Bai Shao (白芍)
【Alias】
Bai Shao Yao (白芍药), Jin Shao Yao (金芍药).
【Source of Medicinal Material】
This product is the dried root of the plant Paeonia lactiflora Pall. (毛茛科). It is harvested in summer and autumn, cleaned, and the head and tail along with fine roots are removed. It is boiled in water, the outer skin is removed or peeled before boiling, and then dried in the sun.
【Properties and Taste】
Bitter, sour, slightly cold. It enters the Liver (肝) and Spleen (脾) meridians.
【Functions and Indications】
Tonifies blood, regulates menstruation, restrains yin and stops sweating, softens the liver and alleviates pain, and calms liver yang. It is used for blood deficiency with sallow complexion, irregular menstruation, spontaneous sweating, night sweats, flank pain, abdominal pain, limb cramps, headache, and dizziness.
【Precautions】
Should not be used with Li Lu (藜芦); caution is advised for those with deficiency-cold abdominal pain and diarrhea.
【Associated Formulas】
① For flank pain in women: Xiang Fu Zi (香附子) 4 liang, Huang Zi vinegar 2 bowls, salt 1 liang, boil until dry, with Rou Gui (肉桂), Yan Hu Suo (延胡索, stir-fried), and Bai Shao Yao. Grind into a fine powder, take 2 qian each time, decoct in boiling water, and take at any time. (Zhu Shi Ji Yan Yi Fang – Shao Yao Decoction)
② For dysentery with pus and blood, urgency, and heaviness: Bai Shao 1 liang, Dang Gui (当归) 0.5 liang, Huang Lian (黄连) 0.5 liang, Bing Lang (槟榔), Mu Xiang (木香) 2 qian; Gan Cao (甘草) 2 qian (stir-fried), Da Huang (大黄) 3 qian, Huang Qin (黄芩) 0.5 liang, Guan Gui (官桂) 2.5 qian. Cut finely, take 0.5 liang each time, boil in 2 cups of water until reduced to 1 cup, take warm after meals. (Su Wen Bing Ji Bao Ming Ji – Shao Yao Decoction)
③ For abdominal pain during pregnancy: Dang Gui 3 liang, Bai Shao 1 jin, Fu Ling (茯苓) 4 liang, Bai Zhu (白术) 4 liang, Ze Xie (泽泻) 0.5 jin, Chuan Xiong (川芎) 0.5 jin (or 3 liang). Grind these six ingredients into a powder. Take a small spoonful mixed with wine, three times a day. (Jin Gui Yao Lue – Dang Gui Bai Shao San)
④ For postpartum abdominal pain due to blood stasis: Bai Shao 2 liang, Gui (去粗皮) and Gan Cao (炙) each 1 liang. Grind these three ingredients coarsely, take 3 qian each time, boil in 1 cup of water, simmer until 7 parts remain, strain, and take warm, without time restrictions. (Sheng Ji Zong Lu – Shao Yao Decoction)
⑤ For dysmenorrhea: Bai Shao 2 liang, Gan Jiang (干姜) 8 qian. Grind into a fine powder, divide into 8 packets, take one packet daily with yellow wine during menstruation, for three consecutive weeks. (Inner Mongolia – New Medical Methods of Chinese Herbal Medicine)
⑥ For women with prolonged red or white discharge: Bai Shao 3.5 liang, Gan Jiang 0.5 liang. Grind finely, fry until yellow, pound and strain. Take 2 qian on an empty stomach with juice, twice a day. (Guang Li Fang)
⑦ For bleeding from wounds that won’t stop: Bai Shao 1 liang, fry until yellow, grind finely into powder. Take 2 qian with wine or rice wine. Start with three doses, gradually increase. (Guang Li Fang)
⑧ For swollen and painful feet: Bai Shao 6 liang, Gan Cao 1 liang. Grind into powder, take with white soup. (Sui Shi Guang Ji)
⑨ For pain in the bones due to wind toxin: Bai Shao 2 fen, Hu Gu (虎骨) 1 liang (stir-fried). Grind into powder, place in a silk bag, soak in 3 sheng of wine for five days. Take 3 he each time, three times a day. (Jing Yan Hou Fang)
【Clinical Applications】
