IngredientsLiquidambar taiwaniana Hance (synonym: Liquidambar formosana Hance) is a large deciduous tree common to woodlands in central and southern China, Taiwan, and parts of Indochina. It is classified in the family Altingiaceae and is native to East and Southeast Asia. The genus name reflects the tree's most distinctive characteristic: the genus name Liquidambar was first given by Linnaeus in 1753 from the Latin liquidus ('fluid') and the Arabic ambar ('amber'), in allusion to the fragrant terebinthine juice or gum which exudes from the tree.
Liquidambar, commonly called sweetgum, is the only extant genus in the flowering plant family Altingiaceae and has 15 species; they were formerly often treated as part of the Hamamelidaceae and are native to southeast and east Asia, the eastern Mediterranean, and North America. Liquidambar formosana is a tertiary remnant species with a broad subtropical distribution, found in the provinces south of the Qinling Mountains and Huaihe River in China, northern Vietnam, Laos, and South Korea.
Liquidambar formosana is a large, native, deciduous tree that grows up to 30–40 meters tall. The leaves are 10–15 cm wide and are three-lobed, unlike the five- to seven-lobed leaves of most American Liquidambar species. Leaves grow in an alternate arrangement and are simple, palmately-veined, with serrated margins. Roots can be aggressive and branches are usually covered with corky projections. The individual flowers are unisexual; however, both sexes can be found on the same plant (monoecious).
The common name "sweet gum" refers to an aromatic sweet balsam or gum that exudes from wounds to the tree. L. formosana oleoresin is made up of a solid resin component and a volatile component; the essential oil from the oleoresin can be obtained by hydrodistillation.
Multiple plant parts are employed medicinally:
In traditional remedies, the bark and leaves were sometimes brewed as teas or decoctions to help with digestive issues, respiratory discomfort, and to promote overall vitality. The sweet, slightly spicy scent of the resin made it a popular addition to balms and liniments intended to relieve coughs, chest congestion, and rheumatic pain. In modern commerce the material appears as whole dried fruit (for decoction), concentrated granules, and liquid tincture preparations.
In Traditional Chinese Medicine (TCM), Lu Lu Tong, or "all roads open," is the hard, spiky fruit of native sweetgum species. It first appeared in Chinese medical literature in Omissions from the Materia Medica (Bencao Shiyi), by Chen Cangqi, in 720 AD. Bitter in taste, aromatic, and neutral in temperature, Lu Lu Tong is claimed to promote the movement of blood and qi, water metabolism and urination, expel wind, and unblock the channels. It is an ingredient in formulas for epigastric distention or abdominal pain, anemia, irregular or scanty menstruation, low back or knee pain and stiffness, edema with difficult urination, or nasal congestion.
In Traditional Chinese Medicine, Lu Lu Tong belongs to the "Herbs that invigorate the Blood" category. Like the name indicates, these herbs tend to stimulate blood flow. In TCM they are used to help the circulation of blood in cardiovascular conditions or menstrual irregularities, as well as to treat acute pains caused by Blood Stagnation. They can also be used to treat Blood Stagnation when it causes certain tumors, cysts, and hardened clots.
Lu Lu Tong is bitter in flavour and neutral in nature. It functions to promote the movement of Qi and Blood, open the channels, expel Wind, and promote urination. Clinical indications include Wind-Damp painful obstruction (Bi) syndrome manifesting as pain and stiffness of the lower back and knees. Additional TCM indications include epigastric pain and abdominal distention with irregular, scanty menstruation, and nasal congestion with painful obstruction.
In TCM, Lu Lu Tong is appreciated for its neutral, slightly bitter quality and its association with the Liver and Stomach meridians. It is commonly included in formulas designed to promote smooth movement and flow, especially in blends that seek to harmonize stagnation or support energetic balance.
L. formosana resin has numerous medical applications in Asian folk medicine, such as being a promoter of blood circulation, an alleviator of blood stasis, an analgesic, and an anti-inflammatory and wound-healing agent. Known in pharmacognosy as Liquidambaris Resina, the resin of Liquidambar formosana has been used in Chinese medicine for the treatment of carbuncle, herpes, swelling ulcer, hemorrhinia, and toothache.
