Notes on This Category

• This category consists of two moistening herbs – Sheng di and Xuan shen – and three moving herbs – Chi shao, Mu dan pi, and Zi cao. Xi jiao should no longer be used.

• Herbs in this category are commonly combined with:
A. Herbs that strengthen the spleen and stomach, when there is deficiency of these organs.
B. Herbs that nourish Yin, when there is injury of body fluids by heat or the patient has pre-existing Yin deficiency.
C. Herbs that clear heat and reduce fire, when there is a combination of Qi and Xue level invasion.

• Herbs in other categories also cool the blood. Consider as appropriate: Bai Mao Gen [Stop Bleeding], Bai Tou Weng [Clear Heat & Toxins], Bai Wei [Clear Deficiency Heat], Ban Lan Gen [Clear Heat & Toxins], Ce Bai Ye [Stop Bleeding], Da Qing Ye [Clear Heat & Toxins], Dai Zhe Shi [Subdue Liver], Dan Shen [Move Blood], Di Yu [Stop Bleeding], Di Gu Pi [Clear Deficiency Heat], Gui Ban [Nourish Yin], Mo Han Lian (Han Lian Cao) [Nourish Yin], Huai Hua [Stop Bleeding], Luo Shi Teng [Expel Wind-Damp], Qian Cao Gen [Stop Bleeding], Qing Dai [Clear Heat & Toxins], Qing Hao [Clear Deficiency Heat], Sang Ye (charred) [Acrid, Cool], Xiao Ji [Stop Bleeding], Yin Chai Hu [Clear Deficiency Heat], Yu Jin [Move Blood], Zhi Zi [Clear Heat Reduce Fire], Zhu Ru [Resolve Phlegm].

Chi Shao Yao – Red Peony root

Nature: bitter, slightly cold

Enters: Heart, Liver, Spleen

Actions: Promotes blood circulation, dispels blood stasis, relieves pain; clears heat; cools the blood; clears liver fire.

