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

2 comments on “Chi Shao Yao – Red Peony root

  1. Matt Ferguson says:

    on the seventh bullet I think you may have reversed bai shao for chi shao as I usually associate chi shao with wild not cultivated being either unpeeled cultivated lactiflorae or veitchii which is mostly found in the wild.

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