Stephania Tetrandra is the root of the plant Fourstamen Stephania Root from the Stephania Tetrandra family or Cocculus Root from the Dutohmanspipe Fruit family. The former is called Fourstamen Stephania Root and is mainly produced in Zhejiang, Anhui, Hubei, Jiangxi, and other places; the latter is called Cocculus Root and is mainly produced in Guangdong, Guangxi, and other places. The original plant grows on slopes, open fields, and in shrublands. It prefers a warm and humid climate, is intolerant to drought and waterlogging, and thrives best in well-drained, deep, and fertile sandy soil. It has a bitter and pungent taste and a cold nature. It belongs to the bladder, kidney, and spleen meridians. Its effects include dispelling wind-dampness, relieving pain, and promoting diuresis. The clinical name is Stephania Tetrandra.
bubble_chart Compendium of Materia Medica
Shennong Bencao Jing: It has a pungent taste and a neutral nature. It is used to treat wind-cold, warm syndromes, heat qi, various epilepsy conditions, expel evil qi, and promote urination and defecation.
Mingyi Bielu: It has a bitter taste, warm nature, and is non-toxic. It is used to treat edema, wind swelling, remove bladder heat, cold-damage disease, cold pathogenic heat qi, apoplexy, spasms of the hands and feet, stop diarrhea, disperse abscesses and swellings, malignant nodules, various scabies and ringworm, insect sores, open striae and interstice, and benefit the nine orifices.
Bencao Shiyi: The Han attribute it to water qi, while the wood attribute it to wind qi, promoting circulation. It grows as a vine on wood, and when blown, air passes through one end like Ricepaperplant Pith.
Yaoxing Lun: Fourstamen Stephania Root, a sovereign herb, has a bitter taste and is slightly toxic. It can treat damp wind, facial deviation, pain in the hands and feet, disperse retained phlegm, and is used for lung qi cough and asthma.Cocculus Root, an envoy herb, is incompatible with Radix Asteris and Halite, and has a bitter and pungent taste. It can treat male limb joint apoplexy, toxic wind causing muteness, disperse stagnant qi and swellings, warm malaria wind edema, and treat the bladder.
Kaibao Bencao: It has a pungent and bitter taste, neutral and warm nature, and is non-toxic. It treats edema, wind swelling, removes bladder heat, cold-damage disease, cold pathogenic heat qi, apoplexy causing spasms of the hands and feet, stops diarrhea, disperses abscesses and swellings, malignant nodules, various scabies and ringworm, insect sores, opens striae and interstice, and benefits the nine orifices.
Yaolei Faxiang: Fourstamen Stephania Root has a cold nature and a very bitter taste.
It treats dampness-heat swelling from the waist down to the feet and beriberi. It tonifies the bladder, removes retained heat, and circulates through the twelve meridians.
Tangye Bencao: It circulates through the twelve meridians.
Yaolei Faxiang: It treats dampness-heat swelling from the waist down to the feet and beriberi, tonifies the bladder, removes retained heat, and circulates through the twelve meridians. Use after removing the skin.
Shennong Bencao Jing: It treats wind-cold, warm malaria, heat qi, various epilepsy conditions, expels evil qi, and promotes urination and defecation. It treats edema, wind swelling, removes bladder heat, cold-damage disease, cold pathogenic heat qi, apoplexy, spasms of the hands and feet, stops diarrhea, disperses abscesses and swellings, malignant nodules, various scabies and ringworm, insect sores, opens striae and interstice, and benefits the nine orifices.
Yaoxing Lun云: Fourstamen Stephania Root, a sovereign herb. Also, Cocculus Root, an envoy herb. It is incompatible with Radix Asteris and Halite. It removes blood dampness stroke heat.Bencao Yanyi Buyi: It has a cold nature, bitter and pungent taste, and is yin within yang. It treats dampness-heat swelling from the waist down to the feet, tonifies the bladder, removes retained heat, circulates through the twelve meridians, and treats apoplexy and spasms of the hands and feet. Shennong Bencao Jing: Fourstamen Stephania Root, a sovereign herb; Cocculus Root, an envoy herb. The Han attribute it to water qi, while the wood attribute it to wind qi. Also, Cocculus Root is not used in medicine, but ancient formulas commonly used it to treat lung atrophy with hemoptysis and excessive phlegm. Fourstamen Stephania Root and Pepperweed Seed are ground into powder in equal parts, mixed with sticky rice water, and taken in the amount of one qian, which is very effective.
Bencao Fahui: Jiegu says: It has a cold nature and bitter taste. It treats dampness-heat swelling from the waist down to the feet and beriberi. It tonifies the bladder, removes retained heat, and circulates through the twelve meridians. Zhuzhi Mijue: It is pungent, bitter, and yin in nature. It drains damp qi and is used after removing the skin. Also, it removes lower energizer dampness swelling and pain, and bladder fire pathogen, and must be used with Fourstamen Stephania Root, Chinese Gentian, Phelloendron Bark, and Anemarrhena.
