Introduction: Mr. Tao Yufeng has compiled 24 clinical treatment principles for “Cang Zhu” based on ancient texts, the experiences of historical physicians, and his own clinical insights, which are worth learning and collecting.
1
Cang Zhu (Atractylodes) promotes sweating and is more effective than Bai Zhu (White Atractylodes); it supplements and eliminates dampness, but its strength is not as great as Bai Zhu. Generally, for deficient soil, it should be paired with Bai Zhu to nourish it; for abundant soil, it should be paired with Cang Zhu to balance it.
It is said that Bai Zhu retains while Cang Zhu disperses, hence Bai Zhu is good for supplementation, while Cang Zhu is good for dispersing. Cang Zhu aids digestion and stops vomiting and diarrhea similarly to Bai Zhu, but it uniquely excels at draining water and relieving stagnation.
2
Cang Zhu governs dampness in the upper, middle, and lower parts of the body.
Dampness in the upper jiao can easily lead to phlegm, thus it is used to dry dampness and resolve phlegm; dampness in the middle jiao causes stagnation and diarrhea, thus it is used to relax the middle and strengthen the spleen; dampness in the lower part leads to weakness in the knees and legs, and it can be used with Huang Bai (Phellodendron) to treat weakness (adding Niu Xi (Achyranthes) is even better), which can strengthen the knees and legs.
3
Cang Zhu combined with Huang Bai treats lower jiao damp-heat; Huang Bai is bitter, which overcomes heat, thus it can eliminate heat from dampness; Cang Zhu is drying, which overcomes dampness, thus it can eliminate dampness from heat. The two complement each other, hence the formula is called Er Miao (Two Marvels).
4
Cang Zhu and Chuan Xiong (Ligusticum) can resolve various stagnations, adding other herbs according to the symptoms.
It is said that Cang Zhu combined with Xiang Fu (Cyperus) and Chuan Xiong can resolve various stagnations.
It is said that Cang Zhu with Xiang Fu can open up stagnation. The six types of stagnation: phlegm, fire, dampness, food, qi, and blood, all arise from abnormal transformation and cannot ascend or descend, with the disease located in the middle jiao, thus the herbs must facilitate both ascending and descending.
Cang Zhu is a herb of the Yangming meridian, with a pungent and strong flavor, it strengthens the stomach and spleen, promotes the qi of grains, can directly enter other herbs, dispel Yangming dampness, and regulate and consolidate; Xiang Fu is a herb that quickly moves qi in the yin, it descends qi rapidly, thus the two herbs work together to disperse stagnation and balance.
5
Cang Zhu when combined with Huang Bai, Niu Xi, and Shi Gao (Gypsum) can guide it downward to eliminate lower body damp phlegm; when combined with Gan Cao (Licorice), Chen Pi (Dried Tangerine Peel), and Hou Po (Magnolia Bark), it can eliminate middle jiao dampness and balance the excess qi in the stomach; when combined with scallions, Ma Huang (Ephedra), and Xing Ren (Apricot Kernel), it can eliminate evil from the flesh to the skin surface.
6
Cang Zhu combined with Fang Feng (Saposhnikovia) promotes sweating, combined with Huang Bai it overcomes dampness, and combined with Shan Zhi Zi (Gardenia) it resolves the dryness of Cang Zhu.
7
Cang Zhu combined with Qiang Huo (Notopterygium) stops body pain; combined with Shu Di Huang (Rehmannia), Gan Jiang (Dried Ginger), it treats sallow complexion and poor appetite; combined with Huang Bai, Niu Xi, Mu Guo (Papaya), and Shi Hu (Dendrobium), it can strengthen walking ability; combined with Ku Shen (Sophora), Mu Li (Oyster), it treats children’s stomach damp-heat, preventing food from generating muscle; combined with Mai Dong (Ophiopogon), Shi Hu, Huang Bai, Bai Shao (White Peony), Mu Guo, Yi Ren (Job’s Tears), and Wu Wei Zi (Schisandra), it is a key herb for treating weakness.
8
Cang Zhu is a holy herb for treating dampness, especially effective when paired with Ma Huang.
When both herbs are used in equal amounts, they can induce profuse sweating; if Cang Zhu is used in double the amount of Ma Huang, it induces mild sweating; if Cang Zhu is three times that of Ma Huang, it increases urination, having a diuretic effect; if Cang Zhu is four times that of Ma Huang, although there is no significant sweating or diuresis, the damp evil can transform itself.
9
Cang Zhu has a good function of moving qi and resolving stagnation, clinically indicated for abdominal distension, thick greasy tongue coating. For simple qi stagnation, 6-10 grams is appropriate; if qi stagnation is accompanied by dampness, 10-15 grams can be used.
