附子系列

Chapter 6. Fuzi series

Fuzi is the branch root of plant Aconitum carmichaeli Debx. It works to improve the cardiovascular function of the body. So it is used in many clinic conditions showing fade cardiac function and poor micro blood circulation. It is therefore called a General herb in the TCM. In TCM, it functions to warm up the body from very deep inside, much stronger than the function of herb Guizhi.

Fuzi is highly toxic. So there is some special requirement in preparation of it before clinic use. For its granule form that we are using, its toxic level has been well reduced to safe level.

(1). 附子汤

Fuzi Tang

附子（去皮，生破八片）二枚, 茯苓  三两, 人参  二两, 白术  四两, 芍药  三两

Fuzi (remove skin, cut) 90 gram, Fuling 45 gram, Renshen 30 gram, Baishu 60 gram, Shaoyao 45 gram.

右五味，以水八升，煮取三升，去滓，温服一升，日三服。

Add the herbs and 2000 ml water into a herbal pot. Bing to boil and keep in mild boiling until the liquid in the pot is about 750 ml. Collect the herbal tea. Drink one third of the tea each time, three times a day.

19　太阳病，发汗，遂漏不止，其人恶风，小便难，四肢微急，难以屈伸者，桂枝加附子汤主之。

In the Taiyang stage, if sweating therapy[1] causes continuous sweat, and if the person feels dislike wind, has difficulty in urination, arms and legs feels tight and hard to bends or stretch, Guizhi jia Fuzi Tang should be used.[2]

07　少阴病，得之一、二日，口中和，其背恶寒者，当灸之，附子汤主之。

With Shaoyin stage for one to two days, if the person feels normal in the mouth (no dryness, thirsty or other taste), but feels cold on the back[3], use moxibustion therapy[4] and use Fuzi Tang.

08　少阴病，身体痛，手足寒，骨节痛，脉沉者，附子汤主之。

With Shaoyin stage, if the person feels body pain, Jue condition, joint pains and has deep pulse, use Fuzi Tang. [5]

妇人怀娠六、七月，脉弦，发热，其胎愈胀，腹痛恶寒者，少腹如扇，所以然者，子藏开故也，当以附子汤温其藏。（方未见）

If a woman has pregnancy for six or seven months, has string pulse, fever, but feels bloating, pain, chilly and cold feeling in the lower abdomen, this condition is due to open of the uterus. For the treatment, use Fuzi in herbal formula. 

(2). 真武汤

Zhenwu Tang

茯苓　三两， 芍药　三两， 生姜（切）三两， 白术　二两， 附子（炮，去皮，破八片）一枚

Fuling 45 gram, Shaoyao 45 gram, Fresh ginger 45 gram, Baishu 30 gram, Fuzi (processed, remove skin) 45 gram.

右五味，以水八升，煮取三升，去滓，温服七合，日三服。

Add the herbs and 2000 ml water into a herbal pot. Bring to boil and keep it in mild boiling until the liquid volume in the pot is about 750 ml. Drink one third of the tea each time, three times a day.

04　太阳病发汗，汗出不解，其人仍发热，心下悸，头眩身俽动，振振欲擗地者，真武汤主之。

When in the Taiyang stage and after sweat therapy, the person has sweat but the disease remains[6]. He feels fever/hot, palpitation[7], dizziness[8] and shaking in the body[9] (almost to fall). In this case, herb Zhenwu Tang should be used mostly.

15　少阴病，二、三日不已，至四、五日，腹痛，小便不利，四肢沉重疼痛，自下利者，此为有水气。其人或咳，或小便不利，或下利，或呕者，真武汤主之。

(3). 附子米汤

Fuzi Genmi Tang

附子（炮）一枚，半夏  半升，甘草  一两，大枣  十枚，粳米  半升

Fuzi 25 gram, Banxia 65 gram, Gancao 15 gram, Chinese date 10 badges, Genmi 65 gram. 

右五味，以水八升，煮米熟汤成，去滓，温服一升，日三服。

Add the herbs and 2000 ml water into a herbal pot. Bring to boil and keep in mild boiling until the Genmi is eatable. Remove the reside. Collect the herbal tea. Drink one third of the tea each time, three times a day.

