Notes on this Category

Herbs in this category are commonly combined with:
A. Herbs that strengthen the spleen and stomach, when there is deficiency of these organs.
B. Herbs that nourish Yin, when there is injury of body fluids by heat or the patient has pre-existing Yin deficiency.
C. Herbs that clear heat and cool the blood, when there is heat and toxicity in the blood.
D. Herbs that dry or drain dampness when there is associated dampness.

Bai Hua She She Cao – Hedyotis = Oldenlandia – “White-Patterned Snake’s Tongue Herb”

Nature: sweet, slightly bitter, cold

Enters: Stomach, Small Intestine, Large Intestine, Liver

Actions: Drains dampness, promotes urination; clears heat; eliminates toxicity; relieves stagnation of heat and toxicity; reduces abscesses.

Indications:
• Lower Jiao damp-heat: hot, painful urination. Also for damp-heat jaundice.
• Heat and toxicity: acne, carbuncles, boils, swollen, painful throat, intestinal abscess, appendicitis, sores, ulcerations, snake bite, ulcerative colitis. Used internally and topically.
• Cancer: stomach, esophagus, rectum (take 60g daily, long term, while monitoring digestion for cold damage). Usually combined with other herbs, such as Ban zhi lian.
• Strongly relieves fire-toxicity.

Dose: 15-60g

Bai Jiang Cao – Patrinia or Sonchus or Thlaspi

Nature: acrid, bitter, slightly cold

Enters: Stomach, Large Intestine, Liver

Actions: Clears heat; eliminates toxicity; relieves stagnation of heat and toxicity; drains pus; dispels blood stasis, relieves pain; calms the Shen.

Indications:
• Heat and toxicity: carbuncles, abscesses in organs, surface sores and swellings. Used internally and/or topically.
• Blood stasis (especially heat-induced): pain, especially in the chest and abdomen. Also for postpartum and postoperative pain.
• Prostatitis – drains pus out of the prostate.

• Shen disturbance with heat: anxiety and insomnia.
• Mumps: one study of over 200 cases showed Bai jiang cao to effectively treat mumps (used with Shi gao, internally plus applied topically as a paste), providing relief to 90% of cases within 24 hours.
MLT: Specific for colitis/intestinal heat. Anti-inflammatory.
Hsu: Antibacterial; protects the liver: stimulates regeneration of liver cells, prevents denaturalization.

Dose: 9-15g (to 30g)

Bai Lian – Ampelopsis

Nature: bitter, acrid, slightly cold

Enters: Heart, Stomach, Liver

Actions: Promotes tissue regeneration, heals wounds; clears heat; eliminates toxicity.

Indications:
Heat and toxicity: carbuncles, boils, burns
Topical: for wounds. Also works cosmetically on wrinkles – temporarily tightens the skin.

Dose: 5-10g

Bai Tou Weng – Pulsatilla root – Chinese Anemone – “White-Headed Old Man”

Nature: bitter, cold

Enter: Large Intestine, Liver, Stomach

Actions: Cools the blood; clears heat; eliminates toxicity.

Indications:
• Key herb for dysentery (bacterial or amebic) due to damp-heat or heat-toxicity: fever, abdominal pain, loose stools with pus and blood, tenesmus. Can be used alone for this.
• Effective in treating scrofula after it has ulcerated and when healing is slow.
Hsu: Anti-trichomonas; antiamebic; cardiotonic effects, dilates peripheral vessels.
K&R: (P. vulgaris – Pasque flower) Antispasmodic, emmenagogue, sedative, estrogen antagonist, sympatholytic. Wood excess.
• One of the best plants to drain repletion of Liver Yang, the whole plant is used to treat symptoms of Liver fire, hyperthyroid symptoms, tachycardia, neuralgia, migraines, bronchial spasms of pertussis, allergic rhinitis and asthma, spasms of colonopathy on the right side, colitis, dysmenorrhea, liver congestion, symptoms of depression with the sudden mood swings of menopause, pain in the pelvic and genital area, pelvic congestion, hysteria, phobias, anguish.
• Also has diaphoretic and diuretic properties.
• All parts of the fresh plant are dangerous, causing nausea, vomiting, diarrhea, intestinal spasms, skin inflammation, and asphyxiation.
RW: (P. vulgaris) Take internally for inner eye conditions: iritis, scleritis, disease of the retina, and above all, grey or senile cataract and glaucoma. (More effectiveness in glaucoma than cataract.)
IBIS: Affinities: female reproductive tract.
• Sedative, analgesic, antispasmodic, antibacterial.
[Western] dosage: tincture: 0.1 – 10 gtt. t.i.d.; up to 60 gtt. t.i.d. (Hoffman).
• Therapy: toothache, insomnia, headache, depression/irritability, nervous conditions; dysmenorrhea, amenorrhea, leukorrhea, spasm in reproductive system; skin infections, respiratory tract infections, asthma.
• Contraindicated for use in pregnancy; uterine stimulant and gastrointestinal irritant (De Smet, Farnsworth).
• Contraindicated for nursing mothers because of its gastrointestinal irritant effect (Brinker, Brooks).

Dose: 6-15g

Bai Xian Pi – Dictamnus root bark – Chinese dittany – “White Fresh Bark”

Nature: bitter, cold

Enters: Spleen, Stomach

Actions: Dries dampness; eases itching; clears heat; eliminates toxicity; expels wind.

Indications:
• Damp-heat: carbuncles, eczema with copious yellow discharge or pus and itching. Also for wind-heat skin conditions.
• Damp-heat: jaundice or Bi syndrome (used in combination with other herbs).
MLT: For fungal diseases associated with itching, especially effective when combined with Ku shen.
Hsu: Antipyretic, antifungal.

Dose: 6-9g

Ban Bian Lian – Chinese Lobelia – “Half-Edged Lily”

Nature: acrid, cold

Enters: Heart, Small Intestine, Lung

Actions: Helps the Lungs descend fluids to the bladder, promotes urination, relieves edema; disperses the Lungs; clears heat; eliminates toxicity; cools the blood.

Indications:
• Heat and toxicity, poisons and venoms: snake bite, bee or wasp sting; also for swelling and pain from furuncles; fire toxin patterns including tonsilitis. Herb of choice for bites and stings – may be used internally or topically.
• Retention of harmful fluid: edema (often floating edema), ascites, mid- or end-stage schistosomiasis.
• Bensky/Gamble classifies with herbs that drain dampness.
• Not to be confused with the North American herb Lobelia inflata.
MLT: Cancer: anti-neoplastic properties.
Hsu: Diuretic, hypotensive, hemostatic.

Dose: 15-30g

Ban Lan Gen – Isatis root or Baphicacanthus

Nature: bitter, cold

Enters: Heart, Lung, Stomach

Actions: Clears heat; eliminates toxicity; cools the blood; benefits the throat; strongly relieves swelling and disperses stagnation.

Indications:
• Warm febrile diseases, warm epidemic disorders.
• Swelling: painful, swollen, sore throat, mumps.
• Damp-heat: jaundice.
• Very broad spectrum and powerful antiviral and antimicrobial effects.
• Viral infections: quite effective for encephalitis B, hepatitis A, B and C, EPI’s.
MLT: Ban lan gen and Da qing ye are the most powerful anti-viral herbs in all of herbal medicine.
• Good for skin blotches from heat in the blood.
• Agent Orange disease.
• Similar to Western Baptisia tinctoria (Wild Indigo).
SD: May help antidote lead poisoning.
DY: With Shan dou gen for mutual reinforcement, to clear heat, eliminate toxicity, and strongly disinhibit the throat. For such indications as:
– 1. Painful, red, and swollen throat due to replete heat. This combination is usually sufficient to treat severe throat inflammations (including strep throat, tonsillitis, pharyngitis, laryngitis, etc.) due to heat-toxins or replete heat. However, when this combination needs further reinforcement, add She gan, Jin yin hua, Lian qiao, Xuan shen, and Gan cao.
– 2. Toothache and painful, swollen gums due to replete heat.
– 3. Oral ulcers due to replete heat.
• With Xuan shen to clear heat, resolve toxins, cool the blood, nourish Yin, downbear fire, disinhibit the throat, disperse swelling, and stop pain. For painful, red, swollen throat with dry, red tongue, and a fine, rapid pulse due to Yin deficiency generating a deficiency fire or replete fire which damages Yin. For heat-toxins, add Shan dou gen and Gan cao. For deficiency fire, add Mai men dong and Sheng di huang.

Dose: 15-30g

Ban Zhi Lian – Scutellaria barbata – Barbat Skullcap – Bearded Scute – “Half-Branch Lotus”

Nature: acrid, cold

Enters: Lung, Large Intestine, Small Intestine, Liver, Stomach

Actions: Promotes urination to relieve edema; clears heat; eliminates toxicity; invigorates the blood, promotes movement and disperses in the course of clearing.

Indications:
• Cancer (heat and toxicity): Lung, stomach, intestines. (One study seemed to indicate that this herb alone is not a cure.)
• Heat and toxicity: carbuncles, snake bite, abscesses, furuncles, sores, trauma.
• Retention of harmful fluid: ascites.
• Chronic hepatitis.

Dose: 15-60g

Chuan Xin Lian – Andrographis – Green Chiretta – Kariyat – “Thread-the-Heart Lotus”

Nature: bitter, cold

Enters: Small Intestine, Large Intestine, Lung, Stomach

Actions: Dries dampness; clears heat; eliminates toxicity.