Indications:
• Blood stasis: pain and swelling (including after trauma), dysmenorrhea, amenorrhea, immobile abdominal masses. Not for amenorrhea due to cold/Yang deficiency.
• Xue level heat or heat in blood: skin eruptions, fever, purple tongue, bleeding including hematemesis, epistaxis.
• Liver fire: red, swollen, painful eyes.
• Heat-toxicity in the blood: carbuncles, boils, red, swollen eyes.
• Many sources classify this herb as a blood mover.
• Compared to Mu dan pi, Chi shao is only to be used for excess heat, while Mu dan pi can be used either for excess or deficiency. Chi shao is stronger than Mu dan pi at relieving pain.
Chi shao and Bai shao may be derived from the same plant (Paeonia lactiflora). Usually, but not always, Chi shao is gathered in the wild, while Bai shao is cultivated. The two are used together for pain and irritability associated with constrained liver Qi stagnation or pain and swelling due to trauma. (See Eric Brand’s article below)
• For hepatitis, Chi shao is often used in very high doses (to 60g).
Hsu: Tranquilizes the CNS; suppresses abdominal pain caused by spasm of the smooth muscle of the small intestine; inhibits common cold viruses; dilates coronary arteries.
DY: When using many cold herbs, add Chi shao to prevent the cold from causing blood stagnation.
• For Hepatitis A and B (Chi shao regulates gamma GT and transaminases) due to liver fire or liver blood stasis. Most hepatitis (especially enduring cases) presents with blood stasis. Give 10-30g/day (depending on the severity of stasis) on a routine basis in this disease.
• With Bai shao to nourish the blood, constrain Yin, stop pain, cool the blood without causing blood stasis, and drain and nourish the liver. For such indications as:
– 1. Persistent low-grade fever due to heat in the blood. (Add Sheng di, Di gu pi, and Mu dan pi.)
– 2. Dry mouth and tongue, red and painful eyes due to insufficiency of fluids or Yin caused by residual heat. (Wine mix-fry both herbs and add Xiang fu and Dang gui.)
– 3. Lateral costal and chest pain, abdominal pain and conglomerations due to blood stasis or liver depression Qi stagnation.
– 4. Menstrual irregularities or amenorrhea caused by blood stasis, blood deficiency, and/or liver depression Qi stagnation.
Eric Brand: Bai Shao comes from one plant, Paeonia lactiflora, whereas official Chi Shao can come from two plants, P. lactiflora and P. veitchii.  The later only produces Chi Shao and is only found in the wild.  The former can produce either bai shao or chi shao and can be either cultivated or wild-crafted.  If it is cultivated and subjected to pao zhi (boiling and scraping off the root bark), it is bai shao.  If it is wild-crafted and used crude, it is chi shao.
Here’s the rub:  In ancient texts, bai shao and chi shao weren’t differentiated.  Their distinct clinical actions were only elaborated about a thousand years ago, during the Song dynasty.  Early texts, such as the Shang Han Lun, didn’t differentiate the two medicinals.  Fast forward to modern day.  The Japanese Pharmacopoeia uses only the Latin binomial Paeonia lactiflora for Shao Yao (there is no official bai shao vs. chi shao differentiation in the J.P.), and its specification for quality is based on paeoniflorin content.  Paeoniflorin is more concentrated in the root bark, so the Japanese market often imports product that hasn’t been processed (no boiling and removal of the root bark).
In China, Bai Shao and Chi Shao are regarded as two separate medicinals.  Both use paeoniflorin content for quality control testing, but the standard minimum content of chi shao is higher than that of bai shao, because bai shao naturally has less paeoniflorin due to its traditional pao zhi.  In many ways, the different spectrum of active ingredients is thought to be reflect their traditional differentiation in terms of clinical use- the higher relative paeoniflorin content found in chi shao may be related to its different clinical applications when compared to bai shao.  Personally, I would prefer to use the traditional Bai Shao product, complete with the requirements of 1) cultivated rather than wild-crafted, and 2) subjected to traditional pao zhi- boiling and removal of the root bark.  In my mind, a cultivated product with the root bark intact is almost halfway between Chi Shao and Bai Shao, not quite traditional Bai Shao and not quite traditional Chi Shao.  However, such a product is exactly what is used as Shao Yao in Japan.

Dose: 4.5-15g

Mu Dan Pi – Cortex of Tree Peony root – Moutan – Paeonia suffruticosa

Nature: bitter, acrid, slightly cold

Enters: Heart, Liver, Kidney

Actions: Promotes blood circulation; dispels blood stasis; clears heat, including deficiency heat; cools the blood; drains pus, reduces swelling; clears liver fire.

Indications:
• Heat in the blood or Xue level heat: skin eruptions, hematemesis, epistaxis, hemoptysis, subcutaneous bleeding, frequent and profuse menstruation.
• Blood stasis: dysmenorrhea, amenorrhea, uterine masses, lumps, bruises, swelling, pain due to traumatic injury. Often combined with Gui zhi.
• Yin deficiency heat: fever (especially low grade, evening), steaming bone disorder. Particularly used in the aftermath of febrile disease. Most suitable in the absence of sweating.
• Heat-toxicity in the blood: yang-type carbuncles, boils, abscesses – including intestinal abscess. Also used topically for firm, non-draining sores.
• Liver fire: headache, eye pain, flank pain, flushing, dysmenorrhea.
• Appendicitis: with Yi yi ren, Da huang.
• Lowers blood pressure. In one study using Mu dan pi to treat 20 cases of hypertension, all diastolic readings dropped 10-20 mm Hg within 33 days, and symptoms improved.
• Use it in its raw form to cool the blood.
• Dry-fry it to promote blood circulation.
• Char it to stop bleeding.
MLT: Mu dan pi’s blood circulating properties are similar to Gui zhi.
• For trauma, bruises with ecchymotic blood
• Strong downward action: not for wind-heat or Qi level heat – can drive exterior pathogens deeper into the body.
DY: Stops bleeding.
With Dan shen to quicken the blood and dispel stasis, cool the blood, and eliminate deficiency heat. For indications such as:
– 1. Hematemesis, epistaxis, metrorrhagia, purpura, and also rubella and pruritis due to heat in the blood division.
– 2. Menstrual irregularities, dysmenorrhea, amenorrhea, dark purple menstrual blood with clots, and postpartum abdominal pain due to heat in the blood which causes blood stasis.
– 3. Continuous, low-grade fever due to Yin deficiency heat. In this case, if there are night sweats, use Di gu pi instead of Mu dan pi.
– 4. Hot, red, swollen, painful joints due to hot Bi or impediment.
Mu dan pi is incompatible with garlic and coriander.
Hsu: Hypotensive, antibacterial, tranquilizing effects.

