Nature: sweet, bitter, cold

Enters: Large Intestine

Actions: Purges accumulation and stagnation.

Indications:
• Excess heat in the large intestine: constipation.
• Do not cook too long (over 10 minutes) or at too high a temperature – just add to water at 95°-100° C and let it steep. Water temperatures under 75° C will not be hot enough to extract the purgative constituents of this herb. Cooking over 1 hour will completely eliminate any purgative properties.
• Doses over 10g may cause nausea, abdominal cramps, and vomiting (can be combined with Huo xiang to prevent these side effects).
• Fan xie ye’s purgative effect takes 2-6 hours.
• Sources conflict on Fan xie ye’s strength and nature:
Liu: Milder purgative than Da huang.
Li: Stronger purgative than Da huang.
BII: Probably the best-tolerated laxative.
MLT: Can cause griping – combine with a warming herb to counteract this side effect (e.g. Sheng jiang, Chen pi).
K&R: Metal yang, water yang.
• Inhibits resorption of water from the colon.
• Contraindicated with intestinal inflammation, pelvic congestion, or pregnancy.
JC: Cathartic (pods: laxative; leaflets: simple purgative), slight stimulant, antibilious, anti-periodic, tonic.
• A somewhat prompt cathartic that acts on nearly the entire intestinal tract, especially the colon. Suitable for chronic constipation. Acts locally on the intestine wall, increasing peristalsis and secretions, to produce copious yellow stools. Does not constipate afterwards.
• The leaves cause griping and flatulence (the pods do not), and the odor is nauseous to many persons. The griping and nausea may be alleviated by adding some corrective herb, such as: cloves, ginger, cinnamon, coriander, fennel, manna, etc. Often given with licorice.
• Two main varieties, Alexandrian or Nubian senna (Cassia acutifolia, C. senna, C. lenitive, C. officinalis, C. aethiopica) and East Indian or Tinnevelly senna, are used. The former is preferred by most herbalists since it is milder, but equally certain in its action.
• Should not be used when there is an inflamed condition of the GI tract.
• Shortly after administration (2-30 minutes) it may dye the urine reddish.
IBIS: Drug interactions:
• Sennosides aggravate nephropathy from analgesics associated with dehydration (DeSmet).
• Decrease in absorption of oral drugs due to decrease in bowel transit time (DeSmet).
• Aggravates loss of potassium associated with use of diuretics (DeSmet).
• Overuse or misuse can cause potassium loss leading to increased toxicity of cardiac glycosides (Wichtl, DeSmet) such as those in Adonis, Convallaria, Urginea, (Brinker, DeSmet) Helleborus, Strophanthus, and Digitalis (Brinker).

Dose: 1.5-3g for mild purgation. 5-10g for strong purgation.