Bai Shao (White Peony) is the root of the perennial herbaceous plant Paeonia lactiflora, belonging to the Ranunculaceae family. It is cool in nature, with a sour, sweet, and bitter taste, and has functions such as nourishing blood, calming the liver, and alleviating pain.
Mr. Gao Huiyuan has extensive experience in using Bai Shao. Through various combinations, he has widely applied it in clinical practice for multiple diseases. As practitioners, we deeply appreciate his unique combinations, which provide much inspiration.
1
Bai Shao and Gan Cao (Licorice), Nourishing Yin and Alleviating Pain
Bai Shao is sour and cold, while Gan Cao is sweet and neutral. The combination of sour and sweet helps to nourish Yin and alleviate pain.
In treating “cramping of the feet,” Zhang Zhongjing prescribed Shaoyao Gan Cao Tang (Peony and Licorice Decoction) to nourish the blood and muscles, which effectively relieved the cramping.
Moreover, if the treatment is misapplied and the medicine does not address the disease, resulting in damage to the middle Qi and invasion of external pathogens, leading to symptoms such as abdominal distension and pain due to cold in the middle Jiao, Bai Shao combined with Gan Cao can stabilize the spleen and alleviate pain. Adding Gui Zhi (Cinnamon Twig), Sheng Jiang (Fresh Ginger), and Da Zao (Jujube) can warm the middle and harmonize the stomach, thus tonifying the spleen and preventing the retention of pathogens, leading to the cessation of abdominal pain.
2
Bai Shao and Gui Zhi (Cinnamon Twig), Harmonizing Ying and Wei, Dispelling Wind
The combination of Bai Shao and Gui Zhi can coordinate the Ying and Wei, as seen in the Gui Zhi Tang (Cinnamon Twig Decoction), which is used to treat exterior conditions of wind-cold and disharmony of Ying and Wei leading to spontaneous sweating.
Bai Shao nourishes and consolidates Yin, while Gui Zhi dispels wind and harmonizes Yang. The two herbs complement each other, balancing Yin and Yang, movement and stillness, thus achieving a harmonious state where the Ying and Wei are balanced, the exterior is secured, and sweating is stopped while expelling pathogens.
Additionally, the sour and sweet properties of Bai Shao can harmonize the interior and alleviate pain, while the warm and acrid nature of Gui Zhi can tonify the middle and address deficiency, effectively treating abdominal pain due to deficiency-cold, which is commonly seen in clinical practice.
3
Bai Shao and Chai Hu (Bupleurum), Soothe the Liver and Relieve Depression, Harmonize Liver and Spleen
The use of Bai Shao with Chai Hu is most effectively illustrated in the Xiao Yao San (Free and Easy Wanderer Powder), which is formulated for liver Qi stagnation and blood deficiency.
The liver is the organ that stores blood and prefers to disperse and flow freely, while it dislikes stagnation. When Qi is stagnant, it leads to disharmony between Qi and blood. Xiao Yao San utilizes Bai Shao to nourish blood and support the liver, combined with Chai Hu to disperse and smooth the liver, achieving a balance of consolidation and dispersion, thus providing the effects of soothing the liver, harmonizing blood, and alleviating pain.
This formula is commonly used for symptoms of liver Qi stagnation such as dizziness, chest and flank pain, and menstrual irregularities or dysmenorrhea in women due to liver-spleen disharmony.
In clinical practice, Mr. Gao often combines it with Dang Gui (Angelica), Chuan Xiong (Szechuan Lovage), to invigorate blood or with Dang Shen (Codonopsis) and Bai Zhu (Atractylodes) to tonify Qi, enhancing the effects of regulating Qi and alleviating pain.
4
Bai Shao and Huang Qin (Scutellaria), Clear Heat and Stop Dysentery, Harmonize the Middle and Alleviate Pain
Bai Shao can regulate the liver and alleviate pain, harmonizing the Tai Yin and Ying Qi to stabilize the spleen, while Huang Qin clears heat and dampness from the Yangming and strengthens the intestines. The combination of these two herbs is used to treat heat dysentery with abdominal pain and heaviness, or diarrhea due to damp-heat in the large intestine.
Zhang Zhongjing’s Huang Qin Tang (Scutellaria Decoction) is an example of treating the combined disease of Tai Yang and Shao Yang with diarrhea and abdominal pain.
Wang Mengying believed that in warm diseases where cold pathogens have deeply penetrated and transformed into heat, using Bai Shao with Huang Qin, which is bitter and cold, can directly clear internal heat, addressing the heat that is hidden in the Yin, thus following the principle of proper treatment.
Mr. Gao believes that when these two herbs are stir-fried, their cold nature is moderated, and they can effectively enter the blood level, commonly used for symptoms such as fetal fire disturbing the stomach, nausea and vomiting, or fetal restlessness. The combination can drain fire without harming the fetus, nourish the righteous Qi without causing stagnation, and can be used cautiously for those with a weak spleen and stomach.
