【Name】 : Fuzi (Aconite)/Fupian (Aconite slices)/Heifuzi (Black Aconite)
【Category】 : Warming Interior Herbs
【Functions】 : Revive Yang and rescue from collapse, warm and tonify the Spleen and Kidney, dispel cold and alleviate pain. It is very pungent and hot, warming Yang and expelling cold.
【Properties】 : Very pungent, very hot. Toxic.
【Meridians Entered】 : Heart, Spleen, Kidney.
【Dosage】 : 3 to 9 grams, generally considered best when decocted first.
【Cautions】: Internal use: decoction, 3-9 grams; or in pills or powders. External use: ground into powder for topical application.
【Contraindications】； Contraindicated in cases of Yin deficiency with excess Yang, true heat with false cold, and in pregnant women.
【Herb Name and Processing】 : Processed Fuzi, Heifu (Black Aconite), Shufu (Cooked Aconite), Danfu (Light Aconite slices) (from the root of Aconitum, soaked in brine (saline) and then boiled with tofu, then the tofu is removed and dried. In other regions, due to different processing methods, there are distinctions such as Shufu, Huangfu (Yellow Aconite), and Mingfu (Bright Aconite), but in Shanghai, these distinctions are no longer made.) Shengfuzi (Raw Aconite), Xianfuzi (Salty Aconite) (from the root of Aconitum, processed with brine, cleaned, sliced, and dried for medicinal use. Raw Aconite is more toxic than cooked slices and must be strictly controlled for use, generally only for external use.)
【Formula Examples】 : Si Ni Tang (Four Reversal Decoction) from “Shang Han Lun” : Fuzi, Ganjiang (Dried Ginger), and Gancao (Licorice) treat cold Shaoyang disease, with internal Yin cold, Yang Qi about to collapse, presenting with abdominal pain and diarrhea, cold extremities, and a weak pulse that is about to disappear. 【Toxicity and Management】 Aconitine affects various peripheral and central nervous systems, first stimulating and then paralyzing. Lethal dose: Aconite tincture 2 ml, Aconitine 2 mg. Symptoms: initial numbness of lips and tongue, nausea, numbness of hands and feet, followed by irregular movements, vomiting, palpitations, pale face, cold skin, chest tightness, agitation, reduced pain sensation, slow weak heartbeat, decreased blood pressure, slow breathing, difficulty swallowing, speech disorders, respiratory center suppression. May lead to sudden death. Management: Gastric lavage with potassium permanganate, keep warm, inject a large dose of atropine. For severe paralysis, give stimulants, oxygen, artificial respiration, and intravenous fluids. Shock can be treated with norepinephrine.
【Applications】 :
1. Used for symptoms of Yang collapse, weak pulse about to disappear, etc. Fuzi is pungent and hot, mainly used for spontaneous cold sweating, cold extremities, weak pulse, or due to excessive sweating, vomiting, or reversal. Often combined with Ren Shen (Ginseng), Gan Jiang, and Zhi Gan Cao (Honey-fried Licorice). If there is profuse cold sweat and Yang collapse, Fuzi and Ren Shen should be combined with Long Gu (Dragon Bone), Mu Li (Oyster Shell), and other astringent herbs to stop sweating; if after severe bleeding there are cold extremities, sweating, and weak pulse, it can be used with Ren Shen, Fuzi, Long Gu, and Mu Li combined with Mai Dong (Ophiopogon) and Wu Wei Zi (Schisandra) to revive Yang and rescue Yin.
2. Used for Kidney Yang deficiency, fear of cold, cold extremities, Spleen Yang deficiency, abdominal pain, and loose stools. Fuzi strongly tonifies Yuan Yang and benefits the source of fire. For all symptoms of Kidney Yang deficiency, weak life fire, fear of cold, cold extremities, impotence, and frequent urination, it can be applied, often combined with Rou Gui (Cinnamon), Shu Di Huang (Rehmannia), Tu Si Zi (Cuscuta), and Shan Yao (Chinese Yam); if Spleen Yang deficiency, cold abdominal pain, and loose stools, Fuzi can be combined with Qi-tonifying and Spleen-warming herbs like Dang Shen (Codonopsis), Bai Zhu (Atractylodes), Gan Jiang, and Zhi Gan Cao.
3. Used for wind-cold-damp Bi syndrome, and pain in the joints and bones. Fuzi has a warm nature and can dispel cold dampness, thus having a good effect on wind-damp pain that is dominated by cold, often combined with Gui Zhi (Cinnamon Twig).
