TCM Book Club Issue 2037
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IIntroduction:Fuzi (Aconite) “circulates through the twelve meridians,” a concept proposed by Huang Gongxiu in “Bencao Qiuzhen.” Huang’s evaluation of the functions of the herb Fuzi is indeed thought-provoking. (Editor/Yan Qifeng)
Discussion on Fuzi’s “Circulation Through the Twelve Meridians”
Author/Wu Rongzu
The saying that Fuzi “circulates through the twelve meridians” is found in the book “Bencao Qiuzhen” by the Qing dynasty physician Huang Gongxiu, which states: “Fuzi is spicy, very hot, purely Yang, and toxic. Its nature is to move and not to stay, circulating through the twelve meridians, reaching everywhere, and is the primary agent for supplementing the true fire of the Mingmen (Gate of Life).” Huang’s evaluation of the functions of the herb Fuzi is indeed thought-provoking.
1. The Meaning of “Circulating Through the Twelve Meridians”
“Circulating through the twelve meridians” refers to the three Yin and three Yang of the human body, encompassing the skin and muscles externally, and the five organs and six bowels, tendons, and marrow internally. There should be no part that is not included. Upon reviewing various herbal texts, few herbs possess such broad capabilities, which is precisely why ancient physicians documented the pharmacological characteristics of Fuzi based on long-term clinical practice.
For example, in “Tangye Bencao”: “…floating and sinking, reaching everywhere, being the Yang among Yang, thus it moves and does not stop.” In “Bielu”: “…it is the leader among all herbs.” In “Bencao Zheng”: “Fuzi, due to its nature of moving through the meridians, is said to have the same effect as wine, capable of eliminating both exterior and interior cold… reviving Yang Qi.” In “Bencao Jingdu”: “Fuzi, with a spicy taste and warm qi, has a rapid fire nature, reaching everywhere… Fuzi can cause the pulse to rise from above to below, circulating and reaching to alleviate counterflow.” In “Bencao Zhengyi”: “Fuzi, being spicy and very hot, its nature is good at moving, thus it is the essential Yang medicine that circulates through the twelve meridians, expelling exterior cold from the skin, and internally warming the lower source to eliminate cold and dampness, penetrating both inside and outside, affecting the three Jiaos and all organs, truly treating any real cold.” In “Bencao Jingshu”: “Fuzi’s qi and taste are both very spicy and very hot… its nature is to move and not to stay.”
In “Bencao Beiyao”: “Fuzi is spicy and sweet, toxic, very hot and purely Yang, its nature is floating and not sinking, it circulates through the twelve meridians, reaching everywhere. It can guide Qi-replenishing herbs to restore lost original Yang, guide blood-replenishing herbs to nourish insufficient true Yin, induce dispersing herbs to open the pores and expel exterior wind-cold, and warm herbs to reach the lower Jiao to eliminate interior cold-dampness, treating three Yin cold damage, wind stroke, cold stroke, Qi counterflow, phlegm counterflow, cough, vomiting, choking, spleen leakage, cold dysentery, cold diarrhea, cholera, cramping, wind bi, mass accumulation, and diseases of the Governor Vessel, stiff spine and counterflow, children’s chronic fright, variola gray-white, and non-healing carbuncles, all signs of chronic cold and stubborn cold…”
From the above excerpts from various medical texts, it is evident that the herb Fuzi is a medicine with great potential.
2. Analysis of Formulas Containing Fuzi
In clinical treatment, Chinese medicine is often used in the form of formulas. To reflect the clinical pharmacological effects of Fuzi, especially its expertise in “circulating through the twelve meridians,” I have collected some ancient formulas containing Fuzi and made a rough classification to support this.
The classification is based on the premise that since Fuzi can circulate through the twelve meridians and reach everywhere, formulas containing Fuzi must be able to broadly affect different pathological locations within the human body. Therefore, I have divided it into two parts: the first part reflects the effects of Fuzi on local lesions in the human body; the second part reflects the effects of Fuzi on the overall Yin-Yang of the human body. In the first part, I further classify it into: effects on superficial lesions and effects on internal lesions. From a clinical perspective, the indications for the first part of the formulas generally are not very critical, while the indications for the second part of the formulas are more severe, presenting a critical situation of “Yin and Yang separation.”