5
Bai Shao and Fang Feng (Saposhnikovia), Balance Liver Wood, Soothe Wind and Comfort the Spleen
The combination of Bai Shao and Fang Feng is most typically seen in the Painful Diarrhea Formula, which functions to drain the liver and tonify the spleen, used for pain and diarrhea due to liver wood attacking the earth.
Using Bai Shao can drain wood and stabilize earth, while Fang Feng disperses the liver and soothes the spleen; thus, it is often used for those with spleen deficiency or disharmony between the liver and spleen presenting with diarrhea and abdominal pain.
Mr. Gao believes that in this case, the herbs should be stir-fried for optimal effect.
According to the “Pharmacological Interpretation of Medicinal Substances,” Bai Shao is described as “bitter, sour, and cold in nature, not originally a spleen channel herb. Stir-frying it reduces its cold nature, allowing it to disperse and consolidate the spleen Qi, while the heat of the stomach can help consolidate it… thus draining the liver’s evil while alleviating the spleen’s Qi.”
After stir-frying, Fang Feng’s ability to dispel wind and release the exterior is reduced, but it has a better effect on uplifting the spleen Yang.
6
Bai Shao and He Ye (Lotus Leaf), Nourish Yin and Soothe the Liver, Promote Cooling Blood
In clinical practice, Mr. Gao often uses stir-fried Bai Shao to soften the liver and stabilize the spleen, combined with He Ye to promote spleen Qi, along with Dang Shen, Bai Zhu, and Fu Ling (Poria) to tonify the spleen and stomach, treating spleen deficiency with Qi sinking and diarrhea.
Additionally, the combination of these two herbs, along with other herbs such as Ce Bai Ye (Platycladus), Sheng Di (Rehmannia), and Sheng Ai Ye (Mugwort), is specifically used to treat blood heat leading to symptoms such as hemoptysis, epistaxis, excessive menstruation, and metrorrhagia in women.
7
Bai Shao and Tian Ma (Gastrodia), Nourish Yin and Soothe the Liver, Extinguish Wind and Calm Convulsions
According to the “Correct Interpretation of Materia Medica,” Tian Ma is dense and solid, yet clear and smooth, rich in lipids, thus able to calm and stabilize, nourishing fluids to extinguish internal wind, historically known as Ling Feng Cao (Calming Wind Herb).
The combination of these two herbs is suitable for treating headaches, dizziness, and pediatric convulsions caused by blood deficiency and internal liver wind.
In clinical practice, Mr. Gao often combines it with Jizhu (Tribulus), Chrysanthemum, Gou Teng (Uncaria), and Dang Gui, achieving rapid effects.
8
Bai Shao and Gou Teng (Uncaria), Clear Heat and Soothe the Liver, Nourish Yin and Extinguish Wind
Bai Shao, when used raw, is relatively cold, nourishing blood and softening the liver, while Gou Teng is sweet and cool, clearing liver heat and calming the liver. The combination of these two herbs is used for headaches, head heaviness, and dizziness caused by insufficient liver blood and Yin, leading to excessive liver Yang.
In clinical applications, it is often combined with Xia Ku Cao (Selfheal), Huang Qin, and Shi Jue Ming (Abalone Shell).
For example, the Ling Yang Gou Teng Tang (Antelope Horn and Uncaria Decoction) uses raw Bai Shao with Gou Teng to alleviate liver urgency and extinguish wind, nourishing kidney fluids to dispel heat, and adding Ling Yang Jiao (Antelope Horn) to calm the liver and stop spasms, effectively treating convulsions and coma due to excessive heat in the liver channel.
9
Bai Shao and Bai Zhu (Atractylodes), Benefit the Liver and Strengthen the Spleen, Harmonizing Storage and Function
Bai Shao benefits the spleen and harmonizes the liver, while Bai Zhu strengthens the spleen Yang. The combination of these two herbs harmonizes Yin and Yang, tonifying both liver and spleen, effectively treating spleen deficiency with abdominal pain and diarrhea.
Moreover, since the liver stores blood and the spleen governs blood, Bai Zhu strengthens the spleen’s ability to transport and transform, allowing Qi and blood to be abundant and regulated, while Bai Shao nourishes the liver and consolidates Yin.
Thus, Mr. Gao emphasizes the use of stir-fried Bai Shao and Bai Zhu for conditions caused by dysfunction of the liver and spleen leading to metrorrhagia, excessive menstruation, delayed menstruation, and difficulty in clearing blood. He often adds herbs such as lotus root, charred lotus leaf, charred blood remnants, and charred palm to consolidate Yin, nourish blood, and stop bleeding without leaving stasis, allowing old stasis to resolve and new blood to generate.
10
Bai Shao and Dang Gui (Angelica), Nourish Blood and Harmonize Ying, Also Able to Stabilize Pregnancy
Dang Gui nourishes and harmonizes blood, commonly used for blood disorders. Its sweet and warm nature can harmonize Ying and blood, while its acrid and warm nature can disperse internal cold, and its bitter and warm nature can drive away heart cold. Bai Shao, on the other hand, focuses on nourishing blood and consolidating Yin.