【Effects of Fuzi】 : Revive Yang and rescue from collapse, tonify fire and assist Yang, dispel cold and eliminate dampness.
Treats excess Yin with Yang collapse, profuse sweating leading to Yang collapse, vomiting and diarrhea, cold pain in the chest and abdomen, Spleen leakage with cold diarrhea, edema in the feet, childhood convulsions, wind-cold-damp Bi syndrome, spasms and cramps, impotence, cold in the uterus, sores and ulcers, and all diseases of deep cold and stubborn cold.
(1) Revive Yang and rescue from collapse: has a strong effect in reviving Yang. Used for fear of cold, cold extremities, and weak pulse about to disappear, often combined with Ren Shen, or Gan Jiang and Gan Cao.
(2) Tonify Yang Qi: Fuzi is pungent and hot, its nature is to move and not to stay, it can circulate through the twelve meridians, thus it can be used for all symptoms of Yang Qi deficiency, especially to tonify Kidney Yang. For tonifying Kidney Yang, it is often combined with Rou Gui.
(3) Dispel cold and alleviate pain: This herb is very hot and has a strong ability to dispel cold, thus it can treat abdominal pain and diarrhea caused by internal cold invasion, as well as pain due to cold damp obstruction.
Note on Herb Compatibility
Beneficial combinations: Fuzi combined with Gan Jiang and Gan Cao not only enhances the warming effect but also reduces the toxicity of Fuzi, thus these three are often used together in cold-dispelling formulas. The principle is that after combining, the alkaloids undergo chemical changes that greatly reduce toxicity.
Incompatible combinations: Fuzi is incompatible with Bei Mu (Fritillaria), Gua Lou (Trichosanthes), Bai Ji (Bletilla), Bai Lian (Nymphaea), Ban Xia (Pinellia), and is afraid of Xi Jiao (Rhinoceros Horn), thus Fuzi should not be combined with the above herbs.
Fuzi Combinations for Treating Six Stubborn Diseases
Fuzi, first recorded in “Shen Nong’s Herbal Classic”, is named because it grows attached to Aconitum (the mother root). This herb is very pungent and hot, strong and dry, good at moving and not staying, can assist heart Yang to open the meridians, warm Spleen Yang to strengthen movement, and tonify Kidney Yang to benefit fire, making it a key herb for warming the interior and supporting Yang. In clinical applications, as long as the syndrome is accurately identified and the combinations are appropriate, it can treat various diseases, especially for difficult and urgent conditions, and stubborn cold diseases, often achieving quick effects. Here are some examples:
Fuzi combined with Ma Huang for treating Kidney Cough
Kidney cough, also known as Kidney Meridian cough. Symptoms include cough, pain in the lower back, and in severe cases, cough with phlegm, caused by cold evil invading the Kidney, treated with Ma Huang Fuzi Xi Xin Tang. In this formula, Ma Huang disperses cold and releases the exterior, Fuzi warms the meridians and assists Yang, and Xi Xin helps Ma Huang release the exterior and assists Fuzi in warming the meridians. The combination of Ma and Fuzi, one dispersing and one tonifying, allows the exterior to be released without harming Yang. For example, treating an elderly woman with a surname Zhu, who had a cough for 30 years in autumn. Recently, she had cough and vomiting, with tears and phlegm, even urinary incontinence, accompanied by cold body, lower back pain, white tongue coating, and wiry pulse, diagnosed as Kidney cough. The herbs used were Fuzi 5g, Ma Huang 3g, Xuanfu Hua 10g, Dai Zhe Shi 20g, Dang Shen 15g, Zhi Ban Xia 10g, Chen Pi 10g, Gan Cao 6g, Xi Xin 3g, and after 10 doses, symptoms disappeared.