Dose: 6-12g

Sheng Di Huang – Rehmannia root (unprepared) – “Fresh Earth Yellow”

Nature: sweet, bitter, cold

Enters: Heart, Liver, Kidney, Spleen

Actions: Nourishes Yin, generates body fluids; clears heat; cools the blood; cools upward-blazing heart fire; slightly promotes bowel movement (by generating fluids).

Indications:
Ying or Xue level heat: feverish body, dry mouth, deep red tongue, hemorrhage.
• Heat in the blood: epistaxis, hematemesis, hematuria, uterine bleeding.
• Heart fire blazing upward: mouth and tongue sores, irritability, insomnia, afternoon or low grade fever, malar flush.
• Injury of Yin or body fluids by heat: constipation, dry mouth, red tongue, thirst, continuous low-grade fever.
• Yin deficiency: wasting and thirsting disorder, throat pain.
• Sheng di huang’s ability to nourish Yin is relatively weak compared to most herbs classified as Yin tonics.
• Hepatitis: Sheng di is a liver protectant.
• Rheumatoid arthritis: May reduce joint pain and swelling, improve function, nodules, and rash, and decrease temperature. May reduce ESR to normal.
• Eczema.
• Ulcerative colitis.
MLT: Antifungal, antibacterial.
• Normalizes blood sugar for diabetes mellitus.
• Stimulates new growth of flesh and bone for injuries.
PFGC: Moistens the skin, promotes a glossy appearance.
• In patients with weak stomach Qi, it may cause poor appetite.
• Can be used to gently clear away exuberant Qi – after taking it, it will bring about temporary peace.
• Contains iron – partly responsible for its ability to generate and cool the blood.
• Boosts the vessels, generates jing and marrow, brightens the eyes, clears the ears, treats taxation heat.
Hsu: Hemostatic, diuretic, lowers blood sugar.
DY: In the beginning of treatment, it can cause loose stools for 1-3 days. This side effect usually goes away on its own.
HF: An An Shen (spirit calming) herb, important in Gu Zheng (Gu parasite) formulas (because of emotional disturbance common in patients with Gu).

Dose: 9-30g

Shui Niu Jiao – Water Buffalo Horn – Bubalus bubalis

This herb is used as a substitute for Xi Jiao – Rhinoceros Horn

Nature: salty, cold

Enters: Heart, Liver, Stomach

Actions: Clears heat; cools the blood; relieves toxicity.

Indications:
Shui niu jiao and Xi jiao have basically the same functions and composition, but Shui niu jiao is significantly weaker than Xi jiao. See Xi jiao below.
• Ox horn is also used.

Dose: 30-120g in decoction, 6-15g as a powder

Xi Jiao – Rhinoceros Horn

This herb has been included only because of the important position it has held historically in classical Chinese herbal medicine. The market for this and other rare animal products has led to the endangerment and abuse of many wonderful creatures. It is seriously unethical to use this herb.

Nature: bitter, salty, cold

Enters: Heart, Liver, Stomach

Actions: Cools the blood; stops bleeding; reduces fire; eliminates toxicity; calms the Shen; relieves convulsions and tremors.

Indications:
• Heat in the blood or Ying or Xue level invasion of heat: epistaxis, hematemesis, erythema, purpura, convulsions, delirium, very high fever.
• Blockage of the heart by fire (in disease caused by damp-heat): delirium, high fever, coma.
Ying or Xue level heat: unremitting high fever, loss of consciousness, delirium, convulsions, manic behavior.
• Heat and toxicity: skin eruptions
• Used mainly for cases of extreme heat.
• Never cooked. Powdered and taken directly.
• Do not combine with aconite.

