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[Harm] Areca nut (Binglang) can cause the descent of various Qi mechanisms, reaching to the extreme lower part. For patients with Qi deficiency and sinking, it should be avoided. If the Spleen and Stomach are deficient, even if there is food stagnation, it is not suitable for use.
For diarrhea: It is not suitable for use if there is no tenesmus (a feeling of incomplete defecation with straining). Do not use for heart and abdominal pain without solid accumulation or non-parasitic accumulation. It is not suitable for malaria not caused by mountainous miasma. Any disease belonging to dual deficiency of Yin and Yang, insufficiency of Middle Qi, rather than gastrointestinal congestion or distension from retained food, is strictly contraindicated. Excessive consumption can also cause fever. In Lingnan, where miasma is prevalent, people drink Areca nut as tea, which depletes true Qi; therefore, locals suffer from frequent illness and short lifespans.

[Benefits] Bitter, pungent, warm in nature. Enters the Spleen, Stomach, and Large Intestine meridians. It descends rebellious Qi from the upper body, rapidly relieves tenesmus, attacks phlegm masses, removes swelling, digests food stagnation, treats malaria, cures Hong Kong foot (Beriberi), and kills parasites. Pungency breaks Qi, bitterness kills parasites.

[Processing] Soak until permeable, then slice. In recent prescriptions, some are roasted over fire. However, raw Areca nut produced locally must be obtained within the local region. Those from other places have necessarily been boiled and fumigated; how can they be considered raw?

[Harm] The *Neijing* states: "Excess conditions require purgation." Da Huang (Rhubarb Root and Rhizome) has a strongly bitter, cold, and drastic purgative nature, with fierce momentum, driving straight through. Unless there is heat accumulation in the Blood level and deep, solid pulses in all six positions, do not lightly administer its purgative action. Da Huang acts on the Blood level. If the disease is in the Qi level, or in cases of Stomach cold and Blood deficiency, or during pregnancy and postpartum, using it constitutes punishing the innocent (damaging healthy Qi unnecessarily). Whenever blood obstruction is due to Blood exhaustion rather than heat accumulation; chills and fever due to Yin deficiency rather than Blood accumulation; masses (Zheng Jia) due to Spleen and Stomach weakness rather than stagnation; constipation due to Blood stasis, dryness, or intestinal dryness rather than food stagnation; lower abdominal pain in women due to Liver channel Blood deficiency rather than menstrual obstruction or old blood stasis, it is not suitable for use. If the initial stage belongs to Stomach deficiency, the treatment should focus on tonifying Stomach Qi and clearing damp-heat, avoiding reckless purgation. Careful differentiation is essential. Reckless misprescription damages Stomach Qi and may lead to critical danger. Beware!

[Benefits] Strongly bitter and cold. Enters the Spleen, Stomach, Heart, Liver, and Large Intestine meridians. It purges有形 (solid) accumulations; suitable for water, food, and phlegm knotting. It has the power to restore order from chaos, earning the name "General" for its swift and drastic action. It clears excess heat in the Blood level; suitable for Blood stasis and rebellious Blood.
Zhang Zhongjing's Xiexin Tang (Drain the Epigastrium Decoction) treats vomiting and epistaxis due to insufficient Heart Qi. This actually refers to excess pathogenic fire in the Pericardium, Gallbladder, and Stomach due to insufficient Heart Qi. Although called "Draining the Heart," it actually drains latent fire in the meridian Blood. Furthermore, for epigastric fullness that is soft upon pressure, Dahuang Huanglian Xiexin Tang (Rhubarb and Coptis Decoction to Drain the Epigastrium) is used to drain Spleen and Stomach damp-heat, not the Heart itself. When a disease originates from a Yin pattern, purgation leads to fullness; this is cold injuring the Ying-Blood, with pathogenic Qi binding in the Upper Jiao. The upper Stomach corresponds to the Heart area, so it is called "Draining the Heart," but it actually drains the Stomach. When a disease originates from a Yang pattern, purgation leads to chest bind (Jie Xiong); this is heat pathogen sinking into the Blood level, also located at the upper Stomach. Both Daxianxiong Tang Wan (Major Draining the Chest Decoction Pills) use Da Huang to drain pathogenic factors in the Spleen and Stomach Blood level. If the chest bind is in the Qi level, only Xiaoxianxiong Tang (Minor Draining the Chest Decoction) is used. If fullness is in the Qi level, only Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) is used.

[Processing] Sichuan-produced varieties with brocade-like patterns are superior. Wash, slice, soak to extract juice, and mix into other medicines. For processed use, soak in wine or steam with wine mixed, which moderates the nature and allows upward movement. For pathogenic heat located in the upper body, the ascending property of wine helps achieve efficacy. Raw and cooked Da Huang differ in strength; raw is more drastic. To achieve purgation, one must not consume grain food immediately after administration. Da Huang cannot promote purgation when combined with grain food.