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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

Classification:
Bai Zhu: N. Qi Tonic
Cang Zhu: J. Aromatics that Resolve Dampness

Uses:
Bai Zhu: 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:
-Sweating associated with deficiency
-strengthens the exterior defense to prevent acute attacks of Wind-Cold or Epidemics

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

Cang Zhu: DARK ATRACTYLODES:
1. Dries Damp, Strengthens the Spleen:
-Damp obstructing the digestive system (poor appetite, loose bowels, nausea, fatigue)
-stronger to dry damp but weaker to Tonify than the White.

2. Clears Wind-Damp, Promotes Sweat:
-acute Wind-Cold conditions (Chills, Fever, headache and body aches, nasal congestion)
-Wind-Damp conditions (muscles and joint pain)

3. Dries Damp, Promotes Urine:
-Damp-Heat in the lower body (Damp-Heat in the legs, vaginal discharge, swollen sore joints)

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

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

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.

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:
i. Atractylodes Cang Zhu with Astragalus Huang Qi, Poria Fu Ling
ii. Atractylodes Cang Zhu with Anemarrhena Zhi Mu, Gypsum (Shi Gao) and Licorice.
5. External Wind-Cold-Damp:
i. Atractylodes Cang Zhu with Saposhnikovia Fang Feng, Cyperus rotundus Xiang Fu
ii. 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: