White Atractylodes Rhizome is the rhizome of the plant Atractylodes macrocephala from the Asteraceae family. It is mainly produced in provinces such as Zhejiang, Hubei, Hunan, and Jiangxi. The variety produced in Yuqian, Zhejiang is considered the authentic medicinal material, hence it is also known as "Yu Shu." For medicinal use, it is categorized into raw White Atractylodes Rhizome and stir-fried White Atractylodes Rhizome. If stir-fried until dark brown, it is referred to as charred White Atractylodes Rhizome.
I. Efficacy and Application
White Atractylodes Rhizome tastes bitter and sweet, and is warm in nature. It belongs to the spleen and stomach meridians.
Efficacy It can tonify qi, strengthen the spleen, dry dampness, promote diuresis, stop sweating, and calm the fetus. Its characteristics include being good at tonifying spleen qi and calming the fetus, having the function of strengthening the "acquired constitution," and being able to promote diuresis and eliminate dampness. It is one of the "Four Gentlemen" in traditional Chinese medicine and is praised by physicians as an essential herb for tonifying qi and strengthening the spleen, as well as a key herb for treating phlegm retention and edema.
It is commonly used for the treatment of conditions such as spleen deficiency with reduced appetite, abdominal distension and diarrhea, phlegm retention with dizziness and palpitations, edema, spontaneous sweating, and fetal restlessness.
Abstracts of Famous Works by Renowned Authors:
The Classic of Materia Medica: "It primarily treats wind-cold-damp impediment, dead flesh, tetany, jaundice, stops sweating and eliminates heat, and disperses food."
Bie Lu: "It resolves phlegm and water, eliminates wind-water accumulation and swelling between the skin, warms the stomach, promotes digestion, and increases appetite."
"Pearl Pouch": "Eliminates dampness and boosts qi, tonifies the middle and supplements yang, dissolves phlegm and expels water, promotes fluid production and quenches thirst, stops diarrhea and dysentery, reduces swelling in the lower legs."
Compendium of Materia Medica: The spleen detests dampness. When dampness prevails, qi cannot circulate and transform, so how can fluids be generated? Therefore, it is said: The bladder is the reservoir of fluids, and only through qi transformation can they be discharged. Using Atractylodes macrocephala to eliminate dampness allows qi to circulate freely, thereby generating fluids.
"Ben Jing Feng Yuan": "Raw Atractylodes macrocephala has the effects of removing dampness, benefiting dryness, eliminating phlegm, promoting diuresis, treating wind-cold-dampness arthralgia, dead muscle spasms and jaundice, dispersing blood stasis around the waist and navel, and addressing disorders of the Chong meridian, counterflow qi, and internal urgency. When processed, it has the effects of harmonizing the middle, supplementing qi, quenching thirst, promoting fluid production, stopping sweating, clearing heat, improving appetite, and calming the fetus."
Changsha Materia Medica: "Atractylodes macrocephala replenishes the middle and dries dampness, quenches thirst and promotes fluid production, greatly benefits spleen essence, nourishes stomach qi, lowers turbid yin to improve appetite, effectively stops vomiting, raises clear yang to aid digestion, and can treat diarrhea."
Ben Cao Bei Yao: "It replenishes blood in the blood and qi in the qi. It can induce sweating when there is no sweat and stop sweating when there is sweat. By drying dampness, it can promote urination, generate fluids, stop diarrhea, resolve phlegm and edema, and treat jaundice and damp impediment. By tonifying the spleen, it can improve appetite, relieve fatigue, stop muscle fever, and dissolve abdominal masses. By harmonizing the middle, it can stop vomiting, alleviate pain, and calm the fetus."
"Medical Records of Integrating Chinese and Western Medicine": "It is good for strengthening the spleen and stomach, resolving phlegm and dampness, and stopping diarrhea. It treats spleen deficiency causing distension, spleen dampness causing thirst, spleen weakness leading to weakness in limb movement, and even pain."
II. Compatibility and Application
1. For symptoms such as reduced appetite, loose stools, abdominal distension, and fatigue caused by spleen qi deficiency and impaired transportation and transformation. Atractylodes macrocephala is a key herb for tonifying qi and strengthening the spleen. To treat spleen qi deficiency, physical weakness, fatigue, and various deficiencies, it is often combined with ginseng, poria, and licorice, forming the renowned formula for tonifying deficiency, the Four Gentlemen Decoction. Based on the Four Gentlemen Decoction, with modifications and adaptations, it serves as the foundation for numerous tonifying formulas and is one of the most commonly used prescriptions in clinical traditional Chinese medicine, which should be emphasized for mastery.
The Four Gentlemen Decoction may appear simple in its formulation, yet it embodies the profound principle that "strengthening the body's vital energy and consolidating its foundation is the key to treating all diseases." In the medical records of the renowned Japanese classical formula expert, Otsuka Keisetsu, it is frequently documented that by modifying the Four Gentlemen Decoction and having patients take it over an extended period, numerous cases of severe consumptive diseases were successfully cured.
