Pharmaceutical Name:

Rhizoma Coptidis

Botanical Name:

Coptis chinensis Franch. C.
Coptis diltoidea C. Y. Cheng et Hsiao
Coptis teetoides C. Y. Cheng
Coptis omeiensis C.Y.Cheng

Common Name:

Coptis root  
Golden Seal Root

Source of Earliest Record:

Shennong Bencao Jing

Part Used & Method for Pharmaceutical Preparations:

Five to seven year old roots, or rhizomes, are dug and gathered in autumn and dried for use, or fried with ginger juice.

Properties and Taste:

Bitter and cold

Meridian:

Heart, liver, stomach and large intestine

Functions:

To clear heat and dry dampness
To reduce fire and dispel toxins

Indications and Combinations:

1.     Clears Heat and Dries Dampness:
Very bitter, very cold, and extremely drying in nature, Huang Lian is one of the strongest herbs to clear heat, dry dampness and eliminate toxins. It is commonly used to treat diarrhea or dysentery that may or may not contain pus and blood, burning sensations of the anus after defecation, foul-smelling stools, rectal tenesmus, feelings of incomplete evacuation, abdominal pain, epigastric distention and fullness, thirst with no desire to drink, vomiting or nausea, a slippery rapid pulse, and a red tongue with greasy, yellow coating. 
~ Damp-heat blocking the middle jiao manifested as a full sensation in the epigastric region and vomiting.
*Use with Scutellaria root (Huang Qin), Pinellia tuber (Ban Xia) and Dried ginger (Gan Jiang).
~ Damp-heat accumulated in the intestines manifested as diarrhea or dysentery.
*Use with Scutellaria root (Huang Qin) and Pueraria root (Ge Gen); if the resulting manifestation is tenesmus, Coptis root (Huang Lian) is used with Costus root (Muxiang) in the formula Xiang Lian Wan.

~ Liver fire attacking the stomach manifested as vomiting.
*Use with Evodia fruit (Wu Zhu Ya). If it is heat in the stomach, which causes vomiting, then use with Bamboo shavings (Zhu Ru).  

~Gastric pain and ulcers due to Liver fire attacking the Stomach.

*Use with Fructus Evodiae (Wu Zhu Yu), Rhizoma Cyperi (Xiang Fu) and Rhizoma Corydalis (Yan Hu Suo). 

~Acid Regurgiation: 

*Use with Endoconcha Sepiae (Hai Piao Xiao) and Bulbus Fritillariae Thunbergii (Zhe Bei Mu). 

~Bleeding peptic ulcer: 

*Use with Rhizoma Bletillae (Bai Ji) and Galla Chinesis (Wu Bei Zi).

~ Febrile diseases manifested as high fever, irritability, loss of consciousness and delirium.
*Used with Gypsum (Shi gao) and Capejasmine (Zhi zi).

~Ulcers on the tongue

*Use with Herba Asari (Xi Xin) and Fructus Gardeniae (Zhi Zi).

~ Boils, carbuncles and furuncles. 
*Use with Scutellaria root (Huang Qin), Honeysuckle flower (Jin Yin Hua), Forsythia fruit (Lian Qiao) and Capejasmine (Zhi Zi).

~ Excessive fire in the stomach.

*If the manifestation is hunger after consuming sufficient food, then use with Fresh Rehmannia root (Sheng Di Huang) and Trichosanthes root (Tianhuafen). 

~Excessive thirst

*Use with Gypsum Fibrosum (Shi Gao), Radix Trichosanthis (Tian Hua Fen) and Radix Anemarrhenae (Zhi Mu).

*If the manifestation is a toothache, then use with Cimicifuga rhizome (Sheng Ma) and Fresh rehmannia root (Sheng Di Huang) and Radix Angelica Dahuricae (Bai Zhi).

2. Sedates Fire

Liver fire: Clinical manifestations of Liver fire include dizziness, headache, redness of the face and eyes, a bitter taste in the mouth dry throat, short temper, irritability, insomnia or nightmares, burning hypochondriac pain, tinnitus, constipation, hematemesis, or epistaxis, a red tongue with yellow coating, and a wiry, slippery and rapid pulse. 

~Liver fire: use with Fructus Evodiae (Wu Zhu Yu), Radix Bupleuri (Chia Hu), and Radix Paeoniae Alba (Bai Shao). 

~Red eyes due to Liver yang rising.

*Use with Concha Haliotidis (Shi Jue Ming), Semen Cassiae (Jue Ming Zi), Radix Gentianae (Long Dan Cao), Herba Equiseti Hiemalis (Mu Zei) and Excrementum Vespertilionis Murini (Ye Ming Sha).

