Introduction:Mr. Tao Yufeng has compiled 35 clinical applications of “Fu Zi” (Aconite) based on ancient texts, the experiences of historical physicians, and his own clinical insights, which are worth learning and collecting.
1
Fu Zi is the most useful yet the most difficult to use.
2
Fu Zi is the premier herb for reviving yang and rescuing from collapse, used for conditions of insufficient yang qi, internal cold, profuse sweating, severe diarrhea, dyspnea, and sudden collapse from stroke, all of which require this powerful herb to restore balance.
It is said that this herb can supplement the original yang, capable of ascending and descending, reaching internally and dispersing externally. It can resolve cold stagnation in the organs, affect the muscles and bones, and relieve blockages in the meridians and blood vessels. In warming and unblocking, it also possesses significant astringent properties, thus treating excessive sweating leading to yang deficiency, cold intestines causing diarrhea, and lower jiao yang deficiency with spontaneous emissions.
3
Fu Zi is highly effective in drawing fire back to its source, subduing false heat, and works well with Ren Shen (Ginseng) and Huang Qi (Astragalus) for success, especially with Bai Zhu (Atractylodes) and Di Huang (Rehmannia). Regardless of exterior or interior conditions, it should be urgently used when the pulse is thin and lacks vitality, and there is no heat present.
4
For cold in the meridians, Fu Zi should be the chief herb.
5
Fu Zi is not warming without Gan Jiang (Dried Ginger); it is moderated by Gan Cao (Licorice) and complemented by Gui Zhi (Cinnamon Twig) to nourish the Ming Men (Gate of Life).
6
Fu Zi’s urgent nature is moderated by Gan Cao; its toxicity is resolved by Gan Cao; its dispersing nature is enhanced by Gan Cao to benefit the heart and spleen; its scattering nature is adjusted by Gan Cao to harmonize the defensive and nutritive qi.
7
Cooked Fu Zi paired with Ma Huang (Ephedra) provides both warming and tonifying effects, as seen in Zhang Zhongjing’s Ma Huang Fu Zi Xi Xin Tang and Ma Huang Fu Zi Gan Cao Tang; raw Fu Zi paired with Gan Jiang provides warming with dispersing effects, as in Zhang Zhongjing’s Gan Jiang Fu Zi Tang and Tong Mai Si Ni Tang.
8
For qi deficiency, use Si Jun Zi Tang (Four Gentlemen Decoction); for blood deficiency, use Si Wu Tang (Four Substance Decoction); for severe deficiency, add cooked Fu Zi. Both Si Jun and Si Wu are gentle and harmonizing formulas, requiring Fu Zi’s robust nature to achieve success.
It is said that adding a small amount of Fu Zi to tonics can enhance their efficacy.
9
In cases of great deficiency, Ren Shen and Bai Zhu are ineffective, and Fu Zi must be added to invigorate the spirit and promote appetite. If there is yin deficiency with yang excess, leading to emaciation and a rapid pulse, do not use lightly.
10
In formulas for dampness, a small amount of Fu Zi is advisable to promote circulation through the meridians.
Additionally, individuals with excess dampness should also add Wu (Aconite) and Fu Zi to facilitate circulation.
It is said that Fu Zi can guide qi herbs through the twelve meridians to restore lost original yang; guide blood tonics into the blood to nourish insufficient true yin; guide dispersing herbs to open the pores to expel wind and cold; and guide warming herbs to the lower jiao to eliminate internal cold dampness.
11
Fu Zi combined with Gan Jiang and Gui Zhi is indicated for cold damage in the yin meridians, warming the center and dispersing cold to induce sweating; when combined with Ren Shen, Rou Gui (Cinnamon), and Wu Wei Zi (Schisandra), it supplements the fire of the Ming Men;
with Ren Shen and Chen Pi (Tangerine Peel), it treats prolonged pain, vomiting, and reverse stomach, especially in those who are deficient and without heat.
12
For yang deficiency with spontaneous sweating, three formulas are used:
If the exterior yang is not firm and there is spontaneous sweating, use Qi Fu Tang (Huang Qi and Fu Zi); if the spleen yang is obstructed and there is spontaneous sweating, use Shu Fu Tang (Bai Zhu and Fu Zi); if the kidney yang is floating and there is spontaneous sweating, use Shen Fu Tang (Ren Shen and Fu Zi).
13
Zhang Zhongjing’s use of Fu Zi’s warming properties has two methods: mixed with Ling (Poria), Shao (Peony), and Gan Cao, or mixed with Di Huang (Rehmannia) and Ze Xie (Alisma), as in winter, it is pleasant and a method to supplement deficiency; when combined with Jiang (Ginger) and Gui (Cinnamon) for heat, or with Ma (Ephedra) and Xin (Asarum) for strength, it is a method to rescue yang in summer.
