Understanding the Chinese Medical Herb Aconite (Fuzi)

Authors: Hongxue Yao, Jenny Ou
Translator: Ping Wu
Editor: William Loung

May 20, 2017

Recently, the San Francisco aconite poisoning incident has caused public panic and social concern, as well as anxiety among Chinese medicine practitioners. To properly investigate this incident, eliminate public fear of taking aconite, and negative impact on Chinese medicine, and help mainstream society further its understanding and confidence in traditional Chinese medicine, the American Association of Chinese medicine is providing knowledge of the Chinese herb, aconite.

Aconite is a commonly used traditional Chinese medicine. It can also be called sliced aconite, salted aconite, black aconite, and white aconite. Aconitum is the root of the “Wutou” Ranunculaceae Aconitum carmichaeli Debx. It is produced in Jiangyou County in Sichuan province, China. There are 336 counties and cities and 10 provinces, including Shanxi, Guizhou, Hunan, Hubei, Gansu, Yunnan, Guangxi, Jiangxi, and Anhui that are suitable for aconite production. The nature of aconite is spicy, sweet, hot, and toxic. It goes to the heart, kidney, and spleen meridians. The indications for aconite use include the following: rescue Yang, tonify fire to raise Yang energy, and eliminate cold to stop pain. It is called “the number one first aid medicine to restore the Yang from dying.”

Aconite is effective for the following: it is widely used to treat shock from death of Yang; extremely cold limbs and faint pulse; impotence; cold uterus; cold pain at heart, stomach, and abdomen; cold vomiting and diarrhea; cold edema; Yang deficiency; exogenous, cold and damp pain; subcutaneous ulcer sore; and all chronic severe cold diseases. 

Usage and dosage:

Aconite is toxic when eaten raw. It must be cooked and properly processed. The general processing methods include these: Toasting, soaking, steaming, and boiling. Clinically used forms include toasted aconite or steamed aconite. After the preparation of aconite, toxicity is greatly reduced, but not fully eliminated, so aconite must be clinically used with caution, especially with regards to dosage. Though 3-15 grams is the typical range used, 18-30 grams may be used to rescue life from Yang collapse.

The boiling time is from one hour to one and a half hours. The purpose is to reduce the toxicity of aconite. For safety reasons, before taking it, one should get advice from a Chinese medicine practitioner who has been professionally trained. Chinese medicine practitioners generally use aconite in conjunction with other Chinese medicines in a single herbal formula prescription to inhibit the toxicity of aconite and to boost the effectiveness or function of aconite.

Attention and prohibition:

Pregnant women and breastfeeding women are prohibited from taking aconite. Aconite cannot be used with Pinellia, Trichosanthes, trichosanthin, Fritillaria, Ampelopsis japonica, or tubes of hyacinth bletilla. The toxic component of aconite, aconitine, mainly acts on the myocardium, vagus nerve, and peripheral nerve excitation, resulting in poisoning symptoms such as tongue numbness, limb numbness, tingling, dizziness, blurred vision, nausea, and vomiting. Severe aconite poisoning may lead to death. When people use herbal formulas containing aconite, they must pay attention to dosage of aconite, and the intake methods: never drink cold water or wine soaked with Aconite; must cook the herbal formula with drinking water for a long time to eliminate aconite toxicity, and so that its treatment becomes effective.

Poisoning treatment procedures:

Go to a nearby hospital emergency department or call 911 for help.

Chinese medicine procedures:

Chinese medicine with green beans or honeysuckle can detoxify. Treatment of aconitine poisoning prescription is sweet soil mung bean soup, which includes the following: licorice 100g, soil Fuling 50g, and mung bean 50g. Licorice root can inhibit the toxicity of aconitine, as aconitine’s antidote.

Western medicine procedures:

1, toxicology confrontation: the key is to use atropine in the early stage with adequate, repeatedly maintaining the principle of atropinization, timely heart auscultation and ECG examination to find any cardiac damage that can be quickly treated.

