Medicinal Uses of White Peony Root (Bai Shao)
Chinese name: Bai shao
Latin name: Peonia lactiflora
Organ affinities: liver
Flavor and temperature: bitter, sour, sweet, cool, slightly astringent.
TCM Actions: builds liver blood, subdues liver yang, restrains the yin, softens the liver
White peony root (bai shao) is the peeled root of the Peonia lactiflora plant. Chi shao is the root of the same plant, but is unpeeled and thus red in color, and has slightly different uses. In this article I'm talking about white peony root. White peony root is sometimes prepared in different ways (ie stir fried), which all have slightly different uses or affinities. It's typical for Chinese herbs to be prepared in some way. For our purposes, raw white peony root works just fine, and is the most typically seen on the market.
I really enjoy looking from the perspective of individual herbs and what specific lessons they carry. White peony teaches us many different things, the first of which is the importance of well nourished liver blood for a well functioning musculoskeletal system. The liver nourishes the "sinews," which is an awkwardly translated word that roughly corresponds to ligaments, tendons and muscles. If our liver blood is running low (aka deficient), our sinews are poorly nourished. This manifests as muscular weakness, muscle cramps, muscle spasms, numbness, "growing pains," restless leg, higher instances of injury, weakness of the tendons, hypertonicity or hypotonicity of tendons, inflammation of the tendons, and poor flexibility.
Now enter WHITE PEONY ROOT, the sinew-nourishing extraordinaire. White peony has an affinity for the musculoskeletal system, as well as being one of the primary liver blood builders in Chinese medicine, making it perfect for a musculoskeletal problem with liver blood deficiency as its primary cause (see above symptoms). It is a specific for muscle spasms (combine with licorice root) and pain in the abdomen, which especially includes spasms in the stomach and intestines, but also works well for the lower legs, face and diaphragm. A while back I had been taking overly large doses of draining herbs, which have the unfortunate side effect of depleting blood and yin. Among other strange symptoms, my knee began to randomly give out while I was walking. I tried several topical things for it, and it took a very VERY long while to realize that the underlying pattern was blood deficiency with wind (the spasm-like nature of the knee giving out was the giveaway). I finally started drinking white peony tea, and after about a month I was completely cured of the strange knee weakness and pain that has plagued me for so long. And later on I discover that white peony is a specific for blood deficiency caused by excessive use of draining herbs. BAM! Half of the battle in herbal medicine is divining the mystery that is the human body so we can actually use all this herbal knowledge that we have. Maybe more than half... moving on to more lessons from white peony.
That brings me to another important action of white peony: subduing liver yang. Yin (which includes blood) with its water like tendencies and yang with its fire like tendencies are always pushing against each other, creating a sort of dynamic balance in our body. Yin moving downward and yang moving upward. Like Lung qi, Liver qi is meant to move downward. It is liver yin that cools and condenses it so that it does just that, However, if our liver blood or yin is weak, then the liver yang will move upward because it is no longer being held in balance. This diagnosis is called "Liver yang rising" in Chinese medicine, and is the most typical cause of a headaches and dizziness. LYR can also cause irritability and anxiety. I like to compare it with the energy of a volcano. It's a funny image and I think it does the situation a lot of justice.
Lavender and feverfew both are bitter and redirect the liver qi downward, thus their effectiveness for headaches. Because white peony nourishes liver blood AND subdues liver yang, it is a unique single remedy for this scenario. If the headache is indeed of this type, white peony should be very effective. If the headache is caused by dampness, phlegm or kidney deficiency, it will likely have no effect. You can combine white peony with lavender for even more downward moving energy for acute headaches. Also try this combination for vertigo (if there are other signs of blood deficiency).
White peony "softens the liver" (also translated at "pacifies the liver"), which then allows easier passage of qi and blood through the liver. Since the liver is responsible for circulating qi throughout the body, it is rather important that qi be able to move quickly and efficiently through. Bupleurum (chai hu) actually MOVES liver qi, which white peony does not do, so I think it's important to unpack this action a little. Liver qi stagnation (imagine a traffic jam) can be caused by liver blood deficiency (imagine dry vessels) in the same way a stream can't run in a drought. In order for there to be movement, there needs to be substance. White peony is a specific for that type of liver qi stagnation, which is actually a secondary imbalance (meaning that liver blood deficiency is primary, and is causing liver qi stagnation). When liver qi stagnation is a primary imbalance because of repressed emotion and poor diet, then bupleurum may be more appropriate. This is a kind of chicken and the egg scenario, and can be difficult to suss out. The two are often used together in classic Chinese formulas such as Free and Easy Wanderer (Xiao yao san) and Four Substances Decoction (Si wu tang).
Another reason bupleurum and white peony are often paired, is that draining and moving herbs such as bupleurum deplete blood and yin over time, so adding white peony to the formula negates that side effect. You will see white peony and other blood building herbs like dang gui used as balancing herbs in many Chinese formulas to protect the fluids. This is a formulation strategy commonly used in many disciplines of herbalism which involves adding herbs to a formula to counteract negative effects or side effects of one of the main herbs (aka "the cheif").
