A big thank you to Dr. Heiner Fruehauf for his help with this project!

All translations below are my own unless otherwise noted.

Table of Contents

Part 1: Early References

Part 2: Etymological Investigation

Part 3: Life World

Part 4: Preparation

Part 5: Formulas

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Part I: Early References

The following is a brief survey of early Chinese references to Wuzhuyu (Fructus Evodia rutaecarpae). The passages are extracted from the following texts:

I. Shennong bencao jing (“Shennong’s Classic of Roots and Grasses”): Chinese medicine’s earliest extant materia medica, likely written during the Eastern Han (25-220 CE); authors unknown.

II. Shanghan zabing lun (“Treatise on Cold Damage and Miscellaneous Diseases”): Zhang zhongjing’s master work, comprising the Shanghan lun and Jingui yaolue, dated around the beginning of the 3rd c. CE.

III. Xijing zaji (“Miscellaneous Records of the Western Capital”): A collection of short stories and notes from the Western Han, covering such varied subjects as politics, culture, poetry, astronomy, history, geography, and technology. Here, I cite a passage on the Double Nines (or Double Yang) Festival, which takes place on the ninth day of the ninth month. As part of the celebration, Wuzhuyu was plucked and worn.

IV. Sun simiao’s Qiren yueling: This passage was passed along to me in a truncated digital form by Heiner Fruehauf, with his translation. I include it here because it also connects Wuzhuyu to the Double Nines Festival.

V. Erya yi (“Wings of the Erya”): A commentary on the oldest extant Chinese dictionary, the Erya. The Erya likely dates to the 3rd c. BCE, while this commentary, by Luo Yuan, dates to the 10th c. CE.

VI. Mawang dui (“King Ma’s Mound”) texts: These writings, tentatively dated to third to second centuries BCE, were excavated from Western Han tombs at the Ma wang dui site in the early 1970s. Included here are excerpts from the following texts translated by Donald Harper: Wushier bingfang (“Recipes for 52 Ailments”) and Tai chan shu (“Book of the Generation of the Fetus”).

VII. Liji (“Record of Rites”): One of the five classics of the core Confucian cannon, the Liji is a collection of descriptions of ritual matters written in the Warring States and Western Han periods.

***

A few central themes run throughout these references, including: Wuzhuyu’s warm-to-hot qi, pungent taste, and capacity for drying; its affinity for the Earth-center and the head (and for addressing nausea, vomiting, headache, and intense psycho-emotional disturbances); its role in rectifying counter-flow; its relevance on the occasion of the Double Nines festival; its strong fragrance; its use as a spice and/or condiment; and its potential toxicity.

***

I. Shennong bencao jing

吳 茱 萸
Wuzhuyu:

味辛溫
Its flavor is pungent and warm.

主溫中下氣
It governs warming the center and down-bearing qi;

止痛欬逆
stopping pain, cough and counter-flow;

寒熱
and cold and heat.

除濕血痺
It removes dampness and blood impediment.

逐風邪
It chases out wind evil.

開湊理
It opens the interstices.

根殺三蟲
Its root kills the three insects. [The three insects are likely three worms. Dr. Fruehauf tentatively classifies these as roundworms, tapeworms, and hookworms.]

一名藙
Another name is Yi. [For further examination of 藙 Yi, please see the discussion on etymology below.]

生山谷
It grows in mountains and valleys.

IIa. Shanghan lun

辨陽明脈證并治
“Distinguishing Yangming Pulses, Patterns and Treatments”

Line 243:

食穀欲嘔者屬陽明也
When after eating there is a desire to vomit, this belongs to Yangming.

吳茱萸湯主之
Wuzhuyu Tang governs.

得湯反劇者屬上焦也
If taking this decoction (leads to) severe rebellion, this pattern belongs to the upper burner.

吳茱萸湯方：
Wuzhuyu Tang formula:

吳茱萸一升洗辛熱人參三兩甘溫生薑六兩切辛溫大棗十二枚擘甘溫
Evodia: one sheng; washed; acrid and warm. Ginseng: three liang; sweet and warm. Fresh ginger: six liang; cut; acrid and warm. Jujube: twelve pieces; broken; sweet and warm.