The two herbs, when used in equal amounts, nourish and supplement blood, harmonize blood, and consolidate the liver, ensuring that Ying blood is abundant, with the heart governing blood and the liver storing blood. This combination is clinically used for symptoms of blood and Qi deficiency and disharmony between Qi and blood.
Additionally, the Dang Gui San (Angelica Powder) from the “Jin Kui Yao Lue” treats conditions of fetal restlessness due to blood deficiency in the liver and spleen’s inability to properly transport blood.
11
Bai Shao and Fu Zi (Aconite), Revive Yang and Expel Cold, Harmonize Ying and Consolidate Yin
Bai Shao nourishes blood and harmonizes Ying, softening the liver and stabilizing the spleen, while Fu Zi is acrid and warm, expelling cold and strengthening Yang. Bai Shao’s sourness can benefit blood, while Fu Zi’s acrid nature can restore Qi; Bai Shao consolidates Yin and stops sweating, while Fu Zi secures the kidneys and revives Yang. The combination of these two herbs applies both cold and heat, treating conditions of Yin injury and Yang deficiency.
Mr. Gao believes that for cold conditions, warming is necessary. Even when using Fu Zi, one must be cautious of damaging Yin with excessive heat. The combination of Bai Shao and Fu Zi allows Fu Zi to enter the blood level to disperse cold, while Bai Shao’s sourness nourishes Yin, also moderating Fu Zi’s acrid and hot nature, achieving a balance of hardness and softness, allowing Fu Zi to warm Yang and expel cold without harming Yin or causing blood movement, making this combination particularly appropriate.
In clinical use, the dosage for Fu Zi is 6-8 grams, and for Bai Shao, it is 10-15 grams.
12
Bai Shao and Ma Ren (Sesame Seed), Consolidate Yin and Harmonize the Spleen, Moisten and Alleviate Constipation
Zhang Zhongjing used this combination for conditions of strong stomach and weak spleen, with Yang excess and Yin injury, as seen in the Ma Zi Ren Wan (Sesame Seed Pill), where insufficient fluids in the spleen fail to moisten the intestines, leading to dryness and constipation, with heat and Qi excess causing dryness in the stomach and injury to the stomach Yin, resulting in symptoms such as dry stools and infrequent, yellow urination.
Using Ma Ren can moisten the intestines and promote bowel movements, while Bai Shao nourishes Yin and harmonizes the interior, consolidating fluids to assist in moistening, allowing the Yangming dryness to be expelled and the Taiyin fluids to be nourished, thus resolving the condition of spleen deficiency.
Later generations have derived the Live Blood Moistening Decoction and the Nourishing Ying and Cheng Qi Decoction from Zhang Zhongjing’s principles.
Additionally, Mr. Gao also uses Bai Shao with Dan Pi (Moutan) to clear liver heat; with Gui Ban (Tortoise Shell) to consolidate Yin and subdue Yang, softening the liver and extinguishing wind; with Shu Di (Rehmannia) to nourish both liver and kidney; with Gou Qi Zi (Goji Berry) to nourish Yin and clear the liver, moistening and supporting the wood; with Ye Jiao Teng (Polygala) and He Huan Pi (Mimosa) to nourish blood, soften the liver, nourish Yin, and calm the spirit; as well as with Huang Qi (Astragalus), Gui Zhi, and Fang Feng to tonify Qi, warm the channels, and harmonize Ying to treat conditions of insufficient righteous Qi, disharmony between Ying and Wei, invasion of wind pathogens, and symptoms such as numbness of the skin and joint pain due to poor circulation of blood and Qi.
Regarding the preparation of Bai Shao, Mr. Gao believes that it is generally used raw for nourishing Yin, supplementing blood, and softening the liver; for soothing the liver, it should be stir-fried with vinegar; for harmonizing the middle and alleviating urgency, it should be stir-fried with wine; for stabilizing the spleen and stopping diarrhea, it should be stir-fried with earth; and for consolidating blood and stopping bleeding, it should be stir-fried to charcoal.
Mr. Gao emphasizes that due to Bai Shao’s slightly cold nature and its sweet, bitter, and sour flavors, it should be used cautiously in cases of exterior conditions without sweating or in cases of measles that have not yet surfaced, to avoid incomplete sweating and insufficient eruption of the rash; for those with a history of spleen deficiency and excess cold, it should be combined with other herbs to prevent adverse changes.
In summary, Bai Shao is a versatile herb that Mr. Gao has skillfully combined and widely applied in treating external and internal injuries, as well as gynecological disorders, showcasing unique insights that are valuable for future practitioners to learn from.
Note: This article is excerpted from “Clinical Practitioner Gao Huiyuan,” published by China Traditional Chinese Medicine Publishing House in April 2004. This public account is used solely for academic exchange; please indicate the source when reprinting.