【临证本草】茯苓
Overview
茯 苓 Fúílng (Shénnóng Běncǎo Jīng) is the dried sclerotium of the fungus Poria cocos (Schw.) Wolf, belonging to the family Polyporaceae. It is primarily produced in Anhui, Yunnan, and Hubei provinces. Harvesting occurs mainly from July to September. After excavation, the sclerotia are cleaned of dirt and piled for “sweating” before being spread out to dry until the surface is dry, followed by repeated “sweating” until wrinkles appear and most of the internal moisture is lost, then air-dried, referred to as “Fúílng gè”; or fresh Fúílng can be cut into different parts and air-dried, referred to as “Fúílng kuài” and “Fúílng piàn”. The product has a faint aroma and a bland taste. The best quality has a fine white cut surface and strong adhesive properties. It is used raw.【Properties】Sweet, bland, neutral. It enters the Heart, Lung, Spleen, and Kidney meridians.【Functions】Promotes urination and leaches out dampness, strengthens the Spleen, calms the mind, and settles the spirit.
【Dosage】Decocted for oral use, 10–15g.
Applications
1. Edema and reduced urination
This herb has a sweet and bland taste; the sweetness can tonify, while the blandness can leach out dampness. Its properties are neutral, allowing it to dispel pathogens while supporting the righteous Qi, promoting urination without harming the vital energy. It is indeed a key herb for promoting urination and reducing edema, applicable for various types of edema due to cold, heat, deficiency, or excess. It can treat edema caused by internal dampness, leading to difficulty in urination, often combined with Ze Xie (Alisma), Zhi Ling (Polyporus), and Bai Zhu (Atractylodes) in formulas such as Wǔ Lǐng Sǎn (《Shāng Hán Lùn》); for edema due to Spleen and Kidney Yang deficiency, it is often combined with Fu Zi (Aconite) and Sheng Jiang (Ginger), as in Zhēn Wǔ Tāng (《Shāng Hán Lùn》); for water-heat mutual constraint, Yin deficiency with difficulty in urination, and edema, it is often combined with Hua Shi (Talc), Ejiao (Donkey-hide Gelatin), and Ze Xie (Alisma), as in Zhū Lǐng Tāng (《Shāng Hán Lùn》).
2. Phlegm-dampness causing dizziness and palpitations
This herb is adept at leaching out water and dampness, preventing the accumulation of phlegm. It can treat dizziness and palpitations caused by phlegm-dampness, often combined with Gui Zhi (Cinnamon Twig), Bai Zhu (Atractylodes), and Gan Cao (Licorice), as in Fúílng Guìzhī Shù Gāncǎo Tāng (《Jīn Kuì Yào Lǜ》); if phlegm is stagnant in the stomach causing vomiting, it is often combined with Ban Xia (Pinellia) and Sheng Jiang (Ginger), as in Xiǎo Bànxià Jiā Fúílng Tāng (《Jīn Kuì Yào Lǜ》).
3. Spleen deficiency with poor appetite and loose stools
This herb has a sweet taste and enters the Spleen meridian, capable of tonifying the Spleen and stopping diarrhea by leaching out dampness, allowing the middle burner to clear and descend turbid substances. It is particularly suitable for diarrhea due to Spleen deficiency with excess dampness, often combined with Shan Yao (Chinese Yam), Bai Zhu (Atractylodes), and Yi Yi Ren (Job’s Tears), as in Shēn Fúílng Bái Zhú Sǎn (《Hé Jì Jú Fāng》); for treating Spleen and Stomach deficiency with fatigue, poor appetite, and loose stools, it is often combined with Ren Shen (Ginseng), Bai Zhu (Atractylodes), and Gan Cao (Licorice), as in Sì Jūnzǐ Tāng (《Hé Jì Jú Fāng》).
4. Restlessness of the heart and spirit, palpitations, and insomnia
This herb nourishes the Heart and Spleen while calming the mind and spirit. It is commonly used to treat palpitations due to deficiency of both Heart and Spleen, insufficient Qi and blood, insomnia, and forgetfulness, often combined with Huang Qi (Astragalus), Dang Gui (Angelica), and Yuan Zhi (Polygala), as in Guī Pí Tāng (《Jì Shēng Fāng》); if there is Heart Qi deficiency leading to inability to contain the spirit, causing anxiety and restlessness, it is often combined with Ren Shen (Ginseng), Long Chi (Dragon’s Tooth), and Yuan Zhi (Polygala), as in Ān Shén Dìng Zhì Wán (《Yī Xué Xīn Wù》).
