TCM Properties

Traditional Use

Clears Deficiency Heat and cools bone-steaming fever — tidal fever, night sweats, and steaming-bone sensation from Yin deficiency; principal TCM herb for late-stage febrile disease with lingering Heat in the Ying level
Clears Summer-Heat and releases exterior — summer febrile illness, alternating fever and chills, and nausea
Resolves malarial disorder — alternating chills and fever of malaria; the primary source of artemisinin, the modern WHO first-line anti-malarial drug
Cools the Blood — skin eruptions and bleeding from Blood Heat

Cools Liver Heat — red eyes and headache from Liver Heat uprising
Aromatic digestive — pungent volatile fraction used in folk medicine for nausea, poor appetite, and summer heat-induced indigestion

Qing Hao Bie Jia Tang (青蒿鳖甲汤) — Wu Jutong's (温病条辨, 1798) classical formula for late-stage Wen Bing with Yin deficiency and residual heat in the Ying level; Qing Hao combined with Bie Jia (soft-shelled turtle shell), Sheng Di Huang, Zhi Mu, and Mu Dan Pi — the definitive formula for 'steaming-bone fever' with night sweats and low-grade persistent fever
Hao Qin Qing Dan Tang (蒿芩清胆汤) — modern classic for Damp-Heat in the Gallbladder with alternating fever-chills and bitter taste; Qing Hao combined with Huang Qin, Zhi Ban Xia, Chi Fu Ling, Zhu Ru, Bi Yu San

Zhou Hou Bei Ji Fang (肘后备急方, Ge Hong, ~340 CE): 'To treat malaria, take a handful of Qing Hao in two sheng of water, wring out the juice, and drink it all' — this passage, a direct cold-water extraction avoiding heat-labile destruction of artemisinin, was specifically cited by Tu Youyou as the inspiration leading to the discovery of artemisinin; the 2015 Nobel Prize in Physiology or Medicine was awarded to Tu Youyou for this discovery
NAMING NOTE: The stub pinyin 'Huang Hao' (黄蒿) is a regional dialect name for Artemisia annua; the official Chinese Pharmacopoeia 2020 name is 'Qing Hao' (青蒿), Latin Herba Artemisiae Annuae — both names refer to the same plant (A. annua) and the same drug; 'Huang Hua Hao' (黄花蒿, yellow-flowered wormwood) is the specific botanical Chinese name; 'Huang Hao' is used in north China dialects

Artemisinin (qinghaosu; sesquiterpene lactone endoperoxide; C15H22O5; the principal bioactive compound; anti-malarial, anticancer, anti-inflammatory)
Artesunate, artemether, dihydroartemisinin (semi-synthetic artemisinin derivatives; first-line WHO anti-malarial drugs)
Artemisitene (related sesquiterpene; anti-malarial, anti-inflammatory)
Artemetin (polymethoxyflavone; anti-inflammatory, antipyretic)
Scopoletin and scopolin (coumarins; anti-inflammatory, spasmolytic)
Essential oil: camphor, caryophyllene, artemisia ketone, 1,8-cineole (antimicrobial, anti-inflammatory)

Anti-malarial — Nobel Prize mechanism: artemisinin contains an endoperoxide bridge that reacts with intraparasitic haem iron in Plasmodium species, generating cytotoxic free radicals that kill the parasite; effective against chloroquine-resistant Plasmodium falciparum; artesunate (intravenous) is the WHO recommended treatment for severe malaria; artemisinin combination therapies (ACTs) are the global first-line standard of care — the foundational pharmacological validation of Ge Hong's 1,600-year-old traditional prescription (Nobel Prize 2015, Tu Youyou)
Anticancer: artemisinin and its derivatives induce cancer cell apoptosis and ferroptosis via the same iron-dependent free radical mechanism; selectively cytotoxic to cancer cells due to elevated intracellular iron and transferrin receptor expression; anti-angiogenic effects via VEGF and HIF-1α suppression; clinical trials ongoing for breast, lung, colorectal, and haematological malignancies
Anti-inflammatory and immunomodulatory: artemisinin inhibits NF-κB, suppresses Th1/Th17 responses, and reduces TNF-α, IL-6, and IL-1β; clinical studies show benefit in systemic lupus erythematosus and inflammatory bowel disease — validates the classical Yin-deficiency fever and immune-inflammatory applications beyond infectious disease

Spleen-Stomach Deficiency Cold — cold-bitter nature strongly contraindicated with chronic diarrhea, cold abdomen, and digestive weakness; can cause severe nausea and vomiting
Malaria monotherapy: artemisinin should never be used as monotherapy for malaria — WHO mandates artemisinin combination therapy (ACT) to prevent resistance emergence

Standard TCM dose (whole herb decoction): 6–12 g, added near the end of decocting to preserve volatile oil; do not boil prolongedly — artemisinin is heat-labile and significantly degraded by prolonged cooking (hence Ge Hong's cold-water extraction instruction)
Pregnancy: artemisinin derivatives are embryotoxic in animal studies in the first trimester; WHO advises against use in first trimester unless benefit outweighs risk for severe malaria; avoid in pregnancy for non-malarial indications
CYP2B6 and CYP3A4 induction: artemisinin is a potent auto-inducer of its own metabolism (CYP2B6) and induces CYP3A4 — reduces plasma levels of CYP3A4-substrate drugs (statins, immunosuppressants, antiretrovirals, oral contraceptives) with repeated dosing
QT interval: high-dose artemether-lumefantrine combinations may prolong QT; avoid with other QT-prolonging drugs
Do not confuse with Yin Chen Hao (茵陈蒿, A. capillaris — jaundice herb) or Ai Ye (艾叶, A. argyi — moxibustion herb); these are distinct drugs with different indications

CYP3A4 substrates (statins, immunosuppressants, antiretrovirals, oral contraceptives) — artemisinin induces CYP3A4; reduced plasma drug levels with repeated dosing
CYP2B6 substrates (efavirenz, bupropion, cyclophosphamide) — artemisinin induces CYP2B6; monitor for reduced efficacy
QT-prolonging medications — additive QT prolongation risk with artemether-based formulations
Anticoagulants — artemisinin derivatives may affect vitamin K metabolism; monitor INR with warfarin