Fu Kang Ning Pian (妇康宁片) contains Bai Shao 200g, Xiang Fu 30g, Dang Gui 25g, San Qi 20g, Ai Ye (艾叶, carbonized) 4g, Mai Dong (麦冬) 50g, Dang Shen (党参) 30g, Yi Mu Cao (益母草) 150g. Take 80g of Bai Shao and grind with Xiang Fu, Dang Gui, San Qi, and Ai Ye into fine powder, mix well. The remaining 120g of Bai Shao, Mai Dong, Dang Shen, and Yi Mu Cao are decocted twice, combine the decoctions, filter, and concentrate to a paste, add the above powder and excipients, mix well, granulate with 70% ethanol, dry, and compress into 1018 tablets, each tablet weighing 0.25g, coated with sugar. The tablets are brownish, with a slightly bitter taste. Functions to regulate menstruation, nourish blood, and relieve pain. Used for deficiency of qi and blood, abdominal pain during menstruation, taken orally, 8 tablets each time, 2-3 times a day or taken 4-5 days before menstruation. (Ministry of Health – Drug Standards: Chinese Medicine Formulations, Volume 2, 1989)
【Processing and Preparation】
Bai Shao: Remove impurities, separate by size, soak in water until 80% translucent, remove, dry, and ensure uniform moisture inside and out, slice, and dry. Jiu Bai Shao (酒白芍): Take Bai Shao slices, spray evenly with yellow wine, slightly moisten, stir-fry over low heat, remove, and cool. (For every 100 jin of Bai Shao slices, use 10 jin of yellow wine)
Fried Bai Shao: Take Bai Shao slices, stir-fry in a pot over low heat until slightly yellow, remove, and cool. Charred Bai Shao: Take Bai Shao slices, stir-fry in a pot over high heat until charred yellow, spray with a little clean water, remove, and dry. Soil-fried Bai Shao: Take Fu Long Gan (伏龙肝) fine powder, heat in a pot, add Bai Shao slices; stir-fry until the outside is coated with soil color, remove, sift out the soil, and cool. (For every 100 jin of Bai Shao slices, use 20 jin of Fu Long Gan fine powder)
【Properties of Medicinal Material】
This product is cylindrical, straight or slightly curved, with flat ends, 5-18 cm long and 1-2.5 cm in diameter. The surface is whitish or light brownish-red, smooth or with longitudinal wrinkles and fine root marks, occasionally with remnants of brownish outer skin. It is solid, not easily broken, with a flat cross-section, whitish or slightly brownish-red, with distinct growth rings and radiating rays. It has a faint odor and a slightly bitter, sour taste.
【Various Discussions】
1. In the “Bencao Tujing”: “Bai Shao has both red and white varieties. Cui Bao’s “Ancient and Modern Annotations” states that there are two types of Bai Shao, one is grass Bai Shao, and the other is wood Bai Shao. The latter has larger flowers and deeper colors, commonly referred to as peony, but it is not. The ancients also had a method of consuming it raw, stating that there are two types of Bai Shao, one is Jin Shao (金芍药), and the other is Mu Shao (木芍药). Jin Shao is used for treating diseases, being white and fatty, while Mu Shao is purple and thin with many veins. If you want to consume it, ensure it is clean, peel it, boil it in flowing water until it boils a hundred times, dry it in the shade, and then steam it in a wooden steamer, covered with clean yellow earth, for one day and night, and then dry it in the shade.”
2. In the “Bencao Bieshu”: “According to the “Bencao”, Bai Shao grows in hilly areas and valleys, but most of the ones used today are cultivated by families. To ensure large flowers and leaves, manure must be added, and the roots are harvested in August and September, processed into medicine, and then dried for sale. The true Yang of Huainan is abundant, and herbalists see its large size but do not know that its fragrance is not good, so it cannot be blamed for its efficacy. It is advisable to follow the “Bencao” and use those that grow in hilly areas and valleys as superior.”
