Introduction: Today we will learn from the experiences of three great TCM predecessors (Mr. Gong Shicheng, Mr. Li Hanqing, and Mr. Bai Qingzu) regarding the use of Aconite.
01
Experience of Gong Shicheng (“Clinical Experience with Medicinal Use”)
1. Warming Yang and Stopping Diarrhea
Aconite warms and supplements the fire of the Mingmen (Gate of Life), restoring Yang from within.
For cases of Spleen and Kidney Yang deficiency with persistent diarrhea, when the effects of the formula “Liqi Zhongtang” are not evident, replace the dried ginger with roasted Aconite slices to warm the Kidney and restore the Yang, thus eliminating internal cold and dampness, making it easier to stop the diarrhea caused by deficiency cold.
Gong Shicheng commonly prescribes 10-12g of roasted Aconite slices, first decocted, combined with Dangshen (Codonopsis), Jiao Baizhu (Fried Atractylodes), roasted ginger, and honey-fried licorice, emphasizing the dosage of Aconite for treating the lower Jiao (Lower Burner), as it is said, “To tonify the Spleen is not as effective as tonifying the Kidney.”
2. Rescuing Yang from Collapse
Aconite warms the five organs, restores Yang Qi, draws fire back to its source, and subdues false heat, which must be used promptly.
In any disease approaching the danger of sweating collapse, whether it is loss of Yang or loss of Yin, it is often difficult to make a definitive diagnosis. If Yin fluids are lost with sweat, the misuse of Aconite is akin to “rescuing the feet while losing the path.”
For loss of Yang: the body feels cool, sweat is thick and sticky like paste, the sweat is cold, the taste is bland, the body feels cold, the breath is weak, hands and feet are cold, and the tongue is moist, pulse is weak, or floating and empty. The medication should be warm, using Aconite 10-15g, combined with Hongshen (Red Ginseng), Shanyurou (Cornelian Cherry), dried ginger, and honey-fried licorice;
If there is loss of Yang along with signs of Yin loss, one can use the “Liuwai Huoyang Decoction”—Aconite combined with dried ginger, honey-fried licorice, ginseng, cooked Rehmannia, and Angelica, balancing hardness and softness to rescue from collapse.
3. Expelling Blood Stasis from the Limbs
Raynaud’s syndrome, similar to “Blood Stasis” or “Four Extremities” syndrome, presents with pale hands that can turn blue or dark purple, numbness and pain in the fingers, and coldness in the extremities. In severe winter, the fingertips may appear dark purple or waxy yellow, with exacerbated pain.
For those who do not respond to the “Danggui Sini Decoction,” add roasted Aconite slices and Mu Xiang (Aucklandia) for significant efficacy.
02
Experience of Li Hanqing (“Clinical TCM Practitioner – Li Hanqing”)
1. Aconite Combined with Rhubarb
Li Hanqing believes that biliary ascariasis is similar to TCM’s “Ascaris Pain.”
The treatment methods are twofold: one is to kill the parasites, such as with Wumei Pill; the other is to change the environment of the pain, such as with licorice rice honey decoction or rice vinegar.
Clinically, biliary ascariasis often presents with a mixed cold-heat syndrome, with more cold than heat. In such cases, using “Dahuang Fuzitang” is often more effective than Wumei Pill. Common dosages include Aconite 9g, Rhubarb 4.5g, and Xixin (Asarum) 4.5g.
2. Aconite with Dried Ginger and Honey-Fried Licorice
Li Hanqing believes that from the perspective of rescuing Yang and reversing counterflow, it is highly effective for those with declining Yang of the Heart, Spleen, and Kidney. It can be said to be the best herb for rescuing Yang and reversing counterflow.
Aconite combined with dried ginger and honey-fried licorice treats cold extremities due to Spleen and Kidney Yang deficiency, diarrhea with watery stools or incontinence, and weak pulse; if the tongue coating is yellow or accompanied by a bitter mouth, it indicates an excess of Yin against Yang, and cooling herbs like Huanglian (Coptis) or pig bile should be added; if there is profuse sweating, it indicates Qi collapse, and ginseng should be added.
The main difference between the treatments of loss of Yang and counterflow collapse by predecessors using “Sini Decoction” and “Shenfu Decoction” is the presence or absence of sweating and diarrhea. If sweating is profuse, ginseng must be used; if diarrhea is present, dried ginger must be added. If both sweating and diarrhea are present, both ginseng and dried ginger should be used simultaneously.
3. Aconite Combined with Cinnamon
Li Hanqing believes that from the perspective of warming Yang and promoting diuresis, Aconite itself does not have diuretic properties, but it is effective for edema due to Spleen and Kidney Yang deficiency or Heart and Kidney Yang deficiency.
If we consider only the effects of promoting Yang and diuresis, Aconite is not as effective as cinnamon, but in treating edema, palpitations, cold extremities, and a weak pulse due to Spleen and Kidney Yang deficiency, or Heart and Kidney Yang deficiency, Aconite is superior to cinnamon.
For edema caused solely by Kidney Yang deficiency, combining cinnamon and Aconite to tonify Kidney Yang often enhances the diuretic effect.
03
Experience of Bai Qingzu (“Medical Garden English – Bai Qingzu”)
1. Aconite Combined with Cinnamon
Dai Yuanli said: “With cinnamon, one can tonify the Mingmen.” Cinnamon is spicy, sweet, and very warm, being the Yang among Yangs, it heavily enters the Kidney and Bladder, also warming and supplementing the spirit of the Mingmen.