14
Fu Zi and Rou Gui are both pungent and warming, capable of assisting the original yang. However, when the original yang is about to collapse or is floating and escaping, Fu Zi should be used instead of Rou Gui.
Indeed, Fu Zi is thick in flavor, while Rou Gui has both thick flavor and dispersing properties, not suitable for rescuing from critical conditions. Observing Zhang Zhongjing’s “Shang Han Lun” (Treatise on Cold Damage), it is clear that Fu Zi is used while Rou Gui is not.
15
Raw Fu Zi is particularly potent; in cases of sudden severe illness with cold limbs and clear skin, weak pulse, or vomiting and diarrhea, clear and cold symptoms, it is ineffective without using raw. Other cold illnesses can be treated gradually, using cooked to moderate its effects.
16
When using Wu Tou (Aconite) and Fu Zi, it is advisable to take them cold, as heat is used for cold conditions.
When yin cold is below and the deficient yang is floating above, treating with cold will exacerbate the yin, worsening the illness; treating with heat will reject and not accept. Cold herbs taken with hot drinks will dissipate the cold, and the heat will emerge, leading to recovery without violating the principles, thus achieving great benefits.
17
Some individuals can take Fu Zi with a small amount without issue, while others may experience dryness with prolonged use, indicating that Fu Zi must be used according to individual constitution.
18
The purpose of using Fu Zi is to invigorate weakened functions, not limited to specific areas, thus the illness must exhibit symptoms of functional decline.
For example, if the pulse is deep, weak, and slow, indicating extreme fatigue of heart function, Fu Zi can invigorate it; in new or chronic illnesses, with cold skin and dullness, spontaneous sweating, this indicates extreme decline in overall circulation, and Fu Zi can stimulate it;
in heat illnesses with initial agitation, incoherent speech, sudden confusion, and murmuring, this indicates brain function is impaired, and Fu Zi can stimulate it; in cases of diarrhea, with undigested food, this indicates long-standing dysfunction of intestinal absorption, and Fu Zi can promote movement.
In summary, invigorating functional decline is a necessary condition for using Fu Zi; otherwise, it is unnecessary to use Fu Zi, and forcing its use will lead to immediate harm.
19
The signs of yang collapse progress through four stages, and the timing of Fu Zi’s use must be grasped.
The first stage is when the back of the wrist and hand are cold; the second stage is when sweating occurs and the skin is cool, with the whole body cold; the third stage is when the hands are cold past the elbows and the feet past the knees; the fourth stage is when body temperature disperses, skin is cold, and cold sweat appears.
The first stage indicates the onset of yang collapse; the second stage is the evidence of yang collapse, where Fu Zi is most effective; the third stage indicates yang collapse is in crisis, and Fu Zi should be urgently administered, still hoping for a turnaround; if it reaches the fourth stage, the timing for Fu Zi has been lost, and recovery is difficult.
20
In yin conditions, using Fu Zi is difficult due to the need for accurate differentiation.
Yun Tieqiao shared his experience:
In yang conditions, sweating occurs with hot skin; in yin conditions, sweating occurs with cool skin;
In yang conditions, there is initial coolness in the fingertips, and the face is red and bright; in yin conditions, there is coldness in the wrist, initially no redness in the face, but later it becomes red, and the fingertips do not show cyanosis, with sweating on the head.
In yang conditions, there is agitation, red face, red tongue, profuse sweating, thirst, and slippery pulse; in yin conditions, there is agitation, weak voice, cold limbs, and deep, weak pulse.
Yin conditions also have a characteristic of clear diarrhea, where the stool is as it was eaten, undigested, mixed with black water, commonly known as “leaky bottom,” requiring urgent use of Fu Zi, which can induce sweating and sleep, restoring yang qi throughout the body, allowing bladder qi to function, leading to frequent urination, and stopping the leakage. This also belongs to the principle of balancing excess and deficiency.
21
Indications for urgent use of Fu Zi in Shaoyin disease:
① Pulse is tight with sweating.When the pulse is tight without sweating, it indicates cold evil on the surface, belonging to Taiyin syndrome; when the pulse is tight or even hard with sweating, it indicates Shaoyin yang collapse (Shaoyin syndrome generally has a weak, deep pulse; if the pulse is tight and hard, the condition is more severe);
② Tongue color is dry and withered.The tongue appears dry and withered like a lychee shell, purple-brown, indicating kidney yang cannot ascend, different from the tongue color of yang conditions with heat, where the fluids are robbed, indicating yin conditions.
