Lamiaceae
Salvia miltiorrhiza
Dan shen · Red sage · Chinese sage
- Part used
- root
- Native range
- China and Japan
- Morphology
- A perennial sage to about eighty centimetres with pinnate leaves and violet-blue flowers, over a striking brick-red root that gives it both its Chinese and its English names.
What is in it
Evidence
Widely used in China as an injectable and oral preparation for angina and stroke, with a large domestic trial literature. Independent systematic reviews find the evidence promising but methodologically weak, and injectable preparations have their own adverse event record.
Safety
Anticoagulant and antiplatelet activity is well characterised and clinically significant. Case reports of markedly raised INR in people on warfarin are among the best documented herb-drug interactions from the Chinese materia medica. Injectable preparations used in China have caused anaphylaxis.
Interactions: Strongly potentiates warfarin — well documented; Additive with antiplatelets; Caution before surgery
Regulatory: Permitted as a listed medicine ingredient in Australia. Injectable forms are not registered outside China.
How the traditions classify it
Three systems, rating the same plant. Where they disagree, none of them is correcting the others — they are separate frameworks that arrived at their categories independently.
Historical use
In the Shennong Bencao Jing and used continuously since, principally for what the tradition calls blood stasis — a category that includes presentations Western medicine would call angina.
Recorded as history and attributed where possible. Long use establishes that a plant was widely used, not that it worked, and not that it was safe.
Worth knowing
Dan shen is the Chinese herb most likely to cause a genuine clinical problem in a Western hospital, and the reason is that it does something real.
Its anticoagulant effect is not theoretical. The case reports of INR climbing dangerously in patients on warfarin who added dan shen are specific, repeated, and exactly the kind of thing that gets missed because nobody asks about herbs on admission.
It is also a plant whose traditional indication maps unusually well onto a Western one. Blood stasis with chest pain is not angina, and the two categories overlap enough that a tradition reaching for dan shen and a cardiologist reaching for an antiplatelet are, occasionally, reaching at the same thing.
Nomenclature verified against GBIF backbone taxonomy.