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Aconitum, Fu Zi, 附子
Prepared Aconitum, Zhi Fu Zi, 制附子
Sichuan Aconite accessory root, Aconite Daughter root
Fu Zi, Su Fu Zi (prepared) (TCM)
Fu Zi, Su Fu Zi (prepared) (TCM)
Curtis’s Botanical Magazine, 1841
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LEFT: Bai Fu Pian (White Aconite slices, without bark); RIGHT: Hei Fu Pian (Black Aconite slices, with bark)
Botanical name:
A. carmichaeli (syn. A. chinense)
A number of Aconite species are used in the various systems:
1. Europe: A. napellus
2. India & Tibet:
a. A. chasmanthum
b. A. ferox (Nepalese Aconite)
The above species are synonymous in effect, just the strength may vary. This is especially so with Wild versus farmed varieties. In TCM, the majority of the root of Fu Zi is farmed, whereas other varieties of Aconite (Chuan Wu, Cao Wu) are gathered from the wild and are much more toxic. It appears most of that on the Indian market is wild-crafted, leading to its possible greater strength.
Parts used:
Prepared 'Daughter' (accessory) root
Temperature & Taste:
Hot, dry. Pungent, Extremely Toxic
Classification:
M. Warm to Expel Cold
A. carmichaeli (syn. A. chinense)
A number of Aconite species are used in the various systems:
1. Europe: A. napellus
2. India & Tibet:
a. A. chasmanthum
b. A. ferox (Nepalese Aconite)
The above species are synonymous in effect, just the strength may vary. This is especially so with Wild versus farmed varieties. In TCM, the majority of the root of Fu Zi is farmed, whereas other varieties of Aconite (Chuan Wu, Cao Wu) are gathered from the wild and are much more toxic. It appears most of that on the Indian market is wild-crafted, leading to its possible greater strength.
Parts used:
Prepared 'Daughter' (accessory) root
Temperature & Taste:
Hot, dry. Pungent, Extremely Toxic
Classification:
M. Warm to Expel Cold
Uses:
1. Warms the Yang, Clears Cold:
-marked coldness and Yang deficiency of the Heart, Spleen or Kidney
-cold chest pain with palpitations and shortness of breath
-cold abdominal pain with watery diarrhea and undigested food, nausea
-cold pain of the lower back, lower back pain, copious clear urine, impotence
-has Yang tonifying qualities (which is not seen in the Aconite main root)
2. Revives the Yang:
-devastated Yang and where Cold is in excess; frigid extremities, pale complexion, faint pulse
-diarrhea with undigested food, feeling very cold, cold extremities and very faint pulse
-severe sweating, vomiting or diarrhea,
-important herb for Yang collapse as a result of Shock
3. Clears Cold-Wind-Damp, Eases Pain:
-Wind-Cold-Damp painful obstruction of the muscles, joints and channels
-internal cold obstructing the organs
-the Wild versions (Chuan Wu, Cao Wu, Wu Tou etc) are stronger for this effect
SYMPTOM PICTURE:
According to TCM, the symptoms picture for a patient appropriate to the use of Aconite is: a feeling of coldness, cold limbs, a pale, flabby tongue with a white or greasy coating, a weak pulse or a deep and slow pulse and clear urine. Various other symptoms may be present such as lower back pain and weakness, cold p[ain in the joints, impotence.
DOSE:
1. The root is always bought ready-prepared in factories. Therefore, it is common practice for a practitioner to taste a new batch of Aconite. If it is numbing to taste, it is still potentially toxic.
2. When decocted (typical use in TCM) it must be cooked for up to an hour (30–60 minutes before adding the other herbs). Larger doses are boiled for longer periods. In addition, cooking with Ginger and/or Licorice can enhance its function of warming Yang while reducing toxicity.
3. The root should be soaked and washed in water before decocting to remove salts used in its preparation.
4. If the root is used in powdered form, the broken pieces of root should be dry-fried in a hot wok until they become slightly yellowed to further reduce toxicity.
5. In any dosage form, the addition of Licorice and/or Ginger root is wise.
6. Individual response can be varied. Some people may experience mild side effects within the dosage range while others can take far larger doses.
7. Tolerance develops meaning doses can generally be increased if required.
8. It is always wise to begin with lower doses, increasing as needed.
Decoction: 3–15 grams, boiled for 30–60 minutes before adding other herbs (total cooking time minimum 1–1½ hours).
To rescue the Yang (such as in Shock or collapse from Yang deficiency): 15–30 grams in decoction.
Prepared root in powder and pills: 10–50mg (up to 100 or 200mg)
In the 'Sichuan Fire School' (Huo Shen Pai) large doses of aconite are used, sometimes up to 200 grams per day.