Bencao Jingshu: Stephania Tetrandra obtains the yang qi from the earth and is also influenced by the dryness qi of autumn to grow, hence its taste is bitter, pungent, and neutral, warm and non-toxic. Jiegu described it as very bitter, pungent, and cold, which is accurate. However, its nature is dry and not mild, it is good at moving downward, and excels at removing dampness. Because its pungency can disperse and its qi is fierce, it primarily treats wind-cold warm malaria, heat qi, various types of epilepsy, and removes pathogenic qi. It removes dampness and moves downward, hence it benefits urination and defecation. This is what is recorded in the Benjing. Bielu treats edema, wind swelling, removes bladder heat, opens striae and interstice, benefits the nine orifices, and stops diarrhea, all of which are the effects of removing dampness. It mentions cold-damage disease, cold pathogenic heat qi, and apoplexy causing spasms in the hands and feet, but since cold cannot be removed by dry medicines, it should not be tried lightly. It also mentions dispersing abscesses, malignant nodules, various sores, scabies, and insect bites, but if these are not in the lower part of the body, it should not be used. It treats damp wind causing facial distortion and pain in the hands and feet, truly caused by apoplexy dampness, and can be used in such cases. Phlegm retention not caused by spleen and stomach dampness stroke heat should not be treated with it. Lung qi asthma and cough, not caused by wind-cold dampness obstructing the striae and interstice, should not be treated with it. It is only suitable for treating dampness-heat in the lower energizer, swelling, diarrhea, and foot qi, and can be used to move dampness through the twelve meridians.
Caution: Although Stephania Tetrandra is an essential herb for removing dampness-heat from the blood aspect of the lower energizer, its nature is fierce and its energy is intense. It can break through barriers and disperse obstructions. However, it is extremely bitter and cold (Great Cold, the 24th solar term), which can damage stomach qi. It should not be used in cases of stomach deficiency, yin deficiency, spontaneous sweating, night sweating, bitter mouth, dry tongue, kidney deficiency with difficulty in urination, or blood deficiency during pregnancy and postpartum, even if there is dampness-heat in the lower energizer. Misuse can cause significant harm.Bencao Mengquan: It has a pungent and bitter taste, and its energy is neutral to cold. It is yin in nature and non-toxic. It circulates through the twelve meridians. It is incompatible with Hypoglaucous Yam and can neutralize the toxicity of Realgar. It is antagonistic to Asarum. The root and stem of the plant have different therapeutic uses, and the names vary between "Han" and "Mu." The root, known as Fourstamen Stephania Root, has a texture resembling wheel spokes when broken and a fragrant yellow core. The stem, known as Cocculus Root, has wrinkled skin with small protrusions and is soft and pale. The "Han" variety is primarily used for water qi disorders, while the "Mu" variety is effective for wind pathogens. It is particularly useful for dampness-heat conditions in the lower body, such as swelling, pain, and foot qi, as well as for promoting urination and defecation, clearing bladder heat, and reducing abscesses and swelling. For lung qi disorders like coughing and chest fullness, or conditions such as apoplexy, wind-cold dampness malaria, and pathogenic heat, the "Mu" variety is more effective.
Commentary: According to Dongyuan, Stephania Tetrandra is bitter and cold, purely yin, and can purge dampness-heat from the blood and remove blood stagnation. It tonifies yin and drains yang, supporting the energies of autumn and winter while countering those of spring and summer. It is akin to a bold and daring person who thrives in chaos but can also be directed to achieve good. However, its strong nature can cause discomfort, such as nausea and reduced appetite, upon ingestion. Despite this, it is unparalleled in clearing dampness-heat obstructions, treating lower body swelling, and addressing bladder heat. It is a powerful herb for moving through the meridians, but it must be used judiciously. There are specific contraindications: it should not be used in cases of overexertion, yin deficiency with internal heat, or depletion of original qi and grain qi, as it can exacerbate blood loss. It is also unsuitable for conditions of excessive thirst due to lower energizer heat, as it targets the blood aspect rather than the qi aspect. Additionally, it should not be used for upper energizer qi disorders, such as wind-cold external contraction affecting the lungs, or for chronic conditions with body fluid depletion. In such cases, warming and tonifying herbs like Ginseng and Pueraria Root are preferable. Stephania Tetrandra is only appropriate for dampness-heat in the lower energizer that has spread to the twelve meridians, causing obstructions in the lower orifices.
Bencao Chengya: "Fang" means to defend, and "Ji" refers to the earth element. This herb utilizes water energy to protect the earth from harm. However, its dispersing nature requires careful management. When used correctly, it becomes a cornerstone of obstruction-removing formulas.
The term "Fang" implies defense, and "Ji" refers to the self. When the self is established, boundaries are defined. Thus, this herb excels in harmonizing water and earth. It is also known as "Jie Li" (separation) or "Shi Jie" (stone separation), as its root resembles a wheel spoke, symbolizing its role in dispersing obstructions. It is a key herb in emergent formulas and obstruction-removing formulas. Its neutral energy makes it suitable for wind, cold, dampness, and heat conditions. For warm malaria and epilepsy, which involve yin-yang disharmony, it acts as a strict defender, restoring balance between yin and yang.
Yaoxing Jie: It has a pungent and bitter taste, a neutral to warm nature, and is non-toxic. It enters the twelve meridians and is particularly effective for dampness-heat swelling in the lower body. It treats apoplexy with spasms, facial distortion, scabies, and parasitic sores. It also stops coughing, disperses phlegm, promotes urination and defecation, and clears lingering heat. It is incompatible with Asarum and Hypoglaucous Yam and can neutralize Realgar toxicity.
Note: Stephania Tetrandra is yin within yang, and it can penetrate all meridians. It also has a descending property, making it particularly effective for the lower body. In terms of human characteristics, it is akin to someone who is cunning yet vigorous. When used appropriately, it can fully demonstrate its capabilities; however, if misused, it can lead to disaster. It is indeed an essential medicine for conditions such as dampness-heat obstruction, bladder heat accumulation, and lower body conditions like beriberi, with no suitable substitute. However, its unpleasant odor can deter people, and improper use can lead to loss of appetite. There are four situations where it should not be used: First, if there is dietary overstrain and original qi is already deficient, using Stephania Tetrandra to induce bowel movements can severely deplete blood. Second, if there is excessive thirst and drinking, indicating heat in the lung's qi aspect, Stephania Tetrandra, being a blood medicine for the lower energizer, is not suitable. Third, if there is an external common cold with cold pathogens transmitted to the lungs, leading to dark yellow urine and difficulty in urination, this is a contraindication for blood medicines in the upper energizer qi aspect. Fourth, after a prolonged illness, if body fluids are not circulating properly, indicating a deficiency in the upper energizer with thirst, it should be treated with sweet and warm tonics; using bitter and cold agents like Stephania Tetrandra can hasten the deterioration. There are two types, named after their roots and seedlings: the Han type is effective against water qi, and the Mu type against wind qi, with slight differences in their effects.
