“The body is the foundation of revolution. If the body is unwell, no matter how many delicacies are presented, one cannot enjoy them.” This was said by my friend’s mother a few days ago.
My friend told me that her mother always has trouble sleeping at night, often becoming irritable due to minor issues or outside noise, and feels a tightness in her chest and shortness of breath. They went to the hospital for a check-up, but the doctor said there was nothing serious and prescribed two boxes of medication. However, once the medication was stopped, the feelings of “tightness and palpitations” returned, and her sleep did not improve.
So, I suggested she buy two boxes of Tian Wang Bu Xin Dan (Heavenly Emperor’s Heart-Supplementing Pill), and if the chest tightness worsened, she could also take Compound Dan Shen Pian (Compound Salvia Tablets).
Just a couple of days ago, my friend called to say that her mother’s symptoms had significantly improved, and she casually inquired about the local situation… This led to the reflection on life mentioned at the beginning of the article.
◎ Hand-drawn by an eight-year-old
In fact, Dan Shen (Salvia miltiorrhiza) is a very common herb in our lives. I have seen many elderly people who have become knowledgeable about their health over time and have summarized some self-care methods for the signals of illness in their bodies. For example, when experiencing chest tightness or palpitations, they would take a few Dan Shen Pian or Dan Shen Di Wan (Dan Shen Drops).
So, how effective are these methods? How should one choose between Dan Shen, Dan Shen Pian, and Dan Shen Di Wan? What should one pay attention to when selecting Dan Shen? Today, let’s discuss topics related to Dan Shen so that everyone can better cope with chest tightness and irritability.
Not all “Shen” can simply “nourish the body”.
When it comes to “Shen”, people instinctively associate it with “tonics”, believing that any herb with “Shen” in its name is good for regular consumption, just like Ren Shen (Ginseng), Dang Shen (Codonopsis), Xi Yang Shen (American Ginseng), and Tai Zi Shen (Prince Ginseng).
However, this impression is both right and wrong. There are many types of herbs in the “Shen” category, and besides their nourishing properties, some have bitter, cold, heat-clearing, and damp-drying effects, such as Ku Shen (Sophora root); some clear heat and cool the blood, like Xuan Shen (Scrophularia); some clear heat and detoxify, like Quan Shen; and some nourish yin and generate fluids, like Sha Shen. The cold and heat properties of these herbs vary, and they cannot simply be equated to “regularly nourishing the body”.
◎ Image authorized by Baotu Network
Today’s protagonist, Dan Shen, enters the heart and liver meridians, with effects of promoting circulation, relieving pain, activating blood, clearing the heart, calming irritability, and cooling the blood to eliminate abscesses. It is certainly not a “simple” tonic.
Next, let’s first discuss two mysteries hidden within it: Is Dan Shen cold or warm? Is its ability to activate blood and relieve pain, or to nourish blood and activate blood?
Is the nature of Dan Shen cold or warm?
Dan Shen is the dried root and rhizome of the plant Salvia miltiorrhiza, first recorded in the Shen Nong’s Herbal Classic, classified as a superior herb, and is the best at “activating blood and regulating menstruation” among the “Shen” category. Because of this, the question of Dan Shen‘s cold or warm nature has become one of the most controversial topics in history.
After all, in traditional views, herbs that are good at “activating blood, resolving stasis, regulating menstruation, and alleviating pain” should be pungent, dispersing, and warming. Moreover, Tao Hongjing in his Commentary on the Herbal Classic stated that many people experience redness in their eyes after taking Dan Shen, suggesting that Dan Shen should be hot in nature (“People often experience red eyes after taking it, hence it should be hot in nature”). Miao Xiyong and Zhang Lu also agreed that Dan Shen is “bitter, neutral, and slightly warm”.
However, the Shen Nong’s Herbal Classic clearly records that Dan Shen is “bitter and slightly cold”. The Emergency Formulas for After the Elbow records that Dan Shen and sheep fat can be used to treat burns from hot oil, while the Herbal Monograph states that Dan Shen “can eliminate redness and swelling of the eyes”. Zhang Xichun used it in combination with Jin Yin Hua (Honeysuckle) and Lian Qiao (Forsythia) to treat breast abscesses, all of which are heat-related conditions, indicating that Dan Shen is used to counteract heat with its cold nature.
So, what do you think about the “cold and warm” debate surrounding Dan Shen?
◎ Hand-drawn by an eight-year-old
In fact, I tend to agree with Li Shizhen’s description of Dan Shen in the Compendium of Materia Medica, which states that Dan Shen is “bitter, with a neutral and descending nature, representing the yang within yin.” I believe this description is quite accurate; “the yang within yin”, Dan Shen has a “slightly cold, yin nature” that possesses the “cold nature” characteristics of clearing heat and calming irritability; however, Dan Shen is also a very special “yin herb” because conventional yin herbs are usually more static and less active, while Dan Shen is “the yang within yin”, possessing the ability to “promote circulation, relieve pain, and activate blood”, which also explains why the Shen Nong’s Herbal Classic states that although Dan Shen is a “bitter and cold herb”, it can “treat evil qi in the heart and abdomen, and alleviate abdominal distension and masses”.
