Herb Root (根 gēn)

Shang Lu

Poke root · 商陆

Phytolacca acinosa Roxb. · Radix Phytolaccae

Also known as: Zhang Liu (章柳)

Shang Lu (Poke root) plant

Images shown are for educational purposes only

Shāng Lù (Pokeberry root) is a powerful water-expelling herb used in Chinese medicine for severe edema and fluid accumulation, particularly when the swelling is stubborn and accompanied by difficulty urinating or having bowel movements. It is classified as toxic and must only be used under professional guidance in small, carefully measured doses. Externally, fresh root can be applied as a poultice for swollen, painful abscesses.

Category Harsh expellants (峻下逐水药)
Therapeutic focus Fluid Retention and Edema Kidney and Bladder Health Abscess Support

TCM Properties

Temperature

Cold

Taste

Bitter (苦 kǔ)

Channels entered

Lungs, Spleen, Kidneys, Large Intestine

Parts used

Root (根 gēn)

Educational content • Consult qualified TCM practitioners for diagnosis and treatment

What This Herb Does

Every herb has a specific set of actions — here's what Shang Lu does in the body, explained in both everyday and TCM terms

Therapeutic focus

In practical terms, Shang Lu is primarily used to support these areas of health:

Fluid Retention and Edema Kidney and Bladder Health Abscess Support

TCM Actions

In TCM terminology, these are the specific therapeutic actions that Shang Lu performs to restore balance in the body:

Drains Water and Reduces Edema Promotes Bowel and Urinary Movement Resolves Toxicity and Dissipates Nodules

How these actions work

'Expels water and reduces edema' is the primary action of Shāng Lù. Unlike gentle diuretics such as Fú Líng (Poria) or Zé Xiè (Alisma), Shāng Lù is classified as a drastic purgative for expelling water. It powerfully drives accumulated fluid out of the body, making it suitable for severe, stubborn edema and ascites (fluid accumulation in the abdomen) where milder herbs have failed. Its bitter, cold nature gives it a strongly descending quality that forcefully moves stagnant water downward and outward.

'Promotes urination and bowel movement' describes how Shāng Lù achieves its water-expelling effect. It opens both the urinary and intestinal pathways simultaneously, allowing trapped fluids to drain through urine and stool. This dual-route action distinguishes it from simple diuretics and makes it particularly useful when both urination and bowel function are obstructed by water accumulation.

'Resolves toxins and disperses nodules' applies specifically to the external (topical) use of Shāng Lù. When fresh root is mashed and applied to the skin, it can help reduce swollen, painful abscesses and boils. This use takes advantage of its cold, toxin-clearing nature without the risks associated with internal consumption. It has traditionally been applied topically for carbuncles, boils, and other localized swellings.

Important safety note: Shāng Lù is classified as toxic. It must only be used under professional supervision, in appropriate doses (typically 3 to 9 grams), and for limited duration. Overdose can cause severe gastrointestinal distress, vomiting, diarrhea, and in serious cases, central nervous system depression. It is strictly contraindicated during pregnancy and in patients with Spleen deficiency edema (where the body is too weak to tolerate drastic purgation).

Patterns Addressed

In TCM, symptoms cluster into recognizable patterns of disharmony. Shang Lu is used to help correct these specific patterns.

Why Shang Lu addresses this pattern

This pattern involves severe fluid retention where water has accumulated throughout the body, causing generalized swelling. The underlying mechanism is a failure of the body's water metabolism, often involving the Lungs (which regulate the water passages from above), the Spleen (which transforms and transports fluids), and the Kidneys (which govern water in the lower body). Shāng Lù's bitter, cold, descending nature directly targets this stagnant water, forcefully driving it out through both the urinary and intestinal tracts. It enters all three organ channels involved in water metabolism (Lung, Spleen, Kidney) plus the Large Intestine, making it uniquely suited to open multiple drainage routes simultaneously.