3. In the “Bencao Yanyi”: “Bai Shao is used entirely for its root, and it is best to use those with red flowers and single leaves, as those from the mountains are superior. If the flowers and leaves are abundant, the roots will be weak. However, if the root is mostly red, its taste is astringent. If there are white, coarse, and fat ones, they are better. (钅余) As the classics say, those with blood deficiency and cold should avoid this herb. The ancients said to reduce Bai Shao to avoid middle cold, which should not be ignored.” It regulates qi. If the spleen is deficient, it leads to fullness; if it is full, it will self-dissolve. Treating the middle will relieve the heart from fullness, and draining the liver will relieve flank pain. Those who are good at sighing have spleen problems; if the spleen is healthy, there will be no sighing. If the fire of the liver and spleen is inflamed, the lung will be in distress, leading to cough and shortness of breath. Sour and cold can restrain, so draining the liver and tonifying the spleen will calm the lung, and symptoms of lung distress will be eliminated. Cooling blood and tonifying blood will heal nosebleeds and other symptoms. If the spleen is deficient, the eyes will be dry, and tonifying will relieve dryness. If the liver has no fire, the liver blood will be sufficient; if there is excess yang, it will cause cold and heat, and if there is pain and fullness in the abdomen, it is a sign of blood deficiency and insufficient yin; if the liver and spleen are harmonized, and yin blood is abundant, the previous symptoms will heal.” (Bencao Jing Shu)
4. Discussion on the Astringent Properties of Bai Shao
4.1 Cheng Wu Ji: “The sourness of Bai Shao astringes and nourishes. Sourness is astringent and draining; the sourness of Bai Shao astringes yin and drains evil qi.” (Annotated “Shang Han Lun”)
4.2 Li Dongyuan: “Some say that the ancients used sour and astringent to astringe; why does the “Bencao” mention benefiting urination? It is because Bai Shao can nourish yin, moisten, and stop fluid retention, hence urination occurs naturally, not due to drainage. It is also said that it can alleviate fullness; it is because it damages the liver, which alleviates fullness, thus regulating blood, which is why Si Wu Tang uses Bai Shao. Generally, sour and astringent are astringent and stop dampness, hence it governs the Taiyin meridian, and it can also treat blood sea and enter the nine depths below, later reaching the Jueyin meridian. The white color is in the west, hence it tonifies; the red color is in the south, hence it drains.” (Quoted from “Gang Mu”)
4.3 Jia Suoxue: “Bai Shao, slightly bitter, can tonify yin; slightly sour, can astringe. Because sourness enters the liver, it temporarily uses it to nourish the liver. The liver desires to disperse and abhors astringency, thus it uses sourness to suppress the liver. Therefore, Bai Shao can tonify and drain, specifically acting on the blood sea, regulating menstruation and childbirth in women, and all liver diseases in men should be used to harmonize blood and qi. Its taste is bitter and sour, and it is cold in nature, not a medicine for the spleen meridian. When stir-fried, it removes its nature, and the spleen qi can disperse it, while the stomach qi can restrain it. It governs heat vomiting, stops diarrhea, and relieves abdominal pain due to spleen deficiency, and damp-heat in the intestines and stomach. Thus, it drains the evil of the liver and alleviates the qi of the middle spleen, as stated in the “Nanjing” that damaging the liver alleviates fullness in the middle. Combined with roasted Gan Cao, it forms a harmonious relationship of sour and sweet, which is a wonderful method to tonify the spleen yin.” If there is a chronic cough, it can be used to restrain the lung. It also treats dysentery and abdominal pain, as the lung’s metal qi is trapped in the large intestine, sourness can restrain and alleviate, bitterness can remove impurities, thus Dan Xi treats dysentery, using three to four qian per dose, which is very effective. However, if it is purely for blood dysentery, it is not suitable. Its power cannot promote drainage, but it governs the waterway, thus it uses its sour astringent properties to restrain dampness and allow fluid to flow smoothly, hence urination occurs naturally, and for smallpox, if blood does not adhere, it can be used to restrain blood and return it to the root.” (Yao Pin Hua Yi)
4.4 Zhang Yinan: “Bai Shao has a bitter and neutral taste. Later generations mistakenly altered the sacred texts to say it is slightly sour; the scholars of the Yuan and Ming dynasties have followed this as a sour and cold astringent. For all internal deficiencies and diarrhea, it is often used to astringe; the nature of its efficacy can be strongly discerned, but its taste should not be misrepresented. Try chewing Bai Shao, where is the sour taste? It is also said that new mothers should avoid Bai Shao, fearing its astringent nature. The “Bencao” primarily treats evil qi abdominal pain and eliminates blood stasis, cold and heat, and breaks down hard masses. Therefore, for new mothers with lochia not yet expelled, it is precisely used; however, for internal deficiency and diarrhea, it is not appropriate.” (Bencao Chongyuan)
5. Discussion on Bai Shao’s Ability to Nourish Yin and Soften the Liver, Not Attack the Liver
Zhang Shanlei: “The method of Zhong Sheng is indeed the method passed down from the Qin and Han dynasties. Some say that sour pain is the liver wood harming the spleen; Bai Shao can assist the spleen earth and restrain the liver wood, thus it is the main medicine for abdominal pain. It is important to know that the liver has a strong nature; if it does not use yin fluid to nourish, it will become violent and uncontrollable. The first to suffer is the spleen earth. All heart and stomach pain, abdominal fullness pain, chest and flank stabbing pain, and distension are all due to the strong wood harming the spleen. Since the Song and Yuan dynasties, many have favored fragrant and dry medicines to treat this, using strong to counter strong, and if qi flows and opens, there will be no pain. It is not that they do not seek immediate effects, but the more they dry, the more yin is consumed, and the liver becomes more rampant, leading to more frequent attacks, ultimately resulting in both liver and spleen yin being exhausted, and dry medicines cannot be used again. This method of moving qi and attacking the liver only exacerbates the problem, causing harm rather than benefit. Zhong Sheng uses Bai Shao to treat abdominal pain, both to nourish the spleen yin and to capture the dissipating yin qi, and to nourish the liver yin and soften the aggressive wood, and with qi-moving medicines, it directly cuts off the liver’s fierce qi, which is a clear distinction between draining the liver and softening the liver. Therefore, Bai Shao’s ability to treat abdominal pain, fullness, heart and stomach stabbing pain, and chest and flank distension is precisely due to this method, and it should not be compared with attacking liver medicines.” (Bencao Zhengyi)
6. Discussion on Bai Shao’s Ability to Stop Abdominal Pain
6.1 Zhu Danxi: “Bai Shao drains spleen fire, its nature and taste are sour and cold, and in winter, it must be stir-fried with wine. Abdominal pain is often due to blood vessels being congealed; it must be stir-fried with wine. However, it can only treat blood deficiency abdominal pain, and does not treat others. Its sour and cold astringent nature has no warming or dispersing effect.” (Quoted from “Gang Mu”)
6.2 Yu Zhuan: “Bai Shao not only treats blood deficiency but also can move qi. In ancient formulas for abdominal pain, Bai Shao 4 qian and Gan Cao 2 qian are used, named Shao Yao Gan Cao Tang. Abdominal pain is due to the qi of the nutrients not flowing, reversing in the skin; Bai Shao can move the nutrient qi, and Gan Cao can restrain the reversing qi. Moreover, pain is due to the liver wood overcoming the spleen earth, and Bai Shao can drain the liver.” (Quoted from “Bencao Bei Yao”)
7. Discussion on Bai Shao Not Being a Nourishing Substance
Chen Xiuyuan: “Bai Shao has a neutral descending nature, its taste is bitter and it drains, thus it is an attacking substance, not a nourishing one. Evil qi abdominal pain, difficulty urinating, and all other pains are due to qi stagnation; its main function is to drain qi with its bitter and neutral nature. Blood stasis is when blood is blocked and does not flow, leading to cold and heat imbalance; hard masses are when they have been present for a long time and are solid, leading to pain and fullness, all of which are blood stagnation diseases, and its main function is to use its bitter and neutral nature to move blood. Additionally, when it says it benefits qi, it means that evil qi is attacked and cleansed, thus the original qi naturally benefits, not that Bai Shao can tonify qi.” (Bencao Jing Du)
8. Discussion on Avoiding Bai Shao Postpartum
8.1 Zhu Danxi: “Postpartum, it should not be used due to its sour and cold nature attacking the generating qi. If absolutely necessary, it should be stir-fried with wine.” (Quoted from “Gang Mu”)