Jingyue Quanshu: Bitter in taste, cold in nature, yin in property, descending in action. It removes dampness-heat edema, promotes urination and defecation, relieves heat congestion and swelling pain in various meridians, treats dampness-heat beriberi, clears heat block in the nine orifices, expels dampness-heat from the bladder, liver, and kidney, and addresses heat toxin sores, dampness-heat parasites, and other conditions.
Bencao Beiyao: It clears and promotes water movement, purges dampness-heat in the upper energizer blood aspect.
Great Cold (24th solar term). Benjing neutral, Bielu warm. It is a bladder meridian medicine. It can circulate through the twelve meridians, clear striae and interstice, benefit the nine orifices, and purge dampness-heat in the lower energizer blood aspect. It is a key medicine for treating wind edema. It treats lung qi wheezing and cough, water dampness, heat qi epilepsy, descends qi to expel phlegm, dampness malaria beriberi, and foot cold-damage disease dampness causing beriberi. Cold-dampness stagnates and turns into heat, dampness causes swelling, and heat causes pain. Stephania Tetrandra is the main medicine. For dampness, add Coix Seed, Atractylodes Rhizome, Floweringqince Fruit, and Akebia Stem. For heat, add Scutellaria and Phellodendron. For wind, add Notopterygium and Hypoglaucous Yam. For phlegm, add Bamboo Juice and Arisaema. For pain, add Cyperus and Aucklandia Root. For blood activation, add Four Substances Decoction. For severe constipation, add Peach Kernel and Carthamus. For mild constipation, add Achyranthes Root and Alisma. For pain extending to the arm, add Cinnamon Twig and Chinese Clematis Root. For pain extending to the ribs, add Gentiana. For heel pain, which is due to kidney deficiency, it is not the same as beriberi. It treats wind swelling, abscesses, and malignant sores. If dampness-heat flows into the twelve meridians, causing obstruction of the two yin, this medicine is indispensable. However, it is risky and strong, and is contraindicated for yin deficiency and dampness-heat in the upper energizer qi aspect. The "Ten Kinds of Formula" states: Clearing can remove stagnation, as seen in Ricepaperplant Pith and Stephania Tetrandra. Ricepaperplant Pith is Akebia Stem, and Xu Zhi-cai also considers water-promoting medicines as clearing, which is no different from dry formulas. Akebia Stem is sweet and bland, purging dampness-heat in the qi aspect; Stephania Tetrandra is bitter and cold, purging dampness-heat in the blood aspect. This collection considers water-promoting medicines as obstruction-removing formulas, and changes heat medicines to dry formulas. Chen Cang-qi said: For wind, use Cocculus Root; for water, use Fourstamen Stephania Root. Use after washing with wine. It is incompatible with Asarum and fears Hypoglaucous Yam.
Benjing Fengyuan: Stephania Tetrandra is pungent and cold, purely yin, and treats diseases of the lower energizer blood aspect. Its nature is inferior and impure, good at moving but not staying, and excels at removing dampness. Its pungency can disperse, and its strong qi makes it effective for wind-cold warm malaria, heat qi diseases, expelling evil, and promoting urination and defecation. This is the main treatment in Benjing. Bielu treats bladder heat edema, clears striae and interstice, and benefits the nine orifices, all due to its dampness-removing effect. Hongjing said: Stephania Tetrandra is a key medicine for treating wind. Fourstamen Stephania Root is the root, enters the bladder, and removes dampness-heat below the waist; Cocculus Root is the seedling, moves through the yang qiao, and treats apoplexy spasms and migratory impediment dampness-heat. The "Golden Chamber" formulas Stephania and Astragalus Decoction, Stephania and Rehmannia Decoction, Cocculus Root Decoction, and Five Substances Stephania Tetrandra Decoction are all key medicines for treating phlegm-fluid retention dampness-heat. The "Thousand Gold Formulas" treat enuresis and difficult urination with Three Substances Cocculus Root Decoction, and edema with Three Substances Cocculus Root Decoction, all relying on its ability to circulate through Jingmai. It can purge blood dampness stroke heat, clear stagnation in the meridians, but being risky and strong, improper use can cause heart vexation and reduced appetite. For removing dampness-heat swelling pain, descending beriberi, and bladder heat accumulation, it is indeed a miraculous medicine for circulating through the twelve meridians. However, for overstrain from diet, yin deficiency with internal heat, using Stephania Tetrandra to purge the bowels can severely deplete blood, making it unsuitable. For severe thirst and drinking, long-term illness with body fluids not moving, and upper energizer dampness-heat, Stephania Tetrandra is a lower energizer blood medicine, making it unsuitable. For external contraction evil transmitting to the lung meridian, qi aspect dampness-heat, with yellow and red urine, this is an upper energizer qi disease, making it unsuitable. Generally, upper energizer dampness-heat should not be treated with it, and even for lower energizer dampness-heat, it should only be used if there is obstruction of urination and defecation.
