1. Rescuing Yang from Reversal:
According to the “Essentials of Cold Damage”, Fuzi (Aconite) “has the power to expel Yin and restore Yang, capable of reviving the dead”; the “Compendium of Materia Medica” praises it as “the foremost medicine for rescuing Yang from reversal.” In cases of cholera with vomiting, diarrhea, profuse sweating, and limb coldness, the physician used Ren Shen Si Ni Tang (Ginseng Four Extremities Decoction); with a faint pulse on the verge of collapse and Yang floating outward, he prescribed Tong Mai Si Ni Tang (Unblock Pulse Four Extremities Decoction) with scallion white, pig bile, and human urine; for emergency rescue, he administered Fuzi. For cases of Yang collapse with excessive sweating, Qi Fu Tang (Qi and Fu Decoction) was chosen, and for diarrhea, Li Yong Shu Tang (Utilizing Technique Decoction) was used. During the treatment of 120 cases of adenoviral pneumonia, one case of Yang deficiency with limb coldness was successfully rescued with Ren Shen Fu He Si Ni Tang (Ginseng and Aconite Combined Four Extremities Decoction) as the main treatment. Although only this one case was observed, he believed “one must always be prepared for such a situation.” In the case of “Yang deficiency wanting to collapse (adenoviral pneumonia)”, after both Western and Chinese medicine treatments, the body temperature suddenly dropped dramatically, the patient was in a coma with cold limbs, weak breathing, dry tongue with little moisture, and a pulse that was deep, thin, and weak, indicating damage to Yin fluids and a desire for Yang to collapse. The physician urgently used Western Ginseng 6g, Chuan Fuzi 3g, and Shi Chang Pu 2g to restore Yang and rescue from reversal, decocting it strongly and administering it frequently. That night, the limbs gradually warmed, the coma turned into slight agitation, and phlegm could be coughed out; the next day, respiratory failure eased, and the tongue became red with moisture returning. He continued with a method to tonify Qi and generate fluids (Sha Shen, Mai Men Dong, Wei Ling Xian, Chang Pu, and Yuan Zhi) for five days, leading to a full recovery. This was all thanks to the power of Ginseng and Aconite to save the nearly collapsed Yang!
2. Guiding Fire Back to the Source:
The “Corrected Materia Medica” states that Fuzi “can greatly guide fire back to the source, subdue false heat, and is good at assisting Ren Shen and Huang Qi to achieve success, especially effective with Bai Zhu and Di Huang.” The physician observed a patient with great deficiency appearing as if real, with a red face, dizziness, irritability, and a pulse that was floating, large, and rough, believing it to be a sign of impending collapse. If the spirit was scattered and the patient could not sleep all night, it was also a sign of false excess, and it was urgent to use You Gui Wan (Right Return Pill) with Long Gu, Mu Li, Ci Shi, Gui Ban, and E Jiao to stabilize the Yuan spirit. In a case resembling a stroke, it was diagnosed as excessive emotional strain leading to true Yin deficiency of the liver and kidney, with true Yang floating above, indicating impending liver wind. The physician prescribed nourishing Yin and subduing Yang, assisting Fuzi to guide fire back to the source, and Ren Shen to tonify Qi, allowing Yin to stabilize and Yang to return, gradually alleviating dizziness and tremors.
3. Restoring Yang and Securing Yin:
In a case of “heat disease transitioning to cold (Japanese encephalitis)”, prior to consultation, large doses of pungent, cool, bitter, and cold herbs such as rhinoceros horn, antelope horn, and cow bile were used, yet high fever persisted, with limb coldness and mental confusion, abdominal fullness, and diarrhea with watery stools, with only a small amount of gas expelled, sweating from the head, dry lips, and dry teeth, indicating a mix of deficiency and excess, with evil penetrating the middle burner. The physician administered pungent, purging, and bitter descending agents (Ren Shen, Xia Jiang, Gan Cao, and others), after which diarrhea stopped and fullness reduced, and sweating and heat subsided. At that time, although the heat had receded, the Yuan Qi was injured, showing muscle twitching, limb coldness, and sweating, with a pulse faint and on the verge of collapse, fearing Yang would collapse. Urgently, he used Sheng Mai San (Generate Pulse Powder) with Fuzi, Long Gu, and Mu Li to restore Yang and secure Yin, decocting it strongly and taking it at any time, gradually reducing symptoms, restoring Yin and generating Yang. He then continued with San Cai Tang (Three Ingredients Decoction) with Jujube Seed, Shi Hu, and E Jiao to nourish Yin and benefit the stomach, and within a few doses, the patient recovered.