Indications:
• Damp-heat: dysentery, painful urination, eczema.
• Early stage warm-heat pathogenic invasion: fever, swollen, painful throat, headache.
• Lung heat: cough
• Lung heat and toxicity: abscess.
• Fire-toxin manifestations on the skin: sores, carbuncles.
• Topical: for eczema, snake bite (used fresh for snake bite). Often used in ointment for eczema.
• May be useful for prostate enlargement.
• Upregulates TH1 immunity (i.e., Wei Qi) – useful in acute infection.
• Recent use for loptospirosis.
• For common cold, one study indicated that 3-6g a day shortened duration of infection and mitigated symptoms.
Chuan xin lian can be used as an inexpensive substitute for Huang lian (in some cases).
• Exceedingly, overwhelmingly bitter. Can injure stomach Qi. Over 15g can cause nausea and/or vomiting. When taking it directly as a powder, it is often encapsulated.
PPP: Stimulates the immune system, especially phagocytic activity; stimulates bile production and flow; protects the liver from toxins; counters the damaging effects of free radicals; antiinflammatory; antiplatelet; abortifacient [contraindicated in pregnancy, though Chinese sources do not corroborate this].
• Used in Ayurveda for bitter tonic, stomachic, antipyretic, and laxative properties. Said to increase appetite, strengthen digestion, and diminish flatulence, hyperacidity and biliousness [probably in very small doses].
• Traditional uses include: loss of appetite, atonic dyspepsia, flatulence, diarrhea, dysentery, gastroenteritis, bowel complaints of children, liver infections, diabetes, general debility and convalescence after fevers, respiratory and skin infections.
• Indications supported by clinical trials: bacterial and viral infections including the common cold and pharyngotonsilitis, enteric infections; for prevention of urinary tract infections following shock wave lithotripsy, prophylaxis of common cold.

Examine.com:

Andrographis paniculata (King of Bitters) is an Ayurvedic herb traditionally used for anti-cancer and liver protective effects, and is a Traditional Chinese Medicine for the common cold. Unlike many herbs, most of the bioactivities of Andrographis paniculata can be traced back to a single diterpene molecule known as Andrographolide.

First and foremost, it does appear to be effective for the common cold when taken for 3-5 days after the symptoms first arise. There is surprisingly little evidence for the herb per se (two studies in humans) while much more research tends to use combination therapy of Andrographis paniculata and Siberian Ginseng (Eleutherococcus senticoccus). This combination therapy has been used in traditional medicine and called Kan Jang, and consists of most of the research.

In regards to cancer, Andrographis paniculata appears to have anti-proliferative effects that occur at low concentrations in vitro (not too far off from what is observed following oral ingestion) and limited animal models suggest that anti-proliferative effects of Andrographolide (the bioactive) are relevant following oral ingestion. It does not seem to be too potent in actually inducing apoptosis of cancer cells in animals however, and seems to be more related to merely preventing proliferation.

Safety wise, it appears to be safe acutely and no significant side-effects are noted with consumption of Andrographis paniculata either in isolation or via Kan Jang tablets when taken in a rehabilitative manner for 3-5 days. For prolonged and high dose usage, there is mixed evidence in regards to the testicles (some studies suggesting toxicity, some other studies using the same methods failing to note toxicity; reasons for the difference unknown) and the liver (although most studies not it is highly hepatoprotective, one study in humans noted an elevation of liver enzymes after 60 days that started to normalize when stopping the supplement; reason for this also unknown).

Overall, although there is a lot of promise associated with Andrographolide in general for a wide variety of purposes it is currently seen as effective for acute usage to alleviate symptoms of the common cold or flu.

When looking at the basic root extract (not concentrated in any way), the oral dose of Andrographis paniculata is in the range of 2,000-6,000 mg. The root extract tends to have an andrographolide content in the 1-2%, range with up to 4% having been reported.

When looking at extracts, 200 mg appears to be effective if the andrographolide content is around 30% or so.

In looking at the variability of how much Andrographolide can actually exist in the plant, I would think standardization of this plant (ie. Andrographis Paniculata standardized to 5% Andrographolide) is pretty important; otherwise the effects could be unreliable.

Also, enhancing absorption of Andrographolide via P-glycoprotein inhibition shouldn’t be needed at low oral doses; it only becomes needed when taking high doses.

1. Sources and Composition

 

1.1. Sources

Andrographis Paniculata (of the family Acanthaceae) is a herb with traditional usage for fighting off colds and infection (usually in Chinese medicine[6])[7][8] although antibacterial, antifungal, antiviral, choleretic, hypoglycemic, hypocholesterolemic, and Adaptogen-like effects have been reported as well as being a gastric (stomach) and hepatic (liver) tonic.[9] The usage of Andrographis Paniculata as a liver tonic is seen more in Ayurveda than it is in Traditional Chinese medicine[6] and is used as an anti-neoplastic agent in Ayuredic medicine.[10][6]

It also goes by the names Chiretta (or Chirayetah in Urdu), King of Bitters (as a testament to its bitter properties in Traditional medicine as well as taste), and Kalmegh (Hindi);[8][9] in english it is referred to as Creat[9] and in Traditional Chinese Medicine it is referred to as Chuanxinlian, Yijianxi or Lanhelian.[9] It is a component of a Chinese medication known as Xiang-Qi-Tang alongside Astragalus membranaceus and Cyperus rotundus.[11]

Although all parts of the plant have traditionally been reported at times, the leaves are the most common medicinal part of this plant.[9]

Has usage in traditional medicine for both being a liver tonic and anti-cancer agent (Ayurvedic medicine) and is most popular for its usage in Traditional Chinese Medicine for reducing the severity and length of cold/flu symptoms

 

1.2. Composition

Andrographis Paniculata tends to contain in the leaves:

  • Andrographolide at (commonly seen as the main bioactive[12][8] at 24.72-43.16mg/g in the flowers[13] but 0.81-1.86% (81-186mg/g) overall[14]) with up to 4% being reported.[12]
  • Isoandrographolide, Bisandrographolide A[15] and Neoandrographolide (16.65+/-4.48 mg/g in the cotyledons[13])
  • 14-deoxy-11,12-didehydroandrographolide
  • 14-deoxyandrographolide at 10.67-24.54mg/g (1-2.5%)[13] with highest content in young leaves[13]
  • Andrograpanin[12]
  • Skullcapflavone I
  • 7-O-Methylwogonin[12]
  • Various methoxyflavones[16][17][18][19]
  • 3,4-Dicaffeoylquinic acid[12]
  • Onysilin[12]
  • ?-sitosterol, stigmasterol, and ergosterol peroxide[18]

Despite the above quantification of Diterpenoids (Andrographolide and related names), products derived from the herbs tend to have variable quantities (market assessment of products);[20] and one review[12] noting that the Andrographolide content in the leaves can vary from between 0.5% and 6% dry weight.[20][21][22]

The Andrographolide class of nutrients are the active ingredients, and in the plants themselves they have large variability

 

2. Molecular Targets

 

2.1. TRPs

TRPV4 is a calcium channel that, upon activation, increases intracellular calcium and has been implicated in osmoregulation, nociception, regulation of vascular tone, and heat sensation[23] with some possible roles in heat regulation[24] and usually the pharmacological goal is to antagonize the channel.[23]

Bisandrographolide A has been noted to be an agonist of the TRPV4 receptor with an EC50 of 790-950nM without having any affinity for TRPV1-3; Andrographolide per se was inactive on any receptor.[15]

One of the secondary bioactives is a potent and highly selective TRPV4 receptor activator

 

3. Pharmacology

 

3.1. Absorption

In an oral bioavailability in rats using 20mg/kg of Andrographolide Paniculata (1mg/kg Andrographolide) it was noted that serum Andrographolide has a bioavailability of 91% at this dose, with ten-fold the dose (10mg/kg Andrographolide) having a bioavailability of 21.4%[25] and one study using 120mg/kg Andrographolide noting a poor absorption rate of 2.67%.[26]

The decreasing bioavailability with higher doses appears to be related to excessive P-Glycoprotein efflux, and incubation with Vermapril can increase its absorption and accumulation into cells.[26]

Appears to have great absorption at low doses (1mg/kg in rats, equivalent of 0.16mg/kg in humans or about 11mg for a 150lb human) with progressively reduced absorption at higher doses; this may underlie its apparently high toxicity threshold (large safety buffer)

 

3.2. Serum

In rats fed 20mg/kg Andrographolide Paniculata (1mg/kg Andrographolide) it was noted that Andrographolide had a Cmax of 1.273mcg/mL at a Tmax of 2.41 hours with an AUC of 7.09mcg/h/mL and a half-life of 2.4 hours.[25]

In rats fed 200mg/kg Andrographolide Paniculata (10mg/kg Andrographolide) it was noted that Andrographolide had a Cmax of 3mcg/mL at a Tmax of 1.67 hours with an AUC of 15.07mcg/h/mL and a half-life of 2.9 hours.[25]

In humans using Kan Jang capsules (combination Andrographolide and Acanthapanax senticocus) totalling 17mg Andrographolide, oral consumption resulted in a serum concentration of 141.7+/-20ng/mL with an approximately Tmax of 1.36 hours and a half-life of about 25 minutes, with no detectable Andrographolide detectable in the blood 8 hours after oral administration (some persons having no serum levels after 4 hours).[25] The authors the hypothesized what the steady state value would be following traditional usage (this dose, taken thrice a day) and calculated 660ng/mL; human values obtained in this study were predicted well with rat parameters obtained earlier, suggest they are similar.[25] One other study in healthy male volunteers noted a Tmax at 1.6 hours with a Cmax of 58.62ng/mL following oral ingestion of 200mg isolated Andrographolide.[27]

 

3.3. Metabolism

Following ingestion of Andrographolide, sulfated metabolites are found in the urine[28] and in particular 14-deoxy-12(R)-sulfoandrographolide[29] whcih appears to be structurally identical to an anti-inflammatory drug marketing in China under the name Lianbizhi.[30]|published=1981 Aug|authors=Meng ZM|journal=Yao Xue Xue Bao][26]

 

3.4. Distribution

Andrographolide has been noted to bind to bovine serum albumin (BSA) with an association constant of 2.59 and 5.52 binding sites and maximal binding of 79.2%.[25] 64% of Andrographolide is thought to bind to Bovine Serum Albumin at physiological concentrations, and 55% to human serum albumin.[25]

Andrographolide has been noted to distribute into tissues of persons consuming it with variability, with this study noting that it was fairly rapid tissue accumulation after absorption in 25% of the sample (n=4) with accumulation occurring after 1.5-3 hours in the rest of the sample.[25]

 

3.5. Excretion

It appears that minimal Andrographolide per se is excreted in the urine (rats), with 8.2% of the oral dose beinge excreted in the urine within 72 hours (8.75% overall) and having an elimination rate of 0.128 hours-1 and renal clearance of -0.028 ml/min.[25] The authors suspected with metabolic transformation or fecal excretion accounted for the majority.[25]

 

3.6. Phase I Enzyme Interactions

An ethanolic extract of andrographis paniculata appears to have mixed type inhibitory potential against CYP2C19 with a IC50 of 91.7?g/mL.[31] The methanolic and hexane extracts were weak inhibitors (IC50 values of 123.3?g/mL and 107.1?g/mL; respectively), the water extract showed no inhibitory potential, and andrographolide itself was very ineffective (IC50 greater than 1426.7?M).[31]

 

3.7. Phase II Enzyme Interactions

Andrographus paniculata (95% ethanolic extract) appears to exert relatively potent inhibitory effects against various enzymes of drug metabolism including UGT1A1 (IC50 of 5?g/mL), UGT1A3 (1.7?g/mL), UGT1A6 (5.66?g/mL), UGT1A7 (9.88?g/mL), UGT1A8 (2.57?g/mL), UGT1A10 (15.66?g/mL), UGT2B7 (2.82?g/mL) although the inhibitory effects on UGT1B15 were greater than 50?g/mL.[32]

 

4. Neurology

 

4.1. Neuroinflammation

0.78mg/kg of Andrographis Paniculata in mice for a week prior to LPS injections (pro-inflammatory stimuli) noted that CXCL2 (aka. MIP2) mRNA was significantly suppressed relative to LPS control; 1.52-3.12mg/kg were less effective, but as effective as the active control of 50mg/kg pyrrolidine dithiocarbamate.[33] This study also noted no significant influence of MIP2 mRNA in the liver of the same mice, suggesting a localized effect.[33] MIP-2 is involved in neutrophil accumulation[34] and when active in the brain have been noted to increase blood-brain barrier permeability to immune cells to facilitate recruitment.[35]

 

5. Cardiovascular Health

 

5.1. Cardiac Tissue

Incubation of cardiac muscle with 5-320uM of 14-deoxy-11,12-didehydroandrographolide (DDS) has been noted to cause a concentration-dependent reduction in the rate of atrail beating (heart rate).[36]

 

5.2. Blood pressure

14-deoxy-11,12-didehydroandrographolide (DDS) appears to cause dose-dependent reductions in blood pressure[37][36] (which has led to it’s quantity being restriced in some supplements to avoid possible hypotension[8]). DDS is more effective at reducing blood pressure than andrographolide and neoandrographolide in vivo[37] and appears to have an ED50 value of 3.43mmol/kg (in anaesthetised rats).[36]

The reduction in blood pressure appears to be mediated via adrenoreceptors, and is thought to act as a beta-blocker (antagonist of the beta-adrenoreceptors) as captopril and propanolol both attenuated the effects with the latter nearly abolishing it.[36]

 

5.3. Platelet

Andrographolide is able to concentration-dependently (25-100uM) cause apoptosis of platelets via a mitochondrial dependent pathway, which was inhibited by the caspase-8 inhibitor z-IETD-fmk (suggesting capsase-8 is critical to Andrographolide-mediated apoptosis).[38]

 

6. Interactions with Immunology

 

6.1. Mechanisms

In LPS-activated macrophages, 14-deoxy-14,15-dehydroandrographolide was able to inhibit nF-kB activation with an IC50 of 2?g/mL[18] although up to 10-20?g/mL of the ethyl acetate extract from Andrographis Paniculata is required for such inhibition.[33] At least one study noted that in vitro efficacy of the plant extract (ethyl acetate) is similar to Morus alba and Eucommia ulmodes leaves while being more effective than Astragalus membranaceus and trended to be less effective than Isatis indigotica (all tested in vitro between 2-5?g/mL).[33]

This has been noted elsewhere with the ethyl acetate fraction of Andrographis Paniculata following oral ingestion of 0.78-3.13mg/kg in mice injected with LPS after Andrographis feeding for a week; this study noted that 6.25mg/kg failed to reduce lethality from LPS like lower doses.[33]

Some compounds may have anti-inflammatory effects, with fairly potent effects in vitro

At 1µM, lymphocyte proliferation and IL-2 secretion is enhanced by Andrographolide (14%), 14-deoxyandrographolide (5%), and 14-deoxy-11,12-didehydroandrographolide (7%) although the dichloromethane and methanolic extracts (which contain these molecules) are more potent, suggesting synergism from other bioactives.[39]

On immune cells, Andrographolide may possess weak to moderate immunostimulatory properties

 

6.2. T-Cells

15-30mg Andrographolide daily for up to 6 weeks has been noted to decrease CD4+ T-cell count by 27% in healthy control persons after 6 weeks while increasing CD4+ cell count in persons with HIV by 23.7% at 6 weeks.[40]

 

6.3. Sickness and Infection

Andrographis Paniculata is a popular Traditional Chinese Medicine for the purposes of reducing cold and flu symptoms. Surprisingly, this herb may not possess any anti-bacterial effects.[41]

In persons (n=152) with pharyngotonsillitis, daily ingestion of 3-6g of Andrographis Paniculata were effective at reducing signs and symptoms of pharyngotonsillitis with the higher dose (6g) being as effective as the active control of Paracetemol (Tylenol).[42] Benefits were seen on day three of treatment, with no further benefit seen when measured on day 7.[42]

In persons with uncomplicated Upper Respiratory Tract Infection (URTI) taking 200mg of an extract from the leaves of Andrographis Paniculata (31.3% Andrographolide) in two divided doses of 100mg daily for 5 days noted that while there were no differences between groups at baseline or at three days that on day 5 the Andrographis group experienced reduced symptoms (such as Expectoration, Headache, Cough, Fever, and Fatigue; Earache was the only unaffected parameter).[8] These seemingly general benefits are also noted with 1200mg of the basic plant extract, where 4 days of supplementation was able to reduce all measured symptoms of the common cold relative to placebo while sore throat, nasal secretion, and earache were significantly reduced after 2 days.[43]

In regards to Andrographis alone, it appears to be effective in a general manner against respiratory infections

For the purposes of general immunity, Andrographis Paniculata appears to be used in combination with Siberian Ginseng (Eleutherococcus senticoccus), which is either known as SHA-10 (standardization) or ‘Kan Jang’ tablets; the latter due to the combination also being used in Traditional Chinese Medicine.[1] There appears to be a large amount of human studies originating from Russia in support of this combination (cited from this study,[1] cannot be located online and conducted between 1967-1995).

A pilot study using Kan Jang tablets (SHA-10) with both Andrographis Paniculata (85mg standaridized for 5.25mg Andrographolide plus Deoxyandrographolide) and Siberian Ginseng (9.7mg containing 2% Eleuthroside B and E) with four tablets taken thrice a day (63mg Andrographolides and 116mg Siberian Ginseng daily) noted that the improvement in overall symptoms in persons with URTIs were to a greater degree than placebo over 5 days.[1] These results were later replicated in a Phase III Trial of 180 persons, where Kan Jang capsules at this dose outperformed placebo over the course of 5 days in reducing symptoms from URTI.[1] Similar effects have been replicated elsewhere in a sample of 185 persons using similar dosing, although this latter study noted a larger effect size (while placebo experienced a 23% reduction in symptoms, Kan Jang experienced an 86% reduction) with most significant improvement in throat symptoms (dry and soreness), headache, malaise, sneezing, and runny nose with some efficacy on cough.[2]

One comparative study pitting Kan Jang capsules against Echinacea purpurea using either for a 10 day period in children with colds noted that Kan Jang was significantly more effective than Echinacea.[4]

One study using Kan Jang capsules with additional Schizandra chinensis and Licorice (48mg Andrographolide daily) for one month has noted significantly less symptoms (relative to placebo) in persons with Familial Mediterranean Fever.[5]

Kan Jang tablets (combination therapy of Andrographis paniculata and Eleutherococcus senticoccus) appears to be effective in reducing the signs and symptoms of upper respiratory tract infections when taken at the onset of sickness. At least one study suggests it is more potent than Echinacea purpuera

 

6.4. Virology

In 13 HIV-positive persons given Andrographolide (PN355) at 5mg thrice a day (totalling 15mg) for 3 weeks in escalating dose (10mg for another 3 weeks with the trial ending at 6 weeks) noted a high degree of side-effects associated with treatment (no placebo for comparison) and noted an increase in hepatic enzymes (ALT and AST) associated with treatment and normalized 3 weeks after cessation.[40] There was no influence on HIV RNA content.[40]

 

6.5. Arthritis

Supplementation of Andrographis extract (30% Andrographolide) at three daily doses of 100mg (300mg daily) for 14 weeks in persons with Rheumatoid arthritis failed to significantly reduce joint pain although both the count and degree of tender and swollen joints was significantly reduced with Andrographis intervention.[44] This study also noted reduced serum IgA and complement component C4.[44]

At least one study noted that Andrographis may reduce swelling (but not significantly reduce pain) associated with Rheumatoid Arthritis

 

7. Interactions with Hormones

 

7.1. Testosterone

One study using 20-1000mg/kg of Andrographis Paniculata (10.9% Andrographolide) daily for 60 days has failed to find any significant influence on circulating testosterone levels.[45]

 

8. Interactions with Organ Systems

 

