Sheng Ji San

Flesh-Generating Powder · 生肌散

A classical external powder used to heal chronic ulcers, wounds, and sores that refuse to close. It clears lingering infection, breaks stagnant Blood, dries excess moisture, and stimulates the growth of healthy new skin. Applied directly to the wound, it helps transform a slow-healing lesion into one that actively regenerates.

Composition 6 herbs
Qi
King
Qing Fen (轻粉)
Ru Xiang
Deputy
Ru Xiang
Mo Yao
Deputy
Mo Yao
Xue Jie
Assistant
Xue Jie
Shi Gao
Assistant
Shi Gao
Bing Pian
Envoy
Bing Pian
Explore composition

Educational content Consult qualified TCM practitioners for diagnosis and treatment

Patterns Addressed

In TCM, symptoms don't appear randomly — they cluster into recognizable patterns of disharmony that reveal what's out of balance in the body. Sheng Ji San is designed to correct these specific patterns.

Why Sheng Ji San addresses this pattern

When Toxic-Heat lingers at the surface and stagnates, it rots the flesh and prevents healing. This formula directly clears the Heat-Toxin with Qing Fen and Shi Gao, breaks the associated Blood stasis with Ru Xiang, Mo Yao, and Xue Jie, and dries Dampness that feeds the Heat. The wound bed is then ready for new growth.

A practitioner would look for one or more of these signs

Chronic non-healing ulcers

Wound that refuses to heal with purulent or necrotic tissue

Skin Abscess

Local redness, swelling, and pus formation

Wound with foul-smelling discharge

Putrid exudate indicating lingering Heat-Toxin

Commonly Prescribed For

These conditions can arise from the patterns above. A practitioner would consider Sheng Ji San when these conditions are specifically caused by those patterns — not for all cases of these conditions.

TCM Interpretation

In TCM, a chronic ulcer that refuses to heal is seen as a local condition where the pathogenic factors (Heat, Toxin, Dampness) have not been fully cleared and have led to Blood stasis. The prolonged stagnation consumes the local Qi and Blood, creating a state of 'putrid flesh obstructing new flesh' (腐肉不去,新肉不生). Without removing the dead tissue and breaking the stasis, healthy granulation cannot form.

Why Sheng Ji San Helps

Sheng Ji San works directly on the wound bed to break the cycle: Qing Fen and Shi Gao eliminate the lingering Heat-Toxin; Ru Xiang, Mo Yao, and Xue Jie invigorate Blood and dissolve stasis; Bing Pian penetrates the site and relieves pain. As stasis and Heat resolve, the wound environment shifts from decay to regeneration, and Xue Jie's flesh-generating action promotes new granulation. This formula literally 'removes the putrid to generate the new' (祛腐生肌).

Also commonly used for

Pressure sore

Promotes healing of deep tissue ulcers through stasis-resolving and flesh-generating actions

Diabetic foot ulcer

Improves local microcirculation and granulation, reducing infection and wound duration

Venous leg ulcer

Breaks local stasis and dries exudation, creating conditions for skin regeneration

Post-surgical non-healing wound

Clears residual Toxin-Heat and stimulates new tissue growth to close surgical wounds

Burn wound

Reduces burn depth progression, relieves pain, and promotes healing when applied to clean partial-thickness burns

What This Formula Does

Every TCM formula has a specific set of actions — here's what Sheng Ji San does in the body, explained in both everyday and TCM terms

Therapeutic focus

In practical terms, Sheng Ji San is primarily used to support these areas of health:

TCM Actions

In TCM terminology, these are the specific therapeutic actions that Sheng Ji San performs to restore balance in the body:

How It Addresses the Root Cause

TCM doesn't just suppress symptoms — it aims to resolve the underlying imbalance. Here's how Sheng Ji San works at the root level.

Chronic, non-healing ulcers and wounds arise when Heat and Toxins linger at the local site, accompanied by Blood stasis and Dampness. The prolonged presence of pathogenic factors consumes local Qi and Blood, producing putrid flesh (festering tissue) that obstructs the generation of new, healthy tissue. The underlying dynamic is a local stagnation of Toxin-Heat and Blood stasis, leading to a cycle of poor granulation and persistent ulceration. The principle of treatment is to clear the residual Toxin-Heat, break Blood stasis, dry Dampness, and then stimulate the growth of new flesh.

Formula Properties

Every formula has an inherent temperature, taste, and affinity for specific organs — these properties determine how it interacts with the body

Overall Temperature

Warm

Taste Profile

Predominantly pungent, bitter, and astringent, reflecting blood-invigorating and tissue-astringing properties.