2, the protection of heart damage: aconitine poisoning the heart is mainly through the excitement of the vagus nerve and myocardial damage caused by the clinical manifestations of arrhythmia and conduction blockage. Ventricular arrhythmias like Ventricular premature beats, often multi-source, pleomorphic, premature atrial contraction, premature ventricular contraction, atrial fibrilation, sinus bradycardia, duo-Ventricular premature beats, and triple-Ventricular premature beats are also more common; Lidocaine used for ventricular premature beat treatment is effective.

3, the treatment of complications: the key to treatment of complications is to correctly deal with pulmonary edema, brain edema, arrhythmia and dilution of the contradiction between the toxins. A large number of infusions is one of the measures to rescue, on the one hand fasting patients need to add calories and electrolytes, and on the other hand toxins can be diluted.

  1. Clinical application:

4.1. To rescue one from yang collapse, which usually has sets of symptoms of either faint pulse, spontaneous cold sweat throughout the entire body, and extremely cold limbs; or extreme sweat, vomiting, and life-threatening Yang collapse. Aconite is often used with ginseng, ginger, and roasted licorice root. If the non-stop sweating and Yang collapse become life threatening, besides aconite and ginseng, keel (Long Gu) and oyster shells must be added. If heavy bleeding is causing extremely cold limbs, sweating, and faint pulse, then ginseng, ginger, aconite, and oyster shell can be used with Ophiopogon japonicus (Mai Dong), and Schisandra chinensis (Wu Wei Zi) to rescue one from Yin and Yang collapse.

4.2. For kidney deficiency, aversion to cold, extremely cold limbs, weak spleen yang, abdominal pain, and loose stools. Deficient kidney Yang causes weak life gate fire, aversion to cold, cold limbs, impotence, and frequent urination; aconite can be used with cinnamon, Rehmannia, seed of cuscuta sinensis, and cornus. If weak spleen yang, stomach and abdomen cold pain, loose stool or diarrhea, aconite can be used with Codonopsis, Atractylodes, dried ginger, and roasted licorice root.

4.3. For the wind cold dampness Bi syndrome, whole body pain, joint pain and arthritis, aconite can be used with Cassia Twig (Gui Zhi) and other hebs.

  1. Modern pharmacological effects associated with aconite efficacy:

5.1. Strengthening the heart

Aconite can enhance myocardial contractility, speed up heart rate, cardiac output, and increase myocardial oxygen consumption.

5.2. Effects on blood vessels and blood pressure

Aconite can either increase or decrease blood pressure depending on its percentage of components.

5.3. Anti-shock

Heart-kidney yang vacuity causes extremely cold limbs, faint pulse, and similar symptoms to modern medicine shock.

5.4. Anti-cardiac arrhythmia

Aconite has a significant effect on anti-bradycardia.

5.5. Anti-cold, improve the ability to withstand hypoxia

5.6. Have anti-inflammatory, analgesic effect

5.7. Other pharmacological effects include sedation, calming spirit and local anesthesia

  1. Aconite diet therapeutic values:

Usage: in case of yang collapse, spontaneous sweating, cold limbs, faint pulse, kidney yang deficiency, impotence, frequent urination, cold uterus infertility, spleen-kidney yang deficiency, abdomen cold pain, loose stool diarrhea, yang deficiency edema, inhibited urination, cold damp pain (Bi), and cold joint pain

Method: cook 15g of aconite over an hour until it does not taste spicy; prepare porridge, cooked aconite and other vegetables.

Caution: the toxicity of aconite is due to alkali inside Aconitum carmichaeli Debx. (Aconite is the only ingredient that has toxins to be eliminated.) However, extended cooking of aconite will eliminate the toxicity, so consumers must follow the correct cooking directions for their safety. Aconite can also be used to treat Yang collapse or Yang diversion, but it is better to get treated by a doctor.