③ Skin is moist. The tongue coating robs fluids, while the four limbs are cold, with sweating on the head, indicating yin conditions. In yang conditions, the skin is dry without sweating; in yin conditions, the skin is moist with sweating, clearly distinguishable.
22
In Shaoyin syndrome of cold damage, Fu Zi can certainly restore balance, but it is limited to cases where the pulse is not chaotic, the face is not swollen, the qi is not urgent, and there is no sweating on the head.
Any one of these four indicates difficulty in treatment; if two are present, Fu Zi will be ineffective. This is because Fu Zi warms the kidneys and revives yang, invigorating secretion, which requires internal vitality to be intact before there is a possibility of infusion and support.
If any two of the above four are present, it indicates that “vitality” has been exhausted, and human efforts cannot reverse the situation.
23
Indications for Fu Zi use include three: back cold, clear urination, and deep, weak pulse.All three signs indicate true yang is weak, and Fu Zi is necessary to warm it.
24
Fu Zi’s main functions include five: warming the heart yang to open the pulse, assisting the spleen yang to promote movement, supplementing the Ming fire to restore yang, securing the defensive yang to stop sweating, and expelling cold stagnation to relieve pain.
In small doses of Fu Zi (up to 6 grams), it primarily warms yang and transforms qi, suitable for patients with yang deficiency and qi deficiency with a short illness and acceptable constitution, generally decocted for about 30 minutes.
In large doses of Fu Zi (over 10 grams), it primarily warms yang, secures sweating, relieves pain, and stimulates yang qi, suitable for patients with long-term illness, severe yang deficiency, spontaneous sweating, and persistent pain, generally decocted for over 1 hour.
25
Using Fu Zi to warm yang can be combined with latent yang herbs (such as Long Gu (Dragon Bone), Mu Li (Oyster Shell), and Ci Shi (Magnetite)) or calming herbs (such as Suan Zao Ren (Sour Jujube Seed)) to invigorate yang qi and allow it to be concealed, preventing agitation and restlessness.
26
The effectiveness of Fu Zi lies in its compatibility, aimed at assisting the yang of the heart, kidneys, and spleen to expel cold dampness, promote the flow of qi and blood, and enhance bodily functions to overcome disease.
For treating elderly patients with external pathogens, use Ren Su Yin with added Fu Zi; for qi deficiency and weakness (with low blood pressure as the main symptom), use Bu Zhong Yi Qi Tang with added Fu Zi; for dampness causing edema, use Wu Ling San with added Fu Zi; for hypothyroidism, use Ren Ling Bai Zhu San with added Fu Zi.
Generally, use cooked Fu Zi slices 3-9 grams, starting with a small amount.
27
Fu Zi paired with Bai Shao (White Peony) provides a balance of warming and cooling, enhancing its effects in relieving blockages, stopping pain, breaking up masses, and expelling stagnant blood.
28
Patients with coronary heart disease often exhibit weakened yang qi, clinically presenting as heart failure.
Fu Zi has the effects of strengthening the heart and promoting diuresis; in cases of weak qi and water retention (or even without water retention), this herb can be used to warm yang and promote water metabolism. Even if there is yang damage and yin involvement, or combined with heart fire or liver yang hyperactivity, there is no need for concern.
In cases with the above combined symptoms, this herb can be combined with Shu Di Huang (Rehmannia), Mai Dong (Ophiopogon), or Chuan Lian (Coptis), Shan Zhi Zi (Gardenia), or Shi Jue Ming (Abalone Shell), or Ling Yang Jiao (Antelope Horn) to balance yin and yang, or to harmonize ascending and descending, combining cold and heat, achieving significant clinical effects.
29
Fu Zi 15 grams, combined with Ting Li Zi (Descurainia) 30 grams, treats palpitations and dyspnea with excellent results.
Indications for Fu Zi use include a purple tongue or cyanotic, moist tongue with spots or bruises, thin white or white greasy coating, or cold limbs, clear urination, and loose stools.
30
Fu Zi is commonly used for abdominal pain and diarrhea caused by spleen and kidney deficiency with cold and dampness in the lower jiao.
The dosage can be as low as 10 grams, or more depending on the condition. When using large doses, attention should be paid to compatibility. To prevent its pungent and warming nature, it is often paired with Bai Shao, which can yield remarkable effects. If the stool after taking the medicine contains a large amount of white mucus, this is a good sign of cold dampness being expelled from the abdomen, indicating imminent recovery.