右四味以水七升煮取二升去滓溫服七合日三服
The four flavors at right: use seven sheng of water. Boil to get two sheng, and remove the dregs. Take warm doses, seven ge, three doses per day.

辨少陰病脈證并治
“Distinguishing Shaoyin Disease Pulses, Patterns, and Treatments”

Line 309:

少陰病吐利手足厥冷
When in Shaoyin Disease there is vomiting and diarrhea, counter-flow cold of the hands and feet,

煩躁欲死者吳茱萸湯主之 and vexation and agitation (to the degree that) one longs for death, Wuzhuyu Tang governs.

辨厥陰病脈證并治
“Distinguishing Jueyin Disease Pulses, Patterns, and Treatments”

Line 352:

若其人內有久寒者
If a person has enduring internal cold,

宜當歸四逆加吳茱萸生薑湯主之
it is suitable that Danggui Sini Tang plus Wuzhuyu and Shengjiang governs.

Line 378:

乾嘔吐涎沫頭痛者吳茱萸湯主之
In the case of dry retching, vomiting of frothy saliva, and headache, Wuzhuyu Tang governs.

辨發汗吐下後脈證并治
“Distinguishing the Pulses, Patterns, and Treatments After (A Patient Has Been Treated with) Sweating, Vomiting, and Precipitating”

四逆加吳茱萸生薑湯方
Sini Tang plus Wuzhuyu and Shengjiang Prescription:

當歸二兩芍藥三兩甘草二兩炙
Danggui two liang; Shaoyao three liang, Gancao three liang, roasted;

通草二兩桂枝三兩去皮細辛三兩
Tongcao two liang; Guizhi three liang, minus the skin; Xixin three liang;

生薑半斤切大棗二十五枚擘吳茱萸二升
Shengjiang half a jin, minced; Dazao twenty-five pieces, broken; Wuzhuyu two sheng.

右九味以水六升清酒六升
The nine flavors at right: use six sheng water and six sheng clear wine;

和煮取五升去滓溫分五服
boil together to get five sheng; remove the dregs; divide into five doses and take warm.

一方水酒各四升 (One version of this formula calls for water and wine, four sheng each.)

IIb. Jingui Yaolue

嘔吐噦逆下利病脈証并治第十七
Chapter 17: The Pulses, Patterns and Treatments of Nausea, Vomiting, Retching and Diarrhea Diseases

Line 8:

嘔而胸満者茱萸湯主之。
In the case of nausea and chest fullness, Wuzhuyu Tang governs.

Line 9:

乾嘔吐涎沫頭痛者茱萸湯主之。
In the case of dry heaves, foamy saliva, and headache, Wuzhuyu Tang governs.

婦人雑病脈証并治第二十二
Chapter 22: The Pulses, Patterns, and Treatments of the Various Diseases of Female Patients

Line 9:

問曰: 婦人年五十所病下利数十日不止
Question: A 50-year old woman has incessant diarrhea ten times per day,

暮即発熱少腹裏急腹満
heat effusion near dusk, lower abdominal urgency, abdominal fullness,

手掌煩熱唇口乾 燥何也?
vexing heat in the palms, and the lips and mouth are parched dry: why is this?

師曰:此病属帯下何以故?
Master says: This disease belongs to "below the belt." What is the reason?

曽経半産瘀血在少腹不去何以知之?
Previously there was a miscarriage/abortion, and there is stagnant blood in the lower abdomen that has not been expelled. How does one know?

其証唇口乾燥故知之
Its pattern is: the lips and mouth are parched dry; therefore one knows.

当以温経湯主之
Wenjing Tang must be used to treat.

温経湯方:
Wenjing Tang:

呉茱萸三両 当帰二両 芎藭二両 芍薬二両 人参二両 桂枝二両阿膠二両 生姜二両 牡丹皮(去心)二両 甘草二両 半夏半升 麦門冬一升(去心)
Wuzhuyu 3 liang; Danggui 2 liang; Chuangxiong 2 liang; Shaoyao 2 liang; Renshen 2 liang; Guizhi 2 liang; Ejiao 2 liang; Shengjiang 2 liang; Mudanpi (hearts removed) 2 liang; Gancao 2 liang; Banxia half sheng; Maimendong (hearts removed) 1 sheng.

