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Cang Zhu (Atractylodes) is a commonly used herb in clinical practice, with a pungent and bitter flavor, warm nature, and it enters the Spleen and Stomach meridians. It can dry dampness, strengthen the Spleen, induce sweating, release the exterior, and improve vision. It is often used to treat various dampness syndromes, phlegm, and other conditions. How can we apply this herb clinically to achieve better results? Let’s see what Teacher Zheng Huzhan has to say.
Cang Zhu is a key herb for eliminating dampness and can treat dampness syndromes both internally and externally. Dampness in the upper jiao manifests as heaviness in the head, dampness in the lower jiao presents as swelling in the feet, dampness on the surface of the body leads to heaviness in the limbs, and dampness in the middle jiao causes fullness and distension in the abdomen, poor appetite, diarrhea, etc. All these conditions can be treated with Cang Zhu.Among these, Cang Zhu is particularly adept at eliminating dampness from the middle jiao. When used together with Chen Pi (Citrus Peel), Hou Po (Magnolia Bark), and Gan Cao (Licorice), it forms Ping Wei San (Calm the Stomach Powder). If Ping Wei San is combined with Wu Ling San (Five-Ingredient Powder with Poria), the former dries dampness while the latter promotes urination, forming Wei Ling Tang (Stomach and Poria Decoction) to treat abdominal distension, poor appetite, diarrhea, difficulty urinating, heaviness in the head and body, and a thick, greasy tongue coating, showing good efficacy.
Dampness is a tangible evil that easily obstructs the flow of Qi, leading to abdominal distension. Daytime is associated with Yang, while nighttime belongs to Yin. Individuals with a constitution of Yang deficiency and excess dampness may find that as night falls, the increasing Yin energy in the environment further hinders the circulation of dampness within the body, exacerbating Qi stagnation and resulting in abdominal distension or worsening of the distension.For this type of abdominal distension, as well as Qi stagnation-related distension, if the distension decreases with the release of Qi, I consider Cang Zhu to be a key herb for alleviating distension, often using it in doses up to 30g to aromatically transform dampness and promote the flow of Qi, which frequently yields significant results.Cang Zhu has a remarkable effect in eliminating dampness and can also strengthen the Spleen to transform phlegm and fluid. Therefore,clinically, Cang Zhu is used to treat phlegm and fluid disorders.In the Song Dynasty, physician Xu Shuwei developed a drinking habit that led to symptoms of rib pain, bowel sounds, and reduced appetite, resulting in vomiting of sour and bitter fluids for several days. After trying various treatments without success, he used Cang Zhu alone, and within three months, his condition was resolved. Modern physician Zhu Liangchun has also reported good results using 20g of Cang Zhu steeped in hot water, combined with tonifying Qi and raising Yang formulas, to treat gastric ptosis (Zhu Liangchun’s Clinical Experience Collection: Cang Zhu raises clear Qi and eliminates phlegm), for reference.
Cang Zhu
Source: “Illustrated Guide to Chinese Herbal Medicine”
Night blindness, also known as “sparrow eye.” The clear Yang rises to the upper orifices, while the turbid Yin returns to the lower orifices. If the patient has an excess of dampness and turbidity internally, the turbid evil can obscure the clear orifices, leading to reduced vision at night.Clinically, Cang Zhu can be used alone to transform fluids and guide the damp turbidity obscuring the clear orifices to be expelled through urination, thereby improving vision.“Compendium of Materia Medica, Volume 12” records a method for treating night blindness: “For night blindness, use four taels of Cang Zhu, grind it into powder, soak it overnight, cut it, roast it, and grind it into powder. Take three qian, with three taels of pig liver, cut open, mix the medicine inside, seal it, add one he of millet and one bowl of water, and cook in a sand pot until done, then use the steam to treat the eyes. Eat the pig liver and drink the juice, regardless of age, it can treat all.”
Cang Zhu has the ability to induce sweating and release the exterior while not harming the righteous Qi, thus it can treat conditions of wind-cold with dampness.“New Compilation of Materia Medica, Volume 1” states: “For those with deficiency who are affected by evil, it is better to use Cang Zhu than to use wind-dispersing herbs. This is because the evil is expelled without greatly harming the righteous Qi, and sweating occurs without excessively depleting Yang.”For colds with wind-cold and dampness, presenting with heaviness and pain in the head and body, aversion to cold without sweating, Cang Zhu can be combined with Qiang Huo (Notopterygium), Bai Zhi (Angelica Dahurica), Xi Xin (Asarum), Fang Feng (Siler), Chuan Xiong (Chuanxiong), Huang Qin (Scutellaria), and Sheng Di (Rehmannia) as in Jiu Wei Qiang Huo Tang (Nine-Ingredient Decoction with Notopterygium).
Additionally, I have used Sheng Ma (Cimicifuga), Cang Zhu, and He Ye (Lotus Leaf) as a formula to treat acne due to Spleen deficiency and excess dampness, achieving good results.This is based on the record in “Medical Formulas Explained, Volume 14”: “Qing Zhen Tang treats swelling and pain on the head and face, with aversion to cold and strong heat, resembling a cold damage (thunder head wind). Sheng Ma and Cang Zhu each five qian, with one leaf of He Ye.”
Ancient practitioners believed that Cang Zhu has the ability to dispel filth and prevent epidemics. In “Compendium of Materia Medica, Volume 12,” it is recorded: “In times of illness and epidemics, families often burn Cang Zhu to dispel evil Qi.” Modern research shows that burning Cang Zhu produces smoke that can kill certain pathogenic bacteria. Thus, the ancient practice of fumigating houses that have not been occupied for a long time with Cang Zhu to dispel evil is actually a method to eliminate pathogenic microorganisms and purify the environment. This method can broaden the current medicinal approaches to prevent infectious diseases.
According to the “Chinese Pharmacopoeia,” the common dosage of Cang Zhu is3–9g. It is advisable to prepare it with rice wash to alleviate its drying nature, and those with Yin deficiency and dry heat should use it cautiously.
Pharmacological studies indicate that Cang Zhu has anti-ulcer, promotes gastric motility, protects the liver, anti-hypoxia, sedative, antibacterial, antiviral, anti-tumor, and blood sugar-lowering effects.
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“Essentials of Clinical Chinese Medicine” is authored by Zheng Huzhan, who has over 30 years of clinical experience, focusing on the research of clinical applications of Chinese herbs. Wherever the author goes, he records his insights for future clinical reference. The book introduces key points of clinical application for many commonly used Chinese herbs, reflecting the author’s long-term research and practical experience, making it highly valuable for TCM practitioners, herbalists, students in TCM colleges, and TCM enthusiasts.
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