Dose: 1-2g taken directly

Xuan Shen – Scrophularia root – Ningpo Figwort – “Dark Root”

Nature: bitter, sweet, salty, cold

Enters: Kidney, Lung, Stomach

Actions: Nourishes Yin; strongly clears heat and eliminates toxicity; cools the blood; softens hardness, dissipates nodules and swellings; drains fire.

Indications:
• Stagnation of heat/fire and toxicity in the blood: swollen, severely painful throat, swollen or red eyes, carbuncles, boils, nodes in the skin. For throat problems, Xuan shen can be used for wind-heat, Lung heat, and kidney Yin deficiency patterns when combined appropriately.
Ying level heat with injury of the Yin: feverish body, dry mouth, deep red tongue.
• Heat in the blood or Xue level heat: skin eruption, restlessness, delirium, bleeding, dry mouth, purplish tongue.
• Phlegm-fire: neck lumps, enlarged lymph nodes, etc. (Often with Zhe bei mu)
• Weaker than Sheng di at nourishing Yin.
• Lowers blood pressure – especially effective for renal hypertension – probably by vasodilation.
• Dry-fry it in salt to enhance its Yin nourishing properties.
• Not to be combined with Li lu.
Li: For enlarged lymph nodes, use Xuan shen:Huang lian::1:2.
• Caution with the dosage for sore throat – its ability to generate Yin can create phlegm (2g or less per day is safe).
• Can treat hyperthyroidism
PFGC: Treats rootless kidney fire attacking the throat.
Hsu: Vasodilator; stimulates blood circulation; antiphlogistic; hypotensive; antipyretic; hypoglycemiant; antifungal.
• Use 30-90g for tuberculosis and vasculitis.
DY: Drains floating fire; disinhibits the throat.
• With Ban lan gen to clear heat, resolve toxins, cool the blood, nourish Yin, downbear fire, disinhibit the throat, disperse swelling, and stop pain. For painful, red, swollen throat with dry, red tongue, and a fine, rapid pulse due to Yin deficiency generating a deficiency fire or replete fire which damages Yin. For heat-toxins, add Shan dou gen and Gan cao. For deficiency fire, add Mai men dong and Sheng di huang.
HF: An An Shen (spirit calming) herb, important in Gu Zheng (Gu parasite) formulas (because of emotional disturbance common in patients with Gu).
NAH: (Figwort – S. nodosa) Alterative. Thought to stimulate the lymphatic system. Formerly used [in Western herbalism] to treat scrofula (tuberculosis of the cervical lymph nodes). Because of its eliminative power, it is useful for eruptive skin diseases.
PCBDP: (herb) Diuretic, depurative, anodyne.

Dose: 6-30g

Zi Cao – Zi Cao Gen – Lithospermum or Arnebia Root – “Purple Herb”

Nature: sweet, cold

Enters: Heart, Liver

Actions: Clears heat; cools the blood; promotes blood circulation; promotes the expression of skin eruptions; eliminates toxicity; slight function to moisten the intestines and unblock the bowels; topically clears damp-heat from the skin.