Fuzi combined with Gui Zhi for treating Menopausal Syndrome
Women aged 40-55, experiencing irregular menstruation to menopause, exhibit reproductive physiological changes and autonomic nervous system dysfunction, known as menopausal syndrome. Traditional Chinese medicine believes that Kidney Qi gradually declines, Tian Gui (Heavenly Water) is about to be exhausted, Chong and Ren are weak, and there is insufficient essence and blood, leading to dysfunction in regulating Yin and Yang balance, resulting in Kidney deficiency symptoms, treated with Gui Fu Di Huang Wan. In this formula, Gui Zhi disperses cold and releases the exterior, warms and opens the meridians, Fuzi warms and tonifies the Spleen and Kidney, and supports Yang and dispels cold. The combination of Gui and Fuzi warms the meridians and dispels cold, while also nourishing Kidney Qi. The Kidney is primarily governed by Kidney Qi, and when the Kidney has Qi, the Earth can generate. Therefore, the Kidney Qi pill includes Gui and Fuzi in the nourishing Yin herbs, aiming to slightly generate fire, thus generating Kidney Qi. For example, treating a woman with the surname Wang who had menopausal syndrome for 2 years, with fear of cold, cold extremities, shortness of breath, fatigue, dark complexion, edema in the face and feet, loose stools, irregular menstruation, lower back pain, poor sleep, pale tongue with white coating, and a weak pulse. Diagnosed as Spleen and Kidney Yang deficiency, treated with Fuzi 6g, Gui Zhi 6g, Dang Shen 10g, Chao Bai Zhu 15g, Fu Ling 15g, Shan Yao 10g, Dan Pi 10g, Ze Xie 10g, Sheng Di 10g, after taking 45 doses, all symptoms resolved.
Fuzi combined with Gan Jiang for treating Chronic Diarrhea
Diarrhea is characterized by increased frequency of bowel movements and watery stools. There are many causes of diarrhea, including external evils, internal injury, deficiency syndromes, and excess syndromes, with external evils related to dampness, known as “dampness leads to diarrhea”. Internal injury is related to Spleen deficiency, known as “the root of diarrhea is always due to Spleen and Stomach”. If diarrhea persists for a long time, it indicates Spleen Yang deficiency, leading to Spleen and Kidney Yang deficiency, often presenting with stools that are sometimes loose and sometimes watery, with increased frequency after consuming greasy foods, abdominal rumbling, poor appetite, cold pain in the abdomen, cold extremities, lower back and knee soreness, pale tongue with white greasy coating, and weak pulse. Treated with Fuzi combined with Gan Jiang to warm the Kidney and Spleen, achieving rapid effects. “Zheng Zhi Yao Jue” states, “Fuzi cannot warm without Gan Jiang.” For example, treating a man with chronic diarrhea for 3 years, having 3-4 bowel movements daily, with cold pain in the lower abdomen after bowel movements, requiring hot towels for relief, with a fat tongue and white greasy coating, and a weak pulse. Routine stool tests were normal. The herbs used were Fuzi 6g, Gan Jiang 10g, Dang Shen 15g, Chao Bai Shao 15g, Wu Mei 6g, Cang Zhu 10g, adjusted according to symptoms, and after more than 20 doses, effective results were achieved.
Fuzi combined with Yi Yi Ren for treating Appendiceal Mass
Appendiceal mass is caused by appendiceal necrosis or suppuration after antibacterial and anti-inflammatory treatment, with fever subsiding and pain stopping, and blood tests normal. However, if an appendiceal mass or hardening forms, with a weak constitution and slight persistent pain in the right lower abdomen, during recovery, the appendiceal mass is difficult to resolve. Yi Yi Ren strengthens the Spleen, transforms dampness, and guides turbidity downward, combined with Fuzi to directly reach the disease site and warm the interior to disperse the mass. The combination of Yi and Fuzi allows Yang Qi to flow and turbidity to transform, leading to the resolution of the mass. If adding heat-clearing and detoxifying Bai Jiang Cao, it is called Yi Yi Fuzi Bai Jiang San, which was traditionally used to treat intestinal abscesses. In modern times, this formula has shown good effects in treating chronic appendicitis, appendiceal abscesses, and appendiceal masses. For example, treating a patient with the surname Wang who had an appendiceal mass for more than 20 days without improvement, came for TCM treatment. Symptoms included fatigue, slight pain in the right lower abdomen, fear of cold, normal bowel movements, good appetite, thin white greasy tongue, and weak pulse. Ultrasound indicated a right lower abdominal appendiceal mass of 4×3.2cm. Treated with Yi Yi Ren 20g, Fuzi 5g, Chuan Shan Jia 10g, Tao Ren 10g, Bai Jiang Cao 15g, Chi Shao 15g, Hong Teng 20g, E Zhu 10g, Zao Jiao Ci 10g, Mu Li 20g, after more than a month of treatment, the appendiceal mass disappeared upon re-examination.
