Traditional Chinese Medicine Encyclopedia: Coptis Chinensis
Pinyin Huánɡ Lián
Alias Wang Lian (Shennong’s Classic of Materia Medica), Zai Lian (Discussion on Medicinal Properties).
Source Shennong’s Classic of Materia Medica
Origin The rhizome of the Ranunculaceae plants Coptis chinensis, Coptis deltoidea, Coptis teetoides, or Coptis teeta. It is best harvested after the beginning of winter (November). After digging, remove the stems, leaves, fibrous roots, and soil, then dry in the sun or bake, and remove the coarse skin.
Plant Morphology ① Coptis chinensis
Perennial herb, 15-25 cm tall. Rhizome yellow, often branched, densely covered with fibrous roots. Leaves basal, petiole 6-16 cm long, glabrous; leaf blade slightly leathery, ovate-triangular, up to 10 cm wide, 3-lobed; central lobe slightly rhombic, with a slender petiole 1-1.8 cm long, lobes further deeply divided, with 4-5 pairs of lobules, nearly oblong, apex acute, spaced 2-6 mm apart, margin with needle-like serrations; lateral lobes obliquely ovate, shorter than the central lobe, with unequal 2 deep lobes or rarely 2 entire lobes, lobes often further deeply divided; upper surface along the veins covered with short soft hairs, lower surface glabrous. Flower stalks 1-2, equal to or longer than leaves; dichotomous or multi-branched umbel, with 3-8 flowers; bracts lanceolate, 3-5 deeply lobed; sepals 5, yellow-green, elongated ovate to lanceolate, 9-12.5 mm long, 2-3 mm wide; petals linear or linear-lanceolate, 5-6.5 mm long, apex acute, with a nectar groove in the center; stamens numerous, outer whorl slightly shorter or nearly equal in length to petals, anthers broadly ovate, yellow; carpels 8-12. Capsules 6-12, with stalks, 6-7 mm long. Seeds 7-8, elongated oval, about 2 mm long, brown. Flowering period: February to April. Fruiting period: March to June.
Wild or cultivated. Distributed in Sichuan, Guizhou, Hubei, Shaanxi, etc.
② Coptis deltoidea
Perennial herb. Morphology similar to Coptis chinensis, main feature is the rhizome is unbranched or with few branches. Leaf blade papery, ovate, up to 16 cm long, 15 cm wide, 3-lobed, lobes with distinct petioles; central lobe triangular-ovate, base abruptly narrowed to a slender petiole up to 2.5 cm long, lobes deeply divided 4-6 pairs, lateral lobes obliquely ovate, with unequal 2 deep lobes or half lobes, small lobes adjacent. Bracts linear-lanceolate, nearly 3-lobed or pinnately lobed near the middle. Flower sepals narrowly ovate; petals nearly lanceolate, wider; stamens about 20, only about half the length of petals; carpels 9-12. Seeds sterile.
Cultivated in Sichuan, wild species are rare.
③ Coptis teetoides
Perennial herb, 15-30 cm tall. Rhizome with few branches, internodes short and dense. Basal leaves 4-11, petiole 5-16 cm long; leaf blade lanceolate or narrow ovate, about equal in length to petiole, 3-lobed; central lobe triangular-lanceolate, up to 14 cm long, 6 cm wide, apex gradually pointed, base abruptly narrowed to a small petiole, lobes deeply divided, 7-10 pairs, small lobes elongated oval, with sharp serrations; lateral lobes obliquely ovate, only 1/3-1/4 the length of the central lobe, with 2 deep lobes or occasionally 2 entire lobes, small lobes further divided or with 2 deep lobes; upper surface along the veins covered with fine soft hairs, otherwise glabrous. Flower stalks mostly single, multi-branched umbel, with 3-6 flowers; sepals linear, 7.5-10 mm long, 0.7-1.2 mm wide; petals 9-12, narrow linear, about half the length of sepals; stamens numerous, about 4 mm long; carpels 9-14. Capsules about 8 mm long. Seeds elongated oval, yellow-brown.
Wild in shady, humid forests. Distributed in Sichuan.
④ Coptis teeta
Perennial herb. Morphology similar to Coptis chinensis, main difference is the rhizome has fewer branches, internodes dense. Central lobe ovate-rhombic or long-rhombic, lobes deeply divided 3-6 pairs, small lobes spaced apart. Multi-branched umbel, with 3-5 flowers; bracts oval, 3-lobed or pinnately lobed; flower sepals ovate or elliptical, 6-8 mm long, 2-3 mm wide; petals spoon-shaped or ovate-spoon-shaped, 4.5-6 mm long, 0.5-1 mm wide, apex rounded or blunt, base narrowing to a slender claw, with a nectar groove in the center; carpels 8-15.
Grows in high mountain cold, humid forest shade. Distributed in Yunnan, Changdu region of Tibet, cultivated in Yunnan.
Characteristics Coptis chinensis products can be roughly divided into the following types due to differences in the original plant and production area:
① Wei Lian, also known as Chuan Lian (from the Materia Medica), Chicken Claw Lian, Chicken Claw Coptis, Light Lian. The dried rhizome of the plant Coptis chinensis, often branched, usually 3-6 branches bundled, slightly curved, resembling a chicken claw, about 3-7 cm long, single branch diameter 3-8 mm. The outer surface is yellow-brown, the cork layer is red-brown where peeled; branches have intermittent transverse lines, with swollen nodes resembling beads, with many hard fine fibrous roots and fibrous root marks, some surfaces are smooth like stems, commonly referred to as “crossing the river branch” or “crossing the bridge rod”; the upper part often has brown scales remaining, with an unremoved residual stem or petiole at the top. Firm and hard, with an irregular fracture surface, the bark is dark brown, the wood is golden yellow, with cracks in the rays, the central pith is reddish-yellow, occasionally hollow. Odorless, extremely bitter, chewing can stain saliva red-yellow. The best quality is characterized by thick, bead-like, firm texture, with a red-yellow fracture surface, and no residual stem or fibrous roots.
All cultivated products, mainly produced in Sichuan and Hubei. Shaanxi (Pingli) also produces.
② Ya Lian (from the Materia Medica), also known as Emei Lian, Jiading Lian, Thorn Cover Lian. The dried rhizome of the plant Coptis deltoidea. Mostly single branches, few branches, slightly cylindrical, slightly curved like a silkworm, about 4-8 cm long, diameter about 3-9 mm. The outer surface is brown or yellow-brown, with many intermittent transverse lines, with obvious nodes, with many fibrous root remnants, leaf petiole remnants, and scales, “crossing the river branch” is less than Wei Lian. Firm texture, with an uneven fracture surface, the bark is dark brown, the wood is deep yellow, with obvious rays, the pith is sometimes hollow. Odorless, extremely bitter. The best quality is characterized by thick, bead-like, firm texture, with a yellow fracture surface, and no residual stem or fibrous roots.
