Ku Lian Pi (苦楝皮) — Melia Bark | TCM Herb Guide

At a Glance

• Herb: Ku Lian Pi
• Chinese name: 苦楝皮 (Kǔ Liàn Pí)
• Latin name: Meliae Cortex
• Nature: Cold
• Taste: Bitter
• Meridian: Liver / Spleen / Stomach
• Category: Herbs that Expel Parasites
• Introduction: Ku Lian Pi (苦楝皮), Cortex Meliae, is the dried root bark or stem bark of Melia azedarach or M. toosendan. A powerful anthelmintic, it kills roundworms, hookworms, and pinworms and also clears damp-heat from the skin. Its toosendanin alkaloids paralyze parasites by blocking neuromuscular transmission. Due to significant hepatotoxicity at high doses, it must be used within strict dosing limits and avoided in patients with liver disease or weak constitutions.

Action

• Kills intestinal parasites (roundworms, hookworms, pinworms)
• Clears damp-heat from skin
• Relieves itching (topical)
• Treats tinea and fungal skin conditions (topical)

Clinical Application

• Roundworm and hookworm infestation — combines with Bing Lang, Shi Jun Zi
• Pinworm (enterobiasis) — combines with Bing Lang, Da Huang; also used as enema
• Tinea capitis (ringworm of scalp) — topical decoction or paste
• Skin pruritus and eczema from damp-heat — topical wash
• Vaginal trichomoniasis — douche with decoction

Precautions

• Dosage: 4.5–9 g in decoction — strict limit due to hepatotoxicity
• TOXIC: toosendanin causes hepatocellular damage; do not exceed recommended dose
• Contraindicated in liver disease, hepatitis, or elevated liver enzymes
• Contraindicated in pregnancy
• Contraindicated in spleen-stomach deficiency cold
• Use only in short courses (3–5 days) — do not use long-term
• Root bark (根皮) is more toxic than stem bark (干皮) — use stem bark preferentially

Formula

• Ku Lian Pi Tang (苦楝皮汤): Ku Lian Pi alone decocted — classical roundworm expulsion formula
• Ku Lian Pi + Bing Lang + Shi Jun Zi: comprehensive antiparasitic combination
• Topical paste: Ku Lian Pi + vinegar — applied to scalp for tinea capitis
• Enema formula: Ku Lian Pi + Bing Lang decoction — for pinworm in rectal area

Combinations

• Chinaberry Root Bark (苦楝皮) + Quisqualis Fruit (使君子) + Areca Seed (槟榔) → expel roundworm, pinworm, and hookworm — broad-spectrum anthelmintic
• Chinaberry Root Bark (苦楝皮) + Stemona Root (百部) + Mume Fruit (乌梅) → expel and immobilize roundworm; abdominal pain from ascariasis

Pharmacological Effects

• Anthelmintic
  • toosendanin paralyzes ascaris neuromuscular system — effective against roundworm, pinworm, hookworm, Trichomonas
• Antifungal
  • topical — treats ringworm, tinea
• antiviral; anti-inflammatory; NOTE: TOXIC — overdose causes nausea, vomiting, liver damage; contraindicated in liver disease and pregnancy; do not exceed therapeutic dose or duration

Classic Description

• Ming Yi Bie Lu (《名医别录》): ‘Governs epidemic febrile disease, high fever and manic agitation from wind-cold disorders, kills the three parasites, treats scabies, and promotes urination.’
• Ben Cao Gang Mu (《本草纲目》): ‘Chinaberry Root Bark is bitter and cold with slight toxicity; mainly treats all febrile conditions in children, roundworm, and benefits the Large Intestine.’
• Ben Cao Bei Yao (《本草备要》): ‘Bitter and cold with slight toxicity; enters the Liver, Spleen, and Stomach channels; treats roundworm, scabies; kills parasites; heals tinea; promotes urination.’
• Zhong Hua Ben Cao (《中华本草》): ‘Expels parasites and heals tinea; treats intestinal parasites and fungal skin conditions.’