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Shu Jiao (Sichuan Pepper) is a herb acting on the Foot-Taiyin Spleen channel and the Qi aspect of the Right Kidney. It dispels Cold-Dampness from the Spleen and Kidney but does not treat Wind-Cold or Wind-Dampness. If there is only Cold without Dampness, it is also unsuitable.

It treats Cold-Dampness regardless of whether it involves the Spleen or Kidney, but in tonifying Fire, it focuses exclusively on the Kidney. Why is this? Its nature is Warm and Dry, and its action moves downward; it is sufficient to dispel Cold-Dampness but insufficient to dispel Wind.

The skin is red, the inner membrane white, with yellow flesh in between, and the seeds at the very center are black. This represents the image of the medicinal power traveling from the Lung, through the Spleen, to enter the Kidney. Therefore, it can cause the Fire floating up from the Water to return to the Water. Since Heat syndromes involve Lung pathology and should be unrelated, why is it also attributed to the Lung? This is because when there is Cold-Fluid in the Lung without Cold-Dampness, Shu Jiao is never used to treat Cold-Fluid diseases; nor is it used for pure Cold diseases. Only when Cold-Dampness from the Spleen and Kidney rushes upward causing Lung pathology accompanied by Fire is using Shu Jiao to guide it downward appropriate. The pathology of the Spleen and Kidney resides in their own Zang organs, whereas Lung pathology is connected via the Spleen and Kidney. Although the treated herbs are the same, the root and branch differ significantly. This is why I do not list it alongside Hand-Taiyin Lung herbs.

Since Shu Jiao travels from the Lung directly to the Kidney without stopping midway, its primary merit must be warming the Kidney. Thus, other herbs that warm the Spleen and remove Spleen-Dampness have effects limited to the Spleen; Shu Jiao returns to the Kidney and serves not only the Spleen. Although the Spleen resides in the Central Palace (Middle Jiao) and cannot fly across, are there cases where the Kidney is diseased but the Spleen is not, yet can be treated with Shu Jiao? Let us examine the formulas of Zhang Zhongjing: Wu Tou Chi Shi Zhi Wan (Aconite and Red Earth Pill), where the pathogen is in the Upper Jiao, yet Aconite, Fuzi, Gan Jiang, and Chi Shi Zhi—herbs acting on the Middle and Lower Jiao—are used. This would not be done unless there was Cold-Dampness in the Spleen and Kidney; adding Shu Jiao is specifically to guide the Fire back down. Bai Zhu San, which You Shi considered a formula for Cold-Dampness, combines Bai Zhu and Xiong Chu with Shu Jiao and Mu Li, intending to warm the Lower Jiao. Similarly, Da Jian Zhong Tang and Wu Mei Wan treat vomiting, pain, abdominal fullness, and ascariasis jue with vomiting and irritability. In all these cases, the disease lies in the Spleen and Kidney, with Yang hidden within Yin, and the use of Shu Jiao follows the same principle.

Wu Zhu Yu (Evodia Fruit) trees grow over one zhang high, with greenish-blue bark, and fruits borne at the tips. Its odor is dry and pungent, so it acquires much Wood Qi and its action lies in the Liver. The leaves, flowers, and fruits are all purple; purple is the color of Water and Fire mixed. The fruit ripens in autumn, with a bitter, pungent, and warm taste, and a fierce nature. Within the chaos of mixed Water and Fire, it holds the power to reverse and rotate, thus entering the Liver to extend Yang, subdue Yin, and repel Cold pathogens. Pungency causes ascending, bitterness causes descending; pungency disperses, bitterness consolidates; it both ascends and descends, both disperses and consolidates. Therefore, it does not reach the extreme upper or lower, but merely repels Cold pathogens in the Liver.

Vomiting can be Cold or Hot. If not caused by Shaoyang interfering with the Stomach, it belongs to Jueyin interfering with the Stomach. Shaoyang interference presents as heart vexation, desire to vomit, and vomiting with fever. Jueyin interference presents as vomiting with chest fullness, dry heaving with salivary foam, and headache. Zhang Zhongjing’s Xiao Chai Hu Tang and Wu Zhu Yu Tang clearly distinguish these treatments. Although vomiting is primarily treated with Wu Zhu Yu Tang, mentions of "Yangming Disease" and "Shaoyin Disease" lead people to believe they are unrelated to Jueyin, not realizing they are actually Jueyin manifestations appearing in Yangming and Shaoyin. Why? "Desire to vomit after eating food" indicates the Liver has received Cold pathogens and attacks the Stomach upwards. Without food, Liver Qi is relatively free; with food, the Liver cannot accommodate it and desires to vomit. This is distinct from Wei Fan (Stomantic Reversal) due to Stomach deficiency, hence requiring Wu Zhu Yu Tang. When Liver pathogens attack upwards, they damage the Stomach (Wood overacting on Earth); when pressing downwards, they damage the Kidney (Child transmitting to Mother). Once Child transmits to Mother, vomiting and diarrhea occur together, not just vomiting alone. Shaoyin self-disease involves only diarrhea, not necessarily vomiting; if vomiting and diarrhea coexist, cold limbs and irritability may not accompany them; but if vomiting and diarrhea are accompanied by cold limbs and extreme irritability, this must be due to extreme excess of Liver pathogens.