上十二味以水一斗煮取三升分温三服
The above twelve ingredients: Use one dou water. Cook down to three sheng. Separate into three doses.

亦主婦人少腹寒久不受胎
It also governs lower abdominal cold in women and chronic infertility.

兼取崩中去血或月水来過多及至期不来
Double the dosage for collapse of the center or blood loss, or if there is menorrhagia or amenorrhea.

III. Xijing Zaji “Miscellanies of the Western Capital”

九月九日佩茱萸
On the ninth day of the ninth month, wear Zhuyu (Evodia).

食蓬餌飲菊華酒
Eat fleabane pastries and drink chrysanthemum flower wine.

令人長壽菊華舒時
Guiding humans in extending their lives, Chrysanthemum flowers unfold in this season.

并採莖葉雜黍米釀之
And gather stems and leaves, and the varieties of millet and rice, and ferment them.

至來年九月九日始熟
They will begin to be ready upon next year’s ninth day of the ninth month.

IV. Sun simiao’s Qiren yueling

Note: This is Dr. Fruehauf’s translation. He concludes that this passage is “basically advice how to cope with the blues of fall.”

旧俗重九登高饮酒人多佩带萸囊
It is ancient custom, on the Double Nines, to climb high and drink wine. Many people wore Yu (Evodia) in a purse at their waists.

重陽之日必以肴酒 登髙眺逺為時讌之逰賞以暢秋志
On Double Yang Day, take some specially fermented wine to a high place in the mountains with a great view, and take a sip while you celebrate life.

酒必採茱茰甘菊以泛之既醉而還
The wine should be made by collecting Evodia pods and Chrysanthemum flowers and then steeping them in alcohol. Once you are sufficiently drunk, come back down the mountain.

V. Erya yi

榝一名藙今之茱茰也
Sha: another name is Yi. Today it is (known as) Zhuyu (Evodia).

其味苦辛置之食中
Its flavor is bitter and pungent; its place is the food center.

能去臭
One is able to remove the stench.

南都賦所謂蘇榝
Southern cities are endowed with what is called Susha. [Refer to the last note of the etymological section for more on Sha.]

九月九日取茱茰折其枝…
On the ninth day of the ninth month, fetch some Zhuyu; break off its branch…

鄭氏及説文皆以煎茱茰為藙盖藙必煎乃用…
The Zheng clan says their custom is always pan-frying Zhuyu, as Yi. Covering the Yi is necessary. Pan-fry, and then eat…

風土記曰：俗尚九月 九日謂為上九
The Record of Customs says: It is convention to celebrate the ninth day of the ninth month. You can refer to it as the “Upper Nine.”

茱茰至此日氣烈熟色赤
The qi of Zhuyu, up to this day, is strong and ripe. Its color is red.

可折其房以揷頭云辟惡氣禦冬
You are able to break it from its home in order to stick it in your hair. It is said that it [helps you to] avoid evil qi and to defend against the winter.

VI. Mawangdui Texts (translated by Donald Harper)

Wushier bingfang “Recipes for 52 Ailments”

MSI.E.103

Note: This recipe comes under the heading of “To Make a Person Ailing from the Horse Not Have Spasms.” (Harper asserts that spasms were differentiated into four types named after animals.)

“Urine retention. Make a square pit one and a half chi to a side and as deep as your elbow. Then burn old straw in it until the ash is not quite one half chi deep. Lightly sprinkle fine liquor on it. [?] one zaojia (honey locust), fourteen zao (jujubes), yi style zhuyu (evodia), and jiao (zanthoxylum). Combine, deposit in one spot in the pit, and burn it. Drop the lower (body) into it. When it desists, rinse.”

MSI.E. 157 & 160

Note: These recipes appear under the heading “Ju Abscess Ailment.” Question marks in brackets refer to missing or illegible characters.

