Chapter Thirty-Four: The Weight Loss Applications of Fangji Huangqi Decoction and Loulu Powder
Fangfeng Tongsheng San was originally a formula for treating external wind-evil and internal heat with excess in all three jiaos (exterior, interior, and exterior), not for obesity. There is no record of this formula treating obesity in ancient Chinese medical literature. However, since the Japanese journal *Kampo Medicine* reported in its 1972 issue 10 that this formula could promote metabolism and treat obesity, many people have used it to treat obesity in recent years with good results.
From the perspective of Traditional Chinese Medicine (TCM), the mechanism by which Fangfeng Tongsheng Powder treats obesity may be related to its functions of relieving exterior symptoms, purging, and promoting diuresis. Ancient people believed that obesity was often caused by excessive food intake or excessively high-quality food. For example, the *Ling Shu* (Spiritual Pivot), in its chapter on "Reversal and Order of Fat and Lean," states, "A fat person...is a person who eats excessively." This points out that overeating is a major cause of obesity. The *Su Wen* (Plain Questions), in its chapter on "Comprehensive Assessment of Deficiency and Excess," further states, "A fat and noble person suffers from the disease of consuming high-quality grains." This means that excessively high-quality food is also a significant cause of obesity. Whether it's excessive food intake or excessively high-quality food intake, both can lead to an excess of grain qi, resulting in phlegm and dampness, thus causing obesity. As stated in *Fei Zuan* (The Compendium of Fertility), "Grain qi surpasses primordial qi; when it enters the body, it leads to premature death." The rhubarb and Glauber's salt in the formula not only purge pathogenic heat but also eliminate grain qi, thereby reducing the generation of phlegm and dampness. Ancient people also believed that diaphoretic and exterior-releasing agents not only dispel dampness but, with long-term use, can also deplete body fluids, thus achieving the effect of eliminating phlegm and dampness. As stated in *Ben Cao Jing Shu* (Commentary on the Materia Medica), "Dispersing medicines, how can they be taken immediately? Their claim of lightening the body is merely the removal of dampness." In this formula, ingredients like Fangfeng (Saposhnikovia divaricata), Mahuang (Ephedra sinica), Jingjie (Schizonepeta tenuifolia), and Bohe (Mentha haplocalyx) are all dispersing herbs; long-term use will naturally lead to weight loss. Dampness-draining and diuretic herbs, when used long-term, can also deplete bodily fluids, thus contributing to weight loss. As Li Shizhen said regarding red beans, "Long-term use leads to excessive downward movement, causing fluid loss, thus resulting in emaciation and heaviness." In this formula, Baizhu (Atractylodes macrocephala) and Huashi (Talc) are dampness-draining and diuretic herbs, so they should also have weight-loss effects. From a modern pharmacological perspective, ingredients like Mahuang (Ephedra sinica), Dahuang (Rheum palmatum), Danggui (Angelica sinensis), Jiegeng (Platycodon grandiflorus), Huangqin (Scutellaria baicalensis), and Gancao (Glycyrrhiza uralensis) should all have weight-loss effects. Mahuang, in particular, has an excitatory effect on the cerebral cortex and subcortical centers, similar to the functions of commonly used weight-loss drugs like amphetamine and phenfluramine, both of which can increase the body's metabolic level and suppress appetite. Danggui (Angelica sinensis) can also increase the body's metabolic level. Platycodon grandiflorus, Scutellaria baicalensis, and Glycyrrhiza uralensis have lipid-lowering effects. Rhubarb is a mild laxative that increases intestinal peristalsis and promotes gastrointestinal emptying; this effect can inhibit lipid uptake and absorption. Pharmacological experiments have also proven that rhubarb does indeed have a lipid-lowering effect.
This formula has the functions of relieving exterior symptoms and clearing interior heat, dispelling wind and purging heat. When used as a weight loss medicine, it is suitable for those with internal heat syndrome, especially those with constipation due to heat accumulation.