If it is a case of liver qi stagnation transforming into fire injuring yin, Cang Zhu can be stir-fried with Hei Zhi Ma (Black Sesame); or combined with Shi Hu, Mai Dong, and Xuan Shen (Scrophularia) to avoid injuring fluids and depleting yin.
Cang Zhu combined with a small amount of Gui Zhi (Cinnamon Twig) can disperse liver and transform dampness; combined with Sheng Ma (Cimicifuga), it can promote the ascent of clear qi and the descent of turbid qi; combined with Shu Di, it can tonify without stagnation, and also support spleen function.
10
Gastric prolapse is often due to spleen deficiency and sinking of middle qi, often accompanied by damp evil, with damp turbidity not transforming, making it difficult for clear qi to ascend. To treat this, Cang Zhu can be soaked in hot water and used as a tea, 20 grams daily, which is effective and does not harm yin or create dryness.
11
Cang Zhu is very effective for treating gastric prolapse.
Li Dongyuan referred to Cang Zhu as a “key herb for treating weakness.” Weakness refers to the relaxation and weakness of the tendons and meridians. Gastric prolapse is caused by the relaxation of the ligaments supporting the stomach or the relaxation of the stomach wall, which aligns with the TCM understanding of weakness of the spleen and stomach, leading to the sinking of middle qi and inability to lift.
12
Cang Zhu can reduce swelling in the lower limbs caused by dampness or damp-heat, often used with Huang Bai; for severe swelling, add Hou Po, Bi Xie (Dichroa), Fu Ling (Poria), Che Qian Zi (Plantago), Niu Xi, and Yi Ren, which enhances the function of dispelling dampness and reducing swelling.
13
Persistent edema responds well to high doses of Cang Zhu.
The mechanism is that “draining water and opening stagnation, Cang Zhu excels,” which is one aspect; using high doses of Cang Zhu supports spleen yang, and with sufficient yang, the spleen can function, leading to the resolution of edema, which is another aspect.
For treating cardiac edema, which is due to insufficient spleen yang, Cang Zhu can be used with Gan Jiang; for lung and spleen qi deficiency, with internal stagnation of dampness, Cang Zhu can be combined with Ma Huang, with Cang Zhu’s dosage being three to four times that of Ma Huang; for heart yang deficiency, combine with Gui Zhi; for kidney yang deficiency, combine with Fu Zi (Aconite); for damp phlegm and blood stasis, combine with Tian Qi (Notoginseng) and Ting Li Zi (Descurainia), with Cang Zhu’s dosage between 15-20 grams. In observing a hundred patients, the edema was resolved satisfactorily.
However, it should not be used recklessly in cases of severe heat in edema.
Additionally, using Cang Zhu as the main herb, differentiated treatment for 10 cases of edema due to beriberi also showed good results.
14
A woman aged fifty initially suffered from painful urination, treated with Ba Zheng San (Eight Correcting Powder) and others, but her urination remained obstructed, and her body felt like it was pricked with thorns.
Wang Kentang diagnosed it as dampness from continuous rain, the evil still on the surface, thus used Cang Zhu as the chief herb, with Fu Zi as an assistant, to release the exterior; after one dose, she sweated, and urination was immediately restored.
15
Cang Zhu combined with Xuan Shen has a blood sugar-lowering effect. Using Cang Zhu to treat diabetes takes advantage of its function of “consolidating spleen essence and stopping the leakage of turbid.”
Although Cang Zhu is drying, when combined with Xuan Shen’s moistening properties, it can enhance its strengths while mitigating its weaknesses.
16
The “Compendium of Materia Medica” states that Cang Zhu “treats damp phlegm retention or phlegm with blood stasis forming cysts.”
Phlegm turbidity and blood stasis are pathological products of diabetes, continuously affecting blood sugar biochemistry and metabolism.
Cang Zhu can be added to tonifying lung and kidney, and major qi and yin tonics, not only to strengthen the spleen and open the middle, preventing the cooling and moistening herbs from harming the spleen and stomach, but also to invigorate the turbid and elevate the clear, helping to resolve high blood sugar and phlegm stasis.
It has been used in doses of 10-15 grams, combined with Huang Qi (Astragalus), Sha Shen (Glehnia), Tian Dong (Asparagus), Mai Dong, Xuan Shen, Sheng Di (Rehmannia), Shan Yu Rou (Cornus), Shan Yao (Chinese Yam), and Wu Wei Zi, to create the “Jin Shui Xiang Sheng Yin” (Golden Water Generating Drink), treating 52 cases of type II diabetes, with one dose daily, while gradually reducing the original hypoglycemic Western medicine, and advising patients to control their diet, manage emotions, and balance work and rest.
After taking 40 doses, according to the efficacy standards for diabetes set by the National Administration of Traditional Chinese Medicine, the overall effective rate was 92%, and it was found that Cang Zhu played a crucial and indispensable role in the formula.
