the essence of safflower is almost the opposite. It is a 'Hwalhyeol' (blood-activating) medicine that resolves stagnant blood to expel menstrual or postpartum blood stasis and revitalizes the flow of the meridians. According to the primary indications in OASIS, it treats conditions caused by blocked blood flow, such as Gyeongpye (amenorrhea), Oro-bulhaeng (failure of lochia to discharge), Jilbak-sonsang (bruises/contusions), Jingha-bigoe (masses/nodules), and Tonggyeong (dysmenorrhea). In other words, safflower is a medicine that revitalizes stagnant blood as if making a flower bloom, rather than simply stopping bleeding.

If this blood-activating power is excessive, it can lead to a risk of bleeding. Honghwa-tang (Safflower Decoction) in the Bangyak Happyeon uses safflower as the sovereign herb and combines it with various other blood-activating herbs such as Dangguimi, Doin, Somok, and Useul to treat menstrual obstruction in unmarried women and abdominal distension/pain. Such prescriptions demonstrate that the amount of safflower used and the herbs it is paired with are the standards for safety. It may be inappropriate for those who are pregnant or have a tendency to bleed, which is a natural limitation of herbs with strong blood-activating properties.

Therefore, when using safflower, it is important to remember the meaning of its nickname, 'Hwalhwa' (the blood-reviving flower). Just as its name suggests, it resolves blocked qi and blood when used in appropriate amounts and combinations, but in excessive amounts or for certain constitutions, it may cause the blood to fluctuate excessively. Below, we provide basic information on safflower, its traditional context of use, precautions, and its relationship with other herbs based on available public data.

Summary at a Glance

Here is a summary of the plant origin, properties, and traditional role of safflower.

Category	Content
Hanja Name / Scientific Name	Safflower (Honghwa) · (Unknown)
Origin	Safflower Carthamus tinctorius Dried tubular flowers of Linné (Asteraceae family)
Representative Alias	Including Chihonghwa, Chohonghwa, Bonhonghwa, Namhonghwa, Daehonghwa, Geumhonghwa, Hongranhwa, Pyeonhonghwa, Duhonghwa, etc.
Properties and Tropism	Acrid and Warm (辛溫); acts on the Liver and Heart
Efficacy recorded in literature	Saneo-jitong (dispersing blood stasis to stop pain), Hwalhyeol-tonggyeong (promoting blood circulation to clear the meridians), resolves stagnant blood stasis (Eo-hyeol) and opens the meridians
Primary Indication Records	Gyeongpye (cessation of menstruation), Oro-bulhaeng (failure of lochia to discharge), Jilbak-sonsang (bruises), Jingha-bigoe (masses/nodules), Changyang-jongtong (boils/edema/pain), Tonggyeong (menstrual pain)
Precautions and Contraindications	Due to strong blood-activating properties, extreme caution is required during pregnancy, immediately after childbirth, in cases of menorrhagia, or when used with medicines that clear blood (cooling blood/hemostatic tendencies). When used with tonic medicines for nourishing Yang or Yin, there may be conflicting effects, so verification is necessary.

Is this medicinal herb right for me?

Safflower is a medicinal herb with distinct blood-activating (Hwalhyeol) effects. Therefore, while it is helpful in states where blood is blocked and blood stasis (Eo-hyeol) has occurred, it may be burdensome for those with a tendency to bleed or a constitution/situation that requires clearing the blood. Please consider the following three criteria first.

• Generally suitable cases: This is when it is included in a prescription by a doctor of Korean medicine for conditions where 'stagnant blood' must be resolved, such as menstrual pain, Gyeongpye (cessation of menstruation), or remaining postpartum blood stasis. Honghwa-tang from Bangyak Happyeon, as well as Honghwa-dangguisan and Samul-jogyung-tang from Dongui Bogam, have been traditionally used in this context.
• Cases requiring caution: This includes conditions where menstrual flow is naturally heavy, there are hemorrhagic diseases, or there is a risk of bleeding such as before/after surgery or immediately after childbirth. If safflower's blood-activating power is used in excessive amounts or inappropriate combinations in these situations, it may exacerbate bleeding; therefore, consultation with a doctor of Korean medicine is essential.
• Cases to avoid: It is traditionally known as contraindicated during pregnancy. Pregnant women or those who may be pregnant should avoid both prescriptions containing safflower and taking it alone. Additionally, if you are using other blood-activating medicines or taking anticoagulants/antiplatelet agents, you must inform your medical staff due to potential interactions.

