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Xijun Yan Editor Dan Shen (Salvia miltiorrhiza) in Medicine Volume 3. Clinical Research Dan Shen (Salvia miltiorrhiza) in Medicine Xijun Yan Editor Dan Shen (Salvia miltiorrhiza) in Medicine Volume 3. Clinical Research 123 Editor Xijun Yan Tianjin China ISBN 978-94-017-9465-7 DOI 10.1007/978-94-017-9466-4 ISBN 978-94-017-9466-4 (eBook) Springer Dordrecht Heidelberg New York London Library of Congress Control Number: 2014950646 © Springer Science+Business Media Dordrecht and People’s Medical Publishing House 2015 This work is subject to copyright. All rights are reserved by the Publishers, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publishers’ locations, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publishers can accept any legal responsibility for any errors or omissions that may be made. The publishers make no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Foreword Danshen was originally recorded in Shen Nong’s Classic of the Materia Medica, and detailed information on the herb was also recorded in Thoroughly Revised Materia Medica and The Grand Compendium of Materia Medica in later ages. Danshen is bitter in taste and slightly warm in nature, and is a commonly used but important drug with the function of activating blood circulation and dissipating blood stasis. Danshen has wide applications and good therapeutic effects, is neutral in nature and non-venomous, and its source is widespread and inexpensive, so it is worthy of research and promotion in clinical settings. Based on other researchers’ and our own long-term clinical experience in the application of Danshen, we have found that Danshen has extensive pharmacologic actions and its unique therapeutic actions can be obtained by flexible combination with other drugs. Clinically, Danshen can be used alone to treat various diseases, and pharmacologic actions can be obtained by combination with other drugs. It can ascend and descend along the channels, and has good therapeutic effects on deficiency syndrome and excess syndrome; thus it can be applied extensively in the clinical treatment of various diseases. Based on a summary of the clinical experience with Danshen of prominent TCM doctors, we propose the following principles and methods which could be used as a reference for clinical medical professionals. Invigorating Blood and Dissolving Stasis, Treating Upper and Lower Diseases, as Well as the Syndromes of Deficiency and Excess Treating Upper Diseases Anemarrhena, Phellodendron, and Rehmannia Decoction combined with Danshen, magnetite, cicada moulting, and cyathula root can be used for treatment of patients with symptoms of sudden deafness or hearing loss caused by deficiency in the liver and kidney and stagnation of blood, which has not been cured by long-term use of western medicines. The combination v vi of Danshen, magnetite, chrysanthemum flower, common self-heal fruit-spike, rehmannia root, Chinese gentian, and cyathula root can be used to treat hyperpyrexia of the liver to eliminate liver fire and to dissolve stagnant blood and promote blood circulation, and good therapeutic effects have been obtained. Danshen and magnetite can be used to treat hypertension according to the differentiation of the symptoms, and excellent therapeutic effects have been achieved. Danshen combined with almond, platycodon root, and Sichuan fritillaria bulb etc., has the function of diffusing the lung, activating blood circulation, depressing qi, and stopping coughing. Treating Lower Diseases Danshen has the functions of unblocking blood vessels and meridians, activating blood circulation, and removing obstruction in collaterals, and the drug is bitter in taste and acts in lower meridians, so it is especially suitable for chronic diseases of the lower part of the body. For example, when combined with asper-like teasel root, double teeth angelica root, cyathula root, and Chinese taxillus herb belongs, Danshen can be used to treat rheumatic arthralgia in the lower limbs. Combined with honeysuckle stem, swordlike atractylodes rhizome, cyathula root, amur corktree bark, red peony root, cortex moutan, and Chinese pine nodular branch, etc., Danshen can be used to treat beriberoid pyretic arthralgia with the symptom of red swelling joint. Combined with Chinese angelica, suberect spatholobus stem, figwort root, rehmannia dride rhizome, Japanese honeysuckle flower bud, cassiabarktree twig, and pangolin scales, etc., Danshen can be used to treat vasculitis in lower limbs. Combined with Chinese angelica, nutgrass galingale rhizome, common