Chi Shao: The TCM Herb for Cooling Blood and Relieving Pain
- Health Lab
- Jun 21
- 5 min read
Chi Shao, also known as Red Peony Root or Paeonia lactiflora, is the dried root of a peony plant, widely used in Traditional Chinese Medicine (TCM) for its ability to cool blood, clear stasis, and ease pain. Its balanced action makes it a key remedy for conditions caused by blood heat and stagnation, such as menstrual issues and injuries. Chi Shao’s importance is documented in ancient texts.
The Shennong Bencao Jing (Shennong’s Classic of Materia Medica) listed it as a top-grade herb, noting its use for abdominal pain, blood stagnation, and pain relief. The Mingyi Bielu expanded on its benefits for menstrual irregularities and blood stasis. In the Compendium of Materia Medica, Li Shizhen described its growth in hills and gardens, praising its ability to "disperse bad blood, break up masses, and relieve pain." Chi Shao remains a cornerstone in TCM for blood-related disorders.
Properties of Chi Shao
Nature and Channels
Taste: Bitter
Nature: Slightly cold
Channel: Liver
Main Benefits
Cools blood and clears stasis
Relieves pain
Regulates menstruation
Clears heat from blood
Dosage
Internal use: 6–15 grams, boiled in decoctions.
Growing Regions
Found across China, with significant production in Inner Mongolia and Northeast regions, harvested in spring or autumn.
Identification
Shape: Cylindrical, slightly curved, 5–15 cm long, 1–2 cm in diameter.
Color: Brownish or dark brown surface with rough texture, longitudinal wrinkles, and transverse lenticels.
Texture: Hard, not easily broken, with a pinkish or light brown cross-section showing radial patterns.
Scent and Taste: Mildly fragrant, slightly bitter, and astringent.
Preparation
Used raw, wine-fried, or vinegar-fried. Raw Chi Shao strongly cools blood; wine-frying enhances blood circulation; vinegar-frying boosts pain relief.
Clinical Uses of Chi Shao
Chi Shao is used in TCM to treat various conditions:
Menstrual Irregularities: Addresses irregular periods, heavy or scanty flow, dark clotted blood, and abdominal pain due to blood stasis.
Dysmenorrhea: Relieves severe menstrual cramps or lower back pain from stagnation.
Postpartum Pain: Eases abdominal pain, retained lochia, or dark clotted blood after childbirth.
Trauma and Injuries: Reduces swelling and pain from bruises or sprains.
Sores and Abscesses: Treats red, hot, painful skin sores or abscesses caused by heat and stasis.
Rib Pain: Alleviates fixed, stabbing pain in the ribs from blood stagnation.
Red, Swollen Eyes: Soothes eye inflammation from liver heat or blood heat.
Specific Benefits
Cooling Blood and Clearing Stasis: Contains paeoniflorin, which dilates blood vessels and improves circulation, resolving stasis.
Pain Relief: Eases various types of pain, including menstrual and injury-related discomfort.
Regulating Menstruation: Balances menstrual cycles and reduces pain.
Clearing Heat: Reduces bleeding caused by blood heat.
Chi Shao in TCM Formulas
Chi Shao is often combined with other herbs in TCM formulas to enhance its effects. Here are some examples:
Xue Fu Zhu Yu Tang (Blood Mansion Dispel Stasis Decoction): Combines Chi Shao with Peach Kernel, Safflower, Dang Gui, Chuan Xiong, Rehmannia, Aurantii, Bupleurum, Licorice, Cyathula, and Platycodon to activate blood and relieve chest pain, headaches, or insomnia from stasis.
Dan Zhi Xiao Yao San (Moutan and Gardenia Free Wanderer Powder): Includes Chi Shao to clear liver heat and regulate menstruation, treating irritability, menstrual irregularities, or breast pain.
Qing Ying Tang (Clear the Nutritive Level Decoction): Uses Chi Shao to clear heat and nourish yin, addressing fever and toxicity.
