The branch and leaf of Epimedium sagittatum (Sieb. Et Zucc.) Maxim. or E. brevicornum Maxim. and other Epimedium species; family Berberidaceae.[1]

Mainly in mountain areas, and distributed throughout most of China.[2]

Pungent and sweet in flavor, warm in property[1]

Icariin Benzene Linoleic acid Tannin Oleic acid Vitamin E Palmitic acid Flavonoids Sterols

1. Invigorates kidney and strengthens yang while boosting qi. 2. For deficiency of kidney-yang, manifested as impotence, liver cirrhosis, emission, enuresis, frequent micturition, soreness of the waist and the knees, sterility. 3. Herba Epimedii is related to the Kidney and Liver Channels. 4. Strengthen tendons and bones, and expel wind-dampness: Helps with wind-dampness syndrome with arthralgia, numbness of limbs, muscular spasm and flaccidity of extremities, infantile paralysis, and rheumatoid pain. 5. Eliminates phlegm and relieves cough and asthma symptoms especially chronic cough and asthma (including geriatric asthma), of yang-deficiency type. 6. Also used for coronary heart diseases, hypertension and recently, neurasthenia.

Due to its qi-boosting and spirit quieting effects, Herba Epimedii is traditionally used to relieve stress and fatigue. Chinese folk healers were reported to use 100-200g (10 times the common modern clinical dose) of Herba Epimedii decocted with squid and red wine as a treatment for bodily fatigue and lack of strength due to overtaxation[5]. It is believed to remedy fatigue and absent-mindedness by flooding the brain with blood[6]. Additionally, Herba Epimedii leaf extracts have long been used as an aphrodisiac, and the herb is a common ingredient in the alcoholic "Spring Wine".