4. Supporting Yang and Securing the Defensive Qi:
The physician, when treating spontaneous sweating due to Yang deficiency and weak defensive Qi, often adjusted Yu Ping Feng San (Jade Windscreen Powder) with Fuzi, or alternated with Qi Fu Tang for effectiveness.
5. Warming and Supplementing Kidney Yang (Warming the Kidney and Cultivating the Source):
The “Soup Liquid Materia Medica” states that Fuzi enters “the medicine of the Mingmen (Gate of Life)”; the “Corrected Materia Medica” states: “it is the key medicine for circulating pure Yang through the twelve meridians.” The physician said that chronic wheezing treated by the kidney is due to the instability of kidney Yuan Yang, and the treatment should be with Shen Qi Wan (Kidney Qi Pill). In a case of “spleen and lung disease (chronic bronchitis)”, after phlegm and dampness were resolved, the treatment began with Li Zhong Wan (Regulate the Middle Pill) to warm and strengthen the spleen, followed by Gui Fu Di Huang Wan (Cinnamon and Aconite Rehmannia Pill) to tonify the kidney and secure the foundation. For spontaneous sweating due to true Yuan exhaustion, Ren Shen Fu Tang (Ginseng and Aconite Decoction) was used to warm and support. In late-stage nephritis with renal function decline and Yuan Qi unable to support, Ji Sheng Shen Qi He Li Zhong Wan (Rescue Life Kidney Qi and Regulate the Middle Pill) was used; in cases of “irregular menstruation (three types)”, where menstruation was early, with diarrhea before menstruation, and abdominal distension and pain, Huang Qi Jian Zhong Tang (Astragalus Center Pill) was used with Fuzi, Du Zhong, and Guo Zhi, and after five doses, menstruation was regular without diarrhea; in cases of “menstruation like flooding (one type)”, with low back pain and a pulse that was deep, slow, and weak, Fuzi was added to the kidney-strengthening formula, and symptoms improved. Afterward, Huang Qi Jian Zhong Tang was used with Fuzi and Bai Zhu, taken separately with You Gui Wan, and after two months, menstruation gradually regulated and pregnancy occurred; in cases of “oral ulcers”, the initial treatment was with Feng Sui Dan (Seal the Marrow Pill) with modifications, but diarrhea persisted, so the patient was given Bu Zhong Yi Qi Wan (Tonify the Middle and Benefit Qi Pill) in the morning and Jin Gui Shen Qi Wan (Golden Cabinet Kidney Qi Pill) in the evening, gradually recovering. All these cases involved the regulation of both spleen and kidney! In a case of “low back pain with constipation (prostate enlargement)”, the patient was 86 years old, with true Yin deficiency, Yuan Yang weak, fluids depleted, and Qi exhausted, leading to frequent urination and constipation. The physician used Gui Fu Ba Wei Tang (Cinnamon and Aconite Eight Flavor Decoction) with Dan Pi, adding Tu Si Zi, Du Zhong, Xiang Fu, Guo Zhi, and Ba Ji Tian to tonify the liver and kidney, nurturing Yin and nourishing fluids, while warming and cultivating the source, allowing the kidney’s water and fire to gradually fill, the body became strong, and all symptoms resolved, with no recurrence for five years. If fluids are depleted and generating fluids is ineffective, if it is due to a lack of fire at the bottom of the cauldron, Fuzi must be added. However, in acute heat diseases with fluid damage, the use of Fuzi should be cautious; “if the pattern is unclear, do not use lightly.”
6. Tonifying Qi and Warming the Kidney:
The physician treated an elderly patient whose urinary obstruction was due to middle Qi deficiency, prescribing Bu Zhong Yi Qi Tang (Tonify the Middle and Benefit Qi Decoction) with Fuzi to stimulate kidney Yang, strengthen heart Qi, and ensure sufficient small intestine Qi, leading to natural urination.
7. Warming and Supplementing Yang Qi:
In a case of “cold (one type)”, the patient had a constitution of Yang deficiency, and the defensive Qi was not solid, leading to illness. Initially, Yu Ping Feng San was given with Fuzi to warm Yang and benefit Qi. The aversion to wind decreased, and the aversion to cold reduced, but sweating persisted, with a white, greasy tongue coating, indicating that the defensive Yang was already deficient, and internal dampness was gradually revealing itself. The treatment was changed to warm Yang and benefit dampness, leading to significant symptom reduction. Ultimately, the method of warming Yang and tonifying the middle was used, taking Fuzi with Li Zhong Wan in the morning and Bu Zhong Yi Qi Wan in the evening, gradually recovering. The initial and final treatments were adjusted, but the main principle remained warming Yang.
