The Chinese herb Shu Di Huang (Rehmannia glutinosa) is the product of the tuberous roots of the plants Di Huang or Huai Di Huang from the Scrophulariaceae family, processed through steaming. It has a sweet taste, a slightly warm nature, and is associated with the Liver and Kidney meridians, providing effects of nourishing blood, enriching Yin, benefiting essence, and calming the spirit.
Shu Di Huang has long been regarded as a sacred medicine for nourishing blood and Yin, gaining popularity in prescriptions after the Song Dynasty, quickly becoming a key herb in TCM for replenishing Yin, blood, essence, and fluids.
▲ Di Huang Plant
▲ Shu Di Huang Medicinal Material
Nourishing Blood
This herb has a sweet taste and a moist quality, primarily entering the Liver and Kidney meridians. The Liver stores blood, and the Kidney stores essence; essence and blood share the same source and belong to the Yin category. This herb can both nourish blood and benefit essence, and it has been regarded as a key herb for blood nourishment by physicians throughout history, as noted in the “Ben Cao Bei Yao” which states it is “the superior agent for nourishing blood.”
The heart governs blood, the Liver stores blood, the Spleen regulates blood, and the Kidney essence can also transform into blood. If the functions of these four organs are disordered, blood deficiency cannot nourish, leading to symptoms such as a pale tongue, a white or sallow face, pale lips and eyelids, dizziness, and blurred vision. This herb can be used in combination with Dang Gui (Angelica sinensis) to nourish blood and generate new blood, as in the “Pu Ji Ben Shi Fang”‘s Nei Bu Wan. Alternatively, adding Bai Shao (Paeonia lactiflora) and Chuan Xiong (Ligusticum chuanxiong) can enhance the blood-nourishing and blood-activating effects, as in the “Tai Ping Hui Min He Ji Ju Fang”‘s Si Wu Tang, which is renowned as a formula that addresses “all blood-related diseases.” If blood deficiency fails to nourish the eyes, leading to pain in the eyeballs, inability to see, and sensitivity to light, this herb can be combined with Dang Gui, Bai Shao, Tian Dong (Asparagus cochinchinensis), Chuan Xiong, Niu Xi (Achyranthes bidentata), Bai Zhu (Atractylodes macrocephala), and Fang Feng (Saposhnikovia divaricata), as in the “Shen Shi Yao Han”‘s Xiong Gui Bu Xue Tang. If blood deficiency leads to insufficient nourishment of the muscles, causing numbness and stiffness in the limbs, this herb can be combined with Dang Gui, Bai Shao, Mu Guo (Chaenomeles speciosa), Zhi Gan Cao (Glycyrrhiza uralensis), Chuan Xiong, and Suan Zao Ren (Ziziphus jujuba) as in the “Yi Zong Jin Jian”‘s Bu Gan Tang.
This herb not only has excellent nourishing effects for blood deficiency but also works well for both Qi and blood deficiency. For example, in the “Jing Yue Quan Shu”‘s Liang Yi Gao, this herb is combined with Ren Shen (Panax ginseng) to treat symptoms of fatigue, dizziness, pallor, and a pale tongue with a thin pulse. Alternatively, using the ingredients of Liang Yi Gao as a base, adding Huang Qi (Astragalus membranaceus), Dang Gui, Bai Shao, and Bai Zhu can treat Qi and blood deficiency, as in the “Tai Ping Hui Min He Ji Ju Fang”‘s Shuang He Tang. Furthermore, formulas like Ba Zhen Tang and Shi Quan Da Bu Tang, which nourish Qi and blood, prominently feature this herb as a key ingredient.
The blood-nourishing effects of Shu Di Huang are most commonly applied in gynecological diseases, such as Qi and blood deficiency, blood sea emptiness, and the failure of Chong and Ren channels to nourish, leading to late menstruation or scanty, pale menstrual flow, or even premature menopause. This herb can be used with Ren Shen and Dang Gui, as in the “Jing Yue Quan Shu”‘s Da Bu Yuan Jian and the “Zheng Zhi Zhun Sheng”‘s Zi Xue Tang. If Qi fails to contain blood, leading to excessive menstrual flow, this herb can be combined with Huang Qi, Ren Shen, and Bai Zhu, as in the “Fu Qing Zhu Nu Ke”‘s Gu Ben Zhi Beng Tang.
