Yumeji Takehisa's Artistic Depiction and 'Dang Gui Shao Yao San'

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Yumeji Takehisa (1884–1934) was a luminous figure of the Taisho era in Japan, widely celebrated for his aesthetic talent in portraying the alluring beauty of women—a genre known as Bijin-ga (portrait of beauty). His artistic legacy extends beyond mere visual appeal, as it harmonizes with the principles of traditional East Asian medicine. His Bijin-ga mirrors the ideal embodiment of a traditional Chinese herbal formula. This formula is called "Dang Gui Shao Yao San" in Chinese romanization, referred to as "Toki Shakyaku San" in Japanese pronunciation, and known as "Danggui-jakyaksan" in Korean pronunciation.

Beauty in Yumeji style in Japantimes

Late Spring by Ymeji Takehisa(pen. pencil and watercolor on paper)
グラフィック, 誌大正15年(1926年)4月号に掲載された
「夢二郷土美術館所蔵 竹久夢二名品100選」東方出版、2007年、

In this image, Takehisa depicts a woman whose elegance, grace, and tranquility seem to embody the beneficial effects of Dang Gui Shao Yao San. She is pale with a slender waist and an elongated face; her gestures are calm and soothing, her voice tender and melodious. This image is so closely associated with the traditional herbal formulation that practitioners of Kampo medicine have adopted the term 'Toshaku Bijin (Dang Gui Shao Yao Beauty, 當芍美人)' to describe the quintessential recipient of this remedy.

この「望診」により、とくに女性三大漢方薬（『当帰芍薬散（トウキシャクヤクサン）』『加味逍遥散（カミショウヨウサン）』『桂枝茯苓丸（ケイシブクリョウガン）』）はほぼ決まるといっても過言ではありません。 「待てど暮らせど来ぬひとを宵待草のやるせなさ」とうたわれた竹久夢二の、有名なあの絵 がまさに『当帰芍薬散』の「証（ショウ）」であるため、漢方医はこれを「当芍（トウシャク）美人」と呼び、この薬を使用する目標としました。 すなわち、色白で、顔は面長、柳腰で立ち姿はすっきり、声は優しく耳当たりが心地よく、しぐさがおっとりしている、「ちょっと手を差しのべてあげたくなる日本美人」と漢方医の大家が称したそうですが、こういったイメージが『当帰芍薬散』にぴったりあう「証」なのです。 『当帰芍薬散』は女性の聖薬といわれ、少し虚弱な女性の身体を温め、「水毒（スイドク）」（体内の水のバランスが悪い状態）をとり、月経を整え、痛みを去り、受胎を安んじるといわれます。「水毒」の症状には、頭痛・めまい・嘔気などがみられることがよくありますから、「当芍美人」は実際にフラフラすることが多いのでしょう。また、この薬は「冷え症」の中でもむくみが出やすい方にも有効です。

Through this "Mochin(visual examination), it is not an exaggeration to say that the three major herbal medicines for women (Toki Shakyaku San, Kami Shoyo San, Keishi Bukuryo Gan) are almost determined. The famous painting by Takehisa Yumeji, known as "The Frustration of Waiting for Someone Who Never Comes," is precisely the "sign" of Toki Shakyaku San. Therefore, herbalists refer to this as "Toshaku Bijin" (Beautiful Woman with Toki Shakyaku) and make it their goal to use this medicine. In other words, the ideal image described by renowned herbalists is fair-skinned, with a long face, slender waist, graceful posture, gentle and pleasant voice, and a calm demeanor. They referred to it as the "charming Japanese beauty who makes you want to lend a helping hand." Such an image perfectly matches the "evidence" of Toki Shakyaku San. Toki Shakyaku San is considered a sacred medicine for women. It warms the body of slightly frail women, balances the "water toxicity" (an imbalance of water in the body), regulates menstruation, alleviates pain, and promotes successful conception. Symptoms of "water toxicity" often include headaches, dizziness, and nausea, so it is likely that "Toshaku Bijin" frequently experiences dizziness. Additionally, this medicine is effective for individuals with edema, a common symptom of "coldness syndrome."  (https://www.kouwakai-nakamura.jp/colum-0031.html) 

"Dang Gui Shao Yao San" is hailed as the "sacred medicine for women" along with Xiao Yao San and Gui Zhi Fu Ling Wan in Japan. It is first recorded in Shang Han Lun by Zhang Zhongjing in the Han dynasty. This formula comprises six herbs: Chinese Angelica Root (Dang Gui), Peony Root (Shao Yao), Atractylodes Rhizome (Bai Zhu), Hoelen (Fu Ling), and Alisma Rhizome (Ze Xie). It acts as a comprehensive remedy for the body, simultaneously tonifying blood and gently releasing toxic substances known as Shuidu.