Bencao Chongyuan: Stephania Tetrandra has a pungent and neutral taste, white color with black veins, embodying the qi transformation of mutual generation between metal and water. Its stem is like wood, and wood can control earth, as earth corresponds to the self, hence the name Stephania Tetrandra. It treats wind-cold warm malaria heat qi because wind-cold evil hides in the kidneys, manifesting as warm malaria with heat before cold. Warm malaria is malaria with excess heat qi. The "Classic" says: Warm malaria is heat before cold, caused by wind-cold in winter, and this disease hides in the kidneys. Stephania Tetrandra opens and purges water essence, transporting it outward, thus treating wind-cold warm malaria heat qi. It expels evil in various epilepsies because the pericardium is affected by evil, causing epilepsy resembling ox, horse, pig, sheep, and chicken. Stephania Tetrandra, with its hollow vines, can clear internal Jingmai and reach external Jingmai, thus treating various epilepsies and expelling evil. It promotes urination and defecation because earth is controlled by wood, and wood prevents earth, allowing earth qi to flow freely, thus naturally benefiting the two excretions.
Yu's note: Stephania Tetrandra has a pungent and neutral taste, with hollow stems and vine-like growth. Its roots have patterns resembling wheel spokes. It can promote the upward movement of water essence through purgation and facilitate the outward flow of the internal Jingmai. Therefore, the Jingui Yaolue states: For thoracic fluid retention in the diaphragm, with symptoms of panting, fullness, hard masses below the heart, dark complexion, and deep, tight pulse persisting for several tens of days, if medical purgation and vomiting do not cure, Cocculus Root Decoction is prescribed. It also states: For wind edema with floating pulse, heavy body, sweating, and aversion to wind, Stephania and Astragalus Decoction is prescribed. For skin edema, with swelling of the limbs and water qi in the skin causing trembling of the limbs, Stephania and Poria Decoction is prescribed. The Qianjin Fang treats enuresis and difficult urination with the Three-Ingredient Cocculus Root Decoction. Li Dong-yuan said: Stephania Tetrandra is a medicine for the blood aspect of the lower energizer; it is contraindicated for diseases in the qi aspect of the upper energizer. Consider the syndromes treated by the formulas in the "Jingui": are they in the qi aspect? The blood aspect? Or in the upper energizer? The lower energizer? Stephania Tetrandra is a qi-moving and emetic therapy drug, with properties and effects similar to Lindera and Akebia Stem. Later generations regarded Stephania Tetrandra as a lower-body medicine, but the basis for this is unknown. Dong-yuan also said: Stephania Tetrandra is extremely bitter and cold, capable of draining blood dampness stroke heat. Compared to a person, it is like a dangerous and strong individual, rejoicing in disaster and causing chaos. However, if used properly, it can confront and overcome dangers, making it a drug that causes dizziness. Therefore, the sages preserved it without discarding it. Shennong classified medium-grade drugs as ministers, primarily for regulating blood and qi, expelling evil, and treating diseases, whether toxic or non-toxic, used appropriately according to the disease. Since Stephania Tetrandra is listed as a medium-grade drug and is non-toxic, it has the effect of moving qi and clearing heat when used to treat diseases. The notion of it being dangerous and causing chaos is unfounded, leading later generations to follow it as a maxim and fear it as a poison. Is this not a betrayal of the ancient sages? Dong-yuan's statements are mostly speculative, as he was wealthy and sought fame, lacking genuine scientific inquiry. Li Shi-zhen claimed that throughout history, only Dong-yuan was correct, which is a mistake.
Bencao Qiuzhen: [Comment] Purging the lower energizer bladder's excess heat and dampness.
Stephania Tetrandra specifically targets the bladder. It is bitter, acrid, and extremely cold (24th solar term), with a risky and vigorous nature, excelling in moving downward. It is adept at removing dampness, relieving stuffy orifices, and promoting urination, capable of purging the lower energizer's blood aspect dampness-heat and treating wind edema, making it an essential remedy. Gao said: The materia medica of ten kinds of formulas states: Unblocking can remove stagnation, such as Ricepaperplant Pith and Stephania Tetrandra. Stephania Tetrandra is extremely bitter and cold, capable of purging blood dampness stroke heat, unblocking stagnation, and also purging the bowels, tonifying yin and purging yang. To humans, it is risky and vigorous, delighting in disaster and chaos, capable of initiating disorder, yet when used wisely, it can also counteract danger and peril. Therefore, it can be used to treat water dampness cough, heat-induced epilepsy, warm malaria, beriberi, edema, wind swelling, abscesses, malignant sores, and dampness-heat flowing into the twelve meridians causing obstruction of the two yin. For beriberi with swelling and pain, dampness causes swelling, heat causes pain. For dampness, add Atractylodes Rhizome, Coix Seed, and Floweringqince Fruit; for heat, add Skullcap Root and Phelloendron Bark; for wind, add Notopterygium and Hypoglaucous Yam; for phlegm, add Bamboo Juice and Arisaema; for pain, add Cyperus and Aucklandia Root; for blood deficiency, add Four Substances Decoction; for severe constipation, add Peach Kernel and Carthamus; for mild constipation, add Achyranthes Root and Alisma; for pain extending to the arm, add Cinnamon Twig and Chinese Clematis Root; for pain extending to the ribs, add Gentian. Adapting flexibly to symptoms is key. However, its bitter and cold nature and potent effects mean it should not be used without genuine lower energizer blood aspect excess heat and dampness. Akebia Stem is sweet and bland, purging qi aspect dampness-heat; Stephania Tetrandra is bitter and cold, purging blood aspect dampness-heat. Without actual obstruction of the two excretions, misuse of this herb can lead to significant errors, which must be understood. Although similar to Phelloendron Bark and Belvedere Fruit, Phelloendron Bark purges bladder dampness-heat and also enters the kidney to purge fire, being bitter but not acrid, whereas Stephania Tetrandra is both bitter and acrid, risky and vigorous, thus also treating wind edema and beriberi; Belvedere Fruit purges bladder dampness-heat, being bitter and sweet, slightly less potent than Phelloendron Bark; Stephania Tetrandra is exceptionally vigorous and risky, acrid without sweetness, leading to disorder. Both purge heat and dampness, but their flavors and effects differ significantly.