All cultivated products, mainly produced in Sichuan (Emei, Hongya).
③ Wild Coptis, also known as Phoenix Tail Lian. The dried rhizome of the plant Coptis teetoides. The shape is similar to Ya Lian, but the top often retains a long leaf petiole of 6-10 cm as a wild mark; the rhizome is mostly single or has 2 branches, slightly curved, about 5-6 cm long, diameter 4-6 mm, the outer surface is black-brown, with tightly clustered nodes resembling beads, without “crossing the river branch”; more residual scales, fibrous roots are harder. All wild. Mainly produced in Sichuan (Emei, Hongya, Ebian), with very small yield, but generally considered to be of the best quality.
④ Yun Lian (from the Materia Medica) mainly refers to the dried rhizome of the plant Coptis teeta. Smaller, often curved, twisted, mostly single branches, resembling a scorpion tail. About 1.5-8 cm long, diameter about 2-4 mm. The outer skin is yellow-green or gray-yellow. Other characteristics are roughly similar to the above varieties.
Both cultivated and wild. Mainly produced in Yunnan (Deqin, Weixi, Tengchong, Bijiang).
Chemical Composition Coptis chinensis contains 7-9% berberine, coptisine, methyl berberine, palmatine, columbamine, jatrorrhizine, and other alkaloids, as well as obakunone and obakulactone.
From Emei Coptis, berberine, methyl berberine, jatrorrhizine, palmatine, and two non-phenolic alkaloids, and two phenolic alkaloids have been isolated.
Pharmacological Effects ① Antimicrobial and Antiprotozoal Effects
(1) Bacteria: In vitro tests have shown that Coptis or berberine has strong inhibitory effects on hemolytic streptococcus, meningococcus, pneumococcus, cholera vibrio, anthrax bacillus, and Staphylococcus aureus; it also inhibits dysentery bacillus, diphtheria bacillus, bacillus subtilis, and green streptococcus; effective against pneumonia bacillus, whooping cough bacillus, plague bacillus, Brucella, tetanus bacillus, gas gangrene bacillus, and tuberculosis bacillus; less effective against proteus, E. coli, and typhoid bacillus, and almost ineffective against Shigella sonnei, paratyphoid bacillus, and Pseudomonas aeruginosa. Due to differences in experimental methods, reports vary. For dysentery bacillus, Shiga dysentery bacillus is more sensitive, while Flexneri and Sonnei are less sensitive. Its effect is equal to or better than sulfonamides but weaker than streptomycin and chloramphenicol. The antibacterial effect of crude extracts of Coptis and pure berberine is basically consistent; however, there are some cases where the effects on certain bacteria are not completely consistent. Decoctions have good antibacterial effects, and berberine still has antibacterial effects against strains resistant to streptomycin, chloramphenicol, and oxytetracycline; it has also been reported that adding berberine can restore the sensitivity of intestinal bacteria to these drugs; in both in vitro and in vivo tests, it shows synergistic effects with streptomycin and sulfonamides against Staphylococcus aureus. Although many strains of dysentery bacillus resistant to berberine and sulfonamides exist, there is no complete cross-resistance. In vitro, it has significant inhibitory effects on whooping cough bacillus, although its minimum effective concentration is higher than that of streptomycin and chloramphenicol, its clinical efficacy is at least not lower than that of streptomycin and chloramphenicol. It has inhibitory effects on both avian, bovine, and human tuberculosis bacilli. Due to differences in culture media and strains, its inhibitory effects vary significantly, generally far less than that of para-aminosalicylic acid. In vivo tests show that its efficacy against mice, rabbits, and guinea pigs inoculated with tuberculosis bacilli is not very significant. Some reports indicate that after 3 days of exposure to berberine at a concentration of 1:2000, it does not affect the pathogenicity of the bacteria to guinea pigs, but after 14 days, it can reduce its pathogenicity by half. (2) Other microorganisms and protozoa: In chicken embryo tests, Coptis has certain inhibitory effects on various types of influenza viruses and Newcastle disease virus. In vitro, it has broad and significant inhibitory effects on more than a dozen common pathogenic fungi. It has a strong killing effect on leptospira in vitro, with berberine at 7.5 micrograms/mL and Coptis decoction at 1.9 mg/mL showing significant effects. Coptis decoction and berberine sulfate have anti-amoebic effects both in vitro and in vivo, with in vitro efficacy equivalent to 1/128 of emetine and 1/4 of halofantrine; it also has effects against trichomonas, leishmaniasis, trypanosomiasis, and kills paramecium. Due to its broad effects, it has been suggested as a preservative, with a phenolic coefficient between 5-20. The effective components of Coptis for antibacterial effects are generally considered to be berberine. After Coptis is charred, the content of berberine decreases, and its antibacterial power also weakens. At low concentrations (about 10 mg/100 mL), it is bacteriostatic, while at high concentrations (about 20 mg/100 mL), it is bactericidal. The mechanism of its bactericidal action is complex and not fully elucidated. Berberine can inhibit the growth and respiration of Staphylococcus aureus, suppressing the oxidation process of glucose and intermediate products in bacterial glucose metabolism, especially the dehydrogenation reaction. It has significant antagonistic effects against vitamin PP and B; in alkaline conditions, it can inhibit the binding of pyridoxal to enzyme proteins in E. coli and fecal streptococci, but not in acidic conditions, it can inhibit protein synthesis in bacteria; Coptis and its compound preparations can reduce the potency of Staphylococcus aureus hemolysin and plasma protein coagulase. In studies on cholera vibrio, it has been shown that berberine may damage the cell membrane, leading to changes in intracellular components; it does not affect nucleic acid synthesis but increases the degradation of proteins, and also alters the fatty acid components (both saturated and unsaturated). It has been reported to enhance the phagocytic ability of leukocytes and the liver reticuloendothelial system; it can restore metabolic disorders caused by infections, such as the decrease in myocardial glycogen and certain enzyme activities. For guinea pigs immunized with Brucella live vaccine, berberine (alone or in combination with phosphamine) shows slight inhibition when used early, but has no effect when used later. Staphylococcus aureus, hemolytic streptococcus, and Flexneri dysentery bacillus are very prone to develop resistance to berberine alone. Some bacteria can also assimilate berberine from the culture medium; however, there is no cross-resistance with penicillin, streptomycin, gold mycin, isoniazid, or para-aminosalicylic acid. It has been reported that using Coptis in compound form leads to a much lower formation of resistance than when used alone, and its antibacterial efficacy is also improved.