Fuzi combined with Da Huang for treating Chronic Kidney Failure
The pathogenesis of chronic kidney failure is very complex, located in the Kidney and Spleen, due to long-term chronic nephritis that is untreated or inadequately treated, leading to renal insufficiency or weakness. Clinical manifestations include lower back soreness, fatigue, facial edema, poor appetite, thin greasy tongue coating, and weak pulse, with elevated levels of urea nitrogen, creatinine, and uric acid. TCM diagnosis is Spleen and Kidney Yang deficiency. Fuzi is used to warm and tonify the Spleen and Kidney, combined with Da Huang to promote bowel movements. Modern pharmacological studies have shown that Da Huang can increase intestinal reabsorption, leading to a decrease in the amount of amino acids that synthesize urea, thus reducing blood urea nitrogen and creatinine levels, promoting liver and kidney tissue synthesis, and reducing urea synthesis. Therefore, the combination of Fuzi and Da Huang, using both cold and heat, warms Yang and reduces turbidity, is effective for treating chronic kidney failure and uremia. For example, treating a patient with the surname Zhang who had chronic renal failure for more than 2 years, with dizziness, fatigue, lower back and knee soreness, cold extremities, bilateral lower limb edema, soft on palpation, good appetite, pale tongue with greasy coating, and weak pulse. Urine protein ++, urea nitrogen 9.6mmol/l, blood creatinine 458umol/l, uric acid 553umol/l, blood pressure 150/90mmHg. Diagnosed as Spleen and Kidney Yang deficiency. The herbs used were Fuzi 6g, Sheng Da Huang (added later) 15g, Huang Qi 30g, Zhu Ling 15g, Fu Ling 15g, Ze Xie 15g, Dang Shen 15g, She She Cao 30g, Sheng Bai Zhu 15g, Han Fang Ji 12g, adjusted for 3 months, with edema resolving and remaining symptoms disappearing, re-examination showed urine protein negative, renal function indicated: urea nitrogen 7.8mmol/l, creatinine 126umol/l, uric acid 315umol/l, basically controlled within normal range.
Fuzi combined with Bai Zhu for treating Pulmonary Heart Failure
Pulmonary heart disease is caused by chronic bronchitis complicated by obstructive pulmonary emphysema, leading to pulmonary hypertension, right ventricular hypertrophy, and right heart failure and respiratory failure. TCM believes that the disease is located in the Lung, affecting the Heart, with multiple pathological changes, but related to the Spleen and Kidney. Clinical manifestations include grayish complexion, palpitations, shortness of breath, inability to lie flat, cold extremities, lower limb edema, short urination, pale tongue with a thick greasy coating, and a weak pulse, indicating Spleen and Kidney Yang deficiency. Fuzi enters the Heart, Spleen, and Kidney meridians, warms Kidney Yang, enhances heart contraction, Bai Zhu tonifies the Spleen and promotes urination, and the combination of Fuzi and Bai Zhu can both warm and strengthen the Yang Qi of the Spleen and Kidney to dispel water dampness, and enhance heart function to supply blood and oxygen, restoring heart and lung function. For example, treating a patient with the surname Huang who had chronic pulmonary heart disease for 3 years, with lower limb edema for more than a month, cough, chest tightness, palpitations, and shortness of breath, worsening with activity, short urination, cold extremities, pale tongue with greasy coating, and weak pulse. The herbs used were Fuzi 10g, Bai Zhu 20g, Fu Ling 20g, Huang Qi 30g, Dan Shen 20g, Bai Shao 10g, Chen Pi 10g, Dang Shen 20g, Gui Zhi 6g, and after 3 weeks of treatment, increased urination, edema subsided, cough stopped, and symptoms improved.
Fuzi is a key herb for warming the twelve meridians and pure Yang
Fuzi is pungent and hot, highly toxic, its nature is to move and not to stay, it functions to assist Yang, tonify fire, dispel cold, and eliminate dampness. Fuzi is the leader among herbs, with functions of both tonifying and warming Yang Qi, beneficial for restoring Qi and blood, dispelling cold and promoting Yang, and can be used for difficult-to-treat diseases that have not been cured. I often add Fuzi based on syndrome differentiation and achieve effective results.
Combination with Ma Huang to warm the Lung and transform phlegm for treating Lung Distension
Fuzi is pungent, entering the Lung meridian, thus it can warm the Lung, dispel cold, assist Yang, and solidify the exterior. When combined with Ma Huang, it can both disperse and tonify, applying both attacking and tonifying methods, thus effectively treating Lung distension, cough, and wheezing. In the case of Lung distension, phlegm evil fills the lungs, obstructing Yang Qi, leading to Yang not being able to defend, and any slight exposure to cold can trigger phlegm accumulation, causing symptoms. This is a case of primary deficiency with secondary excess, which cannot be treated by ordinary phlegm-dispelling herbs. Formulas like San Ao Tang, Hua Gai San, Xiao Qing Long Tang, etc., with Ma Huang focus on dispersing, but lack sufficient warming Yang power. Only by adding Fuzi can the Yang Qi be warmed and supported, thus overcoming the enemy. In clinical practice, whenever cough and wheezing occur frequently, with clear and thin phlegm, cold back, and white greasy tongue coating, it is advisable to use Xiao Qing Long Tang with added Fuzi, which often yields effective results.
