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White Atractylodes: Bai Zhu 白朮

Bai Zhu (TCM)

Dark Atractylodes: Cang Zhu 苍术

Cang Zhu (TCM)
Whole wild Atractylodes (Bai Zhu) (Chengdu Medicine Market, Adam, 2017)

Sliced White Atractylodes (Bai Zhu) (Adam, 2016)

Botanical name:
Atractylodes spp.
Two different varieties are used in TCM:
  1. A. macrocephalae (White–Bai Zhu)
  2. A. lancea, A. chinensis (Dark–Cang Zhu)

Parts used:
Root, rhizome

Temperature & Taste:
Warm, dry. Bitter, sweet

Uses:
WHITE ATRACTYLODES
1. Tonifies Spleen, increases Qi, Clears Damp:
-digestive weakness with poor appetite, indigestion, diarrhea and weakness
-it can be used for Melancholy disorders associated with Damp

2. Dries Damp, Promotes Urine:
-Edema, fluid retention, reduced urination associated with Spleen deficiency
-good for fluid swelling of the lower body
-Damp-type joint and muscle Pain
-Leukorrhea
-useful for all Damp-Phlegm conditions associated with deficiency and Spleen weakness

3. Stabilises the Exterior, Stops Sweating:
-used for Sweating associated with deficiency
-it also strengthens the exterior to prevent acute attacks of Wind-Cold

4. Calms the Fetus, Prevents Miscarriage:
-good for Fetal Restlessness (overactive Fetus, heavy, dragging feeling in the lower abdomen during pregnancy along with weakness)
-good to strengthen the mother and fetus during pregnancy
-also good for Edema and fluid retention during pregnancy.


DARK ATRACTYLODES:
1. Dries Damp, strengthens the Spleen:
-stronger to dry damp but weaker to Tonify than the White.

2. Clears Wind-Damp, Promotes Sweat:
-Chills, Fever, headache and body aches, nasal congestion

3. Dries Damp, Promotes Urine:
-used as the White

4. Benefit the Eyes:
-Poor vision, Night-blindness


NOTE:
1. Two separate medicines come under the heading of Atractylodes: White (Bai Zhu) and Dark (Cang Zhu). The White is stronger to increase Qi and tonify the Spleen, for weakness and fatigue. The Red is stronger to alleviate Damp and also promotes sweat due to its warm and aromatic nature. They are combined for cases with both marked deficiency and damp. In cases where Bai Zhu is required but the person has significant Damp but less debility, Cang Zhu may replace Bai Zhu. In formulas requesting Cang Zhu, Bai Zhu may be used if there is marked debility.
2. The two Atractylodes are similar to the Inula (Elecampane) and Costus combination often used in Tibet and India. Inula is stronger to tonfy the Qi, Costus is stronger to move Qi and is more drying and aromatic. The two together more strongly strengthen the Spleen, tonfy Qi and clear Damp and Stagnation. The same can be said of the combination of White and Dark Atractylodes.

PREPARATION:
Bai Zhu:
1. Washed White Atractylodes (Piao Bai Zhu):
  The root or sliced root is soaked in Rice-rinse water, steamed until black, then sun-dried. This lessens its drying effect. It is better for Spleen weakness with Diarrhea.
2. Dry-fried White Atractylodes (Chao Bai Zhu):
  The root is dry-fried with Bran to enhance its Spleen tonifying effect. It may also be stir-fried with earth to enhance its effect against Diarrhea associated with Spleen weakness.
3, Scorched White Atractylodes (Jiao Bai Zhu):
  The sliced root is dry-fried until scorched, then sprayed with water and dried in the sun. This lessens its drying effect, but is better to strengthen the Spleen and Stomach and improve appetite and digestion.

Cang Zhu:
1. Prepared Dark Atractylodes (Zhi Cang Zhu):
  The root is soaked in Rice-rinse water, steamed until black, then sun-dried. This lessens its drying and dispersing effect and stops its diaphoretic effect. It is better for weak patients with excess Damp.
2. Dry-fried Dark Atractylodes (Chao Cang Zhu):
  The herb is either dry fried alone until darkened, or else dry-fried with bran or earth until yellowish-brown. This makes it more drying while reducing its drying and dispersing nature. That fried alone is better for Diarrhea; that fried with Bran is better to harmonise the Stomach; dry-frying with earth enhances the Spleen-tonifying effect.