② Effects on the Circulatory System
Intravenous injection or oral administration of berberine can cause a decrease in blood pressure in anesthetized (dogs, cats, rabbits) or non-anesthetized (rats) animals. Generally, the duration is not long, and repeated administration does not enhance the effect or lead to tolerance. The hypotensive effect is unrelated to the heart, as it can excite the heart and increase coronary blood flow at general or low doses, only inhibiting the heart at high doses; even with increased doses, there is no cardiac arrest phenomenon in isolated toads or cats. The hypotensive effect is related to vasodilation, as the volume of the spleen, intestines, kidneys, and limbs increases simultaneously with the decrease in blood pressure, and both toad vascular perfusion and rabbit renal perfusion also demonstrate that it can directly dilate blood vessels. The hypotensive effect of berberine is not affected by diphenhydramine and reserpine; atropine can block its hypotensive effect (in anesthetized rats), but does not affect the hypotensive response of acetylcholine; therefore, its action may be due to direct stimulation of muscarinic receptors. After extensive research on various factors involved in the hypotensive mechanism, it is generally believed that its hypotensive effect arises from direct action on blood vessels and enhancement of acetylcholine (see next section). Several principles remain inadequately explained, such as ergot toxin can reverse the hypotensive effect of berberine; after injecting large amounts of atropine, the hypertensive effect of acetylcholine can be reversed by berberine, which requires further study.
③ Effects on Acetylcholine and Others
Berberine can enhance the action of acetylcholine at low doses in mammalian heart specimens (heart-lung apparatus, isolated cat heart, isolated rabbit heart auricle, isolated cat heart auricle), while at high doses it antagonizes it. In whole animals, low doses enhance the hypotensive effect caused by acetylcholine or electrical stimulation of the peripheral end of the vagus nerve, while high doses weaken this response. In isolated rabbit ear, frog hind limb perfusion, isolated rabbit intestine, and bronchus specimens, berberine can enhance the action of acetylcholine; it can also enhance salivation induced by electrical stimulation of the chorda tympani nerve or injection of pilocarpine. In experiments on rabbit pupils, local administration of berberine (0.5%) can enhance the action of acetylcholine. Additionally, it can significantly enhance the action of acetylcholine on frog rectus abdominis; at low doses, it exhibits significant anticholinergic effects, while at excessive doses, it can enhance the action of certain drugs with anticholinergic effects. In whole animals, anticholinergic effects can also be observed, but in vivo, the action occurs slowly, unlike atropine, and its intensity (in rabbit head-down and mouse toxicity tests) is not as strong as atropine, and its derivatives may have stronger anticholinergic effects. In summary, berberine has a biphasic effect; its enhancing effect on acetylcholine is related to its anticholinesterase activity, which has been confirmed in the determination of cholinesterase activity in dog, horse serum, and rabbit brain homogenate, but its potency is only 1/200 of neostigmine. On the other hand, the antagonistic effect of berberine on acetylcholine may be due to its chemical structure being a quaternary ammonium compound, thus leading to competitive antagonism between the two.
Berberine also has some adrenergic-like effects; during the hypotensive process induced by berberine in anesthetized animals, the hypertensive response to adrenaline is significantly weakened but quickly recovers. Berberine can antagonize the arrhythmias, bradycardia, and electrocardiogram changes induced by adrenaline and similar substances such as norepinephrine, isoproterenol, and methoxamine in anesthetized rabbits.
④ Effects on Smooth Muscle
In addition to relaxing vascular smooth muscle, berberine also has excitatory effects on other smooth muscles such as the uterus, bladder, bronchi, and gastrointestinal tract. It has significant excitatory effects on isolated guinea pig and cat uterus, even exceeding that of North American Coptis. Coptis decoction at low concentrations increases intestinal tension in isolated rabbit intestine, while excessive concentrations cause relaxation.
⑤ Effects on Bile Secretion and Blood
Berberine has a choleretic effect, increasing bile formation and thinning bile; it has good effects when taken orally for chronic cholecystitis patients. In chronic experiments, berberine taken orally (20 mg/kg) or intramuscularly (2 mg/kg) can lower serum cholesterol. The hot water extract of Coptis can restore the elevated serum C/P value to normal or lower lipid levels in rabbits fed cholesterol or after thyroidectomy. For rabbits with phenylhydrazine-induced arteriosclerosis, the San Huang powder (Coptis, Scutellaria, and Rhei) can lower the elevated C/P value. The previously reported blood sugar-lowering effect has not been confirmed. It has been reported that berberine and certain bitter stomachic drugs (such as the terpenes in cloves) have anti-anemia effects. For rabbits with anemia induced by phenylhydrazine and diamine toluene, berberine can reduce the extent of red blood cell reduction compared to the control group, and hemoglobin also shows some increase. However, there are also reports that no such effect was found with Coptis powder. Earlier reports indicated that berberine could reduce white blood cells and inhibit the amoeboid movement of white blood cells, which has not been confirmed; at general doses, it has no effect on white blood cells.
⑥ Anti-cancer, Anti-radiation, and Effects on Cellular Metabolism
It was previously believed that berberine was a protoplasmic poison or a cell division poison, belonging to the class of alkaloids similar to colchicine, and it has a synergistic effect with colchicine. In tissue culture experiments, it inhibits cellular respiration, oxygen uptake, and causes fatty degeneration of cells, with fluorescence photography showing berberine present in granules within cells. Its inhibition of cellular respiration is mainly due to the inhibition of the oxidative decarboxylation of pyruvate, with no effect on isobutyric acid, yohimbine, acetic acid, or anaerobic glycolysis. It has also been suggested that its inhibition of respiration is mainly due to the inhibition of yellow enzyme, and since cancer tissues have low yellow enzyme content, they are more sensitive to berberine than normal cells. There are also reports that it can inhibit the synthesis of nucleic acids in cancer cells and the utilization of intermediates in the synthesis of purine nucleotides. Although it has carcinogenic effects in vitro, its therapeutic effect on mouse ascitic cancer is not good. Berberine has some protective effects against death caused by Coγ-ray irradiation in mice, and from in vitro yeast experiments, this protection may be related to berberine altering certain characteristics of the surface of microsomes within cells.