A practitioner would look for one or more of these signs

Edema

Severe generalized edema, especially from the waist down

Abdominal Distention

Abdominal fullness and distension from fluid

Difficulty Urinating

Reduced or blocked urination

Constipation

Difficulty passing stool

Commonly Used For

These are conditions where Shang Lu is frequently used — but only when they arise from the specific patterns it addresses, not in all cases

Arises from: Water Overflowing the Skin Water Retention

TCM Interpretation

TCM views edema as a failure of the body's fluid management system. Three organs share responsibility: the Lungs regulate the upper water passages and descend fluids downward; the Spleen transforms and transports water through the middle; and the Kidneys govern water metabolism in the lower body and control the opening and closing of the urinary gate. When one or more of these organs malfunction, water accumulates and overflows into the tissues, causing swelling. Severe edema with obstructed urination and constipation indicates that multiple water pathways are blocked, and the accumulated water has become a substantial pathogenic factor in its own right.

Why Shang Lu Helps

Shāng Lù enters the Lung, Spleen, Kidney, and Large Intestine channels, placing it at every level of the body's water regulation system. Its bitter, cold, forcefully descending nature drives accumulated water out through both urinary and intestinal routes simultaneously. This makes it specifically indicated for the most severe forms of edema where gentler diuretics like Fú Líng or Zé Xiè are insufficient. Modern research has confirmed that Shāng Lù's key active compound (esculentoside A) exerts a diuretic effect by downregulating aquaporin-2 and aquaporin-4 water channels in the kidneys, reducing fluid reabsorption and increasing urine output.

Also commonly used for

Nephritis

Acute and chronic nephritis with edema

Skin Abscess

External application for carbuncles and boils

Constipation

When accompanying severe fluid retention

Herb Properties

Every herb has an inherent temperature, taste, and affinity for specific channels — these properties determine how it interacts with the body

Temperature

Cold

Taste

Bitter (苦 kǔ)

Channels Entered

Lungs Spleen Kidneys Large Intestine

Parts Used

Root (根 gēn)

Dosage & Preparation

These are general dosage guidelines for Shang Lu — always follow your practitioner's recommendation, as dosages vary based on the formula and your individual condition

Standard dosage

3-9g

Maximum dosage

Do not exceed 9g internally. Prolonged decoction (3-4 hours) is essential to reduce toxicity. Higher doses have historically been reported in some clinical settings but carry serious risk of toxicity.

Dosage notes

Use the lowest effective dose within the 3-9g range. Even at standard doses, this herb can cause gastrointestinal irritation. Vinegar-processed Shang Lu (醋商陆, cu shang lu) should be used for internal administration to reduce toxicity, while maintaining diuretic efficacy. Raw Shang Lu is primarily for external use on abscesses and swellings. Prolonged decoction (3-4 hours or more) is traditionally recommended to further reduce toxicity. Some classical recipes call for cooking the root with food items such as mung beans, red adzuki beans, or pork to buffer its harshness. Treatment courses should be short; discontinue once the therapeutic effect (typically diuresis or reduction of swelling) is achieved.

Preparation

For internal use, always use vinegar-processed Shang Lu (醋商陆). Prolonged decoction of 3-4 hours is traditionally recommended to degrade the heat-labile toxic saponins and reduce toxicity. Some classical preparations call for cooking the root inside fish or with adzuki beans and pork to buffer its harsh properties. For external use, fresh root can be pounded with a small amount of salt and applied as a poultice to abscesses and swellings.

Processing Methods

In TCM, the same herb can be prepared in different ways to change its effects — here's how processing alters what Shang Lu does

Processing method

The cleaned, sliced root is stir-fried with rice vinegar (30 kg vinegar per 100 kg herb) until dry. This is the standard processed form listed in the Chinese Pharmacopoeia.

How it changes properties

Vinegar processing significantly reduces the herb's toxicity (to roughly one-third of the raw form's toxicity according to research). The diuretic action becomes somewhat milder and more manageable, while the expectorant effect may be enhanced. The core bitter, cold nature is preserved but moderated. Vinegar processing also reduces irritation to the gastrointestinal lining.

When to use this form

This is the standard form for internal use when treating edema and fluid accumulation. The reduced toxicity makes it safer for oral administration. Choose this form over raw Shāng Lù whenever the herb is taken by mouth.