1. Effects on Sexual Function   Animal Studies   Increase sex organ size and testosterone production in mice Male mice administered Herba Epimedii extract or decoction showed an increase in the weight of prostate glands, seminal vesicles and levator ani muscles[7] as well as in the plasma testosterone level, testicular tissue growth and testicular secretions[8] . Icariin was able to promote testosterone secretion and cAMP synthesis in Leydig cells[9] . When female rats were administered with Herba Epimedii decoction, significant increase in the weight of anterior pituitary, ovary and uterus as well as an increase in the receptor binding affinity of hCG/LH was recorded[10] .       Clinical Studies   Improve impotence Herba Epimedii was used with Semen Custaue to treat 52 cases of impotence. Together with a specific decoction bath and massage, the total effective rate was found to be 92%.[11-12]. A formula containing Herba Epimedii, Fructus Lycii, Cordyceps, Radix Paeoniae Alba and Radix Achyranthis Bidentatae was used to treat 28 cases of impotence; the overall effective rate was 86%[13] .       Restore sexual function in men Herba Epimedii was used together with Rhizoma Curculiginis and Radix Acanthopanacis Senticosi to treat 32 cases of sexual function decline, 21 cases showed significant improvement while seven cases showed improvement[14] .       Alleviate the symptoms of leukoplakia vulvae Patients treated with Herba Epimedii powder mixed in a cream made of liver oil used externally showed significant improvement in leukoplakia symptoms[15] .       Improve mid-cycle menstrual bleeding In a study where the single ingredient Herba Epimedii was used to treat 12 cases of mid-cycle menstrual bleeding, fully satisfactory results were reported in every one of these 12 cases[16] .   2. Effects on cardiovascular system   Animal Studies   Strengthens the contractility of heart muscle A Herba Epimedii decoction was able to increase the contractive force of cardiomyoctes in toad hearts in vitro and in vivo. Herba Epimedii decoction was also able to restore cardiac muscular tension in a pentobarbital sodium induced heart failure toad model. Rabbits injected i.v. with Herba Epimedii decoction showed strengthened cardiac muscle tension.[17]       Increase cardiac output The cardiac output of rabbits injected i.v. with a Herba Epimedii decoction (=1g raw herb/ kg) was significantly increased. In contrast, when rabbits were injected i.v with icariin(1mg/kg), their cardiac output decreased significantly.[18]       Increase Coronary Blood Flow When guinea pig or rabbit hearts were treated with a Herba Epimedii decoction or extract, respectively, in vitro, their coronary blood flow increased[19-20] . When anethesized dogs were injected i.v. with a non amino acid extract or water extract of Herba Epimedii, their coronary blood flow was significantly increased[21-22] . A Herba Epimedii injection was able to restore the pituitrin induced coronary blood flow reduction in guinea pigs[23] .       Protect against inadequate blood supply (ischemia) Herba Epimedii decoction, water and non amino acid extracts showed a protective effect against ischemic damage in rat myocytes[21,22,24] .       Lower blood pressure When applied i.v., a Herba Epimedii decoction was able to lower the blood pressure in rabbits, rats and cats[7] . In a hypertensive rat model, Herba Epidmedii (by gavage) was able to lower the animals' blood pressure significantly. However, the hypertension resumes after cessation of medication. [25]       Promote platelet aggregation Both Herba Epimedii decoction and Herba Epidmedii polysaccharides were able to promote blood platelet aggregation and lower hematocrit both in vitro and in vivo[26] .       Lower cholesterol and triglycerides Administration of Herba Epimedii by gavage to hyperlipidemic rabbits was able to lower their beta-lipoprotein, total cholesterol and triglyceride levels[27] .       Clinical Studies   Decrease symptoms of angina Herba Epimedii tablet and Herba Epimedii extract tablet were used to treat coronary heart disease patients in two separate clinical trials. The patients in both studies showed improvement in ECG readings as well as in the seriousness of angina[28-29] . In another study where coronary heart disease patients were treated with Herba Epimedii injection (intramuscular), the patients experienced improvement in ECG readings as well as symptoms such as angina pain, palpitations and shortness of breath[30] .       Lower blood pressure in patients with hypertension In a study where Herba Epimedii extract tablets were used to treat 115 cases of hypertension, the patients' blood pressure was decreased by 10.7kPa/ 5.33kPa (80/ 40mm Hg) and the overall effective rate was 78%[31] . 3. Effects on Immune Function   Animal studies   Increase antibody production When mice immunized with sheep red blood cells (SRBC) were s.c. injected with Herba Epimedii flavone, Herba Epimedii polysaccharide or icariin, their serum antibody level and the splenic antibody level were significantly increased[32-34].       