The resin, leaves, and bark have been used for centuries to manage symptoms associated with inflammation, such as swelling, pain, and wounds. The traditional use stems from ancient herbal texts and local ethnobotanical practices, where preparations of the plant were applied topically or ingested to alleviate joint pain and inflammatory skin conditions.
Traditional TCM indications include amenorrhea, stomachache, edema, abdominal distension, hypogalactia (insufficient lactation), muscular contracture in the hands and feet, arthritis, anal fistula, sores and boils, tinea and eczema, with a classical decoction dose of 3–10 g, or stir-baking the fruit into charcoal; the material can also be pounded into powder for external application.
More recently, it has been determined that shikimic acid, a key ingredient in the production of Tamiflu (an antiviral medication), can be usefully extracted from the seeds of the sweetgum, though it is present in the seeds in far lower concentrations than in its usual source, Chinese star anise. It is likewise found in small amounts in the leaves of the sweetgum.
Trace elements, volatile oils, terpenoids, flavonoids, phenolic acids, and phenylpropanoids are the natural plant secondary metabolites known from the different organs of L. formosana. These compounds have been identified across multiple plant parts, including the fruit, leaves, stem bark, and oleoresin.
The major components of the essential oils are (E)-caryophyllene (3.3%–64.4%), α-pinene (0.6%–34.5%), β-pinene (0.6%–26.0%), camphene (0.3%–17.3%), and limonene (0.2%–7.9%). Specific profiles depend on the plant part analyzed and geographic source.
In a detailed analysis of the leaf essential oil (EOLF), 25 compounds were identified using GC-FID and GC-MS, and the major compounds were terpinen-4-ol (32.0%), β-pinene (18.0%), γ-terpinene (13.8%), and α-terpinene.
An independent study of L. formosana balsam composition found that among 26 compounds identified, three new triterpenoids were detected. The most abundant volatile compounds were β-caryophyllene (22.7%), α-pinene (23.3%), and β-pinene (19.6%), while the most abundant non-volatile compounds were 3α,25-dihydroxyolean-12-en-28-oic acid (19.1%), oleanonic aldehyde (14.0%), and betulonic acid (13.4%).
From the resin of Liquidambar formosana, researchers isolated Liquidambarine D (a new labdane-type diterpenoid) and nineteen known compounds including five labdanes, eight abietanes, four pimaranes, and two nor-diterpenoids. L. formosana oleoresin has been the source of several abietane diterpenoids, oleanane and lupane triterpenoids with cytotoxic, antifungal, glycogen phosphorylase inhibitory, and nuclear factor of activated T cell (NFAT) transcription factor inhibitory activities.
Modern studies have indicated that Liquidambaris Resina is mainly constituted by triterpenoids, cinnamic acid and its derivatives, and possesses the pharmacological actions of antitumor, antiplatelet aggregation, and anti-arrhythmia. Specifically, 3-keto oleane triterpenes showed strong cytotoxicity against MDA-MB-435S cancer cells, and 28-carboxyl oleane triterpenes possessed significant inhibition of platelet aggregation induced by ADP.
Phytochemical fractionation of Liquidambar fruits revealed that the low-molecular-weight fraction presented phenolic acids and terpenes such as gallic acid, protocatechuic acid, liquidambaric acid, combretastatin, and atractyloside A. Liquidambaric acids are known to present antitumoral, antiviral, and anti-malarial activities. Another compound detected in Liquidambar fruits was combretastatin, which is known as a potent anti-tubulin agent acting as antiproliferative and antitumoral.
There has been increasing interest in L. formosana due to its leaves being rich in shikimic acid, which plays a key role in the synthesis of the antiviral drug oseltamivir phosphate. Shikimic acid is an intermediate in the synthesis of many drugs, the most relevant being the antiviral agent oseltamivir (Tamiflu).
The polysaccharide fraction of Liquidambar fruit extract was found to contain pectic polysaccharides, including acetylated and methyl-esterified homogalacturonans together with arabinogalactan.
