Ke Li Le San (Chebulic Myrobalan Powder) kē lí lè sǎn · 诃梨勒散

Safety. One ingredient: 诃梨勒 (also written 诃子), the fruit of Terminalia chebula. A single-drug powder. Quantities, preparation and method of taking are deliberately not listed here. The line: 气利，诃梨勒散主之 — for 气利, this powder governs. 气利 is a compressed phrase and the commentaries read it more than one way: diarrhoea with the passing of flatus, or involuntary loss of stool with little pain — the "slippery", uncontrolled end of the diarrhoea spectrum rather than the acute, cramping, feverish end. **This library does not pick a winner.** It records that the classical phrase is contested, because a page that smooths over disagreement has stopped being useful. The modern frame that the slippery end of that spectrum sits closest to is faecal incontinence, and this library names the mapping without claiming that the classical term meant it. Faecal incontinence has causes — obstetric sphincter injury, neurological disease, severe chronic diarrhoea of any cause — and it is substantially under-reported, which is the part worth carrying away: it looks rare mainly because people do not volunteer it. Then the drug, and the reason a one-ingredient formula is not a simple formula. 诃子 is very rich in hydrolysable tannins. Tannins are astringent — exactly the property the classical use is pointing at — and tannins also bind: to iron, to alkaloids, to proteins. A high-tannin substance taken by mouth will reduce the absorption of iron supplements and of other medicines taken at the same time. High-tannin herbal intake has also been reported in association with liver injury. "Reported in association" is the strength of that claim, and this library will not stretch it into "causes". The last point is about how it is taken rather than what it is. 散 is a powder that is swallowed. There is no decoction step. Whatever a boiling step would have done — extraction, dilution, some reduction of microbial load — this route does not do. This is the entry in this batch where the shortest ingredient list pairs with the longest list of caveats, and that is worth saying plainly: **the number of ingredients tells a reader nothing about risk.** Chinese-language literature on 诃子 and on 诃梨勒散 exists, largely preclinical or small clinical series. Recorded as existing; not recorded as established.