【Summary】Bitter and slightly cold in nature, this herb has an ascending and floating property, capable of dispelling heat from the interior to the exterior, relieving stagnation and dissipating masses. It is a crucial medicine for treating skin ulcers and heat-induced vomiting, and can also address damp-heat in the spleen and stomach. However, it is considered a lower-grade herb in this category and should not be taken for extended periods; it serves as an auxiliary herb. It is also a key medicine for treating heat accumulation in the Qi level, particularly when fire is trapped.
【Properties】Bitter in taste, slightly cold in nature, it enters the Heart (Xin), Liver (Gan), Gallbladder (Dan), and Pericardium (Xin Bao) meridians.【Functions】Clears heat and detoxifies, reduces swelling and dissipates masses, stops vomiting.【Pharmacological Commentary】Zhu Danxi said: “It drains heart fire,eliminates damp-heat from the spleen and stomach, and treats blood stasis in the middle jiao, serving as an auxiliary herb.”Zhang Yuansu stated: “Lian Qiao has three uses:draining heat from the heart, removing heat from the upper jiao, making it a holy medicine for ulcers.Li Dongyuan said: “This herb must not be absent among the twelve meridian ulcer medicines, as it embodies the principle of dispersing what is congealed.”The Shennong Bencao Jing states: “It is a lower-grade herb. Its taste is bitter, neutral, and non-toxic. It is indicated for cold and hot syndromes, numbness, and phlegm obstruction. It treats carbuncles, ulcers, and toxic swellings. It clears the heart and lungs, promotes urination, and detoxifies various poisons.”The Bencao Xinpian describes: Lian Qiao, bitter in taste, neutral and slightly cold,is light and floating, ascending, and non-toxic. It enters the Shaoyin Heart meridian, the hand and foot Shaoyang, and Yangming meridians.It drains heat from the heart, is particularly effective for damp-heat in the spleen and stomach, and eliminates toxic swellings, treats roundworms, and is especially relied upon in dermatology. It regulates menstruation, alleviates five types of dysuria, and dissipates blood stasis and Qi stagnation. However, it should only be used as an auxiliary herb, not as the main herb, and can be used to attack pathogens but should not be relied upon for tonifying the body; it can be optional.In later generations, it has been widely applied in the treatment of skin diseases,such as the formula Ma Huang Lian Qiao Chi Xiao Dou Tang, which is particularly effective for skin ulcers, and Lian Qiao’s efficacy cannot be overlooked. Especially the Yishui school praises it as the “holy medicine for ulcers”; for skin diseases with heat accumulation, Lian Qiao is essential. If heat accumulates into toxins, it can be combined with Yin Hua (Honeysuckle) for treatment. Its main function is to clear heat from the heart, and it can clear heat from all three Yang meridians in the differentiation of the six meridians, as well as clear Qi-level heat. Dyspepsia and damp-heat in the spleen and stomach are also common applications of Lian Qiao.Zhang Shanlei said: “Lian Qiao is bitter, and bitterness can clear heat. Its round and pointed shape, hollow inside, resembles a heart, thus it specifically clears heat from the heart. This is the natural property of this herb, not a forced interpretation. Moreover, anything light and hollow must have the function of opening and discharging, thus it can also disperse and eliminate heat from the meridians.”Li Shizhen said: “Lian Qiao resembles a human heart, with two halves joined together, containing fragrant seeds. It is the main herb for the Shaoyin Heart and Jueyin Pericardium meridians. Therefore,all pains and itchy ulcers belong to the heart, making it theholy medicine for the twelve meridian ulcers, and it also clears heat from the hand and foot Shaoyang and Yangming meridians.Xu Lingtai said: “All medicines have cold, heat, warm, and cool properties, some belong to the Qi level, and some to the blood level. Generally, those that are Qi-dominant treat Qi, while those that are taste-dominant treat blood.Lian Qiao’s aroma is strong, and its nature is cool, thus it can resolve Qi-level heat stagnation. Its bitter and pungent taste corresponds to the autumn metal season, thus it can also eliminate the evil toxins retained in the liver.Although Lian Qiao is adept at entering the heart blood, its strong and fragrant aroma,its light and ascending nature, allows it to reach the interior and penetrate the exterior. When used in larger quantities, it can induce sweating, which is clear in its principle. Due to its cool nature and ascending property, it is effective for head and eye diseases; it can treat headaches, toothaches, nasal congestion, or runny nose leading to brain leakage.Its ability to enter the Yin and reach the Yang indicates its pivotal role in opening stagnation and dispersing masses,and since it is used as a fruit in medicine,it can directly reach the Liver meridian, thus it is good at relieving liver Qi stagnation, which is also clear in its principle. However, it is even better at entering the heart blood due to its ability to open up stagnation,relieving heat-induced pain and itchy ulcers, which is why Li Shizhen said it is the “holy medicine for the twelve meridian ulcers”; this statement is truly not an exaggeration!Lian Qiao–A Remarkable Remedy for Heat-Induced VomitingIn fact, clinically, it is not only a herb for clearing heat and detoxifying,but also a very good remedy for stopping vomiting, especially for heat-induced vomiting, as seen in the commonly used Bao He Wan, which includes Lian Qiao for this purpose. “All counterflow belongs to fire,” and non-chronic vomiting is often related to heat in the stomach.This discovery is credited to Japanese Kampo practitioners. In the Japanese text Gyushan Chitao, it states: “For adults and children with persistent vomiting, Lian Qiao can be added to any prescription,this is a family secret.” In Shengsheng Tang Zhi Yan, it is recorded: “A two-year-old child, after recovering from convulsions, continued to vomit milk incessantly. Many doctors were at a loss, but after the teacher’s diagnosis, there was no heat, and the abdomen was also harmonious, so a Lian Qiao decoction was prescribed, and one dose had miraculous effects.”