Practical Q&A

We have collected frequently asked questions about safflower from the clinic. Since this herb has a distinct blood-activating (Hwalhyeol) effect, the criteria for determining "if it is right for me" are important. The following answers are based on official and academic materials such as OASIS (Traditional Medicine Information Portal), the Traditional Knowledge Portal, and NIFDS; the final decision regarding intake or prescription must be based on a consultation with a doctor of Korean medicine.

Is safflower a 'detoxifying medicine' that clears the blood?

No. Traditionally, safflower is closer to "resolving and flowing stagnant blood" rather than "clearing the blood." According to OASIS, the effects of safflower are Saneo-jitong (dispersing blood stasis to stop pain) and Hwalhyeol-tonggyeong (promoting blood circulation to clear the meridians), serving to resolve blood stasis (Eo-hyeol) and open the meridians. In other words, it is a medicinal herb used in situations where blood is stagnant, causing pain or Gyeongpye (amenorrhea).

Is it always used for menstrual irregularities?

It is true that safflower is frequently used for menstrual irregularities (amenorrhea) or dysmenorrhea. The Dongui Bogam contains several prescriptions featuring safflower, such as Honghwa-danggui-san, Yukhap-tang, and Samul-jogyung-tang. However, the causes of menstrual issues are not all the same. Cases caused by blood stasis and those caused by a deficiency of Qi and Blood require entirely different approaches, so it is important to confirm your constitution and symptoms through a consultation.

Can it be used during pregnancy?

Safflower is a medicinal herb with a distinct blood-activating effect. The Dongui Bogam warns that "excessive use breaks the blood," which relates to the risk of bleeding when used in large quantities. Particular caution is required during pregnancy, and taking it without consulting a professional Korean medicine doctor is not recommended. Please inquire during your consultation for a specific safety assessment.

How much should I take, and for how long?

The appropriate dosage and duration of safflower use vary depending on the type of symptoms, constitution, and other medicinal herbs used in combination. In Honghwa-tang from the Bangyak Happyeon, it is recorded that 3.75g of safflower is decocted in water with other blood-activating herbs and taken on an empty stomach. However, this is merely an example of a specific prescription and has limitations if applied individually. It is advisable to determine the dosage and duration that suit you through a consultation.

What should I be careful about when taking it with Western medicine?

Safflower is a medicinal herb that can affect blood circulation. Those taking anticoagulants or blood-related prescriptions, or those scheduled for surgery, must inform both their Korean medicine doctor and their primary physician and seek consultation. Specific interactions will be guided individually based on confirmed evidence.

Do safflower tea or safflower coffee have the same effect?

Safflower products in food form and safflower used as a Korean herbal medicine differ in purpose and concentration. According to NIFDS data, the medicinal part of safflower consists of the dried tubular flowers of the safflower plant, defined as Carthami Flos in the Korean Pharmacopoeia (KP11). Everyday beverages have low pharmacological concentrations and different quality standards, making them difficult to rely on for therapeutic purposes. If you have symptoms, a consultation at a Korean medicine clinic is recommended.

Relationship with Other Medicinal Herbs (Yakdae/Pairing)

Safflower's characteristics become more distinct when it is paired with other herbs in a prescription rather than used alone. While the direction of aiding blood activation (Hwalhyeol) remains the same, depending on which herb it is paired with, the focus may shift toward clearing blocked blood, relieving pain, or opening the meridians. In traditional medicine, such pairs are called "Yakdae," and safflower repeatedly appears in prescriptions dealing with menstrual irregularities, blood stasis, trauma, and pain.