(1) Effects on Local Lesions in the Human Body
1. Effects on the Surface:
Skin and pores
Fuzi acts on the skin and pores of the human body. Ancient formulas such as “Shanghan Lun”‘s Guizhi Fuzi Decoction treats excessive sweating with aversion to wind, continuous sweating, body pain, and joint pain; “Shanghan Lun”‘s Mahuang Fuzi Gancao Decoction treats exterior cold with interior deficiency, aversion to cold, body pain, no sweating, and slight fever, with a deep pulse; “Shanghan Lun”‘s Mahuang Fuzi Xixin Decoction treats dual invasion of cold, desire to sleep with a weak pulse, aversion to cold and fever, and body pain; “Qianjin Fang” treats carbuncles and swelling pain with Fuzi powdered and mixed with vinegar for topical application; “Shenghui Fang” treats long-standing scabies with Chuanwu decocted in water to wash the affected area; “Xue Yi Waike Xinfa Fang” treats long-standing carbuncles with cold pus by placing slices of large Fuzi on the affected area and applying moxibustion.
Head
Effects on the head include: “Jinkui”‘s Fangtou Fengsan treats headache from wind; “Danliao Fang”‘s Xie Fu Wan treats Qi deficiency headache; “Sanyin Fang”‘s Biyou San treats wind-cold invasion, unilateral and bilateral headaches that have persisted for years; “Chuanjiabibao Fang” uses Fuzi, gypsum, and musk to treat headache with wandering pain; “Bencao Gangmu” treats cold wind headache with Fuzi (or Chuanwu) combined with Chuanxiong, ginger, and fine tea; “Waitai Miyao” treats headache with Fuzi combined with wine.
Muscles and bones
“Shanghan Lun”‘s Fuzi Decoction treats Shaoyin Yang deficiency, wind-dampness attacking, body pain, and joint pain; “Jinkui Yaolue” has three formulas, namely Guizhi Fuzi Decoction, Baizhu Fuzi Decoction, and Gancao Fuzi Decoction, all using Fuzi with other herbs to treat dampness invading the tendons, joint pain, and heaviness; there is also Wutou Decoction, which treats joint pain that cannot be flexed or extended; additionally, “Benshi Fang” treats numbness from bi syndrome, with Chuanwu, bean juice, and rice porridge taken together; “Wangshi Jianyi Fang” uses raw Fuzi, Mu Xiang, and ginger to treat pain and numbness in the fingers.
Facial or oral cavity
“Mouth”: “Jingyan Fang” treats mouth sores that do not heal for a long time with raw Fuzi, vinegar, and flour applied to the soles of the feet, changed twice daily, and mentions that men should apply to the left and women to the right. “Teeth”: “Shan Fan Fang” uses roasted Fuzi powder placed in cavities to treat toothache from wind and insects. “Eyes”: “Zhang Wenzhong Beiji Fang” uses Fuzi with red skin ground to the size of silkworm sand to treat red, swollen, painful eyes that cannot be opened, with continuous tearing. “Ears”: “Bencao Shiyi Fang” treats sudden deafness with Fuzi soaked in vinegar, cut to a point and inserted, with moxibustion applied twenty-one times. Also, “Zhouhou Fang” uses Fuzi powder with scallion juice inserted into the ear to treat ear discharge with pus and blood; “Nose”: “Pujifang” treats nasal discharge with raw Fuzi powder and scallion juice mixed into a mud-like consistency, placed at the Yongquan point. “Throat”: “Jinxia Fang”‘s Throat Obstruction Pill (Fuzi honey moxibustion) is held in the mouth to treat throat obstruction. “Yili Zhenzhu” treats throat pain and heaviness with upper heat and lower cold; “Tongue”: “Yili Zhenzhu”‘s Ginger Fuzi Fuling Decoction treats inability to move the tongue and drooling.
2. Effects on Internal Conditions
Heart (Chest)
“Shanghan Lun”‘s Zhenwu Decoction treats palpitations and trembling, wanting to collapse; “Jinkui”‘s Yiyiyu Fuzi San treats chest obstruction with urgency; “Jinkui”‘s Wutou Chishizhi Wan treats heart pain radiating to the back, and back pain radiating to the chest; “Xuanming Lun Fang” treats chest pain with Fuzi, Yujin, Ju Hong, and Zhu Chen.
Stomach
“Jingyan Fang” treats vomiting and reverse stomach flow with Fuzi combined with ginger; “Qiyu Fang” uses Fuzi, Banxia, ginger, and warm wine to treat cold stomach with phlegm; “Zhu’s Collected Effective Formulas” treats vomiting blood with Fuzi combined with Dihuang.