8.2 Li Shizhen: “Postpartum, liver blood is already deficient, and further draining is not allowed, hence it is prohibited.” (Quoted from “Gang Mu”)
8.3 Zhang Jingyue: “(Bai Shao) is one of the slightly cold tonics, not as extremely bitter and cold as others. If it is said that its white color belongs to metal, it may harm the liver wood, coldly attacking the generating qi, thus it is not suitable postpartum. If all white or cold herbs are avoided, what then? For example, Zhongjing’s Heishen San and Shao Yao Decoction are all essential postpartum medicines, right? Users should still be cautious. If postpartum blood is hot and yin qi is lost, it is precisely used, without doubt.” (Bencao Zheng)
8.4 Zhang Shanlei: “Danxi said that postpartum Bai Shao should not be used due to its sour and cold nature attacking the generating qi. The term postpartum is broad and without limits. Bai Shao is sour and cold, and those with deficiency-cold should certainly avoid it, but there are still examples of small Jian Zhong. If it is real heat, then Nao, Huang, Qin, and Lian should not be avoided, so why is Bai Shao uniquely prohibited? This must not be Danxi’s statement. The “Daming Bencao” states that it treats all women’s diseases, both before and after childbirth, without regard to cold, heat, deficiency, or excess, which contradicts Danxi. In conclusion, both statements have their merits, and one should not rigidly adhere to rules that may hinder living people.” (Bencao Zhengyi)
9. Discussion on the Differences in Functions Between Bai Shao and Chi Shao
9.1 Liu Han: “The annotations state that there are two types: the red one benefits urination and drains qi; the white one stops pain and disperses blood.” (Kaibao Bencao)
9.2 Cheng Wu Ji: “Bai Shao tonifies while Chi Shao drains; Bai Shao astringes while Chi Shao disperses.” (Annotated “Shang Han Lun”)
9.3 Li Shizhen: “Bai Shao tonifies the spleen, able to drain wood from the earth. Chi Shao disperses evil, able to move stagnation in the blood. “Rihua Zi” states that Chi Shao tonifies qi, while Bai Shao treats blood, which is not accurate.” (Gang Mu)
9.4 Zhang Jingyue: “Bai Shao, being primarily a tonifying herb, while Chi Shao is primarily a draining herb… Bai Shao calms the fetus and alleviates heat and restlessness, while Chi Shao can promote menstruation and move blood.” (Bencao)
9.5 Jiang Rong: “For those with yin deficiency and yang excess, Bai Shao is used to astringe yin and harmonize yang; for those with yin excess and yang stagnation, Chi Shao is used to elevate yin and guide yang to drain it.” (Cui Jin Qiu Bencao Shulu)
9.6 Zhang Shanlei: “In the “Bencao”, although the distinction between red and white is not made, each has its own indications. However, tracing their indications for various diseases, one is for tonifying blood and nourishing the true yin of the liver and spleen, while the other is for expelling blood stasis, breaking down accumulations, and draining, which is Chi Shao. “Cheng Wu Ji” states that Bai tonifies while Chi drains, Bai astringes while Chi disperses. Therefore, to nourish yin and blood, and to moisten the liver and spleen, Bai Shao is used; to invigorate blood and move stagnation, and to expel toxins, Chi Shao is used.” (Bencao Zhengyi)
【Resource Distribution】
Mainly produced in Zhejiang, Anhui, Sichuan, and other regions. Additionally, Shandong, Guizhou, Hunan, Hubei, Gansu, Shaanxi, Henan, and Yunnan also produce it. The Zhejiang product is known as Hang Bai Shao, which is of the best quality; the Anhui product is called Bo Bai Shao, which has the largest yield; the Sichuan product is named Chuan Bai Shao, also known as Zhongjiang Shao, which is also produced in large quantities.
【Plant Morphology】
Perennial herb, 50-80 cm tall. The root is thick, usually cylindrical or slightly spindle-shaped. The stem is erect, smooth, and hairless. Leaves are alternate; with long petioles; 2-3 times compound leaves, leaflets are oval to lanceolate, 8-12 cm long, 2-4 cm wide, with a gradually pointed or sharp tip, wedge-shaped at the base, entire margin, with very fine papillae on the leaf edge, deep green above, light green below, with raised leaf veins on the underside, and the leaf base often has a reddish hue. The flowers are very large, solitary at the top of the flower stem, with 2-5 flowers per stem, the flower stem is 9-11 cm long; there are 3 sepals, leaf-like; about 10 or more petals, ovate, white, pink, or red; many stamens, with yellow anthers; 3-5 carpels, separate. The fruit is a follicle with 3-5 segments, oval, with a hooked tip bending outward. Flowering period is from May to July. Fruiting period is from June to July.