Chapter Three. Herbs that clear Heat
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1. What are the characteristics of herbs that clear internal Heat? What precautions should be observed when they are used?
According to the characteristics of internal Heat and the principle of treatment that Heat syndrome should be treated by Cold, all the herbs that clear Heat are cold in temperature. Because of their other properties, the individual herbs also have specific functions. The characteristics are as follows.
Pungent and cold
Pungency has a dispersing action; Cold may clear Heat. The former moves upwards and outwards, the latter moves inwards and downwards. In herbs that clear Heat, their cold property is stronger than their pungent property, therefore the main direction of the herb is downward. Herbs with both pungent and cold properties can more easily clear Heat than herbs with only a cold property. Because pathogenic Heat has a tendency to ascend and the cold herb has a tendency to descend, there is a severe conflict between the Cold and Heat. Cold herbs are able to suppress pathogenic Heat in very high dosage, so the Heat has to move downwards. But constrained Heat does not agree with Cold herbs and it hides itself in the body. As soon as the patient stops taking the cold herbs, the Heat spreads again. In clinical practice, some chronic infections, such as persistent sinusitis, bronchitis, gastroenteritis, dysentery, hepatitis and urinary tract infection, are the result of using high dosages of cold herbs or antibiotics.
Pungent-cold herbs are able to clear Heat completely without the possibility of producing constrained Heat or hidden Fire and are more suitable for this pathological situation. As pungency can disperse and lift Fire, it can divide the strength of Heat and reduce the conflict between the cold herbs and the Heat pathogenic factor. Thus pungency can assist the cold property of herbs to reduce Fire when the Fire shows itself clearly. These are especially effective for treating intensive Heat, constrained Heat and Fire blazing upwards. They are also used when there is Blood stagnation caused by Heat. Examples include Shi Gao ( Gypsum), Xia Ku Cao ( Prunellae spica) and Mu Dan Pi ( Moutan cortex).
Sweet and cold
Sweetness possesses tonifying and harmonizing abilities. Cold can clear Heat so that it may protect the Body Fluids and Yin. Sweet and cold herbs are effective for reducing Heat and protecting the Body Fluids as well as increasing them when they have been injured by Heat, and for relieving thirst. They are used when Heat is in the Qi and Nutritive levels in acute febrile diseases. The herbs Shi Gao ( Gypsum), Lu Gen ( Phragmitis rhizoma), Sheng Di Huang ( Rehmanniae radix) and Tian Hua Fen ( Trichosanthis radix) possess these properties.
Salty and cold
Saltiness possesses purging and softening actions. It enters the Kidney and the Blood. The salty-cold herbs may reduce Heat and descend Fire, protect the Blood and Yin, and increase the Body Fluids and Yin which have been consumed by Heat. Their effect of directing Heat downwards is stronger than that of pungent-cold herbs or sweet-cold herbs. They mainly treat the syndrome of Heat in the Nutritive and Blood levels in acute febrile diseases. Herbs such as Qing Dai ( Indigo naturalis) and Xuan Shen ( Scrophulariae radix) are the commonly used ones.
Bitter and cold
Bitter substances have a draining ability and a dry nature. Bitter-cold herbs are able to direct Heat or Damp-Heat downwards, reduce Fire and relieve Fire-toxin. Bitter-cold substances treat syndromes of Excess-Heat in the internal organs and in the Qi level, and are used for acute infectious diseases, sores, boils, carbuncles and skin disorders. Examples include Huang Lian ( Coptidis rhizoma), Huang Qin ( Scutellariae radix), Huang Bai ( Phellodendri cortex), Zhi Zi ( Gardeniae fructus) and Long Dan Cao ( Gentianae radix).
Generally speaking, to treat Excessive-Heat, herbs with pungent-cold, bitter-cold and sweet-cold properties should be used, and especially those herbs that enter the Lung and Stomach, Liver and Heart meridians. If the pathogenic Heat is not very strong but the Body Fluids have been injured, then sweet-cold and salty-cold herbs that enter the Liver and Kidney meridians are often chosen.
What precautions should be observed in the use of these herbs?
