Cattail pollen (Pu Huang) Flying squirrel faeces (Wu Ling Zhi)

Shi Xiao San

Chinese: 失笑散

Pinyin: Shī Xiào Sàn

Other names: Sudden Smile Powder

Number of ingredients: 2 herbs

Formula category: Formulas that invigorate Blood and dispel Blood Stagnation

Conditions for which it may be prescribed: DysmenorrheaEpigastric painContinuous lochia and four other conditions

  1. Invigorates Blood
  2. Dispels Blood Stagnation
  3. Eases pain

Contraindications: Contraindicated during pregnancy because of the formula's general ability to... Contraindicated during pregnancy because of the formula's general ability to dispel Blood Stagnation. Also, Cattail Pollen (Pu Huang) can give rise to uterine contractions. Patients with Stomach Deficiency should pay special attention because Flying squirrel faeces can harm Stomach Qi. see more

Source date: 1108 AD

Source book: Materia Medica Arranged According to Pattern

Shi Xiao San is a 2-ingredient Chinese Medicine formula with Cattail Pollen (Pu Huang) and Flying Squirrel Faeces (Wu Ling Zhi) as principal ingredients.

Invented in 1108 AD, it belongs to the category of formulas that invigorate Blood and dispel Blood Stagnation. Its main actions are: 1) invigorates Blood and 2) dispels Blood Stagnation.

In Chinese Medicine health conditions are thought to arise due to "disharmonies" in the body as a system. These disharmonies are called "patterns" and the very purpose of herbal formulas is to fight them in order to restore the body's harmony.

In this case Shi Xiao San is used by TCM practitioners to fight patterns like Blood Stagnation or Liver Blood Stagnation. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as abnormal uterine bleeding, heavy menstruation or irregular menstruation for instance.

On this page, after a detailed description of each of the two ingredients in Shi Xiao San, we review the patterns and conditions that Shi Xiao San helps treat.

The two ingredients in Shi Xiao San

Pu Huang is a king ingredient in Shi Xiao San. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Cattail Pollen (Pu Huang)

Part used: Dried pollen

Nature: Neutral

Taste(s): Sweet

Meridian affinity: SpleenHeartLiverPericardium

Category: Herbs that stop bleeding

Pu Huang is neutral and sweet and it enters the Liver Blood. It not only strongly supports Blood circulation, but also stops bleeding.

Learn more about Cattail Pollen (Pu Huang)

Wu Ling Zhi is a king ingredient in Shi Xiao San. Like the name indicates, it means it has more power than other ingredients in the formula.

2. Flying Squirrel Faeces (Wu Ling Zhi)

Part used: Dried faeces

Nature: Warm

Taste(s): BitterSweet

Meridian affinity: SpleenLiver

Category: Herbs that invigorate the Blood

In general Wu Ling Zhi's main actions are as follows: "Disperses congealed Blood in the lower abdomen and uterus and relieves pain. Promotes childhood nutrition with Cold Stagnation and focal abdominal swelling."

In the context of Shi Xiao San, it is used because it is sweet and warming. It promotes Blood circulation and removes Blood Stagnation.

Learn more about Flying Squirrel Faeces (Wu Ling Zhi)

Conditions and patterns for which Shi Xiao San may be prescribed

It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.

As such Shi Xiao San is used by TCM practitioners to treat two different patterns which we describe below.

But before we delve into these patterns here is an overview of the Western conditions they're commonly associated with:

Abnormal uterine bleeding Heavy menstruation Irregular menstruation Dysmenorrhea Postpartum abdominal pain Continuous lochia Epigastric pain

Again it wouldn't be correct to say "Shi Xiao San treats abnormal uterine bleeding" for instance. Rather, Shi Xiao San is used to treat patterns that are sometimes the root cause behind abnormal uterine bleeding.

Now let's look at the two patterns commonly treated with Shi Xiao San.

Blood (Xue) is one of Chinese Medicine's vital subtances. Learn more about Blood in Chinese Medicine

Blood Stagnation

Shi Xiao San is sometimes prescribed by TCM practitioners to treat Blood Stagnation. This pattern leads to symptoms such as stabbing pain, abdominal masses, purple nails and painful period. Patients with Blood Stagnation typically exhibit choppy (Se), wiry (Xian) or firm (Lao) pulses as well as a reddish-purple tongue.

Blood Stagnation - also often referred to as "Blood Stasis" - is where the Blood flow is heavily restricted in all or parts of the body. It is one of the most important diagnostic conditions in Chinese Medicine because it is frequently the cause of intractable pain syndromes anywhere in the... read more about Blood Stagnation

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Blood Stagnation

Shi Xiao San is sometimes prescribed by TCM practitioners to treat Liver Blood Stagnation. This pattern leads to symptoms such as dark clots in menstrual blood, dark colored blood, irregular menstruation and painful period. Patients with Liver Blood Stagnation typically exhibit wiry (Xian) pulses as well as a bluish-purple sides tongue.

Liver Blood Stagnation usually develops from other patterns, Liver Qi Stagnation, Cold and Heat being the most common ones. Sometimes Qi Deficiency, Blood Deficiency and Phlegm can also be the precursors. 

Liver Qi Stagnation is the most common cause. If left unchecked for a while without being... read more about Liver Blood Stagnation

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