motherwort herb, Danshen can be used to treat menoxenia, menischesis, or blood stasis and abdominal pain after childbirth, and marked effects can be obtained. The same effect can be achieved using Danshen alone: just take Danshen powder with white spirit. Danshen can be combined with rehmannia dride rhizome, prepared rhizome of rehmannia, common anemarrhena, cyathula root, amur corktree bark, hindu lotus stemen, tremolite, fructus corni, wenchow turmeric root tuber, incised notopterygium rhizome and root, and white peony root, etc., to treat liver kidney yin insufficiency or heat accumulation and impotence and prospermia. The above formula is called Essence-Securing and Yang-Raising Decoction (固精启阳汤), with significant therapeutic effects. Treating Deficiency Syndromes The symptoms of deficiency syndromes include asthenia of healthy energy due to long duration of disease, weakness of blood circulation, prolonged deficiency, and excessive stasis. Danshen has the functions of removing Foreword Foreword vii blood stasis and producing new blood, promoting blood circulation but not disintegrating blood stasis. It was described by the ancients that the effect of Danshen is equivalent to that of Four Substances Decoction. Although the effect of Danshen might be exaggerated, Danshen does activate blood circulation and dissipate blood stasis. According to The Grand Compendium of Materia Medica, Danshen’s function is to nourish the blood. Yishen Dingxuan Decoction (益肾定眩汤), which is Lycium Berry, Chrysanthemumm, and Rehmannia Decoction with the addition of Danshen, magnetite, szechwan lovage rhizome, tall gastrodia rhizome, can be used to treat dizziness due to deficiency syndrome, especially kidney deficiency combined with blood stasis with the symptoms of dizziness, soreness, and weakness of waist and knees, gloomy tongue, deep thin and unsmooth pulse, etc. Danshen is usually combined with stir-baked semen ziziphi spinosae, Chinese angelica, rehmannia dride rhizome, and Chinese magnoliavine fruit, etc., to treat palpitation due to deficiency of blood and insomnia, which was called “cultivating the spirit and calming the mind” in The Materia Medica of Ming Dynasty 《大明本草》 ( ). Danshen can be combined with mongolian milkvetch root, Chinese angelica, tuber fleeceflower root and medicinal morinda root to treat deficiency-consumption diseases with symptoms of extreme deficiency of qi and blood, deficiency of kidney qi, and stagnant blood. Treating Excess Syndromes The six pathogenic factors and the seven emotions can hurt the body, and eventually will cause the stasis of qi and blood and show the symptoms of qi stagnation and blood stasis. Danshen has the functions of activating blood circulation and eliminating stagnation, thus it has been used to treat excess syndromes with certain therapeutic effects. For example, Danshen Beverage is usually combined with sandalwood, villous amomum fruit, and turmeric root tuber to treat patients with hepatogenous gastralgia caused by the depression and stagnation of qi and stagnation of blood; thus it can benefit the patients by regulating vital energy and activating blood circulation. Also, these drugs can complement each other very well. Henoch-Schonlein purpura can be treated with the combination of Danshen, suberect spatholobus stem, Indian madder root, redroot gromwell, and red date. It is called “disintegrating stagnated blood, producing fresh blood”; thus the blood escaped from blood channels could return to the meridians. Patients with mania usually suffer from excessive fire, stagnation, and phlegm, and they can be treated with large doses of Danshen based on the symptoms. Menostasis with the symptom of edema usually can be treated with Five Substances Powder with Poria combined with Danshen, amber, common motherwort herb, mongolian milkvetch root, etc. viii Nourishing Blood, Calming the Mind, Eliminating Deficiency-Heat, Stopping Shock, Alleviating Palpitations, and Treating Heart Diseases Danshen is bitter in taste and cold in nature, and acts on blood and returns to the heart, with the functions of eliminating cardiopyrexia and blood heat, calming the mind and palpitations. Thus, these kinds of diseases can be cured rapidly with correct application of the drug. Danshen can be combined with Chinese arborvilae seed, Chinese angelica, rehmannia dride rhizome, Chinese magnoliavine fruit, and stir-baked semen ziziphi spinosae, etc., to treat palpitations and insomnia due to deficiency of blood. Yang Supplementing and Five Returning Decoction can be combined with Danshen, prepared liquorice root, and