Modulate lymphocyte proliferation Mice injected s.c. with Herba Epimedii flavone or Herba Epimedii polysaccharide once a day for seven days showed significant increase in lymphocyte transformation[32-33]. Murine lymphocytes treated with Herba Epimedii polysaccharide were more responsive to phytohaemoagglutinin (PHA) stimulation[32]. Fifty percent ethanol extracts of were able to inhibit mitogen induced lymphocytic growth in vitro in a dose dependent manner. Previous studies on mice treated with overdose of cyclophosphamide showed that Herba Epimedii polysaccharide (injected s.c.) was able to promote T cell production that was suppressed by cyclophosphamide, which in turn inhibited antibody production. However, when cyclophosphamide treated mice were injected s.c. with icariin, the T cell production was suppressed and the antibody production rate was increased[34]. In a hydropredinsolone acetate induced yang deficient mouse model, administration of Herba Epimedii decoction by gavage was able to increase 3H-TdR incorporation rate during lymphocyte transformation and to increase erythrolysin level as well as anti-blood coagulation factor titer[35]. In another study, mice were rendered immuno-depressed by lymphocyte antiserum treatment. When lymphocyte antiserum induced immune-depressed mice were administered with Herba Epimedii decoction, their reduced splenic lymphocyte and splenic plaque forming cell counts were restored[36].       Increase/ restore phagocytic activity of macrophages Macrophages isolated from mice administered s.c. with Herba Epimedii polysaccharides or Herba Epimedii flavone showed increased phagocytic activities[33]. In an immune depressed mouse model induced by anti-lymphocyte antibody treatment, Herba Epimedii was able to restore the carbon phagocytic activity of macrophages[36].       Stimulate IL-2 production At low concentration (100μg/ml and 1000μg/ml), Herba Epimedii polysaccharide was able to stimulate the activity of IL-2 secreted from human peripheral blood lymphocytes, while at high concentrations (2500μg/ml and 5000μg/ml), it would inhibit IL-2 production[37].       Increase DNA synthesis and bone marrow cell proliferation Administration of a Herba Epimedii decoction significantly elevated DNA synthesis by 68% and enhanced bone marrow cell proliferation by 72% in a mouse yang-deficiency model[25].       Clinical Studies   Decrease the symptoms of leucopenia In 22 cases of leucopenia of qi deficient type, treated with a Herba Epimedii powder (15g/bag, 3 bags/ day for the first week and 2 bags/ day from the second weeks onwards) for 30 to 45 days, three cases showed complete recovery, four cases showed significant improvement, five cases showed improvement and two cases experienced no change[38].       Improve quality of life of patients undergoing hemodialysis Patients on erythropoietin medications were treated with Herba Epimedii for 4 months, the infection rate was decreased and IL-2 levels were increased. Improvement in parameters like energy, sleeping, appetite and male sex function were recorded. [39]   4. Effects on Respiratory System   Animal Studies   Anti-asthmatic effects Herba Epimedii extract can completely inhibit coughing caused by electrical stimulation of recurrent laryngeal nerve in cats. It can also relieve histamine-induced asthma in guinea pigs[40].       Clinical Studies   Effective in treating chronic bronchiolitis Herba Epimedii was used to treat 1066 cases of chronic bronchiolitis, the overall effective rate was 74.6%[40].   5. Anti-viral Effect   Animal studies   Antimicrobial and antiviral effect Herba Epimedii was able to inhibit the growth of Staphylococcus albus, Staphylococcus aureus, Neisseria, pneumococcus, Bacillus influenzae, Mycobacterium tuberculosdis, poliovirus, ECHO virus (type 6 and 9) and coxsackie virus (type A9, B4 and B5)[7,25,41].       Clinical studies   More effective than vitamin C in treating viral myocarditis In a study on viral myocarditis, 36 cases were treated with Herba Epimedii extract tablet (7 to 10 tablets/ time, 3 times/ day) and Vitamin C (3g in 500ml glucose solution, i.v. application) while 25 cases were treated with Vitamin C alone. The overall effective rate of former group and later group were 69.4% and 40% respectively.[43]   6. Others   Anti-oxidation effect in animals Water extract of Herba Epimedii was able to inhibit lipid peroxide formation in rat heart, liver, brain and kidney homogenates[44]. In an acute aging mouse model, Herba Epimedii flavone could significantly restore the depressed T and B lymphocyte proliferation, increase SOD activity, decrease lipid peroxide formation and reduce heart and liver lipofuscin[45]. Additionally, icariin has been shown to have catecholamines-antagonizing effects.       Reduce blood glucose in animals Rats treated with Herba Epimedii extracts showed blood glucose level reduction[46], as did experimental hyperglycemic rabbits[25].       Used together with other Chinese medicine to treat Neurasthenia A 3% Herba Epimedii decoction (iontophoresically applied), a Herba Epimedii extract, Herba Epimedii flavone and Icariin were used to treat to 104, 138, 61 and 29 cases respectively , the overall effective rates were 85.6%, 89.9%, 93.44% and 89.6% respectively. Improvement in the sleeplessness symptoms were also recorded in the studies. [47-48]

Decoction: 6-15g, up to 30g for single use[4].

Adverse effects are brought about by extended use, and include dizziness, vomiting, dry mouth, thirst and nosebleeding. In mice, at large doses, it can cause respiratory arrest and hyperreflexia to the point of spasm.[49] It is also contraindicated in Deficiency of Yin with Heat[50].

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