8. Warming Yang and Promoting Dampness:
For Yang deficiency type hypertension, the physician advocated using Fuzi Tang (Aconite Decoction) with Gui Ban, Long Gu, and Niu Xi to treat it. In a case of dizziness (two types, hypertension), the patient had blood pressure of 25.3pa~18.7pa/16pa~12pa (190~140/120~90 mmHg) for four years, with dizziness, palpitations, and irritability. The physician, based on a pulse that was deep and slow, and a tongue that was not red, diagnosed the patient as having Yang deficiency with excessive dampness, and thus prescribed Fuzi Tang with Long Gu, Mu Li, Du Zhong, Qi Zi, Sang Ji Sheng, and Gou Qi Zi. After just 15 doses, all symptoms were eliminated, and blood pressure normalized. In a case of “Yang deficiency with spleen dampness (chronic bronchitis)”, Liu Jun Zi Tang (Six Gentlemen Decoction) was combined with Ling Gui Zhu Gan Tang (Poria, Cinnamon, and Atractylodes Decoction) with modifications, leading to a reduction in cough and phlegm, but with bowel movements occurring 2-3 times a day, and not formed, so Fuzi was added to Li Zhong Wan to guide the Four Spirit Pill to form pills for gradual improvement.
9. Warming Yang and Promoting Water:
In a case of a 14-year history of “palpitations (rheumatic heart disease)” with chronic heart failure and lower limb swelling, the physician prescribed Zhen Wu Tang (True Warrior Decoction) combined with Gui Zhi Long Mu Tang (Cinnamon and Dragon Bone Decoction) to warm Yang and promote water, harmonizing the defensive Qi and regulating the spleen and stomach, leading to significant reduction in edema. In another case of elderly hypertension, the physician viewed it as Yang deficiency with water counterflow, using Zhen Wu Tang with Long Gu, Mu Li, and Ban Xia to warm and settle, achieving recovery. In cases of chronic nephritis with a tendency towards kidney Yang deficiency, Zhen Wu Tang was also chosen to warm and promote water. In cases of “chronic bronchitis” with water and Qi counterflow, dizziness, and palpitations, or cough and wheezing with limb edema, the physician often used Zhen Wu Tang with Wu Wei Zi, Xi Xin, and Gan Jiang, achieving good results.
10. Warming the Channels and Dispelling Cold:
The “Essentials of Cold Damage” states that Fuzi “warms the channels and dispels cold; if not used, what else can save it?” The physician once treated a case in Sichuan, Zitong, where a patient had been exposed to the cold for three nights in a row during summer, resulting in severe pain in both legs and slight aversion to cold, needing assistance to get in and out of bed. Many doctors had treated it without effect, and the physician used 15g of Fuzi (first decocted), 9g of Ma Huang, and 6g of Xi Xin, leading to recovery after 20 doses as if back to normal.
11. Warming and Transforming Cold Dampness:
Zhang Yuanshuo discussed Fuzi, stating, “when paired with Bai Zhu, it is a holy medicine to eliminate cold dampness”; Yu Tuan stated, “it guides warming herbs to the lower burner to expel internal cold dampness”; Wang Ang stated, “it expels wind, cold, and dampness.” The physician believed that cold dampness is often found in those with Yang deficiency and weak spleen, presenting with a pulse that is deep and slow, no significant heat in the body, no thirst, clear urination, loose stools, or heaviness and pain in the body, but with sweating from the head and a preference for warmth in the back. The treatment was Wei Ling Tang (Stomach and Poria Decoction) with Chuan Fuzi, Mu Guo, and Pao Jiang. For cold dampness with a weak and rough pulse, Gui Zhi Fuzi Tang (Cinnamon and Aconite Decoction) was directly administered. In cases of “wind-cold-dampness bi syndrome” due to postpartum Qi and blood deficiency, with external wind-cold and internal dampness combining to cause bi syndrome, the physician skillfully combined warming the channels, dispelling cold, and eliminating dampness, harmonizing the defensive Qi and nourishing the blood, using Huang Qi Gui Zhi Tang (Astragalus and Cinnamon Decoction) combined with Shu Fu Tang (Atractylodes and Fuzi Decoction) with adjustments, leading to pain reduction the next day and menstruation returning after two days.