In these cases:
1. Begin with lesser doses increasing as required.
2. Large doses require longer boiling. For example, a 50 gram dose may be boiled for 2 or more hours; 100 grams for 4 hours.
3. It is always advisable to use adequate amounts of correctives (detoxicants) such as Ginger and Licorice.
4. Individuals response to the drug dictates how far the dose is raised.
5. Formulas specific to the 'Huo Shen Pai' School are generally used when large doses are given.
PREPARATION:
Various methods of preparation are employed. Processing is never carried out by practitioners, but the root is prepared in factories to be supplied to the medicine market. There are a number of different preparations used in China, but generally only White and Black types as pictured above are available on the Western market.
1. Usually, preparation involves soaking a number of times in water or brine, and cooking with herbs or salts, then drying.
2. Dan Fu Pian is prepared with Licorice and Soy bean. It is less toxic than Hei Fu Pian and Bai Fu Pian.
3. Pao Fu Pain :the fresh root is Dry-fried in sand. This is the least toxic preparation.
4. In India, the root is prepared by soaking in Cow urine.
5. The unprocessed product is not generally used internally. It is very toxic, but is sometimes used in external medicine (but should never be applied to broken skin). However, in parts of Sichuan, the dried, unprepared root is occasionally used in cooking where it is stewed with meat for 6 hours as a traditional dish (personal communication).
CORRECTIVES:
1. Ginger (TCM)
2. Licorice (TCM)
3. Saposhnikovia Fang Feng was said to reduce toxicity of Aconite. (Ten Lectures on the Use of Medicinals, Jiao Shu-De)
4. See also the Antidotes below.
SUBSTITUTES:
Delphinium denudatum (Unani)
COMMENT:
1. This is a very potent medicine and is responsible for more deaths in China than any other single herbal medicine. Nevertheless, it is a potent and indispensable medicine in TCM, Tibetan Medicine and Ayurveda.
2. There are a number of types of processing methods used.
3. There are two main varieties used: Black Aconite Pieces (Hei Fu Pian) and White Aconite Pieces (Bai Fu Pian), the former retaining its black root skin, the latter having the black skin removed.
4. There are several different Aconites used in TCM, Ayurveda and Tibetan Medicine. In TCM, Zhi Fu Zi, dealt with here, is most used. It is the strongest tonic. Zhi Chuan Wu is less tonic, but is hotter, and better for strong Wind-Cold-Damp pain.
5. The main difference in the use of Aconite is the application of it as an anti-inflammatory, anti-pyretic, febrifuge in Traditions other than TCM. Its other uses, for example Rheumatic and Arthritic disease and Nervous disorders is quite similar.
6. An old TCM addage states 'Aconitum Fu Zi is not hot without Ginger'. Ginger increases the Yang tonifying effect of Aconite while simultaneously reducing Toxicity. The same can be said of Cinnamon, which likewise enhances teh warming, Yang tonifying effect of Aconite while reducing toxicity.
According to TCM, the symptoms picture for a patient appropriate to the use of Aconite is: a feeling of coldness, cold limbs, a pale, flabby tongue with a white or greasy coating, a weak pulse or a deep and slow pulse and clear urine. Various other symptoms may be present such as lower back pain and weakness, cold p[ain in the joints, impotence.
DOSE:
1. The root is always bought ready-prepared in factories. Therefore, it is common practice for a practitioner to taste a new batch of Aconite. If it is numbing to taste, it is still potentially toxic.
2. When decocted (typical use in TCM) it must be cooked for up to an hour (30–60 minutes before adding the other herbs). Larger doses are boiled for longer periods. In addition, cooking with Ginger and/or Licorice can enhance its function of warming Yang while reducing toxicity.
3. The root should be soaked and washed in water before decocting to remove salts used in its preparation.
4. If the root is used in powdered form, the broken pieces of root should be dry-fried in a hot wok until they become slightly yellowed to further reduce toxicity.
5. In any dosage form, the addition of Licorice and/or Ginger root is wise.
6. Individual response can be varied. Some people may experience mild side effects within the dosage range while others can take far larger doses.
7. Tolerance develops meaning doses can generally be increased if required.
8. It is always wise to begin with lower doses, increasing as needed.
Decoction: 3–15 grams, boiled for 30–60 minutes before adding other herbs (total cooking time minimum 1–1½ hours).
To rescue the Yang (such as in Shock or collapse from Yang deficiency): 15–30 grams in decoction.
Prepared root in powder and pills: 10–50mg (up to 100 or 200mg)
In the 'Sichuan Fire School' (Huo Shen Pai) large doses of aconite are used, sometimes up to 200 grams per day.
In these cases:
1. Begin with lesser doses increasing as required.
2. Large doses require longer boiling. For example, a 50 gram dose may be boiled for 2 or more hours; 100 grams for 4 hours.