In a selection of 12 patients, when Cang Zhu was removed while keeping other herbs and dosages unchanged, the blood sugar reduction was significantly lower; the original formula with Cang Zhu had better and faster hypoglycemic effects.
17
Cang Zhu can treat bi syndrome, applicable for both cold and heat types.
Generally combined with Fu Zi, Gui Zhi, and Gan Cao for cold damp pain; combined with Shi Gao, Qin Jiao (Gentiana), and Yi Ren for hot bi with joint redness and swelling; combined with Qiang Huo, Du Huo (Angelica), Fang Feng, and Wei Ling Xian (Clematis) for wind-cold-damp bi.
18
Cang Zhu is a key herb for treating gout.
For acute gout attacks, with more heat than dampness, use Cang Zhu as the main herb, combined with Zhi Mu (Anemarrhena), Shi Gao, and Fang Ji (Stephania). For those with weak spleen and stomach, add Jing Mi (Glutinous Rice) and Gan Cao; for severe pain, add Yan Hu Suo (Corydalis).
For acute gout attacks with equal heat and dampness, use Cang Zhu as the main herb, combined with Huang Bai, Niu Xi, and Yi Ren. For significant spleen and stomach damp turbidity, add Hou Po Hua (Magnolia Flower) and Can Sha (Silkworm Sand); for severe pain, add Liang Mian Zhen (Two-Sided Needle).
For chronic recurrent gout, with damp stasis obstructing the meridians, use Cang Zhu as the main herb, combined with Hong Hua (Carthamus), Tian Qi, and Chuan Shan Long (Dichroa). If there is qi and blood deficiency, add Dang Gui (Angelica) and Huang Qi; for severe pain, add Qi She (Agkistrodon); if accompanied by sand and stone, add Jin Qian Cao (Lysimachia) and Mao Xu Cao (Cat’s Whiskers).
For chronic recurrent gout, with wind-cold-damp obstructing the meridians, use Cang Zhu combined with Du Huo, Wei Ling Xian, and Mu Guo.
19
Cang Zhu can treat chyluria, with good efficacy in short-term cases, often used with Bai Zhu, Bi Xie, Shan Yao, and Huang Qi.
20
For multiple neuritis, with a course of less than one month, with relaxed limbs and paroxysmal cramping pain, 6-9 grams of Cang Zhu can be added to tonifying herbs, which is effective for early paralysis; this method can also be used for early polio, aiding in recovery from weakness. However, it should not be used for hemiplegia caused by cerebral hemorrhage.
21
For erysipelas occurring in the lower limbs, TCM refers to it as flowing fire. To treat recurrent flowing fire, after the acute phase, use 1000 grams of Cang Zhu, decocted three times, combining the medicinal juices, and simmering over low heat until it becomes a paste, then add 250 grams of honey, mix well, and store in a bottle.
Take one or two spoonfuls, dissolve in water, twice daily, for about half a month as one treatment course, then continue with the same method for 2-3 more courses to consolidate the results.
After taking it, most patients gradually reduce occurrences, or even completely stop, achieving a curative effect.
For milder cases, the Er Miao Wan (Two Marvels Pill) (Cang Zhu, Huang Bai) can be taken, 9 grams each time, twice daily, to achieve similar effects.
22
Cang Zhu 10 grams, Liu Yi San (Six One Powder) 30 grams (in a bag), Bi Xie 10 grams, decocted in water, treats damp-heat obstructed menstruation. The symptoms include amenorrhea with continuous discharge, excessive white discharge, minimal yellow discharge, yellow-white greasy tongue coating, and slightly red tongue.
For amenorrhea due to deficiency, it is not advisable to use.
23
Cang Zhu is a commonly used herb for treating various ophthalmic disorders.
For symptoms such as redness and ulceration at the eye margins, black eyes with cloudy white spots resembling “toothpaste” or “mold,” and swelling in the macula of the retina with symptoms of “distorted vision,” along with a white or greasy tongue coating, and significant dampness, Cang Zhu can be used as the main herb in the formula, with guaranteed effectiveness.
24
Cang Zhu combined with Ze Xie (Alisma), Ban Xia (Pinellia), Chen Pi, Fu Ling, and Tian Ma (Gastrodia) is effective for treating inner ear vertigo.
For cases with thick greasy or yellow greasy coating on the middle and root of the tongue, Cang Zhu is particularly suitable, with a dosage of 15-20 grams.If the coating is thin and white, Bai Zhu can be substituted.
Note:Please follow medical advice for specific treatments and dosages!This article is excerpted from “Clinical Materia Medica,” authored by Tao Yufeng, published by the People’s Health Publishing House, March 2005. This public account is only for academic exchange; if there is any infringement, please contact for deletion, and please indicate the source when reprinting.