I. Cooling Formulas

I. Cooling Formulas

These formulas are suitable for heat-related closed delirium—those characterized by delirium with delirious speech, clenched teeth, stiff neck, limb twitching, high fever with flushed face, a strong, rapid pulse, and a yellow, thick tongue. Typically, this condition arises when heat enters the heart’s pericardium, blocking the pericardial channels, or when foul air suddenly enters the pericardium.

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Niu Huang Qing Xin Wan

From “Wan Mi Zhai Fang”

[Ingredients]

• 0.8 grams of bullhorn (Niu Huang)
• 15 grams of coptis (Huang Lian)
• 9 grams of scutellaria (Huang Qin)
• 9 grams of gardenia (Zhi Zi)
• 6 grams of turmeric (Yu Jin)
• 4.5 grams of cinnabar (Zhu Sha)

[Preparation Method]
Grind the herbs into a fine powder, mix with honey and form into pills about the size of millet grains. Take 7–8 pills per dose, dissolving them in herbal tea. Modern usage: Make pills from honey, weighing 1 gram per pill, taking 1 pill at a time, crushing it and dissolving it in hot water; for children, reduce the dosage accordingly.

[Indications]
Heat affecting the heart’s pericardium (heat blockage).

[Indications for Use]
Delirium with delirious speech, clenched teeth, stiff neck, limb twitching, high fever with flushed face, a yellow, thick tongue, and a rapid,洪 pulse.

[Functions]
Clear heat and detoxify, open the orifices and calm the spirit.

[Formula Explanation]
When heat affects the heart’s pericardium, the heart’s orifices become blocked, resulting in delirium with delirious speech, clenched teeth, stiff neck, limb twitching, high fever with flushed face, a yellow, thick tongue, and a rapid,洪 pulse. The formula uses bullhorn to clear the heat and toxins from the pericardial channels, allowing the orifices to open and the heat to be cleared as the primary treatment. Turmeric promotes qi circulation and resolves stagnation to facilitate orifice opening, while blood circulation and cooling help clear heat, complementing the use of bullhorn to open the orifices and clear heat. Coptis clears heart fire, scutellaria clears lung fire, and gardenia clears fire from the three jiao; these three herbs work together to drain the heat throughout the body as a complementary treatment. Cinnabar calms the mind and tranquilizes the spirit, its sweet and cool nature entering the heart, allowing all the herbs to enter the heart and serve as an auxiliary agent.

[Clinical Additions and Subtractions]
① Add rhino horn, pearl, gold leaf, musk, camphor, and realgar to create An Gong Niu Huang Wan (from “Wen Bing Tiao Bian”), which is more potent than the original formula and suitable for severe cases where heat blocks the heart’s pericardium and causes delirium.
② If constipation occurs and the tongue coating is yellow and thick, increase the amount of rhubarb and mirabilite.

[Reference Materials]
① “When external heat enters the body and the internal pathways become blocked, neither菖蒲 nor turmeric can open the channels; instead, we must use Niu Huang Wan or Zhi Bao Dan to open the blocked pathways.” (Wen Re Jing Wei)
② When heat enters the heart’s pericardium, causing delirium with delirious speech and clenched teeth, in addition to this formula, An Gong Niu Huang Wan, Zi Xue Dan, and Zhi Bao Dan can also be used. All three formulas share the functions of clearing heat, calming spasms, and opening the orifices. Among them, An Gong Niu Huang Wan is stronger in clearing heat, Zi Xue Dan is stronger in calming spasms, Zhi Bao Dan is stronger in opening the orifices, while Niu Huang Qing Xin Wan serves as a balanced combination of clearing heat, calming spasms, and opening the orifices.

[Notes and Comments]
This formula is used to treat meningitis, Japanese encephalitis, toxic dysentery, septicemia, uremia, internal complications of measles, and toxic pneumonia.