Those with deficiency syndromes should avoid using it.
9. Fangji Huangqi Decoction
It treats rheumatism, edema, joint pain, floating pulse, heaviness of the body, sweating, and aversion to wind.
One ounce of Fangji (washed with wine), one ounce and one mace of Huangqi (mixed with wine), seven and a half mace of Baizhu (mixed with ginger juice), and five mace of Gancao (roasted).
Chop the ingredients into pieces the size of hemp seeds. Take 5.7 qian (approximately 15 grams) each time, add 4 slices of ginger, 1 jujube (split), and 1.5 cups of water. Boil until 80% remains, remove the dregs, and drink while warm.
[Note] This formula originates from *Synopsis of Prescriptions of the Golden Chamber* by Zhang Zhongjing of the Eastern Han Dynasty. Originally a formula for treating edema and dampness-related arthralgia, it belongs to the category of formulas for treating superficial deficiency and severe dampness. A floating pulse indicates the disease is on the surface of the body; heaviness of the body indicates internal retention of dampness; sweating and aversion to wind indicate deficiency of defensive qi; and joint pain indicates wind-dampness obstruction. The treatment principle is to tonify qi and strengthen the exterior, invigorate the spleen and promote diuresis. Therefore, *Stephania tetrandra* and *Astragalus membranaceus* are the main herbs in this formula. *Stephania tetrandra*, also known as *Jieli*, *Shijie*, and *Zaijunxing*, is the root of *Stephania tetrandra* and other perennial climbing vines of the Menispermaceae family. It is bitter and cold in nature, and functions to promote diuresis, reduce swelling, dispel wind, and relieve arthralgia. Ancient people believed that *Stephania tetrandra* also has an inhibitory effect. As Li Dongyuan said: "The 'Ten Remedies of Materia Medica' says that it can clear stagnation and remove blockages, such as Tetrapanax papyriferus and Stephania tetrandra. Stephania tetrandra is extremely bitter and cold, and can purge damp heat from the blood, clear blockages, and also purge stools. It can nourish yin and purge yang, and assist medicines used in autumn and winter to purge in spring and summer. Compared to humans, it is dangerous yet strong. It can cause chaos by taking pleasure in others' misfortunes. However, if used properly, it can also ward off sudden dangers. This is a medicine for calming the mind and body, so the sages preserved it and did not abandon it. Generally speaking, its smell is disgusting, and swallowing it will cause mental and physical agitation and reduced appetite. As for the twelve meridians being blocked by damp heat, and for treating beriberi, removing accumulated heat in the bladder and protecting the root cause, this medicine is indispensable. It is truly a miraculous medicine for clearing the path, and there is no substitute for it."
Astragalus membranaceus (Huangqi) is used to replenish qi and blood, promote diuresis, and reduce edema. It was also a commonly used weight-loss medicine in ancient times, and current research suggests it has a good therapeutic effect on obesity. Modern pharmacological studies have shown that astragalus membranaceus does indeed have a diuretic effect, and this effect is relatively long-lasting. Astragalus membranaceus also has a cardiotonic effect, strengthening the contractile function of a normal heart. This effect is more pronounced in hearts weakened by poisoning or fatigue, and it can also improve peripheral circulation. These pharmacological effects of astragalus membranaceus may have a certain therapeutic effect on obesity. Further research is needed to understand the weight-loss mechanism of astragalus membranaceus.
Atractylodes macrocephala invigorates the spleen and dries dampness. Modern pharmacological experiments have proven that Atractylodes macrocephala not only has a significant and lasting diuretic effect, but also has hypoglycemic, antitumor, and anticoagulant effects. In this formula, licorice harmonizes the middle jiao, while ginger and jujube regulate the ying and wei qi, and promote the upward movement of the spleen and stomach. The combined effects of these herbs are to tonify qi and strengthen the spleen, promote diuresis and reduce edema. As a weight-loss formula, it is suitable for qi-deficiency type obesity, especially for simple obesity with edema. This formula also relieves pain and can treat dampness-induced heaviness. However, it should be used with caution in cases of phlegm-heat obstruction or kidney heat accumulation.
