By Eric Brand

I’m writing this blog from Chengdu, China, the capital of Sichuan province. Sichuan is the homeland of Fu Zi (Aconiti Radix Lateralis Praeparata), and it is also the homeland of a trend in Chinese medicine called the “Huo Shen Pai” (Fire God School), which favors the use of hot medicinals to warm yang and free the channels. The Huo Shen Pai school of thought is particularly appropriate in Sichuan for two key reasons- 1) the climate is very damp, and 2) Sichuan is the traditionally authentic region for cultivating aconite. The Huo Shen Pai perspective has recently become a popular topic of conversation in the West, so it seems like an appropriate blog topic to write about while I’m here in its homeland.

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Sichuan has been known for Fu Zi since at least Han dynasty times, and both Fu Zi and Chuan Wu (as well as some types of Cao Wu) are strongly associated with Sichuan. Chinese medicine broadly discusses a concept called “dao di yao cai” (authentic region herbal materials), which basically centers on the topic of which regions are best for each particular herb. Some herbs can be grown across a wide range of regions while others thrive in only a narrow range, and when attempting to grow herbs in different environments it is often difficult to produce herbs that match the quality of the “dao di” region.

Though generally consistent, over the course of time the location that is considered to be the best is occasionally subject to change. For example, Fu Ling from Yunnan province (often called “Yun Ling”) was traditionally considered to be the best, but now the best Fu Ling often comes from areas besides Yunnan. For other items, the “dao di” region has largely remained unchanged for centuries; examples include Ren Shen produced around the mountain area of Chang Bai Shan and Fu Zi grown in the Jiangyou region of Sichuan. Sichuan is the “dao di” production region for a number of important Chinese herbs, such as Huang Lian, Fu Zi, and Chuan Bei Mu, and the expertise around these herbs is generally concentrated in Sichuan as well.

In the USA, much discussion on Fu Zi and the “huo shen pai” (fire god school) originates in Oregon, though this school of thought is now widely discussed on the internet and has gained a bit of attention throughout the country. Heiner Fruehauf, an instructor in Portland, is a devotee of this school of thought and has studied extensively with a professor named Liu Li-Hong in China. Prof. Liu is one of China’s experts from the fire god school, and Heiner’s transmission of the fire god perspective to the West has helped to bring awareness to this particular camp. In addition to stimulating discussion on the theoretical perspective of the fire god school, Heiner has increased awareness of the issue of “dao di yao cai” through his attention to (and distribution of) Fu Zi grown in the authentic Jiangyou region.

Practitioners in the fire god school often use large doses of Fu Zi (30-240g daily), which is somewhat controversial. Adherents report miraculous effects from these Fu Zi-based preparations, while others are hesitant to endorse the widespread use of massive doses of Fu Zi due to its profound heat and toxicity. Naturally, pattern discrimination and climate inevitably affect the treatment response to Fu Zi, and there is an increased concentration of practitioners that draw from the fire god perspective in areas that are cold and damp (such as Sichuan and Oregon). Sichuan is famous for its damp weather and the emphasis on copious amounts of chili and Sichuan peppercorns (Hua Jiao) in its cuisine, so the entire region is marked by hot acrid foods and cloudy weather (I’ve never actually seen the sun come out every time I’ve visited Chengdu, and locals even consume Fu Zi occasionally as a food product). However, beyond pattern discrimination and climate, significant attention has recently been focused the effects of Fu Zi from the Jiangyou region versus other production areas.

One discussion that has arisen in various online discussion groups centers on the concept that Fu Zi produced in the Jiangyou region has superior medicinal effects, and some have suggested that adverse reactions are more common in Fu Zi that is produced outside of the Jiangyou region. I am generally one to respect the concept of “dao di yao cai,” and I also respect the attention that Heiner and others have given to the pursuit of knowledge through Chinese language acquisition and in-depth study with Chinese experts. Nonetheless, the diversity of perspectives in Chinese medicine necessitates that any viewpoint be assessed based upon a comprehensive analysis of a wide range of expert opinions rather than any one single source, and I am always slightly cautious when people say that the only reliable source of a given product is the one that they personally sell. Consequently, I’ve been doing a bit of amateur research on the issue of Fu Zi and the question of toxicity and efficacy as it relates to Jiangyou Fu Zi, so I figured that I would blog about my current understanding of the situation.

In general, there is a lot of evidence that many herbs are influenced by the climate and soil of particular areas. These factors are difficult to duplicate. For example, cultivated American ginseng thrives in Wisconsin; it is generally of slightly lower quality when it is grown in British Columbia and is even less ideal when it is grown in Northeastern China. However, some plants have a narrow tolerance to variations while others are highly adaptive to different circumstances, so the tolerance for different growing regions certainly varies from plant to plant.