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Zi Xue Dan

From “He Ji Ju Fang”

[Ingredients]

• 500 grams of cold stone (Han Shui Shi)
• 500 grams of gypsum (Sheng Shi)
• 1000 grams of magnetite (Ci Shi)
• 500 grams of talc (Hua Shi)
• 1000 grams of nitrate (Nuo Shi)
• 150 grams of green wood fragrance (Qing Mu Xiang)
• 150 grams of sandalwood (Chen Xiang)
• 150 grams of musk (Mo Xiang)
• 30 grams of cloves (Ding Xiang)
• 150 grams of rhino horn (Xi Jiao)
• 150 grams of antler horn (Ling Yang Jiao)
• 500 grams of升麻 (Sheng Ma)
• 250 grams of licorice (Gan Cao)
• 1000 grams of mirabilite (Mang Xue)
• 500 grams of rehmannia (Xuan Shen)
• 90 grams of cinnabar (Zhu Sha) (the original formula included gold, but modern practitioners often do not use it)

[Preparation Method]
Grind all ingredients into a powder, take 3–6 grams per dose, 1–2 times daily, dissolving them in cold water.

[Indications]
Heat affecting the heart’s pericardium, extreme heat causing wind movement.

[Indications for Use]
High fever with delirium, convulsions, thirst and dry lips, clenched teeth, stiff neck, a yellow, thick tongue, and a rapid,洪 pulse.

[Functions]
Clear heat and detoxify, calm the liver and calm the spirit.

[Formula Explanation]
When heat affects the heart’s pericardium, the heart’s orifices become blocked, resulting in delirium with delirious speech. The heart’s pericardium and liver share a yin meridian; when heat affects the heart’s pericardium, the heat also triggers liver wind, leading to stiffness in the neck, clenched teeth, and convulsions. The liver and kidney share a common origin; when heat moves to the liver and wind to the kidneys, thirst and dry lips may occur. In this formula, antler horn enters the heart and liver meridians, clearing heat and toxins from the pericardial channels to open the orifices; it also calms the liver wind to calm convulsions, addressing both the root and the branch as the primary treatment. Rhino horn enters the heart to assist antler horn in clearing heat and toxins from the pericardial channels to facilitate orifice opening, serving as an auxiliary agent. Because this condition often presents with thirst and dry lips—symptoms of excess heat damaging yin—the formula avoids bitter, cold, and drying herbs like coptis and rehmannia, instead using gypsum, cold stone, talc, and other sweet, cool herbs to moisten and nourish fluids as a complementary treatment. Musk helps detoxify and open the orifices, rehmannia clears heat and nourishes yin, while cinnabar and magnetite strengthen the spirit, and green wood fragrance, cloves, and sandalwood promote qi circulation and clear the channels; mirabilite and nitrate help drain heat and resolve blockages, while升麻 helps clear heat and dissipate warmth—all of which serve as complementary treatments. Licorice harmonizes all the herbs and acts as an auxiliary agent.

[Clinical Additions and Subtractions]
① Remove talc; the formula is named Zi Xue (from “Qian Jin Yi Fang”), treating “severe heat caused by metal and stone toxins.”
② Remove rhino horn and sandalwood; the formula is also known as Zi Xue Dan (from “Ben Shi Fang”), with slightly similar indications.

[Reference Materials]
① “This formula is highly potent; the body is not strong, and the condition is not due to real heat—so it should not be used indiscriminately. I’ve seen doctors today, whenever a patient experiences delirium with delirious speech, regardless of whether it’s real or false, simply assume that pathogenic heat has entered the heart’s pericardium and use it without hesitation. However, if a patient speaks incoherently due to insufficient heart qi, overuse of this formula can lead to serious consequences. When treating a patient, one must distinguish between real and false heat, so as to avoid mistakes.” (“Shi Bing Lun”)
② “Wang, a scholar from Qingshan, came to the county to take an exam. He suddenly fell ill with a fever. His teacher, who was a physician, thought it was rheumatism and prescribed medicines like Qiang, Fang, Zha, and Qu, but his fever and thirst only worsened, and he became delirious. He invited Feng to treat him; his pulse was strong and rapid, his tongue was black, dry, and thick—this indicated that heat had turned to dryness, and fluids were being depleted. To treat the heat effectively and preserve yin, Feng did not use harsh, bitter, or drying herbs, but instead used gypsum, cold stone, talc, and other sweet, cool herbs to moisten and nourish fluids. Musk helped detoxify and open the orifices, rehmannia cleared heat and nourished yin, while cinnabar and magnetite strengthened the spirit, and green wood fragrance, cloves, and sandalwood promoted qi circulation and opened the channels; mirabilite and nitrate drained heat and resolved blockages, while升麻 helped clear heat and dissipate warmth—all of which served as complementary treatments. Licorice harmonized all the herbs and acted as an auxiliary agent.” (“Shi Bing Lun · Clinical Cases”)