Channels Entered

Lung Spleen Kidney

Ingredients

6 herbs

The herbs that make up Sheng Ji San, organized by their role in the prescription

King — Main ingredient driving the formula
Deputy — Assists and enhances the King
Assistant — Supports or moderates other herbs
Envoy — Directs the formula to its target
King — Main ingredient driving the formula
Qi

Qing Fen (轻粉)

Dosage 0.1 - 0.3g

Role in Sheng Ji San

Strongly clears Heat and resolves toxicity, dries Dampness, expels putrid flesh and promotes healing of chronic sores
Deputies — Assists and enhances the King
Ru Xiang

Ru Xiang

Frankincense resin

Dosage 3 - 5g
Temperature Warm
Taste Acrid / Pungent (辛 xīn), Bitter (苦 kǔ)
Organ Affinity Heart, Liver, Spleen

Role in Sheng Ji San

Invigorates Blood, breaks stasis, relieves pain and reduces swelling; helps remove stagnant Blood that prevents healing
Mo Yao

Mo Yao

Myrrh resin

Dosage 3 - 5g
Temperature Neutral
Taste Bitter (苦 kǔ), Acrid / Pungent (辛 xīn)
Organ Affinity Heart, Liver, Spleen

Role in Sheng Ji San

Moves Blood, dispels stasis, stops pain and astringes eroded tissue; complements Ru Xiang in breaking Blood stasis
Assistants — Supports or moderates other herbs
Xue Jie

Xue Jie

Dragon's blood resin

Dosage 2 - 4g
Temperature Neutral
Taste Sweet (甘 gān), Salty (咸 xián)
Organ Affinity Heart, Liver

Role in Sheng Ji San

Stops bleeding, promotes tissue regeneration, reduces swelling and accelerates granulation
Shi Gao

Shi Gao

Gypsum

Dosage 5 - 10g
Temperature Cold
Taste Acrid / Pungent (辛 xīn), Sweet (甘 gān)
Organ Affinity Lungs, Stomach
Preparation Calcined (煅) for external use

Role in Sheng Ji San

Clearly heat, reduces exudation and restrains weeping sores, protecting the wound surface
Envoy — Directs the formula to its target
Bing Pian

Bing Pian

Borneol

Dosage 0.5 - 1g
Temperature Cool
Taste Acrid / Pungent (辛 xīn), Bitter (苦 kǔ)
Organ Affinity Heart, Spleen, Lungs

Role in Sheng Ji San

Opens the surface, penetrates the wound site, relieves pain and reduces swelling, and carries the other herbs to the local area

Why This Combination Works

How the herbs in Sheng Ji San complement each other

Overall strategy

This external powder directly addresses the local stagnation of Heat-Toxin and Blood stasis that prevents chronic wounds from closing. By simultaneously clearing Heat, resolving stasis, and promoting tissue regeneration, it transforms the wound environment from one of decay to one of growth.

King herb

Qing Fen (calomel) is the dominant herb, strongly clearing accumulated Heat and Toxins, drying Dampness, and eroding putrid flesh. Its potent action creates the conditions in which new flesh can form.

Deputy herbs

Ru Xiang and Mo Yao work together to invigorate Blood and break stasis, relieving pain and reducing swelling. They remove the Blood stasis that feeds the lingering Heat and physically blocks granulation.

Assistant herbs

Xue Jie (Dragon's blood) stops bleeding, generates new tissue, and adds its own pain-relieving, stasis-removing effect. Shi Gao (Gypsum, calcined) clears residual Heat and restrains exudation, drying the wound surface and providing a clean bed for healing.

Envoy herb

Bing Pian (Borneol) opens the skin and channels, carrying the actions of the other herbs deep into the wound bed while also reducing pain and swelling.

Notable synergies

The pairing of Ru Xiang and Mo Yao is a classic Blood-invigorating duo that powerfully disperses stasis and stops pain; together with Xue Jie they both break stasis and simultaneously promote tissue regeneration, a dual action critical for chronic wounds.

How to Prepare

Traditional preparation instructions for Sheng Ji San

Grind all ingredients into a very fine powder and sift to a uniform consistency. For external use only: sprinkle the powder directly onto a clean, debrided wound, or mix with sterile water, sesame oil, or liquid paraffin to form a paste and apply to the lesion. Cover with sterile gauze. Change the dressing once daily or according to exudate levels. Do not apply to actively bleeding wounds with severe hemorrhage. Avoid contact with eyes and mucous membranes. Qing Fen (calomel) is toxic; do not apply to large open areas for extended periods.

Common Modifications

How practitioners adapt Sheng Ji San for specific situations

Added
Long Gu

Duan Long Gu (煅龙骨) 5-10g, calcined to astringe and dry the wound

Calcined Long Gu strongly absorbs moisture and restrains weeping, drying the wound bed so that the other herbs can more effectively promote granulation.