One perspective suggests that only one region can produce the legitimate product (for example, only sparkling wine from Champagne grapes grown in Champagne can be labeled as Champagne). Others generally believe that with the correct soil, lighting, and temperature correctly matched geographical areas and circumstances can produce products of equal quality. There are many comparisons and legitimate arguments from both sides. If we look at a simple example such as grapes, we find that high-quality wine can be produced in both Napa as well as France, though not every variety will do equally well in both regions (additionally, both regions will consistently outperform, say, Colorado).

There is absolute consensus in the literature that the authentic production region of Fu Zi is the Jiangyou region of Sichuan province. However, as my college horticulture teacher used to say, “plants don’t read books.” Plants don’t really know where the county lines are drawn, and generally plants will thrive wherever they have the perfect blend of environmental factors. The influence of the market and pricing has a tremendous influence on the perception of quality, and it seems unrealistic that only one county could grow really premium product. That said, the situation with Fu Zi is complicated by the fact that we have two issues that affect product quality- production region as well as processing technique.

My current trip to Chengdu was stimulated by a visit here by my teacher Prof. Zhao Zhongzhen. Prof. Zhao was here for the launching of one of his new books on medicinal differentiation, and I was honored to be invited to attend the ceremony and visit the local herbal markets with him for field research. In the past, I’d had the chance to ask Prof. Zhao’s Hong Kong-based team about the Fu Zi situation, and I was also able to inquire about the subject with some of his local friends that are experts working at the Chengdu University of Chinese Medicine. In a nutshell, here is what I learned:

Jiangyou is definitely regarded as the “dao di” area for growing Fu Zi. However, of even greater significance is the fact that Fu Zi processing (the making of Zhi Fu Zi from Sheng Fu Zi) is not harmonized across all regions. On the one hand, we have the modern science of analyzing constituents and aconitine content, but we also have the influence of a traditional art of processing that has remained secretive and subject to regional variation for millennia. The precise processing methods used in different regions are not shared openly, and there are different methods in use from one region to the next. The fact that the traditionally superior Jiangyou region may also have its own particular art of processing adds strength to the argument that the truly premium product comes from Jiangyou.

Chinese medicine sits at an interesting intersection between art and science because we have a lot of traditional knowledge that hasn’t been fully explained scientifically. For example, when we are looking around the herbal marketplace, we are looking at traditional features that are associated with quality and efficacy. We cannot assess the chemical composition of products with our naked eyes, but we have a lot of traditional parameters available for quality assessment that may or may not reflect profound differences when assessed in the lab.

I was talking to one of the leading professors and researchers involved in herbal constituent analysis at Chengdu’s TCM university, and she mentioned that Fu Zi’s toxicity and therapeutic efficacy are basically one and the same (this is an idea that goes back all the way to the Shen Nong Ben Cao Jing some two thousand years ago). She also pointed out that there is not an absolute bridge between tradition and science because traditionally some herbs that are thought to have significantly different quality and efficacy can have minimal differences when assessed with HPLC and other chemical testing methods. In the early generations of Chinese herbal science, significant focus was placed on identifying active constituents and quantities of these substances, but the diverse range of chemical constituents and their subtle variations in herbs makes the state of scientific evidence incomplete in terms of explaining all these traditional aspects of assessment.

As this particular professor put it, there is not a major difference in the toxicity of Jiangyou vs. non-Jiangyou Fu Zi. Rather, there is a perceived difference in its therapeutic efficacy. This view suggests that the difference lies in efficacy rather than toxicity, which is an important perspective to keep in mind.

Ultimately, the current challenge with our knowledge base here in the West on this topic lies in the fact that most people are relying on the opinion of only a few people. Topics such as Jiangyou Fu Zi require a multidisciplinary, evidence-based approach wherein the opinions of many different experts are weighed together. Certainly both traditional and scientific experts have important feedback to offer in this arena, and our knowledge base depends on the opinions of experts from both the clinic and the lab.

Herbal pharmacy is one of the least standard and most diverse fields in Chinese medicine, and one must survey a wide range of experts to research any given topic. The expertise and reliability of each source needs to be weighed into the equation, and absolute, definitive answers can rarely be found for many of the most fundamental questions in issues such as quality discernment. In other words, the main conclusion that I can draw at this time is that we need to seek a diverse range of sources and opinions, and we need to synthesize and share the evidence that we find with one another. No matter how knowledgeable any one expert is, it is essential that we do not blindly trust the conclusions of any single expert. On all topics, we must pursue information as comprehensively as possible to get a sense for the consensus opinion. We must be cognizant of the fact that absolute consensus rarely exists, so we must weigh the reliability of each source based on a complete, realistic perspective of the strengths and limits of their expertise.

In other news, I heard that true Chuan Wu should have a slightly hollow core- much of the product sold as Chuan Wu on the market is actually Fu Zi, not Chuan Wu. Thanks for reading our blog!