dwarf lilyturf root tuber, etc., to treat severe palpitations which belong to deficiency of heart-qi, qi asthenia, and blood stasis. Trichosanthes and Chinese Chive Decoction or Kuanxiong Tongbi Decoction (宽胸通痹汤) (Danshen, mongolian snakegourd fruit, longstamen onion bulb, sandalwood, cassiabarktree twig, Chinese pyrola herb, Chinese hawthorn fruit, szechwan lovage rhizome, dwarf lilyturf root tuber, sanchi. red peony root) can be used to treat hypofunction of yang qi in the chest. Pulse-Engendering Powder and Yimai Tongbi Decoction (益脉通痹汤) (Danshen, different leaves pseudostellaria root tuber, dwarf lilyturf root tuber, Chinese magnoliavine fruit, mongolian snakegourd fruit, prepared liauorice root, stir-baked semen ziziphi spinosae, rosewood heart wood, Chinese hawthorn fruit, Chinese pyrola herb) can be used to treat deficiency in both qi and yin. Based on the principle of Honey-Fried Licorice Decoction, Sishen Anxin Decoction (四参安心汤) (Danshen, american cinseng, lightyellow sophora root, figwort root, stir-baked semen ziziphi spinosae, dwarf lilyturf root tuber, prepared liauorice root, cassiabarktree twig, Chinese hawthorn fruit, Chinese pyrola herb) can be used to treat pectoral stuffiness pain and chest pain, insomnia and pavor, arrhythmia, etc., and good effects have been obtained in clinical treatment. This formula is especially suitable for patients who have taken other prescriptions for a long time without any effects: in treatment according to pattern differentiation, the drug can rapidly improve the electrocardiogram or return it to normal. Stagnation of blood and blood stasis can be induced by hypofunction of yang qi in the chest or deficiency in both qi and yin. According to the theory that “stagnation of qi and blood may bring about pain,” Danshen, which has the function of dissipating blood stasis, can be added to prescriptions to obtain good therapeutic effects. It was recorded in The Grand Compendium of Materia Medica that Danshen has the functions of activating blood circulation, dredging the pericardium or the envelope of the heart, and treating inveterate diseases of the heart, and it is also recorded in Materia Medica of South Yunnan that Danshen has the functions of supplementing the heart, calming the nerves, and treating memory loss, severe palpitation, pavor, and sleeplessness, which demonstrates that Danshen has wide clinical application. Foreword Foreword ix Removing Blood Stasis, Promoting Fresh Blood Production and Circulation, and Treating Acute and Chronic Diseases Danshen has the functions of activating blood circulation and dissipating blood stasis, promoting defecation and urination, and harmonizing qi and blood; thus, extraordinary effects on the treatment of acute and chronic deathly diseases can be obtained when the drug is used correctly. For example, “Tongmai Shuluo Injection” (通脉舒络注射液) (main components include mongolian milkvetch root, Danshen, and szechwan lovage rhizome, etc.), which was developed according to the theory of “Yang-Supplementing and Five-Returning Decoction” and invented by Wang Qingren of Qing Dynasty, has significant therapeutic effects on the treatment of apoplexy; “Naoqiaotong Oral Liquid” (脑窍通口服液) (main components are Danshen, peach seed, forest musk, and lalang grass rhizome, etc.), which was developed according to the theory of “Tongqiao Huoxue Decoction” (通窍活 血汤) and invented by Wang Qingren, can be used for patients with the symptoms of water stagnation of the brain, such as apoplexy, brain tumor, and hydrocephalus. Qingnao Tongluo Tablets (清脑通络片) (main components include Danshen, florists dendranthema, etc.) can be used to prevent and treat threatened apoplexy and apoplexy attacks, and good therapeutic effects can be obtained in both animal experiments and clinical trials, with no toxicity or side effects observed so far. The decoction of Angong Niuhuang Wan (安宫 牛黄丸) and Danshen can be administered by drench or nasal feeding to coma patients due to obstruction of pathogen and pyretic block. The decoction of Suhexiang Wan (苏合香丸) and Danshen can be administered by drench or nasal feeding to patients with cold retention. However, Danshen Injection by intramuscular or intravenous administration can be used for patients with either cold or pyretic block. The drug can be taken orally with Pujindan Ye (蒲金丹液) (tatarinow sweetflag rhizome, wenchow turmeric root tuber, Danshen, etc.) for coma patients that belong to phlegm and dampness block. 