appConfigEntityId

bodyType

customContents

entityId

entityUuid

isVideo

articlePageQuery

article

articleSchemaContent

content

hooksArticlePageAdvertisementConfigArticle

hooksArticlePageFloatingButtonConfigArticle

appConfig

filter

json

liveArticle

Chloe Loung

This series is based on our reporting on TCM: its history, treatments and growing acceptance around the world. This is the seventh instalment.
In the world of traditional Chinese medicine (TCM), few remedies carry the legendary status – or the hefty price tag – of Angong Niuhuang Wan, often referred to as the “miracle pill”.
The old formula, consisting of 11 herbs and minerals, has long been revered as a top-grade emergency medicine, historically used to treat those who have had a stroke or may be about to have one.
According to the World Stroke Organization’s 2025 Global Stroke Fact Sheet, stroke remains a critical global health challenge, with 11.9 million new cases occurring annually and 93.8 million people currently living with the long-term aftermath of the condition.
The Hong Kong Stroke Fund says that about 25,000 new stroke cases occur in the city each year, with 3,500 stroke-related deaths.

That is why Angong Niuhuang Wan has been a fixture in many Chinese households for generations, particularly those with elderly family members. Similar gold-foil-wrapped traditional medicine pills are used in other parts of Asia, such as South Korea.
Angong Niuhuang Wan commands a high price. Even at a common chemist chain in Hong Kong, the cheapest pills are priced at HK$998 each online.
So why is it so expensive, and does it really work?
The recipe was published in 1798 in the medical treatise Wenbing Tiaobian – the Systematised Identification of Warm Diseases – by Wu Jutong, one of the four great physicians and masters of the school of seasonal warm diseases.
In 1870, the formula was adopted by pharmaceutical giant Tong Ren Tang, today China’s largest retailer of TCM. The company was founded in 1669 as the Imperial Court’s sole supplier.
The pill is a rescue drug meant to be taken during the initial critical period immediately following the onset of stroke symptoms.
The pill’s name is a literal description of its purpose and its star ingredient. Angong translates to “peace” and “palace”, the latter of which refers to the pericardium, or the sac around the heart that, in TCM theory, houses the mind. Together, it means to “calm the palace”, meaning to protect the brain and restore consciousness.
Although the “palace” refers to the heart sac, modern TCM and Western practitioners emphasise that this is a drug meant to treat neurological (brain) issues, and is not a treatment for a heart attack.
Niu is the Chinese word for “ox”, and huang means “yellow”. Together, niuhuang is the pharmaceutical term referring to calculus bovis – gallstones formed in cattle. Wan is the literal translation of “pill”.

In TCM, cattle gallstones are highly valued for their purported ability to clear heat and resolve phlegm. Due to the scarcity of these rocklike formations – they occur naturally in less than 1 per cent of cattle – they are one of the most expensive ingredients in TCM, which has led to surgical harvesting from cattle and the development of cultured alternatives.
The pill’s other key – and expensive – ingredients include rhinoceros horn and musk derived from the dried secreted-scent gland sac of the male deer. Both of these ingredients are just as prized as cattle gallstones.
These days, buffalo horn is more commonly used than rhinoceros horn due to the increased protection of the latter.
The ingredients are ground into a fine powder and mixed together with honey to form pills weighing three grams (0.11 ounces) each. These pills are then coated in gold foil, which serves as both a preservative and a traditional “spirit-calming” heavy metal sedative, and then encased in wax.
The pill is not swallowed whole; it must be dissolved in a small amount of warm water and consumed as a liquid. It should not be given to a patient who is unconscious or unable to swallow, as this could lead to choking or lung infections.