Comparison with Similar Herbs
Chi Shao shares blood-activating properties with other TCM herbs but has unique traits:
Dan Shen (Salvia Root): Activates blood, cools it, and calms the mind, ideal for stasis with heat or restlessness.
Hong Hua (Safflower): Strongly activates blood, best for severe stasis, but avoided in pregnancy.
Chuan Xiong (Ligusticum Root): Activates blood and moves qi, excelling in pain relief for headaches and chest pain.
Bai Shao (White Peony Root): Nourishes blood, softens the liver, and calms pain, focusing on blood deficiency rather than heat.
Chi Shao’s cooling and stasis-clearing focus makes it ideal for blood heat conditions, unlike Bai Shao’s nourishing action.
Modern Applications and Research
Modern research highlights Chi Shao’s benefits:
Anti-Inflammatory: Paeoniflorin reduces inflammation, easing tissue damage.
Pain Relief: Effective for inflammatory and nerve pain.
Immune Modulation: Balances immune system activity.
Anti-Platelet Aggregation: Prevents blood clots.
Vasodilation: Improves blood flow.
Clinically, Chi Shao is used for gynecological issues like irregular periods and pelvic inflammation, cardiovascular conditions like coronary heart disease, joint disorders like rheumatoid arthritis, and skin conditions like acne or eczema.
Precautions for Using Chi Shao
Cold Deficiency: Avoid in cases of spleen-stomach cold or blood deficiency without stasis, as its cold nature may harm yang qi.
Pregnant Women: Use cautiously, especially with a history of miscarriage, due to its blood-activating effects.
Bleeding Disorders: Avoid in conditions like hemophilia or low platelets.
Incompatibility: Do not combine with Veratrum (Li Lu), as TCM advises against pairing Chi Shao with it.
Conclusion
Chi Shao is a versatile TCM herb celebrated for cooling blood, clearing stasis, and relieving pain. It effectively treats menstrual disorders, postpartum pain, injuries, and inflammatory conditions, with modern research confirming its anti-inflammatory, analgesic, and circulatory benefits. Its cooling nature requires careful use, especially in those with cold deficiency or pregnancy. By consulting a TCM practitioner for proper dosage and application, Chi Shao can be a powerful ally in managing blood heat and stasis-related health issues.
Chinese Name | 赤芍 |
Chinese Pinyin | Chishao |
English Name | Red Paeoniae Trichocarpae |
Latin Pharmaceutical Name | Paeoniae Radix Rubra |
Category | Roots and rhizomes |
Origin | The dried root of Paeonia lactiflora Pall. (Ranunculaceae). |
Production Regions | Primarily produced in the Chinese provinces of northern east, and inner Mongolia. |
Macroscopic Features | Cylindrical, slightly curved, 5~40cm long, 0.5~3cm diameter. Externally brown, rough, with longitudinal grooves and wrinkles, and with rootlet scars and horizontal raised lenticels, some skin easily falls off. Hard and brittle texture, easily broken; fractured surface is pink-white or pink-red. Cortex is narrow, xylem has radial striations; some with cracks. faintly aromatic odor, slightly bitter sour and astringent taste. |
Quality Requirements | Superior medicinal material is thick and strong, with a white fractured surface and a very powdery nature. |
Properties | Bitter; slightly cold. |
Functions | Clears heat, cools the blood, disperses stasis, relieves pain. Unprocessed Chi shao is advanced on clearing heat and cooling the blood. Apply to body heat and bleeding due to warm-heat disease of heat into blood, red eye and swelling with pain, swollen carbuncles and sore toxin. |
Technical Terms | 'Messy skin and powdery break’: This refers to the thin outer skin of Chi shao, which is loose and easily falls off; the fractured surface is whitish pink and has a powdery nature. ‘Chrysanthemum center’: this refers to radial striations seen on the fractured surface of medicinal material, which have an appearance similar to an open chrysanthemum flower also called ‘chrysanthemum lines’ (ju hua wen). |
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