Aconite (Fu Zi) is a commonly used traditional Chinese medicine, classified as a lower-grade herb in the Shen Nong Ben Cao Jing.
Alias: Tian Xiong, Wu Tou, Fu Pian, Yan Fu Zi, Hei Shun Pian, Bai Fu Pian.
Source: Processed from the lateral roots of the Aconitum plant, commonly known as Wu Tou. The main root is referred to as Chuan Wu in Sichuan Province. All are cultivated.
Production Area: Mainly produced in Jiangyou County and An County of Sichuan Province. Also produced in Shaanxi, Yunnan, and Hunan.
Harvesting and Processing: The roots of Aconitum are harvested from late June (Summer Solstice) to early July (Minor Heat), cleaned of soil, and the lateral tubers are selected and referred to as Ni Fu. They are then processed according to different specifications.
1. Salted Aconite: Select the Ni Fu, wash it clean, and soak it in a mixture of magnesium chloride (brine) and table salt for several days. Afterward, it is taken out and air-dried until semi-dry, then soaked in magnesium chloride solution while continuously adding salt to maintain a supersaturated state. This process is repeated until salt crystals adhere to both the inside and outside of the Aconite, then dried.
2. Aconite Slices: Medium-sized Ni Fu is cleaned, the outer skin is scraped off, and it is cut into two slices. It is then soaked in magnesium chloride solution for several days, boiled for 2-3 minutes, rinsed with clean water, and dyed with yellow sugar and vegetable oil to achieve a dark tea color. It is then rinsed until it no longer causes a tingling sensation, steamed until cooked, and air-dried.
3. Black Aconite Slices: Small Ni Fu is cleaned without scraping the outer skin, soaked in magnesium chloride solution for several days, boiled for 2-3 minutes, rinsed with clean water, and cut into 5mm slices. It is dyed with yellow sugar and vegetable oil to achieve a tea color, then rinsed until it no longer causes a tingling sensation, steamed until cooked, and dried.
4. White Aconite Slices: The processing method is similar to that of black Aconite slices, but the outer skin is scraped off and no dye is added. It is boiled until transparent, air-dried, and then sulfur-fumigated to achieve a white color before being dried.
Identification:
Salted Aconite (Tian Xiong) is conical in shape, approximately 4-8 cm long and 3-5 cm in diameter. The skin is brown or blackish-brown, covered with salt crystals, with several nipple-like protrusions at the top, a raised root in the middle, and a slightly concave bud scar at the apex. Due to prolonged salting, it is heavy and not dry, easily split, with a cross-section showing gelatinized starch, yellow-brown in color, with a slightly lighter center displaying star-like patterns. Salt crystals are also found in the voids, with a salty, slightly bitter, and pungent taste.
Those that are plump, firm, and gray-black are considered the best.
Aconite Slices: Slightly smaller than salted Aconite, with a longitudinal cut surface that is raised at the edges and depressed in the center. Both inside and outside are light brownish-yellow or brownish-yellow, glossy, hard, and not easily broken. When illuminated, it appears semi-transparent, with visible longitudinal vascular lines (xylem) on the outer surface, which also has protrusions and root scars. The taste is mild and flat.
Those that are bright yellow, free of mold, and uniform in size are considered the best.
Black Aconite Slices: Irregularly shaped, approximately 3-4 mm thick, with a blackish-brown outer skin and a brownish-yellow interior. The texture is hard, glossy, and keratinous.
Those that are large, uniform, brownish-yellow, hard, and without white cores are considered the best.
White Aconite Slices: The shape and taste are similar to black Aconite slices, but the entire piece is light yellow-white.
Those that are large, white, transparent, and uniform in thickness are considered the best.
