Zhi Fu Zi / Fu Zi - 制附子 - Radix Aconiti Lateralis Preparata - Aconite

Pharmaceutical Latin:	Radix Aconiti Lateralis Preparata
Common English:	Prepared Aconite / Aconite accessory root Prepared Sichuan Aconite Root

Category

Herbs that Warm the Interior and Expel Cold

Properties

Taste	Temperature	Entering Meridians	Dosage
Acrid (Sweet)	(Very) Hot Toxic	Heart Kidney Spleen	1.5-15g Tincture: 2-4ml For shock and coma, up to 20g or 8ml may be used Cook 30-60 minutes longer than the other herbs. 3-15g (Secondary source)

Actions And Indications

Actions	Indications/Syndromes
Restores Devastated Yang and rescues from rebellion	Devastated Yang with diarrhea containing undigested food, chills, cold extremities and a faint almost imperceptible pulse (often as a result of severe vomiting, diarrhea or sweating)
Warms Ming Men Fire and assists Heart, Kidney and Spleen Yang	Heart Yang Deficiency Spleen Yang Deficiency Kidney Yang Deficiency
Disperses Cold and Dampness, warms the channels and stops pain	Wind-Damp-Cold Bi Cold blocking the organs, channels, bones and Blood vessels Yin flat abscesses

Contraindications, Incompatibilities And Herb/Drug Interactions

Major Combinations

Rz. Zingiberis Gan Jiang	Rz. Zingiberis Gan Jiang Rx. Glycyrrhizae (large dose) Gan Cao	Rx. Ginseng Ren Shen
Counteracts the Internal consequences of an External Wind-Cold attack. Overabundance of Yin fluids due to Deficiency Cold. Cold-Damp Bi. Warms the Spleen and Kidneys, benefits Yang and disperses Cold. Reduces the toxicity of Zhi Fu Zi (even better with Gan Cao).	Strengthens its actions of fortifying Qi and benefiting the Yang for Cold extremities and diarrhea with undigested food due to Collapse of the Spleen and Kidney Yang.	Severe Deficiency of Source Qi and Collapse of Yang with cold extremities, sweating, weak breathing, dizziness and an extremely pale complexion.
Cx. Cinnamomi Rou Gui Rx. Rehmanniae Preparata Shu Di Huang	Rz. Atractylodis Macrocephalae Bai Zhu	Rz. Atractylodis Macrocephalae Bai Zhu Poria Fu Ling
Kidney Yang Deficiency with waning of Ming Men Fire with aversion to Cold, weak and sore back and legs, impotence and urinary frequency.	Spleen Yang Deficiency with a cold, painful abdomen, vomiting and watery diarrhea. Wind-Damp Bi.	Kidney and Spleen Yang Deficiency with retention of pathogenic water with abdominal pain, which is worse with Cold, urinary difficulty, and deep aching and heaviness in the extremities.
Rz. Atractylodis Macrocephalae Bai Zhu Rz. Zingiberis Gan Jiang	Rx. Ginseng Ren Shen Ram. Cinnamomi Gui Zhi	Rx. Astragali Huang Qi