⑦ Other Effects
At low doses, berberine can enhance the excitatory processes in the cerebral cortex of mice, while at high doses it can weaken them; it can also enhance inhibitory processes. Berberine has excitatory effects on the chemoreceptors in the carotid body, bone marrow, and intestinal tract; injection into the carotid body and intravenous injection of this drug do not cause a constant hypotensive response but rather cause fluctuating changes in blood pressure. This phenomenon may be related to its reflexive hypertensive effect on the carotid body. In experiments on rats with croton oil granulomas, histological methods have shown that subcutaneous injection of berberine can help the body strengthen the barrier against inflammatory lesions. The methanol extract of Coptis has anti-inflammatory effects (in rat ankle swelling and croton oil granuloma models), and local administration can reduce the weight of granulomas, with effects similar to those of prednisolone. It is said that berberine has antipyretic, diuretic, local anesthetic, sedative, analgesic effects, prolongs pentobarbital sleep time, and lowers intraocular pressure in rabbits, with no estrogen-like effects. Coptis taken simultaneously with Hemerocallis can reduce the toxicity of the latter to mice.
⑧ Absorption, Distribution, and Excretion
Berberine is not easily absorbed when taken orally. When administered parenterally, it is rapidly distributed to tissues after entering the bloodstream, and blood concentrations are difficult to maintain; after oral administration of 0.4 g of berberine hydrochloride in humans, the blood concentration is 100 micrograms% after 30 minutes (the in vitro bactericidal concentration is about 20 mg%), and then gradually decreases. Even with repeated doses of 0.4 g every 4 hours, the blood concentration does not increase. In vivo, berberine is distributed in almost all tissues, with the highest concentrations in the heart, kidneys, lungs, and liver. Its retention time in various tissues is very short, with only trace amounts remaining after 24 hours, mainly metabolized in the body, with a small portion (6.4%) excreted through the kidneys. After oral administration in rabbits, it can also be absorbed and can remain in the blood for 72 hours, with excretion in urine, with the highest concentration in the heart, followed by the pancreas and liver. In rats, absorption is minimal. When injected, it mainly enters the heart, pancreas, liver, and omental fat; after 24 hours, only a considerable amount of berberine can still be found in the pancreas and fat. Only a small amount (1%) is excreted in urine.
Toxicity Berberine is relatively safe at therapeutic doses, with very few side effects, and no obstacles have been observed with long-term use. Oral administration of 2.0 g of berberine or continuous use of 100 g of Coptis powder has not shown any side effects. In animal experiments, toxicity is also very low; oral administration to mice is not easily lethal, with the minimum lethal dose for intraperitoneal injection being 0.01 g/kg, and the median lethal dose measured at 0.066 g/kg (for Huangbai or Coptis, it is 0.52 and 0.73 g/kg, respectively). Cats given 0.1 g/kg orally can cause systemic depression and vomiting, leading to death after 8-10 days, with respiration shifting from excitation to paralysis, and seizures may occur before death.
Preparation Coptis: Remove impurities, wash off dirt, soak, slice, and dry in the shade. Fried Coptis: Fry Coptis slices over low heat until the surface turns dark yellow, then remove and cool. Ginger Coptis: Use fresh ginger to extract juice, add an appropriate amount of boiling water, and evenly spray onto Coptis slices, allowing absorption, then fry over low heat until the surface turns dark yellow, then remove and cool. (For every 100 jin of Coptis slices, use 12 jin and 8 taels of fresh ginger.) Wu Coptis: First, take Wuzhuyu and boil with an appropriate amount of water, remove the residue, then mix Coptis slices into the soup until the soup is absorbed, and fry slightly over low heat until slightly dry, then remove and cool. (For every 100 jin of Coptis slices, use 6 jin and 4 taels of Wuzhuyu.) Wine Coptis: Mix Coptis slices with yellow wine, let it sit for a while, and fry until the surface turns dark yellow, then remove and cool. (For every 100 jin of Coptis slices, use 12 jin and 8 taels of yellow wine.) According to “The Theory of Processing Medicinal Materials”: “For using Coptis, wipe the surface with cloth to remove hair, then soak in paste water for two days, filter, and dry in willow wood fire.”
Taste and Properties Bitter, cold.
① Shennong’s Classic of Materia Medica: “Bitter, cold.”
② Wu Pu Materia Medica: “Shennong, Qibo, and Lei Gong: Bitter, non-toxic; Li Shi: Slightly cold.”
Meridian Entry Enters the Heart, Liver, Stomach, and Large Intestine meridians.
① Materia Medica of Decoction: “Enters the Hand Shaoyin meridian.”
② Commentary on the Classic of Materia Medica: “Enters the Hand Shaoyin, Yangming, Foot Shaoyang, Jueyin, Yangming, and Taiyin meridians.”
③ Commentary on the Classic of Materia Medica: “Enters the Foot Shaoyin Kidney meridian and Hand Shaoyin Heart meridian.
Functions and Indications Clears heat, drains fire, dries dampness, detoxifies, and kills parasites. Treats seasonal heat toxins, febrile diseases, excessive heat causing irritability, fullness and vomiting, bacterial dysentery, heat diarrhea and abdominal pain, lung abscess, vomiting, epistaxis, hematochezia, thirst, accumulation of food, ascariasis, whooping cough, sore throat, fire eyes, oral ulcers, carbuncles, eczema, and burns from scalds.
① Shennong’s Classic of Materia Medica: “Mainly for heat in the eyes, tears flowing from the corners, brightening the eyes, abdominal pain, diarrhea, and swelling pain in women’s genitals.”
② Commentary on the Classic of Materia Medica: “Detoxifies the poison of croton seeds.”
③ Supplement to the Classic of Materia Medica: “Mainly for the cold and heat of the five viscera, chronic diarrhea with pus and blood, stops thirst, great fright, removes water, benefits bones, regulates the stomach and thickens the intestines, benefits the gallbladder, and treats oral ulcers.”
④ Discussion on Medicinal Properties: “Kills children’s roundworms, treats red eyes and pain, calms the liver and removes heat toxins.”
⑤ Supplement to the Classic of Materia Medica: “Mainly for emaciation and shortness of breath.”
⑥ Materia Medica of the Day: “Treats the five labors and seven injuries, benefits qi, stops abdominal pain; calms the heart and lungs, promotes flesh growth, stops bleeding; treats carbuncles, night sweats, seasonal heat diseases; steamed with pig stomach for pills, treats children’s roundworm qi.”
⑦ Directing Formulas of Ren Zhai: “Can remove evil blood from the heart cavity.”
⑧ Pearl Bag: “Drains heart fire, and relieves fullness under the heart. Fried with wine or soaked in wine, it is effective above the neck.”
⑨ Wang Haogu: “Mainly for heart disease and counterflow, and accumulation in the heart.”
⑩ Supplement to the Classic of Materia Medica: “Fried with ginger juice, it effectively disperses heat.”
⑪ Classics of Materia Medica: “Detoxifies the effects of excessive medication and light powder poison.”
⑫ New Compilation of Materia Medica: “Stops vomiting, relieves acid reflux, detoxifies the eyes, calms the heart, stops nocturnal emissions, stabilizes agitation, relieves fullness.”
