The yang energy of the human body is like the sun; its vaporization function maintains the normal operation of the body’s fluid system, resulting in sweat and urine. When yang energy is deficient, the metabolism of sweat and fluids is disrupted, leading to conditions such as spontaneous sweating, edema, urinary retention, and polyuria. Today, Associate Chief Physician Li Wenjin will introduce this TCM formula that warms and tonifies yang, promotes water metabolism, and reduces swelling, the renowned formula from the Treatise on Febrile Diseases—Zhen Wu Decoction.
In ancient mythology, the Great Emperor Zhen Wu is a deity guarding the north, also known as the Xuanwu Emperor, associated with the water element in the Five Elements theory, and revered as the god of the north and water. As the water deity, Zhen Wu Decoction is a formula for treating various edema-related disorders, representing the quintessential formula for warming yang and promoting water metabolism.
01
Zhen Wu Decoction Ingredients
【Classic Formula】Fu Ling (Poria) 90g, Bai Shao (White Peony) 90g, Sheng Jiang (Fresh Ginger) 90g, Bai Zhu (White Atractylodes) 60g, Fu Zi (Aconite) 10g (processed, peeled, and broken into eight pieces). Combine the five ingredients, add 8 liters of water, boil down to 3 liters, and strain. Take 7 portions warm, three times a day. (From the Treatise on Febrile Diseases)
【Common Dosage】Fu Ling 20g, Bai Shao or Chi Shao 20g, Sheng Jiang 15g or Gan Jiang (Dried Ginger) 10g, Bai Zhu 15g, Zhi Fu Zi (Processed Aconite) 15g. (The above dosages are for adults)
【Preparation Method】Use 1500ml of water, first boil Fu Zi for 30 minutes, then add the other herbs, bring to a boil, and simmer for an additional 40 minutes to obtain 300ml of decoction, divided into 2-3 doses to be taken warm.
02About Zhen Wu Decoction
【Classic Indications】
For Tai Yang disease, sweating occurs, but the sweating does not resolve the fever; the patient still has fever, palpitations, dizziness, and a sensation of heaviness in the body.
Abdominal pain, difficulty urinating, heaviness and pain in the limbs, and diarrhea indicate the presence of water qi; the patient may cough, have difficulty urinating, diarrhea, or vomiting.
【Constitutional Requirements】
Fatigue, fear of cold, cold limbs, a deep and thin pulse, a swollen tongue with a slippery coating. Symptoms may include edema, diarrhea, difficulty urinating, palpitations, dizziness, etc. The tongue is swollen with a slippery coating and has tooth marks. The pulse is deep and weak. Most patients have severe underlying diseases with potential damage to vital organ functions.
【Applicable Diseases】
Chronic congestive heart failure, chronic glomerulonephritis, nephrotic syndrome, chronic renal failure, anemia, hypoproteinemia, side effects of adrenal cortex hormones, hypothyroidism, Ménière’s disease, ascites due to liver cirrhosis, gastric retention due to gastric ptosis, menopausal syndrome, pelvic effusion due to chronic pelvic inflammatory disease, excessive leukorrhea, joint effusion in rheumatoid arthritis, hydronephrosis, intestinal tuberculosis, tuberculous peritonitis, hypertension, hypotension, dizziness after carbon monoxide poisoning, vertebrobasilar insufficiency, post-concussion syndrome, senile tremor, head bobbing syndrome, fasciculation syndrome, extrapyramidal symptoms caused by high doses of chlorpromazine, facial muscle spasms, tremors due to long-term corticosteroid use, arthritis, sciatica, avascular necrosis of the femoral head, trigeminal neuralgia, etc.
【Modification Methods】
For thirst, difficulty urinating, and edema, combine with Wu Ling San (Five-Ingredient Powder with Poria); for spontaneous sweating, combine with Huang Qi Gui Zhi Wu Wu Decoction (Astragalus and Cinnamon Decoction); for low back pain and lower limb edema, combine with Ji Sheng Shen Qi Wan (Kidney Qi Pill); for hypothyroidism and abdominal distension, add Ma Huang (Ephedra) and Gan Cao (Licorice).
【Precautions】
Use with caution in those with dark skin, jaundice, or a ruddy complexion.
Zhen Wu Decoction is the first formula for dispelling cold and promoting water metabolism. In clinical differentiation, it can be boldly used whenever the main pathogenesis is yang deficiency, along with the primary clinical manifestations. It is important to note that Fu Zi is toxic; when using it, choose processed Fu Zi and ensure it is boiled for over an hour. In cases of severe heart failure, processed Fu Zi can be used in doses of 30-50g, requiring boiling for over 2 hours, taking only the first decoction, and dividing it into 3-6 doses for safer and more reliable use.
03Warm Reminder
Traditional Chinese Medicine emphasizes syndrome differentiation and treatment; each person’s constitution is different, and so is the medication. Therefore, the above herbal formula should be used under the guidance of a qualified TCM practitioner!
Educational Expert
Li Wenjin, Associate Chief Physician, Master’s degree, Deputy Director of the Internal Medicine Department at Anji County TCM Hospital (acting department head), currently a member of the Lattice Disease Branch of the Zhejiang Province TCM Association, a candidate for the New Talent Program of Zhejiang Province, a member of the Youth Committee of the Huzhou TCM Association, and a member of the Huzhou Atrial Fibrillation Center Alliance.He has studied in the Cardiology Department at Shao Yifu Hospital and Zhejiang TCM Hospital.A participant in the first classic formula class in Huzhou.He has hosted and participated in 7 projects from the Zhejiang Provincial TCM Administration and Huzhou Science and Technology Bureau.With nearly 15 years of clinical work in internal medicine, he specializes in the treatment of coronary heart disease with medication and stent implantation, interventional treatment of structural heart disease, drug and interventional treatment of arrhythmias, hypertension, heart failure, and critical conditions in cardiology.Expert Consultation Hours: Monday and Saturday morningsConsultation Location: Outpatient 221 in the morning·END·【If useful, please share】Contributed by 丨 Internal Medicine Department Li Wenjin
Edited by丨Cherry
Reviewed by丨Jiang Li, Cai Xinjian
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