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Chapter 15 of 20
本草纲目
The Insects Section of the Compendium of Materia Medica contains extensive records of insects and their derivatives used as medicine, covering several dozen insect-based medicinals including honey, beeswax, silkworms, blister beetles (cantharides), scorpions, leeches, cicada sloughs, centipedes, earthworms, and toads. On the basis of organizing the experiences of his predecessors, Li Shizhen systematically documented each drug's nature and flavor (properties and tastes), principal indications, and specific methods of use.
In terms of content, the insect-based medicinals can be roughly categorized into several groups:
Sweet, neutral, and nourishing type: Such as honey🍯 (sweet, neutral, non-toxic; moistens the intestines, unblocks the bowels, relieves urgency, and alleviates pain), beeswax (sweet, slightly warm; stops dysentery, regenerates flesh), and insect white wax (regenerates flesh, arrests bleeding, rejoins tendons and bones). These medicinals lean toward supplementation, moistening dryness, and promoting tissue regeneration—they are the most gentle and most accessible in everyday life within the insects section.
Wind-dispelling and collateral-unblocking type: Such as white stiff silkworm (salty, pungent, neutral; dispels wind, resolves phlegm, dissipates masses), whole scorpion (sweet, pungent, neutral, slightly toxic; extinguishes wind, arrests convulsions, unblocks collaterals, alleviates pain), centipede (pungent, warm, toxic; dispels wind, settles fright, attacks toxins, dissipates masses), and cicada slough (salty, sweet, cold; disperses wind-heat, promotes eruption of rashes, relieves itching). The ancients believed that insect medicinals excel at "borrowing and threading" (moving through the body), capable of penetrating deep into the channels and collaterals to search out and expel latent wind pathogens. Therefore, they were primarily used for convulsive conditions, bi pain (arthralgia), and sores/toxicity.
Blood-breaking and stasis-dispelling type: Such as leech (salty, bitter, neutral, slightly toxic; breaks blood, dispels stasis), gadfly (bitter, slightly cold, toxic; breaks blood, unblocks menstruation), ground beetle (i.e., Eupolyphaga; salty, cold, toxic; breaks stasis, rejoins bones), and blister beetle/mylabris (pungent, cold, toxic; attacks toxins, erodes sores). These medicinals are fierce and potent in nature; the ancients believed their "blood-devouring" nature could break up stagnant blood and accumulated masses within the body.
Toxin-attacking and swelling-dispersing type: Such as toad venom (chan su) (sweet, pungent, warm, toxic; attacks toxins, reduces swelling, alleviates pain), wasp nest (sweet, neutral, toxic; attacks toxins, kills parasites), mole cricket (salty, cold; promotes diuresis, reduces swelling), and tadpole (clears heat, resolves toxins). These are mostly applied topically or taken internally to attack toxins and dissipate masses.
Miscellaneous treatment type: Such as firefly (improves vision), silverfish (promotes diuresis, treats strangury), woodlouse (promotes urination), grub (external use for sores), and slug (applied externally for centipede bites). Each has its specific use.
The methods of administering insect medicinals are extremely diverse: internal administration (ground into powder and swallowed, taken with wine, made into honey pills, or decocted as a soup), external application (poulticing, fumigation and washing, suppository administration, ear packing, eye-dropping, nasal insufflation), as well as physical therapies (such as honey suppositories for relieving constipation, or live leeches for drawing out pus). This reflects the ancient medical concept of "using the nature of insects to treat human diseases," applying the distinctive characteristics of insects themselves (burrowing/threading, blood-devouring, hole-penetrating, flying) to manage various categories of human ailments.
Glossary of terms:
The core medical principle embodied in the insects section is a quintessential application of traditional Chinese medicine's "analogical association based on observed phenomena" (qu wen shua xiang) in materia medica.
1. Insects thread and course, excelling at penetrating channels and collaterals. The ancients observed that insects are skilled at crawling, boring through, and flying, and therefore believed their medicinal nature "excels at threading and drilling," enabling them to penetrate deep into the channels, collateral vessels, joints, and the tiny spaces between the viscera—searching out and expelling lurking wind pathogens, stagnant blood, and phlegm turbidity. As the later Warm Disease school put it: "Insect and ant products search out and expel pathogenic elements lodged in the collaterals." Scorpion, centipede, and white stiff silkworm are used for wind-stroke, convulsions, and bi syndromes precisely because of this understanding—they can reach depths of the "collateral vessels" where plant-based remedies cannot go.
2. Combating toxicity with toxicity: using insects to subdue pathogens. Mylabris, toad venom, and wasp nest are all toxic substances. The ancients considered that their "toxicity" could precisely counter the body's "toxic pathogens" (such as sores, scrofula, and malignant ulcers). This idea of "counteracting toxin with toxin" is an important principle in external medicine of TCM—applying the fierce and violent nature of toxic medicinals to attack stubborn pathological products. At the same time, the ancients placed great emphasis on processing (e.g., removing wings and legs, stir-frying with rice, calcining, wine-processing) to reduce toxicity on the one hand and preserve efficacy on the other.