Modern Research
1. Chemical Composition
Mainly contains polysaccharides, with the highest content of β-Poria polysaccharides; triterpenoid components: Poria acid, block Poria acid, and tooth hole acid; sterol components: ergosterol, etc. It also contains proteins, fats, lecithin, and adenine.
2. Pharmacological Effects
Decoctions, syrups, alcohol extracts, and ether extracts of Poria have diuretic, sedative, anti-tumor, and positive inotropic effects on the heart. Poria polysaccharides enhance immune function. This herb also has liver-protective, blood sugar-lowering, anti-aging, and anti-gastric ulcer effects.
Additional Herbs
Poria Skin, Fú Shén
1. Poria Skin
This is the dried outer skin of the sclerotium of Poria cocos (Schw.) Wolf.
Properties: Sweet, bland, neutral; it enters the Heart, Lung, Spleen, and Kidney meridians.Function: Promotes urination and reduces swelling.Indicated for edema and difficulty in urination.Dosage: Decoction 15–30g.
2. Fú Shén
This is the part of the dried sclerotium of Poria cocos (Schw.) Wolf that contains pine roots.
Properties: Sweet, bland, neutral; it enters the Heart, Lung, Spleen, and Kidney meridians.Function: Calms the mind and spirit.Indicated for restlessness of the heart and spirit, palpitations, forgetfulness, and insomnia.Dosage: Decoction 10–15g.
Experience of Renowned TCM Practitioners
Yue Meizhong’s Experience:Hair loss often occurs due to water rising and eroding the hair roots, causing them to rot and fall out. Poria can ascend to leach out water and dampness, guiding the drink downwards; when the dampness is removed, hair growth can occur. Although it does not directly promote hair growth, it aligns with the treatment principle of “addressing the root cause and treating the main issue.” Zhang Shiwán stated: “Poria derives its essence from the pine, being sweet and bland, it can preserve the true Qi of the five organs. Its nature is to first ascend and then descend.” The 《Nèi Jīng》 states: “When fluids enter the stomach, they overflow the essence and Qi, ascending to the Spleen, where the Spleen Qi disperses the essence, returning to the Lung, regulating the water pathways, and descending to the Bladder.” This indicates that the bland and leaching nature must first ascend and then descend, allowing the Bladder to transform Qi, thus facilitating urination.
Xu, a 21-year-old male, was first diagnosed on July 6, 1974. The patient had alopecia areata, with a round patch the size of a walnut on the top of his head, gradually becoming bald. Many said this condition was difficult to cure, and the patient was very depressed. His pulse was soft, and his tongue was slightly white, with no other discomfort. Yue prescribed a decoction of Poria: 500–1000g of Poria, ground into a fine powder, taken at 6g per dose, mixed with boiled water, twice a day, continuing until hair regrowth was observed. After more than two months of treatment, he returned for a follow-up, and hair had regrown, achieving basic recovery. Another case involved a child over ten years old with alopecia, who had lost three to five patches of hair. A decoction of Poria was given, and after three months, hair began to grow back. (《Míng Zhōng Yī Zhì Bìng Jué Zhāo》)
Fan Guibin’s Experience:In clinical practice, I have found that high doses of Poria have a good sedative and hypnotic effect, with no significant adverse reactions. Take 50g of Poria, decoct twice, yielding about 100ml of liquid, divided into two doses, taken before lunch and half an hour before bedtime. During the treatment, all sedatives should be discontinued, and spicy and irritating foods should be avoided. A treatment course lasts one month.
