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Introduction:
Everyone loves affordable and effective products. Is there a traditional Chinese medicine that is inexpensive, effective, and can treat multiple diseases? The commonly used blood-activating herb Dan Shen (Salvia miltiorrhiza) is one. Although it contains the character “shen (参)”, Dan Shen is not related to the ginseng of the Araliaceae family. However, Dan Shen is not simple in its therapeutic applications; it has a wide range of uses, excellent efficacy, is neutral and non-toxic, and is widely available and inexpensive, making it a herb worthy of serious study and promotion.
Dan Shen has a wide range of blood-activating uses, is inexpensive and readily available, and should be promoted.
Author/Zhang Xuewen
Dan Shen is a commonly used blood-activating herb with a wide range of uses, excellent efficacy, is neutral and non-toxic, and is widely available and inexpensive, making it a herb worthy of serious study and promotion.
1Resolves stasis and activates blood to treat various diseases, suitable for both excess and deficiency conditions.
① Treatment of upper body diseases
For sudden deafness due to liver and kidney deficiency and poor blood circulation, where conventional treatments have failed, a formula of Zhi Bai Di Huang Tang (Anemarrhena, Phellodendron, and Rehmannia Decoction) with added Dan Shen, magnetite, cicada slough, and Chuan Niu Xi (Cyathula officinalis) has shown repeated clinical efficacy; for liver heat affecting the ears, a combination of Dan Shen with magnetite, chrysanthemum, summer withered grass, raw Rehmannia, gentian, and Chuan Niu Xi can clear liver fire, resolve stasis, and open the orifices, proving to be very effective in clinical practice; for hypertension, Dan Shen and magnetite are often selected based on syndrome differentiation, yielding remarkable results.
Animal experiments have shown that Dan Shen can dilate peripheral blood vessels and lower blood pressure. For cough due to lung qi stagnation and poor blood circulation, Dan Shen is often combined with apricot kernel, platycodon, and Chuan Bei Mu (Fritillaria cirrhosa) to activate blood, promote lung function, and relieve cough.
② Treatment of lower body diseases
Dan Shen promotes blood circulation and alleviates stasis, making it particularly effective for lower body stagnation. For rheumatic pain in the lower joints, it is often combined with Chuan Xu Duan (Dipsacus), Du Huo (Angelica pubescens), Chuan Niu Xi, and Sang Ji Sheng (Mulberry mistletoe); for rheumatic heat causing red, swollen, and painful joints, Dan Shen is combined with honeysuckle vine, Cang Zhu (Atractylodes), Chuan Niu Xi, Huang Bai (Phellodendron), Chi Shao (Red Peony), and Dan Shen; for lower limb phlebitis, it is often combined with Dang Gui (Angelica sinensis), Jie Xue Teng (Sanguisorba officinalis), Xuan Shen (Scrophularia), raw licorice, honeysuckle, cinnamon twig, and pangolin; for menstrual irregularities, amenorrhea, or postpartum abdominal pain due to blood stasis, Dan Shen can be taken alone or combined with Dang Gui, Xiang Fu (Cyperus), and Yi Mu Cao (Leonurus) for effective results; for impotence and premature ejaculation due to liver and kidney stagnation (stasis) heat, Dan Shen is combined with raw Rehmannia, cooked Rehmannia, Zhi Mu (Anemarrhena), Chuan Niu Xi, Huang Bai, lotus stamen, Yang Qi Shi (a mineral), Shan Yao (Dioscorea), Yu Jin (Curcuma), and Qiang Huo (Notopterygium), known as Gu Jing Qi Yang Tang, showing significant efficacy.