[as seen in Tang Benqi’s Huang Han Yixue]This statement has been verified in clinical practice. Contemporary physician Zhang Zhenqin is known for using Lian Qiao to stop vomiting, reportedly inspired by Tang Benqi’s Huang Han Yixue, and has verified its effectiveness in clinical practice for over twenty years.For example, treating a 58-year-old female retired worker with recurrent lumbar pain and edema for three years, accompanied by frequent vomiting and inability to eat for five days. She presented with facial and lower limb edema, lumbar pain, fatigue, and nausea with vomiting, unable to take food or medicine. No cold or heat symptoms, no desire for drink, and scant urination. The pulse was deep, thin, rapid, and slightly slippery, the tongue was pale red with a thin white coating. After ineffective treatment with Western medicine for inflammation, diuretics, and antiemetics, she switched to TCM treatment. Using 20g of Lian Qiao, decocted slowly and taken in small amounts, the vomiting stopped immediately.Another case involved an 8-year-old girl who, after overeating ice pops and biscuits, experienced abdominal pain and vomiting at night. Despite treatment with anti-inflammatory and analgesic medications and intravenous fluids, the pain decreased but vomiting persisted, leading her to seek outpatient treatment.Diagnosis: pulse tight and rapid, tongue coating pale yellow, tongue body red and lacking moisture, with tenderness in the epigastric area. Diagnosed as food injury to the stomach.Stomach heat rebelling upwards. Initially, Lian Qiao15gwas used, decocted and taken in small amounts. Bai Shao10gand Zhi Gan Cao6gwere added. The stomach pain also resolved.[Hunan Journal of Traditional Chinese Medicine,1986（2）：29]Physician He Yunqiang has experienced in clinical practice that using the detoxifying and blood-activating decoction by Wang Qingren (Chai Hu, Lian Qiao, Ge Gen, Chi Shao, Sheng Di Huang, Ji Ke, Dang Gui, Tao Ren, Hong Hua) to treat cholera,has shown that with Lian Qiao, the vomiting stops effectively; without Lian Qiao, the vomiting is difficult to control..Modern pharmacological studies indicate: “Lian Qiao decoction… has an antiemetic effect comparable to that of chlorpromazine two hours post-injection. It can also inhibit vomiting induced by subcutaneous injection of apomorphine in dogs, suggesting that its antiemetic action may be due to inhibition of the chemoreceptor trigger zone in the medulla.”[Yu Yingzheng, Chinese Medicine Dictionary, Beijing: People’s Health Publishing House, 1995：730]A 77-year-old female patient was first diagnosed on May 10, 1991, with vomiting for five days. The Western diagnosis was neurogenic vomiting, treated with medications like Aimoer and Weifuan (antiemetics) without effect, leading her to seek TCM treatment. The tongue was red, the coating was thin yellow, and the pulse was slippery and rapid.I prescribed Lian Qiao alone 60g in water decoction. After two doses, the vomiting stopped, and the patient recovered.A 40-year-old male patient was first diagnosed on October 21, 1995. He had been vomiting after breakfast for over two months.Despite treatment with various formulas like Xuanfu Dai Zhi Shi Tang and Wen Dan Tang, there was no effect. He appeared pale, weak in speech, fatigued, with a pale tongue and thin coating, and a weak pulse. The diagnosis was spleen and stomach Qi deficiency. He was treated with Liu Jun Zi Tang. After three doses, there was no significant effect.Again, Lian Qiao was added to the previous formula for three more doses.After finishing the medication, his condition improved dramatically, and follow-up after two years showed no recurrence.[Shanxi TCM,2001,17（2）：41]Learning from the above experiences and cases, Wang Xingfu primarily uses Lian Qiao in clinical practice to treat heat-induced vomiting. He once treated a 35-year-old male patient who had been experiencing frequent nausea and a desire to vomit. My student prescribed Xuanfu Dai Zhi Tang combined with Ding Xiang Shi Di Tang, but after three doses, there was no effect, and the vomiting became more frequent. Upon my examination, I found no errors in the prescription but was puzzled as to why it was ineffective. Upon detailed examination,the tongue was slightly red, the coating was yellow and greasy,the pulse was slippery,and there was a foul odor from the mouth,leading me to conclude: this is food stagnation, heat-induced vomiting, not the syndrome for Xuanfu Dai Zhi Tang.I prescribed Bao He Wan, with a heavy dose of Lian Qiao.Chao Shan Zha 30g, Chao Shen Qu 30g, Jiang Ban Xia 30g, Fu Ling 15g, Chen Pi 30g,Lian Qiao 60g, Lai Fu Zi 30g, Sheng Da Huang 10g, Sheng Gan Cao 6g. Three doses, decocted and taken three times a day.After one dose, he had a bowel movement with foul-smelling, loose stools, and subsequently, the vomiting decreased. After finishing three doses, he was cured. This formula is a combination of Bao He Wan and Da Huang Gan Cao Tang, specifically treating the syndrome of food stagnation and heat-induced vomiting.Lian Qiao excels in treating heat-induced vomiting, along with Zhu Ru (Bamboo Shavings) and Lu Gen (Reed Rhizome), being key herbs for this condition.Disclaimer: Most of the content in this series of herbal notes comes from historical herbal texts, Chinese herbal movements, discoveries in herbal medicine, discussions on herbal properties, reflections on herbal medicine, efficacy studies, records of herbal prescriptions, and legendary uses of herbs. I have only selected and organized this information for learning and exchange purposes. If there are any inappropriate uses, please contact me for removal.