Indications:
• Skin eruptions due to a warm-heat pathogen, heat in the blood, or extreme heat and toxicity in the blood: early measles, chickenpox, eczema, carbuncles, boils, burns. Especially good for dark red or purple skin disorders.
• Heat in the blood: constipation.
• Topical: for damp-heat skin lesions, vaginal itching. Often used in ointment for burns, sores, etc.
• May inhibit ovulation.
• Antineoplastic effects.
• Doctrine of signatures: Its purple color conveys it ability to enter the blood and to treat purple skin eruptions.
JTCM: Its nature is mild. It cools the blood but is not harsh, it moves blood, but not recklessly. It promotes muscle regeneration, clears dampness, heals ulcers, kills parasites and fungus. It can prevent the growth of bacteria and also has anti-inflammatory properties. It promotes blood circulation, growth of the epithelium, and excretion of toxins. It treats allergic purpura due to heat in the blood.
• Treatment of chronic hepatitis B and liver stagnant-heat:
Zi cao treats liver stagnant-heat: dull complexion, liver or spleen enlargement, jaundice, stabbing pain in the liver area, low grade fever, restlessness, burning urination, constipation, bitter taste, dry mouth, dark red tongue with a sticky yellow coat, wiry pulse. This pattern includes chronic hepatitis B (its main pathology is stagnant damp-heat-toxicity). Experiments show the herb has activity against the hepatitis B virus. It also treats cirrhosis and ascites.
To treat chronic liver stagnant-heat, combine Zi cao with Mu dan pi, Chi shao, Shan zha, Hu zhang, Bai jiang cao, Ku shen, Chai hu, Yu jin, Yin chen hao. Add Huang qi and Tai zi shen if there is Qi deficiency. Add Nu zhen zi and Sheng di if there is Yin deficiency.
Zi cao oil for neurodermatitis:
Zi cao oil: Soak Zi cao in sesame oil (1 part herb : 2 parts oil) for 15 days. Strain the oil. Apply it to rashes 3-6 times/day.
Treats neurodermatitis (skin rash due to nervous system disorder, including with severe paroxysmal itchiness).
Zi cao for retinal phlebitis and other eye problems:
Zi Yun eye drops: Decoct 500g each of Zi cao and Dang gui for 15 minutes. Strain. For each liter of the fluid: Add 1kg Feng mi. Cook for another 10 minutes. Strain. Add 100g Bing pian and 3g She xiang.
Drop into the eyes three times daily.
Treats retinal phlebitis (including blindness caused by it), cataracts, bleeding of the eyes.
While applying the above eyedrops, give this formula internally:
Zi Lan Tui Yi Tang: Zi cao, Ban lan gen, Mu zei, Chan tui, Huang qi, Pao jia pian. In 30 days, the symptoms of 85% of patients are controlled. 95% of patients recover in 90 days.
Zi cao for festering otitis media:
Zi cao oil #2: soak 100g Zi cao in 1kg sesame oil. Cook over low heat until the Zi cao becomes charcoal colored.
Treats festering otitis media. To use, clear any pus from the ear with 3% hydrogen peroxide. Apply 3-4 drops of oil into the ear 4-5 times/day. Complete recovery usually takes 3-7 days.
Can be used for both acute and chronic ear conditions.
Zi cao for burns:
Zi Yun Gao: melt 150g beeswax. Add 30g each of Zi cao and Dang gui, and 500 mL sesame oil. Cook until the oil changes to a reddish-purple color. Strain, cool.
Apply to burns – especially first and second degree.
Zi cao for chronic ulcers:
Zi Cao Gao: soak Zi cao (30g), Dang gui (15g), and Chuan jiao (3g) in 300 mL sesame oil for 24 hours. Bring to a boil. Add Chuan shan jia (9g). Strain. Add 60g beeswax. Allow to cool.
Apply topically to chronic ulcers: Sterilize the surface of the ulcer. Apply Zi Cao Gao. Cover with gauze. Use a hot water bottle to warm it for 20 minutes, twice a day. Change the gauze once daily. Ulcers usually heal in 14 or fewer applications.
K&R: (L. officinalefruit, leaves, flowers) Diuretic, emmenagogue, inhibits pituitary gonadotropins [FSH and LH], TSH antagonist.
• Wood yang, fire yang, earth yang:
Wood: biliary dyskinesia, urinary and biliary calculi, hyper-folliculine dysmenorrhea, mastosis, mastitis, hot flashes, spastic colon.
Fire: excess pituitary hormone secretion, especially inhibits FSH and LH.
Earth: hyperfolliculine dysmenorrhea, PMS.
RW: (various Lithospermum species) Contraceptive: antigonadotropic, anovulatory actions. Like oral contraceptives, it blocks the gonadotropic hormones of the anterior pituitary. Only reliable after prolonged use. Still does not reach the almost total efficacy of the contraceptive pill. Taken as a daily infusion by American Indian women for a period of six months to ensure infertility.

Dose: 3-9g