There are two types, Han and Mu, [Comment] Cocculus Root. For treating wind, use Cocculus Root; for treating water, use Fourstamen Stephania Root.
Depei Bencao: Incompatible with Asarum.
Bitter, acrid, cold. A fundamental herb of the taiyang, it travels the twelve meridians, purging upper energizer blood aspect dampness-heat. Dispels wind and water, treats warm malaria, reduces abscesses, and heals insect sores.
Combined with Malva Nut, it relieves difficult urination; with Anemarrhena and Phelloendron Bark, it removes lower energizer dampness swelling; with Peach Kernel, it treats severe constipation. With Gentian, it treats hypochondriac pain; with Arisaema, it treats hot phlegm; with Clematis, it treats shoulder and arm pain.
The heart and flowers are large, yellow ones are genuine. For dispelling wind, use Cocculus Root; for treating water, use Fourstamen Stephania Root. Wash with wine, steam with Plantain Root before use.
Do not use for heat in the upper energizer. Stephania Tetrandra is a lower energizer herb. Qi aspect wind-heat with difficult urination, original qi deficiency, yin deficiency with internal heat, post-illness thirst are all contraindications.
Bencao Jing Jie: Stephania Tetrandra has a neutral qi, embodying the descending metal qi of autumn; it is acrid and non-toxic, obtaining the dry metal flavor of the west, entering the hand taiyin lung meridian. Its flavor is more descending than ascending, yin in nature.
Wind-cold warm malaria is a condition of feeling wind-cold but suffering from only heat without cold; heat-induced epilepsy is a condition of heart heat suffering from all kinds of wind epilepsy, as warmth and heat are both yang pathogens, epilepsy and malaria belong to wind wood, Stephania Tetrandra's neutral qi can clear yang pathogens, its acrid flavor can calm wind wood and dissipate wind phlegm.
Eliminating pathogens, acrid and neutral products can remove warmth and heat pathogens.
Urine comes from the bladder, bladder body fluids, lung qi transforms and exits, Stephania Tetrandra's neutral qi can transform qi, thus promoting urination; stool comes from the large intestine, the lung and large intestine are exterior-interior related, the acrid flavor can moisten the intestines, thus promoting defecation.
However, its foulness harms the stomach, use with caution.
Shennong Bencao Jingdu: Stephania Tetrandra has a neutral qi, embodying metal qi; it is acrid and non-toxic, obtaining metal flavor, entering the hand taiyin lung meridian.
Wind-cold warm malaria is a condition of feeling wind-cold but suffering from only heat without cold; heat-induced epilepsy is a condition of heart heat suffering from various epilepsies, as warmth and heat are both yang pathogens, epilepsy and malaria belong to wind wood, Stephania Tetrandra's neutral qi can govern them.
Eliminating pathogens, it further states it can remove the pathogenic qi of the spleen.
The lung being the upper source of water, and also exterior-interior related to the large intestine, Stephania Tetrandra's acrid and neutral nature regulates lung qi, thus benefiting both excretions.
Benjing Shuzheng: Mainly treats wind-cold warm malaria heat, meaning it specifically addresses the heat of this disease, indicating that if there are other factors, additional treatments should be combined; it eliminates evil in various epilepsy cases, meaning it can remove evil in this disease, suggesting that if there are other causes, additional treatments should also be combined; it benefits urination and defecation, meaning that this heat and evil, when treated with this substance, are expelled through urination and defecation rather than through sweating or vomiting. The reason for this is that Stephania Tetrandra has a pungent taste that promotes circulation and a neutral qi that promotes descending. Its white root symbolizes the lungs, its yellow flesh symbolizes the spleen, and its black veins symbolize the kidneys. The lungs govern the skin and body hair, the spleen governs the muscles, and the kidneys govern water. The veins resemble the spokes of a wheel, extending from the center outward to the deficient skin, symbolizing diseases that originate from the kidneys and spread to the muscles. All the listed symptoms can be treated by it. So, are warm malaria and epilepsy both kidney diseases? The Nue Lun says: Warm malaria is caused by wind in winter, hidden in the bone marrow, and when it encounters the Great Heat (12th solar term), the pathogenic qi and sweat are expelled. This disease is hidden in the kidneys, and its qi moves from the inside to the outside, which is what is meant by the disease spreading from the kidneys to the muscles. The Qianjin says: If the disease first manifests as body heat, convulsions, fright, crying, and then epilepsy, with a floating pulse, it is yang epilepsy, located in the six fu-organs, and externally in the skin, which is easier to treat; if the disease first manifests as body cold, without convulsions or crying, and the pulse is deep during the attack, it is yin epilepsy, located in the five zang-organs, and internally in the bone marrow, which is extremely difficult to treat. It also says: There are three types of epilepsy: wind epilepsy, fright epilepsy, and food epilepsy. Wind epilepsy is caused by sweating due to warm clothing and wind entering the body. At the initial stage, the fingers are bent as if counting, indicating wind epilepsy; fright epilepsy is caused by fright and occurs with loud crying; food epilepsy is characterized by refusal to nurse, vomiting, cold followed by heat, and then epilepsy. If it is not due to kidney qi rising, it would not cause sudden unconsciousness; if it is not due to kidney qi carrying phlegm and saliva, ascending to the heart, and penetrating the blood vessels, it would not cause convulsions and spasms. Moreover, yang epilepsy affects the skin, and yin epilepsy affects the bone marrow, which can be said to be diseases that spread from the kidneys to the muscles. As for the Bielu mentioned cold-damage disease with chills and fever, pathogenic qi passing through the striae and interstice, it is similar to the heat of warm malaria; apoplexy with spasms in the hands and feet is similar to eliminating evil in epilepsy; removing bladder heat, benefiting the nine orifices, and stopping diarrhea are similar to benefiting urination and defecation. Boils, malignant nodules, scabies, and insect sores are all caused by dampness accumulating in the muscles, and wind edema is also caused by wind edema stagnating in the muscles, all of which are within the scope of Benjing treatment.