DOSE:
The prepared types are used in the same doses as the unprepared root.
Bai Zhu (White Atractylodes): 6–15 grams in Decoction; 1.5–4 grams in powder
Cang Zhu (Dark Atractylodes): 3–9 grams; 1–3 grams in Powder

SUBSTITUTES:
1. Bai Zhu: Elecampane
2. Cang Zhu: Costus

Main Combinations:
WHITE ATRACTYLODES (Bai Zhu):
Spleen Deficiency
1. For Spleen and Qi deficiency with low appetite, fatigue, weakness, Atractylodes Bai Zhu with Ginseng (or Codonopsis Dang Shen), Poria Fu Ling and Licorice and in Si Jun Zi Tang [Four Gentlemen Decoction])
2. For Spleen and Stomach and Qi deficiency with Cold, Atractylodes Bai Zhu with Codonopsis Dang Shen and Ginger (as in Li Zhong Wan [Regulate the Middle Pill])
3. Poor digestion, nausea, loose bowels from Spleen weakness with Damp, Atractylodes Bai Zhu with Orange or Tangerine peel.
4. Diarrhea due to Damp and Spleen weakness, Atractylodes Bai Zhu with Plantain seed (Che Qian Zi)

Phlegm, Damp
5. Edema, combine Atractylodes Bai Zhu with Poria Fu Ling and Alisma Ze Xie.
6. Thin phlegm in the Chest or Edema and water retention associated with Spleen weakness, combine Atractylodes Bai Zhu, Cinnamon twig Gui Zhi and Poria Fu Ling.
7. Wind-Phlegm-type Dizziness, Vertigo and Headache, combine Atractylodes Bai Zhu with Pinella Ban Xia, Gatrodia Tian Ma (as in Ban Xia Bai Zhu Tian Ma Tang).

Other
8. Spontaneous Sweating:
i. associated with deficiency, combine Atractylodes Bai Zhu with Astragalus Huang Qi.
ii. with aversion to Wind, Atractylodes Bai Zhu with Astragalus Huang Qi and Saposhnikoviae Fang Feng (as in Jade Windscreen Powder [Yu Ping Feng San]). This formula is also effective for strengthening those that continually catch cold and to prevent infection during Epidemics.
10. Restless Fetus:
i. associated with Heat, combine Atractylodes Bai Zhu with Scutellaria Huang Qin.
ii. due to marked Qi deficiency (fatigue, pale face, breathless), combine with Astragalus Huang Qi; severe cases, add Ginseng to the above.
iii. associated with Kidney weakness (lower back pain, constant urination), combine Atractylodes Bai Zhu with Taxillus Sang Ji Sheng and Eucommia Du Zhong.
iv. from Blood deficiency, combine Atractylodes Bai Zhu with Rehmannia Shu Di Huang and Paeonia Bai Shao.
11. Senile Dementia, Atractylodes Bai Zhu with Ginseng, Rehmannia Shu Di Huang, Dang Gui, Licorice, Polygala Yuan Zhi (as in Qi Fu Yin)
12. Rheumatism, Atrcatylodes Bai Zhu, Sesame seed (Chinese Materia Medica, Stuauoft)
13. Pills to promote Longevity:
i. mix powdered Atractylodes Bai Zhu with Date pulp and form pills. (Chinese Materia Medica, Stuauoft)
ii. Atractylodes Bai Zhu with Lycium Gou Qi Zi, Mulberry (Sang Shen), powder and form pills with Honey. (Chinese Materia Medica, Stuauoft)
iii. Atractylodes Bai Zhu with Polygonum He Shou Wu, Black Beans, Chinese Red Dates (Da Zao), Lycium Gou Qi Zi, Mulberry (Sang Shen), powder and form pills with Honey. (Chinese Materia Medica, Stuauoft)