Aconite formula

Aconite porridge: processed aconite 10g, fried or roasted ginger 15g, rice 100g. Grind processed aconite and fried ginger into powder of which 5g is added into rice cooked as porridge. In addition half of the two herbs can be boiled for at least 1.5 hours with water, then mixed with the rice porridge.

According to the <> formula, aconite is used to warm the interior to dispel cold. Fried or roasted ginger warms the middle jiao to dispel and stop diarrhea. It is used to treat interior cold, abdomen pain, diarrhea, and loose stool.

Aconite mutton soup: processed Aconite 25g, mutton 1000g. Lamb or mutton meat is washed, cut into pieces, removed of bloody water, cooked with aconite slices in boiling water. After, add raw ginger, onions, pepper, and salt, and cook until the meat is well cooked. The aconite mutton soup makes four servings.

This formula uses slices of aconite to warm kidney to raise Yang, supplemented by mutton meat which warms kidney yang, and raw ginger and pepper, which are helpful to yang qi (energy). The formula also treats cold limbs due to yang deficiency, frequent urination at night, abdominal cold pain, and low back pain.

Porridge with the Aconite slice Jobstears Seed: slices of aconite 10g, Jobstears Seed 30g, rice 100g. Boil Aconite slices with water for at least 1.5 hours, then add Jobstears Seed and rice, and cook porridge. This produces two servings.

In this formula, slices of Aconite dispel cold to stop pain, Jobstears Seeds remove dampness and relax the tendons. It is used to treat wind cold dampness Bi, joint pain, and muscle spasms.

  1. Conclusion:

From ancient times to the present day aconite has both medical and therapeutic effects. A famous Chinese medicine professor at The Yunnan Chinese Medicine University, Rongzu Wu is the author of many books about “Yunnan Huo (fire) Shen Branch” (云南火神派), and also third generation successor. His grandfather, Mr. Peiheng Wu, is one of the four well-known doctors in the Yunnan province. He was well known as “Fuzi Wu” because he mastered the use of aconite. He was recognized as the pioneer of Chinese medicine herbal formula as well as the founder of Yunnan Huo Shen Branch. He was the author of << Peiheng Wu medical clinical case study >>, << Peiheng Wu Chinese medicine top ten master talk >>, << Aconite (FuZi) pharmacological and clinical application >>, and << Chinese herbal medicine briefing >>. He summarized the distinctions between cold and heat syndromes with sixteen word tips: cold symptoms are demonstrated by “feeling heavy and extreme cold, lying down with closed eyes, low voice and short of breath, lack of speech and qi (energy)”; heat syndromes are demonstrated by “feeling light, aversion to heat, insomnia with eyes open, loud voice, bad breath with coarse breathing”. Because he emphasized the importance of yang qi (energy), he was good at using aconite. Therefore, he left behind many medical clinical experiences for the next generation of “Shen Huo (fire) branch” students to learn.

About the toxicity of aconite, Mr. Wu Rongzu answered the Shenzhen Crystal Newspaper question “Your grandfather Mr. Wu Peiheng was well known to use aconite, but we know that aconite itself is toxic. This is also the dialectical thinking of Chinese medicine?” by replying “Yes, Aconite is like Electricity: lightning which can kill people, but if you can tame or manipulate it, it can benefit mankind. Aconite is an excellent herb to treat cold disease, but it worsens heat disease. Because applying aconite on patient with hot disease is like adding fuel to fire. Syndrome differentiation is the core of Chinese medicine, and is also the essential elements of traditional Chinese medicine”.

In the 1980s, there was a popular saying: “The Wu family cooked a huge pot of aconite all day long for the patients to use. When the last patient left, they put the rest of the aconite on the dining table as food. This may sound a bit exaggerated, but day and night people continued to wait at the door of the Wu’s. This is a fact. But “Wu aconite” and his descendants’ creative application of aconite make it a legend of traditional Chinese medicine.

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