[Notes and Comments]
This formula is used to treat Japanese encephalitis, meningitis, hepatic coma, typhoid fever, toxic dysentery, high fever and convulsions in children, blood disorders, cerebrovascular accidents, high fever and delirium associated with cancerous tumors.

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Zhi Bao Dan

From “He Ji Ju Fang”

[Ingredients]

• Rhino horn (Xi Jiao)
• Turtle shell (Tao Mei)
• Amber (Hu Po)
• Cinnabar (Zhu Sha)
• Realgar (Xiong Huang) – each 30 grams
• Camphor (Long Nao)
• Musk (Mo Xiang) – each 0.3 grams
• Bullhorn (Niu Huang) 15 grams
• Incense (An Xi Xiang) 45 grams (the original formula included gold leaf and silver leaf, but these are no longer used)

[Preparation Method]
Grind all ingredients into a powder, mix with honey, and form into pills about the size of a mulberry seed. Dissolve three to five pills in ginseng tea. Modern practice uses 3-gram pills; take one pill per dose, crushing it and dissolving it in hot water.

[Indications]
Heat affecting the heart’s pericardium, phlegm obstructing the heart’s orifices.

[Indications for Use]
Delirium without speech, abundant phlegm and rough breath, high fever with red tongue, yellow, greasy coating on the tongue, and a slippery, rapid pulse.

[Functions]
Clear heat and detoxify, clear phlegm and open the orifices.

[Formula Explanation]
When heat enters the heart’s pericardium, the heart’s orifices become blocked, resulting in delirium with delirious speech. The heart’s pericardium and liver share a yin meridian; when heat enters the heart’s pericardium, the heat also triggers liver wind, leading to stiffness in the neck, clenched teeth, and convulsions. The liver and kidney share a common origin; when heat moves to the liver and wind to the kidneys, thirst and dry lips may occur. In this formula, antler horn enters the heart and liver meridians, clearing heat and toxins from the pericardial channels to open the orifices; it also calms liver wind to calm convulsions, addressing both the root and the branch as the primary treatment. Rhino horn enters the heart to assist antler horn in clearing heat and toxins from the pericardial channels to facilitate orifice opening, serving as an auxiliary agent. Because this condition often presents with thirst and dry lips—symptoms of excess heat damaging yin—the formula avoids bitter, cold, and drying herbs like coptis and rehmannia, instead using gypsum, cold stone, talc, and other sweet, cool herbs to moisten and nourish fluids as a complementary treatment. Musk helps detoxify and open the orifices, rehmannia clears heat and nourishes yin, while cinnabar and magnetite strengthen the spirit, and green wood fragrance, cloves, and sandalwood promote qi circulation and open the channels; mirabilite and nitrate drain heat and resolve blockages, while升麻 helps clear heat and dissipate warmth—all of which serve as complementary treatments. Licorice harmonizes all the herbs and acts as an auxiliary agent.

[Clinical Additions and Subtractions]
① Ancient physicians used ginseng tea to dissolve this formula, aiming to restore mental clarity and support the body’s natural defenses against illness.
② The “Ji Fu Fang” used baby urine mixed with fresh ginger juice to dissolve this formula, aiming to enhance the effects of clearing heat and opening the orifices.

