Sang Piao Xiao San: A Chinese herbal medicine for Heart and Kidney Deficiency
- Hongji Medical
- Feb 10
- 6 min read
Chinese herbal medicine, Sang Piao Xiao San, a time-honored prescription from the Compendium of Materia Medica, is a cornerstone of traditional Chinese medicine.
Named after its key ingredient, the mantis egg sheath (Sang Piao Xiao), this formula is renowned for its ability to consolidate semen and stop nocturnal emissions.
It primarily treats symptoms caused by deficiencies in both the heart and kidneys, such as frequent urination, nocturnal emissions, spermatorrhea, and mental confusion, by nourishing these vital organs and restoring balance.
Composition of Sang Piao Xiao San
Sang Piao Xiao San combines eight herbs, carefully blended according to the principles of monarch, minister, assistant, and envoy to address both symptoms and root causes:
Main Herb (Monarch)
Mantis Egg Sheath (Sang Piao Xiao, roasted): Sweet, salty, and neutral, it enters the liver and kidney meridians. It excels at consolidating semen, stopping nocturnal emissions, and stabilizing the bladder to reduce frequent urination.
Assistant Herb (Minister)
Ginseng: Boosts vital qi, nourishes the heart and spleen, and enhances the consolidating effects of Sang Piao Xiao. It strengthens the body’s foundation by replenishing qi and blood.
Supporting Herbs (Adjuvant)
Polygala Root (Yuan Zhi): Calms the mind, enhances mental clarity, and fosters communication between the heart and kidneys to balance water and fire.
Acorus Calamus (Shi Chang Pu): Clears phlegm, opens the mind, and sharpens focus and vision.
Dragon Bone (Long Gu): Soothes nerves, consolidates semen, and reduces excessive sweating.
Poria (Fu Ling): Strengthens the spleen, promotes urination, and calms the mind, supporting ginseng’s nourishing effects.
Harmonizing Herbs (Envoy)
Angelica Root (Dang Gui): Nourishes and activates blood, preventing stagnation while supporting overall vitality.
Tortoise Shell (Gui Ban, vinegar-fried): Nourishes yin, strengthens the kidneys, and supports bones and tendons. Paired with ginseng, it replenishes both qi and yin.
Understanding the Pathogenesis
The root cause of the conditions treated by Sang Piao Xiao San lies in a deficiency of both the heart and kidneys, disrupting the balance between water (kidney) and fire (heart). The kidneys store essence and govern water; when deficient, they fail to regulate the bladder, leading to frequent urination or incontinence.
Weak kidney essence also destabilizes the “essence gate,” causing spermatorrhea, nocturnal emissions, or cloudy, rice-like urine. Additionally, insufficient kidney essence impairs communication with the heart, resulting in heart qi deficiency, mental confusion, and forgetfulness. Over time, this imbalance depletes qi and blood, manifesting as a pale tongue, white coating, and weak pulse.
Conditions Treated
Sang Piao Xiao San is tailored to address symptoms of heart and kidney deficiency, including:
Frequent urination or cloudy, rice-like urine: Caused by weak kidney qi and poor bladder control.
Nocturnal emissions, spermatorrhea, or impotence: Resulting from a weak essence gate and deficient kidney yang.
Mental confusion and forgetfulness: Due to poor heart-kidney communication and lack of nourishment for the mind.
Fatigue and poor appetite: Linked to spleen and stomach weakness from prolonged deficiency.
Postpartum exhaustion or sexual overexertion: Leading to depletion of qi and yin, particularly in women.
How It Works
Sang Piao Xiao San restores balance by:
Consolidating Semen and Stopping Emissions: Sang Piao Xiao directly targets the essence gate, stabilizing it to prevent nocturnal emissions and frequent urination.
Nourishing Heart and Kidneys: Ginseng, tortoise shell, and angelica replenish qi, yin, and blood, strengthening the heart and kidneys.
Calming the Mind: Polygala, acorus calamus, dragon bone, and poria soothe the spirit, improve mental clarity, and reduce restlessness.
Balancing Water and Fire: The formula fosters harmony between the heart and kidneys, ensuring proper communication and function.
This holistic approach treats both the symptoms and underlying deficiencies, promoting long-term health.
Modern Applications
In contemporary medicine, Sang Piao Xiao San is used to treat a range of conditions linked to heart and kidney deficiencies:
Nocturia and Enuresis in Children: Regulates bladder function, reduces nighttime urination, and improves sleep quality.
Interstitial Cystitis: Alleviates frequent urination and urgency by stabilizing the bladder and nourishing yin.
Cardiovascular Health: Ingredients like ginseng and angelica promote blood circulation, reduce thrombosis risk, and support heart health, potentially lowering the risk of heart disease.
Diabetes and Neurasthenia: Addresses symptoms like fatigue, mental fog, and urinary issues caused by qi and yin deficiency.
Modern research highlights the formula’s efficacy in regulating bladder function, improving circulation, and supporting neurological health, making it a versatile remedy.