“Take bailian (ampelopsis), huangqi (astragalus), shaoyao (peony), gui (cinnamon), jiang (ginger), jiao (zanthoxylum), and zhuyu (evodia)—altogether seven substances. For ju abscesses of the bone, double the bailian. For ju abscess of the flesh, double the huangqi. For ju abscesses of the testicles, double the shaoyao. Use one portion of each of the others. Combine, and put one large three-fingered pinch into a cup of liquor. Drink it five or six times a day. Wait for it to desist.”

“Another. Take bailian, huangqi, shaoyao, and gancao (licorice)—and boil the four substances. [?], jiang, Shu jiao (Shu zanthoxylum), and zhuyu (evodia)—(use an amount of) the four substances equivalent to one of the (first four) substances. The first is bone [?] using one cup of liquor [?] muscle type, which glares and glitters…Drink four times a day. Once it is ready to burst, stop.”

Taichan Shu “Book of the Generation of the Fetus”

MSV.3

Note: The following excerpt comes from a conversation between Yu and You Pin (“Youth Multiplier”), who is likely a male expert on childbirth. You Pin is describing the life of the fetus over its nine months in the womb.

“In the fifth month Fire is bestowed on it, and vapor first forms. Rise late and [?] wash the hair. Wear a thick layer of clothing and remain inside the house. At dawn inhale heaven’s rays and avoid harm from the cold. The appropriate foods are rice and wheat; the appropriate boiled dishes are beef and mutton, mixed with zhuyu (evodia).”

VII. Liji “Book of Rites”

Neize “The Inner Principle”

膾春用蔥秋用芥
Chopped meat: in spring, use scallion; in fall, use mustard.

豚春用韭秋用蓼
Suckling pig: in spring, use leek; in fall, use smartweed.

脂用蔥膏用薤
For lard, use onion. For fat, use shallot.

三牲用藙和用醯獸用梅
Three domestic animals: use Yi, together with pickle. Wild animals: use plum. [Dr. Fruehauf suggests that the three animals might refer to the goat, cow, and pig. Yi might be considered, in the context of this line, the peppery spice made from evodia fruit, as opposed to the fruit itself. See Part 2 for a discussion of Yi.]

鶉羹雞羹鴽釀之蓼
As for quail soup, chicken soup, and the curlew, ferment them with smartweed.

魴鱮烝雛燒雉薌無蓼
Bream and tench are steamed; pullets, roasted; and pheasants, with fragrant herbs and no smartweed.

Part 2: An Etymological Investigation of 吳 茱 萸

I. Looking Closer at the Three Characters

吳 Wu refers to the region where 萸 Yu was known to grow.

茱 Zhu refers to Master Zhu, who, according to legend, introduced the king of Chu, ailing from a stomachache, to the healing properties of Wuyu. The king thereafter added Zhu to the name of the medicinal, according to Dr. Fruehauf.

萸 refers to the plant itself. Without the grass radical, it becomes 臾 Yu “a moment or an instant.” The Shuowen jiezi defines 臾 as: 束縛捽抴 “It is to tie up, to seize and drag.” Dr. Fruehauf relates this image of “tying up” to “tying up a prisoner and dragging him by the hair.” Early scripts of 臾 depict a person holding his own head; others seem to show a head being grabbed by another being.

This is relevant because, as Dr. Fruhauf is quick to point out, Wuzhuyu is an herb “of the head.” Firstly, it addresses headaches; most modern practitioners use the herb for either headaches or cold in the Stomach (as in the case of Liver cold invading the earth and causing diarrhea and nausea). But Wuzhuyu’s capacity for influencing the gut-head relationship also extends to varieties of psychological distress. As we’ll see below, Wuzhuyu helps to lead a patient suffering from mental-emotional crisis back to a calm, resourced state.

II. Looking Closer at Wuzhuyu’s Alternate Names

The Shennong bencaojing states: 一名藙 “Another name is Yi.” (Note that the Bencao gengmu would later give this name 藙 Yi to a weaker species, 食茱萸 Shizhuyu.) When stripped of the grass radical, 藙 Yi becomes 毅 Yi. On the left is 豙 Yi, which depicts an “enraged pig with its hair sticking up.” It means “bravery.” On the right is 殳 Shu “spear.” The Shuowen jiezi defines 毅 Yi as: 妄怒也一曰有決也 “It is absurdity and anger; another meaning is ‘to have determination.’” 妄 Wang, translated as “absurdity,” is “to be out of sorts; wild; frantic.” 決 Jue is “certain; resolute; to decide.”