Toxicity: This product can cause poisoning if improperly processed or used in excessive amounts. Symptoms of poisoning include burning sensation in the mouth, numbness (starting from the fingers and spreading throughout the body), salivation, nausea, possible vomiting, fatigue, difficulty breathing, dilated pupils, irregular pulse (weak and slow), cold and sticky skin, pale complexion, and possible sudden death. Rescue methods include: 1-2% tannic acid for gastric lavage, appropriate use of emetics; administration of activated charcoal (mixed with water); intravenous injection of glucose saline. Symptomatic treatment; timely use of stimulants such as Nikethamide; maintain warmth; provide oxygen or perform artificial respiration if necessary; subcutaneous injection of atropine if the heartbeat is slow and weak.
Processing: Aconite slices: Black Shun slices and White slices can be used directly as medicine.
Light Aconite slices: Take salted Aconite, soak in clean water, changing the water 2-3 times daily until the salt is removed, then boil with licorice and black beans until the taste is slightly numbing when tasted. Remove, discard the licorice and black beans, scrape off the skin, cut into two slices, and boil in water for about 2 hours. Remove, air-dry, and repeatedly moisten until thoroughly soaked, then slice and dry. (For every 100 jin of salted Aconite, use 5 jin of licorice and 10 jin of black beans.)
Processed Aconite slices: Take salted Aconite, wash it clean, soak in clean water overnight, remove the skin and navel, slice, and soak until it tastes slightly numbing. Remove, soak in ginger soup for 1-3 days, then steam until cooked, and bake until 70% dry, then stir-fry over high heat until smoke rises and it slightly bulges, then remove and cool.
Main Components: Contains alkaloids, including aconitine, new aconitine, and mesaconitine. Additionally, it contains non-alkaloid components.
Pharmacological Effects: This product has traditionally been believed to have the effects of reviving yang and rescuing from collapse, dispelling cold, and alleviating pain.
1. Cardiotonic: It can enhance the contraction of the heart. In cases of counterflow (shock, heart failure), the cardiotonic effect of Aconite improves overall circulation, thus treating cardiovascular insufficiency. The effective component is the non-alkaloid part, which generally does not get destroyed by boiling and retains its cardiotonic effect.
2. Analgesic: Experimental evidence shows that the decomposition products of aconitine have a certain analgesic effect.
3. Anti-inflammatory: It has a significant anti-inflammatory effect on experimental arthritis (formaldehyde and egg white-induced).
4. Stimulates the pituitary-adrenal cortex system: The decoction of cooked Aconite significantly reduces the content of ascorbic acid in the adrenal glands of rats, increases the excretion of 17-ketosteroids in urine, and reduces the number of eosinophils in peripheral blood. Additionally, for some patients with adrenal cortical insufficiency, Aconite has adrenal cortical hormone-like effects.
Taste and Properties: Pungent, very hot, and toxic.
Meridians Entered: Enters the twelve meridians.
Functions: Revives yang, rescues from collapse, supplements fire, assists yang, dispels cold, and eliminates dampness.
Indications: Used for internal excess of yin-cold, severe vomiting, diarrhea, and sweating, cold body and limbs, yang collapse, weak pulse, and impending death. For kidney yang deficiency with cold pain in the lower back and knees, and for spleen yang deficiency with prolonged diarrhea, cold body, and aversion to cold, as well as wind-cold-damp bi syndrome.
Clinical Applications: Aconite is only suitable for conditions of yin deficiency and overall functional decline. The reference indications for using Aconite are: 1. Deep, slow, weak, or thin pulse; 2. Aversion to cold, cold limbs, and cold pain in the lower back and knees; 3. Clear, long urine, loose stools, increased frequency belonging to yang deficiency diarrhea; 4. Pale complexion, pale lips, excessive sweating, white, greasy, and swollen tongue. Additionally, the following conditions may also be considered: lower limb edema, drowsiness, and spontaneous sweating. Based on these basic symptoms, combine with other syndromes for appropriate compatibility.