[Reference Materials]
“Treatment for all strokes, measles, plague, or phlegm-heat obstruction, or for phlegm-damp toxicity, water toxicity, as well as for childhood chronic convulsions where the jaw is locked—first, use this formula to open the orifices, then you can proceed with medication. Internal blockage can manifest differently depending on wind, phlegm, cold, or heat; for example, Su He Wan leans toward warming, Yu Shu Dan leans toward draining, and Niu Huang and Zi Xue lean toward cooling. Though each has its own characteristics, the overarching principle is always to use fragrances to open qi and detoxify, and to treat the root cause of the problem. Those who use these formulas can tailor their treatment according to the specific symptoms.” (“Cheng Bian Fang Du”)

[Notes and Comments]
This formula is used to treat Japanese encephalitis, meningitis, toxic dysentery, epilepsy, high fever and convulsions.

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Zhi Bao Dan

From “He Ji Ju Fang”

[Ingredients]

• 30 grams of green wood fragrance (Qing Mu Xiang)
• 30 grams of cloves (Ding Xiang)
• 30 grams of incense (An Xi Xiang)
• 30 grams of sandalwood (Chen Xiang)
• 30 grams of white sandalwood (Bai Tan Xiang)
• 30 grams of fragrant grass (Xiang Fu)
• 30 grams of myrrh (He Ba)
• 30 grams of rhino horn (Xi Jiao)
• 30 grams of cinnabar (Zhu Sha)
• 30 grams of Atractylodes macrocephala (Bai Zhu)
• 15 grams of musk (Mo Xiang)
• 15 grams of camphor (Long Nao)
• 30 grams of Zhi Bao oil (Su He Xiang You)

[Preparation Method]
Mix all ingredients thoroughly, then add camphor and musk. Heat the Zhi Bao oil with a small amount of white honey until it’s warm, then gently stir it into the powdered mixture. Once the ingredients are combined, form the pills (each weighing 3 grams), take one pill per dose, dissolving it in warm water; for children, reduce the dosage accordingly.

[Indications]
Cold energy entering the heart’s pericardium, blocking the heart’s orifices.

[Indications for Use]
Delirium with confusion, clenched teeth, facial asymmetry, limb twitching, phlegm sounds, pale tongue, and a slow pulse—no signs of heat.

[Functions]
Warm and disperse cold, use fragrances to open the orifices.

[Formula Explanation]
Stroke, qi deficiency, or poisoning (phlegm-dampness) can lead to cold energy entering the heart’s pericardium and blocking the orifices. While the primary cause is cold energy, the blockage of the heart’s orifices leads to symptoms like delirium, confusion, and clenched teeth. In this formula, Zhi Bao oil, incense, musk, and camphor act as fragrances to disperse cold and clear the orifices, facilitating orifice opening and clearing. Sandalwood, green wood fragrance, fragrant grass, frankincense, cloves, sandalwood, and myrrh—these fragrances promote qi circulation, harmonize blood, and resolve stagnation, aiding the primary treatment’s efforts to open the orifices and clear the channels. Myrrh and cinnabar help to warm and tighten, preventing fragrances from dispersing vital qi; Bai Zhu strengthens the spleen and dries dampness, aiming to support the body’s natural defenses—both are complementary treatments. White honey harmonizes all the herbs and acts as an auxiliary agent.

[Clinical Additions and Subtractions]
① Remove rhino horn, myrrh, myrrh, sandalwood, fragrant grass, cloves, Bai Zhu, and camphor; the formula is named Guan Xin Zhi Bao Wan (from “Chinese Herbal Medicine Handbook”), used to treat coronary artery disease and angina pectoris.
② Remove Bai Zhu and frankincense to treat qi deficiency due to wind, or to treat convulsions and phlegm-dampness, with efficacy comparable to the above three herbs.

[Reference Materials]
① “For stroke with cold blockage, where the patient loses consciousness; when encountering foul air and phlegm-dampness, where phlegm accumulates and the qi is blocked, causing abdominal pain and coldness; for epidemic cholera, where the abdomen is full and the chest is uncomfortable, with a desire to vomit but unable to pass stool, even leading to coma. This formula was first mentioned in ‘Wai Tai Mi Yao’ (from ‘Guang Ji Fang’), known as ‘Chi Li Jia’ (which means Bai Zhu).” (“Brief Chinese Medical Dictionary”)

