Shang Lu
StarPhytolacca acinosa Roxb.
Traditionally used for
- Cough & breathing
- Digestion
- Bowel health
- Urinary & fluids
- Mood & calm
- Nerves & recovery
- Skin
Cautions & contraindications
- Pregnancy
- Liver conditions
- Kidney conditions
- Toxic — professional use only
☯ TCM Properties
Drains Water and Reduces Edema; Promotes Bowel and Urinary Movement; Resolves Toxicity and Dissipates Nodules
Traditional Chinese Uses
Shang Lu (商陆) is the root of Phytolacca acinosa Roxb. (Phytolaccaceae), Radix Phytolaccae. It is bitter and cold and toxic, entering the Lung, Spleen, Kidney and Large Intestine channels. It drains Water and reduces oedema, promotes both bowel and urinary movement, and resolves toxicity to disperse nodules.
It belongs to the small group of drastic water-expelling drugs, used for severe generalised oedema and for fluid distending the abdomen and chest where gentler diuretics have failed, driving water out through both stool and urine. Externally, the crushed fresh root is applied to carbuncles, sores and hard swellings.
It is toxic and forceful: it is contraindicated in pregnancy and in weak or deficient patients, the dose is small and the course short, and it is used only where the patient's strength can withstand the purge. Excess produces violent vomiting and diarrhoea, abdominal pain, and — through the phytolaccatoxin content — central nervous depression and convulsions. Vinegar-processing reduces its harshness.
Western Herbalism Properties
Relationships
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Botanical Description
Phytolacca acinosa (Asian pokeweed, Indian pokeweed) is a robust herbaceous perennial in the Phytolaccaceae family, growing 0.7-1.5 m tall from a thick, fleshy, often forking white taproot that may exceed 30 cm in length. The smooth, often reddish-tinged, ribbed stems bear alternate, ovate to elliptic-lanceolate, entire leaves 10-30 cm long with prominent venation. Small greenish-white to pinkish flowers about 6-8 mm across are borne in erect, dense terminal racemes 10-20 cm long, each flower with five tepals and 8-10 carpels. The fruit is a dark purple-black, depressed-globose, segmented berry resembling a tiny pumpkin. The whole plant, especially the root, is toxic, containing triterpene saponins and the mitogen phytolaccatoxin (POWO; Wikipedia).
Active Constituents
Esculentoside A
Oleanane-type triterpenoid saponinThe most studied saponin of the root and the usual analytical marker. It has genuine anti-inflammatory activity - it suppresses TNF-alpha production by human monocytes - but it is also a toxin: it is nephrotoxic to human induced-pluripotent-stem-cell-derived kidney organoids, driving epithelial-mesenchymal transition through STING signalling, and it is one of the compounds recovered from the blood and urine of human pokeweed poisoning cases.
Esculentoside B
Oleanane-type triterpenoid saponinIdentified in a zebrafish model as the major toxic factor of Phytolaccae radix. Exposure caused developmental abnormalities, neurotoxicity and altered locomotor behaviour; acetylcholinesterase appears to be a toxic target, and metabolomics showed disruption of D-amino acid metabolism, protein export, autophagy and mTOR signalling.
Phytolaccagenin
Oleanane-type triterpene aglycone (sapogenin)The aglycone shared by the esculentosides and phytolaccosides, and the constituent that contributed most to liver toxicity when phytolaccagenin, esculentoside A and the whole root extract were compared in zebrafish and L-02 cells. Transcriptomics implicated P53 signalling, PPAR signalling and ferroptosis. It is also the dominant species detected in blood after human poisoning, which matters analytically: the parent saponin may be largely absent while the aglycone is high.
Esculentosides C, H and other congeners
Oleanane-type triterpenoid saponinsOver 40 triterpene saponins have been isolated from the root, spanning esculentosides A to U as well as phytolaccosides. Esculentosides A, B, C and H were all identified in the gastric contents and ingested roots of poisoning patients, and A and C were recoverable from blood and urine.
Jaligonic acid
Oleanane-type triterpene aglyconeOne of the triterpene aglycones of the genus, reported alongside phytolaccagenic acid and the acinospesigenins. It is a marker of the saponin pool rather than an independently used active.
Phytolaccagenic acid
Oleanane-type triterpene aglyconeA further sapogenin of the root, reported from both Phytolacca acinosa and Phytolacca americana - one reason chemical profiling alone does not reliably separate the two species.
Xanthomicrol
Polymethoxylated flavoneIdentified by network pharmacology and transcriptomics, with experimental verification, as an active anti-hepatocellular-carcinoma ingredient of Phytolacca acinosa. It is a minor constituent and not a quality marker.
Hypaphorine
Indole alkaloidA tryptophan betaine reported among the non-saponin constituents of the plant. It is not implicated in the drug's toxicity, which is saponin-driven.