Image: Licorice
③ Treatment of deficiency syndromes, chronic illness leading to deficiency, weak blood circulation, and prolonged deficiency causing stasis
Dan Shen resolves stasis and generates new blood, acting without damaging the existing blood. It is said that “Dan Shen alone has the same effect as Si Wu Tang (Four Substance Decoction)”; the Ben Cao Gang Mu states it “nourishes blood”. It is used to treat deficiency-related dizziness, often in the form of Qi Ju Di Huang Tang (Lycium and Chrysanthemum Decoction) modified to create Yin Shen Ding Xuan Tang (Qi Ju Di Huang Tang with Dan Shen, magnetite, Chuan Xiong, and Tian Ma), which is very effective for dizziness, lumbar soreness, pale tongue, and thin, weak pulse in cases of kidney deficiency with stasis; for blood deficiency causing palpitations and insomnia, Dan Shen is often combined with (roasted) jujube seed, Dang Gui, raw Rehmannia, and Schisandra for treatment, with cases of long-term insomnia showing improvement with Dan Shen alone at 50g per day, which aligns with the Da Ming Ben Cao stating it “nourishes the spirit and calms the will”; for deficiency of qi and blood, kidney qi deficiency, and stasis leading to deficiency syndrome, Dan Shen is often combined with (roasted) Huang Qi (Astragalus), Dang Gui, He Shou Wu (Polygonum multiflorum), and Ba Jitian (Morinda) for efficacy.
④ Treatment of excess syndromes
It can treat conditions caused by the six excesses and seven emotions that have harmed the body over time, leading to qi stagnation and blood stasis. Dan Shen activates blood and resolves stasis, proving effective in clinical treatment of excess syndromes. For liver and stomach qi pain, Dan Shen is often combined with sandalwood, cardamom, and Yu Jin for efficacy, as this is a case of qi stagnation and poor blood circulation, thus harmonizing qi and blood; a combination of Dan Shen, madder root, Jie Xue Teng, Zicao (Lithospermum), and red dates has shown repeated efficacy in treating allergic purpura, demonstrating Dan Shen’s ability to “break old blood and generate new blood”, allowing blood that has deviated from its path to return to its proper course.
Reports indicate that animal experiments have shown Dan Shen to inhibit platelet aggregation, reduce the activity of platelet factor 3, and prolong plasma prothrombin time, further confirming its efficacy; for manic conditions characterized by excess heat, stasis, and phlegm, a large dose of Dan Shen can be effective based on syndrome differentiation.Animal experiments have proven that Dan Shen inhibits cyclic adenosine monophosphate phosphodiesterase activity and has a suppressive effect on the cerebral cortex; for edema and amenorrhea, it is often combined with Wu Ling San (Five-Ingredient Powder with Poria) along with Dan Shen, amber, and Yi Mu Cao for efficacy.2Nourishes the heart, calms the spirit, eliminates deficiency heat, stops palpitations, and activates blood stasisDan Shen is bitter and cold, enters the blood and returns to the heart, can clear heart fire, eliminate blood heat, calm the spirit, and stabilize palpitations. Therefore, when used appropriately in clinical practice, the recovery is rapid. For palpitations and anxiety due to insufficient heart qi and blood stasis, it can be treated with Bu Yang Huan Wu Tang (Five-Ingredient Decoction to Restore Yang) with added Dan Shen, (roasted) licorice, and Mai Dong (Ophiopogon); for chest yang deficiency, use Gua Lou Xie Bai Tang (Trichosanthes and Allium Decoction) or Kuan Xiong Tong Bi Tang (Dan Shen, Gua Lou, Xie Bai, sandalwood, cinnamon twig, deer antler, hawthorn, Chuan Xiong, Mai Dong, Tian San Qi, Chi Shao); for both qi and yin deficiency, use Sheng Mai San (Generate Pulse Powder) or Yi Mai Tong Bi Tang (Dan Shen, Tai Zi Shen, Mai Dong, Schisandra, Gua Lou, roasted licorice, roasted jujube seed, sandalwood, hawthorn, deer antler); for chest obstruction, chest pain, insomnia, anxiety, and arrhythmia, use roasted licorice decoction to create Dan Shen An Xin Tang (Dan Shen, American ginseng, bitter cucumber, Xuan Shen, roasted jujube seed, Mai Dong, roasted licorice, cinnamon twig, hawthorn, deer antler), which has shown good clinical results; for those who have not responded to other treatments, a syndrome differentiation prescription can lead to rapid improvement in ECG and other examinations.