4–20 ml of Danshen Injection can be administered by intramuscular injection or intravenous drip at the same time, and the symptoms can be alleviated or out of danger. Clinical practice has demonstrated that Danshen has the functions of activating blood circulation, dredging collaterals, removing blood stasis and promoting fresh blood production, and promoting defecation and urination. Danshen has the function of activating blood circulation and dissipating blood stasis, and thus it can be used to treat ischemic stroke. The effect depends on the function of removing blood stasis and promoting fresh blood production. Pharmacological studies have demonstrated that Danshen can inhibit blood clotting and enhance fibrinolysis activity. According to the theory of Traditional Chinese Medicine, “It is better to promote blood circulation, but not stop bleeding” and “It is better to disperse blood stasis to stop bleeding.” Danshen has the functions of improving microcirculatory blood flow and increasing blood capillary networks, which can reduce blood vessel pressure at the hemorrhage site and thus explains its function of x stopping bleeding. Therefore, the theory of activating blood circulation and dissipating blood stasis has special effects on hemorrhagic stroke. The effects and the formulas can vary based on normal prescriptions, and reaches the best of using drugs flexibly. Epilepsy can be treated with Danshen, tatarinow sweetflag rhizome, thinleaf milkwort root, white Indian buead, stiff silkworm, and reddish jackinthepulpit tuber. Yang hyperactivity due to insufficiency of yin in the liver and kidney and phlegm stagnation in superficial venules and lymph vessels can be treated with Danshen combined with dragon’s teeth, medicinal cyathula officinalis root, amber, glossy privet fruit, cortex moutan and antelope horn, etc. The above complicated miscellaneous diseases can usually be treated by taking oral decoctions combined with 4 ml of Danshen Injection by intramuscular injection according to the patient’s symptoms and signs, and the symptoms can usually be relieved in nonresponders to longterm treatment. To sum up, strange diseases are usually caused by stagnation and prolonged diseases are accompanied by phlegm, which is a key to the treatment of difficult and complicated diseases. As is recorded in Seeking Accuracy in the Materia Medica, with its function of eliminating stagnation, Danshen can treat all kinds of diseases. Clearing Liver, Promoting Gallbladder Function, Dredging Constraint and Stagnation, and Treating Concretions, Conglomerations, Accumulations, and Gatherings with Good Effects Symptoms such as concretions, conglomerations, accumulations, and gatherings (four types of diseases in TCM) are usually initially induced by livergallbladder damp-heat, qi flow disorder in the liver, disturbance of qi movement, or spleen deficiency with damp exuberance, which lead to the disharmony of liver and spleen and dysfunctions of liver, spleen, and kidney. Eventually, these illnesses will result in qi stagnation, blood stasis, and water retention which will accumulate in the abdomen and cause the diseases of concretions, conglomerations, accumulations, and gatherings. Danshen can come into the blood through the liver meridian, and has the functions of promoting blood circulation and qi stagnation, removing blood stasis and promoting water movement, and activating collaterals and subsiding swelling, and thus it is commonly used. For example, hepatitis B belongs to yin insufficiency of the liver and kidney, and can be treated with Effective Integration Decoction, with Danshen usually added into the Decoction. Drugs treating jaundice in different phases usually contain Danshen. Patients with dampness and stagnation can also be treated with Danshen in combination with Chinese thorowax root, Chinese angelica, turtle carapace, common oyster shell, chicken’s gizzard-membrane, areca peel, Indian buead, common burreed tuber, blue turmeric rhizome, etc. Patients with gallstones can be Foreword Foreword xi treated with Danshen combined with rhubarb, chicken’s gizzard-membrane, christina loosestrife herb, Chinese thorowax root, and immature bitter orange. All of these prescriptions have reliable therapeutic effects in improving liver function, softening the liver and spleen, shrinking lumps, eliminating stagnation, and removing urinary calculus. Pharmacological studies on Danshen have demonstrated that it has the functions of reducing the activity of transaminase, protecting injured hepatocytes, promoting cell regeneration and anti-hepatic fibrosis, etc. This is what is meant in Shen Nong’s Classic of the Materia Medica when Danshen has the functions of eliminating accumulations and gatherings