Representative combination prescriptions identified in research are as follows:

• Honghwa-tang A prescription found in the augmented section of the Bangyak Happyeon (1884), serving as a representative example where safflower is used as the chief herb. It combines 3.75g of safflower with Danggui-mi, Do-in, So-mok, U-seul, Yu-gi-no, Jeok-jak-yak, Hyeon-ho-saek, and Ja-wi-hwa, and has been traditionally used for amenorrhea in young women and distending pain.
• Honghwa-danggui-san A prescription found in the Naegyeong section of the Dongui Bogam, where safflower and danggui are used together to treat amenorrhea in young women.
• Yukhap-tang A prescription that adds Bong-chul and Yuk-gye to Samul-tang; it has been traditionally used for amenorrhea and pain from blood clots, as cited in the Dansim.
• Gwangchul-gwegyeon-tang A prescription found in the Dongwon, used to treat abdominal fullness, accumulation, and difficulty in urination or defecation, incorporating 0.8g of safflower.
• Sojong-tang A prescription found in the Jeongjeon, using 0.8g of safflower for scrofula.
• Siho-tonggyeong-tang A prescription found in the Hoechun, where safflower is combined to treat scrofula of the Shao Yang meridian.
• Samul-jogyung-tang A prescription found in the book 《Hoechun》, used for amenorrhea (absence of menstruation) and pain caused by blood stasis masses.
• Changchulbujeonsan A prescription found in the book 《Immun》, where 0.8g of safflower is combined for gout caused by wind-damp-heat.

Because safflower has strong blood-invigorating properties, caution is required for those with a tendency to bleed or those who are pregnant, regardless of whether it is combined with other herbs. Since the effect may increase when used with other blood-invigorating herbs, it is safest to leave the prescription to the judgment of a Korean medicine doctor.

In what form is it consumed?

As safflower is a medicinal herb with distinct blood-invigorating properties, it is generally used together with other herbs within traditional Korean medicine prescriptions rather than being consumed daily as a tea or food. I will explain the different forms of use.

• Tea: Drinking tea brewed with safflower alone is not common. As it is a strong blood-invigorating herb, it may be inappropriate depending on an individual's constitution or current condition, so it is not recommended without professional consultation.
• Food: Using safflower as a daily food ingredient is not common. While it has a history of being used as a dye or cosmetic raw material, general use for edible purposes is not confirmed.
• Jeontang (Decocted Korean herbal medicine): This is the most common form. In traditional Korean medicine prescriptions, safflower is used by decocting it in water with other herbs. Representative examples include Honghwatang from 《Bangyak Happyeon》, and Honghwadangguisan or Yukhap-tang from the Dongui Bogam.
• Professional Prescription: Safflower is most often combined with other herbs for the purpose of invigorating blood, regulating menstruation, and dispersing blood stasis rather than being used alone. It may be included in prescriptions for conditions such as amenorrhea, dysmenorrhea, pain due to blood stasis, or injuries from falls and blows, but it must be administered through the examination and prescription of a Korean medicine doctor.

Interactions and Safety During Use

Safflower is a medicinal herb with distinct blood-invigorating effects. Therefore, it is helpful when blood stasis occurs due to blocked blood flow, but it may be burdensome for those with a tendency to bleed or those with a constitution or condition where the blood is already thin. Here are the points you must check before taking it.

• Pregnancy and Breastfeeding: Traditionally, safflower is classified as a herb with strong blood-invigorating and menstruation-regulating effects. Those who are pregnant or breastfeeding must be especially cautious and should decide only after consulting with a Korean medicine doctor.
• Bleeding tendency: Caution is required for those with heavy menstrual flow, bleeding disorders, or those before and after surgery, as the blood-invigorating action may increase bleeding.
• Concurrent use with other medications: If you are taking Western medications related to blood, such as anticoagulants or antiplatelet agents, there may be concerns regarding interactions when used with safflower. Please consult a Korean medicine doctor regarding concurrent use with Western medicine.
• Overdose: The Dongui Bogam records, “When safflower is used in medicine in only 2 parts, it enters the heart to nourish the blood; if used in excess, it breaks the blood.” In other words, using a small amount helps nourish the blood, but using a large amount strengthens the effect of breaking the blood. Dosage and duration of intake require a professional's judgment.

