Sheng Di Huang 生地黄 (Raw Rehmannia) — Chinese Herbal Medicine

At a Glance

• Herb: Sheng Di Huang
• Chinese name: 生地黄 (Shēng Dì Huáng)
• Latin name: Radix Rehmanniae (Rehmannia glutinosa (Gaertn.) DC., raw/fresh)
• Nature: Cold
• Taste: Sweet / Bitter
• Meridian: Heart / Liver / Kidney
• Category: Herbs that Clear Heat and Cool Blood (清热凉血药)
• Introduction: Sheng Di Huang (生地黄, Raw Rehmannia) is the raw or dried form of the same plant as Shu Di Huang, but with fundamentally different properties. Its cold, bitter nature clears heat from the nutritive and blood levels, cools blood, stops bleeding, nourishes yin, and generates fluids. It is the principal herb for heat entering the blood level (营血分), hemorrhagic fever diseases, and yin deficiency with heat. Used extensively in febrile disease treatment (温病学) and as a yin-nourishing, fluid-generating herb.

Action

• Clears heat and cools blood (清热凉血)
• Nourishes yin and generates fluids (养阴生津)
• Stops bleeding (凉血止血)
• Nourishes the Heart and calms the mind (养心安神)
• Clears heat from the nutritive level (清营透热)

Clinical Application

• Heat entering the nutritive-blood level: high fever, restlessness, maculopapular rash, delirium, hemorrhage — clears heat from the deepest levels
• Hemorrhagic conditions: hematemesis, epistaxis, hematuria, uterine bleeding from heat in the blood
• Yin deficiency with heat: afternoon fever, night sweats, irritability, dry mouth and throat, wasting thirst
• Warm disease damaging fluids: intense thirst, dry lips, constipation from fluid consumption
• Heart fire with restlessness: mouth sores, insomnia, irritability, palpitations
• Wasting thirst (消渴): diabetes-like patterns with intense thirst

Precautions

• Contraindicated in Spleen yang deficiency with loose stools and poor digestion — cold nature injures the Spleen
• Avoid in phlegm-damp obstruction and abdominal fullness
• Use cautiously with iron supplements — may interfere with iron absorption
• Avoid in exterior conditions — cold, yin-nourishing nature can trap pathogens
• Distinguish carefully from Shu Di Huang: opposite thermal natures and primary actions

Formula

• Liu Wei Di Huang Wan (六味地黄丸): uses Shu Di (prepared), but Sheng Di substituted in heat patterns
• Qing Ying Tang (清营汤): Sheng Di + Xuan Shen + heat-clearing herbs — heat in nutritive level
• Xi Jiao Di Huang Tang (犀角地黄汤): Sheng Di + Shui Niu Jiao + Chi Shao + Mu Dan Pi — heat in blood level, hemorrhage
• Zeng Ye Tang (增液汤): Sheng Di + Xuan Shen + Mai Dong — fluid deficiency constipation
• Huang Lian E Jiao Tang (黄连阿胶汤): Huang Lian + E Jiao + Bai Shao + Sheng Di + Ji Zi Huang — Heart fire yin deficiency insomnia
• Si Sheng Wan (四生丸): fresh Di Huang + fresh Ce Bai Ye + fresh He Ye + fresh Ai Ye — heat bleeding (hematemesis, epistaxis)
• Zhi Bai Di Huang Wan variant: replaces Shu Di with Sheng Di for stronger heat-clearing

Combinations

• [Wenbing Tiaobian — Wēn Bìng Tiáo Biàn (温病条辨), Wu Jutong, 1798] Sheng Di Huang + Xuan Shen + Mai Dong: Zeng Ye Tang (增液汤) — for fluid deficiency with constipation after febrile disease
• [Wenbing Tiaobian — Wēn Bìng Tiáo Biàn (温病条辨), Wu Jutong, 1798] Sheng Di Huang + Xuan Shen + Lian Qiao + Dan Shen + Huang Lian + Jin Yin Hua + Mai Dong + Dan Zhu Ye + Shui Niu Jiao: Qing Ying Tang (清营汤) — for heat entering the nutritive level with high fever, restlessness, and rash
• [Wenbing Tiaobian — Wēn Bìng Tiáo Biàn (温病条辨), Wu Jutong, 1798] Sheng Di Huang + Shui Niu Jiao + Chi Shao + Mu Dan Pi: Xi Jiao Di Huang Tang (犀角地黄汤) — for heat in blood level with hemorrhage and delirium
• [Treatise on Cold Damage — Shāng Hán Lùn (伤寒论), Zhang Zhongjing, ~200 CE] Sheng Di Huang + Huang Lian + Huang Qin: Huang Lian E Jiao Tang (黄连阿胶汤) — for Heart fire with yin deficiency causing insomnia and irritability
• [Compendium of Materia Medica — Běn Cǎo Gāng Mù (本草纲目), Li Shizhen, 1596] Sheng Di Huang + Ren Shen + Tian Men Dong + Mai Dong: for qi and yin deficiency after illness with intense thirst

Pharmacological Effects

• catalpol
  • Anti-inflammatory: inhibits NF-κB and COX-2 pathways
  • Anti-diabetic: lowers blood glucose
  • Anti-diabetic: improves insulin sensitivity
• catalpol protective against neurodegeneration
  • Neuroprotective: promotes neurogenesis
• Hemostatic
  • promotes platelet aggregation at the right dose
  • cooling blood reduces hemorrhagic tendency
• polysaccharides
  • Immunomodulatory: stimulate macrophage and T-cell activity
• Cardioprotective
  • reduces myocardial ischemia-reperfusion injury
• Hepatoprotective
  • reduces liver inflammation
• Antifatigue and anti-aging
  • antioxidant, mitochondrial protective

Classic Description

• [Shen Nong’s Classic of Materia Medica — Shén Nóng Běn Cǎo Jīng (神农本草经), ~100 BCE] “Di Huang (fresh) is sweet and cold. It mainly fills bone marrow, grows muscles, removes cold and heat accumulation, and breaks blood obstruction. Made into decoction, it removes cold and heat bi.” (干地黄，味甘寒。主折跌绝筋，伤中，逐血痹，填骨髓，长肌肉，作汤除寒热积聚，除痹。)
• [Compendium of Materia Medica — Běn Cǎo Gāng Mù (本草纲目), Li Shizhen, 1596] “Raw Di Huang: clears heat and cools blood, stops hemorrhage. Prepared Di Huang: fills essence and tonifies blood. The two forms have opposite effects — raw is cold and purging; prepared is warm and supplementing. A physician must distinguish.” (生地黄：清热凉血，止血。熟地黄：填精补血。二者功效相反，生则寒泻，熟则温补，医者必辨。)
• [Systematic Differentiation of Warm Diseases — Wēn Rè Lùn (温热论), Ye Tianshi (叶天士), 1746] “When heat enters the blood level, one must cool blood and dissipate stasis. Di Huang is the primary herb for cooling the blood.” (热入血分，凉血散瘀，地黄为凉血之主药。) Ye Tianshi’s four-level theory (卫气营血) established Di Huang as essential for the deepest level of febrile disease.