Most of the herbs that clear Heat are bitter and cold. They can quickly and strongly clear Heat and reduce Fire in the related organs and places. However, these herbs cannot be used for a long period of time with high dosage, otherwise they may cause a hidden Heat syndrome, the common side-effect of bitter-cold herbs. Because pathogenic Heat has a tendency of ascending and the cold herb has a tendency of descending, a severe conflict between the nature of Cold and Heat develops. Cold herbs are able to suppress pathogenic Heat when their dosages are very high, and the Heat thus has to move downwards; however, as Heat does not agree with the cold nature of the herbs, it withdraws and becomes constrained and hides itself in the body. As soon as the patient stops using the cold herbs, the constrained Heat is free from suppression and it spreads again. In clinical practice, some chronic infections, such as sinusitis, bronchitis, gastroenteritis and urinary tract infection, are the result of using high dosage of cold herbs or antibiotics. Therefore, a small amount of aromatic or pungent herbs that follow the nature of Fire and disperse constrained Fire should be used with the bitter and cold herbs in order to clear the Heat completely.
Generally speaking, cold herbs, and especially bitter-cold herbs, can easily injure the Yang and produce Dampness, so they should not be used for too long and at a large dosage. Bitter-cold herbs may also easily injure the Stomach and may cause stomach cramps and pain, so a proper dosage and a proper course should be arranged carefully. Also, patients with a weak constitution, or suffering from Cold in the Middle Jiao, or weakness of the stomach and intestines, should not use cold herbs in too great a quantity or for too long.
2. What kind of diseases can be treated by the herbs that clear Heat? How should one choose the herbs in clinical practice?
Herbs that clear Heat are used for treating internal Heat syndrome. They are cold in nature and able to reduce Heat, relieve Fire-toxin, cool the Blood and generate the Body Fluids. They can be used for various internal Heat syndromes, which can be differentiated according to the affected internal organs and the Defensive, Qi, Nutritive and Blood levels. Internal Excessive-Heat often develops from exogenous pathogenic Heat, although it also could be the result of other pathological processes in the body. However, no matter what the reasons are, when the Heat and its location are found, specific herbs can be used. The internal Excessive-Heat can be seen and the proper herbs thus can be chosen as follows.
Heat in the Heart and Small Intestine
If heat stays in the Heart and its meridian, the main manifestations are fever, thirst, a dry mouth, bitter taste in the mouth, restlessness, irritability and insomnia. The tongue body is red with a yellow, thin coating. The pulse is rapid and forceful. Herbs that are bitter and cold, or sweet and cold, and enter the Heart meridian are often chosen, such as Huang Lian ( Coptidis rhizoma), Zhu Ye Juan Xin ( Bambusae viride folium), Lian Zi Xin ( Nelumbinis plumula) and Sheng Di Huang ( Rehmanniae radix).
If the urine is also dark with a foul smell, and urination is accompanied by urgent and painful sensations, this indicates that the Small Intestine, the internally–externally related organ, is also disturbed by Heat. Herbs that are bitter and cold, and promote urination and clear Heat, such as Dan Zhu Ye ( Lophatheri herba) and Zhi Zi ( Gardeniae fructus), should be added.
In TCM, many kinds of sores, boils and carbuncles, which are characterized by warmth, swelling, redness and pain, are regarded as the result of a disturbance of the Heart-Fire. Herbs that are cold and bitter and enter the Heart meridian should be used—for instance, Jin Yin Hua ( Lonicerae flos), Lian Qiao ( Forsythiae fructus) and Pu Gong Ying ( Taraxaci herba).
Heat in the Liver and Gall Bladder
If Heat stays in the Liver and its meridian, the symptoms of the patient will include irritability, red and dry eyes, hypochondriac pain and distension, dream-disturbed sleep, insomnia, headache, dizziness and tinnitus. The tongue body is red or red on the border and the coating is yellow. The pulse is wiry, rapid and forceful. Herbs that are bitter and cold and enter the Liver and Heart meridians, such as Huang Lian ( Coptidis rhizoma), Long Dan Cao ( Gentianae radix) and Xia Ku Cao ( Prunellae spica), are selected.
If a female patient also complains that her menstruation is ahead of the expected time and is considerably heavy, this indicates that Heat has disturbed the Blood, and Mu Dan Pi ( Moutan cortex) and Chi Shao Yao ( Paeoniae radix rubra), which are cold and enter the Blood, should be added.
As the Liver opens into the eyes, Liver-Heat or Fire may cause disorders of the eyes, such as dry, red, painful eyes and blurred vision. Herbs that are sweet and cool and enter the Liver meridian are particularly effective in reducing Liver-Fire and benefiting the eyes, such as Qing Xiang Zi ( Celosiae semen), Xia Ku Cao, Jue Ming Zi ( Cassiae semen) and Mi Meng Hua ( Buddlejae flos).