3. It is always advisable to use adequate amounts of correctives (detoxicants) such as Ginger and Licorice.
4. Individuals response to the drug dictates how far the dose is raised.
5. Formulas specific to the 'Huo Shen Pai' School are generally used when large doses are given.
PREPARATION:
Various methods of preparation are employed. Processing is never carried out by practitioners, but the root is prepared in factories to be supplied to the medicine market. There are a number of different preparations used in China, but generally only White and Black types as pictured above are available on the Western market.
1. Usually, preparation involves soaking a number of times in water or brine, and cooking with herbs or salts, then drying.
2. Dan Fu Pian is prepared with Licorice and Soy bean. It is less toxic than Hei Fu Pian and Bai Fu Pian.
3. Pao Fu Pain :the fresh root is Dry-fried in sand. This is the least toxic preparation.
4. In India, the root is prepared by soaking in Cow urine.
5. The unprocessed product is not generally used internally. It is very toxic, but is sometimes used in external medicine (but should never be applied to broken skin). However, in parts of Sichuan, the dried, unprepared root is occasionally used in cooking where it is stewed with meat for 6 hours as a traditional dish (personal communication).
CORRECTIVES:
1. Ginger (TCM)
2. Licorice (TCM)
3. Saposhnikovia Fang Feng was said to reduce toxicity of Aconite. (Ten Lectures on the Use of Medicinals, Jiao Shu-De)
4. See also the Antidotes below.
SUBSTITUTES:
Delphinium denudatum (Unani)
COMMENT:
1. This is a very potent medicine and is responsible for more deaths in China than any other single herbal medicine. Nevertheless, it is a potent and indispensable medicine in TCM, Tibetan Medicine and Ayurveda.
2. There are a number of types of processing methods used.
3. There are two main varieties used: Black Aconite Pieces (Hei Fu Pian) and White Aconite Pieces (Bai Fu Pian), the former retaining its black root skin, the latter having the black skin removed.
4. There are several different Aconites used in TCM, Ayurveda and Tibetan Medicine. In TCM, Zhi Fu Zi, dealt with here, is most used. It is the strongest tonic. Zhi Chuan Wu is less tonic, but is hotter, and better for strong Wind-Cold-Damp pain.
5. The main difference in the use of Aconite is the application of it as an anti-inflammatory, anti-pyretic, febrifuge in Traditions other than TCM. Its other uses, for example Rheumatic and Arthritic disease and Nervous disorders is quite similar.
6. An old TCM addage states 'Aconitum Fu Zi is not hot without Ginger'. Ginger increases the Yang tonifying effect of Aconite while simultaneously reducing Toxicity. The same can be said of Cinnamon, which likewise enhances teh warming, Yang tonifying effect of Aconite while reducing toxicity.
Main Combinations:
1. Devastated Yang with marked coldness, cold extremities, fatigue, lethargy, chills, watery diarrhea, faint pulse, Aconitum Fu Zi with dry Ginger Gan Jiang and Licorice, as in Si Ni Tang. If Qi is very weak, Ginseng is added to form Si Ni Jia Ren Shen Tang.
2. Kidney Yang deficiency, with coldness, weak and painful lower back, impotence, urinary frequency, Aconitum Fu Zi with Rehmannia Shu Di, Cinnamon and Dioscorea Shan Yao. If there is lower back pain and weakness, add Eucommia Du Zhong.
3. Spleen and Kidney Yang deficiency with fluid accumulation, edema, abdominal pain, heaviness of the extremities, Aconitum Fu Zi with Atractylodes Bai Zhu, Paeonia Bai Shao, Poria Fu Ling and fresh Ginger. This is Zhen Wu Tang, True Warrior Decoction.
4. Spleen Yang deficiency, Aconitum Fu Zi with Atractylodes Bai Zhu, dry Ginger (Gan Jiang) and Licorice (as in Fu Zi Li Zhong Wan)
5. Heart Yang deficiency, with coldness, palpitations, shortness of Breath, Aconitum Fu Zi with Ginseng, Licorice and Cinnamon (Rou Gui) or Cinnamon twig Gui Zhi.
6. External Wind-Cold in someone with Yang deficiency, Aconitum Fu Zi combine with Ephedra Ma Huang and Asarum Xi Xin and fresh Ginger.
7. Boils and Wounds, Aconitum Fu Zi, Ginger juice, Dragons Blood (Xue Jie), Sesame seed (Hei Zi Ma), Flowers of Sulphur, Pangolian scales, formed into Pills (Chinese Materia Medica, Stuauoft)
Major Formulas:
Fu Zi Tang
Fu Zi Li Zhong Wan
Shen Qi Wan
Zhen Wu Tang
Si Ni Tang
Cautions:
1. Extremely toxic in its unprepared state. Even the prepared drug is highly toxic in overdose. A number of deaths occur each year in China from Aconite poisoning.