A 2024 study supported by the National Natural Science Foundation of China found that the pill helps regulate blood flow in the brain after an ischemic stroke – the kind caused by a blocked blood vessel. It was found to do this by addressing key circulatory problems: poor blood delivery, stiff blood vessels and blockages in the brain’s smallest vessels.
Various brands have touted the pill’s ability to prevent strokes and acute cardiovascular incidents, leading many to mistakenly use it as a daily health supplement. However, experts say it should not be taken to prevent strokes or cardiovascular diseases.
Michelle Zhang, a TCM practitioner at the Oriental Health Chinese Medicine Clinic in Hong Kong’s Central neighbourhood, emphasises the dangers born of this widespread misconception, warning that excessive consumption can have serious consequences.
“Most people are not informed about the proper usage of the pill,” she says. “My older patients may receive it as a gift, and because they know that it is very expensive, they use it so the medicine won’t go to waste.”
According to the Hong Kong Department of Health, strict dosage control is required for the formula, which contains realgar and cinnabar. Realgar contains arsenic trisulphide, while cinnabar contains mercury sulphide, both of which can lead to poisoning and organ damage if taken over an extended period.
Health authorities in Hong Kong and Singapore, as well as at the United States Food and Drug Administration, have also issued advisories warning of potential mercury and arsenic accumulation from ingesting the pills.

Zhang stresses that Angong Niuhuang Wan is strictly for emergency use within the critical “golden period” – the 60-minute window immediately following the onset of stroke symptoms in which rapid actions can drastically improve survival rates, minimise long-term disability and prevent irreversible brain damage. The window for maximum efficacy is generally considered the first 4.5 hours.
When administered correctly during this time frame, the drug may help prevent permanent brain damage.
A 2022 study on rats published in the journal Chinese Medicine by the University of Hong Kong’s School of Chinese Medicine found that the drug could extend the life-saving clot-busting treatment window by 30 minutes while reducing brain swelling, bleeding risk and death.
A 2021 study on rats at Hong Kong Baptist University suggested that, when used as a protective pre-treatment, the drug significantly shields the brain from damage and preserves its function during a subsequent stroke.
While many people keep the drug at home for emergencies, consultation with a registered Chinese medicine practitioner is crucial before taking it, as it is not suitable for all stroke cases.
In TCM, strokes are differentiated by patterns, primarily by “heat” or “cold” syndromes. Angong Niuhuang Wan, with its cold-natured properties believed to calm the mind and cool the body, is suitable for the first, as it works to counteract “heat” symptoms such as high fever and facial flushing.
“If you take it for the cold type of stroke, it will definitely have adverse effects and worsen the patient’s condition,” Zhang warns. “Without the help of a professional, it is very hard for ordinary people to differentiate, and that is why this medicine can be dangerous.”
The pill provides only a temporary measure, not a cure, and she urges anyone experiencing a stroke to seek medical care immediately.
Zhang says that while trust in the old remedy remains high, there is inadequate public education regarding its application.

Many people have faith in Chinese medicine, she says, especially in formulas like these that have existed for hundreds of years or more.
“It is a very valuable part of our culture,” she says.
“That is why it is so important for us to share accurate information, because using the medicine properly and seeing positive results gives people confidence that traditional practices still work.”
Like what you read? Follow SCMP Lifestyle on Facebook, X and Instagram. You can also sign up for our eNewsletter here.


5 of the best things to do in Hong Kong this weekend, September 18-20

How Jet Li’s trainer Wu Bin, 89, ages well and still nurtures martial arts talent

Ozempic-maker Novo Nordisk slims down to ‘Novo’

How this Hong Kong Gen Z coffee entrepreneur is filling market gap with her can-do attitude

Wellness

How TCM’s ‘miracle pill’ is used to treat strokes, but experts urge caution

A traditional Chinese medicine practitioner checks an elderly man. According to the Hong Kong Stroke Fund, about 25,000 new stroke cases occur in the city each year. Photo: Eugene Lee

Angong Niuhuang Wan is among the most prized traditional Chinese medicine formulas and costs an eye-watering amount. But do the pills actually help prevent and treat strokes, and can they be harmful? A Hong Kong-based TCM practitioner helps us understand more. Photo: Shandong Hongjitang Pharmaceutical Group

Cattle gallstones, or niu huang, are a prized ingredient in TCM and feature in Angong Niuhuang Wan. Photo: Soho/APP

Many people have faith in Chinese medicine, especially in formulas like Angong Niuhuang Wan that have existed for hundreds of years or more. Photo: Shutterstock

TCM practitioner Michelle Zhang treats a patient. Photo: Michelle Zhang

Patients and workers at a TCM clinic in Hangzhou, China. Photo: Shutterstock

How exercise helped a mother tackle serious knee pain and return to cane-free walking