Using cinnamon and Aconite together greatly enhances the warming and supplementing power of the Mingmen fire. Thus, it is suitable for treating symptoms of Kidney Yang deficiency, such as low back pain, coldness in the back, cold testicles, cold extremities, and edema with shortness of breath.
Clinically, using 15g of roasted Aconite and 3g of cinnamon in appropriate formulas has immediate effects.
2. Aconite Combined with Dried Ginger
Dried ginger is spicy and very warm, regulating the middle and tonifying the Spleen. It is an excellent remedy for coldness in the Spleen and Stomach leading to vomiting and diarrhea. The “Sini Decoction” by Zhang Zhongjing uses ginger, Aconite, and licorice together to treat symptoms of Taiyin and Shaoyin diarrhea, cold extremities, and weak pulse.
If encountering sudden cold diarrhea or symptoms of imminent Yang collapse, remove licorice and use only roasted Aconite and dried ginger to rescue from danger.
For treating deficiency cold invading the Stomach, roasted Aconite and dried ginger should be used together.
3. Aconite Combined with Guizhi (Cinnamon Twig) and Baizhu (Atractylodes)
Guizhi is spicy and sweet, light in Qi, dispersing and harmonizing the Wei and Ying, suitable for cold diseases in the extremities. Baizhu is sweet and warm, strengthening the Spleen and Stomach, promoting the movement of dampness and phlegm. The combination of these three herbs is effective in dispelling cold and overcoming dampness, thus suitable for treating bi pain caused by mixed wind, cold, and dampness.
For bi pain, Bai Qingzu often uses Zhang Zhongjing’s Aconite Decoction with added Guizhi, where Aconite is used in small doses of 12-15g, and can go up to 30-60g for rapid effects.
However, for bi pain accompanied by internal heat or deficiency of Yin and blood, Aconite should be avoided.
4. Aconite Combined with Ginseng and Astragalus
Ginseng and Astragalus are excellent for tonifying Qi, suitable for those with insufficient Middle Qi presenting with fatigue, pallor, weakness, shortness of breath, and weak pulse.
However, for those who have been weak for a long time, relying solely on Ginseng and Astragalus may still feel insufficient, thus a small amount of Aconite should be added to enhance the effects of Ginseng and Astragalus, with a dosage of 3-6g being appropriate.
5. Aconite Combined with Angelica
Angelica is sweet and heavy, thus it can tonify blood, while being light and spicy, it can move blood. It has the ability to tonify and move, with Yin and Yang properties, being a blood-moving herb.
The combination of Angelica and Aconite can tonify blood while also having warming and moving functions, suitable for treating menstrual irregularities due to blood deficiency and cold, as blood flows better when warmed.
6. Aconite Combined with Deer Antler Velvet
Deer antler velvet is sweet and salty, warming the Kidney, tonifying the original Yang, filling essence and marrow, and strengthening bones. The combination of deer antler velvet and Aconite warms the Mingmen fire and fills essence and marrow, effectively treating deficiency cold low back pain, inability to bend or stretch, weakness in the lower back and knees, or impotence and nocturnal emissions.
Bai Qingzu often prescribes 3g of deer antler velvet ground into powder, with 15g of roasted Aconite decocted and taken.
7. Aconite Combined with Nutmeg
Nutmeg is spicy and aromatic, regulating the Spleen, drying dampness, expelling cold, and stopping diarrhea, effective for abdominal cold accumulation.
The combination of Aconite and nutmeg warms the Mingmen fire and dries Spleen dampness, used for treating deficiency cold diarrhea, morning diarrhea, and all symptoms of Spleen and Stomach cold deficiency, typically using 60g of nutmeg and 30g of Aconite, ground into pills, with a dosage of 9g, showing excellent efficacy.
8. Aconite Combined with Pinellia
For those with Spleen and Stomach cold deficiency presenting with vomiting, the combination of Aconite and Pinellia is effective, as Aconite warms the fire to generate earth, while Pinellia descends Qi to stop vomiting, leading to recovery from cold-induced vomiting.
For this, Bai Qingzu often prescribes 6g each of Aconite and Pinellia, with 3 slices of fresh ginger, decocted in water and taken warm for recovery.
9. Aconite Combined with Corydalis and Mu Xiang
Corydalis and Mu Xiang promote Qi movement and relieve pain, and when combined with Aconite, which is warming and good at moving, it is excellent for treating abdominal pain due to cold syndrome.
10. Aconite Combined with Dried Tea
The combination of Aconite and dried tea is effective for treating excess Yin against Yang syndrome. Symptoms often include cold extremities, loose stools, clear urination, weak and thin pulse, while the skin feels hot, with thirst and dry throat.
Bai Qingzu often uses Aconite to warm the Mingmen fire and dispel true cold, while dried tea can clear the superficial heat.Tea clears heat, while Aconite supports Yang; the combination of these two has the wonderful effect of balancing Yin and Yang.
Note:Specific treatments and medications should follow medical advice!This article is excerpted from “The First Essential Medicine for Supporting Yang: Aconite,” authored by Fu Wenlu, published by People’s Health Publishing House, April 2010. This public account is used for academic exchange only; if there is any infringement, please contact for deletion, and please indicate the source when reprinting.The cover image is sourced from Shetu Network.