② “For all sudden deaths, comas, phlegm-dampness blockage, loss of consciousness, as well as for demonic spirits and harmful air, or for seasonal plagues. The causes of illness vary—from stroke, cold, summer heat, dampness, phlegm, qi deficiency, to poison—yet the symptoms are often similar. Regardless of the specific pathogen, it is essential to first distinguish between the two paths of blockage and release: while blockage may also present with limb paralysis and a weak pulse, the hands will inevitably clench tightly, bowel movements will be blocked, the mouth will be stiff, and the eyes will stare straight ahead—this indicates that pathogenic factors have surged rapidly, and the body’s vital qi has been suppressed. In such cases, we must use fragrances to open the orifices, either Su He, Niu Huang, Zhi Bao, Zi Xue, or similar formulas, carefully assessing the cold and heat, distinguishing between pathogenic and normal qi, and choosing the appropriate remedy—only then can we ensure that the pathways are cleared and the vital qi restored, before addressing the root cause of the illness.” (“Cheng Bian Fang Du”)

[Notes and Comments]
This formula is often used for hysteria-like fainting, gas poisoning, cerebrovascular accidents, epileptic seizures, coronary artery disease with angina pectoris, and coma due to food poisoning.

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Tongguan San

From “Dan Xi Xin Fa Fu”

[Ingredients]

• Pig tooth soapberry (Zhu Jiao)
• Asarum sieboldii (Xie Xin)

[Preparation Method]
Grind the ingredients into extremely fine powders, mix them thoroughly, and blow a small amount into the nostrils to induce sneezing.

[Indications]
Closed delirium with clenched teeth

[Indications for Use]
Sudden falls, delirium without speech, clenched teeth, phlegm buildup, and a strong, rapid pulse.

[Functions]
Open the orifices and clear the channels.

[Formula Explanation]
When stroke, qi deficiency, or poison—such as phlegm-dampness—lead to cold energy entering the heart’s pericardium and blocking the orifices, clenched teeth result in this condition. This formula’s function is to open the orifices, and it is often used in conjunction with the aforementioned orifice-opening agents to achieve optimal results. The soapberry’s spicy, warm nature helps to open the orifices, while its ability to clear phlegm and open the channels makes it a key ingredient. Asarum’s spicy, warm nature helps to disperse cold, assisting the soapberry in opening the orifices and clearing the channels, creating a synergistic formula. The lungs open their orifices through the nose; the lungs govern the body’s qi, and sneezing through the nose opens the lung’s orifices, allowing lung qi to circulate freely—and thus, the zong qi can flow smoothly, the orifices can open, and the patient can regain consciousness.

[Clinical Additions and Subtractions]
This formula is enhanced with musk and peppermint, and is also known as Tongguan San (from “Yi Fang Yi Jian”). Its functions are identical to this formula.

[Reference Materials]
“After using this formula, those who sneeze can recover; those who do not sneeze have lost lung qi and require further treatment.” (Jiangsu New Medical College: “Chinese Herbal Medicine Formulaology”)

[Notes and Comments]
This formula can be used for patients who are unconscious and have clenched teeth, as an emergency measure to awaken them; after awakening, treatment can be tailored based on the patient’s condition. Clinically, it is often used for hysteria-like fainting, gas poisoning-induced coma, and other conditions.

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Chapter 8: Agents for Warming the Interior and Revitalizing the Yang

Warming the interior and reviving the yang are collectively referred to as warming therapies, and formulas that possess both warming and reviving properties are classified as warming agents. Warming the interior aims to dispel cold from the spleen and stomach; reviving the yang aims to restore weakened kidney yang. Cold in the spleen and stomach, and weakened kidney yang, are collectively known as internal cold, and their causes include direct exposure to cold pathogens or internal generation of cold. To treat cold in the spleen and stomach, one should warm the center and disperse cold—this is known as warming the interior. To restore weakened kidney yang, one should urgently revive the yang—this is known as reviving the yang. The former focuses on acquired energy, while the latter focuses on innate energy. The “Su Wen·Gasping Heaven Theory” states: “Yang qi is like heaven and the sun; if it loses its place, it will shorten life and diminish its brilliance.” Thus, the importance of yang qi to the human body is evident. Cold is a yin pathogen and most easily harms yang; if internal cold is left untreated, it will inevitably lead to yang deficiency. Therefore, warming the interior and reviving the yang are usually used in tandem.