If Damp-Heat accumulates in the Liver meridian, it may bring about symptoms such as swelling of the external genitals or itching in the vagina, eczema, and turbid and foul smelling leukorrhea and urine. Bitter-cold herbs such as Long Dan Cao, Ku Shen ( Sophorae flavescentis radix) and Zhi Zi ( Gardeniae fructus) should be used.
If Damp-Heat accumulates in the Liver and Gall Bladder meridians and obstructs the movement of Qi and water, patients may feel a sense of tightness in the chest, stickiness in the mouth and distension in the hypochondriac region. If Damp-Heat disturbs the secretion of bile then jaundice may appear. Bitter-cold herbs with a fragrant smell, which are able to penetrate turbidity, should be used—for example, Qing Hao ( Artemisiae annuae herba) and Chang Shan ( Dichroae febrifugae radix).
Heat in the Spleen and Stomach
The Spleen and Stomach are in the Middle Jiao. They are responsible for receiving the food and transforming it into Essence, Qi and Blood. Because of its physiological characteristics and functions, the Stomach is considered as a Yang organ which easily generates Heat, and pathogenic Heat easily accumulates here too. The Spleen is regarded as a Yin organ and it is easily injured by Cold; if the Spleen fails to transport water, then water may accumulate in the Middle Jiao and generate Heat, and bring about Damp-Heat here too.
A Stomach-Heat syndrome is characterized by severe thirst, a dry mouth, preference for cold drinks, a tendency to be hungry, toothache, facial swelling, foul breath, a red tongue body with a yellow coating and a flooding, rapid pulse. Pungent, sweet and cold substances that can disperse the intensive Heat and direct it downwards should be chosen—for example, Shi Gao ( Gypsum). Salty, bitter, sweet and cold herbs, which can clear Heat and generate the Body Fluids, are also a good choice—for instance, Zhi Mu ( Anemarrhenae rhizoma), Huang Lian and Sheng Di Huang. If there is bleeding (e.g. hematemesis, bloody stools or purpura), herbs that enter the Blood level and are cold in nature should be used to cool the Blood—for example, Mu Dan Pi, Chi Shao Yao, Zi Cao ( Arnebiae/Lithospermi radix) and Sheng Di Huang.
If Damp-Heat accumulates in the Middle Jiao, the patient may suffer from distension in the stomach and abdomen, loose stools or difficult bowel movements, a reduced appetite and eczema or other itching and weeping skin disorders. Bitter and cold herbs should be used to dry Dampness and clear Heat, such as Ku Shen, Bai Xian Pi ( Dictamni cortex) and Bai Tou Weng ( Pulsatilla radix).
Heat in the Lung and Large Intestine
The Lung is, in TCM, considered a delicate organ. Heat or Cold easily injures it. If Heat invades the Lung and disturbs its dispersing and descending functions, the patient may have a cough, shortness of breath, wheezing, dryness of the nasal passage and of the lips, and some patients chiefly have skin disease. To clear Heat and to restore the normal function of the Lung, sweet, pungent, bitter, salty and cold substances are suggested, such as Shi Gao, Zhi Mu, Huang Qin ( Scutellariae radix) and Lu Gen ( Phragmitis rhizoma).
If Heat disturbs the function of the Large Intestine, the main disorders are abnormal bowel movements and pain in the abdomen. Herbs that regulate bowel movement and clear Heat should be chosen—for instance, Huang Qin, Bai Tou Weng, Qin Pi ( Fraxini cortex) and Ma Chi Xian ( Portulacae herba).
The throat is the gateway of the Lung and the Heat in the Lung may also influence the throat. In clinical practice, many cases of swollen throat, sensations of obstruction in the throat, hoarseness and sore throat are caused by Heat in the Lung. Herbs such as Shan Dou Gen ( Sophorae tonkinensis radix), She Gan ( Belamcandae rhizoma) and Ma Bo ( Lasiosphaera) are particularly suitable for this situation. Because they enter the Lung meridian and are pungent, bitter and cold, they are able to clear Heat, relieve Heat-toxin in the throat and disperse constrained Heat, Phlegm and Qi in the throat.
Heat in the Kidney and Bladder
The Kidney is an organ that stores the Essence and is believed never to have a real Excessive syndrome during pathogenic processes. However, sometimes Empty-Heat in the Kidney can be very strong and may further consume the Essence and the Yin of the Kidney. The symptoms are night sweating, ‘bone steaming’ (a type of fever due to deficiency of Yin, which may not always show when taking temperatures, as though the heat is spreading from the inside of the bone to the outside of the skin), low-grade fever, bleeding gums, spermatorrhea and hypersexuality. Treatment should be given to nourish the Kidney-Yin and at the same time reduce Empty-Fire. Bitter, salty, sweet and cold herbs are often used—for instance Zhi Mu, Huang Bai ( Phellodendri cortex), Di Gu Pi ( Lycii cortex) and Sheng Di Huang.
The Bladder stores the urine, but the Kidney controls the opening and closing of the Bladder. If Heat invades the Lower Jiao or the Bladder, then turbid, scanty urine and difficult and painful urination may appear. Herbs that are bitter and cold and enter the Bladder and Small Intestine meridians should be used to clear the Heat and dry Dampness, or to promote urination, thereby eliminating Damp-Heat; these include Huang Bai, Zhi Mu, Dan Zhu Ye and Long Dan Cao.
Apart from treating internal Heat syndromes of the internal organs, herbs that clear Heat can be used for treating acute febrile diseases and pestilence. Acute febrile diseases are caused by pathogenic Heat invasion in different seasons. These pathogenic changes are characterized by a relatively acute onset, predominance of Heat in the initial stages, and damage of the Body Fluids and Yin. In clinical practice, this is seen in acute infections caused by bacteria, viruses or other pathogenic microorganisms, such as pneumonia, bronchitis, gastroenteritis and dysentery. Pestilence is a kind of virulent infectious disease caused by Heat-toxin—for instance, epidemic cerebrospinal meningitis and poliomyelitis. Acute febrile diseases develop in the body following the four levels—that is, Defensive ( Wei), Qi, Nutritive ( Ying) and Blood ( Xue).
Heat in the Defensive level
This is the initial stage of an acute febrile disease. The clinical manifestations are fever, slight aversion to wind and cold, headache, general aching in the body, a slight thirst and sweating, a red tip and border to the tongue, and a superficial and rapid pulse. Treatment must be given to expel Warm pathogenic factor and clear Heat. Herbs that are pungent, cool, or bitter and cold but fragrant and have dispersing properties should be used; these include Chai Hu ( Bupleuri radix), Ju Hua ( Chrysanthemi flos), Bo He ( Menthae herba), Jin Yin Hua and Lian Qiao.
Heat in the Qi level
This is the mid phase of febrile disease. The clinical manifestations are high fever without chills, perspiration, a dry mouth and thirst, red face, shortness of breath, scanty urine, a red tongue body with a yellow coating, and a rapid, forceful pulse. These symptoms indicate that the Heat is increasing inside the body, and it may injure the Body Fluids. Treatment should use sweet, salty, pungent and cold herbs to clear the Heat, reduce Fire, protect the Body Fluids and vent the Heat to the Defensive level and eliminate it. Herbs such as Shi Gao, Zhi Mu, Jin Yin Hua, Lian Qiao, Zhu Ye and Lu Gen ( Phragmitis rhizoma) are often used.
Heat in the Nutritive level
This is the later and critical stage of an acute febrile disease. The clinical manifestations are fever that worsens at night, severe irritability, restlessness, delirium and indistinct erythema and purpura. The tongue body is deep red without a coating; the pulse is thready and rapid. The symptoms indicate that the Heat is very intensive, has disturbed the Mind and Blood circulation, and has injured the Body Fluids and Yin. Herbs that are sweet, salty, bitter and cold are used to reduce the Fire and increase the Body Fluids and Yin, such as Sheng Di Huang, Mai Men Dong ( Ophiopogonis radix), Dan Shen ( Salviae miltiorrhizae radix) and Xuan Shen ( Scrophulariae radix). At the same time, herbs that can bring the Heat to the Qi level should be used. Because the Heat comes from outside, no matter how deep it has invaded the body, it must be eliminated from the inside to the outside. The commonly used herbs are Jin Yin Hua, Lian Qiao and Zhu Ye.