腹中寒气雷鸣切痛，胸逆满，呕吐，附子粳米汤主之。

If the person has Cold in the abdomen, has strong noise due to intestine movement, has cutting pain in stomach, feels fullness in chest, has nausea, use Fuzi Genmi Tang.

(4). 四逆汤

Sini Tang

甘草（炙）二两,    乾姜  一两半,   附子（生用，去皮，破八片）一枚

Gancao (processed) 30 gram, Ganjiang  23 gram, Fuzi (not cooked, remove skin) 45 gram.

右三味，以水三升，煮取一升二合，去滓，分温再服。强人可大附子一枚，乾姜三两。

Add the herbs and 750 ml water into a herbal pot. Bring to boil until there is 300 ml liquid left in the pot. Collect the herbal tea, separate into several parts. Drink one part each time. Repeat every 2 to 3 hours. If the body is strong or is big in size, use Fuzi of big size, and use 45 gram of Ganjiang.

12　病发热头痛，脉反沉，若不差，身体疼痛，下利清谷[11], 当温其里，宜四逆汤。

If the person feels fever and headache, if his pulse is deep, and if he has continuous diarrhea with non-digested food in the stool and pain in whole body, Sini Tang should be used to warm the body to release the pain. [12]

87　脉浮而迟，表热里寒，下利清谷者，四逆汤主之。

In Yangming stage, if the pulse is floating and slow, it suggests Fire in surface of the body, but a Cold inside. If the person has diarrhea with undigested food, Sini Tang should be used. [13]

05　伤寒，医下之，续得下利清谷不止，身疼痛者，急当救里；後身疼痛，清便自调者，急当救表。救里宜四逆汤，救表宜桂枝汤。

With Cold-invasion Shanghan disease, a bowel-cleansing therapy is given that caused continuous diarrhea of non-digested food in the stool and body pain. This is urgent to support the inside of the body, using Sini Tang; after the diarrhea stops but body pain remains, using Guizhi Tang to deplete the Cold in the body surface layer. [14]

07　下利，腹胀满，身体疼痛者，先温其里，乃攻其表，温里宜四逆汤，攻表宜桂枝汤。

If a person has diarrhea, fullness in abdomen, and body pain, warm and support the body inside first, and improve the body surface condition later. Use Sini Tang to support the inside and use Guizhi Tang to improve the body surface condition.

09　少阴病，脉沉者，急温之，宜四逆汤。

Whenever a person is in Shaoyin stage and with deep pulse, urgent warm treatment with Sini Tang is needed.

13　少阴病，饮食入口则吐，心中温温欲吐，复不能吐，始得之，手足寒，脉弦迟者，此胸中实，不可下也，当吐之，若膈上有寒饮，乾呕者，不可吐也，当温之，宜四逆汤。

In Shaoyin stage, if the person has vomit whenever the food comes into the mouth, has continuous and mild willingness to vomit but cannot vomit out, has Jue condition, has string and slow pulse, it indicates a Shi condition in the chest. Vomiting therapy, but not bowel-cleansing therapy should be used. If there is Cold and Yinxie above the diagram (in the chest), the person feels dry nausea, the vomiting therapy cannot be used either. In this case, use warm therapy, use Sini Tang. [15]

32　大汗出，热不去，内拘急，四肢疼，又下利厥逆而恶寒者，四逆汤主之。

In Jueyin stage, if the person has heavy sweat, continuous fever, spasm in the stomach, pain in the aims and legs, has diarrhea, Jue condition, and feels chilly, use Sini Tang.