Nourishing Yin
This herb is moist and excels at nourishing the Yin of the Liver and Kidney, particularly the Kidney Yin. Kidney Yin is the foundation of the body’s Yin fluids; when Kidney Yin reaches the five organs, it transforms into the Yin of the five organs. If Kidney Yin is deficient, the Yin fluids of the five organs will also be depleted. Zhang Jing Yue, known as “Zhang Shu Di,” had a profound understanding of the Yin-nourishing effects of Shu Di Huang. In his “Ben Cao Zheng” he stated: “For all meridians with Yin and blood deficiency, only Shu Di can suffice.” He also said: “If Yin is deficient and the spirit is scattered, it is not enough for Shu Di to guard and gather it; if Yin is deficient and fire rises, it is not enough for Shu Di to weigh it down; if Yin is deficient and there is agitation, it is not enough for Shu Di to calm it; if Yin is deficient and there is rigidity, it is not enough for Shu Di to soften it; if Yin is deficient and water evils overflow, without Shu Di, how can one control it; if Yin is deficient and true Qi is lost, without Shu Di, how can one return to the source; if Yin is deficient and both essence and blood are damaged, with thin fats remaining, without Shu Di, how can one nourish the intestines and stomach?” This passage comprehensively discusses the therapeutic effects of Shu Di Huang in nourishing Yin and treating diseases.
Shu Di Huang is not only very effective for insufficient Liver and Kidney Yin but is also the most suitable medicinal herb for treating various diseases related to Liver and Kidney Yin deficiency. It is essential for treating internal heat due to Yin deficiency, Yin deficiency with Yang hyperactivity, and Yin deficiency with excessive fire, as well as for conditions like Heart and Kidney disharmony.
Internal Heat Due to Yin Deficiency If there is deficiency of Liver and Kidney Yin, leading to an imbalance of Yin and Yang, with internal heat rising and disturbing, symptoms may include soreness in the lower back and knees, dizziness, tinnitus, bone steaming heat, heat in the palms and soles, night sweats, thirst, and nocturnal emissions. For such conditions, this herb can be combined with Shan Yao (Dioscorea opposita), Dan Pi (Moutan Cortex), Fu Ling (Poria), and Shan Yao to nourish the Liver and Kidney, as in the “Xiao Er Yao Zheng Zhi Jue”‘s Liu Wei Di Huang Wan. If there is significant empty fire, it can be combined with Zhi Mu (Anemarrhena asphodeloides) and Huang Bai (Phellodendron amurense), as in the “Yi Zong Jin Jian”‘s Zhi Bai Di Huang Wan and the “Dan Xi Xin Fa”‘s Da Bu Yin Wan.
Yin Deficiency with Yang Hyperactivity If there is deficiency of Liver and Kidney Yin, leading to insufficient water to nourish wood, resulting in Liver Yang hyperactivity, symptoms may include headaches, dizziness, a feeling of emptiness and fogginess in the head, soreness in the lower back and knees, tinnitus, and insomnia. This herb can be combined with Shan Yao, Shan Yao, Gou Qi Zi (Lycium barbarum), Ju Hua (Chrysanthemum), and Shi Jue Ming (Haliotis) to nourish Yin and subdue Yang, as in the “Jing Yue Quan Shu”‘s Da Bu Yuan Jian and the “Ma Zhen Quan Shu”‘s Qi Ju Di Huang Wan.
Excessive Fire Due to Yin Deficiency If there is excessive fire due to Yin deficiency, disturbing the blood, it can lead to bleeding symptoms. This herb can nourish Yin and reduce fire. For instance, if Kidney Yin is deficient, leading to internal fire, burning the vessels, resulting in short, red, bloody urination, or symptoms like epistaxis, gingival bleeding, or skin bleeding, this herb can be used with Zhi Bai Di Huang Wan, adding Han Lian Cao (Eclipta prostrata), Da Ji (Cirsium), and Xiao Ji (Cirsium setosum). The “Wei Sheng Bao Jian” records a formula using this herb combined with Sheng Di (Rehmannia glutinosa), Gou Qi Zi, Di Gu Pi (Lycium barbarum), and honey to treat recurrent bleeding. Clinical reports indicate that using this herb combined with Huai Hua (Sophora japonica), lotus root slices, and Bai Zi Ren (Platycladus orientalis) to treat hemorrhoidal bleeding due to Yin deficiency and excessive fire has a total effective rate of 89.3%.