of cold and heat, breaking concretions, and removing conglomerations. Dissipating Blood Stasis, Clearing Sanjiao Dampness, and Both Yin Edema and Yang Edema can be Treated Danshen has the functions of promoting blood circulation, clearing waterways, and alleviating edema; thus it can be used to treat edema caused by water retention and blood stasis. Animal experiments have demonstrated that Danshen has the functions of improving renal function, reducing azotemia, and increasing urinary production. Edema belongs to the category of yin water; patients with this disease have symptoms of lower limb and general edema. The symptoms of soreness and hypodynamia are caused by blood stasis and kidney deficiency (e.g., chronic glomerulonephritis, chronic pyelonephritis, nephrotic syndrome), which can be treated with Yishen Huaru Lishui Decoction (益肾化瘀利水汤) (Five Substances Powder with Poria combined with Danshen, mongolian milkvetch root, Chinese taxillus herb, common motherwort herb, medicinal cyathula officinalis root, Chinese hawthorn fruit, lalang grass rhizome, rice paper plant pith). Patients with edema of the lower limbs, drowsiness acratia, abdominal distension, gloomy tongue with stagnation, knotted and intermittent pulse, etc., caused by deficiency of kidney qi and dampness and blood stasis, usually can be treated with True Warrior Decoction combined with Danshen, peach seed, mongolian milkvetch root, and lalang grass rhizome. Patients with symptoms of deficiency of kidney yang can be treated with Golden Cabinet’s Kidney Qi Decoction combined with Danshen, Lalang Grass Rhizome, Eucommia Bark, etc. Patients with symptoms of qi stagnation and water retention can be treated with Bupleurum Liver-Soothing Powder combined with Five Substances Powder with Poria and Danshen, etc. Patients with facial edema (acute renal glomerulus nephritis), which belongs to invasion of the lung by pathogenic wind and disturbance of qi movement in sanjiao, can be treated with Maidservant From Yue Decoction with White Atractylodes Rhizome (越婢加术汤) combined with Danshen, Indian buead, asiatic plantain seed, weeping forsythia fruit, etc. Patients with symptoms of lung qi deficiencycold and impaired waterways can be treated with Linggan Wuwei Jiangxin Decoction (苓甘五味姜辛汤) combined with Danshen, etc., and the therapeutic effects can be enhanced by Danshen. xii Clinically, if the symptoms are defined correctly and the prescription and drugs are reasonably used, Danshen can normally help improve urine abnormalities in patients. The movement of fluid in the body depends on the regulatory function of lung qi, the transfusion function of spleen qi, and the transpiration function of kidney qi. When the body is invaded by exogenous pathogens, the functions of visceral organs are disturbed or the visceral organs are deficient in qi, the functions of sanjiao will be impaired, waterways will be blocked, and water overflows under the skin and muscle, which will lead to edema. Water and blood are homologous. According to On Hyperlipidemia 《 ( 血症论》), water and blood have mutual dependence and they hold together; so water retention and blood stasis are interactive. However, both yin edema and yang edema can coexist with stagnation and the only difference is the order of importance and urgency, which is referred to as “unsmooth blood circulation results in water, and water retention results in blood stasis” in TCM. Cooling Blood, Detoxication, Subsiding Swelling, and Eliminating Carbuncles and Sores Danshen also has functions of subsiding swelling and relieving pain, cooling blood and detoxication, discharging pus, and promoting the growth of flesh. Danshen can be combined with drugs such as weeping forsythia fruit, snakegourd root, mongolian dandelion herb, mongolian snakegourd fruit, etc., to treat mammary abscess. The drug can be combined with Japanese honeysuckle flower bud, weeping forsythia fruit, frankincense, or myrrh to treat swelling. Patients with acute abdominal pain (acute appendicitis, etc.) can be treated with Dahuang Mudan Decoction (大黄牡丹汤) combined with Danshen, sargentgloryvine stem, etc., and good therapeutic effects have been obtained. Patients with chronic appendicitis can usually be treated with Danshen combined with Chinese thorowax root, Indian buead, Chinese goldthread rhizome, widely costusroot, yanhusuo tuber, nutgrass galingale rhizome, mongolian dandelion herb, medicated leaven, etc. Danshen also has the function of cooling blood and detoxication, and thus various poisonings can be treated with Lüdou Gancao Jiedu Decoction (绿豆 甘草解毒汤) (mung bean, liquorice