Common Herb Pairs

These ingredients are traditionally combined with Shang Lu for enhanced therapeutic effect

Chi Xiao Dou
Chi Xiao Dou Equal parts (1:1)

Shāng Lù forcefully expels water through drastic purgation, while Chì Xiǎo Dòu (Adzuki bean) gently promotes urination and reduces swelling through bland percolation. Together they combine a powerful attack on accumulated water with a gentler sustained drainage, and the adzuki bean helps cushion the harsh action of Shāng Lù on the digestive system.

When to use: Severe edema with abdominal fullness and scanty urination. This is a classical pairing seen in the Shāng Lù Dòu Fāng (商陆豆方), where both herbs are cooked inside a carp fish.

Gan Sui
Gan Sui Adjusted by practitioner according to severity; both used in small doses

Both are drastic water-expelling herbs, but they work differently. Gān Suì (Euphorbia) is bitter and descending, forcefully driving water downward. Shāng Lù is described as working by 'breaking through blockages' of stagnant, stuck water. Together they provide a two-pronged attack on severe fluid retention, covering both the descending and unblocking mechanisms.

When to use: Extreme edema and ascites where the fluid is both copious and stubbornly lodged, and the patient's constitution is strong enough to tolerate drastic purgation.

Ze Xie
Ze Xie Equal parts in the classical formula; modern use adjusts to condition

Zé Xiè (Alisma) is a bland, gently percolating diuretic that promotes urination by draining Dampness from the Kidney and Bladder. Paired with the more drastic Shāng Lù, the combination achieves both forceful water expulsion and sustained gentle drainage, preventing the fluid from re-accumulating after the initial purge.

When to use: Edema or ascites requiring an initial drastic approach followed by sustained fluid drainage. This pairing appears in the classical Mǔ Lì Zé Xiè Sǎn from the Shāng Hán Lùn.

Ting Li Zi
Ting Li Zi Equal parts (1:1) in the classical formula

Tíng Lì Zǐ (Lepidium seed) drains fluid from the Lungs downward and opens the upper water passage, while Shāng Lù attacks accumulated water from below through the Kidneys and Large Intestine. Together they open both upper and lower water pathways, creating a top-to-bottom drainage effect.

When to use: Edema accompanied by chest congestion, cough, or breathing difficulty, where fluid is accumulating in both the upper and lower body. This pairing appears together in Mǔ Lì Zé Xiè Sǎn.

Key Formulas

These well-known formulas feature Shang Lu in a prominent role

Shu Zao Yin Zi 疏鑿飲子 King

In this formula from the Jì Shēng Fāng, Shāng Lù serves as the chief herb for treating severe generalized edema with difficult urination and constipation. Classical commentaries specifically identify Shāng Lù as the monarch drug that 'specializes in expelling all types of water.' The formula pairs Shāng Lù's drastic internal purgation with wind-dispersing herbs (Qiāng Huó, Qín Jiāo) to address fluid in both the interior and the body surface, showcasing Shāng Lù's role as the anchor of a comprehensive water-expelling strategy.

Comparable Ingredients

These ingredients have overlapping uses — here's how to tell them apart

Gan Sui
Shang Lu vs Gan Sui

Both are drastic water-expelling herbs classified in the same category. However, Gān Suì is bitter and works by forcefully descending water (苦者取其降), while Shāng Lù's strength lies in unblocking stuck, stagnant water that has accumulated in one place (辛者取其通). Classical texts emphasize this distinction: Gān Suì is better for reversing overflowing, surging water, while Shāng Lù excels at breaking through congested, lodged water. The Shāng Hán Lùn uses Shāng Lù specifically for post-illness lower body edema (Mǔ Lì Zé Xiè Sǎn), while Gān Suì appears in Shí Zǎo Tāng for chest fluid.

Da Ji
Shang Lu vs Da Ji

Both Dà Jǐ (Euphorbia pekinensis) and Shāng Lù are bitter, cold, and toxic drastic purgatives for expelling water. Dà Jǐ is stronger at purging downward through the bowel and is more commonly used alongside Gān Suì in formulas like Shí Zǎo Tāng. Shāng Lù works through both urinary and intestinal pathways and is better at breaking open stubborn fluid blockages. Shāng Lù also has an external-use application for abscesses that Dà Jǐ does not share.