Image: Mai Dong
Upon careful consideration of its therapeutic principles, whether for chest yang deficiency or qi and yin deficiency, both can lead to poor blood circulation and stasis, thus following the principle of “no flow leads to pain”; using Dan Shen in stasis-resolving prescriptions can enhance its efficacy. The Ben Cao Gang Mu states it “activates blood, opens the heart and pericardium… removes stubborn diseases and stagnant qi from the heart and abdomen”; the Dian Nan Ben Cao states: “Nourishes the heart, calms the spirit, treats forgetfulness, anxiety, palpitations, and insomnia”, indicating that Dan Shen is a significant herb for treating various blood stasis syndromes in the heart and chest area.3Eliminates stasis, generates new blood, and opens all meridians, showing remarkable efficacy in critical and stubborn diseasesDan Shen activates blood, resolves stasis, opens the orifices, and harmonizes qi and blood; thus, when used appropriately in treating critical and stubborn diseases, its efficacy is greatly enhanced. For stroke, it is often used in the formula Wang Qing Ren Bu Yang Huan Wu Tang (Wang Qing Ren’s Yang Restoring Decoction) to create Tong Mai Shu Luo Injection (main ingredients include Huang Qi, Dan Shen, Chuan Xiong, etc.); for stroke, brain tumors, and cerebral edema characterized by water and stasis in the brain, it is often used in the formula Wang Qing Ren Tong Qiao Huo Xue Tang (Wang Qing Ren’s Open Orifices and Activate Blood Decoction) to create Nao Qiao Tong Oral Liquid (main ingredients include Dan Shen, peach kernel, musk, and white grass root); for stroke prevention and early warning, it is often used to create Qing Nao Tong Luo Pian (Clear Brain and Open Meridians Tablets) (main ingredients include Dan Shen and peach kernel), which has shown excellent results in animal experiments and clinical treatments, with no reported toxic side effects; for patients in a coma with closed syndrome, if heat-closed, An Gong Niu Huang Wan can be used with Dan Shen decoction for oral administration or nasal feeding; if cold-closed, Su He Xiang Wan can be used with Dan Shen decoction for oral administration or nasal feeding; regardless of cold or heat closure, Dan Shen injection is often mixed with glucose for intravenous drip; for collapse syndrome, it is often used with Shen Fu Tang (Ginseng and Aconite Decoction) with added Dan Shen for decoction or Dan Shen injection mixed with glucose for intravenous drip; for coma due to phlegm-damp closure, it is often combined with Pu Jin Dan Injection (Acori tatarinowii, Yu Jin, Dan Shen) for intramuscular injection, 2-4ml daily, while Dan Shen injection 4-20ml is mixed with 500ml glucose for intravenous drip, often leading to symptom relief or turning critical conditions into stable ones.Practical experience has shown that Dan Shen plays a major role in treating cardiovascular and neurological diseases, especially in critical conditions, primarily by activating blood circulation, opening the meridians, resolving stasis, and generating new blood; for both hemorrhagic and ischemic strokes, Dan Shen is often used to activate blood and resolve stasis, yielding effective results. What is the rationale behind this? Pharmacological studies have shown that Dan Shen can inhibit coagulation function and enhance fibrinolytic activity; according to TCM theory, “blood should flow, not be stopped” and “resolve stasis and stop bleeding”; Dan Shen improves microcirculation and increases capillary networks, leading to decreased vascular pressure at bleeding sites, which can explain its hemostatic effects; thus, activating blood and resolving stasis has a unique mechanism and therapeutic effect for hemorrhagic stroke, demonstrating the wisdom of using medicine appropriately; for treating epilepsy, Dan Shen is often combined with Acori tatarinowii, Yuan Zhi (Polygala), Bai Fu Ling (Poria), Jiang Can (Silkworm), and Nan Xing (Arisaema); for treating liver and kidney yin deficiency with yang hyperactivity and phlegm-stasis deeply hidden in blood vessels, Dan Shen is often combined with Long Chi (Dragon’s teeth), Chuan Niu Xi, amber, Nu Zhen Zi (Ligustrum), Dan Pi (Moutan), and antelope horn powder. For these difficult and strange diseases, it is often used with syndrome differentiation oral decoctions along with Dan Shen injection 4ml/day for intramuscular injection, leading to improvement in long-term treatment-resistant patients.