Kavita Biswas could barely walk short distances before she started physiotherapy and resistance training to strengthen the muscles around her knee. Now the osteoarthritis sufferer can walk for up to 45 minutes at a time and manages her daily life independently. Photo: Kavita Biswas

By the time Biswas had reached her mid-forties, her knee had become so painful that simple daily activities were difficult. Sitting on the floor with her students was no longer possible. Photo: Kavita Biswas

When first diagnosed with a probable meniscus tear, Biswas found even short walks unbearable. Now she is able to cross this bridge near her home on her own. Photo: Kavita Biswas

Doctors confirmed that Biswas had knee ligament damage, but were hesitant to recommend a knee replacement because of her relatively young age. Photo: Shutterstock

Health benefits of mugwort and why it’s big in traditional Chinese and Japanese medicine

A compress with dried mugwort leaves is applied to the head, shoulders and neck during a soothing massage at the Ritz-Carlton in Okinawa, Japan. Photo: ritzcarlton.com

Mugwort is a perennial herb with a number of wellness benefits. Photo: instagram.com/honeysuckleherbal

Dried mugwort leaves are burned on or near the skin’s surface in the traditional Chinese medicine treatment of moxibustion, a form of heat therapy used to relieve joint pain, indigestion and menstrual cramps, and even to treat infertility. Photo: China News Service via Getty Images

A guest enjoys a massage at the spa at The Ritz-Carlton, Okinawa. Photo: ritzcarlton.com

Traditional Chinese medicine remedies for colds, coughs, flu, sleep, fatigue and more

Hong Kong-based traditional Chinese medicine practitioner Elizabeth Yau says that by addressing specific imbalances, TCM herbal remedies can uplift energy levels, reduce stress, improve digestion and restore overall vitality. Photo: Instagram/tcm.elizabeth

There are about 700 herb plants in common use in TCM. Photo: Shutterstock

Seng says that if you have come down with a cold, the best way to treat it naturally is to take personalised Chinese medicinal herbs and get enough rest. Photo: Instagram/tcmbycheehee

Ginger is commonly used in herbal remedies. Photo: Shutterstock

Year of the Horse 2026 predictions for all 12 Chinese zodiac signs. Is your luck in?

Will the Year of the Horse 2026 be lucky for you? Fortune-teller Tong Pik-ha offers her comprehensive predictions for those born under all 12 signs of the Chinese zodiac. Illustration: Victor Sanjinez

Illustration: Victor Sanjinez

Lifestyle

Health & Wellness

Health

Chinese culture

The rise of traditional Chinese medicine

Why traditional Chinese medicine is so special, and how it’s getting a push in Hong Kong

Chinese herbal medicine is dispensed at a pharmacy in Sham Shui Po, Hong Kong. Photo: Yik Yeung-man

Chinese herbal medicine is dispensed at a pharmacy in Sham Shui Po, Hong Kong, where traditional Chinese medicine is being promoted. Photo: Yik Yeung-man

Hong Kong’s acting secretary for health Dr Libby Lee (centre), Chinese Medicine Development commissioner Dr Vincent Chung (right), and Chinese Medicine Practice Subcommittee chairman Chan Wing-kwong at the Hong Kong Chinese Medicine Culture Festival. Photo: www.info.gov.hk

An artist’s impression of the finished Hong Kong Chinese Medicine Hospital, which is set to open in stages from 2025. It will provide predominantly TCM services, with Western medicine doctors playing a supporting role. Photo: HKBU

Traditional Chinese medicine is based on the belief that qi, the body’s vital energy, flows along meridians, or channels, in the body and keeps a person’s spiritual, emotional, mental, and physical health in balance. Photo: Shutterstock

Dr Mok Tik-lun, a lecturer at the School of Chinese Medicine at the Chinese University of Hong Kong. Photo: CUHK

Acupuncture is one of the “four pillars” of traditional Chinese medicine, along with herbal medicine and dietary therapy, tui na massage, and exercise and movement therapy.

