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Nutmeg, also known as Rouguo (Meat Fruit). Its flowers and fruits resemble those of Cardamomi Fructus Rotundus (Caodoukou) but lack a nucleus, hence the name. Although it resembles Caodoukou, its peel and flesh particles are actually of a different category.

The exterior has wrinkles, while the interior features mottled patterns similar to Arecae Semen (Binglang). It is highly susceptible to insect damage. Only when dried thoroughly and sealed tightly can it be preserved for a relatively long period.

The flavor is bitter and pungent, and the nature is warm. It enters the Hand-Yangming Large Intestine Meridian, Foot-Yangming Stomach Meridian, Hand-Taiyin Lung Meridian, and Foot-Taiyin Spleen Meridian. Its main indications include warming the middle jiao and directing rebellious qi downward, warming the spleen and stomach, arresting diarrhea, consolidating the large intestine, treating abdominal distension and pain caused by accumulated cold, cholera with vomiting of clear saliva, resolving retained food and phlegm-fluids, treating deficiency-type diarrhea mixed with cold and heat as well as dysentery with red and white discharge, stopping infantile vomiting, inability to suck milk, and abdominal pain. Medical formularies record its use in treating edema and accumulations, fullness preventing eating, malaria and bi-syndrome, regurgitation, cholera, various conditions where qi rebels upward, frequent urination, and hernia. Nutmeg has meritorious effects in warming the middle and tonifying the spleen. When the spleen is tonified, its transportation function becomes proficient, and its qi naturally descends; this differs from the draining and purging actions of Cyperi Rhizoma (Xiangfu) and Citri Reticulatae Pericarpium (Chenpi). (Zhu Danxi) It is used for chronic diarrhea and dysentery. Materia Medica texts also indicate its treatment of cold-heat deficiency diarrhea. This is likely because prolonged diarrhea leads to deficiency even in heat syndromes, so it is not universally used merely for warming the middle. (Li Shizhen) When combined with Ginseng Radix et Rhizoma (Renshen), Psoraleae Fructus (Buguzhi), Evodiae Fructus (Wuyu), Schisandrae Fructus (Wuweizi), and Amomi Fructus (Sharen), it serves as a supreme remedy for Kidney-diarrhea and Cold-diarrhea. When combined with Amomi Fructus (Suosha), Citri Reticulatae Pericarpium (Chenpi), Ginseng Radix et Rhizoma (Renshen), Red Yeast Rice (Hongqu), Crataegi Fructus (Shanzha), Agastache Herba (Huoxiang), and Maltyum (Maiya), it forms an upper-grade formula for opening the appetite, promoting digestion, and arresting diarrhea. Used alone, it must be processed, ground into powder, and formed into pills with jujube pulp, or taken as powder washed down with Amomi Fructus decoction. This preparation is named "Gongzi Dengyan San" (Lord's Banquet Ascending Powder), which has special efficacy in opening the appetite and promoting digestion. For elderly patients with deficiency diarrhea, take 3 qian of Nutmeg, wrap it in flour, roast until cooked, and grind into powder. Mix with 1 liang of Frankincense (Ruxiang) powder, and form pills the size of wutong seeds using paste made from aged rice flour. Take 60–70 pills each time, washed down with rice drink. For Spleen-diarrhea and Qi-dysentery, take one Nutmeg, wrap it in dough mixed with rice vinegar, roast until cooked, and grind together with flour into powder. Add 1 liang of Allii Tuberosi Rhizoma et Bulbus (Xiebai), stir-fry, and grind into powder. Mix evenly. Also, stir-fry aged barnyard rice until charred and grind into powder. Mix all uniformly. Take 2 qian, decoct as a drink, and mix with 3 qian of the aforementioned two powders. Take once in the morning and once in the evening, and the condition will resolve.

[Discussion] Nutmeg is initially bitter and then pungent, acquiring the metal qi within fire. Fire is the mother of Earth; thus, its action proceeds from the Lung to the Stomach, exerting its effect of warming the middle and directing qi downward. Subsequently, the pungent quality prevails, ultimately achieving a slight coolness by obtaining the肃 (solemn/descending) qi of metal. Metal governs descending and collecting; therefore, its action proceeds from the Stomach to the Large Intestine, exerting effects of both descending and collecting. Generally, warm qi tends to ascend. However, without the complete qi of metal, it cannot descend from the Lung. Qi that descends belongs to metal, but without inheriting warm qi, it certainly cannot collect from the Large Intestine. This substance enables warm qi to descend and enter the central earth (Spleen/Stomach), fully embodying the properties of metal (thus warming the middle, treating accumulated cold, and facilitating transformation). It causes collecting qi to return more effectively to the Large Intestine, rooted in warmth (thus arresting diarrhea and dysentery). Beginning with fire and ending with metal, metal can effectuate collection. Bitter and warm qi ascends; this principle is indeed not easily altered. In cases of dysentery caused by damp-heat with deficiency of qi, combining this substance and Atractylodis Chinensis Rhizoma (Muxiang) as assistants to the principal drug, Coptidis Rhizoma (Huanglian), which is bitter and cold, yields efficacy. Is this merely using warm flavors to assist cold? It is likely to complete the function of Lung qi. Lung qi can both descend and collect, fulfilling the role of Shaoyin within Yang. The virtue of Metal and Fire combining is indeed as such. However, incompetent physicians use it to stop dysentery, casually calling it an astringent agent; how could they understand this? (This substance should only not be applied to excess-heat dysentery in persons whose qi is not significantly deficient.) Furthermore, there is something worthy of further investigation: Heixi Dan (Black Tin Pill) treats various rebellious qi ascending, excess above and deficiency below, and deficiency of yang in the lower origin. This principle was roughly explained under the entry for Angelicae Dahuricae Radix (Baizhi) and should be consulted together.

Miao Xi said: Contraindicated for those with inherent heat-fire in the Large Intestine, acute watery diarrhea due to summer-heat and heat, intestinal wind with bloody stool, and toothache due to Stomach fire. Additionally, it is unsuitable when damp-heat and stagnation are abundant, or at the initial onset of dysentery.

[Processing] Remove the shell and use only the flesh. Those with rich oil content and plump appearance are superior. Wrap in dough moistened with water and glutinous rice flour, or dough mixed with vinegar. Roast in ash fire until yellow and cooked. Remove and beat with paper to remove excess oil. Avoid contact with copper and iron vessels.