Editor’s Note
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Aconite (Fu Zi), as recorded in the Shen Nong Ben Cao Jing, is classified as a pungent, warm, and toxic herb, categorized as a lower-grade medicine. Lower-grade medicines have strong flavors, indicating that this herb has a very pronounced nature; its pungency disperses qi outward, and its warmth promotes movement, thus Aconite can cause qi to move rapidly outward. Therefore, Aconite is believed to have the effect of reviving yang and rescuing from collapse. However, the Shen Nong Ben Cao Jing clearly states, “It should not be taken for long periods,” and is only to be used for treating diseases.
So what are the consequences of modern people using Aconite in large doses? |
Currently, there is a significant faction in TCM that prescribes large doses of Aconite for any illness. I know many doctors who use Aconite in unprecedented amounts. Among the patients I have treated, many had previously taken large doses of Aconite before seeking my treatment. In my clinical practice, I always base my prescriptions on pulse diagnosis, which has allowed me to record and analyze the pulse patterns of these patients who have used Aconite, and I will share my long-term observations with everyone. I understand clearly why these pulse changes occur, but it is difficult to express to others.
Generally, patients who take large doses of Aconite for extended periods tend to fall into two extremes, and the emergence of these extremes is mainly related to the compatibility of Aconite with other herbs.
The first type is when a person takes large doses of Aconite, along with even larger doses of Shan Yu Rou (Cornus), Long Gu (Dragon Bone), Mu Li (Oyster Shell), etc.
In this case, many patients experience a short-term excitement after taking the herbs, which manifests as increased energy, a willingness to be active, improved appetite, and better bowel movements, often accompanied by the disappearance of many pain symptoms. This situation is usually perceived as a positive outcome by the patients, and the doctors also believe it aligns with the diagnosis.
From my observations, if these patients continue to take the original formula, it will only be effective for three to six months. Continuing the dosage will lead to ineffectiveness, and increasing the dosage may yield temporary results, but ultimately, the condition will worsen. If the medication is stopped midway, the illness will relapse within about a week.
Many patients will suddenly experience a rapid deterioration of their condition due to a minor triggering factor (such as sexual activity, taking hormones, or exposure to cold), after which no medication will be effective.
The pulse changes in these patients are as follows:
Initially, when taking these herbs, the cun pulse (寸脉) becomes relatively strong, while the guan (关) and chi (尺) pulses show no significant changes. With continued use, the cun pulse becomes increasingly strong, while the guan and chi pulses become increasingly weak. If continued further, the guan and chi pulses may become nearly imperceptible, while the cun pulse appears as a very firm pulse, like a small bean.
As long as the cun pulse has not become firm or the guan and chi pulses still have a root, finding a knowledgeable physician (not just a famous one) and using a formula like Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) or Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) can restore the pulse to its original state. If the cun pulse has already become firm and the guan and chi pulses are absent, this person often presents with symptoms described by ancient texts as “malignant sores”; if not treated, they may lead to pus formation and death. If the cun pulse is absent, treatment is futile.
The second type is when a person takes large doses of Aconite and Xi Xin (Asarum), without proper compatibility or only slightly supplemented with Shan Yu Rou, Long Gu, Mu Li, etc.
These patients often experience a reaction of expelling cold qi or a sensation of warmth in previously cold areas of the body, which they perceive as a positive sign, and the physician may not recognize it. However, as they continue to take the herbs, the effects diminish, and they are unable to expel the cold qi completely, leading to difficulty in treatment after prolonged use.
The pulse changes in these patients are as follows:
Initially, when taking the herbs, the cun pulse becomes relatively large, while the guan and chi pulses show no significant changes. With continued use, the guan and chi pulses gradually enlarge, and with further use, the guan and chi pulses become extremely large, while the cun pulse becomes absent.
As long as the cun pulse is still present or the guan pulse has not particularly enlarged, finding a knowledgeable physician (not just a famous one) and using a formula like Jian Zhong Tang (Middle-Strength Decoction) can restore the pulse to its original state. If the cun pulse is absent and the guan pulse is particularly enlarged, this is often seen in patients who have taken hormones for a long time. If the chi pulse is absent, treatment is futile.
These two situations are the results I have observed in clinical practice. Theory is meant to guide clinical practice, and clinical practice should also help refine theory. I hope those who are confused can gain insight and improve the application of Aconite. Aconite is pungent and warm, a dispersing medicine, and is classified as a lower-grade herb; it should only be used when absolutely necessary and should never be taken for long periods. This herb is pungent and warm, meant to revive yang, not to tonify yang. I have seen many practitioners who remain oblivious to this until death, which is truly regrettable.
Practicing medicine without understanding the principles can be deadly. Conditions caused by prolonged use of heat-clearing and detoxifying herbs are easier to treat, while the harms of prolonged use of Aconite are difficult to remedy; yang can easily recover, but yin is hard to restore. Beware, beware.
| Author’s Biography |
Wang Wei, a master’s student at Shandong University of Traditional Chinese Medicine, specializes in the Nei Jing and Shang Han Lun, adept at using ancient formulas and micro-needling to treat various ailments, earning a good reputation among the public. He is the author of Clearing the Mist: Returning to Classical TCM Thinking.
Source: Mr. Wang Yong’s blog, images from the internet/Edited by: Wei Jian
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