I. Warming the Center and Dispersing Cold

Warming the center and dispersing cold is a method for treating spleen and stomach deficiency-cold. The spleen and stomach reside in the center, responsible for digestion and transformation; when deficiency-cold occurs, one may experience abdominal distension and pain, intestinal rumbling and diarrhea, nausea and vomiting. Cold easily harms yang; when deficiency-cold is severe, one may feel cold and fear of cold; when cold is severe and congealed, one may experience severe abdominal pain, with heat rising to the skin, causing head and feet to feel cold, and pain spreading up and down.

Lizhong Wan (Ginseng Tea)

From “Shang Han Lun”

[Ingredients]

• Ginseng 9 grams
• Dried ginger 9 grams
• Licorice 9 grams
• Atractylodes macrocephala 9 grams (all three measures)

[Preparation Method]
Grind all ingredients into a fine powder, sift through a sieve, then mix with honey to form pills the size of a chicken egg; modern practice often uses herbal teas.

[Indications]
Spleen and stomach deficiency-cold.

[Indications for Use]
Abdominal fullness with vomiting, poor appetite, abdominal pain, frequent belching, a desire to spit, prolonged discomfort, feeling cold and fearful of cold, and spontaneous sweating.

[Functions]
Warm the center and disperse cold, strengthen the spleen and benefit qi.

[Formula Explanation]
“Qi deficiency leads to cold,” and when spleen and stomach qi is deficient, there is inevitably a condition of spleen and stomach cold. Deficiency and cold are mutually causal. The spleen and stomach reside in the center, responsible for digestion and transformation; when spleen and stomach deficiency-cold occurs, digestion and transformation fail. Clear qi cannot rise on its own, leading to frequent belching; turbid qi cannot descend on its own, leading to vomiting and a desire to spit; cold energy congeals in the middle burner, hindering qi circulation, leading to abdominal fullness and abdominal pain, prolonged discomfort; when deficiency-cold exists internally, yang qi cannot reach the exterior, leading to cold and fear of cold, and spontaneous sweating. The primary cause of these symptoms is deficiency-cold; within deficiency-cold, cold is urgent while deficiency is slow. In this formula, dried ginger warms the center and disperses cold, serving as the primary treatment. Codonopsis strengthens the spleen and benefits qi as an auxiliary agent. When spleen and stomach deficiency-cold occurs, dampness stagnates in the middle burner; Atractylodes macrocephala strengthens the spleen and dries dampness as a complementary treatment. Licorice harmonizes all the herbs and acts as an auxiliary agent.

[Clinical Additions and Subtractions]
① Add cinnamon twig, forming Cinnamon Ginseng Tea, used to treat cases where the Sun’s exterior symptoms have not yet subsided but the patient has experienced repeated diarrhea, leading to continuous diarrhea, abdominal fullness, and a feeling of heaviness in the chest—where the exterior and interior remain unresolved. (Shang Han Lun)
② Add coptis, forming Coptis Decoction (from “Zheng Yin Mai Zhi”), used to treat cases of vomiting with sour liquid and a slow, tense pulse. ③ Add Aconite, known as Aconite Lizhong Pill (from Yan’s Children’s Medicine), which treats deficiency-cold in the spleen and stomach, heart pain, and cholera with vomiting and diarrhea accompanied by muscle cramps.

④ Add Citrus Aurantium and Poria, made into honey pills, known as Citrus Aurantium Lizhong Pill (from Heji Bureau’s Formula), which regulates the middle burner, relieves fullness and discomfort, eliminates phlegm and fluid retention, and stops abdominal pain.

⑤ Add Pinellia (processed with ginger) and Poria, known as Lizhong Phlegm-Dispersing Pill (from Ming’s Miscellaneous Medical Works), which treats deficiency of Yang in the spleen and stomach, internal accumulation of cold dampness, poor appetite with loose stools, and vomiting of clear water.