1. Treating yin syndrome edema (yin water): Any edema accompanied by overall functional decline or failure belongs to yin water, commonly seen in edema caused by chronic nephritis and heart failure. At this time, the patient exhibits significant symptoms of spleen and kidney yang deficiency. General diuretics alone cannot solve the problem; Aconite and dried ginger must be added to warm the kidney and dispel cold, warm the spleen, promote diuresis, and activate overall function (mainly blood circulation). Generally, Aconite can be added to the basis of Wu Ling San with dried ginger, or used in warming yang diuretic decoction. If the spleen-qi strengthening effect is needed, then use dried ginger and Aconite with Bai Zhu, Gan Cao, Hou Po, and Mu Xiang, such as in the Shi Pi Yin (this formula is a representative formula for treating yin water). This formula is also applicable for cold-damp type ascites due to liver cirrhosis; after warming the kidney with Aconite, it can not only promote diuresis but also significantly improve appetite.
2. Treating yang collapse and counterflow, i.e., shock and collapse, characterized by cold skin, weak breathing, cold limbs (counterflow means cold but not warm), weak and thin pulse, and symptoms caused by circulatory failure. Aconite, dried ginger, and ginseng must be used to warm yang and rescue from collapse (cardiotonic and anti-shock). For milder cases, use Aconite Decoction; for more severe cases, use Si Ni Decoction; for the most severe cases, use Shen Fu Decoction. If there is severe cold sweat, add Long Gu, Mu Li, and Wu Wei Zi.
3. Treating yang deficiency and decline, especially kidney yang deficiency (so-called insufficient Mingmen fire), with cold sensations in the lower body, cold and weak pain in the lower back and knees, cold pain in the lower abdomen with pulling pain, frequent urination, and weak pulse. Commonly seen in patients with chronic diseases or elderly individuals. At this time, it is advisable to add Aconite to tonics for faster results. Combine with Shan Yu Rou, Shu Di, such as in the Fu Gui Ba Wei Wan, or combine with Du Zhong, Qi Zi, and Huai Shan Yao, such as in the You Gui Yin.
4. Treating wind-cold-damp bi syndrome, especially in cases where cold is predominant in rheumatic arthritis, with significant pain that occurs with cold and is relieved by warmth, often accompanied by aversion to cold, cold limbs, white tongue coating, and thin wiry pulse. Aconite can be combined with Gui Zhi, such as in the Gui Zhi Jia Fu Zi Tang.
5. Treating cold abdominal pain: Caused by spleen and kidney deficiency-cold leading to intestinal rumbling and abdominal pain, stomach pain, vomiting clear water or phlegm, loose stools, cold hands and feet, and thin wiry pulse (can be seen in ulcer disease, gastrointestinal neurosis, chronic colitis, etc.). Aconite can be combined with dried ginger, Dang Shen, Bai Zhu, such as in the Aconite Li Zhong Tang.
Additionally, Aconite can also be used to warm and transform cold phlegm. For phlegm-damp in the lungs with severe cold symptoms, often feeling cold in the back and having weak cold cough (such as bronchial asthma, certain types of chronic bronchitis), besides using Ma Huang, Wu Wei Zi, and Ban Xia, sometimes Aconite is added to warm the kidney.
Usage Precautions:
1. Avoid use in cases of yin deficiency and heat syndrome. Those with any of the following conditions should not use Aconite: 1. Pulse is full, rapid, or large; 2. Severe constipation; 3. High fever; 4. Internal heat with external cold, true heat and false cold; the above four conditions belong to heat syndrome. If Aconite is used indiscriminately, it is like adding fuel to the fire, worsening the situation, leading to symptoms such as bleeding from the mouth and nose, and even convulsions; 5. Patients with heart disease showing atrioventricular block should also avoid Aconite. General contraindications apply.
2. Aconite should be used cooked. Raw Aconite is prone to toxicity and should not be used. Aconite boiled for more than one hour reduces its toxic effects on the heart, but retains its cardiotonic effect. Therefore, decoctions containing Aconite must be boiled for at least one hour.