Combination with Sheng Mai to nourish the Heart and warm Yang for treating Chest Bi
Fuzi primarily enters the Heart and Shaoyin meridian, greatly tonifying Heart Yang, its nature is to move and not to stay, good at dispelling cold evil, and unblocking blood and Qi. It is used for treating Chest Bi with a threefold benefit. The Heart resides in the Yang position, being a clear and open area. Whenever Heart Yang is insufficient, Yang Qi fails to circulate, and cold evil invades, leading to stagnation of Qi and blood, resulting in chest pain. Symptoms include a thin and weak pulse, pale and swollen tongue, indicating Yang deficiency and Yin excess. In such cases, Fuzi Tang should be used to warm Yang and disperse cold; if the pulse is weak and rapid, and the tongue is red and dry, indicating both Qi and Yin deficiency, then Fuzi should be combined with Sheng Mai San to use Fuzi to invigorate Yang and Sheng Mai to nourish Yin, together forming a master formula for restoring pulse.
Combination with Yin Chen to warm the Spleen, transform dampness, and treat Jaundice
Fuzi is very hot, not only dispelling cold but also drying dampness. Thus, Zhang Yuansu stated: “Fuzi warms the Spleen and Stomach, eliminating Spleen dampness.” When used with Yin Chen, a specific jaundice herb, it warms Yang and transforms dampness, specifically treating Yin jaundice. The onset of jaundice is primarily due to damp evil, known as “the jaundice family obtains it from dampness.” Dampness is sticky and difficult to eliminate, easily obstructing Qi and damaging Yang, thus jaundice that persists for a long time will inevitably damage Yang Qi and worsen the stagnation of water dampness, leading to the transformation into Yin jaundice. Symptoms include a smoky complexion, moist tongue, and a deep pulse. For this, a small amount of Fuzi should be added to the Yin Chen formula to invigorate Spleen Yang, seeking the effect of “the light shining in the sky, the Yin mist dispersing.”
Combination with Shi Wei to warm the Kidney and unblock Lin for treating Urinary Stones
Fuzi has a strong ability to tonify Kidney Yang and warm the Qi of the bladder. When used with Shi Wei and other herbs that clear and unblock Lin, it has the power to warm Yang, move Qi, and unblock Lin to expel stones. In the case of urinary stones, the root cause is Kidney Yang deficiency leading to ineffective Qi transformation, while the superficial manifestation is damp-heat accumulation in the lower jiao. The Kidney governs water and controls urination. When Kidney Yang is strong, Qi transformation is effective, and the separation of clear and turbid is orderly, damp-heat cannot accumulate, and stones cannot form. If Kidney Yang is weak, Qi transformation is insufficient, and the separation of clear and turbid fails, dampness and turbidity cannot descend and accumulate into stones. If treatment is limited to clearing heat and unblocking Lin, not only will stones be difficult to expel, but prolonged use may also damage Yang Qi. Therefore, using Fuzi to warm the Kidney and unblock Yang can replenish and replace the need for unblocking, allowing Yang Qi to be abundant, thus Qi transformation can occur.
Combination with Da Huang to warm Yang and expel turbidity for treating Obstruction
Fuzi combined with Da Huang is based on the principle of the “Jin Kui Yao Lue” Da Huang Fuzi Tang, primarily treating cold accumulation and excess syndrome, often used for chronic nephritis and uremia, Spleen and Kidney Yang deficiency, internal cold dampness, and turbidity evil spreading through the three jiao. When urination is obstructed, it is called “guan”, and when vomiting is persistent, it is called “ge”. Da Huang is a key herb for expelling turbidity and has the power to clear turbidity and open the bowels, but its cold nature can damage Kidney Yang with prolonged use. Fuzi is pungent and hot, functioning to warm and disperse cold turbidity and open blockages, while also controlling the cold nature of Da Huang and preserving its purging ability. The two herbs together form a formula that warms and disperses cold turbidity, combining bitter and pungent to achieve the effect of unblocking and expelling obstruction.
Fuzi is effective when used alone, but its efficacy is even more pronounced when used in combinations.