Common Substitutes & Adulterants

Related species and common adulterations to be aware of when sourcing Shang Lu

The most dangerous confusion is between Shang Lu root and ginseng (Ren Shen) root. Both have fleshy, tapering roots, but Shang Lu can be distinguished by its concentric ring pattern (罗盘纹, "compass markings") visible on the cross-section, compared to ginseng's radial "chrysanthemum heart" pattern (菊花心). Shang Lu also produces a numbing sensation when chewed, while ginseng has a distinctive sweet and slightly bitter aroma. Within the Shang Lu category itself, the two official species can be confused: Phytolacca acinosa (native Chinese pokeweed, white flowers, erect racemes) and Phytolacca americana (American pokeweed, white-pinkish flowers, drooping racemes). P. americana is generally considered more toxic. The red-flowered/red-rooted variants should not be substituted for the white variety. Shang Lu may also be confused with the roots of Ma Chi Xian family plants like Tu Ren Shen (Talinum paniculatum, "local ginseng"), which is non-toxic and edible, further contributing to accidental poisoning.

Educational content — always consult a qualified healthcare provider or TCM practitioner before using any herb.

Toxicity Classification

Classical Chinese pharmacopoeia toxicity rating for Shang Lu

Toxic

Shang Lu's primary toxic components are triterpene saponins (商陆皂苷, especially esculentoside A and related compounds) and phytolaccatoxin (商陆毒素). The American pokeweed species (P. americana) also contains histamine as an additional toxic component and is approximately twice as toxic as the native Chinese species (P. acinosa). Symptoms of poisoning typically appear 20 minutes to 3 hours after ingestion and include: nausea, vomiting, severe watery diarrhea, abdominal pain, dizziness, headache, fever, elevated blood pressure and heart rate. In moderate to severe cases: confusion, slurred speech, agitation, muscle twitching, dilated pupils, loss of coordination, convulsions, and delirium. In fatal cases: severe hypotension, respiratory failure, and cardiac arrest from myocardial paralysis. Proper processing dramatically reduces toxicity. Vinegar processing (醋制) reduces toxicity to approximately one-third of the raw herb. Prolonged decoction (3-4 hours) also significantly degrades the toxic saponins, which are heat-labile. The Chinese Pharmacopoeia specifies 30% vinegar for processing (cu shang lu). Folk antidotes for poisoning include raw Gan Cao (licorice) and crushed raw mung beans (绿豆), taken as a decoction.

Contraindications

Situations where Shang Lu should not be used or requires extra caution

Avoid

Pregnancy. Shang Lu is classified as a pregnancy-prohibited herb (妊娠禁用药) due to its toxic properties and its ability to cause miscarriage. It must never be used during pregnancy.

Avoid

Spleen and Stomach deficiency with weakness. Li Shizhen noted in the Ben Cao Gang Mu that those with weak Stomach Qi should not use this herb, as its harsh draining action can severely damage the digestive system.

Avoid

Edema due to Spleen deficiency without excess. Classical texts stress that Shang Lu should only be used for conditions involving genuine water accumulation with excess pathology (气结水壅). It is not appropriate for deficiency-type edema.

Avoid

Excessive dosage or prolonged use. The Chinese Pharmacopoeia limits the dosage to 3-9g. Exceeding this range significantly increases the risk of toxicity, including gastrointestinal damage, central nervous system depression, and cardiac toxicity.

Caution

Use of the raw, unprocessed root internally. Raw Shang Lu has much higher toxicity than the vinegar-processed form (cu shang lu). Internal use should only be with properly processed herb; the raw form is reserved for external application.

Avoid

Use of the red-rooted variety. Classical sources distinguish the white-rooted Shang Lu (white flowers, used medicinally) from the red-rooted type (red flowers), which is considered significantly more toxic and unsuitable for internal use.