Stephania Tetrandra, as a substance, has black streaks running through its yellow flesh. Its use in treating water invasion in the spleen is unquestionable. However, Zhongjing's treatment of wind edema and skin edema, characterized by heavy body, sweating, aversion to wind, water qi in the skin, swelling of the limbs, and trembling, all align with this. The heavy body is indeed a spleen disease, as the limbs are associated with the spleen. However, the thoracic fluid retention treated by Cocculus Root Decoction and the intestinal water qi treated by Stephania, Pricklyash Seed, Pepperweed, and Rhubarb Pill, one above and one below, seem unrelated to the spleen, yet both use it. Why is this? It is because both upper and lower parts are diseased, and treating the middle is key. If thoracic fluid retention is unrelated to the lower part, why use Mirabilite? If intestinal water qi is unrelated to the upper part, why use Pepperweed Seed? Therefore, a deep and tight pulse and a dark complexion indicate a root of purgation, while dry mouth and tongue indicate a need for emetic therapy. The firmness in the chest due to thoracic fluid retention and the abdominal distension and fullness due to intestinal water qi, though slightly different in their relation to the spleen, ultimately cannot be separated from spleen disease. Moreover, if the disease is in the upper part, vomiting will cure it; if in the lower part, purgation will cure it. If neither vomiting nor purgation works, where else could the disease be if not in the middle? This shows that water-related diseases are mostly deficient in the Jingmai muscles, mostly excessive in the chest, diaphragm, and intestines, and still somewhat deficient within the excess in the chest and diaphragm, but truly excessive within the excess in the intestines. However, the deficient often carry heat, and the excessive often carry cold, which has its reasons. It is precisely because of deficiency and heat that they float outward and rise upward; because of excess and cold, they settle inward and sink downward. This is why Stephania and Astragalus Decoction and Stephania and Poria Decoction use Astragalus and Atractylodes; Cocculus Root Decoction uses Ginseng; and Stephania, Pricklyash Seed, Pepperweed, and Rhubarb Pill uses Pricklyash Seed.
In Stephania and Rehmannia Decoction, Rehmannia is the heaviest, Saposhnikovia Root and Cinnamon Twig are next, and Stephania Tetrandra and Liquorice Root are the least. Yet, the decoction is named after Stephania Tetrandra and even precedes Rehmannia. Why is this? It is because the main symptom dictates the name. The Lingshu chapter on madness states: "Mad speech, startling confusion, frequent laughter, fondness for singing and music, and incessant wandering are caused by great fear, and are treated by targeting the hand Yangming and Taiyin." The Suwen Jutong Lun states: "Fear causes the essence to retreat, retreating causes the upper energizer to close, closing causes the qi to return, returning causes the lower energizer to swell, thus the qi does not move." Now, the disease manifests as madness, incessant wandering and talking, does it not align with the essence retreating and the upper energizer closing? Using Rehmannia treats the retreating essence; using Stephania Tetrandra treats the closing of the upper energizer and the swelling of the lower energizer. It is said there is no cold or heat, fearing it might be mistaken for external contraction; it is said the pulse is floating, fearing it might be directly considered internal damage. The qi's sudden movement, upward and downward, causing turmoil and inversion, is called injury, yet nothing has actually left, called no injury, thus the formula that serves my life may turn against me. However, the qi that turns against me cannot serve my life again, like fire that has turned to smoke cannot return to the fuel, yet within the smoky fuel, there are still unburned parts. Therefore, the way to treat it is to supplement as movement, to move as supplementation. To supplement as movement is Rehmannia's moistening purgation, allowing the stool to pass and thus relieving the lower energizer's swelling, thereby benefiting the essence and stabilizing its residence to prevent retreat; to move as supplementation is Stephania Tetrandra expelling kidney qi that penetrates the muscles and blood vessels, moistening its path to allow passage and descent, Saposhnikovia Root allowing the qi that can return to return to the defense, spreading throughout the body, thus the blood vessels and muscles regain their normal state, not counterattacking to oppress the heart. Thus, how can the decoction not be named after these two, and how can Stephania Tetrandra not precede Rehmannia? The cold-damage disease theory states: "Excessive sweating causes the person to cross hands over the heart, palpitations, and a desire to press, treated by Cinnamon Twig and Liquorice Decoction." That is due to excessive sweating causing heart deficiency and chest fluid oppressing the heart, while here it is water pathogen in the blood vessels attacking the heart. However, the fluid in the chest is a tangible substance, while the water in the blood vessels is only its qi, without substance, thus one is decocted and given, the other is soaked in wine to extract its essence, only taking its qi.
Stephania Tetrandra's stem is like wood, hence named Cocculus Root; later generations, because it comes from Hanzhong, also named it Fourstamen Stephania Root, but they are not two different things. Thus, Zhongjing named the decoction Cocculus Root Decoction when using Stephania Tetrandra alone, and omitted the "wood" character when combining with other substances for ease of reference. Later generations considered the stem as wood and the root as Han, and theories about treating wind and water can be disregarded.