Spleen
“Jinkui”‘s Huangtu Decoction treats spleen meridian injury, leading to blood loss; “Zhu’s Collected Effective Medical Formulas” uses Fuzi, red adzuki beans, and coix to treat spleen deficiency and edema; “Bencao Gangmu” treats cold diarrhea that does not heal for a long time with Fuzi combined with nutmeg and lotus seeds; “Jinkui”‘s Baizhu Fu Decoction treats spleen Yang failure, abdominal distension, and loose stools; “Yan’s Pediatric Formulas” treats children’s cold spleen deficiency with diarrhea.
Liver
“Jinkui” has Dahu Wutou Decoction and Wutou Guizhi Decoction to treat cold hernia abdominal pain; “Jisheng Fang”‘s Xuanfu Wan treats seven hernias causing pain, with body cold and spontaneous sweating; “Yichun Shengyi”‘s Zhuyufugui Decoction treats cold evil directly entering the liver meridian, causing side abdominal cramping, diarrhea, and cold limbs, with blue-purple nails.
Lung
“Zhu’s Collected Effective Medical Formulas”‘s Chenfu Decoction treats wheezing, fullness, and limb swelling, with difficulty urinating; “Jinkui”‘s Shenqi Wan treats phlegm and fluid retention, causing wheezing and shortness of breath.
Kidney (Bladder)
“Jinkui”‘s Shenqi Wan is used to treat kidney deficiency and lower body fluid loss; “Benshi Fang”‘s Jiao Fu San treats kidney Qi rising, causing neck and back stiffness; “Pujifang”‘s Fuzi San is used to treat urinary retention, with weak pulse at both feet, and ineffective treatments for urinary passage.
Intestines
“Jinkui”‘s Yiyiyu Fuzi Bai Jiang San treats intestinal abscess; “Jinkui”‘s Dahu Fuzi Decoction is used for cold accumulation in the large intestine, causing side pain and tight pulse; “Jinkui”‘s Fuzi Jiangmi Decoction treats abdominal cold, causing thunder-like sharp pain; “Shengji Zonglu”‘s Fuzi Wan treats resting dysentery, red and white dysentery, and the book also mentions using Fuzi heart and white honey to treat large intestine cold constipation.
Chong and Ren Vessels
“Jianyi Fang Lun” uses Fuzi and Danggui to form a small warming meridian decoction to treat Chong and Ren deficiency cold, blood cold pain, and menstrual irregularities; “Xiaopin Fang” treats miscarriage with Fuzi powdered and applied with warm wine to the right foot sole.
(2) Effects on the Overall Condition of the Human Body:
Due to the deep invasion of pathogenic factors and the decline of righteous Qi, the pathological location often spreads from local to multiple organs, causing functional disorders that develop into a systemic Yin-Yang imbalance, leading to more critical clinical conditions. At this time, it is urgent to use medication under the guidance of syndrome differentiation to adjust Yin and Yang, to prevent the critical situation of separation of the two, or to use it to rescue from critical situations. Fuzi also shows superior efficacy in this regard.
1. Reviving Yang and Rescuing from Reversal:
“Shanghan Lun”‘s Sini Decoction treats vomiting and diarrhea, cold limbs, aversion to cold, cold breath from mouth and nose, cyanotic lips, and slippery tongue coating, with a faint pulse; “Shanghan Lun”‘s Ganjiang Fuzi Decoction treats hand and foot counterflow, restlessness during the day, and calmness at night; “Shanghan Lun”‘s Tongmai Sini Decoction treats diarrhea with clear grains, internal cold and external heat, with a faint pulse about to disappear; “Shanghan Lun”‘s Tongmai Sini Decoction with pig bile treats frequent critical situations after severe vomiting and diarrhea, with hiccups, restlessness, cold limbs, sweating, and faint pulse; “Shanghan Lun”‘s Bai Tong Decoction is used for symptoms of red face, restlessness, cold limbs, and diarrhea with faint pulse; “Shanghan Lun”‘s Bai Tong Decoction with pig bile treats continuous diarrhea after taking the above formula, with counterflow and no pulse; “Chuanjiabibao Fang”‘s Pile San rescues from Yin excess against Yang; “Jisheng Fang”‘s Huayang Drink treats Yin toxin cold damage, with cyanotic face and cold limbs; “Jingyan Liangfang” treats vomiting and diarrhea with Yang collapse using one piece of Fuzi and one qian of salt for emergency.