12. Warming and Unblocking Cold Accumulation:
The “Compendium of Materia Medica” cites the “Wang’s Original Formula” stating: “Fuzi is heavy and stagnant, warming the spleen and expelling cold.” In late-stage nephritis with renal function decline, Yuan Qi unable to support, presenting with abdominal distension and constipation, bitter and sour taste in the mouth, yellow and scanty urine, the physician often used Warming Spleen Decoction to harmonize the stomach and reduce turbidity for effect. For chronic pain and diarrhea with cold accumulation in the intestines, he often diagnosed it as chronic deficiency-cold diarrhea, with accumulation not yet resolved, and used Warming Spleen Decoction to make honey pills for administration, emphasizing that “if accumulation is not resolved, the disease is difficult to cure.”
13. Warming the Kidney and Dispelling Cold:In cases of acute nephritis, the physician observed a pulse that was deep, thin, tight, or deep, thin, and wiry, with a pale tongue and white coating, lumbar and back coldness, and cold limbs. He used 90g of Fuzi, 60g of Ma Huang, and 60g of Xi Xin, ground into a coarse powder, taking 12g for decoction; or used Ma Huang Fuzi Gan Cao Tang (Ephedra, Aconite, and Licorice Decoction).
14. Assisting in Nourishing the Liver and Kidney:
Yu Tuan stated that Fuzi “guides blood-nourishing herbs into the blood to nourish the insufficient true Yin.” In a case of habitual miscarriage (recurrent abortion) with a history of five miscarriages or premature births, with bleeding for over ten days each time during the fifth month of pregnancy, and this time also with fetal leakage, the physician first adjusted the spleen and stomach to nourish the fetal Yuan, using Wu Wei Zi and other herbs with ginger, jujube, and yam, stopping the nausea after three doses. He then nourished the liver and kidney to secure the fetal foundation, using Tai Shan Pan Shi San (Tai Shan Stone Powder) with modifications (including Chuan Fuzi, Bei Zhi Ren, Shu Di, Ba Ji Tian, and others), taking one dose per week until full term and safe delivery.
15. Tonifying Qi and Strengthening the Heart:
In a case of “false Yang rising (cerebral arteriosclerosis, coronary heart disease)”, the physician analyzed that it was due to insufficient Qi and blood, using Fuzi Tang to tonify Qi and strengthen the heart, adding Gou Qi Zi, Wei Ling Xian, Shan Zhu Yu, Gui Ban, and Nu Zhen Zi to nourish Yin and subdue Yang, achieving satisfactory results.
16. Tonifying the Middle and Nourishing Blood:
The “Compendium of Materia Medica” states that adding a small amount of Fuzi to tonifying herbs can guide them very quickly. In a case of “cold damp bi syndrome (subacute septicemia? rheumatic fever?)”, after repeated treatments with warming Yang, dispelling bi, clearing heat, benefiting Yin, tonifying Qi, and harmonizing the lung and stomach, the evil was dispelled but the righteous was injured, with excessive sweating and a blood sedimentation rate of 30-40 mm/hour. The physician used Gui Qi Jian Zhong Tang (Return Qi to the Center Pill) with Fuzi and other herbs, and after 10 doses, the blood sedimentation rate dropped to 20 mm/hour. He further stated: “The stomach is the root of postnatal health, the source of Qi and blood generation; if the spleen and stomach are strong, Qi and blood are sufficient, then recovery is assured.”
17. Warming the Channels and Controlling Blood:
In a case of “blood in the stool” with a disease course of nearly a month, the physician indicated it was due to internal accumulation of Yin Qi, unable to flow outward, with blood seeping into the intestines. He promptly applied Huang Tu Tang (Yellow Earth Decoction) with modifications, where Fuzi and Bai Zhu aimed to restore the Qi to flow, allowing the blood to warm and circulate, fearing that pungent warmth would move the blood, so he added Huang Qin to monitor and control, along with Ce Bai Ye to assist in astringing the blood, and after 9 doses, the bleeding ceased.
18. Warming the Spleen and Warming the Stomach:
The “Medical Origins” states that Fuzi “warms and heats the spleen and stomach.” In a case of “cold”, the patient had a constitution of Yang deficiency, and after experiencing treatments with pungent dispersing, wind-clearing, and warming phlegm-dampness, the physician switched to Fuzi Li Zhong Tang (Aconite Regulate the Middle Decoction) with modifications, and used it to make pills for gradual improvement.
