Evodia rutaecarpa is the nearly mature fruit of the plant Evodia rutaecarpa from the Rutaceae family. It was historically produced in the "Wu region," hence its name. In Wang Wei's poem "Remembering My Brothers on the Double Ninth Festival," the line "With dogwood in hand, one person is missing" refers to this plant. It is mainly produced in Guizhou, Guangxi, Hunan, Sichuan, and other regions. When processed with licorice decoction, it can moderate the potency of the medicine.
Evodia rutaecarpa is one of the "Six Aged Medicinals" in traditional Chinese medicine. The so-called "Six Aged Medicinals" refer to six Chinese herbs: aged tangerine peel, aged pinellia tuber, aged bitter orange, aged ephedra, aged langdu, and aged evodia rutaecarpa. These herbs are stored for an extended period to reduce their harsh and intense properties, making their medicinal effects milder and more suitable for clinical application, hence the name "Six Aged Medicinals."
I. Efficacy and Application
Evodia Fruit tastes pungent and extremely bitter, it is extremely hot in property and slightly toxic. It has both strong smell and taste, and is a yang within yin medicinal. It belongs to the liver, spleen and stomach meridians.
Efficacy It can disperse cold and relieve pain, soothe the liver and direct qi downward, and dry dampness. Its characteristic is its strong ability to treat Jueyin internal cold, warm the liver, and dry dampness, making it a key herb for Jueyin headache and internal cold diarrhea.
Commonly used for the treatment of Jueyin headache, cold hernia with abdominal pain, cold-damp foot qi, menstrual abdominal pain, epigastric and abdominal distension and pain, vomiting and acid regurgitation, early morning diarrhea, and other syndromes.
Summary of Famous Works by Renowned Authors:
"Ben Jing": "Warm the middle and direct qi downward, relieve pain, treat cough and dyspnea, chills and fever, eliminate dampness and blood impediment."
Bie Lu: "It dispels cold phlegm, alleviates abdominal colic, resolves various cold accumulations and indigestion, treats sudden attacks of evil influences, relieves heart and abdominal pain, counteracts rebellious qi, and benefits the five zang organs."
Bencao Yanyi: "Evodia rutaecarpa is the fastest at directing qi downward, and people with intestinal deficiency will experience more severe symptoms after taking it."
Compendium of Materia Medica: "Evodia fruit, pungent and hot in nature, can disperse and warm; bitter and hot, can dry and strengthen. The conditions it treats all rely on its functions of dispersing cold, warming the middle, drying dampness, and relieving stagnation."
"Ben Cao Jing Shu": "The qi of the spleen and stomach prefers warmth and dislikes cold. Cold causes the middle qi to fail in transportation and transformation, leading to either undigested cold accumulation, or severe abdominal pain, or the stagnation of cold phlegm, resulting in rebellious qi causing cough and disharmony among the five zang organs. Evodia rutaecarpa, with its pungent and warm nature, warms the spleen and stomach and disperses cold pathogens, thereby warming the middle, directing qi downward, and eliminating all symptoms."
"Changsha Materia Medica": "Evodia rutaecarpa is pungent and drying, draining dampness and expelling cold, warming the middle and promoting movement, lowering stomach rebellion to stop vomiting, raising spleen sinking to eliminate diarrhea and dysentery, draining chest and diaphragm fullness and oppression, dispersing foot and knee swelling and pain, transforming cold phlegm and cold rheum, removing belching and acid regurgitation, expelling all cold bi in the channels and joints, calming various cold pains in the heart, abdomen, chest, and head, applying heat to treat various abdominal masses, killing various worms in the organs, treating cholera with cramping, and curing hernia pain and prolapse."
"Compendium of Materia Medica": Moistens the liver and dries the spleen, warms the middle and directs qi downward, eliminates dampness and relieves depression, dispels phlegm and kills parasites, opens the interstices, and expels wind-cold. Treats Jueyin headache, yin toxin abdominal pain. Food stagnation diarrhea and dysentery, blood impediment yin hernia, hemorrhoids and intestinal wind, beriberi edema, mouth and tongue sores.