Another role of liver blood is to anchor your ethereal soul (hun) in your liver. You want your ethereal soul to be close and connected to you, not wandering off someplace like a lost dog. Your ethereal soul is the part of your psyche that is wild, psychic and intuitive. It is what travels when you dream. It houses the subconscious mind, as well as guiding us to our soul calling by giving us vision of where to go and what to do. It sets up our life path ahead of us. Liver blood also plays a part in decision making, which is most certainly related to our life vision. Which career should I choose? Which class should I take? Who should I be friends with? Ah!
Those with liver blood deficiency will feel ungrounded, lost, without direction and mildly anxious and fearful. They may feel out of touch with their intuition, and live excessively in their head. White peony root helps us when our vision is unclear, when we are feeling ungrounded, when we wander in our dreams. White peony is also included in many insomnia formulas where blood deficiency is a component--imagine trying to sleep while your ethereal soul is zipping around! It usually results in excessive and vivid dreaming.
As it turns out, liver blood nourishes your life vision, but also your actual vision from your actual eyes. This means that white peony root has applications in formulas for the eyes where there is floaters and blurry vision. One example of this is migraines that involve vision obscurement, though it may also help with blurry vision.
There is a lot of talk about white peony for menstrual disorders, for which it is fantastic... IN THE RIGHT CONTEXT. Herbs simply won't work if you are wrong about what's going on, so stop throwing herbs at it and do some digging. Liver blood deficiency manifests as irregular periods, either very heavy or very scanty periods, and perhaps fever and sweating during menstruation if false heat is present. Because white peony is also used for abdominal pain and spasm, it is also commonly used in formulas for cramps in combination with other herbs depending on the pattern. Cramps or pain right after bleeding stops is usually caused by blood deficiency, and would be a great scenario for white peony as a single.
Liver Blood is the weakest right before menstruation, which I learned the hard way. I was warming up on a very easy climbing wall the day before my period was meant to start and I severely injured my shoulder doing a very simple move that should have been easy. My liver blood was not nourishing my sinews, leaving me susceptible to injury. This is one reason why it's important to rest before your period!
You know those breakouts at the edges of your mouth that people who menstruate get every month? Those are likely from liver blood deficiency effecting your uterus! I used to have them for YEARS, and then I started taking white peony and they disappeared within three months (yes it took that long, and yes they come back if I don't take care of my liver blood). I think there are a lot of oversimplification among western herbalists that those pimples are simply "heat in the uterus," and that heat clearing herbs are called for, or that white peony is called for because it is cooling. Technically, white peony is effective in stopping that type of breakout because it builds blood, but also clears the heat that can develop from blood deficiency. That type of heat is in a class of heat called "false heat" which develops when yin or blood (and sometimes qi) are too weak to keep the body cool. See the theme here about the interplay between yin and yang?
I'd also like to unpack the question of what white peony does for the liver blood versus liver yin. Liver blood is part of liver yin (just like a square is a type of rectangle), so building liver blood contributes to liver yin, though perhaps not as much as an herb like cooked rehmannia root or goji berry which are considered yin tonics AND blood tonics. Because white peony is kind of sour, it "restrains the yin," also translated as "preserves the yin." What this very ambiguous term means is that the astringency that goes along with the sourness tightens tissues and prevents leakage of fluid from the organs. Schisandra works in the same way only even more strongly. One might wonder how such an astringent and sour herb is at all connected with yin as it seems so drying to the mouth, but in very small doses it's used when the body does not want to hold on to fluids. Connected to this "holding in fluids" action is white peony's ability to reduce sweating, specifically sweating caused by qi deficiency (qi holds fluids in the body) or night sweats caused by yin deficiency (yin keeps the body cool). In fact, white peony is combined with schisandra for night sweats.
If there is concern about white peony being too "cooling," you can combine it with its buddy Chinese angelica root (dang gui). They both nourish liver blood, but Chinese angelica is warming, making them a commonly used pairing of herbs. Chinese Angelica also has the added benefit of moving the blood, which has applications for menstrual pain and other situations where stagnant blood is causing pain and inhibiting the flow of qi and fluids. They are commonly used together as a dui yao, which is defined as two substances that reinforce and synergize to have a greater effect together than either would alone.
PREPARATION AND DOSAGE:
Because it is a building herb, it may take time to see results. I recommend taking white peony consistently over a three month period when using it for chronic or long standing conditions.
DECOCTION: The best method of taking it is a decoction using the root pieces (5-10 grams in decoction). According to Chinese materia medica sources, up to 30g of white peony can be used "in severe cases". I recommend two cups a day white actively building, and then maintaining with a few cups a week once symptoms have leveled out. Don't mistake "white peony tea" (which contains Camellia sinensis leaves) for "white peony root." Mountain Rose Herbs Sells both, and it's annoyingly confusing.
POWDERED EXTRACT: (pictured on right) You can get a powdered extract designed to dissolve in hot water. Search google for Bai shao powdered extract. It can be a little expensive, but it's very convenient and works the same as a decoction.
TINCTURE: You can make or buy a tincture. For any type of real result, I suggest taking 3-4 droppers 3x/day, which for western herbalists may seem rather high.Though I have dabbled in Matt Wood style low doses, I have found that larger doses work better for me personally. For acute scenarios, I have used the tincture in relatively high single doses (1/2 oz of tincture in 4 oz of water) for restless leg syndrome and calf cramps. My partner and I have taken it before climbing sessions to ensure tendon integrity. It takes 30-60 mins to kick in, so time your dose accordingly.
Thanks so much for reading my ramblings.