[Reference Materials]

① “When a Sunyuan disease is characterized by vomiting, diarrhea, and abdominal distension and pain, it indicates that the disease has spread to all three burner zones! However, although vomiting originates from the upper part of the body, it is due to abdominal distension; while diarrhea originates from the lower part of the body, it is also caused by abdominal distension—both are results of failing to treat the middle burner. There are three main causes: one is deficiency of the exterior, where wind-cold enters from outside; another is deficiency of the lower part, where cold-dampness rises from below; and a third is due to eating cold or raw foods, causing cold evil to manifest in the middle burner—these conditions all stem from deficiency-cold. The treatment should focus on warming and tonifying to support the Yang of the stomach and abdomen; when the symptoms of fullness, pain, vomiting, and diarrhea are all alleviated, this is considered a successful outcome!” (From “Shanghan Lai Su Ji”)

② Observation on the treatment of 14 cases of chronic colitis using Lianli Tang: All patients had been suffering from the condition for more than three months, experiencing abdominal pain and diarrhea with recurrent episodes, frequent bowel movements (3 times in some cases, up to 8 times in others), often containing mucus and pus or blood. Among these cases, 5 were initially diagnosed with acute bacterial dysentery, 2 with amoebic dysentery, while the remaining cases had unknown causes. Other symptoms included fatigue, coldness in the abdomen, and chills; most patients exhibited tenderness in the umbilical region or lower abdomen, without any palpable masses. The diagnosis was deficiency-cold in the spleen and stomach, accompanied by residual heat that had not yet been fully eliminated. Treatment primarily used Lianli Tang (with Codonopsis, Atractylodes, Dried Ginger, Licorice, Coptis, and Poria). For those with severe abdominal distension and pain, herbs such as Agarwood, Wuzhu, and Qingpi were added. Those with tenesmus were treated with Citrus Aurantium, Shenqu, and Radix Raphani. For those with bloody stools, herbs like Huangqin and Qinpi were used. When tenesmus and bloody stools subsided, and the hardness and frequency of bowel movements remained abnormal, five-flavor berry, Chinese wolfberry fruit, calcined Dragon’s Blood, and Oyster Shell could be added. After most patients had fully recovered from their symptoms, they often continued treatment with Shanling Bai Zhu Wan or Lizhong Wan to consolidate the therapeutic effect. Treatment durations ranged from 8 days to 62 days, with most cases lasting 16–22 days. Among the 14 cases, 11 achieved clinical recovery, 2 showed marked improvement, and 1 did not respond to treatment. (From “Chinese Medicine Magazine,” 1963, No. 2)

[Commentary] This formula can be used for gastric and duodenal ulcers, chronic colitis, localized ileitis, and bacterial dysentery; it can also be employed for gastrointestinal bleeding and gastrointestinal neurosis.

Xiao Jianzhong Tang from “Shanghan Lun”

[Composition] 6 grams of Gui Zhi (3 liang, peeled), 12 grams of Bai Shao (6 liang, stir-fried in wine), 3 grams of Zhi Gan Cao (2 liang), 9 grams of Sheng Jiang (3 liang, sliced), 24 grams of Yi Tang (1 sheng), and 5 dates (12 dates).

[Administration] Brew the herbs in water, remove the residue, add Yi Tang, then simmer over low heat until dissolved, and take warm.

[Indications] Deficiency-cold in the middle burner.

[Indications] Occasional abdominal pain, preference for warmth and pressure, with relief upon pressing; palpitations in the heart, restlessness and unease; fever due to deficiency.

[Functions] Warm the middle burner, tonify deficiency, harmonize the interior and relieve urgency.