L. formosana's main pharmacological actions as documented in the scientific literature include antitumor, antithrombotic, antimicrobial, antiviral, anti-inflammatory, antidepressant, and antioxidant actions. L. formosana leaves are a strong antioxidant source and may mitigate or prevent the generation of free radicals. It is essential to note that the large majority of mechanistic data derives from in vitro (cell-based) and animal studies, and virtually all relates to L. formosana — the taxonomically near-identical species — rather than to L. taiwaniana specifically. No peer-reviewed clinical (human) trials specifically on L. taiwaniana were identified in the available literature.
A study published in Natural Product Communications (2014) and indexed on PubMed (PMID 25115103) examined the leaf essential oil of L. formosana (EOLF) in LPS-activated mouse macrophages. The essential oil was demonstrated to exhibit anti-inflammatory activity in mouse macrophages. EOLF reduced nitric oxide generation, secretion levels of TNF-α and IL-6, and expression levels of pro-IL-1β, iNOS, and COX-2 in LPS-activated mouse macrophages. EOLF also reduced NLRP3 inflammasome-derived IL-1β secretion. The underlying mechanisms included: (1) reduction of LPS-induced reactive oxygen species generation; (2) reduction of LPS-induced activation of c-Jun N-terminal kinase, extracellular signal-regulated kinase, and p38 MAP kinase; and (3) reduction of LPS-induced nuclear factor-κB activation. These results indicated that EOLF has anti-inflammatory activity and may provide a molecular rationale for future therapeutic interventions in immune modulation. This study was conducted in vitro (cell culture) and in mouse macrophages, not in human subjects.
The key individual constituent driving this activity was identified: LPS-induced nitric oxide generation was inhibited significantly by terpinen-4-ol, the dominant compound in the EOLF. Supporting this, a separate pharmacological investigation of terpinen-4-ol in animal arthritis models found that in vivo, terpinen-4-ol (at 15, 30, and 60 mg/kg) was evaluated using formaldehyde and complete Freund's adjuvant (CFA) arthritic models in rodents; it significantly inhibited paw and joint swelling compared to the diseased group, and showed antioxidant effects while improving haematological and histopathological parameters. The excess production of IL-1β, TNF-α, IRAK, and NF-κB were notably attenuated in all terpinen-4-ol-treated rats. Again, these are animal-model findings.
The fruit extract (infructescence) of L. formosana has also demonstrated anti-inflammatory activity in vivo, as cited in a 2017 study in the Tropical Journal of Pharmaceutical Research (Ma et al., 2017, 16:2403–2410), referenced in the PubMed record for the oleoresin essential oil study.
Like the stem and leaves, the fruits can synthesize macromolecules and secondary metabolites with important antioxidant activity. A radical scavenging assay showed that the antioxidant capacity of the ethanolic fraction of L. styraciflua fruit (a closely related species) had an IC₅₀ of 3.67 µg/mL, while all three fractions showed an antioxidant effect comparable to ascorbic acid at a concentration of 100 µg/mL.
The L. formosana essential oils were screened for antimicrobial activity against a panel of potentially pathogenic bacteria and fungi and showed promising antimicrobial activities with minimum inhibitory concentration (MIC) ≤ 625 µg/mL. These findings were in vitro. Many pharmacological activities appear to be attributable to terpenoid and flavonoid constituents; terpenoids had been proposed as being responsible for the antitumor, antimicrobial, and antiviral activities documented for L. formosana.
Results of a study on pentacyclic triterpenes from L. formosana resin showed that 3-keto oleane triterpenes had strong cytotoxicity against MDA-MB-435S cancer cells and that 28-carboxyl oleane triterpenes possessed significant inhibition of platelet aggregation induced by ADP. Two new triterpenes and eight known triterpenes with potent cytotoxicity and antiplatelet aggregation activity were isolated from the petroleum ether extract of Liquidambaris Resina. These results were obtained in cell-based assays, and have not been validated in clinical trials.