Internal ascendance of Yin Cold leading to lack of arousal of Spleen Yang with abdominal pain, Cold, and watery diarrhea.	Weak Heart Yang with palpitations, shortness of breath and chest pain.	Spontaneous sweat and chills due to Yang Deficiency.
Hb. Ephedrae Ma Huang Hb. Asari Xi Xin	Cx. Cinnamomi Rou Gui	Hb. Asari Xi Xin
Wind-Cold Attack with preexisting Yang Deficiency.	Powerfully tonifies Kidney Yang, for Kidney Yang Deficiency with lower back pain and weakness in the legs and knees. Deficiency of Ming Men Fire with impotence or infertility. Overabundant Yin leading Yang to float outward. (separation of Yin and Yang) Damp-Cold Bi in the channels with generalized aches and pains and difficulty rotating the trunk. Leads Fire back to its source for Kidney Yin Deficiency with Fire Blazing Up-ward (small dose of each, 1-2g, combined with Yin tonics.	Disperses Cold and stops pain. Cold damage both Internal and External with aversion to Cold, headache and generalized body aches with aching joints. Wind-Damp-Cold Bi with spasms of the joints and intolerable pain.
Per. Zanthoxyli Chuan Jiao	Poria Fu Ling	Cornu Cervi Lu Jiao Rx. Rehmanniae Preparata Shu Di Huang Cx. Cinnamomi Rou Gui Sm. Cuscutae Tu Si Zi Actinolitum Yang Qi Shi Rx. Morindae Ba Ji Tian Rx. Angelicae Sinensis Dang Gui Fr. Lycii Gou Qi Zi
Strengthens the warming effect on the Spleen for Spleen Yang Deficiency with Cold-Dampness leading to Cold pain in the epigastrium, nausea, vomiting and diarrhea. Kidney Yang Deficiency with Deficiency of Ming Men Fire allowing Cold-Damp to accumulate in the Lower Jiao leading to urinary frequency, cold sweats or spermatorrhea.	Lower body edema and dysuria.	Infertility.
Sm. Cuscutae Tu Si Zi Hb. Epimedii Yin Yang Huo Cx. Cinnamomi Rou Gui	Rx. Ginseng Ren Shen Rz. Atractylodis Macrocephalae Bai Zhu Rz. Zingiberis Gan Jiang	Ram. Cinnamomi Gui Zhi Rz. Atractylodis Macrocephalae Bai Zhu Rx. Glycyrrhizae Gan Cao
Impotence.	Spleen Yang Deficiency.	Cold-Damp Bi.
Rz. Zingiberis Gan Jiang Rx. Glycyrrhizae Preparata Zhi Gan Cao Rx. Ginseng Ren Shen	Rx. Ginseng Ren Shen Rx. Ophiopogonis Mai Men Dong Fr. Schisandrae Wu Wei Zi	Rz. et Rx. Notopterygii Qiang Huo Rx. Angelicae Pubescentis Du Huo Rx. Clematidis Wei Ling Xian Hb. Taxilli Sang Ji Sheng
Heart Yang collapse with vomiting, a fading pulse, icy extremities and profuse perspiration.	As a decoction administered through the nose for shock.	Joint and muscle pain, numbness and difficulty of movement.
Rx. Angelicae Sinensis Dang Gui Excr. Trogopterori Wu Ling Zhi Rz. Corydalis Yan Hu Suo	Rx. Ginseng Ren Shen Rx. Astragali Huang Qi
Menstrual pain caused by Cold.	Yin sores.

