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The horsefly, also known as the horsefly insect (Machang), has effects roughly similar to those of the leech (Shuizhi). However, its bitter taste is more pronounced and it possesses a salty flavor. Its nature is such that it bites and sucks the blood of cattle, horses, and other animals. Bitterness can purge stagnation, while saltiness enters the blood level to promote circulation. Furthermore, its green color corresponds to the Liver channel, and its nature is hot; since it feeds on blood, it is used to treat all diseases caused by blood stasis (Xuejie). Nowadays, people do not use it because they consider it toxic. However, Zhang Zhongjing's Didang Tang (Thistle Decoction) treats Taiyang disease (diseases resulting from pathogenic invasion of the Taiyang meridian), characterized by yellowing of the body, deep and knotted pulse, fullness in the lower abdomen with free urination, and a manic-like mental state; this is Blood Accumulation (Xuxue). The formula uses leeches and horseflies. If urination is difficult, it is not blood accumulation, and Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill) should be used instead. This pill treats consumptive disease with emaciation, internal dry blood retention, skin rough like fish scales, and dark circles around the eyes; it contains both leeches and horseflies because they can dissipate old blood stasis accumulated in the zang-fu organs, yielding miraculous effects. Generally speaking, using toxic herbs to treat diseases is like using criminal law to punish thieves; without such measures, it is insufficient to dispel evil pathogens and restore righteous qi.

The female horsefly (Muheng) is considered efficacious when found sucking blood from the bellies of cattle or horses. It expels blood stasis, treats blood obstruction, alternating chills and fever, limb soreness, red and painful eyes, tearing due to trauma, breaks down hard masses, eliminates abdominal accumulations and growths, removes foul blood from the chest, abdomen, and five zang organs, unblocks meridians, and induces abortion rapidly. After collection, it is dried in the shade, wings and legs are removed completely, and it is stir-fried before use.

It inherits the qi of Fire and Metal, hence its taste is pungent and sweet, its temperature is warm, and it is toxic. It belongs to Wood, has a green color, and specifically enters the Foot Jueyin Liver Meridian. Due to its pungent and warm dispersing nature, it enters the Liver to eliminate wind and drive out pathogens. It is required for treating true wind-stroke in adults and acute convulsive wind in children. When the whole insect is used, it is called Quanxie (Whole Scorpion). Using only the tail is called Xieshao (Scorpion Tail), which has an even stronger force and specializes in descending and purging downward. For infantile umbilical wind (Qifeng), suitable for Wind-Dispersing Powder treatment: it manages wind strike after umbilical cord cutting in newborns, causing cyanotic lips, mouth puckering with white foam, and inability to nurse. Use 21 whole scorpions, coat with non-ash wine, roast, and grind into powder. Add a small amount of Mosher (Shexiang). Each dose is taken by mixing half a "zi" (a traditional unit of weight) with decoction of Lonicerae Japonicae Flos (Jinyinhua, Honeysuckle Flower). For adult wind-phlegm, use one scorpion with head and tail intact, wrap it with four mint leaves, roast over fire until scorched, grind together into powder, take as one dose, washed down with plain water. For pediatric convulsive wind, divide into four doses, administered as above. If roasted together with Juglans regia seed (Hetao, Walnut) and ground into yellow powder, taken with honeysuckle tea, it treats chronic buboes (Hengxuan) that fail to heal.

The scorpion (Xie) treats pediatric convulsions and epilepsy, twitching of hands and feet, adult wind-stroke with deviation of the mouth and eyes, expels wind-phlegm causing deafness, resolves wind-toxicity manifesting as urticaria, excels at driving out Liver wind, and penetrates deeply into bones and sinews. Zhu Danxi stated: "Traumatic wind often leads to death; without the whole scorpion to open blockages, [treatment fails]. Roasting it, grinding it into powder, and taking it with wine demonstrates its clear efficacy in treating wind disorders."