The sedative and calming effects of Poria are reflected in sedative formulas such as Suan Zao Ren Tang, Tian Wang Bu Xin Dan, and Gui Pi Tang, and are also confirmed by modern research, but reports on its single herb application are rare. From treatment results, the single herb application of high-dose Poria for insomnia also shows good efficacy, being simple, convenient, economical, and effective, worthy of promotion. [Fan Guibin. High-Dose Poria Treatment for Insomnia: 24 Cases. Chinese Medicine Research, 2006, 19(2): 35]
Wang Qi’s Experience:Poria preserves true essence and assists Yang to stop nocturnal emissions Poria, sweet and bland, is used to promote urination, leach out dampness, strengthen the Spleen, and calm the mind, commonly used for edema and reduced urination, phlegm-dampness causing dizziness, Spleen deficiency with loose stools, as in formulas like Wǔ Lǐng Sǎn, Fúílng Guìzhī Bái Zhú Gāncǎo Tāng, and Shēn Fúílng Bái Zhú Sǎn. If used for calming the mind, it can also treat palpitations and insomnia, as in Suan Zao Ren Tang. Professor Wang uses Poria in male reproductive health, believing it has the function of “preserving true essence and assisting Yang to stop nocturnal emissions.”
Supplementing deficiency and assisting Yang
He stated that before the Jin and Tang dynasties, ancient people often used Poria to supplement deficiency and assist Yang. As early as in the 《Sù Nǚ Fāng》, there are references to Gēng Shēng Wán (Gēng Shēng refers to Poria) for treating men’s five labors and seven injuries, and for kidney tonification. Poria pills for treating male internal deficiency; Poria powder for longevity and vitality. The 《Sù Nǚ Jīng·Sì Jì Bǔ Yì Fāng Qī Shǒu》 all use Poria, which not only addresses issues in the bedroom but also strengthens the body and prolongs life. The 《Qiān Jīn Fāng》strong> also frequently uses Poria for supplementation in the bedroom. Many physicians throughout history have elaborated on this, such as Li Dongyuan, who described it as “bland to open the orifices, sweet to assist Yang”; Wang Haogu stated, “It can stop excessive urination and promote urination when it is insufficient; when used with wine and bright red cinnabar, it can preserve true essence”; Zhang Shiwán also stated, “Poria derives its essence from the pine, being sweet and bland, it can preserve the true Qi of the five organs.” He believes that the ancient use of Poria to assist Yang is due to its calming effect, as harmonious spirit and Qi are essential for sexual intercourse, thus making Poria one of the main herbs for male reproductive health.
Stabilizing essence and stopping emissions
Poria has the effect of stabilizing essence and stopping emissions, which was also commonly used in ancient times. For example, the 《Zhí Zhǐ Fāng》 used “Bái Fúílng powder, two qian, mixed with rice soup, taken twice daily” to treat heart deficiency and nocturnal emissions; the 《Pǔ Jì Fāng》strong> used “Bái Fúílng, two liang, and Sūn Shā Rén, one liang, ground into powder” to treat excessive nocturnal emissions; the 《Jù Fāng》strong> used “Fúílng, four liang, made into wax pills” to treat “men with deficient Yang, weak essence, unclear urination, frequent leakage, and disturbed sleep with many dreams.” Modern research has shown that Poria has a central nervous system inhibitory effect. It is believed that nocturnal emissions and premature ejaculation often occur due to the lack of interaction between the heart and kidneys, which is referred to as a state of autonomic nervous system dysregulation, where the sympathetic nervous system’s excitability threshold is lowered, and the parasympathetic nervous system’s excitability function is reduced, leading to easy ejaculation. Poria has a regulatory effect on the nervous system, thus achieving the function of “preserving true essence and stabilizing emissions.”In clinical practice, Poria is often combined with Yuan Zhi to calm the mind, while Yuan Zhi enters the Kidney; together, they facilitate communication between the heart and kidneys, preserving true essence, and are used to treat male reproductive issues such as impotence, premature ejaculation, and nocturnal emissions. Additionally, for male hair loss, a decoction of Poria can be used, consisting of 500–1000g of Poria ground into a fine powder, taken at 10g per dose, twice daily, for about two months to promote regrowth. [Wang Dongpo, Zhang Kailin. Wang Qi’s Experience in Male Reproductive Health. Chinese Medicine Journal, 2003, 44(5): 343]
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This article is excerpted from 《Fāng Jì Xué》 (Thirteenth Five-Year Plan, China Traditional Chinese Medicine Press) and《Míng Lǎo Zhōng Yī Yòng Yào Xīn Dé》
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Editor-in-Chief: Jia Bo, Editors: Zhang Dong, Wang Zhi, Article Editor: Liu Jifang
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