19. Tonifying Fire and Supplementing Earth:
In a case of “Yang deficiency with spleen dampness (diarrhea)”, the physician initially used Li Zhong Tang with modifications, leading to normal bowel movements, but the patient still lacked strength and had spontaneous sweating, abdominal rumbling, and coolness, with a slow and weak pulse, so the original formula was adjusted to make honey pills for regular consumption.
20. Warming and Stopping Dysentery:
For cold dysentery with watery stools, limb coldness, and a faint pulse, the physician often prescribed Li Zhong Tang and Si Ni Tang (Four Extremities Decoction).
21. Calming Reversal Heat:
The “Compendium of Materia Medica” states: “The Yang of the sun manifests outwardly and causes heat; Fuzi can cause it to interact with the Shao Yin and the heat will cease; in cases of Shao Yin spirit mechanism disease, Fuzi can cause it to rise from below and the pulse will circulate, leading to recovery from reversal.” In a case of “dysentery (acute toxic dysentery)”, where the condition was critical and various antibiotics had no effect, the physician, upon second examination, found a mix of cold and heat, with reversal heat prevailing, and a mix of deficiency and excess, indicating that the evil had deeply penetrated the reversal and Tai Yin, with the Yang Ming gastric fluid being the most critical. He urgently administered Wu Mei Wan (Mume Pill) with modifications, and after 2 doses, both the reversal heat and agitation subsided, and the diarrhea improved. Ultimately, he used a tonic to generate fluids, harmonizing the liver and spleen with 3 doses, leading to stability. How swift!
22. Warming the Organs and Killing Parasites:
Li Gao stated that Fuzi “eliminates the cold from the organs, counteracting the three Yin reversals, dampness causing abdominal pain, and cold in the stomach causing worm movement.” In a case of “parasites”, the physician’s uncle, who had a fondness for alcohol and was prone to anger, after a fit of anger, experienced abdominal distension like a stone, slight swelling in the upper limbs, and significant swelling in the lower limbs, with small holes leaking foul yellow fluid, a protruding abdomen, and difficulty with urination and defecation, with a pulse that was deep, wiry, and rough. The physician prescribed Warming White Pills, leading to vomiting of worms and peaceful sleep, and after waking, the patient consumed congee for several days, with swelling subsiding and holes closing. After two months of regulation, he recovered. This is a case that truly follows the principle of “great accumulation and great gathering, which can be treated” and is a remarkable example!
23. Counteracting Pure Cold:
Pure cold substances should be used for heat and fire conditions. However, in a weak body, it is difficult to withstand the attack, and initial effects may be seen, but later it will not be effective.
Human beings rely on stomach Qi as their foundation; pure cold damages the stomach and often worsens the condition. The physician recalled a case of summer illness treated with Huang Lian Jie Du Tang (Coptis Detoxifying Decoction) with Fuzi and Jiang Can (Silkworm). The role of Fuzi is to “use cold without straying far from heat, guiding various medicines without stagnation, counteracting and being able to break through its nest, attacking and breaking the knot.” The physician’s clinical experience often yielded effective methods.
In summary, the above evidence shows that the physician has deeply studied medical principles, dissected the minutiae, and used Fuzi to its utmost, achieving the highest realm of mastery. However, “warming but not drying” is the fundamental principle he adhered to throughout. After all, Fuzi is ultimately a pure Yang, pungent, and warming substance, supplementing fire and supporting Yang while having excess, and caution is especially needed to avoid damaging Yin. Otherwise, with water depleted and Yin exhausted, fire has no attachment, leading to a raging fire. The physician cited the “Treatise on Cold Damage” where Fuzi Tang is paired with Bai Shao, and Si Ni Tang contains Gan Cao; Jin Gui Shen Qi Wan supplements fire in water, all of which adhere to this principle. Therefore, the physician earnestly advised that in clinical practice, one must avoid haphazardly combining purely warming and hot medicines to treat diseases. He often used 9g of cooked Fuzi and Ren Shen, along with 30g of vinegar-prepared Gui Ban for urgent rescue of the nearly collapsed Yin and Yang in the kidney; for treating Qi obstruction and ear deafness due to both Yin and Yang deficiency, he prescribed Ba Wei Shen Qi Wan (Eight Flavor Kidney Qi Pill), all of which were lively and smooth, deeply grasping the essentials of using Fuzi, and also the best interpretation and elucidation of the physician’s principle of “warming but not drying, avoiding damage to fluids, is truly the key to warming methods”.
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