# Ginkgo (Ginkgo biloba) *Chinese *yin-hsing*, and for the seeds *pai-kuo*, ‘white fruits’; *Salisburia adiantifolia* of Stuart; *Ginkgo biloba* L.; in pharmacy *Ginkgo folium** **Known today as.** *Ginkgo biloba*, of the family Ginkgoaceae, a tree which Stuart, in 1911, found growing south of the Yangtse, twenty to thirty feet high, “with thin, vertical leaves resembling a duck’s foot (triangular-fan-shaped).” Its name, he explains, comes from the Japanese reading of the Chinese characters *yin-kuo*. He calls it “a tree of great beauty,” successfully transplanted to Europe and America. The drug of modern pharmacy is the leaf; the Chinese medicine of Stuart’s day used the nut-like seeds. Kind: Plant > **Caution.** Not in pregnancy, since it may impair the clotting of the blood, nor in breast-feeding. Ginkgo may increase the tendency to bleed: people with a bleeding disorder or on anticoagulant or antiplatelet drugs should use it only after consulting a doctor, and it should be stopped three to four days before surgery; bleeding of the eye, nose, brain, and gut has been reported. It may provoke seizures in epilepsy, is not recommended with efavirenz, may raise exposure to dabigatran and nifedipine, and very commonly causes headache. LiverTox, revised in 2018, finds it has not been implicated in liver injury. ## What was it used for? In Chinese medicine, the seed; in Europe, an extract of the leaf for the circulation and the memory. Stuart records that the seeds, with a somewhat fishy taste, “are supposed to benefit asthma, coughs, irritability of the bladder,” and uterine fluxes, that cooked they were thought digestive and good against worms, and that the Japanese used them likewise to promote digestion. ## What does modern science say? The European Medicines Agency’s herbal committee accepts a defined dry extract of the leaf, made with 60 per cent acetone, on clinical evidence, as ‘well-established use,’ for the improvement of age-associated cognitive impairment and of quality of life in mild dementia, and the powdered leaf as a traditional herbal medicine, “exclusively based upon long-standing use,” for heavy legs and cold hands and feet in minor circulatory disorders, once a doctor has excluded serious conditions (monograph of 2015). Its assessment report names the ginkgolides and bilobalide and the flavonoids as characteristic constituents, with ginkgolic acids among the minor ones. The Cochrane review of 2026, of 82 trials in 10,613 people, divides the cognitive claim: in dementia there may be small to moderate benefits at six months for global status, cognition, and daily living, on low-certainty evidence, while in mild cognitive impairment ginkgo probably has little or no effect. Other Cochrane reviews found no clinically significant benefit in intermittent claudication (2013), little to no effect on tinnitus on very uncertain evidence (2022), and an unanswered question in macular degeneration (2013). ## Pharmacognosy and toxicology - **ginkgolides**: terpene lactones, with bilobalide among the characteristic constituents - **bilobalide**: - **flavonoids**: - **ginkgolic acids**: among the minor constituents **Mechanism.** Not established in the sources read for this entry. **Standing.** European Union herbal monograph (2015): well-established use of a defined dry extract for age-associated cognitive impairment and mild dementia, and traditional use, “exclusively based upon long-standing use,” of the powdered leaf for minor circulatory disorders. Cochrane (2026) finds small benefits in dementia on low-certainty evidence and little or none in mild cognitive impairment. ## What lore surrounds it? Raw, the seeds were said by the Chinese to destroy cancer and to counter drunkenness; they were also used to wash clothes. Stuart adds the warning that in some cases they appeared to cause peculiar symptoms of intoxication, “and occasionally to destroy life.” ## What did the older authorities say? **Stuart, *Chinese Materia Medica* (1911).** “In the second month the tree blooms with a greenish-white bud, which opens in the night and quickly drops off, so that men rarely see the flower on the tree.” The Chinese said that seeds with three ridges grew into male trees and those with two into female, so both kinds should be planted together. The nuts were eaten at weddings, their shells dyed red, and much used at feasts. ## Sources - Stuart, G. A. (1911). *Chinese Materia Medica: Vegetable Kingdom*, “Salisburia adiantifolia.” Internet Archive, chinesemateriame00stuauoft. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Ginkgo folium (Ginkgo leaf)*. EMA/HMPC/321097/2012, 28 January 2015. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Ginkgo folium*. EMA/HMPC/321095/2012, 28 January 2014. - Wieland LS, et al. (2026). Ginkgo biloba for cognitive impairment and dementia. *The Cochrane database of systematic reviews*. PMID 41641880. - Nicolaï SP, et al. (2013). Ginkgo biloba for intermittent claudication. *The Cochrane database of systematic reviews*. PMID 23744597. - Sereda M, et al. (2022). Ginkgo biloba for tinnitus. *The Cochrane database of systematic reviews*. PMID 36383762. - Evans JR (2013). Ginkgo biloba extract for age-related macular degeneration. *The Cochrane database of systematic reviews*. PMID 23440785. - LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, “Ginkgo.” National Institute of Diabetes and Digestive and Kidney Diseases, updated 2018. NCBI Bookshelf. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Ginkgo folium (Ginkgo leaf)*. EMA/HMPC/321097/2012, 28 January 2015. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Ginkgo folium*. EMA/HMPC/321095/2012, 28 January 2014. - Wieland LS, et al. (2026). Ginkgo biloba for cognitive impairment and dementia. *The Cochrane database of systematic reviews*. PMID 41641880. - LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, “Ginkgo.” National Institute of Diabetes and Digestive and Kidney Diseases, updated 2018. NCBI Bookshelf. --- *Ginkgo.* In *Materia Medica*, edited by B. C. P. Statema. Version 1, revised 2026-10-17. The Thinking Press. https://thethinkingpress.org/materia-medica/ginkgo Historical description, not medical advice.