⑬ Essentials of Materia Medica: “Treats carbuncles, poison from wine, fetal poison. Removes accumulation, kills roundworms.”
Dosage and Administration For internal use: decoction, 1.5-3 g; or ground into powder, 0.3-0.6 g per dose; or in pills or powders. For external use: appropriate amount, ground into powder for topical application, or decocted in water for washing, or made into ointment, or used as juice.
Precautions Should be used cautiously in cases of yin deficiency with heat, stomach deficiency with nausea, spleen deficiency with diarrhea, and morning diarrhea.
① Commentary on the Classic of Materia Medica: “Avoid using with Huangqin, Longgu, Lishi. Avoid with chrysanthemum, yew, Xuan Shen, and white fresh skin. Avoid with Kuan Dong.”
② Discussion on Medicinal Properties: “Avoid with white silkworm. Avoid pork.”
③ Shu Materia Medica: “Avoid with cow knee.”
④ Zhu Zhenheng: “In cases of cold in the intestines and early onset of cold damage, yin deficiency with blood loss, and spleen damage with blood not returning to the source, it should not be used.”
⑤ Commentary on the Classic of Materia Medica: “In cases of patients with low blood and qi deficiency, weak spleen and stomach, insufficient blood leading to anxiety and insomnia, combined with irritability and thirst, and postpartum insomnia, blood deficiency with fever, diarrhea, and abdominal pain; children with measles and yang deficiency causing diarrhea; elderly with spleen and stomach deficiency causing diarrhea; yin deficiency patients with morning diarrhea, named kidney diarrhea; true yin deficiency, internal heat, and irritability symptoms, should be avoided, as it can be dangerous.”
Formulas ① For treating repeated heart irritability, confusion, and chest fullness: 4 qian of cinnabar, 5 qian of Coptis, and 2.5 qian of raw licorice. Grind into fine powder, soak in soup, steam into cakes, and form pills the size of millet. Take 10 pills after meals, swallowing with saliva. (Ren Zhai’s Directing Formulas: Coptis Anshen Pills) ② For treating Shaoyin disease, with symptoms for two or three days, heart irritability, and inability to sleep: 4 liang of Coptis, 2 liang of Huangqin, 2 liang of Shaoyao, 2 egg yolks, and 3 liang of Ejiao (or 3 pieces). Combine the five ingredients, boil with six sheng of water, take two sheng, remove the residue, and dissolve the gelatin completely, cool slightly, add the egg yolks, and mix well. Take seven he after warming, three times a day. (Treatise on Febrile Diseases: Coptis Ejiao Decoction) ③ For treating heart and kidney disharmony, insomnia: 5 qian of raw Coptis and 5 fen of cinnamon heart. Grind finely, form into pills with white honey. Take on an empty stomach with light salt soup. (Four Categories of Simple and Effective Formulas: Jiaotai Pills) ④ For treating excess heat in the heart: 7 qian of Coptis, 1.5 cups of water, decoct to 1 cup, take warm away from meals. Reduce for children. (Prescriptions) ⑤ For treating fullness in the heart, with a pulse that is floating and slippery: 2 liang of Da Huang and 1 liang of Coptis. Combine the two ingredients, soak in two sheng of 麻沸汤, and strain. Take warm again. (Treatise on Febrile Diseases: Da Huang Coptis Decoction) ⑥ For treating small chest obstruction, with pain upon palpation and a floating pulse: 1 liang of Coptis, half a sheng of Ban Xia (washed), and one large fruit of Gua Lou. Combine the three ingredients, boil with six sheng of water, first boil the Gua Lou, take three sheng, remove the residue, and add the other medicines, boil to two sheng, remove the residue. Take warm three times. (Treatise on Febrile Diseases: Xiao Xian Xiong Decoction) ⑦ For treating severe heat, irritability, groaning, confusion, and inability to sleep: 3 liang of Coptis, 2 liang each of Huangqin and Huangbai, and 14 pieces of Zhi Zi (split). Combine the four ingredients, chop, and boil with six sheng of water to take two sheng, divided into two doses. Avoid pork and cold water. (Secret Essentials of External Medicine: Coptis Detoxifying Decoction) ⑧ For treating febrile diseases with heat in the chest, evil qi in the stomach, abdominal pain, and desire to vomit: 3 liang of Coptis, 3 liang of licorice (roasted), 3 liang of dried ginger, 3 liang of cinnamon (peeled), 2 liang of ginseng, half a sheng of Ban Xia (washed), and 12 pieces of jujube (split). Combine the seven ingredients, boil with one dou of water to take six sheng, remove the residue. Take warm, three times during the day and twice at night. (Treatise on Febrile Diseases: Coptis Decoction) ⑨ For treating vomiting of sour water with a pulse that is wiry and slow: Ginseng, Bai Zhu, dried ginger, roasted licorice, and Coptis, decoct in water. (Syndrome Cause Pulse Treatment: Lian Li Decoction) ⑩ For treating liver fire: 6 liang of Coptis and 1-0.5 liang of Wuzhuyu. Grind into powder, form into water pills or steamed cakes. Take 50 pills with white soup. (Danxi Heart Method: Zuo Jin Pills, also known as Hui Ling Pills) ⑪ For treating various dysentery and blood in the intestines: Half a jin of Ya Zhou Coptis, remove hair, cut, pack into the large intestine of a fat pig, tie securely, and boil in a sand pot with water and wine until soft, then take out, grind, and form into pills the size of a walnut. Take 100 pills with rice soup. (Ren Zhai’s Directing Formulas) ⑫ For treating diarrhea: Grind Coptis and Qing Mu Xiang together, form into pills the size of a walnut. Take 20-30 pills on an empty stomach, twice a day. For those with prolonged cold, use cooked garlic to form pills. Effective for infants. (Military Department Hand Collection: Xiang Lian Pills) ⑬ For treating severe cold diarrhea with slippery intestines, with red and white stools like fish brains, day and night without regulation, and unbearable abdominal pain: 6 liang of Coptis, 2 liang of dried ginger, 3 liang each of Angelica and Ejiao. Combine the four ingredients, grind, and mix with eight cups of vinegar to form pills the size of a large soybean. Adults take 30 pills, children under a hundred days take 3 pills, and those over a year take 5 pills, with adjustments as needed, three times a day. (Qian Jin Fang: Zhu Che Pills) ⑭ For treating intestinal toxins: Grind Eagle Claw Coptis into powder, mix with one clove of garlic, roast until fragrant and soft, grind and form into pills the size of a walnut. Take 30-40 pills with aged rice drink. (Explanation of the Original Formulas: Suan Lian Pills) ⑮ For treating spleen receiving dampness, continuous diarrhea, slow digestion of grains, and stabbing pain in the abdomen, also effective for children with roundworm qi diarrhea: Coptis (remove fibrous roots), Wuzhuyu (remove stems, fry), and Bai Shao each 5 liang. Grind into fine powder, form into pills the size of a walnut. Take 20 pills with strong rice drink on an empty stomach, three times a day. (Prescriptions: Wu Ji Pills) ⑯ For treating insufficient heart qi, vomiting blood, and nosebleeds, also for cholera: 2 liang of Da Huang, and 1 liang each of Coptis and Huangqin. Combine the three ingredients, boil with three sheng of water to take one sheng. Take all at once. (Jin Kui Yao Lue: Xie Xin Decoction) ⑰ For treating thirst with the ability to drink water, sweet urine, resembling fat and flour, with 60-70 urinations day and night: One winter melon, 10 liang of Coptis. Cut off the top of the winter melon, remove the seeds, and fill with Coptis powder, bake in the fire until the Coptis is cooked, then squeeze out the juice. Take one large cup, twice a day. (Recent Effective Formulas) ⑱ For treating women with heat exhaustion and emaciation: 3 liang of Coptis (remove fibrous roots), 1 liang of ginseng (remove the root), 1 liang of red poria, 1 liang of astragalus (sliced), half a liang of wood fragrance, and 1.5 liang of tortoise shell (soaked in vinegar, roasted until yellow, remove the skirt). Combine the medicines, grind finely, and pack into a fresh pig stomach, sew it up, and steam until soft, then grind into a paste. Form into pills the size of a walnut. Take 30 pills with porridge before meals. (Sheng Hui Fang: Coptis Pig Stomach Pills) ⑲ For treating children’s stomach heat and vomiting milk: 2 qian of Coptis and 2 qian of Ban Xia. Grind into fine powder, divide into 100 parts, take three times a day, one part each time. (Liaoning: Selected Data on New Medical Methods of Chinese Herbal Medicine) ⑳ For treating red and painful eyes, removing heat: 0.5 liang of Coptis and one jujube (cut). Combine the two ingredients, boil with five cups of water to take one cup, remove the residue, and apply to the eyes, ten times a day. (Seng Shen Ji Fang: Coptis Decoction) 21. For treating carbuncles and swelling toxins, can be used whether they have ruptured or not: Coptis and areca nut in equal parts, ground into powder, and mixed with egg white for topical application. (Simple Formulas) 22. For treating pustular sores and acute eczema: Coptis, pine resin, and sea cucumber bone each three qian. Grind into fine powder, add two qian of yellow wax, dissolve in an appropriate amount of cooked sesame oil, and mix into a soft ointment. Apply to the affected area three times a day. Before applying the medicine, use a hot towel to wet the affected area to help the scabs fall off. (Inner Mongolia: Selected Data on New Medical Methods of Chinese Herbal Medicine) 23. For treating oral and tongue ulcers: Coptis decocted in wine, and take it in sips. (Zhou Hou Fang) 24. For treating children’s oral thrush: Coptis and aloe in equal parts, ground into powder. Take five parts with honey soup. For horse teeth thrush, mix with toad skin in equal parts, reduce the blue dye by half, and add a little musk. (Simple Formulas) 25. For treating thick flavors from alcohol, pain in the lips and teeth, or ulceration of the gums, or pain in the head, face, neck: 1.5 qian of fried Coptis, 1 qian each of raw Rehmannia, peony root, and angelica, and 2 qian of Cimicifuga. Boil with water, and for severe heat constipation, add Da Huang. (Women’s Good Formulas: Qing Wei San) 26. For treating pregnancy-related irritability, dry mouth, and inability to sleep: Coptis powder, 1 qian each time, taken with porridge, or steamed Coptis pills with wine, also effective. (Women’s Good Formulas) 27. For treating burns: Grind Coptis into powder, mix with tea oil for topical application. (Chinese Medicine Journal (2): 170, 1922) 28. For treating persistent diarrhea from croton seed poisoning: Mix dry ginger and Coptis powder, take a small spoonful. (Supplement to Zhou Hou Fang)
Various Discussions 1. Materia Medica Illustrated: Nowadays, doctors use eye wash soup, combining angelica, peony, and Coptis in equal parts, finely chopped, and boil in snow water or sweet water to make a concentrated juice, wash while hot, and reheat when cold, which is very beneficial for the eyes. It is said that all eye diseases are caused by blood stagnation, so blood-moving medicines combined with Coptis are used to treat them, as blood becomes hot and flows when washed hot, and users have found it effective.
2. Supplement to the Classic of Materia Medica: Coptis is often used to treat dysentery, as it is believed to have a bitter and drying effect. However, some people use it indiscriminately for intestinal weakness and slight blood in the stool, without knowing when to stop, which can lead to danger. If the initial disease is characterized by excessive heat, dysentery can be stopped by taking it, but it is not necessary to take the full dose. If it is weak and cold, it should not be used.
3. Commentary on the Treatise on Febrile Diseases: Bitter enters the heart, cold removes heat; the bitterness of Da Huang and Coptis guides and drains the virtual heat from the heart. For excess heat, it should be drained with bitterness; the bitterness of Coptis lowers Yang. If the roundworm is sweet, it moves; if it is bitter, it calms; the bitterness of Coptis and Huangbai calms the roundworm.
4. Liu Wanshu: Ancient formulas use Coptis as the best treatment for dysentery, as it is suitable for using pungent, bitter, and cold medicines, which can disperse, open up blockages, dry dampness, and overcome heat, thus balancing qi. Most bitter and cold medicines drain, but only Coptis and Huangbai are cold and dry, able to lower fire and remove dampness, thus stopping dysentery, making them the monarch in treating dysentery.
5. Li Gao: All painful, itchy sores and ulcers belong to heart fire; all sores should use Coptis and angelica as the monarch, with licorice and Huangqin as assistants.
6. Materia Medica of Decoction: Coptis is bitter and dry, thus entering the heart, as fire is dried. However, draining the heart actually drains the spleen, as the child can make the mother solid; if solid, it drains the child. For blood, the best assistant is Fangfeng, with Coptis as the middle assistant, and Dihuang as the lower assistant.
7. Zhu Zhenheng: Coptis removes damp-heat from the middle and drains heart fire; if the spleen and stomach qi is weak and cannot transport, then use Poria and Huangqin instead. Fry with pig bile, and add gentian to greatly drain liver and gallbladder fire. For dysentery with stomach heat, use Coptis and ginseng decoction, and drink throughout the day, even if vomiting occurs, continue drinking until one sip can be swallowed.