Thus, Wuzhuyu is used in the case of someone who is totally out of sorts, agitated like an enraged pig. The herb reaches that place of rage or extreme agitation and helps to make the sufferer stable and resolute again. Dr. Fruehauf notes that the herb contains DMT, the psychedelic compound of the tryptamine family that is found in ayahuasca. But whereas psychoactive substances like ayahuasca are ingested to catapult you to a place of altered consciousness, Wuzhuyu is able to access that place and bring you back to "ground zero."

Related to 藙 Yi are 顡 and 𧆈, which replace the spear with the head. Again, there is a connection between this herb and the human head. The Shuowen jiezi defines 𧆈 as: 𧆈煎茱萸 “𧆈 is to pan fry Zhuyu.”

Lastly, we saw earlier that the Erya yi referred to 榝 Sha as an alternative name for 藙 Yi. The Shuowen jiezi defines this character 榝 Sha as: 似茱萸出淮南 “It is like Zhuyu. It is produced in Huainan." Interestingly, the phonetic 殺 sha is “to kill,” perhaps pointing to this species’ toxicity.

Part 3: Life World

Wuzhuyu is the fruit of the Evodia rutaecarpa. The plant, native to China, grows to a height of 30 feet along the sunny edges of woodlands and in suburban settings as an ornamental. It produces long, dark green, shiny leaves and clusters of small, hermaphroditic flowers. The flower petals can be white, green, or yellow. Its fragrant fruit is reddish when it appears in August, and darkens to black by November. The plant prefers moist soil.

Li Shizhen, in his Bencao gengmu, writes of the Wuzhuyu tree: "The twig of evodia is soft and plump. The leaf is long and creased. Fruits are borne on top of the twig. They flock together. The fruit is seedless. It does not look like prickly-ash. One species has big fruit and the other small fruit. For medicinal use, the smaller one is better."

Li Shizhen goes on to quote the Mingyi bielu: "Wuzhuyu grows in the mountain valleys of Shanggu & Yuanqu. Collect the drug on the ninth day of the ninth month. Dry it in the shade." He also quotes Su Song: "The tree is more than ten chi tall. Its bark is bluegreen... In the seventh and eighth month, fruit similar to prickly-ash is borne. It is slightly yellow at first and turns dark purple when ripe. Some say that the fruit that is small and solid and remains blue-green after a long time is Wuzhuyu and the fruit that big and turns black and yellow after a long time is Shizhuyu...But this is not true." (I think Shizhuyu is Zanthoxylum ailanthoides, the Chinese prickly-ash, which produces Sichuan pepper.)

Dr. Fruehauf recalls coming across the Wuzhuyu tree on a China expedition. He considers Guizhou Province to produce the best specimens. The plant, he says tolerates extreme weather (although it does best in damp soil), and grows at an altitude. The berries are still harvested in the wild.

There is some confusion over the classification of this plant genus. Evodia is also known as Euodia, both of which seem to be outdated names that have been subsumed by the genus name "Tetradium." Tetradium is composed of nine species of trees in the family Rutaceae. And so, while the plant continues to be known as Evodia rutaecarpa in Chinese Medicine circles, its formal name is actually Tetradium ruticarpum (I'll continue referring to the Wuzhuyu tree as Evodia rutaecarpa). Perhaps on account of the confused nomenclature, there seems to be little modern-day information available about the life world of Evodia rutaecarpa. Within this genus, Evodia rutaecarpa is much less popular than Tetradium daniellii (also known as the "bee bee tree" or "bee tree"), which blooms at a time (late July-August) when few other tree-sized plants are growing. Perhaps as a result of this lack of competition, it attracts a great number of bees; it is sought after by bee-keepers as a source of late summer honey, and consequently carries much renown throughout its native Korea. This species is growing in popularity as an ornamental plant world-wide; however, it can be susceptible to wind and ice damage due to its weak wood.