For example, in Si Ni Tang, Fuzi combined with Gan Jiang and Gan Cao enhances its ability to revive Yang and rescue from collapse. “Zheng Zhi Yao Jue” states: “Fuzi cannot warm without Gan Jiang, and with Gan Cao, its nature is softened; with Gui, it supplements the Ming Men (Gate of Life).” Xu Huixi in “Lan Tai Gui Fan” states: Once the formula is established, it can allow each herb to fully express its efficacy, but it can also cause herbs to lose their nature, which is the beauty of established formulas. Throughout history, many physicians skilled in using Fuzi have provided numerous successful experiences regarding its combinations.
For example, Ren Shen combined with Fuzi (Shen Fu Tang) warms Yang and benefits Qi, enhancing the effect of rescuing from collapse, and can be used to treat heart failure; Bai Zhu combined with Fuzi (Zhi Fu Tang) can promote the ability to solidify the foundation, warm Yang and solidify the exterior, treating Qi deficiency and spontaneous sweating; Di Huang combined with Fuzi (Di Fu Tang) enhances the ability to nourish blood and generate blood, treating blood deficiency and low fever; Dang Gui combined with Fuzi (Wen Jing Tang) enhances the ability to warm the meridians and nourish blood, treating women’s delayed menstruation and cold in the blood sea; Gui Zhi combined with Fuzi enhances the ability to warm Yang and unblock collaterals, warming the meridians and unblocking collaterals to alleviate pain, treating wind-damp obstruction and limb soreness; Shi Gao combined with Fuzi (Qian Jin Yue Bi Tang) achieves a heat-clearing and heart-strengthening effect, used for treating pneumonia complicated by heart failure, showing good efficacy. It can also use the warmth of Fuzi to counteract the destructive effects of the main herbs.
For example, Ma Huang combined with Fuzi (Ma Fu Xi Xin Tang) warms the meridians and releases the exterior to disperse cold. Due to concerns that Ma Huang may cause excessive sweating and fear of Yang collapse, adding Fuzi ensures that sweating occurs without Yang deficiency, thus treating cold damage with Yang deficiency; Da Huang combined with Fuzi (Da Huang Fuzi Tang) warms Yang, promotes bowel movements, and expels evil, allowing for purging without harming the interior, thus treating cold damage with fullness in the heart; Huang Lian combined with Fuzi (Fuzi Xie Xin Tang) supports Yang while purging heat, taking Huang Lian to purge the heart, and Fuzi to protect Yang, suitable for those with Yang deficiency and sweating with fullness in the heart; Long Dan Decoction may be too cold, and adding Fuzi can eliminate its coldness and strengthen the liver, which has certain efficacy for chronic hepatitis.
In addition, combining with Scorpion can treat childhood convulsions due to deficiency wind; combining with Zhi Mu can treat cold and heat hernia; combining with Pepper can treat middle cold and acid reflux; for Qi counterflow with clear water vomiting; combining with Ling can warm the Kidney and promote urination, treating Yin water edema and fullness in the lower abdomen; combining with Bai Jiang Cao can treat chronic intestinal abscesses; combining with Ling can treat persistent headaches and migraines that do not respond to treatment. Fuzi External Use Formula
Composition of the Medicine ; Fuzi 10g
Preparation and Usage ; First, pour 50g of white wine into a small cup, add 10g of Fuzi, ensuring Fuzi is fully submerged in the wine, soak for half an hour, then simmer on low heat, boiling for 3 minutes, and while hot, use a cotton ball to apply the medicinal liquid to the affected area. Apply 5 times every night before bed, and after each use, add a little white wine to the cup for the next night. For Type I (purpura ≤2cm) patients, one week is one treatment course. For Type II (purpura >2cm and ≤5cm) and Type III (purpura >5cm) patients, two weeks is one treatment course.
Indications ; For frostbite that has not yet ulcerated.
Evaluation ; This formula is derived from a folk prescription. Fuzi has a pungent and sweet taste, is very hot, and toxic. By processing Fuzi with wine, its ability to warm blood vessels and disperse cold is enhanced, which is beneficial for treating frostbite. Clinically, satisfactory results have been achieved in treating unbroken frostbite. It has been found that the earlier the treatment, the better the effect, with lighter cases responding better than severe cases. During treatment, attention should be paid to preventing cold and keeping warm.
Analysis of Fuzi Applications in “Jin Kui Yao Lue”
Fuzi is widely used in “Jin Kui Yao Lue”. In the first 22 chapters of this book, there are 205 formulas, among which 23 include Fuzi (including Aconitum), accounting for more than one-tenth. Observing the patterns of Fuzi usage, a rough analysis can be made for the benefit of colleagues.