Release Water Toxin (Sudok, Suido, Shuidu, 水毒) Gently

The two key herbs, Dang Gui and Shao Yao, are instrumental in nourishing the blood, while Bai Zhu, Fu Ling, and Ze Xie work to eliminate dampness. Despite its detoxifying properties, this formula is gentle, primarily focusing on nourishment while providing mild detoxification. In TCM, or Kampo medicine, there is a concept called 'water poison' (Suido) or an imbalance of water in the body. Symptoms associated with 'water poison' can include headaches, dizziness, cold hands, and nausea. Dang Gui Shao Yao San, by restoring this balance, could offer substantial relief from such symptoms. Its effectiveness in treating 'cold syndrome,' characterized by easy swelling, further testifies to its ability to reestablish internal harmony.

Tonify Blood and Qi

"Dang Gui Shao Yao San" is based on two renowned formulations, Si Wu Tang and Si Jun Zi Tang. Si Wu Tang consists of Dang Gui, Shao Yao, Chuan Xiong, and Shu Di Huang, while Si Jun Zi Tang is made up of Bai Zhu, Fu Ling, Ren Shen, and Gan Cao. As such, "Dang Gui Shao Yao San" brings together the beneficial properties of both these formulas. It simultaneously tonifies Qi and Blood, mildly detoxifies and reduces edema, and alleviates tightness and liver Qi stagnation with Shao Yao.

Primarily utilized for addressing various women's health conditions, Dang Gui Shao Yao San holds a reputation for managing menstrual irregularities, premenstrual syndrome (PMS), dysmenorrhea (painful periods), and menopausal symptoms. These conditions are often attributed to imbalances in the liver blood's insufficiency, according to the principles of traditional East Asian medicine. Dang Gui Shao Yao San, by addressing these root causes, can provide significant relief. For instance, it can help regulate menstrual cycles, alleviate symptoms like irregular periods, heavy or light menstrual flow, and menstrual pain. Similarly, it can ease the discomfort associated with PMS, including mood swings, breast tenderness, and bloating.

The application of Dang Gui Shao Yao San transcends women's health. It is also effective for conditions such as anemia, fatigue, insomnia, and 'cold hands and feet,' enriching the overall quality of life. By nourishing the liver (not literally meaning liver) blood, it aids in the production of red blood cells, helping combat anemia. It also harmonizes the liver (Bai Shao) and spleen (Bai Zhu), improving energy levels and sleep quality, contributing to overall well-being.

Modern scientific research validates the therapeutic efficacy of Dang Gui Shao Yao San. Various clinical studies affirm its benefits in treating anemia and fatigue in women, improving sleep quality in menopausal women, and relieving PMS and dysmenorrhea symptoms. It has also shown potential in enhancing fertility, reinforcing its status as 'women's sacred medicine.'

A study introduced the cases of successful treatment of severe menstrual migraines in five premenstrual women. The patients had previously experienced limited effectiveness with triptans and some had additional complications of tension-type headache or medication overuse headache. However, after starting Dang Gui Shao Yao San, all patients experienced significant improvements in the severity and frequency of their migraine attacks. This suggests that Dang Gui Shao Yao San could be a promising alternative treatment for intractable menstrual migraines that do not respond to conventional therapies, including triptans. (Akaishi T, Takayama S, Ohsawa M, Kikuchi A, Arita R, Nakashima I, Aoki M, Ishii T. Successful treatment of intractable menstrual migraine with the traditional herbal medicine tokishakuyakusan. J Gen Fam Med. 2019 Apr 3;20(3):118-121. doi: 10.1002/jgf2.242.)

Another study led by Masakazu Terauchi et al., for instance, found that Dang Gui Shao Yao San (referred to as TJ-23 in the study) could effectively alleviate headaches and accompanying depression in middle-aged women. (Terauchi M, Hiramitsu S, Akiyoshi M, Owa Y, Kato K, Obayashi S, Matsushima E, Kubota T. Effects of the Kampo formula tokishakuyakusan on headaches and concomitant depression in middle-aged women. Evid Based Complement Alternat Med. 2014;2014:593560)

Dang Gui Shao Yao Beauty

The intriguing intersection of art and traditional medicine, as illustrated by Yumeji Takehisa and the 'Toki Shakuyaku Beauty,' further enriches our understanding of Dang Gui Shao Yao San. The woman in Takehisa's image,that Dang Gui Shao Yao San seeks to be applied. It symbolizes a state where the blood is deficient, and the liver and spleen are in disharmony with stress. In essence, she is a visual representation of the typical indication of taking this medicinal formula. This formula primarily tonifies blood, mildly releases toxins, and enhances Qi. This balanced approach is a testament to the philosophy of traditional East Asian medicine, which emphasizes harmony of Yin and Yang, tonifying and sedating together. This thoughtful combination of herbs allows "Dang Gui Shao Yao San" to address a myriad of health conditions, showcasing its effectiveness as a comprehensive healing formulation.



If you are interested in this beautiful formula, try to dig into more with these resources;

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