Tongcho

A name for promoting urination, a medicine that can weaken the Spleen

The name of Tongcho (通草) as left in the Bencao Gangmu is simple. The character 'Tong' (通) was added in the sense of 'promoting urination.' Classical texts record it in the context of 'opening the nine orifices and blood vessels,' and the Dongui Bogam adds that it 'opens the blocked energy of the various meridians.' This created the image of a medicinal herb that clears blocked energy.

However, this 'opening' (Tong) is sometimes distorted in a different direction today. There is a perception that simply increasing urination for weight loss or 'detox' is healthy, but this is far from the original context in which Tongcho was recorded. In fact, classical texts first list the people who should not use Tongcho. According to the Traditional Knowledge Portal, it is explicitly stated that those with deficiency of both Qi and Blood (氣血兩虛者), those without damp-heat inside the body, and pregnant women should avoid taking it. In other words, because its power to 'open' is strong, there is a warning, prior to its name, that it may further weaken the Spleen in those who are already deficient.

Therefore, Tongcho is a medicinal herb where 'how much,' 'who,' and 'how' it is used are particularly important. It may be included in prescriptions when postpartum breast milk does not flow well, or combined for bloody urine caused by heat in the lower burner, but all of these are decided after a Korean medicine doctor evaluates the patient's constitution and symptoms. To prevent cases where people take it on their own to 'promote urination' only to deplete their energy, this page examines both classical records and modern precautions.

Summary at a Glance

The core of Tongcho lies in 'opening what is blocked,' as its name suggests, but the targets and methods are clearly recorded in the classics. The table below summarizes its origin, properties, primary records, and precautions.

Category	Content
Origin	Hanja name Tongcho (通草), plant of the Araliaceae family Tetrapanax papyriferus The medulla (pith) of K. Koch is used medicinally.
Properties and Meridian Tropism	Sweet and bland, slightly cold, non-toxic. Acts on the Stomach and Lungs.
Representative Aliases	Recorded under the alias Mokbanggi (木防己).
Efficacy Recorded in Literature	Recorded in the Bencao Gangmu and Dongui Bogam lineages as 'opening the nine orifices and blood vessels' and 'opening the blocked energy of the various meridians.' Traditional primary actions include clearing heat and promoting urination, and opening energy to promote lactation.
Main Components and Modern Research	Test research related to antioxidant, anti-inflammatory, and anti-obesity effects has been reported in domestic academic journals, but further verification is needed before expanding this to clinical application evidence.
Combinations and Contraindications	Used in combinations such as Sogyeumeum-ja (for hematuria) and Tongyu-tang or Tongcho-tang (for postpartum lactation failure). Those with deficiency of both Qi and Blood, those without internal damp-heat, and pregnant women should avoid use. Official clinical data on interactions with Western medicines requires verification.

Is this medicinal herb right for me?

As its name suggests, Tongcho is a medicinal herb used under the prescription of a Korean medicine doctor in specific situations where the flow of urine, energy, or postpartum breast milk is not smooth. However, because that 'opening' power can make a deficient person even more deficient, it cannot be used regardless of constitution and symptoms. Please check based on the following three criteria first.

• Generally suitable cases: When heat gathers in the lower burner causing a feeling of decreased or interrupted urination, or when postpartum breast milk does not flow well, it can be used short-term under a Korean medicine doctor's prescription. Even then, a structure that protects energy by combining it with other tonic medicines is necessary.
• Cases requiring caution: Caution is needed if you usually urinate frequently, have a tendency for the Stomach or Lungs to be cold, or feel that your constitution is deficient in energy or blood. Although Tongcho is slightly cold, its diuretic and lactation-promoting actions can worsen deficiency symptoms.
• Cases to avoid: Use is prohibited if deficiency of both Qi and Blood is evident, if there is no damp-heat in the body, or during pregnancy. Records in the Traditional Knowledge Portal also specify that pregnant women should avoid taking it.

Ultimately, Tongcho is not an over-the-counter medicine for 'detox' or 'weight loss,' but a prescription medicinal herb that temporarily opens blocked flows. If it is unclear which category you fall into, it is safest to decide after consulting with a Korean medicine doctor.