8. Han’s Medical Path: For diseases of fire division, Coptis is the main treatment; all five viscera have fire, and when balanced, it is treated; when diseased, it is chaotic. The formula books discuss monarch fire, minister fire, evil fire, and dragon fire, but in fact, it is one qi. Therefore, Danxi states that excess qi is fire, divided into several categories. For treating this disease, fry slightly: for evil and real fire, use Poxiao Decoction; for false fire, use wine; for virtual fire, use vinegar; for phlegm fire, use ginger juice; all should be soaked and fried thoroughly; for qi stagnation fire, use Wuzhuyu; for food accumulation and diarrhea, use Huangtu; for blood stasis and pain, use dry lacquer; all should be mixed with water and fried together, removing Wuzhuyu, Huangtu, and lacquer. For hidden fire in the lower jiao, soak in salt water and fry thoroughly; for eye diseases, soak in human milk and steam, or apply or take. Use raw for the monarch, with a little cinnamon as an assistant, boil until boiling, and take honey on an empty stomach, which can make the heart and kidney communicate instantly. For Wuling and Shili, it greatly treats nocturnal emissions. The above, ginger, wine, and honey are all monarchs, making the monarch the minister, with Bai Shao cooked in wine as an assistant, and Guangmuxiang as the envoy, treating children’s five ailments. Frying with Wuzhuyu, add wood fragrance in equal parts, and double the raw Da Huang, forming water pills to treat five dysenteries. Frying with ginger juice is the best, and the treatment of epilepsy and various wind dizziness and sores is effective, not just for draining heart fire, but also compared to other bitter medicines like Huangqin and Huangbai.
9. Materia Medica of the Classic: Coptis is the immortal medicine for treating wine diseases, the divine herb for draining, with unique effects in all six meridians, mainly for heat in the eyes, tears flowing from the corners, brightening the eyes, abdominal pain, diarrhea, and swelling pain in women’s genitals.
10. Materia Medica of the Classic: Coptis is the main treatment for dysentery, as it is believed to have a bitter and drying effect. However, some people use it indiscriminately for intestinal weakness and slight blood in the stool, without knowing when to stop, which can lead to danger. If the initial disease is characterized by excessive heat, dysentery can be stopped by taking it, but it is not necessary to take the full dose. If it is weak and cold, it should not be used.
11. Commentary on the Treatise on Febrile Diseases: Bitter enters the heart, cold removes heat; the bitterness of Da Huang and Coptis guides and drains the virtual heat from the heart. For excess heat, it should be drained with bitterness; the bitterness of Coptis lowers Yang. If the roundworm is sweet, it moves; if it is bitter, it calms; the bitterness of Coptis and Huangbai calms the roundworm.
12. Liu Wanshu: Ancient formulas use Coptis as the best treatment for dysentery, as it is suitable for using pungent, bitter, and cold medicines, which can disperse, open up blockages, dry dampness, and overcome heat, thus balancing qi. Most bitter and cold medicines drain, but only Coptis and Huangbai are cold and dry, able to lower fire and remove dampness, thus stopping dysentery, making them the monarch in treating dysentery.
13. Li Gao: All painful, itchy sores and ulcers belong to heart fire; all sores should use Coptis and angelica as the monarch, with licorice and Huangqin as assistants.
14. Materia Medica of Decoction: Coptis is bitter and dry, thus entering the heart, as fire is dried. However, draining the heart actually drains the spleen, as the child can make the mother solid; if solid, it drains the child. For blood, the best assistant is Fangfeng, with Coptis as the middle assistant, and Dihuang as the lower assistant.
15. Zhu Zhenheng: Coptis removes damp-heat from the middle and drains heart fire; if the spleen and stomach qi is weak and cannot transport, then use Poria and Huangqin instead. Fry with pig bile, and add gentian to greatly drain liver and gallbladder fire. For dysentery with stomach heat, use Coptis and ginseng decoction, and drink throughout the day, even if vomiting occurs, continue drinking until one sip can be swallowed.
16. Han’s Medical Path: For diseases of fire division, Coptis is the main treatment; all five viscera have fire, and when balanced, it is treated; when diseased, it is chaotic. The formula books discuss monarch fire, minister fire, evil fire, and dragon fire, but in fact, it is one qi. Therefore, Danxi states that excess qi is fire, divided into several categories. For treating this disease, fry slightly: for evil and real fire, use Poxiao Decoction; for false fire, use wine; for virtual fire, use vinegar; for phlegm fire, use ginger juice; all should be soaked and fried thoroughly; for qi stagnation fire, use Wuzhuyu; for food accumulation and diarrhea, use Huangtu; for blood stasis and pain, use dry lacquer; all should be mixed with water and fried together, removing Wuzhuyu, Huangtu, and lacquer. For hidden fire in the lower jiao, soak in salt water and fry thoroughly; for eye diseases, soak in human milk and steam, or apply or take. Use raw for the monarch, with a little cinnamon as an assistant, boil until boiling, and take honey on an empty stomach, which can make the heart and kidney communicate instantly. For Wuling and Shili, it greatly treats nocturnal emissions. The above, ginger, wine, and honey are all monarchs, making the monarch the minister, with Bai Shao cooked in wine as an assistant, and Guangmuxiang as the envoy, treating children’s five ailments. Frying with Wuzhuyu, add wood fragrance in equal parts, and double the raw Da Huang, forming water pills to treat five dysenteries. Frying with ginger juice is the best, and the treatment of epilepsy and various wind dizziness and sores is effective, not just for draining heart fire, but also compared to other bitter medicines like Huangqin and Huangbai.
17. Materia Medica of the Classic: Coptis is the immortal medicine for treating wine diseases, the divine herb for draining, with unique effects in all six meridians, mainly for heat in the eyes, tears flowing from the corners, brightening the eyes, abdominal pain, diarrhea, and swelling pain in women’s genitals.
18. Materia Medica of the Classic: Coptis is the main treatment for dysentery, as it is believed to have a bitter and drying effect. However, some people use it indiscriminately for intestinal weakness and slight blood in the stool, without knowing when to stop, which can lead to danger. If the initial disease is characterized by excessive heat, dysentery can be stopped by taking it, but it is not necessary to take the full dose. If it is weak and cold, it should not be used.
19. Commentary on the Treatise on Febrile Diseases: Bitter enters the heart, cold removes heat; the bitterness of Da Huang and Coptis guides and drains the virtual heat from the heart. For excess heat, it should be drained with bitterness; the bitterness of Coptis lowers Yang. If the roundworm is sweet, it moves; if it is bitter, it calms; the bitterness of Coptis and Huangbai calms the roundworm.