Because safflower has strong blood-invigorating properties, “who, in what condition, and how much” is used is most important. If you are unsure if it is suitable for your condition, please confirm through a consultation.

If you experience these symptoms

If these signs appear

Safflower is a medicinal herb with strong blood-invigorating effects. In appropriate amounts, it resolves blocked blood, but excessive use or use unsuitable for one's constitution may lead to a tendency to bleed or digestive and skin reactions. The following signs indicate that the dosage or your body's condition should be re-evaluated. If these symptoms appear, do not increase or decrease the dose yourself; first, notify the Korean medicine doctor who provided the prescription.

• If the skin becomes red or itchy
• If you experience abdominal discomfort or diarrhea
• If menstrual flow suddenly increases or the menstrual period lasts longer than expected
• If you experience nosebleeds, bleeding gums, or bruise easily
• If dizziness or headaches worsen

If symptoms are severe or worsen rapidly after taking the medicine, it is safer to visit an emergency medical institution. In particular, those with bleeding disorders or those taking anticoagulants or antiplatelet agents must consult their attending medical staff before using blood-activating herbs, including safflower.

Differences from other restorative medicines

Safflower is a medicinal herb that has a stronger characteristic of 'clearing blockages' rather than 'tonifying.' Therefore, if you ask in the clinic, "Is this a restorative tonic?", I would explain that it strictly belongs to a different category from restorative tonics. In traditional Korean medicine, medicinal herbs are broadly divided into those that tonify and those that release; safflower falls into the latter.

Traditional restorative agents such as Gongjindan and Gyeongokgo are used over long periods to supplement Qi and Blood or fill Essence (Jeong) to govern the foundation of the body. In contrast, safflower focuses on releasing blood that is already blocked, known as blood stasis (Eo-hyeol), and clearing the meridians. It is often paired with other herbs in states where there is sufficient blood in the body, but the flow is blocked, causing pain, amenorrhea, or blood stasis. You can think of it as a role that clears a blocked stream of water.

Therefore, it is not appropriate to use safflower alone for those who are dizzy or easily fatigued due to a deficiency of blood. Instead, it is often used together with blood-tonifying herbs such as Angelica gigas (Dang-gui) and Rehmannia glutinosa (Suk-ji-hwang), or blood-tonifying prescriptions are considered first. In representative prescriptions containing safflower, such as Honghwatang or Samul-jogyungtang, safflower acts to release blocked blood, while other herbs are blended to support that flow or relieve pain.

Ultimately, whether safflower is necessary or whether restorative agents like Gongjindan or Gyeongokgo are more appropriate begins with determining whether the current state of the body is 'blocked' or 'deficient.' This distinction is most accurately confirmed through a Korean medicine doctor's examination, medical interview, tongue diagnosis, and pulse diagnosis. If you are considering taking it, please ensure you receive a customized assessment through a consultation.

References

1. Safflower Evidence Material 1: Korea Institute of Korean Medicine official data.
2. Safflower Evidence Material 2: Korea Institute of Korean Medicine official data.
3. Safflower Evidence Material 3: Korea Institute of Korean Medicine official data.
4. Safflower Evidence Material 4: Crude drug data from the National Institute of Food and Drug Safety Evaluation.
5. Safflower Evidence Material 5: Korea Citation Index academic paper.
6. Safflower Evidence Material 6: Korea Citation Index academic paper.
7. Safflower Evidence Material 7: Korea Citation Index academic paper.

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If you would like to check if this medicinal herb is right for you or which prescription it should be used with, please leave a medical inquiry. For those who find it difficult to visit the clinic, non-face-to-face consultations are available; we will provide guidance after first reviewing your current condition and current medications.