2. Reviving Yang and Securing Yin:
“Shanghan Lun”‘s Sini Ren Shen Decoction treats vomiting and diarrhea with great sweating, loss of blood and fluids, with a faint pulse about to disappear; “Shanghan Lun”‘s Fuling Sini Decoction treats great sweating and diarrhea, cold body, and cold limbs, with restlessness and dizziness, with a deep and faint pulse; “Jingyue Quanshu”‘s Huayang Four Flavor Drink treats original Yang deficiency collapse, critical at any moment; “Furen Liangfang”‘s Shen Fu Decoction treats cold limbs, shortness of breath, sweating, and faint pulse, or sudden bleeding and collapse, with cold body.
3. Fuzi and the Mingmen, Sanjiao:
The reason Fuzi can achieve such a wide range of pharmacological effects is closely related to its ability to supplement the Mingmen and enter the Sanjiao, as well as the importance of the Mingmen and Sanjiao in the life activities of the human body.
(1) Fuzi and the Mingmen:
The concept of Mingmen first appeared in the “Nanjing.” Although there is controversy regarding its anatomical location in the medical field, there is a consensus on its importance in the life activities of the human body. Zhao Xianke said: “Mingmen is the master of the twelve meridians.” Zhang Jingyue said: “The greatest treasure of a person is this one breath of true Yang.” “The Yin of the five organs cannot be nourished without it, and the Yang of the five organs cannot be activated without it.” Huang Gongxiu said: “It is the source of human life.” Chen Shiduo said: “All organs and bowels cherish the fire of Mingmen to nourish them.” Zheng Qinan said: “It is the root of human life, the true seed.” The above quotes from various scholars illustrate the important role of the Mingmen in the life activities of the human body.
The Mingmen (fire) is the root of Yang Qi in the human body, also known as original Yang, true Yang, and is the source of Yang Qi. Clearly, the decline of Mingmen fire will inevitably affect the function of Yang Qi in the body, leading to a decline, and subsequently causing an imbalance in Yin and Yang, ultimately resulting in clinical pathological changes. The occurrence of diseases is often due to the interference of internal and external pathogenic factors, disrupting the stable state of Yin and Yang balance, leading to abnormalities such as “Yin excess causing Yang disease” or “Yang excess causing Yin disease,” which can generally be classified into “Yang deficiency and Yin excess” or “Yin deficiency and Yang excess” (there are also cases of both Yin and Yang deficiency). When Yin and Yang exhibit the above imbalanced states, the human body often reflects various clinical symptoms in different postures, whether exterior or interior, cold or hot, deficient or excess, organ or bowel, Qi or blood, etc. Practical experience has shown that as long as one is adept at identifying the imbalanced state of Yin and Yang in the human body and promptly adjusts it, it can often quickly and effectively improve local symptoms and enhance therapeutic efficacy. The “Neijing” emphasizes: “A good diagnostician observes color and pulses, first differentiating Yin and Yang, and treatment must seek the root, which is based on Yin and Yang.”
As mentioned earlier, given the relationship between the Mingmen fire and Yang Qi and the balance of Yin and Yang in the human body, if clinical manifestations of Yang deficiency and Yin excess occur, the main treatment principle is to support Yang and suppress Yin, and the focus of supporting Yang and suppressing Yin clearly lies in supplementing or restoring the Mingmen fire. This can be said to be the embodiment of “treatment must seek the root” in therapeutic practice.
Fuzi is adept at supplementing the true fire of the Mingmen, which has been verified in clinical practice and praised by physicians throughout history. For example, Jin Dynasty’s Zhang Yuansu in “Zhenzhu Nang Yaoxing Fu” states: “Fuzi supplements the Yang deficiency of the lower Jiao (Mingmen).” Qing Dynasty’s Huang Gongxiu in “Bencao Qiuzhen” states: “It is the primary agent for supplementing the true fire of the Mingmen.” Qing Dynasty’s Zhang Yinan in “Bencao Chongyuan” states: “It assists the fire heat of Shaoyin.” Qing Dynasty’s Huang Yuanyu in “Changsha Yaojie” states: “It supplements the fire seed of the extinguished.” Qing Dynasty’s Chen Xiuyuan in “Shennong Bencao Jingdu” states: “It is the first item for reviving Yang and rescuing from reversal.” Qing Dynasty’s Zheng Qinan states: “It can supplement the fire seed that is about to be extinguished.” Since Fuzi can directly reach the Mingmen, warming and assisting true Yang to replenish losses, and fundamentally adjust Yin and Yang, it is undoubtedly very beneficial in the treatment of Yang deficiency and Yin excess conditions.