8.1. Liver

Mechanistically, in HepG2 cells treated with CCL4 both Andrographolide and Andrographis paniculata extract (2.7% Andrographolide) exert cytoprotection when coincubated with maximal protective effects at 30µmol/mL Andrographolide which preserved 84.3% of cell viability (higher concentrations not tested);[46] this was said to be due to its antioxidative capacity (IC50 of 3.2µg/mL (9.2µmol/mL) in DPPH assay with a maximum potency at 15µmol/mL, more potent than Vitamin C which had an IC40 of 4.2µg/mL and reached maximal potency at 40µmol/mL).[46] Protective effects against CCL4 hepatotoxicity have been noted in vivo when mice were pretreated for 8 days with 50-100mg/kg Andrographolide, where only the higher dose of 100mg/kg was associated with a reduction of ALT and AST enzyme secretion with reduced MDA (indicative of lipid peroxidation) and increased glutathione; 100mg/kg Andrographolide was equally effective as the active control of 100mg/kg Silymarins (from Milk Thistle).[47]

Andrographolide has also shown protective effects in H4IIEC3/G(-) liver cells induced with acetominophen toxicity, where 10µM of Andrographolide preserved 55% of cell viability and outperformed 10µM of Kutkin from Picrorhiza kurroa (46%) and Silymarin (24%).[48]

Appears to have general hepatoprotective properties against pro-oxidative toxins, with one study suggesting it is dose-for-dose as effective as Silymarins from Milk Thistle (although Andrographus paniculata supplements tend to be dosed much lower inherently)

One pilot study in persons with HIV (small group of persons without HIV) noted that treatment of 15-30mg Andrographolide in three divided doses was associated with an increase in serum liver enzymes (AST and ALT) in both groups, with the HIV group normalizing liver enzymes 3 weeks after supplement cessation.[40]

 

8.2. Lung

Andrographolide pretreatment to mice 2 hours prior to exposure to smoke fumes has been noted to be associated with less fluid accumulation and changes in biomarkers thought to be due to antioxidative effects (reduced lipid peroxidation and increase antioxidative enzymes); this was thought to be downstream of Nrf2 activation, which was noted in vitro (BEAS-2B cells) to be induced by Andrographolide treatment.[49]

 

8.3. Kidneys

In a series of case studies of persons who underwent Extracorporeal Shock Wave Lithotripsy (ESWL; a kidney stone treatment[50]) given two doses of 1,000mg Andrographis Paniculata daily for 5 days following treatment noted reductions in pre and post-ESWL pyuria, hematuria and proteinuria of similar potency to the active controls of Norfloxacin (200mg) or Cotrimoxazole.[51] These results suggest that Andrographis Paniculata has renoprotective properties.

 

8.4. Intestines

In animals with colitis given a water extract of Andrographis Paniculata, inhibition of CD4+ T-cell differentiation into TH1/TH17 cells was said to underlie the observed protective effects of supplementation where the signs and symptoms of colitis were abolished in mice recieving both supplementation and methyl celluose (which induced the colitis);[52] this study is duplicated in Medline.[53]

An extract known as HMPL-004 at 1200mg (thrice daily dosing of 400mg) in persons with Ulcerative Colitis daily for 54 days (on average) noted that the rate of clinical remission was 21% (clinical signs) or 28% (colonoscopy) with the rate of response being 76% and 82% (clinical and colonoscopy, respectively); the active control of 4500mg Slow-Release Mesalazine achieved similar rates of remission (16% and 24%, respectively) and response (74% and 71%).[54] Another trial using 1200mg and 1800mg in adults with mild-to-moderate colitis noted a dose-dependent increase in ‘response to treatment’ (reduction of symptoms associated with colitis) which trended towards significance at 1200mg but was significant at 1800mg; no significant differences were noted in side-effects relative to placebo.[55]

Appears to show promise in Ulcerative Colitis, with one double-blind and one comparative study coming back positive currently

 

8.5. Testes

Interestingly, one study on Eurycoma Longifolia Jack showed the efficacy of said supplement in a rat model of “Andrographis Paniculata induced infertile rats”.[56] This may have originated from a study in male albino rats where 20mg powder for 60 days induced infertility and a cessation of spermatogenesis[57] and another study noting that 25-50mg/kg isolated Andrographolide for 48 days inducted testicular toxicity and altered spermatozoa.[58]

In opposition to the above, doses of 1000mg/kg Andrographis Paniculata (6.1% Andrographolide) for 60 days in male rats has failed to exert appreciable testicular toxicity[22] and these lack of effects persist when looking at fertility of male rats over 65 days, where the lack of testicular toxicity was replicated.[45] It should be noted that the latter two studies appear to have better methodology than the former two (involving electron microscope analysis of testicular histology and measuring serum levels of biomarkers).[45]

Additionally, a Phase I trial in healthy humans using Kan Jang capsules (the anti-cold Chinese Medicine where Andrographis is paired with Siberian Ginseng) at thrice the recommended dose for 10 days failed to find any toxic effects on sperm cells.[3]

Has been implicated in inducing testicular toxicity, although this is a contested issue and the one human study using feasible oral doses has failed to find any signs of testicular toxicity

 

Edit9. Interactions with Cancer

 

9.1. Immunological Interactions

In lymphocytes (obtained from volunteer) treated with 1?M Andrographolide, an increase in CD3 (61–91% relative to control lymphocytes), CD4+ (40–61%), CD8+ (23–31%), and CD56 (2–3%) marker expression was noted and associated with enhanced lymphocyte-mediated toxicity on K562 cancer cells; this was also noted to occur at 0.1?M.[59]

May enhance lymphocyte-mediated toxicity towards some cancer cells

Treatment of cancer cells with Andrographolide was associated with upregulation of Death-Receptor 4 (DR4) which enhanced TRAIL-mediated apoptosis; this was downstream of p53 induction and abolished with coincubation of N-Acetylcysteine (and thus was mediated by pro-oxidative mechanisms).[60] TRAIL is a selectively tumor cytotoxic agent from the immune system[61] which is a therapeutic target in cancer research.[6][62]

Appears to enhance TRAIL-mediated cytotoxicity in cancer cells via pro-oxidative (possibly hormetic) means

Andrographolide is able to enhance cytotoxicity of reference cytotoxic drugs (5-fluorouracil, adriamycin, and cisplatin) when coincubated in multi-drug resistant colorectal cells[63] where it synergistically enhances the cytotoxicity of other agents.[64]

May confer aid in multi-drug resistant cells

 

9.2. Colon Cancer

In human colorectal carcinoma cells (Lovo) noted that Andrographolide was accumulated up to 0.61+/-0.07?M/mg (12 hours) in cells and displayed a IC50 on cell growth of 8.6?M at 24 hours, with 48 hours incubation of 10-30?M causing near inhibition of proliferation.[65] One study assessing a wide variety of tumor cell lines noted that while the IC50 ranged from 5-15?M that one colon cell line (COLO205) was more sensitive with an IC50 of less than 1?M, although inhibitory effects were noted on all five tested colon cancer cell lines (SW620, HCT116, HT29, KM12, and COLO205)[59] and elsewhere noted to be 11?M on SW620.[39] Andrographolide is not the only molecule in Andrographis Paniculata to have cytotoxic effects on colon cancer cells, but the methylated flavones appear to have higher IC50 values (less potency) and most other diterpenes related to Andrographolide are about 3-fold less effective, although this study noted that 14-deoxy-14,15-didehydroandrographolide was similarly effective on COLO205 cells;[66] this potency of Andrographolide relative to other diterpenes has been noted in Leukeia cells as well.[67]

Andrographolide appears to have potent anti-proliferative effects on a wide variety of colon cancer cells; the cytotoxic effects (ability to kill cells, in this context we mean tumor cells) of Andrographolide are currently not as well researched and some sources hint at it being quite less potent or unremarkable

Andrographolide has been noted to accumulate cells in the G1 phase of the cell cycle (43.28% to 56.05% at 10?M) with a decrease in S fraction in a concentration and time dependent manner; this was associated with a downregulation of Cyclin D1 (no significant influence on Cyclin D3 or E although both Cdk2 and Cdk4 were reduced in protein content) all thought to be downstream of p53 induction of protein content and phosphorylation.[65]

An increase in the Rb/E2F complex has been noted with Andrographolide,[65] and secondary to more of this complex less free E2F is released; E2F being a factor in cell proliferation and its complexation reducing proliferation.[68] One other study has noted anti-invasive effects of Androgapholide on colon cancer cells (CT26 and HT29) although attributed this observation to inhibition of MMP2 (and inhibition of Akt),[69] a protein that promotes invasiveness of tumor cells. Studies in lung cancer cells suggest that MMP2 inhibition may also be downstream of HLJ1 upregulation.[70]

The anti-proliferative effects appear to be mediated by modulation of Cyclin proteins, which appear to be downstream of p53; other evidence (not on colorectal cells) hints that p53 is downstream of prooxidative and hormetic effects

 

9.3. Breast

Andrographolide has been noted to induce apoptosis in breast cancer cells at 0.35-1.4mM in TD-47 breast cancer cells in a concentration and time dependent manner, with apoptosis at 24 hours ranging from 28.55-65.65% and at 72 hours ranging from 76.48-99.72%.[71] This apoptosis was associated with DNA fragmentation associated with an increase in p53 content,[71] and has been noted to be a pathway independent of the mitochondria.[72]

The related structure 14-deoxy-11,12-didehydroandrographolide has been shown to induce both apoptosis and autophagic structures (visually assessed) in TD47 breast cancer cells at 1.5?g/ml[73] (the IC50 found here[74]) and these changes were associated with 2-fold modifications of genes involved in cell cycles (19), cell growth and proliferation (42), tumor suppression (40), apoptosis-related mechanisms (18), and vesicle formation and transport as well as protein degradation (30); all named within the citation.[73]

