Lí Lú (藜芦) — Black False Hellebore Root
On this page
- Overview
- Properties
- Actions and indications
- Incompatibilities
- Cautions and modern status
- Treatment at my clinic
1. Overview
Lí Lú (藜芦) is the root and rhizome of Veratrum nigrum (black false hellebore). It is a classical emetic listed in the foundational Chinese materia medica for inducing vomiting to expel Wind-Phlegm in stroke, acute mania and food poisoning. Veratrum alkaloids are highly toxic and can produce severe cardiac arrhythmia, hypotension and respiratory depression even at modest doses. Li Lu is one of the famous "Eighteen Incompatibilities" of TCM — it must never be combined with Ren Shen (ginseng), Shao Yao (peony), Sha Shen, Dan Shen, Ku Shen, Xuan Shen or Xi Xin. In modern clinical practice in the UK and Europe, Li Lu is almost never used, and safer alternatives are preferred for every classical indication.
2. Properties
| Pinyin name | Lí Lú |
|---|---|
| Chinese characters | 藜芦 |
| Latin name | Radix et Rhizoma Veratri / Veratrum nigrum |
| English name | Black False Hellebore root |
| Nature | Cold |
| Flavour | Bitter, pungent — toxic |
| Channels entered | Lung, Liver, Stomach |
| Category | Emetic herbs |
| Dosage | 0.3–0.9 g (powder); decoction not recommended due to toxicity |
3. Actions and indications
Classical actions
- Induces vomiting to expel Wind-Phlegm — classically used in stroke with rigid phlegm obstruction, acute mania ("wild" manic states) and severe food stagnation.
- Kills parasites — small doses used externally for scabies, ringworm and head lice.
In modern practice these indications are addressed with safer herbs and conventional treatment. Li Lu is largely a historical reference herb rather than a clinical tool.
4. Incompatibilities
Li Lu is the lead herb in the classical "Eighteen Incompatibilities" (Shí Bā Fǎn) of Chinese herbal medicine. It must never be combined with:
- Ren Shen (ginseng)
- Bai Shao and Chi Shao (peony)
- Sha Shen (Glehnia)
- Dan Shen (red sage)
- Ku Shen (Sophora)
- Xuan Shen (Scrophularia)
- Xi Xin (Asarum)
This denylist is taught to every Chinese herbalist and is hard-coded into modern dispensing software. Combinations are treated as an absolute contraindication.
5. Cautions and modern status
Li Lu is highly toxic. Overdose causes severe nausea, vomiting, profound bradycardia, hypotension, cardiac arrhythmia and respiratory depression. Contraindicated in pregnancy, in patients with cardiac disease, in the elderly and the debilitated. I do not prescribe Li Lu in clinical practice; safer alternatives exist for every classical indication and the risk:benefit ratio cannot be justified in the modern context. This page is provided for educational reference within the wider Chinese materia medica.
6. Treatment at my clinic
For every condition Li Lu was historically used to address — stroke recovery, phlegm-misting patterns, mania — modern treatment combines conventional medical care with safer Chinese herbal formulas such as Di Tan Tang for stroke-with-phlegm and Wen Dan Tang for Phlegm-Heat agitation. Online Chinese herbal consultations are available. See prices for costs.
