Huang Lian (Coptis)
is the dried rhizome of the plants Coptis chinensis Franch, Coptis deltoidea C. Y. Cheng et Hsiao, or Coptis teeta Wall. Its main component is berberine-type alkaloids[1].
Illustration of Huang Lian plant
Huang Lian has been used in China for thousands of years. It was first recorded in the “Shennong Bencao Jing” (Shennong’s Classic of Materia Medica) and classified as a superior herb. It is cold in nature and bitter in taste, entering the Heart, Liver, Spleen, Stomach, Gallbladder, and Large Intestine meridians. As an important herb for clearing heat and drying dampness, it is often processed and prepared for different clinical conditions. In ancient times, there were as many as 21 methods for processing Huang Lian, and in modern times, there are still 7 methods including dry frying, soil frying, charcoal frying, salt processing, wine processing, yam processing, and bile processing. Since 2005, the “Chinese Pharmacopoeia” has only included four processed forms: Huang Lian, Jiu Huang Lian (Wine-processed Huang Lian), Jiang Huang Lian (Ginger-processed Huang Lian), and Yu Huang Lian (Evodia-processed Huang Lian), with different processing methods leading to variations in efficacy and clinical applications[2].
How should we choose among the four different processed forms of Huang Lian?
(1) Sheng Huang Lian (Raw Huang Lian)
Take the raw Huang Lian, peel it, rinse it with clean water, and after 1 to 2 hours, rinse it again. Cover it with plastic wrap and let it moisten for 6 to 7 hours in winter and spring, or 2 to 3 hours in summer and autumn. Then cut it into thin slices of about 0.1 cm and dry it. When used, crush it. (Note: When prescribing, if the doctor writes “Huang Lian,” only “Sheng Huang Lian” can be dispensed.) Sheng Huang Lian is effective for clearing damp-heat in the middle jiao and is suitable for conditions such as vomiting, diarrhea, dysentery, carbuncles, and sores in the mouth and tongue caused by damp-heat in the stomach and intestines. For example, the “Zhengzong” Huang Lian Jie Du Tang and the Bai Tou Weng Tang for treating heat dysentery in the “Shang Han Lun”.
Huang Lian slices
(2) Jiang Huang Lian (Ginger-processed Huang Lian)
Mix 100 kg of Huang Lian with 12.5 kg of fresh ginger juice, spray it evenly onto the Huang Lian slices, and after absorption, stir-fry it over low heat until the surface turns deep yellow, then cool it. Jiang Huang Lian is effective for clearing heat and harmonizing the stomach to stop vomiting, particularly for chest tightness and abdominal fullness due to damp-heat obstruction. It is often used in combination with Wu Zhu Yu (Evodia rutaecarpa), Yi Yi Ren (Job’s tears), Bai Dou Kou (White cardamom), Xing Ren (Apricot kernel), Cang Zhu (Atractylodes), Huang Bai (Phellodendron), Hai Piao Xiao (Cuttlefish bone), etc. For example, in the “Hui Chun” Huang Lian Zhu Ru Tang.
(3) Jiu Huang Lian (Wine-processed Huang Lian)
Mix 100 kg of Huang Lian with 12.5 kg of yellow wine, stir well, let it sit for a while, and then stir-fry until the surface turns deep yellow, then cool it. Jiu Huang Lian is effective for clearing and draining excess heat from the upper jiao, particularly for symptoms of irritability and insomnia due to excessive heart fire, sores in the mouth and tongue, and liver fire causing red, swollen eyes. It is often used in combination with Huang Qin (Scutellaria baicalensis), Sheng Di (Rehmannia), Sheng Gan Cao (Raw licorice), Dan Zhu Ye (Lophatherum), Mu Tong (Akebia), Long Dan Cao (Gentiana), Bai Jiang Cao (Patrinia), Pu Gong Ying (Dandelion), and Zhi Zi (Gardenia). For example, in the “Zhun Sheng” Huang Lian Tian Hua Fen Wan.