If treating spleen and stomach deficiency cold, epigastric and abdominal cold pain, loose stools, it is often combined with Codonopsis pilosula, dried ginger, honey-fried licorice, etc., which is Lizhong Decoction. In Peng Ziyi's "Axle-Wheel Theory," Lizhong Decoction is the foundational formula for the "moving the wheel with the axle" method and also the primary formula for strengthening the acquired foundation.
If treating spleen deficiency diarrhea and spleen lung deficiency, it is often combined with ginseng, poria, tangerine peel, etc., such as Ginseng, Poria and Atractylodes Macrocephala Powder, Seven Ingredients Atractylodes Macrocephala Powder, etc. It is a representative formula of "cultivating earth to generate metal", worthy of study.
If treating spleen deficiency with accumulation and stagnation, poor appetite, and epigastric fullness, one can use the method of both attacking and tonifying, using Atractylodes macrocephala to strengthen the spleen, combined with Citrus aurantium to eliminate fullness, which is the Citrus Aurantium and Atractylodes Pill.
2. For spleen deficiency leading to impaired transportation and transformation, water-dampness retention, phlegm-fluid retention, and edema, Atractylodes macrocephala can tonify qi and strengthen the spleen, as well as dry dampness and promote diuresis, making it a key herb for treating phlegm-fluid retention and edema. For various water-qi disorders, it is often combined with cinnamon twig, poria, and licorice, as in the Ling Gui Zhu Gan Decoction.
In addition, there are many classical prescriptions such as Wuling Powder, Zhenwu Decoction, Fuzi Decoction, and Zexie Decoction, all of which adopt the method of "strengthening the earth to control water" and are used to treat various phlegm-fluid retention and edema syndromes, all of which must be mastered.
3. For spleen deficiency with qi weakness, and external deficiency with spontaneous sweating syndrome. Atractylodes macrocephala can replenish qi and strengthen the spleen, and has the effect of consolidating the exterior to stop sweating. For treating external deficiency with spontaneous sweating and qi failing to restrain yin syndrome, it is often combined with Astragalus membranaceus and Saposhnikovia divaricata, known as Jade Screen Powder. In the formula from "Complete Guide to Pediatric Care," it is combined with Astragalus membranaceus and light wheat to treat persistent deficiency sweating.
4. For pregnancy with spleen deficiency and qi weakness, and fetal restlessness syndrome. Atractylodes can tonify qi and strengthen the spleen, and also has the function of calming the fetus. For treating fetal restlessness, if accompanied by internal heat, it is often combined with Scutellaria baicalensis to clear heat and calm the fetus; if accompanied by qi stagnation with chest and abdominal distension, it is often combined with qi-regulating herbs such as Perilla stem, Amomum villosum, and dried tangerine peel; if accompanied by qi deficiency with shortness of breath and weakness, it is often combined with qi-tonifying herbs such as Codonopsis pilosula, Poria cocos, and honey-fried licorice; if accompanied by blood deficiency with dizziness and palpitations, it is often combined with blood-tonifying herbs such as Rehmannia glutinosa (prepared), Angelica sinensis, and Paeonia lactiflora; if accompanied by unstable fetal origin with sore waist and abdominal pain, it is often combined with liver and kidney tonifying herbs such as Eucommia ulmoides, Dipsacus asper, and donkey-hide gelatin to stabilize the fetal origin.
III. Usage and Dosage
White Atractylodes Rhizome is often used in decoctions and can also be made into pills or powders. The usual dosage in decoctions is over ten grams. If it serves as the main ingredient in a prescription, it can be used in doses of several tens of grams or even larger amounts.
The efficacy of raw Atractylodes macrocephala is also related to the dosage. Using more than ten grams can strengthen the spleen and stop diarrhea, while a large dose of tens of grams, or even over a hundred grams, can instead promote bowel movements.
It is generally believed that the raw form is suitable for drying dampness and promoting diuresis, the stir-fried form for tonifying qi and strengthening the spleen, and the charred stir-fried form for strengthening the spleen and stopping diarrhea.
IV. Application Notes
White Atractylodes Rhizome is prone to damage yin due to its drying and dampness-removing properties, thus it is only suitable for conditions with dampness in the middle jiao. It should not be taken by those with yin deficiency and internal heat or those experiencing excessive thirst due to fluid depletion.
Huang Yuanyu said, "Atractylodes macrocephala has a rather congesting and stagnating nature, so it should be assisted with dispersing and unblocking substances. If the lung and stomach fail to open, add ginger and pinellia to expel turbidity; if the liver and spleen fail to circulate, add amomum and cinnamon twigs to promote the flow of stagnation. By allowing it to both tonify and circulate simultaneously, it achieves excellence without drawbacks."
Wang Ang said: "Atractylodes macrocephala is contraindicated for those with blood dryness and no dampness. It can promote pus formation and cause pain, so it should be avoided in cases of ulcers."
Practical Notes on Traditional Chinese Medicine: Revised on the afternoon of January 10, 2021