Main Functions of Fuzi
1. Revive Yang and rescue from collapse
Fuzi is very pungent and hot, mainly used for spontaneous cold sweating, cold extremities, and weak pulse; or due to excessive sweating, vomiting, or diarrhea leading to cold extremities and a pulse that is weak and about to disappear, indicating a critical state of Yang Qi about to be lost. For example, Si Ni Tang treats vomiting due to excess Yin obstructing Yang, with symptoms of “vomiting and weak pulse, with slight fever, and cold extremities”; Tong Mai Si Ni Tang treats cold extremities and diarrhea due to excess Yin obstructing Yang, with symptoms of “diarrhea of clear grains, internal cold and external heat, sweating and cold extremities”; Wu Mei Wan treats “agitation and vomiting, severe abdominal pain, vomiting of saliva, and cold extremities” due to roundworm obstruction, all of which utilize Fuzi’s ability to revive Yang and rescue from collapse.
2. Dispel cold and alleviate pain
For wind-cold-damp evils attacking the body, causing pain in the joints and bones, Fuzi can be used to dispel cold, eliminate dampness, and alleviate pain. For example, Gui Zhi Fuzi Tang treats wind evil predominating in cold Bi syndrome; Bai Zhu Fuzi Tang treats damp Bi syndrome with Yang deficiency; Gui Zhi and Shao Yao Zhi Mu Tang treats wind-cold invasion gradually transforming into heat and injuring Yin; all of these utilize Fuzi’s ability to dispel cold and alleviate pain. Aconitum and Fuzi are similar plants, with Aconitum being the mother root of Fuzi, both having similar properties and functions, but Aconitum is more pungent and hot than Fuzi, thus having a stronger ability to dispel cold and alleviate pain. For paroxysmal pain, characterized by deep cold and stubborn cold, with acute pain and cold extremities, Aconitum should be selected. Formulas like Aconitum Decoction, Aconitum Red Stone Fat Pill, Aconitum Decoction, and Aconitum Gui Zhi Decoction are all designed for such conditions.
3. Warm the interior and assist Yang
For cold evils invading the interior, causing Yang Qi to be trapped, leading to symptoms such as vomiting, diarrhea, cold pain in the chest and abdomen, and poor appetite, Fuzi can warm the interior, dispel cold, and resolve water dampness causing abdominal fullness, pain, and vomiting; Gui Zhi removes Shao Yao and adds Ma Huang and Xi Xin to warm the interior and assist Yang, treating Yang deficiency with Yin condensation and water retention in the stomach; Huang Tu Tang treats cold blood in the stool; Da Huang Fuzi Tang warms Yang and promotes bowel movements, resolving cold accumulation; Yi Yi Fuzi Bai Jiang San expels pus and reduces swelling, invigorating Yang Qi, treating “intestinal abscesses that have formed”; Fuzi Tang warms Yang, disperses cold, warms the uterus, and calms the fetus, treating pregnancy with Yang deficiency and severe cold abdominal pain, all of which utilize Fuzi’s ability to warm the interior and assist Yang.
4. Warm the Kidney and transform Qi
Fuzi functions to strongly tonify Yuan Yang, benefiting the source of fire. For all symptoms caused by Kidney Yang deficiency, weak life fire, and reduced Qi transformation, Fuzi can be used. For example, Kidney Qi Pill treats “edema rising, numbness in the lower abdomen”; treating “deficiency and abdominal pain, with tightness in the lower abdomen and difficulty urinating”; treating “shortness of breath with slight drinking, needing to urinate”; treating “men’s thirst with frequent urination, drinking one dou and urinating one dou”; treating “women’s heat and inability to sleep, but having normal appetite and difficulty urinating”; Gua Lou Qu Mai Wan treats “difficulty urinating, with water retention”; Ma Huang Fuzi Tang treats “Shao Yin’s proper water”, with symptoms of body and facial edema, difficulty urinating, and a deep pulse, all of which utilize Fuzi’s ability to warm the Kidney and transform Qi, promoting the upward movement of fluids and the downward movement of water Qi.
Common Compatibility Methods for Fuzi
1. Combined with Gan Jiang: Especially notable for its ability to revive Yang and rescue from collapse, Dai Yuanli once said: “Fuzi cannot warm without Gan Jiang.” Formulas like Si Ni Tang, Tong Mai Si Ni Tang, etc.
2. Combined with Rou Gui: Warms and tonifies Kidney Yang, invigorating Kidney Qi, achieving the effect of “benefiting the source of fire to dispel Yin obstruction”. Formulas like Kidney Qi Pill (in Kidney Qi Pill, Gui Zhi is often replaced with Rou Gui in later generations).