Practical Q&A

We have gathered frequently asked questions about Tongcho from the clinic. Because the meaning of 'opening what is blocked' is intuitive from the name, it is easy to misunderstand; in reality, it is a herb that requires a very detailed assessment of constitution and symptoms. Based on verified records, we provide answers to questions that would be helpful to discuss during a consultation.

Does Tongcho help with dieting or 'detox'?

Although the name of Tongcho comes from 'promoting urination,' this does not mean it is used as a medicine for weight loss or general 'detox.' The phrases 'opening the nine orifices and blood vessels' and 'opening the blocked energy of the various meridians' recorded in the Bencao Gangmu and Dongui Bogam refer to the context of clearing blocked energy and blood vessels. The goal is not to increase urine volume itself, but to use it under a Korean medicine doctor's prescription when specific heat or stagnation is present. Taking Tongcho for the purpose of weight loss is inappropriate and may cause side effects in those with deficient Qi and Blood.

Can it be used during pregnancy or breastfeeding?

Records state it should not be used during pregnancy. The Tongcho entry in the Traditional Knowledge Portal specifies that 'pregnant women should avoid taking it.' Regarding breastfeeding, Tongcho is included in prescriptions for postpartum lactation failure, such as Tongyu-tang or Tongcho-tang, but these are prescribed after a Korean medicine doctor evaluates the constitution and symptoms. Since modern clinical safety data for direct consumption during breastfeeding requires verification, it must be decided through consultation.

What constitutions or symptoms should avoid this herb?

Caution is required for those with deficiency of both Qi and Blood, those without internal damp-heat, and those with a deficient Stomach or Lungs. This is because it has a slightly cold nature and a bland taste, which leads to diuretic and lactation-promoting actions. In other words, if the 'opening' power is added to a state where energy and blood are already lacking, the deficiency symptoms may deepen. This is why a Korean medicine doctor examines the overall constitution and the state of digestion and urination before prescription.

Are there other medicinal herbs that look similar to Tongcho?

There are cases. In particular, Pueraria lobata (shrubby kudzu, Aristolochia manshuriensis) was found to be sold as mislabeled Tongcho during a 2016 crackdown by the Ministry of Food and Drug Safety. Pueraria lobata is a completely different medicinal herb from Tongcho and poses significant safety concerns; therefore, Tongcho must be used through reliable Korean herbal medicine distribution channels. There have also been cases where Tongcho, Moktong, Baekseonpi, and Mahwang were labeled for food use, so it is important to verify the identity and specifications of the medicinal herb.

In which prescriptions does Tongcho form a core combination?

Representative prescriptions where Tongcho forms a core combination are as follows. These are all classical prescriptions used under the prescription of a Korean medicine doctor.

• Sogye-eumja: A prescription traditionally used when heat accumulates in the lower burner, resulting in bloody urine (hematuria). It consists of lotus root, angelica gigas, gardenia fruit, Sogyé, raw rehmannia root, talcum, Tongcho, porphyra, licorice, and bamboo leaf.
• Tongyu-tang: A prescription traditionally used when breast milk does not flow well due to deficiency of Qi and Blood after childbirth. It consists of licorice, pig trotter, cnidium lancatum, pangolin scale, and Tongcho.
• Tongcho-tang: A prescription used for lactation failure, containing licorice, wheat whisker, platycodon root, Moktong, angelica dahurica, bupleurum root, forsythia fruit, red peony root, Trichosanthes kirilowii, citrus reticulata peel, and Tongcho.

Since these prescriptions are based on specific symptoms and body constitutions, it is important to determine their application through a consultation rather than deciding to take them individually.

Relationship with Other Medicinal Herbs (Yakdae/Pairing)

Tongcho is not used alone. As it has properties that help the flow of blocked Qi or fluids, it finds its place within a prescription only when paired with other medicinal herbs. In tradition, such pairs are called 'Yakdae' (medicinal pairs). In the case of Tongcho, it is often paired with herbs that together manage the flow of specific pathways, such as urine or breast milk. Here are examples of classical prescriptions where Tongcho forms a core combination.