root, weeping forsythia fruit, noble dendrobium stem herb, Danshen, rhubarb, lalang grass rhizome). Patients with dampness, stagnation, pruritus vulvae, and morbid leukorrhea (e.g. cervical erosion, condyloma acuminatum, etc.) can usually be treated with Danshen combined with amur corktree bark, lightyellow sophora root, raw liquorice root, largehead atractylodes rhizome, swordlike atractylodes rhizome, rhiizoma dioscoreae from Henan of China, glabrous greenbrier rhizome, belvedere fruit, wild dendranthema flower, ginkgo seed, etc. The drugs can be taken orally or used as a washing solution, and significant therapeutic effects have been obtained. Patients with dampness and stagnation and dysentery can usually be treated with Pulsatilla Decoction combined with Danshen. Patients with hyperpyrexia and coma can be treated with Peaceful Foreword Foreword xiii Palace Bovine Bezoar Pill decocted with Danshen and taken orally, which can enhance the therapeutic effects and shorten the course of treatment. Patients with scabies with dampness-heat can be treated with Danshen, lightyellow sophora root, and common cnidium fruit, etc., by washing the affected part. It is recorded in The Materia Medica of Ming Dynasty that Danshen has the function of treating ulcers and carbuncles, goiters and swelling and erysipelas, discharging pus, relieving pain, and promoting the growth of flesh. Modern pharmacological research has shown that Danshen has strong inhibitory effects against Staphylococcus, Escherichia coli, Bacillus proteus, Bacterium typhosum, and has a certain degree of inhibitory effect against Bacillus dysenteriae. In summary, drugs cannot be classified into noble or humble classes; the important thing is how and where to use them. Danshen is cold in nature and bitter in taste, has the function of activating blood circulation and dissipating blood stasis, activating collaterals and dredging bi symptoms, promoting blood circulation but not breaking stagnated blood, reaching viscera and all bones, calming the nerves and relieving restlessness, detoxicating and cooling blood, subsiding swelling and relieving pain, promoting tissue regeneration, and treating ulcerative carbuncles and scabies. When a flexible and changeable prescription is made according to the symptoms, good effects usually can be obtained by application of Danshen. However, we need to pay attention to the fact that large doses of the drug can induce diarrhea, and thus people with loose stool due to spleen deficiency and pregnancy should use the drug with caution. There is a great difference in the dosage of Danshen between ancient and modern society; the dosage for adults usually ranges from 10 to 30 g, reaching up to 60 g for some people. The dosage should be small at the beginning and can be increased gradually. Preface to Dan Shen (Salvia miltiorrhiza) in Medicine In the 2008 press conference on the publication of the Chinese edition of the Dan Shen (Salvia miltiorrhiza) in Medicine, several volume editors suggested that the book should be translated into English and distributed internationally. They all believed that the medical communities are enthusiastic about TCM research, and that among the studies on single herbs, the study of Danshen has taken the lead. Therefore, it was a worthy undertaking to introduce the study conducted by the Chinese people over the past 1,000 years, and especially in the past 30 years, to the world. Meanwhile, I was asked unanimously to be its editor-in-chief. After several years of hard work by nearly 100 professors and research scientists, the translation is finally complete. The English edition of Dan Shen (Salvia miltiorrhiza) in Medicine is based on its Chinese edition. Modifications include changing the five-volume format to one volume and deleting some duplicated portions in the Chinese edition. Since the chapters in each volume of the Chinese edition were written by many individuals, details such as biological properties and ancient literature reviews were repeated many times, and the duplications were deleted in the English edition. Also, the various names of Danshen were unified. The appendix in the fifth volume, the prescriptions or formulas in ancient China, and the chapter on information management in the fourth volume were also deleted. The introduction to the production region, common names, and phytochemical components had appeared in the first three volumes, while this time only their first appearance was preserved. Some typos and oversights were corrected after consulting with volume editors. New progress in Danshen research