Sang Zhi (Mulberry Twig)

Chinese Herb Actions

Chinese Herb Dosage

• What is the typical dosage of Sang Zhi?

  Roughly 9–30 g in decoction, depending on the source — Chen gives 10–30 g, while Bensky gives 9–15 g with a maximum of 30 g. The part used is the young twig or branchlet of the white mulberry, cut into thin slices or short segments and dried; it is a light, woody material, which is part of why the customary quantities run higher than for dense roots or barks.

  • Part used — the young branches (twigs) of Morus alba, gathered in late spring or early summer, sliced and dried.
  • Preparation — usually decocted raw; it may also be dry-fried or stir-fried with wine in some traditions to strengthen its channel-opening action for painful obstruction.
  • External — a strong decoction is sometimes used as a soak or wash for painful, swollen limbs.

  Source: Sacred Lotus sources & references (Chen and Bensky ranges as recorded), cross-referenced against multiple online sources (preparation notes). Reference only — not a prescription.

Chinese Herb Contraindications & Cautions

• Are there cautions for Sang Zhi?

  Sang Zhi is one of the gentler herbs in the materia medica and no specific traditional contraindication is recorded here. It is mild, slightly cold and not toxic, and it is used at generous doses without the warnings that attach to most wind-damp herbs (many of which are acrid, warm and drying).

  The sensible reference points are the general ones for a cool, draining herb:

  • Pattern match — its slight coldness suits hot or damp-heat painful obstruction; for clearly cold bi it would normally be combined with warming herbs rather than used alone.
  • Glucose-lowering medicines — see the interactions note. This is a precaution derived from the purified alkaloid pharmaceutical made from mulberry twig, not from the decocted twig itself, but it is worth a practitioner’s awareness.

  Source: Sacred Lotus sources & references (no contraindication recorded), cross-referenced against multiple online sources (materia medica cautions). Reference only, not a substitute for practitioner guidance.

Chinese Herb Toxicity & Overdose

• Is Sang Zhi toxic?

  Low. Sang Zhi is not classified as toxic in the traditional materia medica and no significant toxicity is reported at customary decoction doses. The mulberry tree as a whole has a long food history in China — the fruit is eaten, the leaf is drunk as tea and fed to silkworms — and the twig is the least concentrated of its medicinal parts.

  The best-characterised safety data actually comes from the purified alkaloid extract described in the research section: in a 24-week randomised phase III trial of mulberry twig alkaloid tablets in 600 people with type 2 diabetes, the incidence of treatment-associated adverse events and gastrointestinal disorders was significantly lower in the alkaloid group than in the acarbose comparator group, with no significant difference in serious adverse events. That is safety data for a standardised pharmaceutical extract, not for the decocted twig, but it is the only controlled human safety data associated with this plant part.

  Source: materia medica consensus; PMID 33832957 / DOI 10.2337/dc20-2109 (phase III trial safety data for the purified alkaloid preparation). Reference note, not a safety guarantee, and not transferable to the traditional decoction.

Herb-Drug Interactions

• Does Sang Zhi interact with diabetes medications?

  No well-established clinical herb–drug interaction is documented for the decocted twig, but there is a specific, mechanism-based reason for practitioner awareness around glucose-lowering medicines. Mulberry twig contains the iminosugar alkaloid 1-deoxynojirimycin (DNJ), an alpha-glucosidase inhibitor — the same enzyme target as the prescription drug acarbose. A standardised alkaloid extract of mulberry twig is in fact licensed in China as an antidiabetic medicine.

  The important distinction: that licensed product is a purified, concentrated alkaloid tablet, not the raw twig used in a decoction, and the alkaloid concentrations are not comparable. There is no evidence that Sang Zhi in a traditional formula produces a clinically meaningful glucose-lowering effect. Nonetheless, where a patient is taking acarbose, other alpha-glucosidase inhibitors, or any glucose-lowering medication, this is a reasonable point for a practitioner to be aware of. (Flagged for practitioner confirmation — precautionary and mechanism-based, not a demonstrated interaction.)

  Source: PMID 25778928 (identification and quantification of the three active alkaloids); PMID 36739921 / DOI 10.1016/j.fitote.2023.105444 (regulatory perspective on the licensed alkaloid tablet). Preclinical and regulatory context only.

Western / Biomedical Research

Chinese Herb Clinical Studies & Research

Provided as research context — a summary of published biomedical study, not a therapeutic or medical claim.

• Is there modern research on Sang Zhi (Ramulus Mori)?

  Yes — and unusually for a Chinese herb, it produced an approved pharmaceutical. In 2020 China’s National Medical Products Administration approved Ramulus Mori (Sangzhi) alkaloid tablets, known as SZ-A, for the treatment of type 2 diabetes mellitus. The active fraction is a group of iminosugar alkaloids — 1-deoxynojirimycin (DNJ), fagomine, and 1,4-dideoxy-1,4-imino-D-arabinitol (DAB) — which act by inhibiting alpha-glucosidase, slowing carbohydrate digestion in the gut.