An increase in G1 phase cells with concomitant decrease in S phase (as well as G2/M) has been noted in MCF-7 cells (treated with 5?M Andrographolide) at 24 hours with an increase in sub-G1 cell content at 48 hours.[59] Andrographolide was noted to induce p27 content and subsequent downregulation of Cdk4 (at 25?M).[59]

There is apparent cytotoxicity associated with Andrographolide in brast cancer cells, but at a very high concentration that may not be practically relevant

Growth inhibitory effects have been noted on four breast cancer cell lines (MDA-MB-453, MCF7, MCF7/ADR and T47D) with an IC50 value ranging from 5-15?M[59] and another study using NCI/ADR-RES noting an IC50 of 15?M with Andrographolide and 30?M with 14-Deoxy-11,12-didehydroandrographolide.[39]

There appears to be standard anti-proliferative effects at fairly low concentrations of Andrographolide

Anti-tumor activities of Andrographolide have been confirmed in vivo in mice transplanted with tumors, and was associated with PI3K/Akt and suppression of angiogenetic factors such as VEGF and Osteopontin.[72]

 

9.4. Leukemia

In studies done on leukemic cells, it is noted that while Andrographolide has cytotoxic activity that both 14-deoxy-11,12-didehydroandrographolide and neoandrographide have failed to exert any cytotoxic activity[67] and that Andrographolide-mediated cytotoxicity in HL-60 leukemic cells occurs via mitochondria-dependent mechanisms.[75]

Subsequently, Andrographolide has shown anti-proliferative properties in two Leukemic cell lines (CCRF-CEM, RPMI8226) with an IC50 between 5-15?M[59] and in HL-60 leukemic cells a 27% increase in G0/G1 cell count at the expensive of S and G2/M at 12?g/mL over 36 hours.[75]

One study noting the IC50 of proliferation on Jurkat Lymphoma cells relative to healthy PMBCs noted that two dehydroandrgrapholides and Isoandrographolide had IC50 values of 50-100?M while the IC50 in healthy cells was either 150?M or ‘greater than 200?M’.[66]

Andrographolide has shown to have anti-proliferative effects in Leukemic cells at regular concentrations, with apoptosis being induced at higher concentrations

At least one study has noted that Andrographolide was able to influence differnetiaiton of myeloid leukemia (M1) cells of mice into phagocytes,[76] which is not a common mechanism among plant-derived nutraceuticals.[6]

 

9.5. Melanoma

Isolated Andrographolide has shown anti-proliferative effects in isolated Melanoma cells (A431, M14, UACC62) with an IC50 between 5-15?M[59] with another study using M14 cells noting an IC50 of 11?M.[39]

In mice planted with B16 melanoma tumors, oral ingestion of Andrographolide at 100-200mg/kg oral dose (human equivalent of 8-16mg/kg) was associated with a suppression of tumor growth at 30-36% (100mg/kg) and 39-52% (200mg/kg) over the course of 10 days.[59]

 

9.6. Ovarian

Isolated Andrographolide has been noted with inhibiting proliferation of four ovarian cancer cells (ES2, SKOV3, OVCAR8, and PA-1) with an IC50 between 5-15?M[59] with another study noting an IC50 (SKOV3) of 18?M.[39]

 

9.7. Prostate

Isolated Andrographolide has been noted with inhibiting proliferation of two prostate cancer cells (DU145 and PC3) with an IC50 between 5-15?M[59] with other studies noting growth inhibition (IC50) of 12?M (PC3)[39] and 70-150?M (PC3).[66]

 

9.8. CNS

Isolated Andrographolide has been noted with inhibiting proliferation of three CNS cancer cells (U251, SF268, and SNB19) with an IC50 between 5-15?M[59] with another study replicating these growth inhibitory effects on U251 with an IC50 of 10?M.[39]

In glioblastoma cells (U251 and U87) Andrographolide has been noted to inhibit proliferation in a concentration and time dependent manner between 10-100?M (no cytotoxicity noted) associated with G2/M arrest, increasing the percentage of cells in G2/M phase from 15.73% to 35.15% (123% increase in U251) and 16.99% to 33.61% (98% increase in U87) at 70?M.[77] This was associated with downregulation of Cdc25C and Cdk1 as well as slight inhibition of PI3K/Akt, although coincubation with a more potent PI3K/Akt inhibitor enhanced the anti-proliferative effects greatly.[77]

Anti-proliferative effects on glioblastoma cells appear to be synergistic with the mechanism of PI3K/Akt inhibition

 

9.9. Lung

Isolated Andrographolide has been noted with inhibiting proliferation of six tested lung cancer cells (A549, NCI-H23, HOP62, MES-SA, H522, and MES-SA-DX5) with an IC50 between 5-15?M[59] although another study using H522 noted an IC50 of 16?M.[39] Andrographolide has also been noted to enhance HLJ1 promoter activity secondary to JunB activation, which then caused suppressed activity of MMP2.[70]

 

9.10. Renal

Isolated Andrographolide has been noted with inhibiting proliferation of two renal cancer cells (ACHN and A498) with an IC50 between 5-15?M[59] although another study using A498 noted an IC50 on growth of 28?M.[39]

 

Edit10. Safety and Toxicity

 

10.1. General

In interventions with Andrographis Paniculata, side-effects do not appear to be significantly different than placebo[8][2][25][1] even in one instance where side-effects reached 20% of the study group (same as placebo, suggesting another factor was at play);[42] most reported side-effects (regardless of being different or similar as placebo) generally being mild and infrequent.[7]

One study in HIV positive persons has noted that, with isolated Andrographolide, some symptoms similar to an allergic reaction were reported (from two subjects, no placebo group in this study)[40] while according to manufacturers (data retrived here[7]) there have been 5 reported cases of allergic reactions associated with Andrographis Paniculata supplementation.

In general, human intervention data appears to show that commonly used doses of Andrographis Paniculata are safe; very few instances of allergic reactions or something sharing the symptoms has been reported

In rats, the LD50 appears to be greater than 17g/kg.[78]

Dose: 6-15g

Da Qing Ye – Isatis leaf or Baphicacanthus or Clerodendron or Polygonum tinctorium – “Big Bluegreen Leaf”

Nature: bitter, very cold

Enters: Heart, Lung, Stomach

Actions: Cools the blood, relieves skin eruptions; clears heat; eliminates toxicity.

Indications:
• Any warm-febrile disease or epidemic febrile outbreak.. Especially for epidemic toxin or any severe febrile disease that affects people regardless of their constitution, such as severe contagious disease.
• Heat and toxicity in the blood: swollen and painful throat, erysipelas, mouth ulcers.
Xue level heat and toxicity: coma, skin eruptions, high fever, restlessness.
• Heat in the blood: skin blotches, rashes, and other skin eruptions. Often used in cases with intense fever, irritability, and changes in consciousness.
• May be used for fire-toxicity anywhere in the body, especially the throat and Lungs.
• Very effective in treatment of encephalitis B; commonly used for meningitis.
• Acute dysentery, gastroenteritis.
• Antiviral, antimicrobial.
• Caution with spleen/stomach cold from deficiency.
SD: May help antidote lead poisoning.

Dose: 9-30g

Gui Zhen Cao – Bidens – “Demon/Ghost Spike/Needle Plant”

SD: It is said that the nature of the herb is sweet and bland, with a neutral property, though other sources list it as bitter. Its actions are to expel pathogenic factors from the surface of the body, clear up heat, remove toxin, and eliminate stagnancy. The applications listed include influenza, swollen and sore throat, enteritis, dysentery, jaundice, intestinal carbuncle, epilepsy in children, malnutrition in infants, and hemorrhoids.
In Chinese Medicinal Herbs of Hong Kong, the indications for Bidens pilosa (the only species listed) are: influenza, colds, fever, sore throat; acute appendicitis; acute infectious hepatitis; gastroenteritis, dyspepsia; rheumatic arthralgia; malaria; and hemorrhoids, pruritis.
Oriental Materia Medica reports it to have the functions of removing wind-dampness, dispersing stagnant blood, and invigorating blood. Applications of the herb include rheumatoid arthritis, sprain, insect and scorpion sting, diarrhea, dysentery, hepatitis, acute nephritis, stomach ache, and sore throat.
The substitute Desmodium species are similar to the standard herb known either as hulucha or longshehuang (Desmodium triquetri), which is applied to treat common cold, sore throat, enteritis, dysentery, jaundice, rheumatic arthralgia, and other disorders; the overlap in applications between bidens and desmodium is evident. A review of uses of Bidens bipinnata (the only species mentioned) is presented in Anticancer Medicinal Herbs, including:
Internal Medicine: “It is recorded in Handbook of Chinese Medicinal Herbs that: The decoction of the drug cures dysentery, laryngalgia, dysphagia, vomiting, cardiac spasm and esophageal dilatation, and is effective in
removing toxic materials, stopping diarrhea, and clearing away heat. The drug has been used to treat cecitis in the recent years.” For cancer therapy, 15″“30 grams per day is decocted and taken orally for esophageal cancer;
for gastric cancer, 15 grams of bidens is combined with a complex formula for daily administration.
External Medicine: “It is said in Prescriptions Worth a Thousand Gold that “˜External application of bidens with arctium and blended with pig fat can cure finger cut.’ It is recorded in Dictionary of Chinese Materia Medica that “˜The drug, bitter in taste, mild in nature, and non-toxic mainly cures spider and fly bites through internal and external application.’ It is reported in Materia Medica that “˜Scorpion sting can be cured by external application of the drug.'”
In Chinese-English Manual of Common-Used Herbs, under guizhencao, Bidens bipinnata, B. pilosa, and B. biternata are all listed as the source materials; the applications are: 1. clear away the superficial heat: for common cold of wind-heat type and prevention of influenza; 2. clear away heat and toxic materials: for sore throat, appendicitis, snake bite, and centipede bite; and 3. clear away dampness and heat from the gastrointestines [gastro-intestinal tract]: for diarrhea, dysentery and stomach ache of heat type.
The herb, along with others, is included in the Chinese Patent Gan Mao Qing, a remedy for common cold and influenza. For topical use, the fresh herb is crushed and applied locally or boiled in water to produce a wash for boils, eczema, and tinea.
Based on the traditional claims, bidens would be expected””from the modern perspective””to show infection-inhibiting and anti-inflammatory properties: these actions have been investigated and shown to exist. In fact, bidens extracts are shown to inhibit bacteria, fungi, and viruses and to have potent anti-inflammatory effects in laboratory animal experiments with induced gastric ulcer, liver inflammation, or arthritis-type swelling. In Anticancer Medicinal Herbs, the anticancer potential of the herb is said to be implied by its bacteria inhibiting actions (since many antibacterial substances also inhibit cancer).
Bidens tripartita (lang ba cao), which has been known for many centuries as a remedy for chronic dysentery, was used in a clinical trial to treat 500 cases of dysentery, 65 cases of acute enteritis, 248 cases of chronic enteritis.
In 500 cases of dysentery, 387 cases were reported cured; with 13 not responding in 3 days. In 313 cases of enteritis all were cured (12 chronic cases relapsed later). The authors of the study pointed out that there had been an epidemic of dysentery in Shandong Province for many years and that practitioners at village clinics and the county hospital in Jianan County had used bidens as a remedy for about 10,000 patients.
ITM Formulary: A dried hot water extract of bidens with other herbs has been prepared in tablet form under the name Bidens 6 (Seven Forests). The formula is: Bidens 25%, Hu zhang 20%, Zi hua di ding 15%, Ban lan gen 15%, Ju hua 15%, Gan cao 10%. All the herbs in this formula have anti-infection activities.

