Notes on This Category – Drastic Purgatives / Cathartics

These herbs powerfully eliminate pathological factors (chiefly harmful fluid) by drastically promoting bowel movement.
The effect of these herbs is generally milder when they are roasted or dry fried.
Use with great caution, especially with weak patients. The results can be quite bad.
Contraindicated in pregnancy.

Commonly combined with:
A. Herbs that clear heat and nourish Yin when Yin is damaged by excess heat.
B. Blood tonics when there is blood deficiency.
C. Herbs that promote Qi circulation.
D. Herbs that release the exterior, when there is an EPI associated.
E. Herbs that support the Zhen Qi when the patient has a weak constitution.

Ba Dou – Croton seed – “Clinging Bean”

Nature: acrid, hot, toxic

Enters: Stomach, Lung, Large Intestine

Actions: Unblocks cold accumulation and vigorously purges the bowels; drives out water and reduces edema; dispels clogged phlegm, benefits the throat; promotes healing of abscesses and ulcers.

Indications:
• Severe cold accumulation in the interior: constipation, abdominal fullness, distention, pain.
• Phlegm clogging the throat: difficult breathing, wheezing, severe fullness and distention in the chest and diaphragm.
• Phlegm misting the sensory orifices.
• Ascites.
• Topical: for abscesses that have suppurated but not yet ulcerated, to accelerate the ulcerating process. Also for severe ulcers such as phagedena.
• Bowel obstruction: The prepared herb (see below) was used in 50 cases of intestinal obstruction. The adult dosage was 150-300mg; a lower dosage was used for children. When necessary, the dosage was repeated every 3-4 hours. 40 cases were cured. When there is severe obstruction or no response to this treatment within 48 hours, immediate surgery is required.
• This herb is extremely harsh and should always be used with caution. It is said to be able to “chop through the gate and open the door.”
• When taking this herb, one should avoid drinking hot liquids, as this may severely aggravate its laxative effect.
• If the herb causes unremitting diarrhea, one should take cold rice congee or a tea made from Huang lian and Huang bai.
• The herb is mainly used in its de-fatted form, Ba dou shuang.
• The oil: Oral administration of ½ to 1 drop of the oil causes a burning sensation in the mouth, gastric mucosa, and vomiting, then multiple episodes of watery diarrhea within 30-40 minutes, together with severe abdominal pain and tenesmus, and inflammation of the oral mucosa and GI tract. External application of the oil stimulates the skin and causes redness which may progress to blisters.

Dose: 0.1-0.3g in pills

Da Ji – Euphorbia pekinesis or Knoxia valerianoides – Peking spurge root – “Big Lance from the Capital”

Nature: bitter, acrid, cold, toxic

Enters: Lung, Kidney, Large Intestine

Actions: Strongly eliminates harmful body fluid by purging the bowels; relieves swelling, dissipates nodules.

Indications:
• Retention of harmful fluid: relatively moderate accumulation of fluid in the chest and flanks with such symptoms as labored breathing, dull pain in the lateral aspect of the chest, expectoration of thick sputum, a thick, greasy tongue coat; ascites, hydrothorax, edema.
• Phlegm and fire: lumps.
• Heat and toxicity: carbuncles and boils, red, swollen, painful, toxic, sores. Also used topically for sores and scrofula.
• Acute or chronic nephritis.
• Ascites due to schistosomiasis.
• Milder than Gan Sui.
• Cooking it with honey and Da zao reduces its harsh properties.
• Frying it in vinegar reduces its toxicity.
• Traditionally forbidden in combination with Gan cao. Recent animal studies have shown that a mixture of the two herbs has a much lower LD50 (i.e much higher toxicity) than Da ji alone.
MLT: Very similar to Gan sui. The two are often combined.

Dose: 1.5-3g (1g in powders)

Gan Sui – Euphorbia kansui root – “Sweet Process”

Nature: sweet, bitter, cold, toxic

Enters: Lung, Kidney, Large Intestine

Actions: Violently purges the bowels to strongly eliminate harmful body fluid; clears heat; reduces swelling.

Indications:
• Retention of harmful body fluid: severe accumulation of fluid in the chest and abdomen – ascites, hydrothorax; also for generalized edema, facial edema, abdominal distention. May be combined with Zhu ling to simultaneously promote urination.
• Internal wind and phlegm: epilepsy (uncommon use).
• Topical: for swollen, painful, nodular skin lesions due to damp-heat. This herb is most appropriately used during early stages of this disorder. Herbs that clear heat and eliminate toxicity should be given orally simultaneously.
• Within 30 minutes following administration, borborygmus and cramps will begin.
• The use of this herb is generally limited to robust patients with severe patterns of excess.
• May be given in alternation with Ren shen to avoid causing depletion.
• Frying in vinegar reduces its purgative function.
• Roasting it reduces its tendency to cause vomiting.
• Rarely used in decoctions. The active ingredients may not be water soluble.
• Traditionally forbidden in combination with Gan cao. Animal studies have not produced any conclusive data on this combination.
MLT: The juice can be used topically as a counterirritant to clear warts and other skin nodules.

Dose: 0.3-1g taken directly as power or in pill form

Qian Niu Zi – Morning Glory seed – Pharbitis (Ipomoea) – “Cowherd Seeds”

Nature: acrid, bitter, cold, toxic

Enters: Lung, Kidney, Large Intestine, Small Intestine

Actions: Drives out harmful fluid by promoting bowel movement and urination; dispels accumulation; expels phlegm and fluids; expels intestinal parasites, reduces food stagnation.

Indications:
• Heat accumulation in the stomach or intestines: severe constipation, abdominal distention, urinary difficulty, leg edema.
• Damp-heat accumulation in the stomach and intestines: constipation. (Lower dosage for this indication than the previous indications.)
• Fluid congestion obstructing the Lungs: cough, wheezing, fullness in the chest and abdomen.
• Roundworm or tapeworm infestation.
• Food stagnation.
• Dry-fry the herb for a milder effect.
• Contains d-lysergic acid amide, similar hallucinogenic effect to LSD in large doses.
MLT: Mildest herb in this category.

Dose: 4.5-9g (or 1.5-3g alone as powder)

Shang Lu – Poke root – Phytolacca – “Commerce Continent”

Nature: bitter, cold, toxic

Enters: Lung, Kidney, Large Intestine, Bladder, Spleen

Actions: Eliminates harmful fluid by promoting bowel movement and urination; relieves swelling, reduces sores and carbuncles.

Indications:
• Retention of harmful body fluid: edema, scanty urination, urinary difficulty, constipation.
• Heat and toxicity: carbuncles, sores. Also used topically.
• For skin lesions, it is ground up and applied as a paste with petroleum jelly, honey, or egg white.
• When used internally, it is generally stir-fried with vinegar, which reduces its toxicity.
• The root must be dried, aged more than 3 months, and cooked long to neutralize its toxic elements.
• The traditional antidote for poisoning from the herb (particularly from the berries) is fresh Gan cao and Lu dou (Mung bean).
JC: Powerful alterative, relaxant, cathartic, emetic, resolvent, deobstruent, detergent, anti-syphilitic, antiscorbutic, nutritive.
• Cancer, skin problems, hardened liver, scanty flow of bile, hard, swollen, or enlarged glands (especially the thyroid, spleen, lymph, breast), abnormal growths, bony enlargements from direct injury, rheumatism, dyspepsia, inflamed kidneys.
• Slow but persistently powerful action.
MW: For the stagnant person: lazy, flabby, tired, flops down after work, apathetic (especially teenagers), lack of personal delicacy, disregard of surrounding objects, indifferent to life, “For the person who eats, sleeps, and shits in the same place.” (A few drops of the tincture)
• Has definitely cured cancer. As a cancer preventative, boil it twice.
• For stagnant Qi, blood, and fluid.
NAH: Powerfully stimulates the lymphatic system: tonsilitis, swollen glands, mastitis (poultice).
IBIS: (fresh root, berries)
• Affinities: skin; glandular structures of the buccal cavity, throat, and sexual system; mammary glands; fibrous and serous tissues and mucous membranes of the digestive and urinary tracts; heart; spinal cord; bowels (Felter and Lloyd, p. 1473).
• Alterative, antirheumatic, anticatarrhal, cathartic, emetic, fungicide, narcotic, parasiticide.
• [Western] dosage: tincture of fresh root: 0.2 – 1 mL. tincture of berries: 0.2 – 1 mL. dry powder: 60 – 300 mg.
• Appearance: tongue hurts upon protrusion (Wood).
• Pulse: dull stroke with tremulous or vibratile wave (Scudder, 1903, p. 154).
• Specific indications: pallid mucous tissues with ulceration; sore mouth with small blisters on tongue and mucous membranes of cheeks; sore lips; hard, painful, enlarged glands; mastitis; orchitis; parotitis; aphthae; soreness of mammary glands, with impaired respiration; faucial, tonsillar, or pharyngeal ulceration; pallid, sore throat, with cough or respiratory difficulty (Felter and Lloyd, p. 1475).
• Internal: acute inflammations of the throat; adenitis; acute inflammations of the breast; children’s glandular and skin disorders; sciatic rheumatism; syphilitic disorders with ulceration; long-standing ulcers in psoriasis, dermal abscesses, fissures, boils, and carbuncles (Ellingwood, p. 375); chronic rheumatism; chronic respiratory catarrh; tonsillitis; laryngitis; mastitis (British Herbal Pharmacopoeia p. 157).
• External: as ointment in scabies, tinea, sycosis, acne; as poultice in abscess, mastitis (British Herbal Pharmacopoeia p. 157).
• Contraindicated in pregnancy.
• Laboratory test results: agglutination of red and white blood cells is promoted by pokeweed mitogen (Tedeschi, Eckart and Tedeschi, p. 1524); pokeweed mitogen has been found to stimulate both B and T lymphocytes (Kinghorn, p. 84-90; Von Oettingen, p. 500)

Dose: 3-9g

Yuan Hua – Genkwa flower – Daphne genkwa

Nature: bitter, acrid, warm, toxic

Enters: Lung, Kidney, Large Intestine

Actions: Eliminates phlegm, stops coughing; strongly eliminates harmful body fluid by purging the bowels and promoting urination; kills fungus (topically).

Indications:
• Premier herb for fluid retention in the chest. In China, 500-1000mg capsules are given 2-3 times daily.
• Retention of harmful fluid: congested fluid in the chest, abdomen, or flanks, edema, ascites, hydrothorax.
• Lung cold and phlegm: cough. Shown to be 91% effective for chronic bronchitis.
• Topical: fungal infection, including ringworm.
• Traditionally forbidden in combination with Gan cao. Recent research suggests that there is in fact an increase in toxicity when these two herbs are combined.
• Fry with vinegar to reduce its toxicity.

Dose: 1.5-3g (generally in powder)