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Radix Sophorae Flavescentis (Kushen, 苦参), bitter in taste, cold in nature, heavy and sinking, purely yin, non-toxic. It enters the meridians of the Heart, Liver, Kidney, and Large Intestine. It treats intestinal wind with hematochezia (bleeding from the rectum due to wind pathogen), severe abdominal pain caused by heat-dysentery (dysentery caused by damp-heat accumulation in the intestines) that is unbearable; it cures delirious speech and mental restlessness, and the critical condition of chest binding (a syndrome where pathogens bind in the chest and epigastrium). For those suffering from erythema leprosy (a stubborn skin disease characterized by loss of eyebrows), it has merit in dispelling wind. For those with jaundice (yellowing of the skin and eyes) accompanied by enuresis, it produces immediate effects in draining water. It sweeps away whole-body itching and rashes, stops sudden acute heart pain, kills scabies mites, breaks up masses and accumulations (abdominal lumps), dissipates stagnant qi, brightens the eyes and stops tearing, relieves thirst and generates fluids, unblocks the nine orifices, and promotes bowel movements. However, its action is overly swift and sharp; it should be used sparingly as an assistant or guide herb, not in large doses as a sovereign or minister herb. Claims that it tonifies the Kidney, calms the Five Zang organs, and stabilizes the mind are unreliable statements.

One might ask: Everyone knows that Radix Sophorae Flavescentis does not tonify the Kidney, but few know the reason why it damages the Kidney. Does the fact that it does not tonify the Kidney need asking? Its heavy cold nature destroys Kidney Yang, inevitably leading to five-watch diarrhea (diarrhea occurring before dawn); its bitter-cold nature drains Kidney Qi, inevitably causing pain in the lower abdomen. Since Radix Sophorae Flavescentis is bitter and cold, with a sinking and descending qi mechanism, how can it fail to destroy and drain Kidney Qi? Consequently, five-watch diarrhea and lower abdominal pain are inevitable. To claim it tonifies the Kidney after destroying and draining Kidney Qi is incomprehensible; I urge you not to believe such claims.

Semen Persicae (Qianniu, 牵牛子), pungent and bitter in taste, cold in nature, toxic. Although there are black and white varieties, their functions are identical. It enters the Spleen, Large Intestine, and Small Intestine meridians, and also connects to the Bladder meridian. It removes stagnation and qi-related urgency/dyspnea, treats flaccid masses (subcostal lumps) and gu poison, facilitates difficult urination and defecation, and effectively treats leg fullness and edema. However, its action is extremely swift and sharp, consuming the body's primordial Qi (Yuan Qi, 元气), so it must not be used lightly. While omitting the reasons for not using it lightly and avoiding it entirely is also a biased view, Semen Persicae benefits the dampness of the Lower Jiao by draining water within the Blood level, which is very appropriate. It cannot drain dampness of the Upper Jiao. Draining water within the Qi level invariably damages primordial Qi. Li Dongyuan analyzed this clearly, leaving little room for further debate, yet he did not discuss the Middle Jiao. The Middle Jiao resides between Qi and Blood; since Semen Persicae can drain water from the Blood level, why could it not partially drain water from the Blood level in the Middle Jiao? Alas! Water-dampness is a pathogen. If Semen Persicae can promote urination, why distinguish between Qi and Blood? However, water-dampness enters from below. Damp-pathogens entering from below are external water pathogens, not internal injury water pathogens. Semen Persicae can only purge external water but cannot eliminate internal dampness. Edema of the Upper Jiao results from Qi deficiency failing to transform water, causing bloating upon water intake; over time, it resembles general edema. Thus, using Semen Persicae often exacerbates the condition. For Lower Jiao edema due to Qi deficiency, using Semen Persicae for rapid purging is also often ineffective, similar to the Upper Jiao case. Only true external water pathogens respond well to Semen Persicae's diuretic action. Thus, it is clear that Semen Persicae treats only external water, not internal dampness—not merely treating water in the Blood but not in the Qi. How then to distinguish external water from internal injury water? This distinction lies within the skin. External pathogenic water yields to pressure like mud. Internal injury water rebounds immediately after pressure; even if it does not rebound immediately, it cannot be molded like clay, showing variable responses to pressure. Immediate rebound indicates Qi deficiency but preserved Mingmen Fire (Gate of Life Fire); prolonged non-rebound indicates extreme Qi deficiency and loss of Mingmen Fire. Cases yielding like mud require Semen Persicae to drain water. Cases not yielding like mud, whether rebounding or not, require tonifying the Pre-heaven Qi of the Kidney combined with strengthening the Spleen and opening the stomach to benefit Post-heaven Qi (Hou Tian Zhi Qi, 后天之气) to achieve efficacy. Using Semen Persicae here would not only consume Qi but risk fatal Qi loss alongside fluid drainage. One must be cautious. I highlight the merits of Semen Persicae while correcting errors in Li Dongyuan’s herbal theories.

I have clarified that Semen Persicae treats external water but not internal dampness. However, its treatment of external water varies. External water enters from below (feet) or from the middle (waist and umbilicus). People recognize foot-entry edema easily due to initial foot swelling, but miss waist-and-umbilicus entry, characterized by heavy waist and swollen umbilicus. Failing to distinguish these sources and universally applying Semen Persicae explains its occasional ineffectiveness. Therefore, methods of using Semen Persicae must differ. For water entering from the feet, use Semen Persicae together with Kansui Radix (Gansui, 甘遂) to resolve it. For water entering from the waist and umbilicus, combine Semen Persicae with Atractylodis Macrocephalae Rhizoma (Baizhu, 白术). After one dose, waist heaviness resolves and umbilical swelling subsides; after three doses, both areas become clear.