DARK ATRACTYLODES (Cang Zhu):
1. Spleen deficiency with excess Damp:
i. Damp obstruction, Edema and Leukorrhea, the two Atractylodes are combined.
ii. with abdominal distention, poor appetite, nausea, Atractylodes Cang Zhu with Magnolia bark (Hou Po), Citrus Chen Pi, fresh Ginger and Jujubes (Da Zao)
2. Sudden-onset Diarrhea in Summer or after eating too much, Atractylodes Cang Zhu and Medicated Leaven (Shen Qu) are formed into pills. (as in Qu Zhu Wan from Tai Ping Hui Min He Ji Ju Fang)
3. Heat and Damp in the lower body with pain, swelling and redness of the lower body or skin lesions associated with Wind, Heat and Damp, combine Atractylodes Cang Zhu with Phellodendron Huang Bai.
4. Damp diseases with excess Sweating, Atractylodes Cang Zhu with Anemarrhena Zhi Mu, Gypsum (Shi Gao) and Licorice.
5. External Wind-Cold-Damp, combine Atractylodes Cang Zhu with Notopterygium Qiang Huo, Angelica Bai Zhi, Levisticum Gao Ben
6. Distention and pain of the chest, epigastrium or abdomen due to Damp and Qi obstruction, combine Atractylodes Cang Zhu with Cyperus rotundus (Xiang Fu).
7. Cataracts, Night blindness, combine Atractylodes Cang Zhu with Black Sesame

Major Formulas:
BAI ZHU:
Ba Zhen Tang
Shi Quan Da Bu Tang
Ban Xia Bai Zhu Tian Ma Tang
Liu Jun Zi Tang
Xiang Sha Liu Jun Zi Tang
Bu Zhong Yi Qi Tang
Zhen Wu Tang
Dang Gui Shao Yan San
Yu Ping Feng San
Bai Zhu Shao Yao San
Xiao Yao San
Dan Zhi Xiao Yan San
Li Zhong Wan
Po Chai Pill

CANG ZHU:
Ping Wei San

Cautions:
1. As they are very drying, they are not suitable for dry and Yin deficient conditions.
2. Dark Atractylodes (Cang Zhu) is not used in cases of profuse sweating.

Main Preparations used:

Research:
(Last updated 9/2018)
BAI ZHU
1. IMMUNOSTIMULANT / IMMUNOREGULATORY:
–Polysaccharide of Atractylodes macrocephala Koidz (PAMK) Relieves Immunosuppression in Cyclophosphamide-Treated Geese by Maintaining a Humoral and Cellular Immune Balance.

2. ANTI-VIRAL:
–Antiviral activities of atractylon from Atractylodis Rhizoma.

3. ANTI-INFLAMMATORY:
–Inflammatory Inhibitory Activity of Sesquiterpenoids from Atractylodes macrocephala Rhizomes.

4. ANTI-OXIDANT:
–Anti-oxidant activity with inhibition of osteoclastogenesis by Atractylodes Rhizoma extract.

5. PREVENTS OBESITY (in mice)
–The Root of Atractylodes macrocephala Koidzumi Prevents Obesity and Glucose Intolerance and Increases Energy Metabolism in Mice.

6. INCREASES ENERGY METABOLISM (in mice)
–The Root of Atractylodes macrocephala Koidzumi Prevents Obesity and Glucose Intolerance and Increases Energy Metabolism in Mice.

7. NEUROPROTECTIVE (Components):
–Two new compounds from Atractylodes macrocephala with neuroprotective activity.
8. ANTI-TUMOR:
–Structural characterization and anti-tumor effects of an inulin-type fructan from Atractylodes chinensis. 

9. ANTI-CANCER:
OVARIAN:
–(component): Anti-Tumor Effects of Atractylenolide-I on Human Ovarian Cancer Cells.
LEUKEMIA:
–(component): Induction of apoptosis and differentiation by atractylenolide-1 isolated from Atractylodes macrocephala in human leukemia cells.

10. COLITIS:
–Heme Oxygenase-1 Induction and Anti-inflammatory Actions of Atractylodes macrocephala and Taraxacum herba Extracts Prevented Colitis and Was More Effective than Sulfasalazine in Preventing Relapse

11. GASTRO-PROTECTIVE:
–[Effect of Rhizoma Atractylodis extract in protecting gastric mucosa and modulating gastrointestinal immune function in a rat model of spleen deficiency].

12. PROMOTES GASTRIC FLORA:
–[Effect of Rhizoma Atractylodis extract in protecting gastric mucosa and modulating gastrointestinal immune function in a rat model of spleen deficiency].

13. HEPATOPROTECTIVE:
–Protective effect of a polysaccharide from Rhizoma Atractylodis Macrocephalae on acute liver injury in mice.