If I were to attempt to make some educated guesses into the relationship between the life world of Evodia rutaecarpa and the medicinal properties of Wuzhuyu, I'd start with the fact that Wuzhuyu is a berry. Whereas root medicinals frequently have an ascending effect in the body (as in the case of Gegen), berries, located as they are at the upper and outer reaches of the plant, tend to descend. We see this in Wuzhuyu's capacity for treating headache and nausea: it helps to downbear rebellious qi. Secondly, Evodia rutaecarpa seems to do best in moist soil. We know that the nature of the medicinal is hot and dry, so it makes sense that the plant requires moisture to balance out this nature. Lastly, the fact the fruit has traditionally been collected on the ninth day of the ninth month (Double Yang Day) reveals that it possesses a yang nature, which we know to be true, again via its warming and drying functions.

Part 4: Preparation

Wuzhuyu can be prepared in a variety of ways. It can also be used raw, but only for external application. The following list of preparation methods comes from Dan Bensky’s Materia Medica:

淡 Dan (Bland): The fruit is soaked in water (or in a combination of water and Gancao), which is changed once or twice; it is then sun-dried. This is the minimal preparation required for internal consumption; the soaking process somewhat reduces the toxicity.

製 Zhi (Prepared): Wuzhuyu is added to a Gancao decoction, while the water is still hot. After the fruit soaks up the water, it is baked over low heat until dry. This method is especially effective in giving the herb a harmonious nature that enters and warms the middle jiao and curbs pain.

炒 Chao (Dry-fried): Bland Wuzhuyu is dry-fried until it swells and darkens. This method warms the middle and descends qi, quelling nausea.

黃連炒 Huanglian chao (Coptis-fried): Wuzhuyu is soaked in a Huanglian decoction, until all of the water has been absorbed. This method targets pent-up Liver-Stomach fire causing GERD.

醋炒 Cu chao (Vinegar-fried): Wuzhuyu is soaked in rice vinegar, then dry-fried until dry. This method allows the herb to enter the Liver blood level, soothing the Liver and alleviating pain. It is often used for cold-type dysmenorrhea with blood stasis secondary to Liver qi stagnation.

鹽炒 Yan chao (Saltwater-fried): Wuzhuyu is soaked in saltwater until most of the water is absorbed, and then dry-fried until dry. This method descends qi to the Kidney.

薑炒 Jiang chao (Ginger-juice-fried): Wuzhuyu is soaked in a mixture of ginger and water, until most of the juice has been absorbed, and then dry-fried until dry. This preparation method is best for cold-dampness encumbering the middle jiao.

There seems to be a general consensus that Wuzhuyu is most effective after having been stored for a considerable amount of time. Li Shizhen quotes Sun Simiao: "The longer the drug is stored, the better it works." He also quotes the Mingyi Bielu: "The longer it is stored, the better the quality." Dr. Fruehauf assumes that over time its toxicity wanes a bit.

The Bencao gengmu also lists the leaf, twig, and root of the Wuzhuyu as having medicinal properties. The leaf (Wuzhuyuye) "is good for relieving headache due to invasion of excessive Cold into the brain." The twig (Wuzhuyuzhi), according to Su Song, "is good for treating sudden onset of obstruction of the stool and the urine." The root (Wuzhuyugen) treats worms and diarrhea.

Part 5: Herbal Formulas

Below is a table of established herbal formulas containing Wuzhuyu. Beneath the table, I will go into more depth on the three formulas presented by Zhang Zhongjing.

The three formulas presented in the Shanghan zabing lun are Wuzhuyu Tang, Danggui Sini jia Wuzhuyu Shengjiang Tang, and Wenjing Tang. Let's examine each of the three.

Wuzhuyu Tang is featured in the Yangming, Shaoyin, and Jueyin chapters of the Shanghan lun. In the Yangming chapter, it is recommended for a desire to vomit after eating. In Shaoyin Disease, the formula is advised for "vomiting and diarrhea, counterflow cold of the hands and feet, and vexation and agitation (to the degree that) one longs for death." And in the Jueyin chapter, we see it used for cases of "dry retching, vomiting of saliva and froth, and headache." In the Jinggui yaolue, we find Wuzhuyu Tang in Chapter 17, which focuses on the treatment of nausea, vomiting, retching, and diarrhea. Zhang Zhongjing calls for the formula in two cases of nausea and vomiting, as well as for cases of dry heaves, foamy saliva, and headache.