⚠ Drug Interactions
Phytolacca americana (American pokeweed) - species misidentification hazard
The literature on "pokeweed" conflates two species and a reader must check which one a given study used. Phytolacca acinosa is the Chinese drug Shang Lu; Phytolacca americana is an American species now widely naturalised in China and elsewhere. Their saponin profiles overlap - phytolaccosides A, B, D, E and G are described from P. americana and esculentosides from P. esculenta/acinosa, but both yield phytolaccagenin, phytolaccagenic acid, esculentic acid and jaligonic acid - so a chemical assay does not settle the question and DNA or morphological identification is needed. The consequences are real: a 50-year-old woman in Zhejiang died within 33 hours of eating about 150 g of stir-fried P. americana leaves, with metabolic acidosis (pH 7.11), hypovolaemic shock, troponin I of 12.70 ng/mL and D-dimer of 83.8 mg/L; esculentoside A and phytolaccagenin were confirmed in the plant and her blood. Two Korean patients reached the emergency department after eating misidentified pokeweed roots, with esculentosides A, B, C and H recovered from the roots and gastric contents. Over 2000-2019 the Kentucky poison centre logged 1669 human P. americana exposures, mostly children eating berries; these were generally self-limiting gastrointestinal illness, with no deaths.
Clinical note: Insist on species-level identification of the root. Do not accept material identified only as "pokeweed" or "Shang Lu" without a binomial, and when reading the evidence base for this herb, check which Phytolacca species each study actually used before drawing any conclusion about the other.
Hepatotoxic drugs (e.g. paracetamol/acetaminophen, methotrexate, isoniazid)
Shang Lu is a toxic herb whose hepatotoxicity is documented rather than inferred. Comparing phytolaccagenin, esculentoside A and whole root extract in zebrafish and L-02 hepatocytes showed the aglycone phytolaccagenin contributed most to liver injury, acting through ferroptosis, PPAR signalling, P53 signalling and disordered arachidonic acid metabolism, with oxidative stress and apoptosis downstream. Any co-administered drug loading the same oxidative and lipid-peroxidation pathways compounds this.
Clinical note: Do not combine with hepatotoxic drugs, and do not prescribe in existing liver disease. Given the narrow margin and the availability of safer diuretic herbs, most practitioners should not use this herb at all outside a setting with liver-function monitoring.
Nephrotoxic drugs (e.g. NSAIDs, aminoglycosides, cisplatin, tenofovir)
Esculentoside A is directly nephrotoxic in human induced-pluripotent-stem-cell-derived kidney organoids, and a companion study in human kidney organoids implicated epithelial-mesenchymal transition driven by STING signalling. Because the herb is used precisely to drive diuresis, it is likely to be given to patients who are volume-depleted, which is the state in which nephrotoxic drugs do the most damage.
Clinical note: Avoid in renal impairment and alongside any nephrotoxic drug. Do not use in a dehydrated patient, and check renal function before and during any course.
Loop and thiazide diuretics (e.g. furosemide, hydrochlorothiazide)
Shang Lu is a drastic water-expelling drug that produces both diuresis and catharsis. Stacking it on a pharmaceutical diuretic risks compounding volume depletion and potassium loss. No controlled study of the combination exists; the concern follows from the herb's mode of action and the documented electrolyte and acid-base derangement seen in Phytolacca poisoning.
Clinical note: Do not combine with prescribed diuretics. If it is used at all, monitor weight, blood pressure and serum potassium, and watch for the digoxin toxicity that hypokalaemia can precipitate in a patient on cardiac glycosides.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 3–9 g | — | — | — | ChP 2025 (yaobw.cn mirror; cross-validated against db.ouryao.com). 孕妇禁用 — contraindicated in pregnancy. A drastic water-expelling drug; vinegar-processing reduces its harshness. Replaces a generic filler value generated from tcm_category, which had been cleared to blank. |
| fumigation/wash | Appropriate amount | — | — | — | ChP 2025 (yaobw.cn mirror; cross-validated against db.ouryao.com). 外用适量，煎汤熏洗。 |
Evidence Tier
Moderate evidence · 6 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
0
Randomized controlled trial
0
Other clinical trial
0
Observational / case report
3
2 verified · 1 unverified
Show 3 studies
In vitro / animal
3
1 verified · 2 unverified
Show 3 studies
- Hepatotoxicity of Phytolacca acinosa Roxb mediated by phytolaccagenin via ferroptosis/PPAR/P53/arachidonic acid metabolism
- Metabolic exploration of the developmental abnormalities and neurotoxicity of Esculentoside B, the main toxic factor in Phytolaccae radix
- Nephrotoxicity assessment of Esculentoside A using human‐induced pluripotent stem cell‐derived organoids
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Hepatotoxicity of Phytolacca acinosa Roxb mediated by phytolaccagenin via ferroptosis/PPAR/P53/arachidonic acid metabolism
Phytolaccagenin, esculentoside A and whole Phytolacca acinosa root extract were compared in zebrafish and L-02 hepatocytes. Phytolaccagenin contributed most to liver toxicity, and transcriptomic analysis implicated P53 signalling, PPAR signalling, ferroptosis and disturbed arachidonic acid metabolism, converging on lipid metabolism, oxidative stress and apoptosis. This study used Phytolacca acinosa, not Phytolacca americana.