was included in this book, such as the development of Salvianolate Lyophilized Injection, which finally came on the market in 2011 after 8 years of strict examination, and it was a landmark event in the development of TCM injections. It is unfortunate that we could not include the data on Qishenyiqi Dripping Pills, as the papers have not been published yet. The drug, developed by academician Boli Zhang, passed large-scale, evidence-based medicine clinical research trials in 2010, the first for a TCM drug, and won the 2011 National Science and Technology Progress Award. In principle, the English edition of Dan Shen (Salvia miltiorrhiza) in Medicine is the translation of the Chinese edition, thus preserving the latter’s framework. Because the Chinese edition was written by more than 100 xv xvi Preface to Dan Shen (Salvia miltiorrhiza) in Medicine scholars and published in five volumes, the styles and layouts were not identical. For example, some references were listed at the end of the chapter, while some were listed at the end of the section. The English edition did not change the style. Dan Shen (Salvia miltiorrhiza) in Medicine has amassed Danshen research results since the times of ancient China—it is not only a magnificent historical scroll, but also a huge work which shines the light of modern science and technology. I sincerely thank academicians Yongyan Wang and Boli Zhang. They have given me so much substantive guidance and encouragement despite their busy schedules. Without their help, it would have been impossible to finish the work. I also want to thank every author and volume editor who has participated in the writing and editing of both editions of this book; they have solved various problems which arose during the writing and translating processes. Last but not least, I want to thank the comrades working in the office of Dan Shen (Salvia miltiorrhiza) in Medicine, who have worked patiently and diligently over the past 15 years, collecting and organizing data and information. The publication of the English edition of Dan Shen (Salvia miltiorrhiza) in Medicine is a testimony of our sincere desire for the communication and discussion of TCM among international communities. We earnestly welcome suggestions and criticism from our colleagues around the world. Xijun Yan Editing Committee Chief Editor Xijun Yan Chief Reviewers Yongyan Wang Boli Zhang Associate Chief Editors Naifeng Wu Guoguang Zhu Luqi Huang Lianniang Li Houwei Luo Juntian Zhang Guanhua Du Dean Guo Yiyu Cheng Xuewen Zhang Xinde Shi Zhengliang Ye Yonghong Zhu Shuiping Zhou Hanxi Xue Editing Office Director Renshu Li Members Yonghong Zhu Zhengliang Ye Hanxi Xue Ying Zhao xvii xviii Volume 1. Biology and Chemistry Chief Editors Luqi Huang Lianniang Li Houwei Luo Associate Chief Editors Deyou Qiu Zongsuo Liang Min Chen Editors Xuefeng Feng Wenting Liu Xirong He Jingyuan Song Deyou Qiu Min Chen Jinda Hao Lanping Guo Guanghon Cui Zongsuo Liang Luqi Huang Houwei Luo Lianniang Li Volume 2. Pharmacology and Quality Control Chief Editors Juntian Zhang Guanhua Du Dean Guo Associate Chief Editors Xiumei Gao Shen Ji Ming Zhu Rongxia Liu Haibin Qu Editors Lianhua Fang Yitao Wang Xiaoying Wang Yuehua Wang Dongxia Wang Xiaoming Wang Editing Committee Editing Committee xix Yi Wang Jinhua Wang Jie Wang Xiaoying Wang Hongmei Guang Changsuo Liu Ailin Liu Yan Sun Yonghong Zhu Jinglan Xu Guorong He Xiuying Yang Danshen Zhang Tiantai Zhang Ran Zhang Juntian Zhang Li Zhang Lihua Zhang Bin Zhang Chuan Li Guanhua Du Rong Du Ping Chen Yonghong Chen Xiuping Chen Ji Chen Shuiping Zhou Zhiwei Qu Xiaoming Zhu Zhihao Jiang Minke Tang Zhiwen Li Zhixin Guo Xiumei Gao Mei Gao Hongcai Shang Xinrui Cheng Guangliang Han Jingyan Han Yanqiao Zang Ying Dai Linke Ma Hongzhi Wang Junquan Wang Yi Wang Zhun Feng Zhengliang Ye Yonghui Liu Yan Liu xx Rongxia Liu Shunhang Liu Aihua Liu Xuesong Liu Jianghao Sun Guoqing Wu Ling Tong Yongjiang Wu Wanying Wu Xiaoqian Zhang Xuemin Zhang Jinlan Zhang Xian Zhang Yunfei Li Manling Li Min Yang Yuewu Yang Bilian Chen Shen Ji Jianping Lin Dean Guo Guoqiang Fan Xiaohui Fan Qiang Zheng Zhangzhao Jin Ming Zhu Jun Gao Hongfang Cui Fenglan Cao Rixin Liang Shunnan Zhang Qing Gong Haiou Dong Jianping Han Haibin Qu Volume 3. Clinical Research Chief Editors Guoguang Zhu Xuewen Zhang Xinde Shi Associate Chief Editors Yi Zheng Ruizhi Luo Naifeng Wu Editing Committee Editing Committee xxi Editors Xinde Shi Yan Liu Jinping Liu Jia Liu Yonghong Zhu Danyong Wu Naifeng Wu Xuewen Zhang Renshu Li Ruizhi Luo Yi Zheng Guoguang Zhu Jingsheng Zhao Ying Zhao Jiaoli Guo Shunnan Zhang Keqin Han