There has been increasing interest in L. formosana due to its leaves being rich in shikimic acid, which plays a key role in the synthesis of the antiviral drug oseltamivir phosphate. Shikimic acid content and other breeding traits were evaluated for 387 families of 19 provenances in a provenance-family trial. The interest here is primarily in shikimic acid as a chemical precursor for pharmaceutical manufacturing, not as a direct therapeutic agent derived from L. taiwaniana itself.
Evidence level: Preclinical (in vitro and animal models) only. No human clinical trials specifically for L. taiwaniana identified.
Scientific validation for anti-inflammatory uses is limited. While some related species in the Liquidambar genus (such as Liquidambar orientalis and Liquidambar styraciflua) have been studied for their anti-inflammatory and antioxidant properties, direct research on Liquidambar taiwaniana is sparse. The evidence reflects moderate support from traditional sources but a lack of robust clinical or preclinical studies specifically focused on this species.
While traditional use is well documented, scientific evidence to support anti-inflammatory efficacy remains preliminary or extrapolated from related species. The cell-culture studies and animal models described in Section 4 provide a mechanistic basis for further investigation but do not constitute clinical evidence of efficacy in humans.
Evidence level: In vitro only.
L. formosana leaves are a strong antioxidant source and may either mitigate or prevent generation of free radicals. This finding is based on laboratory assays such as DPPH radical scavenging. No human studies exist that assess antioxidant effects of L. taiwaniana supplementation in vivo.
Evidence level: In vitro only.
The antimicrobial potential of L. formosana essential oils has been demonstrated in laboratory assays at MIC values ≤ 625 µg/mL against pathogenic bacteria and fungi. These results highlight the economic value of L. formosana oleoresin essential oil and the potential therapeutic benefits of its oleoresin essential oils. Whether these concentrations are achievable or safe in human tissue remains untested.
Evidence level: In vitro for platelet studies; TCM traditional use for circulatory effects. No human clinical evidence.
There is a lack of robust clinical or pharmacological studies specifically investigating L. taiwaniana's effects on blood parameters, circulation, or hematological health. Most available literature is ethnobotanical, documenting traditional uses rather than demonstrating efficacy through scientific methods. The antiplatelet aggregation findings from L. formosana resin triterpenoids (reported in a 2011 study in ScienceDirect) are cell-based results.
Evidence level: In vitro only. Entirely preliminary.
Although preliminary studies of L. formosana are under way in different laboratories to use the antitumor, antithrombotic, anti-inflammatory, antimicrobial, antiviral, and antidepressant activities, these studies should be extended to humans in view of the medicinal nature of the plant. The cytotoxicity data against cancer cell lines are strictly in vitro findings. No clinical trial evidence exists for any anticancer application of L. taiwaniana.
Evidence level: Traditional use only. No clinical trial evidence.
Lu Lu Tong is traditionally used to promote urination to address dysuria and edema by draining excess water down and out of the body. TCM properties include promoting the movement of Qi and Blood, opening the channels, expelling Wind, and promoting urination. No modern pharmacological or clinical studies on these specific endpoints were identified.
Evidence level: Traditional use only. No clinical evidence.
Lu Lu Tong is traditionally used to treat skin and nasal allergies such as itching, hives, and allergic rhinitis. TCM indications include nasal congestion with painful obstruction. No randomized controlled trials or observational clinical studies for these applications of L. taiwaniana were found in the literature.
Evidence level: Traditional use only.
Traditional indications in Chinese medicine have included hypogalactia (insufficient lactation). This use has no documented modern clinical validation.
Scientific validation for the specific uses of Liquidambar taiwaniana is limited. While some related species in the Liquidambar genus have been studied for their anti-inflammatory and antioxidant properties, direct research on Liquidambar taiwaniana is sparse. The available evidence reflects moderate support from traditional sources but a lack of robust clinical or preclinical studies specifically focused on this species. Preliminary studies should be extended to humans in view of the medicinal nature of the plant.