3. Symptoms of Aconite poisoning include numbness of the limbs (starting from the fingers), dizziness, weakness, sweating, salivation, nausea, and more severe cases may include palpitations, arrhythmia, hypotension, convulsions, and coma. For mild cases, general treatment such as gastric lavage and warmth is sufficient; for more severe cases, atropine injection is required. Traditional Chinese medicine uses 120g of ginger, 15g of licorice, boiled in water, or 90-120g of mung beans, concentrated decoction, which has a certain detoxifying effect on mild poisoning cases.
4. Experimental evidence shows that licorice or dried ginger cooked with cooked Aconite can reduce the toxicity of Aconite. Therefore, ancient practitioners often used licorice and dried ginger with Aconite in warming agents, which has scientific basis, not only enhancing the warming effect but also reducing the toxicity of Aconite.
5. Traditionally, Aconite is avoided in combination with Bei Mu, Gua Lou, Bai Ji, Ban Xia, and Bai Lian.
6. Aconite is generally better taken warm, although some suggest that those with extreme yang deficiency should take it hot (to enhance its yang-supporting effect), while those with lower body deficiency-cold and upper body false heat, with symptoms such as facial redness and agitation, should take it cold.
Dosage: The dosage of cooked Aconite slices should not be too heavy to avoid toxicity. When used as a guide to enhance the effect of tonics, 1.5-4.5g is sufficient; for cardiotonic, warming, and pain-relieving purposes, 4.5-9g. In cases of shock and collapse, large doses may sometimes reach 18-20g, or even 30g, but must be administered by an experienced physician. In some regions, habitual users of Aconite may take 30-90g (but must be thoroughly processed), which may relate to individual tolerance to Aconite, but should never be considered a standard dosage. In summary, the common dosage of cooked Aconite slices is 3-9g.
Storage: Salted Aconite should be stored in a cool, dry place, sealed; black and white slices should be kept dry and moisture-free.
Example Formulas:
1. Zhen Wu Tang (Treatise on Febrile Diseases): Cooked Aconite slices 9g, Bai Zhu 12g, Bai Shao 9g, Fu Ling 12g, Sheng Jiang 9g, decoct in water.
2. Shi Pi Yin (Jisheng Fang): Cooked Aconite slices 9g, Bai Zhu 12g, Fu Ling 9g, Hou Po 6g, Da Fu Zi 6g, Mu Guo 6g, Cao Dou Kou 3g, Guang Mu Xiang 3g, Gan Jiang 6g, Zhi Gan Cao 3g, decoct in water.
3. Si Ni Tang (Treatise on Febrile Diseases): Cooked Aconite slices 15g, Gan Jiang 6g, Zhi Gan Cao 6g, decoct in water.
4. Aconite Decoction (Treatise on Febrile Diseases): Cooked Aconite slices 12g, Bai Zhu 9g, Dang Shen 12g, Bai Shao 6g, Fu Ling 9g, decoct in water.
5. Shen Fu Tang (Zheng Ti Lei Yao): Ren Shen 15g, cooked Aconite slices 12g, decoct in water.
6. Fu Gui Ba Wei Wan (i.e., Shen Qi Tang) (Jin Kui Yao Lue): Prepared medicine (containing Aconite, Rou Gui, Shu Di, Shan Yao, Shan Yu Rou, Ze Xie, Fu Ling, Dan Pi), 9g daily, taken once or divided into two doses in the morning and evening with warm water, or can be taken with other decoctions.
7. You Gui Yin (Complete Book of Jing Yue): Cooked Aconite slices 4.5g, Rou Gui 3g (pan-fried), Shu Di 18g, Shan Yu Rou 9g, Huai Shan 12g, Du Zhong 9g, Qi Zi 6g, Zhi Gan Cao 3g, decoct in water.
8. Gui Zhi Fu Zi Tang (Jin Kui Yao Lue): Gui Zhi 9g, cooked Aconite 9g, Bai Shao 9g, Sheng Jiang 9g, Zhi Gan Cao 6g, Da Zao 4 pieces, decoct in water.
9. Aconite Li Zhong Tang (Yan’s Pediatric Formulas): Cooked Aconite slices 12g, Gan Jiang 6g, Dang Shen 15g, Bai Zhu 9g, Zhi Gan Cao 3g, decoct in water.