Jiu Huang Lian
(4) Yu Huang Lian (Evodia-processed Huang Lian)
Mix 100 kg of Huang Lian with 10 kg of Wu Zhu Yu, boil the Wu Zhu Yu with an appropriate amount of water, mix the decoction with Huang Lian, and stir-fry until the decoction is fully absorbed and dry. Yu Huang Lian is effective for soothing the liver and harmonizing the stomach to stop vomiting, particularly for conditions of liver-stomach disharmony and vomiting with sour regurgitation due to excessive stomach heat. For example, in the “Ju Fang” Da Xiang Lian Wan for treating accumulation and obstruction, chest fullness, and dysentery with pus and blood.
Research has shown that the factors affecting the content of berberine and total alkaloids in processed Huang Lian include the amount of auxiliary decoction, frying temperature, frying time, and absorption time[3]. Studies have indicated that regardless of the processing method chosen, no new components are produced after processing Huang Lian[4], thus not altering its pharmacological effects. The active components in each processed form remain the alkaloids, while the auxiliary materials serve as drug carriers, guiding the herbs to their respective meridians and reducing toxicity by mitigating their bitter and cold nature. Huang Lian is bitter and cold, entering the Heart, Liver, Gallbladder, Stomach, and Large Intestine meridians, with effects of clearing heat, detoxifying, and drying dampness. It is clinically used for damp-heat fullness, vomiting with sour regurgitation, diarrhea, jaundice, high fever with delirium, excessive heart fire, irritability and insomnia, blood heat causing vomiting and nosebleeds, red eyes, toothache, and clearing abscesses and sores. Pharmacological studies on Huang Lian have shown that it has anti-ulcer, gastric acid secretion inhibition, anti-inflammatory analgesic, antibacterial, and liver-protective effects. Recent studies on processed Huang Lian have demonstrated that it not only retains certain antibacterial activity but also enhances its inhibitory effect on Pseudomonas aeruginosa, with Jiang Huang Lian showing superior inhibition compared to other processed forms.
Huang Lian has a rich flavor, capable of ascending and descending, embodying both yin and yang, and enters the Shaoyin meridian. Its uses are sixfold: (1) to clear heart fire, (2) to eliminate damp-heat in the middle jiao, (3) essential for various sores, (4) to treat wind-dampness, (5) to address red eyes and eruptions, and (6) to stop bleeding in the middle jiao. Zhang Zhongjing used it in nine types of heart fullness and in the five types of Xie Xin Tang; Zhu Danxi’s Zuo Jin Wan states, “Zuo Jin is made from wood on the left to control its metal,” as the heart is the son of the liver. In reality, it drains the son, thus Huang Lian’s bitter cold clears the heart and drains the liver, preventing fire from overcoming metal, allowing metal to control wood, thus balancing fire and lowering it; Wu Zhu Yu, being warm and pungent, can reach the Jueyin, guiding heat downward, assisting Huang Lian in descending and alleviating vomiting, while also counteracting Huang Lian’s bitter cold nature that harms the stomach, thus achieving harmony between the liver and stomach. Moreover, in Zuo Jin Wan, Wu Zhu Yu and Huang Lian complement each other, one being the main herb and the other an assistant, one hot and one cold, working in opposition to achieve both descending and harmonizing effects while clearing fire and regulating qi to disperse stagnation[5].
In clinical practice, the selection of Huang Lian should vary according to the differentiation of syndromes, as only by choosing correctly can the efficacy of Huang Lian be fully realized to achieve therapeutic goals.
References: [1] Xiao Yingying, Zhang Yi. Research progress on methods for evaluating the ability of traditional Chinese medicine to penetrate the blood-brain barrier. Chinese Journal of Pharmacology and Clinical Medicine, 2007, 23(5): 255-257. [2] Yuan Sitong. Study of medicinal Chinese herbal slices. Beijing: People’s Health Publishing House, 2001: 95. [3] Li Chengzu. Current issues and countermeasures in the traditional Chinese medicine processing industry. Guangming Traditional Chinese Medicine, 2012(3): 597-598. [4] National Pharmacopoeia Committee. Chinese Pharmacopoeia. Part One. Beijing: Chemical Industry Press, 2010: 286. [5] Zhu Li, Xu Peiying. Research progress on the processing of traditional Chinese medicine. Journal of Heze Medical College, 2011($): 67-69.
Contributed by: Li Fei (Supervisor: Deng Min)
Editor: Office Promotion Review: Xiong Ba, Zeng Rong
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