Shēng Má (升麻) — Cimicifuga Rhizome

On this page

1. Overview
2. Properties
3. Actions and indications
4. Key formulas
5. Modern research
6. Cautions and contraindications
7. Treatment at my clinic

1. Overview

Shēng Má (升麻) is the dried rhizome of Cimicifuga heracleifolia, C. dahurica or C. foetida — related to the Western herb black cohosh, though the species used in TCM are different. It belongs to the category of Cool-acrid herbs that release the Exterior in the Chinese Materia Medica. Its most clinically distinctive role is to raise sinking Yang — lifting prolapsed organs and sunken middle Qi — for which it is paired with Chai Hu in the famous formula Bu Zhong Yi Qi Tang.

I prescribe Shēng Má as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

2. Properties

3. Actions and indications

Principal actions

1. Releases the Exterior and vents rashes (early-stage measles)
2. Clears Heat and resolves toxicity, particularly in the head, mouth and throat
3. Raises Yang and lifts sunken Spleen/Middle Qi

Indications

1. Early-stage measles, particularly when the rash is incompletely vented
2. Mouth and gum ulcers, sore swollen throat, toothache from Stomach Fire
3. Prolapse of organs (rectum, uterus, stomach), haemorrhoids and chronic diarrhoea from middle Qi sinking, in combination with Huang Qi and Chai Hu

4. Key formulas containing Shēng Má

Shēng Má appears in Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) for sunken middle Qi with prolapse, fatigue and chronic loose stools; and in Sheng Ma Ge Gen Tang for measles eruption.

5. Modern research

Chinese Cimicifuga species contain triterpene glycosides (cimigenosides, cimicifugosides), phenolic acids and chromones. Pharmacological studies report anti-inflammatory, antiviral, antipyretic and bone-protective effects. The Chinese species and the Western black cohosh (Actaea racemosa) share some constituents but are not interchangeable.

6. Cautions and contraindications

Contraindicated in cases of Yin-deficiency Heat with rising Yang, and in active asthma or wheezing where the ascending action is inappropriate. Use small doses for the raising effect; larger doses for venting rashes.

Important: Chinese herbs should always be prescribed by a fully qualified herbalist who is a member of the Register of Chinese Herbal Medicine (RCHM).

7. Treatment at my clinic

I prescribe Shēng Má as part of tailored herbal formulas for prolapse, chronic fatigue with sinking middle Qi, gum and mouth ulcers from Stomach Fire, and as a small-dose adjunct in Spleen-Qi-deficiency formulas. Every prescription is individually formulated following a full TCM assessment.

I see patients in person at my clinic in Wokingham, Berkshire. Online Chinese herbal medicine consultations are available.

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