• Sogye-eumja A prescription cited in the Naegyeong section of the Dongui Bogam. Along with lotus root, angelica gigas, gardenia fruit, Sogyé, raw rehmannia root, talcum, porphyra, licorice, and bamboo leaf, Tongchoit is included and has been traditionally used when heat accumulates in the lower burner, resulting in bloody urine (hematuria). Here, Tongcho is combined to lower heat and assist the flow of urine.
• Tongyu-tang This is a prescription found in the 'Breast' section of Volume 3 of the 'External Form' part of the 《Dongui Bogam》, passed down through the 《Uigam》. It is used together with licorice, pig's trotter, Cnidium officinale, and pangolin scales. Tongcho 37.5gis used, and it has been traditionally used for lactation failure where breast milk does not flow well due to deficiency of Qi and Blood after childbirth. As the name suggests, it is a representative combination for the purpose of 'making the breast milk flow'.
• Tongcho-tang Also a prescription passed from the Uigam to the Oehyeong section of the Dongui Bogam. Along with wheat whisker, platycodon root, Moktong, angelica dahurica, bupleurum root, forsythia fruit, red peony root, Trichosanthes kirilowii, and citrus reticulata peel, Tongcho 2.625gis included, and it was traditionally used when breast milk flow is not smooth.

As such, while Tongcho has a single property of 'clearing blockages,' the herbs it is combined with change completely depending on which pathway it is intended to clear. When managing heat and blood in the urine, it is paired with talcum and raw rehmannia root; when caring for postpartum breast milk, it is paired with cnidium lancatum and pig trotter. Therefore, Tongcho is a medicinal herb whose use varies not only by body constitution and symptoms but also by the herbs it is used with.

In what form is it consumed?

Tongcho is a medicinal herb made from the dried light pith (髓) found inside stems. Due to its properties, it is generally not consumed conveniently as a tea or beverage, but is typically decocted with other medicinal herbs within a Korean medicine prescription. We provide guidance on the confirmed methods of use by form.

• Tea: Not common. Tongcho is not a medicinal herb intended to be steeped and drunk alone; classical records primarily describe it being blended and decocted within a prescription.
• Food/Cooking: Not common. Tongcho is a pharmaceutical raw material, not a food ingredient. There have been cases where the Ministry of Food and Drug Safety (MFDS) detected and penalized the labeling and sale of Tongcho as a food product.
• Decoction (煎湯, boiling Korean herbal medicine): This is the most common form. As recorded in the Dongui Bogam as “煎服之佳” (best when decocted and consumed), the traditional method of use is boiling it in water. It is used as a decoction with other herbs in prescriptions such as Sogyeumeum-ja, Tongyu-tang, and Tongcho-tang.
• Professional Prescriptions: As a rule, Tongcho should be used under the prescription of a Korean medicine doctor. In particular, there are clear records of contraindications, such as pregnancy, deficiency of both qi and blood, or the absence of damp-heat; therefore, it must be blended after evaluating the patient's constitution and symptoms.

Interactions and Safety During Use

Because of its property to 'clear blockages,' as its name suggests, Tongcho is used when necessary but is not a medicinal herb that anyone can use. We provide guidance focusing on precautions confirmed in classical records and modern pharmacopoeias.

• Pregnancy: Both the Tongcho entry in the Traditional Knowledge Portal of Korea and its English version explicitly state that 'pregnant women should avoid consumption.' As a rule, it should not be taken during pregnancy without consulting a Korean medicine doctor.
• Deficiency of both Qi and Blood (氣血兩虛): For those with a constitution lacking both energy (qi) and blood, the 'clearing' power of Tongcho may instead deepen the state of deficiency.
• Absence of damp-heat: Since Tongcho is a medicinal herb whose primary function is to clear heat and promote urination (淸熱利尿), there is no reason to use it if heat and dampness are not blocked within the body.
• Tendency toward coldness in the stomach or lungs: It is recorded as having a slightly cold (微寒) property, so caution is required for those with a distinct tendency toward coldness in the stomach or lungs.
• Concurrent use with Western medicine: Official or academic data confirming pharmacokinetic or pharmacodynamic interactions between Tongcho and specific Western medicines have not been found. If you are taking Western medicine, please be sure to inform your Korean medicine doctor.
• Risk of forgery or mixing: Tongcho is a medicinal herb managed as a pharmaceutical raw material by the Ministry of Food and Drug Safety. As seen in the 2016 MFDS crackdown cases, there were instances where substances such as arrowroot (Kwanmok-tong, Aristolochia manshuriensis) were sold by deceiving consumers into thinking they were Tongcho. It is important to receive prescriptions through reliable Korean herbal medicine manufacturing and distribution channels.