I assert Wu Zhu Yu is a Liver herb. Blood is stored in the Liver, so warming the Liver should warm the Blood; however, Wu Zhu Yu disperses Cold in the Qi of the Blood, it does not warm Cold in the Blood itself. In Jueyin disease progressing to vomiting, diarrhea, cold limbs, and extreme irritability, if this were a Blood disease, why is Dang Gui absent? Dang Gui Si Ni Tang, with a pulse fine and nearly imperceptible, treats Blood Cold; why is Wu Zhu Yu absent initially and added only later for chronic Cold? This proves it is not a Stomach or Kidney herb. In Yangming, being the convergence of two Yangs, Cold is hard to invade. Zhang Zhongjing frequently mentions Empty-Cold in the Stomach but provides no formulas using Wu Zhu Yu. Even if one claims Wu Zhu Yu treats Stomach Cold, does one not know that Jueyin disease with dry heaving, salivary foam, and headache requires Wu Zhu Yu? As the key herb for Liver Cold, using it for Stomach Cold without Liver Cold will surely cause errors. Thus, Zhang Zhongjing warned against misuse, stating "if symptoms worsen after taking the decoction, the disease is in the Upper Jiao." So where is the herb for the Upper Jiao? Ban Xia Gan Jiang San treats Stomach Cold with dry heaving and salivary foam. Other formulas like Gan Cao Xie Xin Tang and Huang Lian Tang contain Gan Jiang to treat Stomach Cold. I realize here that Gan Jiang and Wu Zhu Yu correspond to Huang Lian and Huang Qin. The Ben Jing states Huang Lian treats intestinal abdominal pain, while Huang Qin treats intestinal issues but not abdominal pain. Hence, in Xiao Chai Hu Tang, Huang Qin is removed for abdominal pain, but in Huang Lian Tang, Huang Lian is used for abdominal pain. Same Cold herbs cannot be used interchangeably. How can same Heat herbs be used indiscriminately? I do not consider Wu Zhu Yu a Kidney herb because there are specific Kidney herbs that govern different territories. Fu Zi warms the Kidney, Gan Jiang warms the Spleen. For Taiyin Zang Cold, Si Ni Tang is suggested, but Si Ni Tang is not the primary formula for warming the Spleen; Li Zhong Wan is. Li Zhong Wan contains Gan Jiang but no Fu Zi. Si Ni Tang for Kidney Cold contains both. Why? Because Kidney Cold inevitably insults the Spleen; Gan Jiang acts as the central authority in the Spleen and the vanguard in the Kidney, so Ginger and Aconite cannot be missing. Wu Zhu Yu cannot compare. The Kidney houses True Yang; there is supporting Yang to suppress Yin, but no repelling Yin to damage Yang. Wu Zhu Yu is listed under Shaoyin not to treat Kidney Cold, but to treat Liver Cold spreading to the Kidney. Reviewing these points, what doubt remains that Wu Zhu Yu is not a Blood, Stomach, or Kidney herb?

Wen Jing Tang contains Blood Stasis in the Lower Abdomen, using Wu Zhu Yu as the Sovereign herb, not because it moves stasis. Women around fifty suffering from non-acute conditions require slow treatment, not aggressive purging. Thus, Xia Yu Xue Tang or Di Dang Tang are avoided; instead, Gui Zhi, Bai Shao, and Dan Pi move stasis gently. Combined with Ren Shen, Gan Cao, Chuan Xiong, Dang Gui, E Jiao, Mai Dong, Sheng Jiang, and Ban Xia, they tonify the Center, regulate Qi, harmonize Blood, and moisten dryness. Preparations are meticulous. Why then need the bitter-warm and pungent-fierce Wu Zhu Yu? One must understand that women's diseases often stem from deficiency, accumulated Cold, and stagnant Qi. Blood stasis remaining in the Lower Abdomen indicates chronic Cold. Chong and Ren vessel Blood are governed by the Liver. Stagnant Qi in the Liver cannot be dispelled except by Wu Zhu Yu. This is the pivot of the syndrome; "Warming the Menses" records its essence.

Wu Zhu Yu does not reach the extreme upper or lower. Yet, Jueyin headache treated by Wu Zhu Yu Tang and Blood Stasis in the Lower Abdomen treated by Wen Jing Tang seem extreme. However, these are effects of repelling Liver Cold, not direct action on the head or lower abdomen. By extension, the uses of Wu Zhu Yu are extensive. The Stomach governs descending, the Spleen governs ascending. The Spleen's ability to ascend benefits from the control and transformation of Wind-Wood (Liver). Thus, Liver disease affects the Spleen. Wu Zhu Yu enters the Liver to drive out pathogens, transforming Yin stagnation into Yang harmony. How can the Spleen remain unwarmed, and abdominal pain/bloating remain untreated? Its nature is more bitter than pungent, with more descending than ascending. The Liver governs dispersion and drainage; when Liver Qi is peaceful, it flows downward naturally. This is why it also benefits Large Intestine obstruction and treats dysentery-like stagnation.

There is also its use as an adjuvant (Fan Zuo). The ancient formula Zuo Jin Wan treats Liver Fire excess causing left hypochondriac pain, seemingly unsuitable for the hot Wu Zhu Yu. However, in this formula, Huang Lian exceeds Wu Zhu Yu by five times. Liver excess requires Wu Zhu Yu for dispersion; with more Huang Lian and less Wu Zhu Yu, it does not aid Heat but resolves stagnant Heat, benefiting both Liver and Spleen. Thus, it is effective for abdominal pain. Clinical application varies; one cannot be rigid.