Metabolic exploration of the developmental abnormalities and neurotoxicity of Esculentoside B, the main toxic factor in Phytolaccae radix
Using a zebrafish larval model, esculentoside B was identified as the major toxic factor of Phytolaccae radix. It caused developmental abnormalities, neurotoxicity and altered locomotor behaviour; acetylcholinesterase activity and CNS developmental gene expression indicated impaired central nervous system development, and metabolomics showed disruption of D-amino acid metabolism, protein export, autophagy and mTOR signalling.
Nephrotoxicity assessment of Esculentoside A using human‐induced pluripotent stem cell‐derived organoids
Human induced-pluripotent-stem-cell-derived kidney organoids were used to characterise the renal toxicity of esculentoside A, the principal saponin of Phytolacca root, providing a human-cell basis for the nephrotoxicity long attributed to the drug.
Description of a fatal case of acute Phytolacca americana poisoning due to leaf ingestion in China
A 50-year-old woman developed severe gastrointestinal symptoms two hours after eating roughly 150 g of stir-fried pokeweed leaves and died of multi-organ failure within 33 hours, with metabolic acidosis (pH 7.11), hypovolaemic shock, troponin I 12.70 ng/mL and D-dimer 83.8 mg/L. UPLC-Qtrap MS confirmed esculentoside A (133 mg/kg in the whole plant, 0.1 ng/mL in blood) and its metabolite phytolaccagenin (2.50 mg/kg in the plant, 2.37 ng/mL in blood). The species was Phytolacca americana, not the Phytolacca acinosa of the Chinese materia medica, but the toxic saponins are shared and the case shows what the class can do.
Human exposures to Phytolacca americana in Kentucky
An observational review of 1669 human pokeweed exposures reported to Kentucky poison control between 2000 and 2019. Patients were mostly young (median age 3 years), exposures were almost all unintentional oral ingestions and mostly of berries. There were 239 adverse events, predominantly abdominal pain, nausea, vomiting and diarrhoea, with cutaneous oedema, pain and swelling after dermal contact. Treatment was supportive and no deaths occurred. Again this is Phytolacca americana, not the Chinese drug.
Identification of phytolaccosides in biological samples from pokeweed intoxication patients using liquid chromatography-tandem mass spectrometry
Two patients reached the emergency department after unknowingly eating misidentified pokeweed roots. In one patient's blood, esculentoside A was 1.9 ng/mL and esculentoside C 1.5 ng/mL, with esculentosides B and H below the limit of quantification; esculentosides A, B, C and H were identified in gastric contents and in the ingested roots, and A and C in urine. The saponin pattern detected corresponds to the esculentoside profile of the Chinese pokeweed group rather than the phytolaccoside profile of Phytolacca americana, which is exactly why the paper matters for identifying which species a patient ate.
⚠ Safety & Contraindications
- Pregnancy
- Liver conditions
- Kidney conditions
- Toxic — professional use only
Contraindications
Contraindicated in pregnancy and in the weak or depleted.
Safety Warnings
- Dose-sensitive; poisonings follow self-medication and confusion with edible roots.
- Processing with vinegar moderates the toxicity.
⚠ Rule-Based Cautions
These entries come from the deterministic rule tables that gate Verscienta's formula tools — classical pair prohibitions, pregnancy and lactation contraindications, and dose ceilings.
Pregnancy
Avoid toxic purgative
⚠ Toxicity Information
Vomiting, profuse diarrhoea and abdominal cramping, then in serious poisoning convulsions, respiratory depression and hypotension.
Historical Texts
Shen Nong Ben Cao Jing
Han dynastyReferences
- Tooba Khalid, Chieh-Wei Chang, Samir Anis Ross, Faiza Naseer, Abdul Qadeer, Chien-Chin Chen, Hafiz Abdul Rafey. Traditional uses, botanical description, phytochemistry, and pharmacological activities of Phytolacca acinosa: a review . Frontiers in Pharmacology (2025) [DOI]
- Junaid A. Magray, Bilal A. Wani, Aijaz H. Ganie, Roof Ul Qadir, Hanan Javid, Irshad A. Nawchoo. From folklore to pharmacology: A comprehensive review of Phytolacca acinosa Roxb. A multipurpose medicinal herb . Fitoterapia (2025) [DOI]
- Jiayao Liu, Yang Zhou, Pincheng Zhou, Ting He, Pengcheng Liu, Jie Wang, Peixu Lin, Jialing Hou, Huanhuan Sun, Haiqing Ma. Mechanistic insights into xanthomicrol as the active anti-HCC ingredient of Phytolacca acinosa Roxb.: A network pharmacology analysis and transcriptomics integrated experimental verification . Journal of Ethnopharmacology (2024) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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