~Photophobia, blurred vision, spots in front of the eyes, night blindness and acute conjunctivitis caused by Liver blood deficiency and Liver yang rising.

*Use alone in decoction. It can also be used as an external wash for the eyes. 

Heart Fire: The following are all symptoms associated with Heart fire:

~Insomnia and irritability caused by Heart fire

*Use with Cinnabaris (Zhu Sha) and Radix Rehmanniae (Sheng Di Huang). 

~Insomnia and irritability associated with Heart fire and deficiencies of yin and blood.

*Combine with Colla Crii Asini (E Jiao) and Radix Paeoniae Alba (Bai Shao). 

~Hematemesis and rectal bleeding due to heat in the blood

*Use with Radix Scutellariae (Huang Qin) and Radix et Rhizoma Rhei (Da Huang). 

~Aversion to heat and irritability due to excess heat and fire

*Add Fructus Gardeniae (Zhi Zi) and Radix Scutellariae (Huang Qin). 

~Delirium

*Use with Rhizoma Acori (Shi Chang Pu), Concretio Silicea Bambusae (Tian Zhu Huang), Fructus Forsythiae (Lian Qiao), Radix Rehmanniae (Sheng Di Huang). 

3. Clears Fire Toxin

Dermatological disorders arising from toxic fire: Huang Lian is commonly used to eliminated heat and toxins present at the skin level, characterizedd by abscesses and lesions. Apply the powder of this herb topically. 

~Abscesses, lesions, carbuncles, furuncles, burns, swelling and inflammation due to heat toxins

*Use with Radix Scutellariae (Huang Qin), Tadix et Rhizoma Rhei (Da Huang) and Fructus Forsythiae (Lian Qiao) to clear heat and eliminate toxins. 

Pharmacological Effects:

• Antibiotic: Huang Lian has a broad spectrum of antibiotic effects against Bacillus dysenteriae, Mycobacterium tuberculosis, Salmonella typhi, E. coli, Virbrio cholerae, BAcillus proteus, Pseudomonas aeruginosa, Diplococcus meningitidis, Staphylococcus aureus, beta-hemolytic streptococcus, Diplococcus pneumoniae, Corynebacterium diphtheriae, Bordetella pertussis, Bacillus anthracis, and leptospira. The inhibitory effect is strongest against E. coli, Mycobacterium tuberculosis, and Staphylococcus aureus. Use of Huang Lian or its components individually is commonly associated with resistance. On the other hand, the use of Huang Lian within an herbal formula reportedly enhances its antibiotic effectives over tenfold with little incidence of resistance. Berberine, one of the components of Huang Lian, is most effective for gastrointestinal infection, but not for systemic infection, since it has poor absorption by the intestines and a short half-life. In addition to is antibacterial effect, Huang Lian also has antifungal and antiviral activities. According to one report, a 15% decoction of Huang Lian is effective against numerous pathogenic fungi and dermatophytes. Lastly, Huang Lian has an inhibitory effect against influenza and hepatitis viruses. 

• Anti-inflammatory: Oral administration of berberine has demonstrated a marked anti-inflammatory effect. 

• Cardiovascular: Intravenous injection of berberine lowered blood pressure. The mechanism of blood pressure reduction is dilation of hte blood vessels and inhibition of secretion of the adrenal glands. Berberine also has antiarrhythmic actions. 

• Cholagogic: Huang Lian and berberine act to increase production and decrease density of bile acid. Addicionally, they reduce the plasma level of cholesterols. 

• Antiulcer: Huang Lian inhibits the secretion of gastric acid and is commonly used in conjunction with other herbs to treat peptic ulcers. 

• Others: Huang Lian has local anesthetic and antidiarrheal effects. 

Dosage:

2-10 g in decoction. The maximum dosage of Huang Lian is 15 g. Huang Lian has different functions depending on how it is processed:

~The unprocessed herb is stronger to clear heat, sedate fire and dry dampness. 

~Frying with grain-based liquor gives Huang Lian an ascending function and diminishes its bitter and cold impact. 

~Frying with Ginger (Sheng Jiang), Evodia Fruit (Wu Zhu Yu) gives Huang Lian dispersing and ventilating functions, weakens its bitter and cold affects, and enhances its nausea-relieving function. 

~Frying with pig bile enhances the effectiveness of Huang Lian to sedate fire of the Liver and Gallbladder. 

Cautions:

This herb should be used with caution; large dosages may weaken the stomach. It must be used with caution in patients who have cold, yang deficiency, yin deficiency, or deficiency of the Spleen and Stomach. Huang Lian is relatively safe, but may be associated with the following side effects: allergic reaction, allergic rash, dizziness, headache, tinnitus, nausea, vomiting, palpitations, shortness of breath, abdominal fullness, diarrhea, and reduction of red blood cells.