In the ancient Chinese medical text "Fu Xing Jue," there are the Greater and Lesser Six Deity Decoctions, which correspond to the twelve commonly used classical formulas in "Shang Han Lun." The main herbs in these formulas should be emphasized. Specifically, these include: the Lesser and Greater Yang Dan Decoctions, which are the Guizhi Decoction and Huangqi Jianzhong Decoction with added Ginseng from "Shang Han Lun," with the main herbs being Huangqi and Guizhi; the Lesser and Greater Yin Dan Decoctions, which are the Huangqin Decoction with added Ginger and the Xiaochaihu Decoction with added Peony from "Shang Han Lun," with the main herbs being Chaihu and Huangqin; the Lesser and Greater Qinglong Decoctions, which are the Mahuang Decoction and Xiaoqinglong Decoction from "Shang Han Lun," with the main herb being Mahuang; the Lesser and Greater Baihu Decoctions, which are the Baihu Decoction and Zhuye Shigao Decoction with Ginseng replacing Ginger from "Shang Han Lun," with the main herb being Shigao; the Lesser and Greater Zhuniao Decoctions, which are the Huanglian Ejiao Jizihuang Decoction and Huanglian Ejiao Jizihuang Decoction with added Ginseng and Dried Ginger from "Shang Han Lun," with the main herbs being Jizihuang and Huanglian; and the Lesser and Greater Xuanwu Decoctions, which are the Zhenwu Decoction and Zhenwu Decoction with Dried Ginger replaced by Ginger and added Ginseng and Licorice from "Shang Han Lun," with the main herb being Fuzi. According to the author's perspective, based on the original text of "Fu Xing Jue," three additional herbs should be included: Guizhi, Huangqin, and Huanglian. The main herbs in all these formulas total nine: Huangqi, Guizhi, Chaihu, Huangqin, Mahuang, Shigao, Jizihuang, Huanglian, and Fuzi. Except for Jizihuang, which is less commonly used today, the other herbs should be studied intensively, as they form the foundation of clinical practice in traditional Chinese medicine.
II. Compatibility and Application
1. For cold pain in the epigastrium and abdomen, hernia pain, headache, and diarrhea due to deficiency and cold. Evodia fruit can warm the middle and dispel cold, and it is also good at relieving stagnation in the liver meridian, providing excellent analgesic effects. For treating cold pain in the epigastrium and abdomen, it is often combined with dried ginger, costus root, and other herbs that warm the middle and promote qi flow.
For treating cold hernia with abdominal pain, it is often combined with Lindera aggregata and fennel.
For the treatment of chronic diarrhea or early morning diarrhea caused by spleen and kidney yang deficiency, it is often combined with Psoralea corylifolia, Myristica fragrans, Schisandra chinensis, etc., which is known as Sishen Wan.
If treating liver and stomach deficiency cold with turbid yin ascending counterflow syndrome, manifesting as nausea after eating, or vomiting sour fluid, or dry heaving, or spitting clear, cold, frothy saliva, chest fullness and epigastric pain, vertex headache, aversion to cold and cold limbs, even accompanied by reversal cold of the hands and feet, diarrhea, restlessness and agitation, pale tongue with white, slippery coating, deep and wiry or slow pulse, it is often combined with ginseng, fresh ginger, and jujube for application, which is the main formula for Jueyin disease, Evodia Decoction.
Huang Yuanyu said: "For treating Jueyin disease, with dry retching, spitting of frothy saliva, and headache. It is due to earth deficiency and wood stagnation, the middle qi being attacked, stomach qi ascending instead of descending, turbid qi rushing upward, thus causing headache and dry retching. Damp qi congeals and stagnates, thus often spitting frothy saliva. Ginseng and jujube nourish earth and tonify the middle, while evodia and ginger descend counterflow and soothe wood."