(2) Fuzi and the Sanjiao:
The Sanjiao, one of the six bowels, is the largest of the hollow organs, also known as the outer organ, or solitary organ. (“Chinese Medical Dictionary”). The historical debates regarding its essence can be set aside, but there is a relatively unified understanding of the Sanjiao’s role in connecting the exterior and interior, and its relationship with the five organs and six bowels. For example, “Suwen: Wulou Jin Ye Bie Lun” states: “The Sanjiao emits Qi to warm the muscles and fill the skin.” “Ling Shu: Ying Wei Sheng Hui” states: “The upper Jiao is at the stomach opening, and connects to the throat above, passing through the diaphragm and spreading in the chest… the middle Jiao is also in the stomach, emerging after the upper Jiao… the lower Jiao is separate from the intestines, draining into the bladder and seeping in.” “Jingyue Quanshu” states: “The Sanjiao is the overseer of the five organs and six bowels.” It can be seen that the Sanjiao has a significant role, connecting the exterior and interior, and linking the five organs and six bowels, with a tendency to reach everywhere.
The Sanjiao is closely related to the Mingmen, historically referred to as “the Sanjiao is the envoy of the Mingmen,” and “rooted in the Mingmen.” The Mingmen is the source of Yang Qi in the human body, and the Mingmen fire distributes Yang Qi throughout the body, warming the muscles and filling the skin externally, and nourishing the five organs and warming the six bowels internally, thus maintaining the overall balance of Yin and Yang and ensuring the normal functioning of life activities in the human body.
Fuzi, being spicy and very warm, “enters the Sanjiao and Mingmen” (“Tangye Bencao”) and is good at supplementing the true fire of the Mingmen. Its nature is to move and not to stay. Due to the characteristics of Fuzi, its pharmacological properties support Yang and seek the root, assisting the Mingmen and distributing through the Sanjiao, reaching the exterior and interior, meridians and organs, adjusting the overall Yin and Yang balance of the body, thereby improving various local pathological changes. Generally, whenever there is internal or external injury, organ disease, Qi deficiency, blood stasis, phlegm accumulation, or Qi stagnation, as long as it belongs to the category of Yang deficiency and Yin excess, Fuzi can be used as the main herb in the formula, and it will certainly yield good therapeutic effects. Therefore, it is not an exaggeration to say that Fuzi “circulates through the twelve meridians.”
4. Conclusion
1. Fuzi enters the Mingmen and Sanjiao, supplementing the lower Jiao’s original Yang, its nature is to move and not to stay. Given the importance of the true Yang of the Mingmen in the dynamic balance of Yin and Yang in the human body, and the Sanjiao’s connection to the interior and exterior, maintaining the upper and lower, it is clear that the relationship between Fuzi, Mingmen, and Sanjiao determines the wide-ranging pharmacological effects and indications of Fuzi in clinical practice, hence the ancient saying that Fuzi “circulates through the twelve meridians.”
2. Although Fuzi possesses such a wide range of clinical effects, it is merely a herb that supplements fire and assists Yang. Its treatment of diseases and adjustment of Yin and Yang primarily excels in supporting Yang and suppressing Yin, thus its indications are for Yang deficiency and Yin excess conditions. In clinical practice, if one does not follow syndrome differentiation and treatment principles, and uses Fuzi indiscriminately without distinguishing Yin and Yang, it is evidently not a scientific and practical approach.
3. Modern research on Fuzi’s effects on cardiac strengthening, coronary dilation, analgesic and anti-inflammatory effects, stimulation of the pituitary-adrenal cortex, blood pressure reduction, and promotion of saturated fatty acid and cholesterol metabolism has revealed encouraging pharmacological effects, but this still cannot fully explain its extensive clinical efficacy. It can be believed that with the rapid development of modern science and the in-depth exploration of life sciences, the pharmacological effects of Fuzi will be comprehensively understood, benefiting humanity even more.
4. This article discusses the pharmacological effects of Fuzi based on ancient medical literature, explores the special relationship between Fuzi and the Mingmen and Sanjiao, and provides a preliminary theoretical discussion on Fuzi’s circulation through the twelve meridians, indicating that Fuzi is a Chinese medicine with great potential. Any errors are welcome for correction by readers.
Recommended Reading
Medicinal Herbs Circulating Through the Twelve Meridians
The Twelve Meridian Acupuncture Points as Poetry
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