“通草 … 通利九竅血脈” Cited from records in the 《Bencao Gangmu》 and the 《Dongui Bogam》

The most accurate way to determine if this medicinal herb is necessary and if it suits your constitution and current medications is through an individual consultation. If you have any questions about Tongcho, please discuss them during your visit to Baekrokdam Korean medicine clinic.

If you experience these symptoms

If these signs appear

Due to its property of 'clearing blockages,' using Tongcho for longer than necessary or by someone whose constitution is not suited for it may result in further depleting energy and body fluids. The following are known warning signs that may appear during the intake of Tongcho. If these symptoms occur, rather than reducing the dose or stopping on your own, please first notify the Korean medicine doctor managing your prescription.

• Excessive urine output, or feeling cold and depleted of energy As this is a medicinal herb with diuretic and drainage effects, it may excessively deplete body fluids and energy in those with a deficient (Heo) constitution.
• Abdominal discomfort or frequent diarrhea Due to its slightly cold (Mi-han) and bland (Dam) properties, it may place a burden on the digestive function of individuals with a deficient stomach and intestines.
• Abnormal changes in postpartum lactation or increased fatigue Even when used for postpartum lactation failure, adjustments in combination with other restorative medicines and dosage are necessary for those in a state of Qi and blood deficiency.
• If there is a possibility of pregnancy or if currently pregnant Both the Traditional Knowledge Portal of Korea and its English version explicitly state that 'pregnant women should avoid taking it'.

If these symptoms are severe, or if your general condition deteriorates rapidly, such as experiencing shortness of breath, dizziness, or an irregular heartbeat, please visit an emergency medical institution.

Differences from other restorative medicines

Tongcho is a medicinal herb with a different nature from restorative medicines (Boyak) intended for 'supplementing (Bo)'. As the name suggests, it is a herb aimed at 'clearing blockages' rather than filling deficient energy or body fluids. Therefore, its purpose of prescription differs from traditional restorative medicines such as Gongjindan or Gyeongokgo.

Gongjindan is a prescription that supplements Qi and blood and helps balance the mind and body, used to replenish long-term deficiency (Heo). Gyeongokgo also has a strong character as a restorative agent (Bo-je) that nourishes Qi and blood and manages complexion, menstruation, and digestion. In contrast, Tongcho is a herb that is contraindicated for people with Qi and blood deficiency. Records in the Traditional Knowledge Portal of Korea specify that 'those with deficiency of both Qi and blood (Gi-hyeol-yang-heo)' should avoid taking it. In other words, in the very state that restorative medicines seek to fill, a state where both energy and blood are deficient, Tongcho may actually be inappropriate.

Another difference is the form of the prescription. While Gongjindan and Gyeongokgo are often made as tonic supplements for long-term use, Tongcho is frequently used alongside other herbs in short-term prescriptions to treat specific symptoms, such as heat and blockage in the urinary tract or postpartum lactation failure. Examples include Sogye-eumja or Tongyu-tang mentioned previously.

This does not mean that Tongcho is always harmful because it is a 'clearing herb'. It can be used appropriately in situations where the flow of energy is blocked, such as when damp-heat (Seup-yeol) accumulates causing blood in the urine, or when breast milk does not flow well after childbirth. However, rather than making this judgment yourself, it is safer to comprehensively check your constitution, current symptoms, and other medications through a consultation with a Korean medicine doctor. It is best to determine in the clinic whether Tongcho is necessary or if Gongjindan or Gyeongokgo is more suitable.

References

1. Tongcho Evidence Material 1: Korea Citation Index academic paper.
2. Tongcho Evidence Material 2: Korea Citation Index academic paper.
3. Tongcho Evidence Material 3: Korea Citation Index academic paper.
4. Tongcho Evidence Material 4: docs.waglewagle.net Evidence.
5. Tongcho Evidence Material 5: koreantk.com evidence materials.
6. Tongcho Evidence Material 6: koreantk.com evidence materials.
7. Tongcho Evidence Material 7: koreantk.com evidence materials.
8. Tongcho Evidence Material 8: koreantk.com evidence materials.

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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.