Disharmony of the Five Organs Due to Yin Deficiency If there is Kidney Yin deficiency, leading to disharmony between the Heart and Kidney, resulting in insufficient Heart Yin, symptoms may include palpitations, insomnia with many dreams, forgetfulness, and night sweats. This herb can be combined with Bai Zi Ren, Tian Dong, and Mai Dong (Ophiopogon japonicus) to nourish Yin, support the Heart, and calm the spirit, as in Bai Zi Yang Xin Wan. If there is Kidney Yin deficiency and Stomach fire rising, leading to headaches, loose teeth, or even gingival bleeding, this herb can be combined with Shi Gao (Gypsum), Mai Dong, Zhi Mu, and Niu Xi, as in the “Jing Yue Quan Shu”‘s Yu Nu Jian. If both Lung and Kidney Yin fluids are deficient, leading to internal fire disturbance, resulting in cough with little phlegm, possible blood-streaked phlegm, dry mouth and throat, five hearts heat, and red cheeks with night sweats, this herb can be combined with Xuan Shen (Scrophularia ningpoensis), Bai He (Lilium), Chuan Bei Mu (Fritillaria cirrhosa), and Jie Geng (Platycodon grandiflorum) to nourish Yin, moisten the lungs, and clear heat, as in the “Shen Zhai Yi Shu”‘s Bai He Guo Jin Tang. Additionally, this herb can be combined with Mai Dong and Wu Wei Zi (Schisandra chinensis), as in Mai Wei Di Huang Wan; or with Ban Xia (Pinellia ternata) and Fu Ling, as in the “Jing Yue Quan Shu”‘s Jin Shui Liu Jun Jian.
Gynecological Conditions Due to Yin Deficiency For women, the Liver is considered the source of vitality, thus Liver blood and Kidney Yin are particularly important. Shu Di Huang can nourish blood and enrich Yin, making it a commonly used herb in gynecology. For instance, if there is Kidney Yin deficiency, leading to insufficient essence and blood, resulting in failure to nourish the Chong and Ren channels, symptoms may include scanty menstruation, amenorrhea, or irregular bleeding before and after menopause. This herb can be combined with Shan Yao, Gou Qi Zi, and Shan Zhu Yu (Cornus officinalis), as in the “Jing Yue Quan Shu”‘s Gui Shen Wan, Zuo Gui Yin, and You Gui Yin. For treating infertility due to insufficient Yin and blood, this herb can be combined with Dang Gui, Bai Shao, and Shan Yao to create the Yang Jing Zong Yu Tang (as in “Fu Qing Zhu Nu Ke”). Alternatively, it can be used with the “Yi Fang Ji Jie”‘s Er Zhi Wan to nourish Yin and blood, regulate the Chong and benefit essence. Modern treatments for various gynecological diseases also utilize this herb, such as using San Huang Hong Re Tang (Shu Di Huang, Hu Huang Lian, Huang Bai, Gui Ban, etc.) to treat menopausal heat symptoms, or combining this herb with Bai Shao, E Jiao (Colla corii asini), and Huang Lian to create the Menopausal Tranquilizing Capsule for treating menopausal syndrome, or combining this herb with Huang Qin, Bai Zhu, and Sang Ji Sheng (Taxillus chinensis) to create a formula for treating habitual miscarriage. This illustrates the important role of this herb in treating various gynecological conditions.
Benefiting Essence
Kidney essence is a mixture of congenital and acquired essence, closely related to the body’s growth, development, reproduction, and various physiological activities. This herb excels at benefiting essence and filling the marrow, making it an indispensable medicine for treating Kidney essence deficiency. For instance, if there is insufficient Kidney essence, leading to premature aging, early hair loss, dryness, or early graying of hair, loose teeth, tinnitus, forgetfulness, and dementia, this herb can be combined with He Shou Wu (Polygonum multiflorum), Gou Qi Zi, and Gui Ban Jiao (Testudinis Carapax) to nourish Kidney essence and prevent aging, as in Shou Wu Wan. For cases of insufficient Kidney essence, delayed development, short stature, soft bones, and sluggish movements, this herb can be combined with Lu Rong (Cervus nippon), Wu Jia Pi (Acanthopanax gracilistylus), and Shan Zhu Yu to nourish the Kidney and benefit essence, as in the “Yi Zong Jin Jian”‘s Jia Wei Liu Wei Di Huang Wan. For insufficient Kidney essence, leading to premature aging, men with low sperm count and infertility, and women with scanty menstruation and infertility, the “Jing Yue Quan Shu”‘s Gu Yin Jian can be used, combining this herb with Ren Shen, Wu Wei Zi, and Tu Si Zi (Cuscuta chinensis) to benefit essence and assist Yang, restoring the heavenly essence.
Modern pharmacological studies have found that the polysaccharides in Shu Di Huang have excellent antioxidant effects, such as increasing the activity of superoxide dismutase, catalase, and glutathione peroxidase in aging animals’ blood, and reducing the levels of lipid peroxides in plasma, brain, and liver homogenates, thus exhibiting anti-aging effects.
Calming the Spirit
When Yang enters Yin, it leads to sleep. The heart governs blood and houses the spirit, the Liver stores blood and houses the soul, and the Kidney governs essence and has the ability to communicate with the heart spirit. Therefore, when Yin blood is deficient, and the functions of the three organs are disordered, it can lead to difficulties in falling asleep, vivid dreams, unsatisfactory sleep, early waking, and inability to fall back asleep. Shu Di Huang nourishes the blood of the heart and liver, enriches the essence of the Kidney, and can cultivate Yin, contain Yang, nourish the heart spirit, and calm the soul, thus having a calming and sleep-promoting effect.