Notes

1. Use of this herb is widespread, particularly for patterns of interior Cold arising from Yang Deficiency.
2. Vomiting, diarrhea or sweating are common precursors of Devastated Yang.
3. For shock or heart failure, this herb is given by injection.
4. In these situations it is essential, because it supports Heart Yang to unblock the vessels and improve circulation, and it tonifies Kidney Yang to augment Fire and prevent loss of the source Yang.
5. Its nature is downward-moving, and it can dispel pathogenic factors lodged between the Exterior and Interior.
6. According to one major source, this herb has six functions: 1: remove Cold; 2: relieve epigastric mass; 3: warm and nourish the viscera; 4: heal diverse Wind conditions; 5: alleviate Qi Stagnation; 6: stop abdominal pain due to Cold.
7. It is reputed to cure carbuncles and pyogenic infections.
8. For polyps, steep 5 pieces in wine for three days, then wash the polyp with the liquid three to four times daily.
9. It inhibits the growth of live, proliferating Stomach cancer cells.
10. Research has shown it to be effective against cancers of the Stomach, esophagus, Liver, Colon and rectum.
11. Unprocessed, this herb is highly toxic. The toxic dose is generally well above normal amounts (about 15-60 gm.). Overdoses respond to treatment with atropine and lidocaine.
12. Throughout its history of use, the toxicity of this herb has been a serious concern. To lower its toxicity it is usually processed with salt or brown sugar, or bleached with water or sulfur. One processing method leaves the herb black, known as “black aconite” Hei Fu Zi, which directs its action to the Kidneys. Another leaves it white, known as “white aconite” Bai Fu Zi, which is used for Bi pain. Where the full strength of the herb is needed (in emergencies or for topical use), the untreated “fresh” form Sheng Fu Zi is used, although this form is seldom used today.
13. Cornu Rhinoceri Xi Jiao, Sm. Phaseoli Lu Dou and Flos Lonicerae Jin Yin Hua are used to lessen the toxicity of this herb.
14. Toxic overdose shows as drooling, nausea, vomiting, diarrhea, light-headedness, blurred vision, and numbness of the mouth and extremities. In advanced cases there may be premature atrial contractions, dyspnea, tremors, incontinence, stupor, and lowered temperature and blood pressure.
15. The main root is Wu Tou, covered under analgesics, and the branch root is Fu Zi; when there is no branch root and only a single root, it is called Tian Xiong, which is gentler than Fu Zi.
16. Fu Zi travels through the 12 meridians and rescues Yang Qi that has been lost. It guides the medicine into the blood vessels, where it may nourish the Blood.
17. In the upper body it nurtures the Heart, in the middle it nurtures the Stomach, and in the lower body it strengthens Kidney Yang.
18. Aconite is said to “waken the Yang”: it activates metabolism, generates Heat, clears stagnant water, tonifies the cardiac muscle and strengthens the Urinary Bladder.
19. Some practitioners are overly cautious about the hot nature of Fu Zi; its effect depends on how the formula is constructed. It is usually combined with other herbs that move moisture, so the formula as a whole will be heating. If the patient feels too hot afterward, take out the Fu Zi.
20. Raw Fu Zi is quite toxic, but a couple of hours of cooking makes it fit for use. Processed Fu Zi is frequently labeled toxic, yet its toxicity is actually quite low. Even so, it is contraindicated in pregnancy, and in strong individuals the daily dose should stay at or below 10 gm. per day. Only processed Fu Zi should be taken internally.
21. This herb and Rz. Zingiberis Gan Jiang both treat Devastated Yang. This herb warms and tonifies Kidney and Spleen Yang with a more immediate, less localized effect, whereas Gan Jiang is aimed more at Spleen and Stomach Deficiency Cold and its effect lasts relatively long.
22. This herb and Cx. Cinnamomi Cassiae Rou Gui both warm and tonify Ming Men Fire and treat Yang Deficiency Cold of the Lower Jiao, but this herb is the stronger of the two.
23. Radix Aconiti Preparata Zhi Chuan Wu resembles Zhi Fu Zi, but Fu Zi is best for Cold and can be combined with tonifying herbs, while Chuan Wu is best for Wind and is so drying that it is unsuitable for use with tonics. Radix Aconiti Kusnezoffii Preparata Zhi Cao Wu is gathered in the wild and treats severe Wind and stubborn Bi.
24. Zhi Fu Zi and Cx. Cinnamomi Rou Gui are both acrid and warm, and both move into the Lower Jiao to tonify Kidney Yang, augment Ming Men Fire, disperse Cold and treat Cold-Damp Bi. Fu Zi enters all twelve channels, assists the Du channel and is used for Devastated Yang. Rou Gui focuses on the Heart, Spleen, Liver and Kidney channels and is not used for Devastated Yang.
25. Zhi Fu Zi, Cervi Cornu Pantotrichum Lu Rong and Cx. Cinnamomi Rou Gui all warm the Kidneys and fortify Yang. Zhi Fu Zi and Rou Gui are both acrid, harsh, hot and drying, with a strong, rapid action that warms the Interior, expels Cold and helps tonify Yang. Lu Rong is sweet, warm, soft and moistening, and it acts gradually to tonify Yang while moistening Jing and Blood. All three treat Kidney Yang Deficiency, but Fu Zi and Rou Gui suit only Kidney Yang Deficiency with Excess Internal Cold and are inappropriate when Jing or Blood is deficient. Lu Rong is not suited to expelling Internal Cold, but it is the best choice for Yang Deficiency with insufficiency of Jing, Blood and marrow.
26. Baked Aconite Accessory Root Bao Fu Zi is a little less toxic and mainly warms the Spleen and Kidneys. It is used for Cold pain in the epigastrium and abdomen, and for nausea and diarrhea from Deficiency Cold.
27. Bland Aconite Accessory Root Dan Fu Zi no longer numbs the tongue, is far less toxic, and is the standard form for rescuing Yang, dispersing Cold, warming and unblocking the channels and collaterals, and tonifying Ming Men Fire. The safe dosage is 3-15g.
28. Paired with Gan Jiang as a Dui-Yao, it restores Devastated Yang.
29. It carries the action of the other herbs in a formula into all twelve channels.
30. Dui Yao pair with Da Huang: for constipation with abdominal pain, aversion to Cold and cold limbs from Cold Accumulation. Used together in Da Huang Fu Zi Tang.