Caution

Elderly, frail, or constitutionally weak patients. The harsh, draining nature of this herb can easily damage Qi and fluids in those who lack robust constitution.

Caution

Children, unless under strict specialist supervision with carefully adjusted dosage. Children are more susceptible to its toxic effects.

Classical Incompatibilities

Traditional Chinese pharmacological incompatibilities — herbs or substances to avoid combining with Shang Lu

Shang Lu does not appear on the classical Eighteen Incompatibilities (十八反) or Nineteen Mutual Fears (十九畏) lists. However, the Ben Cao Jing Ji Zhu (《本草经集注》) records that dog meat should not be eaten when taking Shang Lu (有当陆勿食犬肉). Additionally, classical sources advise against consuming salt for 100 days after taking Shang Lu, and avoiding Gan Cao (licorice) for 3 days.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

Absolutely contraindicated in pregnancy. Shang Lu is officially classified as a pregnancy-prohibited herb (妊娠禁用药) in Chinese Pharmacopoeia and standard TCM textbooks. Its potent water-draining and downward-moving properties can damage the fetus and stimulate uterine contraction, leading to miscarriage. Its toxic saponins pose additional risks of systemic toxicity to both mother and fetus. There is no safe dose during pregnancy.

Breastfeeding

Shang Lu should be avoided during breastfeeding. Its toxic saponins (esculentosides) and phytolaccatoxin may transfer into breast milk. Given its classified toxicity and the lack of safety data for nursing mothers, there is no established safe dose. The potential for gastrointestinal irritation, central nervous system effects, and cardiac toxicity in the infant through breast milk exposure makes this herb unsuitable for breastfeeding women.

Children

Shang Lu should generally be avoided in children due to its toxicity. If absolutely necessary under strict specialist supervision, dosages must be significantly reduced (historical sources mention 2-3 qian, roughly 6-9g, as the upper limit for children in decoction form with prolonged boiling of 3-4 hours to reduce toxicity). Children are more susceptible to the herb's toxic effects on the gastrointestinal system, central nervous system, and heart. The raw form must never be given to children internally.

Drug Interactions

If you are taking pharmaceutical medications, be aware of these potential interactions with Shang Lu

Diuretics: Shang Lu has significant diuretic properties. Concurrent use with pharmaceutical diuretics (furosemide, hydrochlorothiazide, spironolactone) may lead to excessive fluid loss, electrolyte imbalance, and hypotension.

Cardiac glycosides (digoxin): Shang Lu's potential to cause cardiac arrhythmias and its effect on electrolyte balance (through aggressive diuresis and potassium loss) may increase sensitivity to digoxin toxicity.

Antihypertensive medications: Severe cases of Shang Lu toxicity involve hypotension. Combined use with antihypertensive drugs could lead to dangerous drops in blood pressure.

Central nervous system depressants: Shang Lu toxicity includes CNS depression (drowsiness, confusion, loss of consciousness). Concurrent use with sedatives, anxiolytics, or opioids may compound these effects.

Note: Formal pharmacokinetic interaction studies are lacking. The above interactions are inferred from the herb's known pharmacological and toxicological profile. As a toxic herb with a narrow therapeutic window, Shang Lu should be used with extreme caution in patients taking any pharmaceutical medications.

Dietary Advice

Foods and dietary considerations when taking Shang Lu

Classical sources specifically state: avoid eating dog meat while taking Shang Lu (有当陆勿食犬肉). One classical formula also advises avoiding salt for an extended period (up to 100 days) and avoiding Gan Cao (licorice) for 3 days after taking Shang Lu preparations. As Shang Lu is a harsh, cold, draining herb, avoid cold and raw foods during treatment to protect the Spleen and Stomach. Light, easily digestible foods are preferable. Mung beans and licorice are traditionally used as antidotes if toxicity occurs.