3. Combined with Gui Zhi: Warms the meridians and unblocks Yang, dispelling wind and eliminating dampness. Formulas like Gui Zhi Fuzi Tang, Gui Zhi Shao Yao Zhi Mu Tang.
4. Combined with Bai Zhu: Warms Yang and eliminates dampness to treat Bi pain. Formulas like Bai Zhu Fuzi Tang.
5. Combined with Gui Zhi and Bai Zhu: Acts on both the exterior and interior, assisting Yang and transforming dampness, alleviating Bi pain. Formulas like Gan Cao Fuzi Tang.
6. Combined with Aconitum, Shu Jiao, and Gan Jiang: Especially strong in dispelling cold and alleviating pain. “Yi Zong Jin Jian” states: Aconitum, Fuzi, Jiao, and Jiang are “all very pungent and hot, with no other considerations, just strongly dispelling Yin evil.” Formulas like Aconitum Red Stone Fat Formula.
7. Combined with Yi Yi Ren: To warm the interior, disperse cold, and eliminate dampness. Formulas like Yi Yi Fuzi San.
8. Combined with Ban Xia: Achieves the effects of warming the middle, alleviating pain, dispelling cold, and reducing counterflow. Formulas like Fuzi Jiang Mi Tang.
9. Combined with Ma Huang and Xi Xin: Has the ability to warm and release the interior Yang, allowing Yang Qi to flow, dispelling Yin condensation, and clearing water and phlegm. Formulas like Gui Zhi removing Shao Yao and adding Ma Huang, Xi Xin, and Fuzi Tang.
10. Combined with Da Huang: Using both cold and heat, Da Huang’s cold nature is controlled while preserving its purging ability, thus warming and expelling cold accumulation. This is especially true for cold accumulation in the middle jiao, as “only warmth can resolve its cold, and only downward movement can remove its accumulation”. The two herbs together achieve this effect. Formulas like Da Huang Fuzi Tang.
11. Combined with Ma Huang: Warms the meridians and induces sweating, as in Ma Huang Fuzi Tang.
Dosage and Administration of Fuzi
Administration: For urgent cases of Yang collapse requiring revival, raw Fuzi is often used, and must be combined with Gan Jiang, as in Si Ni Tang, Tong Mai Si Ni Tang, etc.; for alleviating pain, processed Fuzi is often used, without needing to combine with Gan Jiang, but should be based on cold dampness as the cause, as in Gui Zhi Fuzi Tang, Bai Zhu Fuzi Tang, Gan Cao Fuzi Tang, Gui Zhi Shao Yao Zhi Mu Tang, Yi Yi Fuzi San, etc.; for severe pain due to deep cold and stubborn cold, Aconitum should be used, thus for cold dampness affecting the joints, cold hernia abdominal pain, chest Bi heart pain, and cold Qi counterflow, formulas containing Aconitum should be used.
Fuzi and Aconitum contain toxic components such as Aconitine, which have paralyzing effects on the respiratory center, vascular motor center, and reflex functions, thus they should be boiled for a long time before use. Reports indicate: “Heating for more than four hours can completely destroy Aconitine, but the efficacy of Fuzi remains intact.” Aconitum, in addition to long boiling, should also be boiled with white honey, which can both mitigate Aconitum’s toxicity and enhance its efficacy.
Dosage: For reviving Yang and rescuing from collapse, the dosage is generally heavier, such as in Si Ni Tang, where “raw Fuzi is used as one piece” approximately equivalent to 21 grams today; in Tong Mai Si Ni Tang, “Fuzi is used as a larger piece”, approximately equivalent to 30 grams today.
For dispelling cold and alleviating pain, the dosage is also heavy, such as in Gui Zhi Fuzi Tang, where “processed Fuzi is used as three pieces”, approximately equivalent to 63 grams today; in Gui Zhi Shao Yao Zhi Mu Tang, “processed Fuzi is used as two pieces”, approximately equivalent to 42 grams today. For treating general Yang deficiency diseases, the dosage of Fuzi is generally lighter.
Currently, the approximate dosage of Fuzi is as follows: for reviving Yang and rescuing from collapse, a single dose can be 9-15 grams; for alleviating pain, a single dose can be 6-9 grams; for general Yang deficiency diseases, a single dose can be 1.5-6 grams.
In summary, the application of Fuzi in “Jin Kui Yao Lue” is quite extensive, with clever combinations and precise dosages. These valuable experiences still hold significant guiding importance today and are worth learning from for future practitioners.
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