Heat in the Blood level
This is the most critical stage of an acute febrile disease. The clinical manifestations are fever which is higher during the night, restlessness, obvious purpura, hematemesis, epistaxis, blood in the stools, occasional coma, delirium, convulsions, a deep red or purple tongue without coating and a thready, rapid pulse. The symptoms indicate that Heat-toxin has already entered the Blood, consumed it, disturbed its circulation and caused bleeding. At this point, treatment should be focused on cooling the Blood and dispersing the congealed Blood in time. Herbs that are cold in nature, enter the Blood level and are pungent or with dispersing ability, should be used; these include Mu Dan Pi, Sheng Di Huang, Chi Shao Yao and Dan Shen.
During the recovery stage of a febrile disease, the pathogenic factors are no longer so strong, but the Qi and Yin of the body have also been severely consumed. The main symptoms are fever which starts in the night and disappears in the morning, or a lingering low-grade fever, tiredness, poor appetite, shortness of breath, a red tongue with thin coating or without coating, and a weak, thready, rapid pulse. Herbs that are sweet and cold and enter the Kidney, Stomach or Lung meridians are used to reduce the Deficient-Heat from the Yin level, such as Yin Chai Hu ( Stellariae radix), Di Gu Pi and Bai Wei ( Cynanchi atrati radix).
3. What are the characteristics of Shi Gao ( Gypsum)? Why is it often used with Zhi Mu ( Anemarrhenae rhizoma)? What are the differences between their actions?
Shi Gao is the most important substance to clear internal Heat, especially Heat in the Qi level. As it is a mineral substance and is heavy in weight, it is considered to have a descending tendency. It is pungent, sweet and very cold, and enters the Lung and Stomach meridians. Shi Gao can clear Heat in these meridians and organs directly and strongly. It is often used to treat Heat in the Lung when the patient has a high fever, thirst, irritability, shortness of breath, profuse sweating, a very red tongue and a forceful, rapid pulse. This syndrome can be found in pneumonia, acute bronchitis or some infectious childhood diseases. It can also be used in headache and toothache in the region where the Stomach meridian passes through.
Shi Gao can quickly and directly clear Heat in the Stomach; it also powerfully clears Heat in the other parts of the body. It is used in acute infectious disease, epidemic cerebrospinal meningitis, epidemic encephalitis B, measles and scarlet fever in children. It can also be used for disorders such as asthma, cerebrovascular accident when the Heat has spread through the Lung, Heart, Liver, Stomach and Large Intestine meridians.
Shi Gao can also be applied to clear Heat in the other organs and meridians. It is especially used when the Heat is so strong that it covers many meridians and organs. The Stomach meridian is the Bright Yang meridian where there is an abundance of Yang and Heat. That is because the Stomach is responsible for receiving, ‘ripening’, digesting and transporting food. The whole process produces a large amount of heat; therefore the organ and meridians are called the ‘Sea of Yang and Heat’. Moreover, the Stomach meridian connects with many other meridians; if Heat has spread through the whole body, then clearing Heat in the Bright Yang meridian may reduce Heat in the other meridians. This is a clearing-Heat strategy.
Shi Gao has another feature compared with the other herbs which clear Excessive-Heat. Most of those herbs are bitter and cold. Because bitterness has the tendency to move downwards, and Cold, of course, can clear Heat, they can quickly and strongly clear Heat and reduce Fire in the right situation. But these herbs cannot be used for a long period of time; with a high dosage or long period of time of usage, the bitter-cold herbs may cause a hidden Heat syndrome, which is a common side-effect of bitter-cold herbs. Moreover, bitterness possesses a drying property, so may injure the Yin of the body, which has already been injured by Excessive-Heat. Bitter and cold substances may injure the Stomach-Qi and Yang and disturb the digestion, especially in patients with weakness in the Middle Jiao. Shi Gao has a strong point compared with these herbs: it is very cold, but sweet. The combination of cold and sweetness may generate the Body Fluids and benefit the Yin of the body. Shi Gao can strongly clear Heat, but without the side-effect of injuring the Stomach-Yang. Moreover, Shi Gao also has a pungent property, so it not only clears Heat and reduces Fire but also disperses the Heat. This feature is closer to the ascending nature of Fire so that it does not cause constrained Fire or hidden Heat. In addition, the pungent property of Shi Gao can vent Heat from the Qi level to the Defensive level in acute febrile diseases and is more effective for Excess conditions.
Zhi Mu is bitter and cold and enters the Lung, Stomach and Kidney meridians. Although it is cold and bitter, it is moist in nature. This is the difference from the other herbs that are bitter, cold and with drying properties. It can clear Heat, reduce Fire, moisten the Dryness and generate Yin. Because it can generate the Kidney-Yin, it is particularly used for Heat in the Qi, Nutritive and Blood levels. Shi Gao and Zhi Mu are often used together, as this enhances the effect of clearing Heat.