Dose: 9-60g (60-120g for acute appendicitis)

Hong Teng – Sargentodoxa vine – “Red Vine”

Nature: bitter, neutral

Enters: Large Intestine, Liver

Actions: Promotes blood circulation, disperses stasis, alleviates pain; clears heat; eliminates toxicity; reduces abscesses.

Indications:
• A key herb for appendicitis. For appendicitis, it is often used in high doses (60g) and is combined with herbs such as Pu gong ying, Da huang, and Hou po.
• Blood stasis: dysmenorrhea, trauma, joint pain.
• Wind-dampness: joint pain.
• Heat-toxicity: abscesses, skin lesions with heat, swelling, and pain.
• Prostatitis.
• Antibacterial.

Dose: 15-30g

Jin Yin Hua – Honeysuckle flower – Lonicera – “Gold Silver Flower”

Nature: sweet, cold

Enters: Lung, Stomach, Large Intestine

Actions: Clears heat; eliminates toxicity; expels wind-heat; clears lower Jiao damp-heat.

Indications:
• Wind-heat or early stage of warm-heat pathogenic invasion: fever, slight aversion to cold, slight sensitivity to wind, sore throat, headache. This herb can be applied to Wei, Qi, or Ying level heat invasion.
• Heat and toxicity: carbuncles, boils, dysentery, hot painful sores and swellings, arthritis, intestinal abscess. Especially useful for affections of the breast, throat, or eyes.
• Lower Jiao damp-heat: dysenteric disorder or painful urinary dysfunction.
• Externally contracted summer-heat.
• Tuberculosis.
• Chronic conjunctivitis, keratitis, corneal ulcers.
• By IM injection or injection into acupoints, Jin yin hua has proven useful in treating severe acute pneumonia and bacillary dysentery.
• Also for many purulent diseases including appendicitis with perforation, mastitis, erysipelas.
• Broad antimicrobial, antiviral. Anti-inflammatory.
• Not for yin-type ulcers or for sores due to Qi deficiency.
DY: For severe heat-toxicity, dysentery, or pyogenic skin infections, use 30-60g per day. High doses can be used without side effects.
• With Lian qiao to strongly and effectively clear heat and resolve toxins. For indications such as:
– 1. Colds and influenza due to wind-heat. (Yin Qiao San)
– 2. Warm diseases with internal heat. (Yin Qiao San)
– 3. Headache, eye pain, toothache, sinusitis, and painful, swollen throat due to wind-heat.
– 4. Skin eruptions with pruritis due to wind-heat.
– 5. Skin inflammation due to heat toxicity.
– Neither herb is acrid. They are often included in formulas for dispelling wind-heat to prevent the production of heat toxins or to prevent heat from entering deeper into the interior. They are able to limit the worsening of colds, influenza, and other illnesses due to wind-heat.HF: A Sha Chong (kill worms or parasites) herb, important in Gu Zheng (Gu parasites) formulas.
K&R: Water yin, fire yin. Diuretic, antiseptic, sudorific, febrifuge, oxytocic.
• Tonsilitis, strep, pyelonephritis, acute articular rheumatism.
• The leaf may accelerate childbirth.

Dose: 9-60g

 
Ren Dong Teng: the stem – “Stem that Resists Winter”
• Similar functions Jin yin hua, but does not disperse wind-heat.
• Also clears wind, heat, and dampness from the channels.
• Wind-damp-heat in the channels: hot, swollen, painful joints that are difficult to move (arthritis).
• Doctrine of signatures: the stem resembles a meridian – clears the meridians, treats the extremities.
15-30g

Lian Qiao – Forsythia fruit

Nature: bitter, slightly cold

Enters: Heart, Lung, Liver, Gallbladder

Actions: Disperses internal stagnant heat (from Qi stagnation); clears heat; eliminates toxicity; can separate a mixture of Yang pathogenic factors.

Indications:
• Wind-heat or early stage attack of warm-heat pathogen: fever, headache, thirst, sore throat, slight chills.
• Heat and toxicity: various kinds of carbuncles, nodules, boils, lymph swellings, all hot sores.
• Some benefit in acute nephritis and macular hemorrhage.
• May possess antiemetic properties.
• Doctrine of signatures: resembles the heart and, like the heart, it is light when open.
• Broad spectrum antimicrobial like Jin yin hua. Lian qiao is better against Shigella and Staphylococcus aureus, while Jin yin hua is better against Salmonella and hemolytic Streptococcus.
HF: A San Du, scattering toxin medicinal, typically found in Gu Zheng (Gu parasites) formulas.
Hsu: Antiviral, cardiotonic, diuretic.
DY: Clears heat from the whole body; clears the heart and upper burner fire; treats skin inflammations; scatters nodulation and disperses swelling.
• Do not exceed 15g/day – can damage the stomach Yang (sometimes 30g per day can be tolerated for a short time).
• With Jin yin hua to strongly and effectively clear heat and resolve toxins. See Jin yin hua above for specific indications of this combination.
Lian qiao is superior to Jin yin hua for clearing heat-toxicity, but (unlike Jin yin hua) Lian qiao does not reinforce the expelling actions of herbs which disperse wind-heat.

Dose: 6-15g
Two types of Lian qiao: (B&G, DY)
• Qing lian qiao or Qing qiao: the blue-green fruit which has just begun to ripen. It is superior for clearing heat, resolving toxins, and treating warm diseases, fever, and erysipelas.
Huang lian qiao or Lao qiao: the ripe, yellow fruit – called “Old” qiao. It is superior for dispersing abscesses and swelling, scattering nodulation, and treating goiter, subcutaneous nodules, skin inflammations, and carbuncles.
Lian Qiao Xin: the seed
• Clears heat-toxicity which have entered the pericardium causing vexation, agitation, irritability, insomnia, high fever with delirium, mental confusion, loss of consciousness.

Ma Bo – Lasiosphaera or Calvatia – Puffball mushroom

Nature: acrid, neutral

Enters: Lung

Actions: Eases the throat; stops bleeding; clears Lung heat; disperses wind-heat.

Indications:
• Lung heat: swollen, painful throat, cough, aphonia; hemoptysis, epistaxis.
• Topical: for bleeding (most often in the oral cavity and lips), sores, wounds, epistaxis. Also for bleeding gums associated with frostbite.
• For hemorrhage from surgery (prostate, liver, spleen, kidneys) and trauma. In one series of 467 cases, it was successful 98% of the time.
• Can easily induce sweating and vomiting in its unprepared form. The herb should be honey-fried except when used to stop bleeding.
• Large doses can induce nausea.
• Possesses antimicrobial properties.
• Wrap in cheesecloth or a tea bag while cooking.
Hsu: Antiphlogistic, antipyretic, astringent.

Dose: 1.5-4.5g

Ma Chi Xian – Purslane – Portulaca – “Horse’s Teeth Amaranth”

Nature: sour, cold

Enters: Large Intestine, Liver

Actions: Relieves fire toxicity; cools the blood; clears damp-heat; treats sores; antidotes wasp and snake poison.

Indications:
• Damp-heat or fire toxicity: dysenteric disorders; hot or bloody painful urinary dysfunction. In clinical studies involving thousands of subjects, decoctions of Ma chi xian reduced the incidence of bacillary dysentery in those exposed during epidemics. The herb is about as effective as sulfa drugs in treating acute and recurrent bacillary dysentery – over 90% effective in acute cases and less than 60% effective in chronic cases.
• Carbuncles, sores, red-and-white vaginal discharge. Applied topically or taken internally.
• Wasp stings, snake bites: for pain and swelling.
• Recently used for post-partum bleeding.
• Hookworm: when juice or tablets of Ma chi xian were taken by 192 subjects, 80% had a negative stool sample in one month.
• Appendicitis: A decoction of Ma chi xian and Pu gong ying was used in treating 31 cases of clinically diagnosed appendicitis. Of these, only one needed surgery; all others recovered uneventfully.
• Contractile effect on the uterus.
• Often prepared as a wash for skin problems.

Dose: 15-60g (The fresh used is often used at double the dry dosage)

Niu Huang – Cow, Ox, or Water Buffalo Gallstone (Bezoar) – “Cattle Yellow”

Nature: bitter, cold

Enters: Liver, Heart

Actions: Clears the heart, strongly opens the orifices, awakens the Shen by resolving phlegm; extinguishes liver wind, relieves tremors; clears heat; eliminates toxicity.