Compound Formulas:
1. For treating vomiting, sweating, fever, chills, and cold limbs: 2 liang of licorice (roasted), 1.5 liang of dried ginger, 1 piece of Aconite (raw, peeled, broken into eight pieces). Combine these three ingredients, boil with 3 sheng of water, reduce to 1 sheng and 2 ge, strain, and take warm. Strong individuals may use 1 piece of Aconite and 3 liang of dried ginger. (Treatise on Febrile Diseases, Si Ni Tang)
2. For treating febrile diseases with yin excess, characterized by agitation and refusal to drink water: 1 piece of large Aconite burned to ash, preserved, and powdered; take with honey water. (Secret Treasure of the Family, Pi Li San)
3. For treating yin toxicity febrile diseases, with a pale face, cold limbs, abdominal pain, and cold body: 3 pieces of large Aconite (processed, peeled) powdered. Each dose is 3 qian, mixed with half a cup of ginger juice and half a cup of cold wine, taken together. Wait until the lower abdomen feels warm like fire. (Jisheng Fang, Hui Yang San)
4. For treating febrile diseases that have already turned downward, with sweating, internal and external deficiency, evil not resolved, no major heat, daytime agitation, and nighttime calmness, no vomiting or thirst, and a deep, weak pulse: it is advisable to take this. Also for treating sudden wind-cold, long-standing phlegm, cold pain in the heart and abdomen, cholera, and all forms of deficiency-cold: 1 liang of dried ginger (coarsely ground), 1 piece of Aconite (raw, peeled, finely sliced). Mix well. Each dose is 3 qian, boiled with 1.5 cups of water until reduced to 1 cup, strain, and take warm before meals. (Jufang, Jiang Fu Tang)
5. For treating all forms of counterflow heart pain, small intestine, and bladder pain that cannot be stopped: 1 liang of Aconite (processed), 1 liang each of Yu Jin and Ju Hong. Grind into powder, mix with vinegar to form pills the size of sour jujube, coated with cinnabar. Each dose is one pill, taken with wine for men and vinegar soup for women. (Xuan Ming Lun Fang, Chen Sha Yi Dan)
Note:
1. Aconite has a cardiotonic effect, increasing the heart’s contraction amplitude, but raw use in excess can lead to toxicity. Symptoms include arrhythmia, which can ultimately lead to cardiac and respiratory paralysis and death, hence cooked Aconite is commonly used in clinical practice.
2. Aconite, after absorption, has a paralyzing effect on sensory and motor nerves, initially exciting and then paralyzing the sensory nerve endings of mucous membranes and skin (but without local irritation), thus providing analgesic effects.
3. Clinical reports indicate that powdered Aconite mixed with vinegar or boiled into a paste and applied externally can treat sciatica.
Appendix:
Wu Tou (Prescription Name: Chuan Wu, Cao Wu) is the main root of the Aconitum plant. It is pungent, warm in nature, and highly toxic. Its main component is aconitine, which is present in higher quantities than in Aconite, thus its analgesic effect is stronger than that of Aconite, but its cardiotonic and cold-dispelling effects are not as strong. Aconite can expel cold and provide urgent relief, while Wu Tou excels in dispelling wind and alleviating pain; moreover, Aconite can be included in tonics, while Wu Tou cannot. Wu Tou is commonly used to treat wind-cold bi pain, with a dosage of 1.5-6g, and its representative formula is Wu Tou Tang. Prescription: Processed Chuan Wu 6g, Ma Huang 6g, Bai Shao 6.9g, Huang Qi 9g, Gan Cao 4.5g, decoct in water.
There are two types of Wu Tou: Chuan Wu, which belongs to the Karst Aconitum, mainly cultivated in Sichuan, and Cao Wu, which belongs to the Northern Aconitum, found in the wild in various regions. The components and uses of Chuan Wu and Cao Wu are generally similar, but Cao Wu has stronger toxicity and effects.
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