Cupping, in which heated glass jars create suction to promote circulation and the flow of qi. Photo: Getty Images

Why Chinese Gen Z are getting TCM winter body checks

Qiu Jingchuan, deputy chief practitioner at Lei Yun Shang, takes a patient’s blood pressure at the company’s TCM clinic in Shanghai, China. Photo: Lisa Cam

Lei Yun Shang’s TCM clinic in Shanghai. Photo: Lei Yun Shang

Hong Kong-based TCM practitioner Samuel To at his clinic in Central. Photo: Xiaomei Chen

San fu tian moxibustion patches on a patient. Photo: Samuel To

Inside Lei Yun Shang’s TCM clinic in Shanghai. Photo: Lei Yun Shang

How celebrities are driving TCM’s boom in the West and the treatments people seek

Ex-One Direction band member Zayn Malik praises Nin Jiom Pei Pa Koa, a Chinese herbal syrup, as an “elixir” for his voice in an interview with British Vogue in June 2024. Photo: SCMP composite/YouTube (@British Vogue)/Ninjiom.com

Serena Williams, who is featured having both cupping and acupuncture sessions in an HBO documentary. Photo: EPA-EFE

Tsao-Lin Moy does cupping for a client at her practice in New York. Photo: Nick Onken

Dr Reuben Chen, a doctor based outside Dallas, uses Chinese medicine extensively in his practice. Photo: Dr Reuben Chen

Traditional Chinese medicine relies on a huge range of ingredients to provide treatments. Photo: Shutterstock

Tara Greenberg, a Chinese medicine practitioner and fertility specialist in California, is seen with acupuncture needles in her face and head. Photo: Instagram/point.holisticwellness

How TCM could help fight dementia. With cases set to triple, a Hong Kong expert explains

Researchers, including in Hong Kong, have been looking at the potential of traditional Chinese medicine to treat dementia, cases of which are forecast to rise as the elderly population grows. Photo: Yik Yeung-man

Dr Fanny Ip Chui-fun, chief scientific officer of the Hong Kong Centre for Neurodegenerative Diseases, says there is a pressing need to find solutions to dementia. Photo: HKCeND

TCM has the potential to help treat dementia because of the way it promotes gut health – which is linked to brain health. Photo: Shutterstock 

The leaves and bark of Ginkgo biloba, a tree which has been around for 250 million years, have long been used in TCM. They are believed to improve cognitive function. Photo: Shutterstock

VascuReform is a herbal brain health product under the Cogniherbs label designed to protect cognitive function. Photo: Infitech

A diagram of a cross-section of the brain of an Alzheimer’s sufferer, showing atrophy of the cerebral cortex and an enlarged hippocampus and ventricles. Photo: Shutterstock 

Why acupuncture attracts growing numbers of people for its pain relief and other effects

TCM practitioner Elizabeth Yau gives a patient facial acupuncture. Acupuncture has become a common TCM treatment. Photo: Elizabeth Yau

Chee Hee Seng is spreading the word of the value of TCM through social media, raising followers’ awareness – and curiosity – about this age-old medical system. Photo: Instagram/tcmbycheehee

Elizabeth Yau inserts acupuncture needles in a client’s stomach. Photo: Elizabeth Yau 

Chee Hee Seng was exposed to Chinese medicine from a young age and is now using it to help his family. Photo: Instagram/@tcmbycheehee

A patient undergoes cupping therapy. Photo: Elizabeth Yau

How luxury traditional Chinese medicine treatments are finding more fans in Hong Kong

Yun Wellness, at the Island Shangri-la in Hong Kong, regularly hosts guest acupuncturists, tai chi masters and bonesetters. Photo: Yun Wellness

Kelly Chain Yeung Pui-kuen, a TCM practitioner at Chain’s Medicare Centre in Admiralty, Hong Kong. Photo: Jonathan Wong

Goods for sale at Chain’s Medicare Centre. Photo: Jonathan Wong

The interior of Chuan Spa at Cordis, Hong Kong. Photo: Karma Lo

Yun Wellness’ spa treatments are built around a holistic philosophy that seeks to revitalise the body and the mind. Photo: Yun Wellness

Jessie Chan, assistant director of Chuan Spa at Cordis, Hong Kong. Photo: Karma Lo

The prized Angong Niuhuang Wan is thought to help stroke victims if taken at the right time. But when is that, and can it harm you?


How TCM’s ‘miracle pill’ is used to treat strokes, but experts urge caution

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}The prized Angong Niuhuang Wan is thought to help stroke victims if taken at the right time. But when is that, and can it harm you?

The prized Angong Niuhuang Wan is thought to help stroke victims if taken at the right time. But when is that, and can it harm you?