36　(厥阴) 呕而脉弱，小便复利，身有微热，见厥者，难治，四逆汤主之。

In Jueyin stage, if the person has nausea, weak pulse, easy urine again[16], mild hot, and Jue condition, it is hard to recover, use Sini Tang however. [17] 

阴盛者属阴经，则下利为虚寒，即论中所谓少阴下利反发热不死，少阴下利清谷， 里寒外热，不恶寒而面赤者是也。盖阳与阳合，不合於阴，为三阳合病，则不下利而自汗出，乃白虎汤证也；阴与阴合，不合於阳，为三阴合病，则不发热而吐利厥逆，乃四逆汤证也。诚以人之藏府互根，阴阳相合，三阳既有合并之病，则三阴亦有合并之病，不待言矣。

If the condition shows more as Yin stages, the diarrhea belongs to weak Cold, as indicated in the book as Shaoyin diarrhea but with fever; as Shaoyin diarrhea with non-digested food in the stool; as cold inside but surface hot, the person has no chilly but the face is red in color. Usually if a Yang stage co-exists with another Yang stage, not with any Yin stage, it is the Yang co-exist condition. The person has no diarrhea but has sweat, indicating a Baihu Tang condition; if a Yin stage co-exists with another Yin stage, not with any Yang stage, it is Yin co-exist condition, the person has no fever, but nausea, diarrhea and has Jue condition, indicating a Sini Tang condition. This is because in the body, the Zang and Fu[18] organs are linked, associated functionally each other, if the three Yang stage (which is the disorder in the Fu, such as urine bladder – Taiyang; large intestine – Yangming; and gall bladder – Shaoyang) have disorder, the three Yin stage can have disorders at the same time. This is easy to understand.

05  伤寒脉浮，自汗出，小便数，心烦，微恶寒，脚挛急, (当与桂枝增桂加附子汤，以温经止汗) 反与桂枝汤，欲攻其表，此误也，得之便厥。咽中乾，烦燥吐逆者，作甘草乾姜汤与之，以复其阳。若厥愈足温者，更作芍药甘草汤与之，其脚即伸；若胃气不和，谵语者，少与调胃承气汤；若重发汗，复加烧针者，四逆汤主之。

With Shanghan disease, the pulse is floating and the person has sweat and frequent urine, annoyed/impatience, slight chilly, spasm in feet[19]. (It should use Guizhi jia Guizhi jia Fuzi Tang to warm up the body and stop the sweat). If Guizhi Tang aloe is given to deplete the Xieqi from the body surface, it is a wrong treatment. It will cause reverse Jue condition (cold hands and feet). If the person feels dry in mouth, annoyed/impatience, vomiting, give Gancao Ganjiang Tang to restore his Yangqi. If his hands and feet return to warm, give Shaoyao Gancao Tang to release feet spasm. If the person has non-harmonized stomach, has Chattering syndrome, give Tiaowei Chengqi Tang. If he was given repeated sweat therapy and warm-acupuncture, use Sini Tang.

07  既吐且利，小便复利，而大汗出，下利清谷，内寒外热，脉微欲绝者，四逆汤主之。

In Huoluan disease, the person has vomiting, diarrhea, but also frequent urine and heavy sweat; the diarrhea contains more non-digested food; and the pulse is weak to disappear, use Sini Tang. [20]

08   吐利汗出，发热恶寒，四肢拘急，手足厥冷者，四逆汤主之。

In Huoluan disease, if the person has vomiting, diarrhea, sweat, fever and chilly, spasm in the arm and legs, has Jue syndrome, use Sini Tang. [21]

(5). 四逆加人参汤

Sini jia Renshen Tang

於四逆汤方内，加人参一两，馀依四逆汤方

Add 15 gram of Renshen into the standard Sini Tang. Cook and drink it as Sini Tang.

10  恶寒脉微而腹利。利不止[22]，亡阳也[23]，四逆加人参汤主之。

In Huoluan disease, if the person feels chilly, diarrhea and the pulse is weak, if his diarrhea continuous, it depletes Yangqi. Use Sini jia Shenshen Tang.[24]

(6). 茯苓四逆汤

Fuling Sini Tang

茯苓六两， 人叁一两， 甘草（炙）二两， 乾姜一两半， 附子（生用，去皮，破八片）一枚．

Fuling 90 gram, Renshen 15 gram, Gancao (processed) 30 gram, Ganjiang 24 gram, Fuzi (not processed, chop into eight pieces) 30 gram.

右五味，以水五升，煮取三升，去滓，温服七合，日三服。

Add the herbs and 1250 ml water into a herbal pot. Bring to boil and keep in mild boiling until the liquid in the pot is about 750 ml. Collect the herbal tea. Drink 175 ml each time, repeat three times a day.