Based on TCM tradition and the limited available phytochemical and pharmacological data, the following body systems and health domains are associated with Liquidambar taiwaniana:
In TCM, Lu Lu Tong bulk herb is used in the daily dosage of 5 to 9 g. In most cases, bulk herbs are cooked in boiling water to make tea or soup for consumption. An alternative classical source gives a range of 3–10 g, taken as a decoction, or stir-baked into charcoal.
The decoction dosage range is 3–10 g; for external application, the fruit is pounded into powder for direct application to the affected area.
One commercial tincture preparation reports a suggested use of 20–30 drops (approximately 1 mL) dissolved in 2 oz of juice or water, up to 4 times per day, though this is a manufacturer-stated dosage and not a dosage established by a clinical trial.
In rodent arthritis studies examining the principal active constituent terpinen-4-ol (found in L. formosana leaf essential oil), terpinen-4-ol was evaluated at 15, 30, and 60 mg/kg using formaldehyde and CFA arthritic models; it significantly inhibited increases in paw and joint swelling compared to the diseased group. These animal dosages are not translatable to human use without further study.
Note: No standardized human clinical dosages for Liquidambar taiwaniana preparations have been established in peer-reviewed clinical trials.
Lu Lu Tong / Liquidambar taiwaniana is contraindicated during pregnancy and for women with hypermenorrhea. It is contra-indicated during pregnancy and for patients with heavy menstruation. This contraindication is consistent across multiple TCM reference sources. The likely basis is the herb's traditional classification as a blood-activating and channel-opening agent, which can stimulate uterine circulation.
Lu Lu Tong should be used in controlled dosage as it may induce palpitations. This substance should not be used during pregnancy or by those experiencing heavy menstruation. It should also be used with caution as it may cause heart palpitations. The mechanism underlying this effect has not been established in published pharmacological research.
Lu Lu Tong is contraindicated for women with hypermenorrhea, consistent with its TCM categorization as a blood-invigorating herb that promotes circulation and may augment menstrual bleeding.
There is a lack of robust clinical or pharmacological studies specifically investigating L. taiwaniana's effects on blood parameters, circulation, or hematological health. Most available literature is ethnobotanical, documenting traditional uses rather than demonstrating efficacy through scientific methods. Accordingly, formal safety data from randomized controlled trials or systematic toxicological studies in humans are not available.
Most available literature is ethnobotanical, documenting traditional uses rather than demonstrating efficacy through scientific methods. Some phytochemical analyses have identified resinous compounds and essential oils with potential anti-inflammatory or analgesic properties, but these findings are preliminary and not directly linked to blood system support. No peer-reviewed study has formally characterized herb-drug interactions for L. taiwaniana preparations.
Harvests of the right species at proper maturity are identified by experienced professionals, cleaned, cut or sliced, and dried. In many cases, special processing methods such as soaking with rice wine, steaming, or roasting are applied as mandated by traditional Chinese medicine traditions to prepare the herbs, achieve desired properties, enhance efficacy, and reduce toxicity. Whether such traditional processing steps materially affect the safety or potency of the product has not been examined in modern controlled studies.
Most references in the scientific literature pertain to the closely related Liquidambar orientalis or L. formosana, with very limited documentation specific to L. taiwaniana. There is a lack of robust clinical or pharmacological studies specifically investigating L. taiwaniana's effects on blood parameters, circulation, or hematological health.
The species designations Liquidambar taiwaniana Hance and Liquidambar formosana Hance are used synonymously across the TCM and phytochemical literature. The Chinese herb Lu Lu Tong is described as the dried, burr-covered fruit of the beautiful sweetgum tree (Liquidambar taiwaniana Hance; synonym: Liquidambar formosana Hance), a large deciduous tree common to woodlands in central and southern China, Taiwan, and parts of Indochina. Readers should be aware that pharmacological findings cited as being for L. formosana in peer-reviewed journals are generally considered applicable to L. taiwaniana under this synonymy, but species-specific biochemical differences have not been systematically ruled out. Further research is required to isolate and identify more new compounds that contribute to pharmacological effects.
Health conditions that Liquidambar taiwaniana may help support.
Body systems that Liquidambar taiwaniana may help support.
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