According to Dr. Fruehauf, Wuzhuyu Tang is one of the representative Jueyin formulas. Wuzhuyu Tang is composed of four herbs: Wuzhuyu, Shengjiang, Renshen, and Dazao. Wuzhuyu governs warming the interior and redirects rebellious qi downward. As is often the case, it is paired with Shengjiang, which also serves to warm and disperse. Dr. Fruehauf particularly emphasizes Wuzhuyu's partnership with Dazao: Wuzhuyu is intensely drying and Dazao seems to soften its toxicity, the way Gancao does for Fuzi.

Jueyin disease can be understood as "counter-flowing Yin." The counter-flow comes from an extreme cold: yang is failing to rise, and Yin is rushing in instead. Dr. Fruehauf argues that Wuzhuyu Tang warms the yang of the Liver, Pericardium and Stomach, and, by doing so, is warming counter-flowing Yin—particularly foamy, mushy substances that are rising to the head and causing headaches, nausea, and disorientation. Its clinical applications encompass all manner of brain-chemistry disorders, including addiction. Dr. Fruehauf uses the example of the love-sick patient who can't eat, which highlights a disruption within the Pericardium, and its clock-pair, the Stomach. Dr. Fruehauf will recommend taking the decoction for just a few days for the less extreme case of headache and nausea, while more dire cases involving severe brain-chemistry disruption can warrant consumption of the formula for six months or more.

Zhang Zhongjing recommends Danggui Sini jia Wuzhuyu Shengjiang Tang in the Shaoyin chapter for a patient with enduring internal cold (內有久寒). In the formula, Wuzhuyu and Shengjiang are added to Danggui Sini Tang, which is found on the preceding line. Danggui sini tang governs reversal cold and a very thin pulse. Danggui itself serves to tonify and harmonize the blood. Wuzhuyu and Shengjiang are added in cases where the there is not only yang deficiency, but also often where brain circulation has been compromised and degenerative changes have taken place, as in Parkinson's. In these cases, the Dangui Sini Tang moves up the yang, and the Wuzhuyu and Shengjiang move down and dry out the pathological yin. In less severe cases, the deep cold of a DGSN jia WZYSJT patient can manifest as loose stool, nausea, GERD, and pain (especially in the lumbar region).

Zhang Zhongjing uses Wenjing Tang in Chapter 22 ("The Pulses, Patterns, and Treatments of the Various Diseases of Female Patients") of the Jinggui yaolue. Wenjing can mean "Warm the Channel" or "Warm the Menses." This is a larger formula (twelve ingredients) that is a great remedy for infertility and pain due to a cold uterus. Dr. Fruehauf asserts that "the womb belongs to the Jueyin, and there's nothing more warming for the Jueyin than Evodia." Wuzhuyu's presence in this formula is interesting, given that the formula is known to moisten; it's a drying herb added to a group of yin-nourishing herbs, like Maimendong and Ejiao. The Wuzhuyu in Wenjing Tang serves to warm and alleviate pain; the formula is suitable to administer long-term, since the amount of Wuzhuyu is minimal, and there are so many moist herbs to counter-balance its harshness.

Lastly, Dr. Fruhauf considers Zuojin Wan a significant formula for stomach ulcers. He points out that H. pylori bacteria loathes berberine; the formula contains only Huanglian (Coptis, which is loaded with berberine) and Wuzhuyu (studies show the Wuzhuyu also inhibits the growth of H. pylori). In cases of H. pylori-induced ulcers, Dr. Fruehauf contends that they are due not to heat but to cold; Wuzhuyu, of course, warms the center, thus making the stomach less hospitable to any unwelcome bacteria. Regardless of its efficacy, the patient might have to be in dire need to consume this formula: it combines perhaps the two most foul-tasting herbs in the Chinese materia medica.