20. Liu Wanshu: Ancient formulas use Coptis as the best treatment for dysentery, as it is suitable for using pungent, bitter, and cold medicines, which can disperse, open up blockages, dry dampness, and overcome heat, thus balancing qi. Most bitter and cold medicines drain, but only Coptis and Huangbai are cold and dry, able to lower fire and remove dampness, thus stopping dysentery, making them the monarch in treating dysentery.
21. Li Gao: All painful, itchy sores and ulcers belong to heart fire; all sores should use Coptis and angelica as the monarch, with licorice and Huangqin as assistants.
22. Materia Medica of Decoction: Coptis is bitter and dry, thus entering the heart, as fire is dried. However, draining the heart actually drains the spleen, as the child can make the mother solid; if solid, it drains the child. For blood, the best assistant is Fangfeng, with Coptis as the middle assistant, and Dihuang as the lower assistant.
23. Zhu Zhenheng: Coptis removes damp-heat from the middle and drains heart fire; if the spleen and stomach qi is weak and cannot transport, then use Poria and Huangqin instead. Fry with pig bile, and add gentian to greatly drain liver and gallbladder fire. For dysentery with stomach heat, use Coptis and ginseng decoction, and drink throughout the day, even if vomiting occurs, continue drinking until one sip can be swallowed.
24. Han’s Medical Path: For diseases of fire division, Coptis is the main treatment; all five viscera have fire, and when balanced, it is treated; when diseased, it is chaotic. The formula books discuss monarch fire, minister fire, evil fire, and dragon fire, but in fact, it is one qi. Therefore, Danxi states that excess qi is fire, divided into several categories. For treating this disease, fry slightly: for evil and real fire, use Poxiao Decoction; for false fire, use wine; for virtual fire, use vinegar; for phlegm fire, use ginger juice; all should be soaked and fried thoroughly; for qi stagnation fire, use Wuzhuyu; for food accumulation and diarrhea, use Huangtu; for blood stasis and pain, use dry lacquer; all should be mixed with water and fried together, removing Wuzhuyu, Huangtu, and lacquer. For hidden fire in the lower jiao, soak in salt water and fry thoroughly; for eye diseases, soak in human milk and steam, or apply or take. Use raw for the monarch, with a little cinnamon as an assistant, boil until boiling, and take honey on an empty stomach, which can make the heart and kidney communicate instantly. For Wuling and Shili, it greatly treats nocturnal emissions. The above, ginger, wine, and honey are all monarchs, making the monarch the minister, with Bai Shao cooked in wine as an assistant, and Guangmuxiang as the envoy, treating children’s five ailments. Frying with Wuzhuyu, add wood fragrance in equal parts, and double the raw Da Huang, forming water pills to treat five dysenteries. Frying with ginger juice is the best, and the treatment of epilepsy and various wind dizziness and sores is effective, not just for draining heart fire, but also compared to other bitter medicines like Huangqin and Huangbai.
25. Materia Medica of the Classic: Coptis is the immortal medicine for treating wine diseases, the divine herb for draining, with unique effects in all six meridians, mainly for heat in the eyes, tears flowing from the corners, brightening the eyes, abdominal pain, diarrhea, and swelling pain in women’s genitals.
26. Materia Medica of the Classic: Coptis is the main treatment for dysentery, as it is believed to have a bitter and drying effect. However, some people use it indiscriminately for intestinal weakness and slight blood in the stool, without knowing when to stop, which can lead to danger. If the initial disease is characterized by excessive heat, dysentery can be stopped by taking it, but it is not necessary to take the full dose. If it is weak and cold, it should not be used.
27. Commentary on the Treatise on Febrile Diseases: Bitter enters the heart, cold removes heat; the bitterness of Da Huang and Coptis guides and drains the virtual heat from the heart. For excess heat, it should be drained with bitterness; the bitterness of Coptis lowers Yang. If the roundworm is sweet, it moves; if it is bitter, it calms; the bitterness of Coptis and Huangbai calms the roundworm.
28. Liu Wanshu: Ancient formulas use Coptis as the best treatment for dysentery, as it is suitable for using pungent, bitter, and cold medicines, which can disperse, open up blockages, dry dampness, and overcome heat, thus balancing qi. Most bitter and cold medicines drain, but only Coptis and Huangbai are cold and dry, able to lower fire and remove dampness, thus stopping dysentery, making them the monarch in treating dysentery.
29. Li Gao: All painful, itchy sores and ulcers belong to heart fire; all sores should use Coptis and angelica as the monarch, with licorice and Huangqin as assistants.
30. Materia Medica of Decoction: Coptis is bitter and dry, thus entering the heart, as fire is dried. However, draining the heart actually drains the spleen, as the child can make the mother solid; if solid, it drains the child. For blood, the best assistant is Fangfeng, with Coptis as the middle assistant, and Dihuang as the lower assistant.
31. Zhu Zhenheng: Coptis removes damp-heat from the middle and drains heart fire; if the spleen and stomach qi is weak and cannot transport, then use Poria and Huangqin instead. Fry with pig bile, and add gentian to greatly drain liver and gallbladder fire. For dysentery with stomach heat, use Coptis and ginseng decoction, and drink throughout the day, even if vomiting occurs, continue drinking until one sip can be swallowed.
32. Han’s Medical Path: For diseases of fire division, Coptis is the main treatment; all five viscera have fire, and when balanced, it is treated; when diseased, it is chaotic. The formula books discuss monarch fire, minister fire, evil fire, and dragon fire, but in fact, it is one qi. Therefore, Danxi states that excess qi is fire, divided into several categories. For treating this disease, fry slightly: for evil and real fire, use Poxiao Decoction; for false fire, use wine; for virtual fire, use vinegar; for phlegm fire, use ginger juice; all should be soaked and fried thoroughly; for qi stagnation fire, use Wuzhuyu; for food accumulation and diarrhea, use Huangtu; for blood stasis and pain, use dry lacquer; all should be mixed with water and fried together, removing Wuzhuyu, Huangtu, and lacquer. For hidden fire in the lower jiao, soak in salt water and fry thoroughly; for eye diseases, soak in human milk and steam, or apply or take. Use raw for the monarch, with a little cinnamon as an assistant, boil until boiling, and take honey on an empty stomach, which can make the heart and kidney communicate instantly. For Wuling and Shili, it greatly treats nocturnal emissions. The above, ginger, wine, and honey are all monarchs, making the monarch the minister, with Bai Shao cooked in wine as an assistant, and Guangmuxiang as the envoy, treating children’s five ailments. Frying with Wuzhuyu, add wood fragrance in equal parts, and double the raw Da Huang, forming water pills to treat five dysenteries. Frying with ginger juice is the best, and the treatment of epilepsy and various wind dizziness and sores is effective, not just for draining heart fire, but also compared to other bitter medicines like Huangqin and Huangbai.