31
For some stubborn chronic diarrhea and cold deficiency diarrhea patients, only with heavy use of Fu Zi can the yang be warmed, cold expelled, and dampness driven away. The dosage can be small at 6 grams, or large at 30-60 grams.
This herb contains aconitine, which has toxic side effects on the heart, so elderly patients and those with organic heart diseases, especially conduction disorders, should use it with caution.
For any dosage over 10 grams, it must be decocted first. For 15-30 grams, generally decoct for 1 hour, and for over 30 grams, decoct for 2 hours.
For some cases of early morning diarrhea, it may be necessary to use up to 60 grams for effectiveness. However, it is generally advisable to start with a small amount and gradually increase, avoiding sudden large doses.
Fu Zi has been used in combination with Rou Gui, Pao Jiang (Fried Ginger), and other herbs to successfully treat stubborn chronic diarrhea, achieving satisfactory results.
However, Fu Zi should not be used in large amounts in the following situations:
1. In cases of emaciation, especially in women, as they may appear to have yang deficiency but actually have internal heat, leading to suboptimal results.
2. In cases with mucus in the stool, even if there is spleen deficiency and yang deficiency, large doses are not advisable; small amounts of Fu Zi should be combined with herbs that clear and regulate the spleen or temporarily avoided.
3. In cases of yang deficiency, but with loose stools that are not satisfying, or if the stools are loose but occur only once every few days.
4. In southern humid and hot regions, where many people are weak and often have internal heat, even if there is yang deficiency, large doses are not suitable.
5. In elderly patients or those with rapid heart rates or arrhythmias.
32
For treating children with yang deficiency and chronic diarrhea, using processed Fu Zi with Rou Gui yields immediate effects.
Additionally, for treating stomach pain (gastritis, gastric and duodenal ulcers, chronic gastritis), regardless of cold or heat conditions, processed Fu Zi combined with Huang Lian (Coptis) is effective (though the dosages of the two herbs vary), and has been repeatedly proven effective.
33
In the “Jin Kui Yao Lue” (Essential Prescriptions of the Golden Chamber), the use of Gua Lou (Trichosanthes) and Qu Mai (Dianthus) pills for urinary difficulties and thirst indicates that Fu Zi combined with heat-clearing and damp-dispelling herbs can treat stubborn edema, achieving good results.
34
When treating chronic diseases of a cold deficiency nature, using processed Fu Zi at 1.5-3 grams can be effective, while 6-9 grams is needed for its analgesic effect.
35
When using Fu Zi in large doses, it is advisable to add 3-5 slices of fresh ginger or a spoonful of honey to prevent toxicity; alternatively, Fu Zi can be decocted for half an hour first, ensuring that enough water is used for decoction without adding cold water midway.
Source: Xiao Xiangru Channel, this article is excerpted from “Lin Zheng Ben Cao,” authored by Tao Yufeng.
Traditional Chinese Medicine Acupuncture and Tuina Department: Xie Yibing
★ Associate Professor
★ Associate Chief Physician
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Graduated from Fujian University of Traditional Chinese Medicine in 1990, with over 30 years of clinical experience.
Specialties
1. Traditional Chinese Medicine for Chronic Rhinitis and Cough: Utilizing rhinitis ointment and floating needle therapy to comprehensively treat various acute and chronic rhinitis, allergic rhinitis, and sinusitis. Also treating chronic cough, adenoid hypertrophy, chronic pharyngitis, and asthma.
2. Traditional Chinese Medicine for Yang Deficiency Acupuncture and Qi Guidance: a) Various constitution adjustments: treating women’s yang deficiency, cold uterus, cold limbs, menstrual pain, headaches, and infertility; treating qi and blood deficiency leading to fatigue, easy colds, prolonged illnesses, and hair loss; b) Reducing dampness and lowering lipids: treating abdominal obesity, primary hypertension (grades 1 and 2), hyperlipidemia, and gout; also treating chronic urticaria, eczema, neurodermatitis, and acne.
3. Traditional Chinese Pediatric Tuina: Treating children’s colds, coughs, sore throats, loss of appetite, food stagnation, enuresis, diarrhea, and torticollis.
4. Traditional Chinese Pain Management: Utilizing rapid effect muscle relaxation and pain relief techniques, floating needles, and buried threads to treat various acute and chronic soft tissue injuries, degenerative changes causing pain, arthritis, spinal diseases, and related visceral dysfunctions. Specializing in treating cervical spondylosis, headaches, dizziness, lumbar disc herniation, lumbar muscle strain, and chronic gastrointestinal pain.
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