15发汗若下之，病仍不解，烦躁者，茯苓四逆汤主之。

If after bowel-cleansing therapy followed by a sweat therapy again, if the Taiyang symptoms remain and the person feels annoyed emotionally and physically, herb Fuling Sini Tang is the main choice.[25]

(7). 通脉四逆汤

Tongmai Sini Tang

甘草（炙）二两， 乾姜　三两， 强人可四两， 附子（生用，去皮，破八片）大者一枚

Gancao (processed) 30 gram; Ganjiang 45 gram, (for big size body, it can be 60 gram), Fuzi (not processed, remove skin, cut into pieces) 45 gram.

右三味，以水三升，煮取一升二合，去滓，分温再服，其脉即出者愈。

Add the herbs and 750 ml water into a herbal pot. Bring to boil and keep in a milk boiling until there is about 300 ml liquid left in the pot. Collect the herbal tea. Separate it into several parts. Drink each part in warm, repeat every two to three times, until the pulse becomes stronger.

17  少阴病，下利清谷， 里寒外热，手足厥逆，脉微欲绝，身反不恶寒，其人面色赤，或腹痛，或乾呕，或咽痛，或利止脉不出者，通脉四逆汤主之。

In Shaoyin stage, if the person has diarrhea of non-digested food in the stool, feels inside cold but outside hot, reverse cold in the hands and feet, has very thin pulse that feels nearly to disappear, he has no chilly but the face is red, he may feel pain in stomach, or has dry nausea, or has sour throat, or the diarrhea stops but the pulse disappears, the herb Tongmai Sini Tang is used.

30  下利脉沉而迟，其人面少赤，身有微热，下利清谷者，必郁冒汗出而解，病人必微厥，所以然者，其面戴阳，下虚故也。(用通脉四逆汤)

In Jueyin stage, if the person has diarrhea with non-digested food in the stool, deep and slow pulse, has slight red color in the face, mild hot in the body, he will have sweat and feel cloudy mind, then to get recovered. He should also feel mild Jue condition, since he has a Daiyang condition[26]: his face is mild red in color. （use Tongmai Sini Tang）.

下利清谷，里寒外热，汗出而厥者，通脉四逆汤主之。

IF the person has diarrhea with non-digested food in the stool, has Cold inside and Fire outside, has sweat and reverse cold in the hands and feet, use Tongmai Sini Tang.

(8). 白通汤

Baitong Tang

葱白四茎,   乾姜一两,   附子（生，去皮，破八片 ）一枚

Chinese onion stems, four stems; Ganjiang 15 gram, Fuzi (not cooked, remove skin) 45 gram. 

右三味，以水三升，煮取一升，去滓，分温再服。

Add the herbs and 750 ml water into a herbal pot. Bring to boil until there is 250 ml liquid left in the pot. Collect the herbal tea, separate into several parts. Drink one part each time. Repeat every 2 to 3 hours.

10　少阴病，下利，白通汤主之。

In the Shaoyin stage, if the person has diarrhea, use Baitong Tang. [27]

11　少阴病，下利脉微者，与白通汤，利不止，厥逆无脉，乾呕烦者，白通加猪胆汁汤主之。服汤脉暴出者死，微续者生。

In Shaoyin stage, if the person has diarrhea and weak pulse, use Baitong Tang. If the diarrhea continues, hands and feet feels cold that is developing to the elbow and knee (reverse cold), and the pulse is very difficult to feel (no pulse can be felt), person has dry nausea and feels annoyed/impatience, use Baitong jia pig gallbladder juice Tang. After drinking the herbal tea, the person suddenly has big pulse, he cannot be alive; if his pulse is weak, he will be alive.

(9). 赤丸方

Chi Wan

茯苓  四两，半夏（洗）四两（一方用桂，）乌头（炮）二两，细辛  一两

Fuling 60 gram, Banxia (washed) 60 gram, Wutou (processed) 30 gram, Xixin 15 gram.