Bencao Xinbian: Stephania Tetrandra, pungent and bitter in taste, cold in nature, yin in property, non-toxic. It can enter the kidneys to expel dampness, relieving dampness-heat from the waist down to the feet, foot pain, and beriberi. It promotes urination and bowel movements, reduces bladder heat, dissipates abscesses and swelling, alleviates apoplexy and spasms, and treats wind-cold dampness malaria pathogenic heat. It seems that Stephania Tetrandra is a supreme remedy for dispelling dampness-heat and regulating meridians. However, its nature only allows it to move downward, not upward. For dampness-heat in the upper energizer, it must not be used, as it would greatly deplete vital qi, leading to danger. Some say Stephania Tetrandra is a medicine for the lower energizer blood aspect, effective in the blood aspect but not in the qi aspect. However, even for dampness-heat in the lower energizer, it should only be used once and not repeatedly. The nature of Stephania Tetrandra is particularly fierce; a single dose can immediately disperse dampness-heat in the kidney meridian. The kidneys are for tonification, not purgation; overuse will purge the kidneys, so how can it be used again?
Someone asked, "The 'Materia Medica' states that Stephania Tetrandra can traverse the twelve meridians, but you only mention its entry into the kidneys. I cannot help but have doubts. If Stephania Tetrandra indeed traverses the twelve meridians, then it should be able to treat all diseases of the upper energizer, such as those of the head, eyes, chest, diaphragm, and throat. Why is it only seen to cure lumbar diseases through purgation? The area from the waist to the feet is precisely what the kidneys govern. Isn't this clear evidence that it enters the kidneys? Therefore, the claim that it enters the twelve meridians is a misconception passed down by predecessors, while my assertion that it enters the kidneys is based on solid evidence."
Someone asked, "Stephania Tetrandra treats dampness in the kidneys, and Siegesbeckia treats wind within the kidneys. If these two are combined, can they treat kidney diseases? This seems like a good idea, but in reality, it could be very harmful. The kidneys can be tonified but not purged. Using a mild purgative is already a last resort. If both are used together, the kidneys will quickly become exhausted. I mention this in response to your question to warn those who advocate purgation."
Someone asked, "Stephania Tetrandra drains dampness not only in the kidneys, but you insist that it only affects the kidneys, claiming it only treats dampness in the waist and feet. However, the area below the waist and feet is not entirely governed by the kidneys. Opposite the waist is the navel, and attached to the feet are the tendons. The navel belongs to the spleen, and the tendons belong to the liver. How can it be said that everything belongs to the kidneys? To claim that Stephania Tetrandra treats the kidneys but not the liver and spleen—who would believe that? Therefore, when the kidneys are diseased, the navel and tendons are also affected. Stephania Tetrandra treats dampness in the kidneys, and the dampness in the navel and tendons is also eliminated. This does not mean it enters the spleen and liver. Stephania Tetrandra enters the kidneys, not the liver and spleen. Why must you doubt this?"
Bencao Fenjing : Stephania Tetrandra is very pungent, bitter, and cold. It enters the bladder to remove fire pathogens, can traverse the twelve meridians, open the striae and interstices, benefit the nine orifices, purge damp-heat in the blood aspect of the lower energizer, treat wind and promote water movement, descend qi and expel phlegm. Its nature is risky and vigorous, suitable only for damp-heat obstruction and beriberi. For cases where damp-heat in the lower energizer causes obstruction of the two yin, this herb is used. There are two types: Fourstamen Stephania Root is used for water disorders, and Cocculus Root is used for wind disorders.
Fourstamen Stephania Root is cold in nature and bitter in taste, belonging to the yin of yin. It treats damp-heat swelling and severe beriberi from the waist down to the feet, and traverses the twelve meridians. It is also said to remove dampness, swelling, and pain in the lower energizer, as well as bladder fire pathogens. Stephania Tetrandra, Gentian, Phellodendron Bark, and Anemarrhena are essential for this. However, if there is dietary overstrain, original qi deficiency, yin deficiency with internal heat, and Stephania Tetrandra is used to purge the bowels, it will severely deplete the blood. This is the first reason it should not be used. If there is great thirst and excessive drinking, indicating heat in the qi aspect of the upper energizer lung meridian, it should be treated with draining and purging methods. Stephania Tetrandra, being a blood-regulating herb for the lower energizer, is not suitable. This is the second reason it should not be used. If there is external common cold with pathogenic cold transmitted to the lung meridian, causing qi aspect damp-heat and dark yellow urine or even obstruction, this is the third reason it should not be used. If a person has a prolonged illness with impaired body fluids and upper energizer deficiency thirst, using this bitter and cold herb will quickly endanger them. This is the fourth reason it should not be used. Therefore, Stephania Tetrandra should not be used for any damp-heat in the upper energizer. It should only be used when there is true damp-heat in the lower energizer that has spread to the twelve meridians, causing obstruction of the two yin.
Bencao Sibianlu : The root of Stephania Tetrandra is white on the outside and yellow on the inside, with black lines resembling wheel spokes. It has a pungent and neutral taste, thus treating wind-dampness disorders from the kidneys to the spleen and lungs. Since the lungs govern the skin and body hair, does it disperse through the skin and hair? However, a wheel can rotate but not overflow, so Stephania Tetrandra does not induce sweating but directly purges through urination. Examples include the "Jinkui" Yijiao Lihuang Pill (see Rhubarb Rhizoma) and the "Qianjin" Sanwu Cocculus Root Decoction.