  An important framing point before the findings: this is a purified, standardised alkaloid extract developed as a drug. It is not the same thing as Sang Zhi decocted in a traditional formula, and its clinical results should not be read as evidence for the traditional wind-damp use of the twig.

  • Phase III trial vs acarbose — a 24-week multicentre, randomised, double-blind, double-dummy, parallel-controlled non-inferiority trial in 600 people with type 2 diabetes (360 on SZ-A, 240 on acarbose) reported HbA1c reductions of −0.93% for SZ-A and −0.87% for acarbose, a between-group difference of −0.05% — that is, comparable glucose lowering — with significantly fewer treatment-associated adverse events and gastrointestinal disturbances in the SZ-A group.
  • Placebo-controlled trial — a separate randomised, double-blind, placebo-controlled multicentre study supported the efficacy and safety of the same preparation.
  • Earlier comparative study — a smaller 2016 randomised, double-blinded, double-dummy, active-controlled study had already compared the alkaloid tablet with acarbose, finding comparable HbA1c and postprandial glucose effects with fewer gastrointestinal adverse events.
  • Regulatory significance — a 2023 review describes the tablet as the first botanical hypoglycaemic drug approved under China’s integrated review-and-approval system, which combines traditional theory, human-use experience and clinical trials as three lines of evidence.
  • Preclinical breadth — animal and cell studies on the same alkaloid fraction report effects on gut microbiota and bile acid metabolism, adipose tissue inflammation, diet-induced obesity and fatty liver, pancreatic beta-cell function, diabetic nephropathy, atherosclerosis and diabetic wound healing. These are laboratory and animal findings, not clinical claims.

  No controlled human trials exist for the traditional decocted twig in its classical wind-damp indication; the research above concerns the isolated alkaloid fraction.

  Sources: PMID 33832957 / DOI 10.2337/dc20-2109 (phase III trial vs acarbose, Diabetes Care 2021); PMID 35048240 / DOI 10.1007/s11655-021-2885-9 (placebo-controlled multicentre study, 2022); PMID 27547230 / DOI 10.1155/2016/7121356 (earlier active-controlled study); PMID 36739921 / DOI 10.1016/j.fitote.2023.105444 (regulatory perspective, Fitoterapia 2023); PMID 25778928 (quantification of DNJ, fagomine and DAB); PMID 35308210, PMID 37359004, PMID 35624769, PMID 36501080, PMID 39243750 (preclinical studies). Research context, not a therapeutic claim, and not applicable to the traditional decoction.

Chinese Herb Notes

• How many Chinese herbs come from the mulberry plant, and is Sang Ji Sheng one of them?

  Four medicinals here come from the white mulberry (Morus alba) itself — and Sang Ji Sheng is not one of them. Sang Ji Sheng is a mistletoe that grows on mulberry (and other host trees); it is a separate parasitic plant in a different family, not a part of the mulberry. This is one of the most common identification errors in the materia medica, and the shared “Sang” (桑, mulberry) in the name is exactly why.

  The four mulberry-plant medicinals:

  • Sang Zhi (Mulberry Twig) — the young branch. Bitter, sweet, slightly cold; Liver channel. Dispels wind-dampness and benefits the joints, especially of the upper limbs.
  • Sang Ye (White Mulberry Leaf) — the leaf. Sweet, bitter, cold; Liver and Lung. A cool, acrid exterior-releasing herb that clears Lung heat and brightens the eyes.
  • Sang Bai Pi (Mulberry Root Bark) — the bark of the root. Sweet, cold; Lung and Spleen. Drains Lung heat, stops cough and wheezing, and promotes urination to reduce edema.
  • Sang Shen (Mulberry Fruit) — the fruit spike. Sweet, cold; Heart, Liver and Kidney. A blood and yin tonic that also moistens the Intestines.

  The two “Sang” herbs that are NOT mulberry parts:

  • Sang Ji Sheng (Mulberry Mistletoe Stems) — the stems and leafy twigs of a mistletoe (recorded here as Ramulus Loranthi Seu Visci) that parasitises mulberry and other trees. It is a yin-tonifying, Liver-and-Kidney-nourishing, sinew-and-bone-strengthening herb that also calms the fetus — an entirely different profile from any mulberry part. Because mistletoes take up material from their host, the host tree traditionally matters for quality; that host relationship is the only connection to mulberry.
  • Sang Piao Xiao (Mantis Egg Case) — not a plant at all, but the egg case of a praying mantis, classically the one deposited on mulberry branches. It is an astringent that stabilises the Kidney and secures essence.

  Key formula: Sang Zhi is a deputy in Juan Bi Tang (Remove Painful Obstruction Decoction, from Yi Xue Xin Wu), where it works with Qin Jiao and Hai Feng Teng to dispel wind-damp and unblock the channels and collaterals without the harsh dryness of the chief herbs Qiang Huo and Du Huo. It is also commonly combined with Gui Zhi, Jiang Huang and Hai Tong Pi for shoulder and arm pain. (Traditional formula context, not treatment advice.)

  Source: Sacred Lotus sources & references (identity and channel data for all six herbs above; Juan Bi Tang composition), cross-referenced against multiple online sources.