Clinical reports have indicated that using this herb combined with Huang Lian (Coptis chinensis), Bai Shao, E Jiao, Huang Qin, and Fu Ling to create the Menopausal Tranquilizing Capsule, taking 5 capsules three times a day for one month, has shown significant efficacy in treating insomnia. Folk TCM practitioner Ji Ling Hui has treated patients with insomnia lasting over a month using 500 grams of Shu Di Huang and 6 grams of cinnamon, achieving excellent results. The heavy use of this herb, with less cinnamon, aims to nourish Yin blood, harmonize Yin and Yang, and calm the spirit to aid sleep. After learning from this experience, I have clinically used a reduced dosage of Shu Di Huang to 150 grams and cinnamon 3-5 grams, achieving remarkable results. For example, I treated a student who was unable to sleep for several nights due to academic pressure as graduation approached. His tongue was red with no coating, indicating heart blood deficiency and lack of nourishment to the spirit. I prescribed 150 grams of Shu Di Huang and 5 grams of cinnamon, and after two hours of taking the medicine, he felt drowsy and slept soundly through the night, recovering after a few days of adjustment. It should be noted that this method is particularly effective for those with insufficient Yin blood and a red tongue with little coating, while those with excessive phlegm and dampness may experience less efficacy.
Modern pharmacological research has found that the polysaccharide components in the decoction of this herb have an inhibitory effect on the nervous system, enhancing the hypnotic effects of subthreshold doses of pentobarbital sodium and thiopental sodium.
Lowering Blood Sugar
Diabetes generally falls under the category of “Xiao Ke” in TCM, initially characterized by dryness and heat. As the disease progresses, Yin deficiency and dryness heat may coexist, and in chronic cases, Yin deficiency predominates. Although there are three types of diabetes, they often coexist, and treatment primarily focuses on nourishing Kidney Yin, with additional herbs to nourish the Yin of the lungs and stomach and clear heat. For instance, this herb can be combined with Shi Hu (Dendrobium), Mai Dong, Bai He, and Sheng Di to enhance its Yin-nourishing and thirst-quenching effects; combined with Zhi Mu, Shi Gao, and Niu Xi to enhance its ability to clear stomach heat; or combined with Huang Bai, Zhi Mu, and Shan Yao to enhance its Yin-nourishing and fire-reducing effects. Reports indicate that using the Er Di Er Dong Yang Yin Tang (Shu Di Huang, Sheng Di Huang, Tian Dong, Mai Dong, etc.) to treat 136 cases of type 2 diabetes, with one dose per day for 15 days per treatment course, resulted in a total effective rate of 93.0%, significantly higher than the control group.
Modern pharmacological studies have found that the oligosaccharides and rehmanniosides in Shu Di Huang have a blood sugar-lowering effect in experimental animals.
Preventing Dementia
In recent years, the incidence of vascular dementia and senile dementia has been rising annually, placing a significant burden on patients, families, and society. Both vascular dementia and senile dementia fall under the category of “dementia” in TCM. Since the Kidney governs the bones and produces marrow, which connects to the brain, the pathological factors of insufficient Kidney essence often coexist with blood stasis and phlegm obstruction. Shu Di Huang nourishes the Kidney and fills essence, benefiting the marrow and intellect, thus playing an important role in the treatment of this condition. According to the experience of Master Zhang Zhi Yuan, one of the three major clinical effects of Shu Di Huang is to regulate brain atrophy and senile dementia, treating symptoms such as dizziness, significant memory loss, confusion, inability to recognize family members, and difficulty with basic arithmetic. This herb can improve the aging state of brain tissue lacking nutrition, often combined with Dang Gui, Shan Yao, Dan Shen (Salvia miltiorrhiza), Chuan Xiong, water leeches, San Qi (Panax notoginseng), and saffron for long-term use, yielding observable effects.
Modern pharmacological research has found that the decoction of Shu Di Huang enhances learning and memory, providing modern medical support for its treatment of dementia.
Shu Di Huang is typically used in decoctions at a dosage of 10-30 grams, and in pills or powders as appropriate. Due to its heavy and moist nature, excessive or prolonged use may lead to reduced appetite and aversion to food, so it is often combined with herbs that regulate Qi and promote digestion, such as Chen Pi (Citrus reticulata), Sha Ren (Amomum villosum), and Fo Shou (Citrus medica). Additionally, those with Qi stagnation, excessive phlegm, or prone to abdominal distension and loose stools should use this herb with caution.
(Note: The formulas and herbs mentioned in this article should be used under the guidance of a qualified physician.)
Source: Guangdong Traditional Chinese Medicine