4. What are the differences between Sheng Shi Gao (raw Gypsum) and Duan Shi Gao (calcined Gypsum)?
Shi Gao is a kind of mineral substance which contains calcium sulfate. After being mined, cleaned and smashed, the product is called Sheng Shi Gao. Sheng Shi Gao is sweet, very cold and pungent, and enters the Lung and Stomach meridians. It can strongly clear Excessive-Heat in the Lung and can be used for febrile diseases which manifest with high fever, intense thirst, irritability, profuse sweating, shortness of breath and cough. At the same time, it can clear Stomach-Fire and can therefore treat headache, toothache, mouth ulcers, a foul smell in the mouth and burning in the Stomach.
After Shi Gao is calcined by strong fire, it is called Duan Shi Gao. Its cold and pungent properties are reduced by this process, while it obtains an astringent property and is effective in drying Dampness. This fine powder can be applied topically to treat skin diseases or wounds that are weeping, and is also used if the healing process is slow, such as in eczema, burns and ulcerated sores.
5. Why is Shi Gao ( Gypsum) the first-line choice when Excessive-Heat spreads through the entire body?
The syndrome of Excessive-Heat spreading throughout the entire body is often seen in acute febrile diseases which manifest as high fever without chills, profuse sweating, anxiety, thirst, irritability, even unconsciousness and delirium. The patient has a very red tongue with dry yellow coating and a rapid, forceful pulse. This syndrome can be seen in some infectious diseases and inflammations in Western medicine. At this stage, the Heat is so strong that it is hard to tell which organ is not disturbed by the Heat. The treatment must be given in time to reduce Heat quickly and protect the Yin and Body Fluids in order to stop the process of the disease. The Stomach meridian of foot Bright Yang has an abundance of Qi and Blood from the digestion and transportation of food. It also easily produces Heat from all these activities; that is why the Bright Yang meridian and organ are regarded as the ‘Sea of Food’ and the ‘Sea of the Yang and Heat’.
One of the strategies for clearing Heat from the entire body is to clear Heat from the Bright Yang meridian and organ. After that it will be much easier to reduce the Heat from the other organs and meridians. As Shi Gao enters the Stomach meridian and is very cold in nature, it can rapidly and strongly clear Heat from the Bright Yang organ and meridian in order to reduce Heat elsewhere. Since it is sweet and cold, it can also generate the Yin and Body Fluids to supplement the consumed fluids and to prevent their further consumption. Moreover, it is also pungent, so can disperse Heat and direct it downwards; therefore it can clear Heat without the possibility of forming hidden Fire. For these reasons, Shi Gao is an excellent substance for treating internal Excessive-Heat.
6. What are the differences in clearing Liver-Heat between the herbs Zhi Zi ( Gardeniae fructus), Xia Ku Cao ( Prunellae spica), Long Dan Cao ( Gentianae radix) and Chuan Lian Zi ( Toosendan fructus)?
All four of these herbs are bitter and cold, are very effective for draining Liver-Fire and are often used for Excessive Liver-Heat syndrome. However, there are differences between their actions.
Zhi Zi is bitter and cold, and does not enter the Liver meridian, but enters the Heart, San Jiao and Lung meridians. Its bitter and cold nature gives it a descending action, and it is able to clear Heat and to reduce Fire from the Upper Jiao, especially from the Heart. As the Liver and Heart have a mother–son relationship according to the Five Elements theory, Liver-Fire can very easily and quickly transport the Heat into the Heart. Treatment aimed at reducing Heart-Fire in order to reduce Liver-Fire is very effective and has become a commonly used strategy. For this reason, Zhi Zi can not only reduce Heart-Fire and treat restlessness, insomnia, a bitter taste in the mouth and a warm sensation in the chest, but also reduces Liver-Fire indirectly and treats irritability and dream-disturbed sleep. Besides clearing Heart-Fire and Liver-Fire, this herb has the function of promoting urination, reducing Fire and regulating the San Jiao water passage. It is also used for painful urinary dysfunction due to Damp-Heat in the Lower Jiao, as well as jaundice due to Damp-Heat in the Liver and Gall Bladder when bile is obstructed by Damp-Heat, such as in acute hepatitis and acute cholelithiasis.
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