Is the function of Dan Shen in “nourishing” or “eliminating”?
“A decoction of Dan Shen has effects similar to Si Wu Tang (Four Substance Decoction)”. If we simply interpret this sentence literally, we might easily understand Dan Shen as a tonic for “nourishing blood”. However, as mentioned earlier, Dan Shen is a key herb for “activating blood and regulating menstruation”. What is the difference between these two interpretations? Is it a misunderstanding or a deviation?
Let’s start with Si Wu Tang. Si Wu Tang is now regarded as a fundamental formula for women’s health, a general remedy for regulating menstruation. A gynecology teacher I once followed always used Si Wu Tang as a base, adjusting it for various conditions related to menstruation and pregnancy. For issues related to yin and blood, it invariably includes Di Huang (Rehmannia), Bai Shao (White Peony), Dang Gui (Angelica), and Chuan Xiong (Szechuan Lovage). Women rely on the liver for their constitution, and yin blood is fundamental; the essence of life originates from the liver and kidneys, hence women’s issues often reflect on their menstruation. In Si Wu Tang, Di Huang nourishes blood and enriches yin, while Bai Shao softens the liver and restrains yin. The combination of these two nourishes the liver’s yin blood and clears the liver’s empty heat; many women experience liver qi stagnation, emotional distress, and yin blood deficiency, leading to qi stagnation. Dang Gui nourishes blood and activates blood, while Chuan Xiong promotes qi and moves blood. By flexibly adjusting the four ingredients, this formula can either nourish yin blood, activate qi and blood, clear empty heat, or regulate qi stagnation, which is why it is considered a fundamental formula for women’s health.
Now, looking at Dan Shen, it is not a simple tonic and does not have a nourishing blood effect. Some may argue that the Shen Nong’s Herbal Classic states that Dan Shen “benefits qi” and the Supplementary Records say it can “nourish blood and eliminate stubborn qi in the heart and abdomen”. Isn’t being able to benefit qi and nourish blood a form of supplementation?
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In this regard, Zhang Bingcheng in the Materia Medica Simplified stated, “Dan Shen has effects similar to Si Wu Tang, capable of eliminating stasis and generating new blood without harming the righteous qi, effectively treating wind and dispersing masses, with a neutral nature that promotes blood circulation… Although Dan Shen has the name ‘Shen’, its blood-nourishing power is insufficient, while its blood-activating power is abundant, making it a key herb for regulating blood.” Dan Shen is red in color and primarily governs the blood aspect. The so-called benefit to qi and nourishment of blood refers to its ability to activate blood and regulate menstruation, which can eliminate stagnant blood in the body, thus achieving the goal of smooth qi and blood flow, which is what we often refer to as “using activation to nourish”.
In the Qing Dynasty, Chen Xiuyuan explained: “Today, people say that a decoction of Dan Shen has effects similar to Si Wu Tang, believing it to be a blood-nourishing and blood-activating herb for women’s health, while the true efficacy of Dan Shen is obscured.” What is obscured here is the “true efficacy” that suggests “Dan Shen itself does not possess blood-nourishing power; nourishing blood is achieved based on the elimination of stasis.”
Activating Blood and Regulating Menstruation: A Good Medicine for Women’s Health
Dan Shen is good at activating blood and eliminating stasis, capable of breaking up old blood and generating new blood without harming the righteous qi, stopping excessive bleeding and regulating menstruation, making it an excellent medicine for women’s health. The Women’s Theory of Clarity states that Dan Shen “treats women’s menstrual irregularities, whether early or late, excessive or insufficient, and can stabilize the fetus before delivery and eliminate lochia after childbirth.” Its nature is slightly cold, making it particularly suitable for conditions of blood heat and stasis, such as dysmenorrhea, heavy menstrual flow, and early menstruation. For simple menstrual irregularities with mild pain and light stasis, Dan Shen powder can be taken with yellow wine. If there is significant stasis in the lower abdomen with severe pain or palpable masses, it is necessary to enhance the ability to move qi and activate blood, which can be achieved by combining with San Qi (Notoginseng), Hong Hua (Safflower), Chuan Xiong, and Dang Gui.
Many young women experience menstrual issues. Among them, there is a group of people who, before their period, not only experience lower abdominal pain but also develop many acne spots on their faces. These dark red spots are difficult to remove even with various skincare products. This indicates the presence of stagnant blood in the body. Dan Shen can activate blood and regulate menstruation, as well as cool the blood and eliminate abscesses, alleviating dysmenorrhea while significantly improving the appearance of these dark red acne spots, which can also be considered a form of beauty treatment.
