Pharmaceutical Name:

Cortex Moutan

Botanical Name:

Paeonia Suffruticosa Andr.

Common Name:

Moutan Bark
Tree Peony Bark

Source of Earliest Record:

Shennong Bencao Jing

Part Used & Method for Pharmaceutical Preparations:

The roots are dug and gathered in autumn.  After the fibrous roots have been removed, the roots are dried in the sun.

Properties and Taste:

Bitter, pungent and slightly cold

Meridian:

Heart, liver and kidney

Functions:

To clear heat and cool blood
To invigorate blood and resolve blood stagnation

Indications and Combinations:

1. Clears Heat and Cools blood

Yin-deficient heat: Mu Dan Pi treats this imbalance to relieve steaming bones sensations, nighttime fevers, the absence of perspiration, and thirst. Typical patients with these symptoms are women experiencing menopause. 

~Steaming bones sensations: use Mu Dan Pi with Di Gu Pi (Cortex Lycii), Qing Hao (Herba Artemisiae Annuae) and Bie Ja (Carapax Trionycis). 

~Menopause with yin deficiency and heat: Use this herbs with Zhi Mu (Radix Anemarrhenae) and Sheng Di Huang (Radix Rehmanniae).

~Spermatorrhea due to Kidney yin deficiency and heat: add Ze Xie (Rhizoma Alismatis), Fu Ling (Poria) and Shan Zhu Yu (Fructus Corni). 

Heat in the blood level: Maculae, bleeding-related blotches on the skin, purpura, hematemesis, hemoptysis, hematuria, and epistaxis are all commonly caused by heat driving the blood out of the vessels.

~Hematemesis and epistaxis because of heat in the blood level: Use with Chi Shao (Radix Paeoniae Rubrae) and Sheng Di Huang (Radix Rehmanniae).

Menstrual Disorders: Clinical manifestations of heat affecting the chong (thoroughfare) and ren (conception) channels include hypermenorrhea, early menstruation, and epistaxis during menstruation. There are also forms of abnormal bleeding in which heat drives blood out of the vessels and thus creates shortened menstrual cycles, early menstruation or hypermenorrhea. Night fevers and morning or daytime chills are also common complaints. Often, premenstrual or postmenstrual feverish sensations may be present. 

~Feverish sensations: Use with Bai Shao (Radix Paeonia Alba), Huang Qin (Radix Scutellariae) and Chai Hu (Radix Bupleuri).

Liver Yang rising or Liver fire: Mu Dan Pi treats hypertension, irritability, redness of the face and eyes, and short temper. 

~Liver yang or Liver fire: Use with Zhi Zi (Fructus Gardeniae), Chai Hu (Radix Bupleuri) and Bai Shao (Radix Paeoniae Alba).  

2. Invigorates Blood Circulation and Disperses Blood Stasis

Amenorrhea or abdominal masses: Because of blood stagnation, patients may experience amenorrhea and abdominal masses such as fibroids, tumors or other similar masses. Mu Dan Pi, cool in thermal property, can invigorate blood circulation and disperse blood stasis without drying the body, which is not characteristic of most blood-invigorating herbs. 

~Amenorrhea or dysmenorrhea with severe pain, stagnation and heat: Use with Tao Ren (Semen Persicae), Chi Shao (Radix Paeoniae Rubrae) and Fu Ling (Poria) to activate blood circulation, remove blood stagnation and relieve pain. 

Bruises resulting from traumatic injuries: Mu Dan Pi can be used for the bruises, broken ones, inflammation, swelling and pain associated with traumatic injuries. 

~Musculoskeletal injuries with inflammation, swelling, bruises and pain: Use with Ru Xiang (Gummi Olibanum), Mo Yao (Myrrha) and Su Mu (Lignum Sappan).

Abscess: Mu Dan Pi is a key herb in treating abscess, especially intestinal abscess or appendicitis. 

~Suppurative inflammation: combine this herb with Jin Yin Hua (Flos Lonicerae), Lian Qiao (Fructus Forsythiae) and Bai Zhi (Radix Angelicae Dahuricae). 

~Intestinal abscess with abdominal pain and mucus in the stool: Use with Da Huang (Radix et Rhizoma Rhei), Tao Ren (Semen Persicae) and Dong Gua Zi (Semen Benincasae).

~Acute appendicitis that has not suppurated, with fever, vomiting and lower-right-quadrant pain: add Da Huang (Radix et Rhizoma Rhei), Mang Xiao (Natrii Sulfas), Tao Ren (Semen Persicae), Dong Gua Zi (Semen Benincasae) and Chi Shao (Radix Paeoniae Rubrae).

Dosage:

6-12 g  in decoction. The maximum dosage of Mu Dan Pi is 30 g. The unprocessed herb is stronger to clear heat and cool blood; the liquor-fried herb (with grain-based liquor) more strongly activates blood circulation and disperses blood stagnation: and the charred herb more effectively stops bleeding.

Cautions:

Cold in nature, Mu  Dan Pi should be used with caution in patients who are experiencing deficiency and cold. Since it has blood-activating and stasis-removing functions, it is contraindicated in patients who are pregnant or have excessive bleeding during menstruation.