Image: Yuan ZhiIn summary, many strange diseases are due to stasis, and chronic diseases often involve phlegm; this is key to treating difficult and miscellaneous diseases. As stated in the Ben Cao Qiu Zhen, “Dan Shen… removes all stasis, thus no disease remains.”4Clears liver, benefits the gallbladder, and alleviates stagnation; suitable for treating masses and accumulationsMasses and accumulations are often caused by liver and gallbladder damp-heat, liver failing to disperse, qi stagnation, or spleen deficiency leading to damp obstruction, resulting in dysfunction of the liver, spleen, and kidney, which over time leads to qi stagnation, blood stasis, and water retention in the abdomen, forming masses and accumulations. Dan Shen enters the liver channel and blood, effectively moving qi stagnation in the blood, resolving stasis and promoting water flow, activating collaterals and reducing swelling, thus it can be used frequently. For hepatitis B with liver and kidney yin deficiency, it is often combined with Yi Guan Jian (Liver-Soothing Decoction) with added Dan Shen; for jaundice at various stages, Dan Shen is often included in the prescription; for abdominal distension due to water and damp obstruction, it is often combined with Chai Hu (Bupleurum), Dang Gui, turtle shell, oyster, chicken inner gold, big belly peel, cloud poria, San Leng (Sparganium), and E Zhu (Curcuma zedoaria); for gallstones, Dan Shen is often combined with Da Huang (Rhubarb), chicken inner gold, Jin Qian Cao (Lysimachia), Chai Hu, and Zhi Shi (Bitter Orange), which has shown reliable efficacy in improving liver function, softening the liver and spleen, reducing masses, and promoting stone expulsion.Pharmacological studies of Dan Shen indicate that it can lower SGPT, protect damaged liver cells, promote liver cell regeneration, and have anti-fibrotic effects. This aligns with the Shen Nong Ben Cao Jing stating that Dan Shen can eliminate “cold and heat accumulations, breaking masses and accumulations”, which is consistent with later experiences of Dan Shen’s ability to shrink the liver and spleen.5Resolves stasis, benefits dampness, and reaches the three burners; both yin and yang water can be eliminatedDan Shen promotes blood circulation, benefits water pathways, and resolves edema, thus it can treat edema caused by water retention and blood stasis. Animal experiments have shown that Dan Shen can improve kidney function, reduce azotemia, and promote diuresis. For edema (yin water) in the lower limbs and generalized swelling, with symptoms of lumbar soreness and fatigue, in cases of kidney deficiency and blood stasis (such as chronic glomerulonephritis, chronic pyelonephritis, nephrotic syndrome), it is often used in the formula Yi Shen Hua Yu Li Shui Tang (Kidney Nourishing and Stasis Resolving Water-Draining Decoction) (Wu Ling San with added Dan Shen, Huang Qi, Sang Ji Sheng, Yi Mu Cao, Chuan Niu Xi, Shan Zha, Bai Mao Gen, Tong Cao); for lower limb edema, fatigue, abdominal distension and pain, pale tongue, and intermittent pulse, which are caused by weak heart yang and water-damp blood stasis, it is often used in Zhen Wu Tang (True Warrior Decoction) combined with Dan Shen, peach kernel, Huang Qi, and Bai Mao Gen; for kidney yang deficiency, it is often used in Jin Gui Shen Qi Tang (Golden Cabinet Kidney Qi Decoction) with added Dan Shen, Bai Mao Gen, and Du Zhong (Eucommia); for qi stagnation and water retention, it is often combined with Chai Hu Shu Gan San (Bupleurum Soothing Powder) and Wu Ling San; for yang water facial swelling (acute glomerulonephritis, etc.) due to wind obstructing the lung and poor qi flow in the three burners, it is often used in Yue Bi Jia Zhu Tang (Yue Bi Decoction with Atractylodes) with added Dan Shen, cloud poria, Che Qian Zi (Plantago), and Lian Qiao (Forsythia); for lung qi deficiency and cold water pathways, it is often used in Ling Gan Wu Wei Jiang Xin Tang (Poria, Licorice, Schisandra, and Ginger Decoction) with added Dan Shen, which can enhance efficacy.