3. Blood-devouring insects break blood and dispel stasis. Leeches, gadflies, and ground beetles all have the habit of sucking blood or dwelling in putrid blood. Based on this, the ancients inferred that they could "break blood and dispel stasis," and used them to treat severe blood-stasis conditions such as postpartum blood stasis, traumatic injuries, and abdominal masses/accumulations. The "Di Dang Tang" (Resistance Decoction) in Zhang Zhongjing's Treatise on Cold Damage, which uses leech and gadfly, is the classic expression of this idea.
4. Even among insects, some are sweet, neutral, and nourishing. Honey, beeswax, and insect white wax—all sweet and neutral in nature—demonstrate that not all insect-section medicinals are fierce and attacking; some have moistening, regenerating, and supplementing effects. Honey moistens the intestines, unblocks the bowels, relieves urgency, and alleviates pain; beeswax regenerates tissue and arrests bleeding. This shows that ancient physicians had a multifaceted understanding of insect-derived substances.
5. External therapies dominate, with diverse and ingenious methods. Insect medicinals are extensively employed in external treatments: rectal suppositories, ear packing, eye drops, nasal insufflation, poultices, fuming/soaking washes, and mouth rinses. This embodies the TCM principle that "the rationales of external treatment are the same as those of internal treatment"—medicinal action absorbed through the skin and mucous membranes can equally treat internal conditions while reducing the risk of oral toxicity.
Aspects that can be confirmed:
Honey's laxative effect: Modern medicine confirms that honey contains large amounts of fructose and glucose; in some individuals, fructose malabsorption can produce an osmotic laxative effect. Its hypertonicity also helps retain water in the intestinal lumen, promoting bowel movements. Honey suppositories as a mild means of relieving constipation still have analogous clinical applications (the same principle behind glycerin suppositories and enemas).
Honey's antimicrobial and wound-healing effects: Modern research confirms that honey has broad-spectrum antimicrobial activity (due to low pH, high osmotic pressure, hydrogen peroxide content, and various antibacterial components) and promotes wound healing. This strongly resonates with the Compendium's records of honey being used externally for "hot oil burns" and "oral ulcers."
Hirudin's anticoagulant effect: Hirudin (leech anticoagulant) is one of the most potent natural anticoagulants ever discovered, specifically inhibiting thrombin. Modern medicine has developed it into an anticoagulant medication (e.g., bivalirudin) for preventing and treating thrombotic diseases. This coincides remarkably with the ancients' use of leeches to "break blood and dispel stasis." Hirudotherapy—the use of live medicinal leeches—remains in use in microsurgery today (e.g., for venous congestion after digital replantation).
Bee venom's analgesic and anti-inflammatory effects: Modern research suggests that peptide components of bee venom (such as melittin) possess anti-inflammatory and analgesic properties. There is a certain research basis for apitherapy (bee-sting therapy) as an adjunctive treatment for rheumatoid arthritis—this corresponds with the ancients' use of bees and wasp nests for "wind-type bi of the hands and feet."
Anticonvulsant effect of cicada slough: Animal experiments suggest that the extract of cicada slough has certain sedative and anticonvulsant effects, providing partial pharmacological support for its historical use in treating "pediatric convulsions" and "tetanus."
Antitumor research on cantharidin: Cantharidin and its derivatives (such as norcantharidin) have shown inhibitory effects on certain tumor cells in laboratory research, and modern medicine has developed these into antitumor adjunctive drugs. This resonates with the ancient understanding of mylabris's potent ability to "attack toxins and erode sores."
Points that must be frankly stated:
Lack of modern evidence-based support for certain indications: Uses such as silkworm-egg paper for "lifelong infertility" (contraception), ascaris worms dropped into the eyes for eye diseases, fireflies for improving vision, or silverfish for treating strangury lack modern pharmacological evidence. Some of these are recordings of ancient folk experience and should not be exaggerated in their efficacy.
Safety issues of toxic substances: Mylabris, toad venom, centipede, scorpion, and wasp nest are all toxic substances. Oral ingestion readily causes poisoning. Although the ancients had processing methods to reduce toxicity, the safety margin is extremely narrow. Modern clinical practice rarely uses them internally, and self-administration is strictly prohibited.
Hygienic and ethical concerns: The original text includes uses of maggots, roundworms, waste-pit materials, and live-leech blood-sucking as therapy. Under modern sanitary and ethical standards, these should not be replicated. Such methods reflect practical expedients from antiquity when sterile conditions and effective drugs were unavailable.
Limitations of "analogical association": The inferences drawn from insects' "threading and drilling," "blood-devouring" qualities, and similar attributes, though supported by some clinical experience, are based on analogical reasoning rather than strict causal relationships. They require investigation and verification through modern scientific research.
