Tabanus bivittatus Matsumura, Tabanus mandarinus Schiner (the dried female body; family Tabanidae)
Nature and flavour. Bitter, slightly cold; listed as slightly toxic in the classical materia medica; Liver system.
A biting fly, dried, and one of the least comfortable items in the materia medica for a modern reader to accept. Classical texts class it with the drugs that break blood and drive out stasis, and record it for amenorrhoea with a hard abdominal mass, for postpartum stasis, for fixed stabbing pain, and for the swelling and pain of traumatic injury. It is characteristically paired in the classical literature with 水蛭 and 土鳖虫, and the grouping itself tells the reader something: these are the drugs the tradition reaches for when it believes stasis is severe, and it does not reach for them casually. Modern clinical evidence for these uses is limited and is not established, and the traditional indications describe a pattern-based way of deciding, not a diagnosis a reader can apply to themselves.
性味归经。苦，微寒；传统本草列为有小毒；归肝经。
一味晒干的吸血虻虫，对本草的现代读者来说是最不容易接受的一类药材。古籍将其归入破血逐瘀之品，用于经闭伴腹部硬块、产后瘀阻、固定刺痛，以及跌打损伤的肿痛。在古典文献中它常与水蛭、土鳖虫同用，这个组合本身就说明了问题：传统认为瘀血重证时才动用这几味，且并非随意使用。上述用途的现代临床证据有限，尚未被证实；传统所载的指征属于按证判断的方法，而不是读者可以往自己身上套的诊断。
传统列为有小毒，且在传统分类里被归入峻烈破血之品，而不是温和的活血药。孕期禁用 —— 古典理由是其破血、下行。有出血倾向者、活动性溃疡患者、血小板极低者、术前患者不宜；与华法林及其它抗凝药同用的相互作用顾虑已有文献记载。虫类药都涉及虫类蛋白过敏的真实风险，出现反应应当停用而非继续。安全之后第二个问题是品种认定：虫类药材以干品流通且常破损，到手的未必是标签所写的种。不属于可自行使用的药材，须在合格执业者监督下使用。
1 related entry.