Botanical Description

Physical characteristics and morphology of the Shang Lu source plant

Phytolacca acinosa Roxb. (and Phytolacca americana L.) is a robust perennial herbaceous plant in the Phytolaccaceae family, growing 0.8 to 1.5 metres tall. The stem is erect, cylindrical, and sometimes tinged purplish-red. The leaves are elliptical to ovate-lanceolate, 9 to 18 cm long and 5 to 10 cm wide, with pointed tips and wedge-shaped bases. The plant produces upright racemes (in P. acinosa) or drooping racemes (in P. americana) bearing small white or pinkish flowers about 6 mm across, with 5 tepals, typically 8 to 10 stamens, and 8 to 10 fused carpels. Flowering occurs from June to August, with dark purple-black berries ripening from August to October.

The medicinal root is large, fleshy, conical, and can weigh several kilograms when mature. It has a characteristic cross-section showing concentric ring patterns known as "compass markings" (罗盘纹, luópán wén), which is the key feature distinguishing it from ginseng root. The plant grows naturally in valleys, hillsides, forest margins, and roadsides at elevations of 500 to 3,400 metres, and is commonly found in moist fertile soils, along paths, and near cultivated land.

Sourcing & Harvesting

Where Shang Lu is sourced, when it's harvested or collected, and how to assess quality

Harvesting season

Autumn through early spring (秋季至次春), when the root is dug up, cleaned, and sliced for drying.

Primary growing regions

Shang Lu (Phytolacca acinosa) is mainly produced in Henan, Hubei, and Anhui provinces. The introduced species Chui Xu Shang Lu (Phytolacca americana, American pokeweed) is mainly produced in Shandong, Zhejiang, and Jiangxi provinces. The herb is also found wild across Shaanxi, Hebei, Jiangsu, Guangxi, Sichuan, and other provinces. It grows widely in moist, fertile soils along hillsides, forest margins, and roadsides throughout central and southern China. There is no strong single dao di yao cai region, as the plant grows abundantly in many provinces.

Quality indicators

Good quality Shang Lu root slices should be large, thick, and firm with a yellowish-white to light brown colour. The cross-section should clearly display the characteristic concentric ring pattern known as "compass markings" (罗盘纹, luopan wen), which is the single most important identifying feature. The taste should be initially slightly sweet, followed by a numbing sensation on the tongue with prolonged chewing (久嚼麻舌). The herb should be dry, free of mould and insect damage, and stored in a dry place. Avoid roots that are dark, soft, or lack clear concentric rings. The white-rooted variety (from P. acinosa with white flowers) is preferred for medicinal use over the red-rooted variety, which is considered more toxic.

Classical Texts

Key passages from the classical Chinese medical texts that describe Shang Lu and its therapeutic uses

Shen Nong Ben Cao Jing (《神农本草经》, lower grade):
Original: 「味辛平。主水张疝瘕痹，熨除痈肿，杀鬼精物。一名䓪根，一名夜呼。生川谷。」
Translation: "Flavour acrid, nature neutral. It primarily treats water [retention], distension, hernias, masses, and impediment. Applied as a hot compress it removes abscesses and swelling. It kills malign spirits. Also called Dang Gen and Ye Hu. Grows in mountain valleys."

Ben Cao Jing Ji Zhu (《本草经集注》, Tao Hongjing):
Original: 「有当陆勿食犬肉。」
Translation: "When taking Shang Lu, do not eat dog meat."

Ben Cao Gang Mu (《本草纲目》, Li Shizhen):
Li Shizhen recorded that the white-flowered variety (白昌, bái chāng) was used by ancient people as a vegetable and could be steamed and eaten, while the red-flowered variety (赤昌, chì chāng) was toxic and could injure the sinews, bones, and kidneys. He noted: "胃气虚弱者不可用" ("Those with weak Stomach Qi must not use it").

Ben Jing Shu Zheng (《本经疏证》):
This text distinguished Shang Lu from Da Ji and Gan Sui, noting that while they share water-draining functions, Shang Lu's acrid flavour gives it a unique ability to "open blockages and guide through obstructions" (决壅导塞) rather than simply purging water downward. It cited Zhang Zhongjing's use of Shang Lu in Mu Li Ze Xie San for water retention below the waist after major illness.