2. For cold-damp beriberi with pain, or upward rushing into the abdomen causing distress and a feeling of impending death. Evodia rutaecarpa can both disperse cold and dry dampness, as well as direct rebellious qi downward. It is often combined with Chaenomeles speciosa, Areca catechu, and Citrus reticulata, as in the formula Jī Míng Sǎn.
3. For vomiting and acid regurgitation. Evodia rutaecarpa can warm the liver, direct qi downward, and stop vomiting. For treating vomiting due to stomach cold, it is often combined with warming and antiemetic herbs such as ginger and pinellia.
If treating liver depression transforming into fire, vomiting and swallowing acid, Evodia rutaecarpa is often combined with Coptis chinensis, pungent opening and bitter descending, stopping vomiting and controlling acid, namely Zuojin Pill. This formula is commonly used in modern times for various diseases mainly characterized by hypochondriac pain, stomach heat, acid reflux, and vomiting of saliva, with significant therapeutic effects, worthy of study.
4. For guiding fire downward. To treat mouth and tongue sores, you can grind evodia rutaecarpa into powder, mix it with vinegar, and apply it to the soles of the feet. This can guide fire downward and cure the condition overnight.
5. Usage of Evodia in "Treatise on Cold Damage Diseases". Evodia has a pungent taste and warm nature, capable of warming the middle and dispelling cold, descending qi, and relieving pain. For treating Taiyin internal deficiency-cold syndrome, characterized by abdominal pain, headache, vomiting, cold limbs, and fine pulse, it is often combined with ginger, dried ginger, aconite, croton, and ginseng, as seen in formulas such as Evodia Decoction and Nine-Pain Pill.
If treating the combination of Taiyang and Taiyin syndromes, with cold limbs and chronic internal cold, it is often combined with cinnamon twig, ginger, asarum, and angelica, known as Danggui Sini Jia Wuzhuyu Shengjiang Tang.
If treating Jueyin syndrome, or cold in the lower abdomen of women, or accompanied by metrorrhagia and blood loss, or excessive menstrual flow, or delayed menstruation, it is often combined with Angelica sinensis, Ophiopogon japonicus, donkey-hide gelatin, and moutan bark, which is known as Wenjing Decoction.
III. Usage and Dosage
Evodia is often used in decoctions and can also be made into pills or powders. The usual dosage in decoctions ranges from a few grams to over ten grams. For external use, apply an appropriate amount.
Due to its pungent, dry, and extremely hot nature, which easily damages yin, Zhang Zhongjing applied it by first rinsing it several times with boiling water before adding it to the medicine, in order to reduce its harsh and intense properties. However, the dosage of Evodia rutaecarpa used in Zhang Zhongjing's prescriptions was quite large, with one dose equivalent to over 50 grams today. Therefore, the method of rinsing with boiling water before adding it to the medicine was adopted. In modern practice, the dosage used by physicians is typically only a few grams, so it can also be decocted together with other herbs. Nevertheless, when a larger dosage is required, it is still advisable to refer to Zhang Zhongjing's method for greater safety.
Washing away the bitter taste, drying in the sun, and pounding into pieces for use.
Huang Yuanyu said, "Wash several times with hot water."
Wang Ang said: "Soak to remove the bitter and strong juice before use. It must be soaked several times. For stopping vomiting, stir-fry with coptis water; for treating hernia, stir-fry with salt water; for treating blood disorders, stir-fry with vinegar."
IV. Application Precautions
Evodia fruit is pungent, hot, and dry in nature, and it tends to damage qi and stir fire. Therefore, it is contraindicated for those with yin deficiency and heat.
The taste of Evodia fruit is extremely bitter and very difficult to swallow, so it is best to avoid using it whenever possible.
Li Dongyuan said: "It should not be used excessively, as its pungent and hot nature may harm the primordial qi."
Li Shizhen said, "Excessive consumption may cause internal heat and harm the eyes."
Wang Ang said: "It moves qi and stirs up fire, causing dizziness and sores, and is contraindicated for those with blood deficiency and fire."
Practical Notes on Traditional Chinese Medicine: Second Draft at Noon on January 19, 2021#TCM Practical Notes#