Tao Yin-ju said: Stephania Tetrandra is a key herb for treating wind edema. Both water and fluids are types of dampness, so Stephania and Astragalus Decoction treats wind-dampness, Stephania and Poria Decoction treats water, and Cocculus Root Decoction treats fluids. Although there are three names, the principle is the same. The term "wind edema" is indeed inseparable. Wind is a yang pathogen that enters from the outside, causing chills. When wind-cold is first contracted, it should be treated with sweating. Stephania Tetrandra is not responsible for this. Internal wind, if there is no yin pathogen internally, cannot exist alone. Therefore, water, fluids, and dampness are what it relies on. When water, fluids, and dampness are removed, the wind is also removed. This kind of wind can be treated with Stephania Tetrandra. However, Poria and Atractylodes cannot do this, but Stephania Tetrandra can, because the black lines resembling wheel spokes have the wonderful effect of accompanying wind edema.
Some say: Stephania and Rehmannia Decoction treats symptoms like madness, reckless behavior, incessant talking, absence of chills or fever, and a floating pulse. Could it also be due to dampness and phlegm, and yet treated with Stephania Tetrandra? It is said: This is a unique prescription from Zhong Sheng, which cannot be compared with others. Zhao's theory suggests that blood deficiency follows evil, and evil combines with yang to cause such symptoms. According to this chapter, a floating pulse indicates blood deficiency, Suwen states that when yin cannot overcome yang, the pulse becomes rapid and leads to madness, which can be used as evidence for symptoms like madness. This annotation is accurate. However, it does not specify what kind of evil it is. Xu's theory suggests that wind evil merges into the heart, causing excessive heart fire, hence the symptoms of madness, reckless behavior, and incessant talking, which is clearer than Zhao's annotation. However, the reason for using this prescription and its ingredients has not been explained. Upon careful consideration, the four ingredients soaked in wine to extract juice are not for yang pathogen or exterior pathogen. The large amount of Unprocessed Rehmannia Root is not for tonifying blood or cooling blood. Using Cinnamon Twig and Saposhnikovia Root for exterior pathogen indicates that it is wind evil from outside. Using Unprocessed Rehmannia Root with Cinnamon Twig and Saposhnikovia Root indicates that the treatment is not to resolve through sweating. Without resolving through sweating and using wine to enhance the effect of the medicine to search for the evil, the evil will not be left behind. Extracting raw juice from the four ingredients and steamed juice from Rehmannia allows yin-yang to be separated, thus calming yang and stabilizing yin. However, if wind has no way out, it will not cease. If yin does not return to its position, it will still bind yang. To separate what is combined, Zhong Sheng chose Stephania Tetrandra. Stephania Tetrandra moves outward and also downward. With the skill of operation, the wind between the surface will naturally subside. With the ability to return to the origin, the disturbed yin will also calm down. Some say Stephania Tetrandra treats wind-dampness but not wind-dryness, not knowing that using several times the amount of Rehmannia in wind medicine turns wind from dry to moist, which is suitable for Stephania Tetrandra, truly a case of human ingenuity surpassing nature.
bubble_chart Modern Pharmacology
- Fourstamen Stephania Root alkaloids have strong protective effects against cerebral ischemia and hypnotic effects; Stephania Tetrandra alkaloid has antipyretic effects. Fourstamen Stephania Root alkaloids significantly inhibit the automaticity of the sinoatrial node and can counteract the effects of calcium ions on the increased contractility and oxygen consumption of the left atrium and papillary muscles in animals, while also exhibiting frequency-dependent or use-dependent properties.
- Fourstamen Stephania Root alkaloids can increase coronary flow; they have a significant preventive effect on ischemic and hypoxic damage caused by posterior pituitary hormones; they also provide some protective effects against experimental myocardial infarction; they can rapidly convert barium ion-induced arrhythmias to sinus rhythm, demonstrating antiarrhythmic effects.
- Fourstamen Stephania Root alkaloids have significant hypotensive effects; Stephania Tetrandra nolin alkaloid can also cause hypotension, but its effect is weaker than that of Fourstamen Stephania Root alkaloids and is prone to rapid tolerance.
- Fourstamen Stephania Root alkaloid A has a significant inhibitory effect on platelet aggregation induced by various factors in animals.
- The total alkaloids of Fourstamen Stephania Root, as well as its alkaloids A, B, and C, all have analgesic effects, with the total alkaloids being the most potent.
- Fourstamen Stephania Root alkaloids and Stephania Tetrandra nolin alkaloid both have certain anti-inflammatory effects, with the effect of Fourstamen Stephania Root alkaloids being stronger than that of Stephania Tetrandra nolin alkaloid. Fourstamen Stephania Root alkaloids also have some anti-allergic effects.
- Fourstamen Stephania Root alkaloids inhibit the smooth muscle of the uterus, reduce the pressure within the fallopian tube, and inhibit the movement of eggs through the fallopian tube.
- Fourstamen Stephania Root alkaloids and some of their analogs have a relaxing effect on striated muscles.
- Fourstamen Stephania Root alkaloids at a concentration of 1:4000 can kill 100% of Ehrlich ascites cancer cells in vitro. They have significant cytotoxic effects on KB, Hela, and Helas cells.
- Fourstamen Stephania Root alkaloids have a certain inhibitory effect on experimental silicosis in rats.
- Fourstamen Stephania Root decoction has antibacterial effects against dysentery bacilli and various fungi. Among them, Fourstamen Stephania Root alkaloids have inhibitory or killing effects on tissue amoebae both in vitro and in vivo.
- Fourstamen Stephania Root (10g/kg) administered orally can significantly increase urine output in rats.
- Fourstamen Stephania Root alkaloids can also induce vomiting in pigeons. Stephania Tetrandra alkaloid liniment can promote the repair of skeletal muscle cells. Both exhibit immunosuppressive effects.