Precautions
When using Sang Piao Xiao San, keep the following in mind:
Indications: Best suited for heart and kidney deficiency with symptoms like frequent urination, spermatorrhea, mental confusion, pale tongue with white coating, and weak pulse.
Contraindications: Avoid in cases of frequent urination or spermatorrhea caused by damp-heat in the lower abdomen or excessive yang fire.
Side Effects: Generally safe with minimal side effects, but use under a practitioner’s guidance to avoid overuse.
Dietary Notes: Maintain a balanced diet and avoid overly stimulating foods to support the formula’s effects.
Sang Piao Xiao San exemplifies the precision of traditional Chinese medicine, offering a comprehensive solution for heart and kidney deficiencies while promoting vitality and balance.
Chinese Name | 桑螵蛸散 |
Phonetic | Sang Piao Xiao San |
English Name | Mantis Egg Shell Powder |
Classification | Astringent formulas |
Source | 《Extension of the Materia Medica》Ben Cao Yan Yi《本草衍義》 |
Combination | Mantidis Ootheca (Sang Piao Xiao) 1 liang (30g), Polygalae Radix (Yuan Zhi) 1 liang (30g), Acori Tatarinowii Rhizoma(Chang Pu) 1 liang (30g), Draconis Os (Long Gu) 1 liang (30g), Ginseng Radix et Rhizoma (Ren Shen) 1 liang (30g), Poria (Fu Shen) 1 liang (30g), Angelicae Sinensis Radix (Dang Gui) 1 liang (30g), Testudinis Carapax et Plastrum (Gui Jia) 1 liang (30g) |
Method | Grind all the medicinals into a fine powder. 6g of the powder constitutes a single dose. Swallow the powder with a decoction of ren shen before bed. This formula can also be prepared as a decoction and taken before bed by adjusting the medicinals quantities based on the original ratios. |
Action | Harmonizes and supplements the heart and the kidney, consolidates essence and arrests emission and urination. |
Indication | Sang Piao Xiao San is indicated for a pattern of both heart and kidney deficiency. Signs and symptoms include frequent urination, turbid urine, enuresis, spontaneous seminal emission, absent-mindedness, poor memory, a pale tongue with white coating and a thready, thin pulse. |
Pathogenesis | This pattern is caused by deficiency of both the heart and kidney and failure of the water and fire to interact. The kidney governs water and stores the essence. Therefore, when the essence is not contained due to kidney deficiency and the bladder fails to ensure retention, problems such as frequent urination and enuresis occur. When the essence is not stored and controlled properly due to kidney deficiency, disorders involving seminal emission, spontaneous seminal emission, or turbid colored urine will manifest. The consumption of kidney essence leads to kidney qi deficiency and fails to move upward and interact with the heart. This leads to heart deficiency. Together, these two circumstances cause malnourishment of the spirit and symptoms such as poor memory and forgetfulness. If this is not corrected in time, it will eventually impair the body’s essence, blood, and original qi. This type of deficiency is observed by a pale tongue body, a white tongue coating, and a deficient, weak pulse. The treatment is to harmonize and supplement the heart and kidney, consolidate essence, and arrest emission and urination. |
Application | 1. Essential pattern differentiation Sang Piao Xiao San is commonly used to treat deficiency of the heart and kidney. This clinical pattern is marked by frequent urination or enuresis, absent-mindedness, pale tongue with white coating, thready and weak pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of a heart and kidney deficiency pattern: pediatric frequent urination or enuresis, diabetes mellitus, and neurasthenia. 3. Cautions and contraindications It is not applicable for frequent urination, enuresis, seminal emission, or premature ejaculation caused by damp-heat accumulation in the lower jiao, or frenetic stirring of ministerial fire. |
Additonal formulae | Suo Quan Wan (Stream-Reducing Pill 縮泉丸) [Source]《Wei’s Family - Circulated Formulas》Wei Shi Jia Cang Fang《魏氏家藏方》 [Ingredients] Wu yao and yi zhi ren in equal amounts [Preparation and Administration] Grind the ingredients into powder and form into pills with the size of a phoenix tree seed using powdered shan yao (fried). 50 pills (6g) are taken with salted water or salted wine. [Actions] Warms the kidney and dispels cold, consolidates essence and arrests enuresis and emission. [Applicable Patterns] Deficient-cold bladder pattern. Symptoms include: frequent urination, enuresis, aversion to cold in the lower abdomen, a pale tongue, and a deep and weak pulse. |
Remark | 1. Reeves' Terrapin (Chinemys reevesii / Mauremys reevesii) is listed as "Endangered" in the International Union for the Conservation of Nature and Natural Resources (IUCN) Red List of Threatened Species. Also, it is listed in the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) Appendix III. Its trade is regional control and subject to permits or certificates of origin. 2. Ginseng (Panax ginseng) is listed in the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) Appendix II. Its trade is allowed but subject to licensing controls. |
