Shao Yao Tang — Peony Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Comparisons with related formulas
7. Cautions

Overview

Shao Yao Tang — the “Peony Decoction” — is a Jin-dynasty formula by Liu Wansu (1110–1200), one of the four great masters of the Jin-Yuan period. It addresses Damp-Heat dysentery (li ji) with bloody, mucousy stools, abdominal pain, tenesmus and burning anus. The formula illustrates the principle of “treating disease with its opposite” — combining cold draining herbs with warming Qi-moving herbs to harmonise the Qi and Blood disorder underlying the diarrhoea.

The chief herb Bai Shao softens the Liver and relieves abdominal cramping. Huang Lian and Huang Qin clear Damp-Heat. Da Huang purges accumulated Heat downward. Mu Xiang, Bing Lang and Dang Gui move Qi and Blood. Rou Gui (small dose) prevents the cold herbs from causing further stagnation.

I prescribe Shao Yao Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Shao Yao Tang is prescribed for Damp-Heat dysentery:

• Bloody, mucousy stools — the cardinal sign
• Abdominal pain — cramping, relieved by bowel movement
• Tenesmus — urge to defecate without relief
• Burning anus
• Mild fever
• Foul-smelling stool
• Tongue — red, yellow greasy coat
• Pulse — slippery, rapid

Key herbs

1. Bai Shao (large dose) — softens the Liver and relieves abdominal cramping
2. Huang Lian, Huang Qin — clear Damp-Heat from the intestines
3. Da Huang — purges Heat downward
4. Mu Xiang, Bing Lang — move Qi downward and resolve tenesmus
5. Dang Gui — nourishes and moves Blood (relevant for bloody diarrhoea)
6. Rou Gui (small dose) — warms the channels; balances the cold herbs
7. Gan Cao — harmonises

Formula actions

1. Clears Damp-Heat from the intestines
2. Regulates Qi and Blood
3. Resolves dysentery (bloody mucousy diarrhoea)
4. Relieves tenesmus and abdominal cramping

Conditions treated

1. Acute bacterial dysentery (alongside antibiotics if needed)
2. Acute ulcerative colitis flare — see ulcerative colitis
3. Amoebic dysentery (alongside antiparasitic treatment)
4. Acute proctitis with bloody mucousy stools
5. Infectious gastroenteritis with Damp-Heat pattern
6. Traveller’s diarrhoea with bloody pattern

Comparisons with related formulas

• Bai Tou Weng Tang — for severe Heat-toxin dysentery with bright red blood; more cold and direct.
• Ge Gen Huang Qin Huang Lian Tang — for Damp-Heat diarrhoea spreading from exterior; with fever and surface signs.
• Huang Qin Tang — simpler formula for Damp-Heat diarrhoea without blood.

Cautions

Acute bloody diarrhoea needs medical investigation to identify the cause (bacterial, parasitic, ulcerative colitis, ischaemic, cancer). Sudden onset, fever or systemic signs warrant urgent assessment.

Contains Da Huang — not appropriate in pregnancy.

Not appropriate for cold-pattern diarrhoea or chronic deficiency diarrhoea.

Always consult a qualified Chinese herbalist registered with the RCHM.

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