Indications:
• Heat-toxicity: painful, red, swollen or ulcerated throat, canker sores, boils, carbuncles, ulcers, sores, herpes lesions, and a wide variety of hot swellings.
• Liver wind (due to extreme pathogenic heat): spasms, tremors, (infant) convulsions.
• Heat or phlegm-heat blocks the heart in wind-stroke or epilepsy: coma, difficulty speaking, delirium, seizures.
• Note: this herb should not be used alone for phlegm, as its cold nature may congeal the phlegm.
• Not as strong as She xiang at opening the orifices.
• The genuine article is expensive and difficult to find. The lab produced variety (Ren gong niu huang) is available, which is comparable to the true herb for treating heat-toxicity, but is weaker than the true herb at opening the orifices.
• Bensky/Gamble classifies with herbs that open the orifices.
MLT: Due to its rarity and expense, it is mostly used in the patent Niu Huang Jie Du Pian.
• With rhinoceros or water buffalo horn: for legionnaire’s disease, meningitis, encephalitis.
Hsu: Sedative to the CNS, respiratory, and circulatory systems; cardiotonic; raises blood pressure; stimulates RBC and hemoglobin production.

Dose: 0.15-1g (used only in pills and powders)

Pu Gong Ying – Taraxacum – Dandelion

Nature: sweet, bitter, cold

Enters: Liver, Stomach

Actions: Drains dampness; clears heat; eliminates toxicity; promotes lactation; reduces abscesses; dissipates nodules.

Indications:
• Heat-toxicity: inflammation – mastitis, appendicitis, prostatitis; carbuncles, boils, abscesses, nodules (especially when firm and hard). Used internally and topically.
• Damp-heat: jaundice, painful urination.
• Insufficient lactation: especially when due to heat.
Pu gong ying clears heat without the risk of damaging the stomach.
• The leaves are better at draining dampness than the root. The root is generally regarded as better at eliminating toxicity than the aerial parts.
• Antibacterial; anti-inflammatory.
K&R: Cholagogue, laxative, diuretic. Wood excess, metal deficiency, water excess.
• Wood: biliary dyskinesia, vesicular calculi, constipation, obesity, cellulitis, urea, gout, hypercholesterolemia, varices, acne, herpes, eczema.
Metal: acne, chronic rheumatism.
Water: excess uric acid, urinary calculi, urea, renal insufficiency.
• Also for various states of congestion of the liver and pancreas.
• Use as an eyewash for acute conjunctivitis.
Yoga: Bitter, sweet/cooling/pungent. P, K-; V+
• Alterative, diuretic, lithotriptic, laxative, bitter tonic.
• Detoxifies Pitta and Ama conditions.
• For swollen lymph nodes, tumors, suppressed lactation, breast problems.
• Similar to the Indian herb Bhringaraj – may substitute.
• Detoxifying for over-consumption of fat, fried foods, and meat.
MLT: For cirrhosis, hepatitis; all breast disorders.
• The whole herb is strongly diuretic, especially the leaves.
Joe: Rich in potassium. Therefore, when used as diuretic, it should not deplete potassium in the body.
RW: Rich in vitamins, especially C.
• Contains substances which act like enzymes, stimulating the function of the large glands – especially the liver and kidneys – and stimulating cell metabolism as a whole.
• Diuretic and cholagogue: encourages kidney function and promotes secretory function in the liver. Good for gall and kidney stones.
• For a tendency to form gallstones: must take dandelion for 4-6 weeks (best done in the spring, and repeated in the fall if necessary).
• One of the best herbs to use in chronic rheumatic complaints, chronic degenerative joint disease, and arthritis (requires repeated, consistent courses of treatment).
MW: The root focuses more on the (Western) liver – for stagnant metabolism, waste products/fluids building up. The leaf focuses more on the (Western) kidneys.
• Will stop infections in bones (e.g., infected tooth and jaw).
• Good when the tongue has a geographic coat.
• For mental illness: manic depression, obsessive-compulsive disorders (generally takes time to work – 6-12 weeks – not usually for acute disease).

Dose: 9-30g (up to 100g fresh)

Qin Pi – Fraxinus branch bark – Korean Ash

Nature: bitter, cold

Enter: Liver, Gallbladder, Large Intestine

Actions: Clears heat, drains liver fire; drains dampness; disperses wind-dampness; eliminates toxicity; benefits the eyes.

Indications:
• Stagnant liver heat: red, swollen, painful eyes or superficial visual obstruction.
• Damp-heat or large intestine heat and toxicity: dysentery (not amebic) with pus and blood.
• Wind-dampness: Bi syndrome, mainly hot.
• Bensky/Gamble classifies Qin pi with herbs that clear heat and dry dampness.
Hsu: Antiphlogistic; analgesic; suppresses arthritis; diuretic.

Dose: 4.5-15g
Excelsior species: Similarity to Qin pi (Fraxinus rhynchophylla, F. bungeana, F. chinensis) unknown. However, studies done in Russia would seem to indicate that Eastern species possess the same (or similar) properties as Western species.
K&R: (Ash – F. excelsior) Laxative, purgative, febrifuge, astringent.
• Moves the bowels, relieves the pain of constipation.
• Stimulates sluggish metabolism, stimulates secretions of the Islets of Langerhans.
• In Russia it is used as a circulatory stimulant to warm the hands and feet (warms the entire body).
• For intermittent fevers. Once used in place of quinine for malaria.
• Uremia (Cheynes-Stokes), arteriosclerosis, hypercholesterolemia.
• Metal, water, fire, and earth excess:
Metal: arterial hypertension, arteriosclerosis, hypercholesterolemia, uremia.
Fire: urinary calculi, gout, rheumatism.
Water: oliguria, urinary calculi, hypertension, arteriosclerosis, promotes longevity.
Earth: arthritis, arteriosclerosis, rheumatism, stimulates sluggish lymph.

Qing Dai – Indigo – A preparation of Shi Gao and Da Qing Ye

Nature: salty, cold

Enters: Liver, Stomach, Lung

Actions: Cools the blood; relieves swelling; clears heat; eliminates toxicity.

Indications:
Heat or heat and toxicity in the blood: epistaxis, hemoptysis, hematemesis.
Heat and toxicity in the liver: infant convulsions, fever.
Heat in the Lungs: cough, sticky sputum, difficulty breathing.
Heat and toxicity: mumps, carbuncles, acne. Used both internally and topically.
Topical: inflammation of oral cavity and throat (often combined with Bing pian).
One component (Dian yu hong) is effective for treating leukemia, raises RBC count, decreases abnormal cells.

Dose: 1.5-3g directly in pills or powders (to 9g or more when cooked)

Shan Dou Gen – Sophora root (S. tonkineenis or S. subprostata) – “Mountain Bean Root”

Nature: bitter, cold

Enters: Lung, Large Intestine

Actions: Benefits the throat; relieves swelling, alleviates pain; clears heat; eliminates toxicity.

Indications:
• Heat and toxicity: swollen, sore, painful throat; carbuncles, psoriasis. A key herb for sore throat due to heat and toxicity.
• Lung heat: cough.
• Damp-heat: jaundice.
• Topical: use the powder for pain, redness, and swelling of the oral cavity or cervix.
• Anti-neoplastic effects.
• Doses over 10g may cause nausea and/or vomiting.
Hsu: Anti-cancerous effects against malignant carcinomas; antimicrobial.
DY: Shan dou gen is the most efficient Chinese medicinal for treating throat inflammations due to heat-toxins or replete heat.
• With Ban lan gen for mutual reinforcement, to clear heat, eliminate toxicity, and strongly disinhibit the throat. For such indications as:
– 1. Painful, red, and swollen throat due to replete heat. This combination is usually sufficient to treat severe throat inflammations (including strep throat, tonsillitis, pharyngitis, laryngitis, etc.) due to heat-toxins or replete heat. However, when this combination needs further reinforcement, add She gan, Jin yin hua, Lian qiao, Xuan shen, and Gan cao.
– 2. Toothache and painful, swollen gums due to replete heat.
– 3. Oral ulcers due to replete heat.

Dose: 3-9g

She Gan – Belamcanda rhizome – “Arrow Shaft”

Nature: bitter, cold

Enters: Lung

Actions: Powerfully eliminates phlegm; eases the throat; clears heat; eliminates toxicity.

Indications:
• Phlegm-heat or fire excess or fire-toxicity: swollen, painful throat. Sometimes used alone for sore throat.
• Phlegm accumulation: cough, asthma, wheezing.
She gan’s powerful ability to eliminate phlegm makes it valuable for cold- phlegm patterns also, for which it should be combined with warm herbs.
• May be useful for uterine fibroids.
• Increases secretion of saliva.
• Liu: Not recommended for treating wind-heat. Since it is bitter, not acrid, it may drive the pathogen to the interior.
• The exquisite cultivated flower of this plant is sometimes called Blackberry Lily or Leopard flower.
MLT: Anti-hyaluronidase activity, especially useful to control inflammation; topical: for sores, dermatitis.
Gargle: with a little salt and lemon juice in water for severe sore throat.
Hsu: Antifungal, hypotensive.

Dose: 1.5-9g

Tu Fu Ling – Smilax – Sarsaparilla

Nature: sweet, bland, neutral

Enters: Liver, Stomach

Actions: Clears heat; eliminates toxicity; resolves dampness; relieves joint pain and muscle spasm.

