Huang Lian (Coptis chinensis) is an extremely bitter, dry, and cold herb. However, when a certain characteristic of an herb reaches its extreme, its effects in that aspect can also be very strong.Huang Lian is best known for clearing heat, especially adept at clearing damp-heat from the gastrointestinal tract, and also effective in clearing heart fire and stomach fire.

Huang Lian (Image source: Tuchong Creative/Today’s Headlines)

1. Traditional Efficacy

1. Damp-Heat Syndrome(1) Spleen-Stomach Damp-HeatSpleen-stomach damp-heat can easily lead to abdominal distension, fullness, nausea, vomiting, diarrhea, and a yellow greasy tongue coating.Huang Lian is often combined with Ban Xia (Pinellia ternata), Huang Qin (Scutellaria baicalensis), Ren Shen (Ginseng), Gan Cao (Licorice), and Da Zao (Jujube) to form the Ban Xia Xie Xin Tang (Half Summer Decoction), used for mixed cold-heat abdominal distension and discomfort. Clinically, it is commonly used for acute and chronic gastroenteritis, and chronic hepatitis with the above symptoms.Huang Lian is frequently used for lower jiao damp-heat diarrhea, dysentery, or intestinal inflammation primarily due to damp-heat.If accompanied by tenesmus, abdominal pain with diarrhea, and a feeling of incomplete bowel evacuation, it is often combined with Mu Xiang (Aucklandia) to form the Xiang Lian Wan, which clears heat and dries dampness while promoting qi and relieving stagnation.

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The effective component extracted from Huang Lian, berberine (Huang Lian Su), is made into Huang Lian Su Pian or Berberine Hydrochloride Tablets (Note: this is a Western medicine), commonly used for acute gastroenteritis, acute bacterial dysentery, and other gastrointestinal diseases.

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(2) Damp Sores and EczemaThe Huang Di Nei Jing (Yellow Emperor’s Inner Canon) states: “All painful and itchy sores belong to the heart.” Sores and abscesses are often related to heat toxin in the heart, and Huang Lian is good at draining heart fire, commonly used for various skin sores and abscesses.Huang Lian is effective in clearing heat and drying dampness, used for damp sores caused by moisture invading the skin, such as redness and papules, blisters, and itching on the skin around the ankles, which can be treated by grinding Huang Lian with rosin and sea turtle shell into a fine ointment for application.2. Heat SyndromeHuang Lian clears heat, particularly effective in clearing heart fire, stomach fire, and liver fire.(1) Excess Heart FireUsed for symptoms caused by excess heart fire such as vomiting blood, nosebleeds, constipation, yellow and red urine, red and swollen eyes, mouth and tongue sores, irritability, and a yellow greasy tongue coating, often using the Xie Xin Tang (Drain the Heart Decoction) from the Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet).If heart fire is too strong, leading to deficiency of heart yin and causing insomnia and irritability, it is often combined with E Jiao (Donkey-hide Gelatin) and Shao Yao (Peony) to drain fire while nourishing yin, as in the Huang Lian E Jiao Tang (Huang Lian and E Jiao Decoction) from the Shang Han Lun (Treatise on Cold Damage).Huang Lian E Jiao Tang: Huang Lian, Huang Qin, Shao Yao, E Jiao, and egg yolk (Image from the internet, please delete if infringing).Used for excessive heart fire and disharmony between heart and kidney, leading to insomnia and vivid dreams, it can be combined with Rou Gui (Cinnamon) to clear the heart and calm the spirit, harmonizing heart and kidney, as in the Jiao Tai Wan.Modern clinical practice uses Huang Lian capsules (mainly composed of Huang Lian) for recurrent canker sores, showing excellent results.(2) Excess Stomach FireCommonly used for toothache, vomiting, and thirst caused by excess stomach fire.Toothache, pulling headache, facial heat, pain that decreases with cold and worsens with heat, or bleeding and swollen gums, foul breath, and a red tongue with yellow coating are typical symptoms of stomach heat attacking upward.

In this case, you have excess heat!Stomach heat attacking upward is often treated with Huang Lian combined with Sheng Di (Rehmannia), Dang Gui (Angelica), Mu Dan Pi (Moutan), and Sheng Ma (Cimicifuga), as in the Qing Wei San (Clear Stomach Powder) from the Lan Shi Mi Cang (Secret Collection of the Orchid Chamber).Used for stomach heat vomiting, often accompanied by burning sensation in the stomach, acid reflux, etc., Huang Lian is often combined with Ban Xia, Zhu Ru (Bamboo Shavings), and Ju Pi (Tangerine Peel) as in the Huang Lian Ju Pi Zhu Ru Ban Xia Tang (Huang Lian, Tangerine Peel, Bamboo Shavings, and Ban Xia Decoction) from the Wen Re Jing Wei (Treatise on Warm Diseases).(3) Excess Liver FireExcess liver fire can easily lead to red and swollen eyes and can also cause liver fire to attack the stomach, presenting as rib pain, vomiting, acid reflux, belching, bitter mouth, and dry throat. Huang Lian is often used with Wu Zhu Yu (Evodia) as in the Zuo Jin Wan (Left Metal Pill) from the Dan Xi Xin Fa (Heart Method of Dan Xi).

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3. Skin Sores and AbscessesUsed for heat toxin accumulating in the skin, causing sores and abscesses, redness, swelling, and pain, often combined with Jin Yin Hua (Honeysuckle), Huang Qin, and Lian Qiao (Forsythia).Modern clinical practice uses tea oil mixed with Huang Lian to treat pressure ulcers.

2. Three Types of People Who Should Avoid Huang Lian

1. Huang Lian is extremely bitter and cold; patients with spleen and stomach deficiency and cold, who easily experience stomach pain, abdominal distension, and loose stools, should avoid using Huang Lian alone.

2. Ordinary people, especially children, who take Huang Lian for too long can also harm the spleen and stomach, so it is advised to adhere to the principle of stop when the disease is resolved and not to continue taking it after recovery.

3. Huang Lian is drying in nature and can easily damage body fluids, so those with yin deficiency and low body fluids, commonly presenting with dry mouth, constipation, irritability, night sweats, flushed face, red tongue with little coating, etc., should use Huang Lian with caution.

Related Reading Portulaca oleracea is a medicinal food that can be used for melasma, acne, urticaria, and various skin diseases. ReferencesThe Shennong Bencao Jing, Shang Han Lun, Jin Gui Yao Lue, Lan Shi Mi Cang, Wen Re Jing Wei, Dan Xi Xin Fa, Yi Zong Jin Jian, Si Ke Jian Xiao Fang, Chinese Clinical Herbal Medicine, Zhang Tingmo’s Clinical Herbal Medicine Lecture Notes [Fujian Medical Journal, 2009, 31(4):170] [General Practice Medicine Clinical and Education, 2009, 7(5):549]This article is an original work by Huang Yaoshi and may not be reproduced without permission. Please indicate the source when reprinting from Huang Yaoshi’s notes.Huang Yaoshi updates the most concerned traditional Chinese medicine, proprietary Chinese medicine, and health knowledge daily. The prescriptions and methods mentioned in the text are for learning and reference only; please use them under the guidance of a physician. If you need treatment, please visit a regular hospital and consult a professional physician for syndrome differentiation and treatment.