Historical Context

The history and evolution of Shang Lu's use in Chinese medicine over the centuries

Shang Lu is one of the oldest recorded medicinal substances in Chinese medicine, appearing in the Shen Nong Ben Cao Jing (神农本草经) as a lower-grade (下品) herb, indicating it was recognized as potent but potentially harmful. Its name also appears in even more ancient texts: the Zhou Yi (《周易》, Book of Changes) mentions "苋陆" in the Guai hexagram, which commentators identify as Shang Lu. The Warring States period medical text Wan Wu (《万物》), unearthed from the Mawangdui tombs, records that "商陆羊头之已鼓张也" (Shang Lu with sheep's head [treats] drum-like abdominal distension), making it one of the earliest documented drug combinations.

Classical physicians drew an important distinction between the white-flowered and red-flowered varieties. Lei Gong's Treatise on Processing (《雷公炮炙论》) stated that the white variety (白昌) could even be made into cakes by Daoist practitioners, while the red variety (赤昌) was considered dangerously toxic. This distinction persists in modern practice: the red-rooted form (often identified as P. americana) is regarded as more toxic. Tragically, the root's resemblance to ginseng has led to repeated poisoning incidents throughout history and into modern times, as people mistake it for a tonic herb. The folk name "土人参" (tǔ rén shēn, "local ginseng") has contributed to this dangerous confusion.

Zhang Zhongjing included Shang Lu in his Mu Li Ze Xie San (牡蛎泽泻散) in the Shang Han Lun for treating water accumulation below the waist after a major febrile illness. Later commentators emphasized that Shang Lu's role in that formula was specifically to open the upper source of water metabolism via the Lung and Kidney, distinguishing it from other harsh water-draining herbs like Gan Sui and Da Ji.

Modern Research

4 published studies investigating the pharmacological effects or clinical outcomes of Shang Lu

1

Comprehensive Review: Traditional uses, botanical description, phytochemistry, and pharmacological activities of Phytolacca acinosa (2024)

Khalid T, Chang CW, Ross SA, Naseer F, Qadeer A, Chen CC, Rafey HA. Frontiers in Pharmacology, 2024, 15:1480034.

This review article compiled global research on Phytolacca acinosa, identifying key bioactive compounds including triterpene saponins (esculentosides A through T, phytolacacinoside A) and flavones. It summarized evidence for anti-inflammatory, anti-tumor, antiviral, antimicrobial, and diuretic activities, while noting significant toxic potential that limits clinical use.

2

Comprehensive Review: From folklore to pharmacology: A comprehensive review of Phytolacca acinosa Roxb (2025)

Magray JA, Wani BA, Ganie AH, Qadir RU, Javid H, Nawchoo IA. Fitoterapia, 2025, 182:106446.

This review highlighted P. acinosa's significant pharmacological effects including antimicrobial, anti-tumor, antioxidant, antiviral, anti-inflammatory, and molluscicidal properties. It also stressed the plant's toxic effects on living organisms and underscored the need for more toxicological investigations to ensure safe medicinal use.

PubMed
3

Comparative Analysis of Saponins from Different Phytolaccaceae Species and Their Antiproliferative Activities (2017)

Saleri FD, Chen G, Li X, Guo M. Molecules, 2017, 22(7):1077.

This study compared triterpene saponin profiles in P. acinosa roots from Sichuan and Shandong provinces, and in P. americana, using LC-MS. A total of 60 saponins were detected. Cytotoxicity testing against gastric (SGC-7901) and liver (Hep G2) cancer cell lines showed that P. acinosa from Sichuan had the strongest antiproliferative activity, demonstrating significant regional variation in bioactive compound content.

4

Triterpenoid saponins from roots of Phytolacca acinosa (2018)

Du L, Wang JX, Chen CD, Wang F, Zhou HY, Du W. Zhongguo Zhong Yao Za Zhi, 2018, 43(12):2552-2556.

A new triterpenoid saponin named esculentoside U was isolated from P. acinosa roots, a commonly used traditional Chinese medicine with anti-inflammatory and anti-rheumatoid activities. The compound's structure was elucidated using spectroscopic methods.

PubMed

Research on individual TCM herbs is growing but still limited by Western clinical trial standards. These studies provide emerging evidence and should be considered alongside practitioner expertise.