2. Only the prepared root is used internally.
3. It is wise to begin with lesser doses, increasing as needed. Cooking time can also be longer to begin with (2 hours), reducing cooking time over a number of days.
TOXICITY:
LD50 of unprepared Aconitum Fu Zi orally in mice is 5.5 mg/kg.
LD50 of prepared Aconitum Fu Zi orally in mice is 161 mg/kg.
ANTIDOTES:
NOTE: Overdose from Aconite is potentially lethal and therefore any overdose should be sent to hospital immediately.
1. Licorice (TCM)
2. Ginger, fresh and dried (TCM)
3. Cinnamon–infuse 5–10 grams of Cinnamon in hot water and drink, repeating if necessary.
4. Garlic
5. Asafetida
6. Anthora (Aconitum anthora) was regarded as a specific antidote to the toxic Aconites. Anthora is a non-toxic (less toxic) species of Aconite. Similarly, in Tibetan Medicine, non-toxic (less toxic) species of Aconite (A. heterophyllum etc.) are regarded as counterpoisons to the toxic Aconites.
7. Delphiniums are closely allied to the Aconites. D. denudatum has, similar to the above-mentioned Aconites, been regarded as an antidote to the toxic Aconites.
8. Ground Pine: "It is an especial thing for the Poison of the Aconites of all sorts". (Culpeper)
9. Herb True-Love: 'The leaves or berries thereof are effectual to expel Poison of all sorts, especially that of the Aconites'. (Culpeper)
10. Purified Borax is regarded as an antidote in Ayurveda. Recent research has shown it to be an effective antidote to both acute and sub-acute Aconite poisoning.
11. Compound Decoctions from TCM:
i. Fresh Ginger, Licorice, Mung Bean (Lu Dou), Black Soy bean (Hei Dou), Sophora Ku Shen; Coptis Huang Lian, Ginseng; Astragalus Huang Qi (dosage of each herb depends on symptoms)
ii. irregular Heartbeat: Sophora Ku Shen (20 grams), Licorice (10 grams).
iii. Cold extremeities and very weak pulse, Ginseng, Licorice, dry Ginger
Main Preparations used:
Prepared Aconite Root (Zhi Fu Zi)
1. Extremely toxic in its unprepared state. Even the prepared drug is highly toxic in overdose. A number of deaths occur each year in China from Aconite poisoning.
2. Only the prepared root is used internally.
3. It is wise to begin with lesser doses, increasing as needed. Cooking time can also be longer to begin with (2 hours), reducing cooking time over a number of days.
TOXICITY:
LD50 of unprepared Aconitum Fu Zi orally in mice is 5.5 mg/kg.
LD50 of prepared Aconitum Fu Zi orally in mice is 161 mg/kg.
ANTIDOTES:
NOTE: Overdose from Aconite is potentially lethal and therefore any overdose should be sent to hospital immediately.
1. Licorice (TCM)
2. Ginger, fresh and dried (TCM)
3. Cinnamon–infuse 5–10 grams of Cinnamon in hot water and drink, repeating if necessary.
4. Garlic
5. Asafetida
6. Anthora (Aconitum anthora) was regarded as a specific antidote to the toxic Aconites. Anthora is a non-toxic (less toxic) species of Aconite. Similarly, in Tibetan Medicine, non-toxic (less toxic) species of Aconite (A. heterophyllum etc.) are regarded as counterpoisons to the toxic Aconites.
7. Delphiniums are closely allied to the Aconites. D. denudatum has, similar to the above-mentioned Aconites, been regarded as an antidote to the toxic Aconites.
8. Ground Pine: "It is an especial thing for the Poison of the Aconites of all sorts". (Culpeper)
9. Herb True-Love: 'The leaves or berries thereof are effectual to expel Poison of all sorts, especially that of the Aconites'. (Culpeper)
10. Purified Borax is regarded as an antidote in Ayurveda. Recent research has shown it to be an effective antidote to both acute and sub-acute Aconite poisoning.
11. Compound Decoctions from TCM:
i. Fresh Ginger, Licorice, Mung Bean (Lu Dou), Black Soy bean (Hei Dou), Sophora Ku Shen; Coptis Huang Lian, Ginseng; Astragalus Huang Qi (dosage of each herb depends on symptoms)
ii. irregular Heartbeat: Sophora Ku Shen (20 grams), Licorice (10 grams).
iii. Cold extremeities and very weak pulse, Ginseng, Licorice, dry Ginger
Main Preparations used:
Prepared Aconite Root (Zhi Fu Zi)