Image: Dan Shen
In clinical practice, as long as syndrome differentiation is accurate and Dan Shen is used appropriately, it can often help eliminate abnormalities in urine tests. The movement of body fluids relies on the regulation of lung qi, the transformation of spleen qi, and the evaporation of kidney qi. If external pathogens invade or if organ functions are disordered or qi is deficient, the three burners may fail to perform their functions, leading to poor water pathways and resulting in edema.Blood and water share a common source; as stated in the Blood Syndrome Theory: “Water and blood support each other… and are interdependent.” Therefore, water retention and blood stasis influence each other, and whether it is yin water or yang water, the principles are the same, with differences in severity and urgency, hence the saying “if blood is not flowing, it becomes water… if water is obstructed, blood cannot flow”.6Cool blood, detoxify, and reduce swelling; can be used for abscesses and skin diseasesDan Shen also has the functions of reducing swelling and pain, cooling blood, detoxifying, and promoting pus drainage and tissue regeneration. For breast abscesses, it can be combined with honeysuckle, tianhua fen (Trichosanthes), and dandelion; for abscesses and skin infections, it can be combined with honeysuckle, dandelion, frankincense, and myrrh; for acute abdominal pain (such as acute appendicitis), it can be combined with Da Huang and Mu Dan Pi for excellent results; for chronic appendicitis, it is often combined with Chai Hu, cloud poria, red vine, Huang Lian (Coptis), Mu Xiang (Aucklandia), Yan Hu Suo (Corydalis), Xiang Fu, dandelion, and Shen Qu (Fermented wheat); due to Dan Shen’s cooling and detoxifying properties, it can be used in the Green Bean and Licorice Detoxifying Decoction (green beans, licorice, honeysuckle, Dendrobium, Dan Shen, Da Huang, Bai Mao Gen) for treating various poisoning emergencies with good results. For damp-heat toxic skin itching and discharge (such as condyloma acuminatum, cervical erosion, etc.), it is often combined with Huang Bai, Ku Shen (Sophora), raw licorice, Bai Zhu, Cang Zhu, Huai Shan (Chinese yam), Tu Fu Ling (Smilax), wild chrysanthemum, and Zao Jiao (Ziziphus jujuba) for internal use and external washing, showing significant efficacy; for damp-heat toxic dysentery, it is often combined with Bai Tou Weng Tang (White Head Weng Decoction) with added Dan Shen; for high fever and delirium, it can be combined with An Gong Niu Huang Wan using Dan Shen decoction for oral administration, which can enhance efficacy and shorten treatment duration; for damp-heat scabies, it can be used with Dan Shen, Ku Shen, and She Chuang Zi (Cnidium) for decoction and washing the affected areas.The Da Ming Ben Cao states that Dan Shen treats “malignant sores, abscesses, goiter, and toxic swellings, promotes pus drainage, and regenerates tissue”. Modern pharmacological studies have shown that Dan Shen has strong inhibitory effects on Staphylococcus, Escherichia coli, and Proteus, and a certain inhibitory effect on typhoid and dysentery bacteria.In summary, there is no distinction between expensive and cheap medicines; what matters is their appropriate application. Dan Shen is cold in nature and bitter in taste, with the effects of activating blood and resolving stasis. It opens the meridians, promotes new blood generation, acts without damaging existing blood, calms the spirit, relieves anxiety, detoxifies, cools the blood, reduces swelling, relieves pain, and promotes pus drainage for treating abscesses, skin diseases, and dysentery. If syndrome differentiation is applied correctly and the herbs are used flexibly, Dan Shen can yield effective results. However, it should be noted that those with spleen deficiency and diarrhea, as well as pregnant women, should use it cautiously. Additionally, the dosage of Dan Shen varies greatly between ancient and modern practices; based on our experience, the common dosage for adults is generally between 10-30g, with some individuals using up to 60g, starting with a smaller dose and gradually increasing.