Indications:
• Damp-heat (including with toxicity): joint pain, turbid and painful urination, jaundice, genital problems (liver channel).
• Dampness and toxicity: skin problems including acne, carbuncles, boils, herpes.
• Syphilis: pain and spasms of the muscles around joints (use with Jin yin hua and Wei ling xian)
• Lupus.
• Lyme disease.
• Treats and prevents leptospirosis.
SD: May help antidote arsenic and mercury poisoning.
K&R: Depurative, diuretic, stimulates LH secretion.
• Water excess, metal deficiency.
Water: nephritis, edema, gout, arthritis, rheumatism.
Metal: skin problems, flatulence; mild diaphoretic.
• Also for leukorrhea with inguinal lymphatic swelling.
• Eliminates urea for uremia; psoriasis.
• Contains hormone precursors.
• Traditionally used as a tonic.
BII: Binds to gut endotoxins for conditions associated with high levels of toxins: psoriasis, eczema, arthritis, ulcerative colitis.
• Possibly beneficial in cancer treatment.
Hall: For reproductive hypofunction, difficulty conceiving/sterility.
• May eliminate the inherited traces of unresolved disease (particularly syphilis).
• Teenage acne.
Yoga: Dwipautra: P, V- (does not increase Kapha)
• Alterative, diuretic, diaphoretic, antispasmodic, antisyphilitic, anti-rheumatic.
• Purifies the genitourinary tract – dispels infection and inflammation.
• Purifies the blood, improves Agni.
• Helps dispel accumulated Vata from the intestines.
• Cleanses the mind of negative emotions, useful in many nervous disorders.
• Tonic action on the sexual organs.
• Topical: As a wash for genital sores or herpes.
• Use as a hot fomentation for painful, arthritic joints.
MLT: Lymph cleanser.
• Able to penetrate the blood-brain-barrier: useful for spirochete-type microbes – syphilis, Lyme disease.
• Also useful for herpes.
JC: Alterative, diuretic, tonic, stimulant, relaxant, demulcent, diaphoretic, cathartic, anti-arthritic, anti-syphilitic, depurant, deobstruent, anti-scorbutic, carminative, poison antidote.
Hsu: Anti-tumor effect – use 500-750g.

Dose: 15-60g

Ya Dan Zi – Brucea fruit – “Crow Gallbladder Seed”

Nature: bitter, cold, toxic

Enters: Large Intestine, Liver

Actions: Treats dysenteric disorders; treats intermittent fever and chills; topically treats corns and warts.

Indications:
• Topical: for warts and corns. For warts, the wart can be seen as a parasite and Ya dan zi as an antiparasitic herb which feeds the parasite and then kills it. Ya dan zi is broken open and the white seed inside is applied to the wart. Usually requires continuous application for at least 10 days. For the first 10 days, nothing may appear to be happening. By 14 days, the wart should suddenly be gone.
• Chronic or recurring dysenteric disorders. An important herb for chronic cold stagnation dysenteric disorders that wax and wane, or alternating hard and soft stool. Particularly useful for dysentery due to protozoa.
• Malarial disorders: alternating fever and chills. Yan dan zi’s antimalarial effect is stronger than that of Chang shan and equal to quinine. In experiments the dosage required for an antimalarial effect was quite high and side effects of nausea and vomiting sometimes occurred.
• Generalized inhibitory effect on the CNS.
• Kills Entamoeba histolytica and the malarial parasite, but has no effect against Shigella or Salmonella. The herb has a success rate from 72-94% against amebic dysentery with a recurrence rate of approximately 6%.
• Antiparasitic against a number of intestinal parasites.
• Extremely bitter taste, stimulates the stomach to the point that it may cause nausea, pain, and diarrhea. It is therefore not used in decoctions. It is either placed in capsules or inside Long yan rou.

Dose: 10-15g for malarial disorders; 10-30g for dysenteric disorders

Ye Ju Hua – Wild Chrysanthemum flower

Nature: acrid, bitter, slightly cold

Enters: Lung, Liver

Actions: Drains fire; relieves toxicity.

Indications:
• Heat and toxicity: furuncles, carbuncles, sores, sore swollen throat.
• Wind-fire: red eyes.
• Topical: for chronic cervicitis.
• Hypertension: used either alone as an infusion or with Pu gong ying and Jin yin hua in a decoction.
• Antibiotic effects.
• Lowers blood pressure: the flower alone is less toxic and more effective than the entire plant.
• Helps prevent common cold.
• In patients with acute bronchitis, Ye ju hua reduces the number of acute attacks.
MLT: More detoxifying than Ju hua.
• Use internally or externally for all inflammations.
• Compared to Ju Hua, this flower is tiny.
• May be very similar to (Western) Feverfew.

Dose: 6-15g

Yu Xing Cao – Houttuynia – “Fishy-Smelling Herb”

Nature: acrid, slightly cold

Enters: Lung, Large Intestine

Actions: Drains pus; clears heat; eliminates toxicity; reduces swelling and abscesses; drains damp-heat, promotes urination.

Indications:
• Heat and toxicity in the Lungs: cough with sticky sputum, including extreme Lung phlegm-heat with green phlegm or Lung abscess with pus and blood. A key herb for Lung abscess. Also for bacterial pneumonia, COPD, bronchitis.
• Damp-heat: painful, burning urination, colitis, diarrhea.
• Heat and toxicity: carbuncles, sores, pus. Used internally or topically.
• Topical: for skin problems, especially herpes.
• Cook with sesame oil and soy sauce and eat to promote digestion, improve the appetite.
• Antimicrobial.
• Should not be cooked long.
MLT: Good for treating the adverse effects of tobacco addiction. Use in a formula with Ren shen, Sang bai pi, Gua lou, Jie geng: take two 00 capsules of this powdered mixture every 1-2 hours to lessen cravings, and support detoxification. Lower the dose after 3-4 days.
Hsu: Strengthens capillary walls; antifungal, antibacterial, antiviral, diuretic.

Dose: 15-60g

Zao Xiu – Qi Ye Yi Shi Hua – Chong Lou – Paris Rhizome

Nature: bitter, slightly cold

Enters: Liver

Actions: Clears heat; eliminates toxicity; relieves swelling and pain; subdues liver wind to relieve convulsions; mildly moves blood.

Indications:
• Heat and toxicity: snake bite, carbuncles, boils, acne.
• General herb for any kind of pain.
• Liver wind stirring: epilepsy, convulsions.
• Warm-heat pathogen: coma, convulsions.
• Blood stasis: pain after trauma (inferior to San qi for this).
• Particularly good for early stages of heat and toxicity.
DuiYaoOnline.com:
• Phlebitis: zao xiu mixed with vinegar was grounded to get the juice which was applied to affected areas of phlebitis caused by injection of various anti-cancer drugs. 30 cases were treated and the effect was satisfactory.
• Uterine bleeding: zao xiu was grounded into raw powder, made into dry powder and capsulated. Each capsule contains 2g crude drug. It could be used to treat dysfunctional uterine bleeding, menorrhagia due to uterine fibroids or pelvic inflammation.
• Chronic bronchitis: zao xiu was made into tablets, 3g, bid after meals, 10 days as a course of treatment, 3 courses totally. It had satisfactory effect on chronic bronchitis.
• Chronic hepatitis B: zao xiu, wu wei zi, guan zhong, nu zhen zi, ku shen, etc., 1 dose daily, 2 months as a course of treatment. The total effective rate was 92.8%.
• Acute infections of bile system: zao xiu, bai hua she she cao, ban bian lian, jin qian cao, dan shen, 30g each; zhi shi 20g; huang lian 10g; sheng da huang 6g, with jaundice, add yin chen. The control group was treated with intravenous drip of antibiotics. Results: all indices in the treated group were significantly supeior to those of the control group.
• Stomach cancer: zao xiu 50~100g, other formula based on TCM differentiation could be combined, water decoction, 10 days as a course of treatment, 7~8 courses totally. 15 cases of stomach cancer in late stage with wide metastasis were treated, 11 cases survived more than 1 year, 4 cases more than 2 years.
• Vulvitis: zao xiu, tu fu ling, ku shen, 90g, huang bo, da huang, 45g each; long dan cao, bi xie 30g each; ku fan 15g. 1 dose daily, water decoction. The juice was used to steam and wash the private parts, tid, 30 minutes daily, 56 treated cases were all cured.

Dose: 5-10g

Zi Hua Di Ding – Viola yedoensis – Violet – “Purple Flower Earth Spike”

Nature: bitter, acrid, cold

Enters: Liver, Heart

Actions: Clears heat; eliminates toxicity; clears hot sores.

Indications:
• Heat-toxicity: inflammation, swelling – erysipelas, boils, mastitis, appendicitis, mumps, other hot swellings; red, swollen eyes; swollen, painful throat and ears. Especially useful for boils. Weaker than Pu gong ying for mastitis.
• Hot sores and abscesses – especially of the head and back. Used internally and topically (usually fresh).
• Snake bite: chew and apply topically.
MLT: Softens lumps, including cancer.
• As a syrup: use as an expectorant and to ease sore throats.

Dose: 9-15g
Western Species: It has not been clearly established as to which of the Western species – Viola odorata (Sweet Violet) or V. tricolor (Wild Pansy) – is most similar to the Chinese species, and to what degree.
Hall: (V. odorata) Its root system resembles chains of lymph nodes: clears lymph blockage, lymph cancer (throat), lymph stasis, blood-component changes.
• This herb is a symbol of death of one kind and rebirth in a different dimension.
RW: (V. odorata) Expectorant: chronic bronchitis.
(V. tricolor) Skin conditions: Excellent results with eczema in infants, milk crust and other chronic skin complaints. In adults, chronic eczema will at times respond very well. However, it is necessary to take it for a long time.
• Topical: gauze soaked in the tea can be used for skin complaints, including for tuberculous skin conditions.
K&R: (V. tricolor) Wood yang, metal yin.
Diuretic (volumetric), laxative, depurative, diaphoretic, anticoagulant, antipruritic; tonic to the venous system; anti-allergic and anti-inflammatory properties.
• Skin problems (juvenile acne, herpes, hives, eczematous varicose ulcers, chronic psoriasis, eczema).
• Hemorrhoids, phlebitis, constipation.
• Arthritis, rheumatism with oliguria.