Educational content — always consult a qualified healthcare provider or TCM practitioner before using any herbal formula.

Contraindications

Situations where Sheng Ji San should not be used or requires extra caution

Avoid

Do not apply to wounds in the early stage of purulent infection with pus or necrotic tissue; suitable only after debridement and cleaning.

Caution

Avoid use on actively bleeding wounds or large open wounds without medical supervision.

Avoid

Contraindicated for internal use; external application only.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

For external use only; systemic absorption is minimal. However, due to the presence of blood-invigorating herbs (乳香, 没药, 血竭), use with caution during pregnancy, particularly on large wounds or near the abdominal area. Consult a healthcare professional before use.

Breastfeeding

No specific data on breast milk transfer exists for the herbs in this formula. Topical application to intact or healing skin is unlikely to result in significant systemic exposure. Caution is advised; avoid application to nipples or areas where the infant might ingest the powder.

Children

External use only, not for ingestion. For children, clean the wound with warm water, then apply a small amount of powder (0.5–1 g for infants or children under 10 kg, 1–2 g for children over 10 kg) once or twice daily. Do not use during the early pus-filled stage or on actively bleeding wounds. Supervise application to avoid accidental ingestion.

Drug Interactions

If you are taking pharmaceutical medications, be aware of these potential interactions with Sheng Ji San

Due to the presence of 乳香 (Frankincense) and 没药 (Myrrh), which may have mild antiplatelet activity, caution is advised when this powder is applied to large wounds in patients taking anticoagulant or antiplatelet drugs (e.g., warfarin, aspirin, clopidogrel). However, topical application results in minimal systemic absorption, so clinically significant interactions are uncommon. No formal interaction studies exist.

Usage Guidance

Practical advice for getting the most out of Sheng Ji San

Best time to take

Apply 1–2 times per day after cleaning the wound; no specific time restriction. Consistent application is key.

Typical duration

Apply daily until the wound closes and new tissue is well formed, typically 1–3 weeks. Discontinue if redness, swelling, or irritation occurs.

Dietary advice

During wound treatment, avoid raw, cold, greasy, and spicy foods that may obstruct the movement of Qi and blood or generate damp-heat. Limit alcohol and smoking. A light, warm, and easily digestible diet (e.g., soups, lean proteins, cooked vegetables) supports tissue repair and recovery.

Classical Texts

Key passages from the classical Chinese medical texts that first described Sheng Ji San and its clinical use

[ "{\n \"originalText\": \"腐肉不去,新肉不生。\",\n \"translation\": \"If the corrupt flesh is not removed, new flesh cannot grow.\"\n }", "{\n \"originalText\": \"脓腐已净,方可生肌。\",\n \"translation\": \"Only after pus and necrotic tissue have been cleared may one promote tissue regeneration.\"\n }" ]

Historical Context

How Sheng Ji San evolved over the centuries — its origins, lineage, and place in the broader tradition of Chinese medicine

The formula name Sheng Ji San (生肌散) has appeared in multiple historical surgical texts. The Ming dynasty work Waike Zhengzong (外科正宗) includes a version with Qing Fen (Calomel), Ru Xiang (Frankincense), Xue Jie (Dragon’s Blood), and Bing Pian (Borneol). The Qing dynasty Yizong Jinjian (医宗金鉴) and Waike Dacheng (外科大成) also record related formulas, emphasizing the principle of ‘removing slough to promote new tissue’ (祛腐生肌). The modern standard patent medicine, containing Xiang Pi (Elephant skin, now often substituted), Long Gu (Dragon Bone), Mo Yao (Myrrh), Er Cha (Catechu), Xue Jie, Bing Pian, Chi Shi Zhi (Red Halloysite), and Ru Xiang, represents an evolution of these classical prescriptions, focusing on astringing, activating blood, and encouraging granulation in indolent wounds.

Modern Research

A published study investigating the pharmacological effects or clinical outcomes of Sheng Ji San

1

Clinical Medication Regularity in Treatment of Chronic Refractory Wound with Removing Slough and Promoting Growth of Tissue Regeneration 2004–2019: A Data Mining Study (2021)

Zhu S, Huang Z, Qian J, et al. Chinese Journal of Modern Applied Pharmacy, 2021, 38(2): 218-224.

This data mining study analyzed 117 TCM formulas used externally for chronic refractory wounds. High-frequency herbs included Xue Jie (血竭), Bing Pian (冰片), Ru Xiang (乳香), Mo Yao (没药), and others—many of which are components of Sheng Ji San. The study supports the therapeutic strategy of activating blood, clearing toxins, and astringing to promote wound healing.

DOI

Research on TCM formulas is growing but still limited by Western clinical trial standards. These studies provide emerging evidence and should be considered alongside practitioner expertise.