右四味，末之，真朱为色炼丸，丸如麻子大，先食，酒饮下三丸，日再夜一服。不知稍增之，以知为度。

Prepare the herbs into pills as 0.5 cm in diameter. Eat three pills after food, with the help of wine for swallow. Eat once more in the day time and once at night. If the person feels no slight dizzy or slight cloud in the mind after taking the pills, increase the number of the pill each time until he feels such healing effect.

寒气厥逆，赤丸主之。

If the Cold is strong and causes Jue condition (cold hands and feet, the cold develops reverse up towards the body stem), use Chiyuan Tang.

(10). 大乌头煎

Wutou Jian

乌头（熬，去皮，不咀）大者五枚

Wutou (processed, remove peel), big size, 5 badges.

右以水三升，煮取一升，去滓，内蜜二升，煎令水气尽，取二升，强人服七合，弱人服五合，不差明日更服，不可一日再服。

Add the herb and 750 ml water into herbal pot. Bring to boil and keep in mild boiling until there is 250 ml left. Remove the residue, add 500 ml honey in, continue to boiling until there is no water vapor comes. Collect 500 ml. For person with strong body ship, drink 175 ml; for person with skinny body shape, drink 125 ml. If the symptom does not improve, repeat the drinking next day, not the same day any more.

腹痛，脉弦而紧，弦则卫气不行，即恶寒，紧则不欲食，邪正相抟，即为寒疝。绕脐痛苦，发则自汗出，手足厥冷，其脉沉紧者，大乌头煎主之。

If the person has pain in the abdomen, pulse is string and tight, the string pulse suggests the Weiqi does not move properly, e.g. the person feels chilly; the tight pulse means loss of appetite. All of these cause Cold Shan[28]. The person feels pain around the naval, and has sweat and feels cold in the hands and feet when the pain comes. In such Cold Shan disease, use Da Wutou Jian.

(11). 乌头汤

Wutou Tang

麻黄，芍药，黄耆各三两，甘草，川乌（咀，以蜜二升，煎取一升，即出乌头）五枚

Mahuang 45 gram, Shaoyao 45 gram, Huangqi 45 gram, Gancao 15 gram, Chuangwu (cut into small pieces, cook in honey 500 ml, until there is about 250 ml honey left. Collect the Wutou) five badges.

右五味，咀四味，以水三升，煮取一升，去滓，内蜜煎中，更煎之，服七合；不知，尽服之。

Add the herbs into 750 ml water. Bring to boil and keep in mild boiling until there is about 250 ml liquid left. Remove the residue, collect the herbal tea, mix it with honey continue to cook for a while. Drink 70% of the collected tea. If the person feels nothing special[29], drink all the remaining tea.

味酸则伤筋，筋伤则缓，名曰泄，咸则伤骨，骨伤则痿，名曰枯；枯泄相搏，名曰断绝。荣气不通，卫不独行，荣卫俱微，三焦无所御，四属断绝，身体羸瘦，独足肿大，黄汗出，胫冷，假令发热，便为历节也。病历节，不可屈伸，疼痛，乌头汤主之。（注：本段提示湿气为痹症原因之一）

Sour taste damages the tendon, the tendon becomes weak so as hard to contract, after damage. This condition is called depletion/relief. Salty taste damages the bone. The bone becomes atrophy after damage. This condition is called withered condition. When both the relief and the withered conditions are in the body, it is called Duanjue. If the Rongqi is blocked, the Weiqi can not move by itself. If both the Weiqi and Rongqi are weak, there is no defense system to defense the three Jao Cavity, and no more nutrition to nourish the arms and legs, the body becomes skinny and weakness with only the feet swelling and big. The body has yellow sweat[30], cold legs[31]. If the person feels hot[32], it belongs to Lijie disease. In this case, the joints feel pain, and hard to bend or to stretch. Use Wutou Tang for the treatment.[33]

病历节，不可屈伸，疼痛，乌头汤主之。

If the person has the Lijie disease, the joint is painful and hard to bend, use Wutou Tang.

《外台》乌头汤 治寒疝腹中绞痛，贼风入攻五藏，拘急不得转侧，发作有时，使人阴缩，手足厥逆。