Since Dan Shen is so effective, what should those with cold-congealed blood stasis do? There are two methods: first, through processing, traditional Chinese medicine can achieve the effect of retaining the useful properties while eliminating the harmful ones. Dan Shen is cold in nature, but when processed with alcohol, it can transform its cold nature into warmth, enhancing its ability to activate blood and eliminate stasis; second, appropriately combining it with warming herbs can also mitigate its cold nature, such as pairing it with Wu Zhu Yu (Evodia) or Rou Gui (Cinnamon).
Eliminating Stasis and Relieving Pain: A Protective Herb for Cardiovascular Health
Dan Shen is excellent at promoting blood circulation and eliminating stasis, applicable to various stasis-related conditions, with its most common use being in cardiovascular health. For example, the famous Dan Shen Yin (Dan Shen Decoction) consists of Dan Shen, Tan Xiang (Sandalwood), and Sha Ren (Amomum), where Dan Shen activates blood and eliminates stasis to relieve pain, Tan Xiang regulates qi and disperses stagnation to alleviate heart pain, and Sha Ren warms the middle and promotes qi to eliminate stagnation. Together, they work to regulate qi, disperse stagnation, and stop pain, treating chest pain due to blood stasis. The remedy recommended to my friend’s mother at the beginning of the article was Dan Shen and Hong Hua to treat chest tightness and shortness of breath.
The heart governs the blood vessels, and the smooth flow of qi and blood largely depends on the strength of heart function. As one reaches middle age, yang qi gradually declines, qi and blood circulation slows, and vascular elasticity deteriorates, leading to a state of qi stagnation and blood stasis. The Shen Nong’s Herbal Classic states: “Dan Shen governs evil qi in the heart and abdomen, causing gurgling sounds in the intestines, with cold and heat accumulating, breaking up masses and eliminating stagnation,” which includes the feeling of chest tightness that often occurs after middle age.
Dan Shen is red and enters the blood, governing the heart meridian, promoting blood circulation, and enhancing the heart’s blood supply capacity. The components of Dan Shen, such as Dan Shen Ketone, Dan Shen Acid, and Dan Shen Phenol, can inhibit platelet aggregation, protect against myocardial ischemia, and prevent atherosclerosis, which is one of the reasons Dan Shen has gained prominence in cardiovascular medicine. If there is stagnant blood causing symptoms of chest tightness and heart pain, one can choose suitable small herbs to make health tea. For those with qi deficiency and blood stasis, experiencing dull chest pain, Dan Shen can be combined with Huang Qi (Astragalus) to tonify qi and activate blood; for those with blood stasis and a risk of bleeding, Dan Shen can be combined with San Qi to activate blood and stop bleeding; for those with significant blood stasis and severe chest pain, Dan Shen can be combined with Hong Hua for a stronger blood-activating effect.
There are many proprietary Chinese medicines made from Dan Shen, with the most familiar being Compound Dan Shen Di Wan and Compound Dan Shen Pian.
◎ Hand-drawn by an eight-year-old
Compound Dan Shen Pian is a tablet made from powdered herbs, which can only be taken orally, and its effects are slow to manifest, so it cannot be used for acute angina; it is only suitable for routine treatment of coronary heart disease. Compound Dan Shen Di Wan is made from extracts of Dan Shen and San Qi, and can be taken orally or sublingually. The sublingual method allows for rapid absorption and can be used as an emergency remedy for angina. Both of these proprietary medicines contain Bing Pian (Borneol), which may cause some gastrointestinal irritation; if the reaction is significant, they can be taken after meals.
Those with a tendency to bleed, pregnant women, or those already taking anticoagulants should avoid using these medications.
Calming the Mind and Aiding Sleep: Dan Shen Can Stabilize the Spirit and Assist Sleep
Calming the mind has two meanings. One is the unsettled spirit, manifested as unclear consciousness, mental impairment, or confusion, or even mania. Dan Shen is cold in nature, clears heat, cools the blood, and can eliminate heat, thus it can be used for mental unrest caused by heat illness. The Dayuanzi’s Materia Medica states that Dan Shen can “nourish the spirit and stabilize the mind, treating blood evil causing heart irritability”. For cases of heat evil entering the heart and causing irritability and confusion, Dan Shen can cool the blood and calm the mind; the Herbal Compendium records that “if a woman suddenly becomes mad, speaks and acts irrationally, does not avoid relatives, and is not ashamed, Dan Shen can be taken in a dose of eight taels, ground into powder, and taken three qian morning and evening.” The other meaning is insomnia; Dan Shen can be used for palpitations and insomnia due to blood not nourishing the heart. The Dian Nan Materia Medica once stated that Dan Shen “calms the mind and nourishes the heart, governing forgetfulness, anxiety, and insomnia”. For insomnia, Tian Wang Bu Xin Dan nourishes yin and blood, clears the heart, and calms the mind, where Dan Shen serves the purpose of calming the mind and aiding sleep.
Well, that concludes today’s content.
Dan Shen, an “herb of the yin within yang” and a medicine for calming the mind and regulating menstruation, is also a powerful herb for activating blood and relieving pain, serving as a protective herb for cardiovascular health.
See you next time~
— THE END —
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