(The following are general life insights, not targeting any specific disease and not constituting diagnostic or treatment advice.)
Daily-use tips on honey: As a natural food, honey consumed in moderate amounts aids in moistening dryness and providing nourishment. However, note: infants under one year of age should not consume honey (due to the risk of botulinum spores); honey has a high sugar content, so those with diabetes or obesity should control their intake; honey should not be heated at high temperatures for prolonged periods, as this may destroy its active ingredients. 🌿
Aligning with nature in daily routine: Many insect-section drugs relate to "wind" and "fright." The ancients deemed "wind as the chief of the hundred diseases" and especially stressed avoiding invasion by wind-pathogens. In daily life, guarding against wind, keeping warm, and maintaining regular routines provide the foundational protection against external-contraction illnesses.
The worldview of "unobstructed flow": A large proportion of insect-section drugs address various forms of "blockage"—stubborn stool, difficult urination, insufficient lactation, and amenorrhea. The ancients held that "if there is flow, there is no pain; if there is pain, there is no flow." Keeping all bodily systems open (the intestinal tract, urinary tract, blood/qi, channels and collaterals) constitutes the underpinning of health. This suggests to us that mindful diet, appropriate exercise, maintaining regular bowel movements, and emotional equanimity are among the most important everyday-health practices. 💨
The prudence of preferring external therapy over internal administration: The extensive use of external dressings, fumigation/washing, and suppository insertion in the insect section reflects the cautious ancient maxim: "if it can be used externally, do not take it internally." The lesson today: for superficial physical discomfort (such as skin or mucosal symptoms), consider safe topical management first, and avoid unnecessary oral medications.
An attitude of reverence toward "toxic" substances: When the ancients used toxic materia such as mylabris and toad venom, they applied extreme caution, with strict protocols on processing, dosage, and methods of administration. This reverence toward toxic substances reminds us in everyday life to be judicious about any "high-potency" product—never chasing "strong medicine for speedy results."
Insect medicinals and collateral disease theory: The Qing dynasty physician Ye Tianshi posited that "protracted illness enters the collaterals"—in chronic disease, pathogens become embedded in the collateral vessels, insufficiently treatable by botanical medicines alone; instead, insect/ant products are needed to "search and expel collateral pathogens." Insect-section medicinals are precisely the pharmacopoeial basis of this therapeutic approach, leaving an enduring legacy for the treatment of post–wind-stroke sequelae, chronic arthralgia, tumors/accumulations, and other conditions.
Five-Insect Pills / Five-Insect Formula: In later formula studies, combinations of whole scorpion, centipede, earthworm (di long), ground beetle, and white stiff silkworm establish the celebrated "five-insect" composite formula (Wuchong Wan/San), drawing on the strengths of each creature to dispel wind, unblock collaterals, break stasis, and dissipate masses. Its lineage may be traced back directly to the systematic collation of insect medicinals in the Compendium's Insects Section.
Restore the corresponding organ with organs / supplement form with parallel form: Several insect drugs embody a practice of matching by analogy. Ootheca mantidis (mantis egg case) treating seminal emission and enuresis offers an example: because the egg case analogizes in form the "storehouse of reproduction," it is held capable of consolidating the essence-energy.
Processing to reduce toxicity: Removing wings/legs of mylabris and stir-frying with rice; processing toad venom with wine; removing the head and feet of centipedes—demonstrates an overriding canon that "toxic medicines are processed so as to be safely used." The matter-of-factly "tonic vinegar mixtures" encoded in these methods serve not merely technique to improvement but protect as a system of safe medicinal presentation.
Honey with pills: In the preparation of Chinese herbal medicines, honey’s paramount use is as an excipient for producing honeyed boluses. Many passages in the insect records direct "add honey to make boluses" across various formulas, showing 甘 slow harmony. ““When ingesting these formulations.
Shen Nong's Classic of the Materia Medica (Divine Husbandman's Classic—Shen Nong Ben Cao Jing)): Bug-derived pharmaceuticals appear throughout the three grades in the ancient fundamental manuscript; indeed honey in the superior and leech in the inferior stand apart, “主要逐恶血瘀血”—allowing comparisons for one to the other for understanding insects among the ancients in remote times.
Treatise on Cold Damage and Miscellaneous Diseases (Shang Han Za Bing Lun): Zhang Zhongjing devoted known competence—as but among antique practitioners he merits equal primacy across Di Dang Tang ‑hemplucking or displacing varieties and leech/gadfly)—"Distills includes Dry Earth Def." and Kouk Chah... to pills, formed specifically alongside drones nest.
Systematized Identification —Warmdisease Acquisition (Wen Bing Tiao Bian): Through comprehensive Wumen jade inheritance, Wu Jutong lucid explores their stage employing the “old male also always rule in earlier illness says chronic ails → enters Luven”??> Better the overall approach, complete those salient contributions establishing principle one. Right here clarifies relevant opinions: "never stuck on the kind severity from particular details formula..."
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