10. Loulu Powder
Suitable for obese individuals with hypertension and hyperlipidemia.
Take 15 grams of *Echinops latifolius*, 15 grams of *Cassia tora* seeds, 30 grams of *Alisma plantago-aquatica*, and one lotus leaf. Decocted in water and taken twice daily.
[Note] This formula comes from *A Collection of Ancient and Modern Health and Beauty Formulas*, edited by Zhang Ju. The main ingredient, *Loulu*, also known as *Jiahao*, *Guiyouma*, and *Yelan*, is the root of *Loulu* qizhouensis or *Loulu* yuzhouensis*, a perennial herbaceous plant of the Asteraceae family. It has a bitter, salty, and cold nature, and is currently used clinically primarily as a heat-clearing, detoxifying, swelling-reducing, and lactation-promoting medicine. However, ancient people believed it also had the functions of promoting weight loss, anti-aging, and longevity. For example, the earliest extant Chinese medical text, *Shennong Bencao Jing*, states: "Loulu...long-term use lightens the body, invigorates qi, sharpens hearing and vision, and prolongs life." Research shows that *Loulu* contains a substance called strychnine, which has similar effects to strychnine. Small doses have an excitatory effect on animals, while large doses can cause spasms. It has a wake-up effect on barbiturate-induced sleep in mice and can excite neuromuscular mechanisms, promoting peripheral nerve recovery. Clinically, it can be used to treat various incomplete paralysis syndromes and paralysis due to peripheral or central motor neuron conduction disorders. It also has a tonic effect on patients with vascular dystrophy on the basis of systemic weakness. Bluethorn alkaloids can cause a decrease in blood pressure and an increase in myocardial contractility in anesthetized cats. Abroad, its fruit is used as a cardiotonic to treat patients with hypertension and arteriosclerosis, indicating that *Echinops latifolius* is a promising anti-atherosclerotic and anti-aging drug. Its decoction can improve dietary hyperlipidemia in rabbits, reduce atherosclerotic lesions, lower serum lipid peroxidation levels, and reduce the content of lipofuscin in tissues such as the brain and kidneys. Experiments have shown that ecdysterone contained in *Echinops latifolius* can lower blood lipid levels in rats, reduce lipid peroxidation and cell death in cultured smooth muscle cells, and promote cell proliferation. Considering its pharmacological effects of stimulating the central nervous system and lowering blood lipids, it should have a weight-loss effect. *Echinops latifolius* has very low toxicity; the lethal dose and therapeutic dose differ greatly, making it suitable for long-term use.
Cassia seed is currently mainly used clinically as a medicine for clearing the liver and improving eyesight, but ancient people believed it also had the function of promoting weight loss. For example, the *Shennong Bencao Jing* states that "long-term use benefits essence and brightens the eyes, making the body lighter." Modern research shows that water extracts, alcohol-water extracts, and alcohol extracts of cassia seed have hypotensive effects on anesthetized dogs, cats, and rabbits. Clinical reports also indicate that cassia seed has lipid-lowering effects. For instance, an observation of the therapeutic effect of cassia seed on hyperlipidemia in 100 patients showed that before treatment, cholesterol levels were (484–210) mg/dL, with an average of 246.91 mg/dL. After treatment, these levels decreased to (110–208) mg/dL, with an average decrease of 87.9 mg/dL. Within two weeks, 85% of patients' cholesterol levels returned to normal, and within four weeks, 96% returned to normal levels, with a total effective rate of 98%. This demonstrates its good lipid-lowering effect. Cassia seed also has a mild laxative effect due to the presence of anthraquinone compounds. Cassia seeds can accelerate gastric emptying and reduce lipid intake, which is beneficial for weight loss.