Hi all,

I have been thinking about this for a while now. And I have been experimenting both on myself and with patients. I guess that much of this has come about from the Fire Spirit schools being so much in the public eye as of late. I want to write down some random or semi-random thoughts on the use of Fuzi. Please feel free to add your own.

Fuzi can trigger negative reactions in the following situations:

When the pattern does not call for Fuzi. This is of course obvious and goes without saying. That said, what happens when a healthy person who doesn't need Fuzi is administered Fuzi? In my opinion there are two scenarios which are likely (in order of relevance)

If the internal environment is dry, whether that is yangming excessive dryness or shaoyin deficiency dryness, Fuzi is going to cause internal heat. In excess patterns this will be yangming dry heat with dry tongue, thirst, dry stool and vexation. In shaoyin patterns this will be rapid pulse, palpitations (heart racing), insomnia, dry mouth, hot flashes, decreased urination, bleeding, etc. Both patterns did not call for Fuzi in the first place and should have been easy to differentiate.

But it is the second scenario that is harder to catch. A lot of people have latent chronic shaoyang patterns. These can sometimes flare-up, at which times they are easy to spot. But sometimes they are subdued. These asymptomatic intervals do not represent harmony of shaoyang. When Fuzi is administered, the reactions are less obvious than in the dryness conditions. And therefore it is important to point them out.

First and foremost, these patients can develop headaches and sore throat. These are also the most likely patients to feel dizzy after ingestion of Fuzi. Regardless of the fact that dizziness is a good sign for positive clinical effects of Fuzi, here it indicates the flaring of the ministerial fire.As the imperial fire is stirred, the ministerial fire flares up violently, causing full body discomfort (malaise), alternating waves of warmth followed cold extremities, swollen lymph nodes, localized rashes especially in groin and armpits, and flare-ups of pre-existing skin conditions, especially of the likes of eczema or fungal conditions, as well as dry itchy eyes, rushing sounds in the ears, etc.These are the patients who can develop hypertension.

On top of that, when Fuzi formulas are given to patients who obviously need it (e.g. auto-immune conditions), but patients develop shaoyang symptoms, then the Fuzi formula, regardless of how well it is indicated,will NOT produce ANY expected results whatsoever. Then the formula needs to be discontinued, and the patient needs to be given a shaoyang formula, most preferably Chaihu Guizhi Ganjiang Tang. In other words, when you are certain a person needs Fuzi and the formula they are on should work, but it's not, it is DEFINITELY because they have a shaoyang pattern which needs to be harmonized first.

Lastly, since Fuzi warms up the small intestine, it is rather incompatible for patients who consume daily alcohol and who are because of it experiencing a "drinker's nose" (jiu zhao bi, chin.) (rosacea on the face due to alcohol) and hemmorhoids with slight blood loss noticeable on toilet paper (near-bleeding). In mild cases thses signs are ok to disregard and one can just carry out the treatment. But in severe cases one must first cool the small intestine's hot damp condition with a Zhizi formula, before pursuing the supply of proper fire to the SI. Under no circumstances should one use Chixiaodou and Fuzi at the same time since they will cancel each other out. I have not yet tried Fuzi and Zhizi at the same time, but I prefer to treat them separately. Remember, I personally don't treat shaoyang and shaoyin simultaneously, except for the Sini San jia Fuzi scenario, which is arguably not a full-on shaoyang pattern, nor does Fuzi here treat a full-on shaoyin pattern.

So, shelve the machismo and don't think that high doses of Fuzi will fix any problem, just because of the principle that yang is the ultimate answer to the riddle of life. It is a dangerous herb. That said, use it whenever you have to and at whichever dose you have to use it at. It is a life-saver. Just don't try to save lives with your eyes closed... Be aware and watch out for warning signs.

Respectfully,

Arnaud