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Introduction: Teacher Tong Xiaolin is an expert in using Huang Lian (Coptis chinensis) to treat diabetes. This article introduces the principles of using Huang Lian in terms of compatibility, dosage, and contraindications, providing excellent guidance for clinical use.
Huang Lian (Excerpt)
Author/Tong Xiaolin
1. Key Principles of Huang Lian
Although Huang Lian is bitter, it is essential for treating “sweet disease” (diabetes). Its bitter and cold nature does not harm the stomach, especially when paired with ginger as a counteracting herb.
For lowering blood sugar, a larger dosage is recommended, while for stomach regulation, a smaller dosage is appropriate. Spicy herbs can disperse stagnation, while the bitterness of Huang Lian regulates Qi.
A small amount of Huang Lian (3-5 grams) can be combined with spicy herbs to regulate the spleen and stomach. For detoxification and clearing heat, a larger dose is needed (15-30 grams), especially for treating abscesses and heat in the stomach. The bitter and cold nature of Huang Lian can harm the stomach, so it should be paired with dried ginger to prevent constipation, and caution is advised for liver disease patients.
Note:
Huang Lian is the primary herb for diabetes, commonly referred to as “sweet disease.” All diseases can be treated with their opposites. The natural opposite of sweetness is bitterness. Therefore, almost all bitter herbs can lower blood sugar. For example: Zhi Zi (Gardenia), Zhi Mu (Anemarrhena), Long Dan Cao (Gentiana), Huang Bai (Phellodendron), Huang Qin (Scutellaria), Ku Guo (Bitter Melon), and Ku Ding Cha (Bitter Tea) are all bitter and cold herbs that can lower metabolism and treat infections and inflammation. Pairing with warming herbs like Sheng Jiang (Fresh Ginger), Gan Jiang (Dried Ginger), or Pao Jiang (Processed Ginger) can mitigate their bitter and cold effects on the stomach.
In my practice, I use Huang Lian to regulate the spleen and stomach, typically in doses of 1.5 to 6 grams; for clearing heat and detoxifying, I use it in short courses of 15 to 30 grams; and for lowering blood sugar, 15 to 30 grams is the common dosage, with a maximum of 120 grams for diabetic ketoacidosis.
Application points: ① Adjust dosage based on blood sugar levels. ② Always pair with dried ginger to prevent stomach harm from the bitterness and cold nature.
For those with normal spleen and stomach function, the ratio of Huang Lian to dried ginger should be 6:1; for those with weak spleen and stomach, the ratio should be 3:1 or 1:1. This combination retains the blood sugar-lowering effect while reducing the bitter and cold nature.
However, for diabetic patients with liver disease (including fatty liver), caution is necessary when using Huang Lian and Chai Hu (Bupleurum). The dosage should not be too large, the duration should not be too long, and liver function should be regularly monitored.
2. Huang Lian with Ginger
Those who do not understand the counteracting properties may view Huang Lian as harmful, fearing it will damage the stomach; however, those who truly understand its bitter and cold nature regard Huang Lian as a divine herb specifically for treating diabetes.
Note:
Ginger acts as a counteracting herb for Huang Lian, mitigating its bitter and cold nature while preserving its blood sugar-lowering effects. Ginger can be fresh, dried, or processed, depending on the specific situation.
The bitter and cold nature can harm the stomach, which is a common adverse effect of bitter and cold herbs, limiting their application, especially in those with a tendency towards deficiency and cold. However, the effects of these bitter and cold herbs are often irreplaceable. From my years of experience, ginger is the most effective warming herb for the stomach and the best adjunct for bitter and cold herbs, greatly expanding their indications without harming the stomach. This is the essence of the “assistant” role in TCM, and its charm lies here.
Dried ginger is a key adjunct for using bitter and cold herbs to lower blood sugar. Its warming and dispersing effects on cold are irreplaceable by other warming herbs (such as Fu Zi (Aconite), Rou Gui (Cinnamon), and Wu Zhu Yu (Evodia)). Bitter is the natural opposite of sweet, so most bitter and cold herbs can lower blood sugar, but long-term use of bitter and cold herbs can easily harm the stomach. Using dried ginger as a counteracting herb for bitter and cold resolves this issue, allowing for the use of bitter herbs even in mid to late stages of diabetes.
Fresh ginger can also be used to assist bitter and cold herbs. Its main difference from dried ginger is its stronger ability to disperse and induce sweating. Diabetic patients may fall into two categories: those with excess heat and those with Qi deficiency. For those with excess heat, fresh ginger can assist bitter and cold herbs, promoting sweating to help release heat, and the patient will not feel discomfort from sweating. However, for those with Qi deficiency, excessive sweating can harm the vital energy, so diabetic patients with Qi deficiency and excessive sweating should not use fresh ginger as a counteracting herb but should use dried ginger instead.
This article is excerpted from “Weixin Medical Collection – New TCM Theories by Tong Xiaolin,” published by Shanghai Science and Technology Press.
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