[Formula Explanation] Cold primarily causes contraction and restriction; when contraction occurs, circulation is blocked, leading to pain. When cold stagnates in the middle burner, occasional abdominal pain arises. If the middle burner is deficient, pain follows warmth and pressure, and pressing alleviates the pain. The spleen and stomach reside in the center, belonging to Earth, and are the source of Heart Fire; when the child’s energy is weakened, the mother’s energy is stolen, resulting in palpitations in the heart and restlessness due to deficiency. The spleen and stomach are the origin of vital energy and bodily fluids; when the spleen and stomach are deficient in warmth, the vital energy and fluids become unbalanced, cold becomes prevalent within, and excess yang rises above—this leads to fever due to deficiency. Ultimately, the root cause of these symptoms lies in deficiency-cold in the middle burner; the primary treatment should be warming the middle burner to disperse the cold and tonifying deficiency to address the underlying deficiency. In treating symptoms caused by deficiency-cold, abdominal pain is often severe and distressing; only by employing methods that harmonize the interior and relieve urgency can we address both the root cause and the symptoms, achieving comprehensive healing. In this formula, Yi Tang provides sweet and warm nourishment to replenish deficiency, Gui Zhi warms the middle burner and disperses cold—these two herbs together shoulder the responsibility of warming the middle burner and tonifying deficiency, serving as the primary medicinal ingredients. Bai Shao is sour and bitter, while Gan Cao is sweet and neutral; the combination of these two herbs aligns with the principle of “sour and sweet harmonizing yin,” working together to relieve urgency and stop pain as an auxiliary component. Sheng Jiang and dates, one pungent and one sweet, one external and one internal, work together to harmonize the vital energy and fluids, acting as “guides and harmonizers.”

[Clinical Adjustments]

① Add Astragalus, known as Astragalus Lizhong Tang (from Jin Gui Yao Lü), to treat deficiency-related urgency and various deficiencies in the body.

② Add Angelica, known as Angelica Lizhong Tang (from Qian Jin Yi Fang), to treat postpartum weakness and deficiency, persistent abdominal pain, shortness of breath, or to treat tightness in the lower abdomen, pain radiating to the lower back, and loss of appetite.

③ Add Angelica and Astragalus, known as Angelica-Astragalus Lizhong Tang, to treat cases where the Xiao Jianzhong Tang formula is used alongside both deficiency and qi-blood deficiency.

[Reference Materials] “This formula is essentially Gui Zhi Tang with doubled Shao Yao and added Yi Tang; it is called Xiao Jianzhong, meaning ‘to establish the middle qi’—even though the middle burner is already deficient, the exterior has not yet been harmonized, so we do not dare to use excessive tonification. Therefore, Gui Zhi harmonizes the vital energy and fluids, Shao Yao doubles the dosage and adds Yi Tang to help build the middle burner, while allowing the patient to drink warm porridge to induce sweating—this approach emphasizes the deficiency in the middle burner rather than the exterior of the cold.” (From “Yi Zong Jin Jian”)

[Commentary] This formula, when adjusted, can be used for gastric and duodenal bulb ulcers, neurasthenia, aplastic anemia, thrombocytopenic purpura; it can also treat episodic hypoglycemia and fevers of unknown cause.

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Wu Zhu Yu Tang

From “Shanghan Lun”

[Composition] 3 grams of Wu Zhu Yu (1 sheng, washed in soup), 9 grams of Ren Shen (3 liang), 15 grams of Sheng Jiang (6 liang, sliced), and 4 dates (12 dates, split).

[Administration] Brew the herbs in water, then take the decoction.

[Indications] Cold stagnation in the stomach, headache due to Jue Yin, and diarrhea due to Shaoyin.

[Indications] Nausea after eating, acid reflux and discomfort, headache at the crown of the head, dry vomiting of saliva, cold hands and feet, and agitation leading to death.

[Functions] Disperse cold, descend rebellious qi.

[Formula Explanation] When cold stagnation occurs in the stomach, abdominal pain arises, nausea and acid reflux occur after eating; the Foot Jue Yin Liver Meridian intersects with the Du Meridian at the crown of the head, and the cold in the stomach rises upward, colliding with Liver Qi and reaching the crown of the head—this leads to dry vomiting and salivation, along with headache. The spleen and stomach reside in the center, rising from the Heart and controlling the Kidney; when cold in the middle burner is severe, “Yellow Mother” fails to mediate, and the Heart and Kidney become ill—this results in cold hands and feet, and agitation leading to death. Although this formula addresses three symptoms, its root cause lies in cold in the stomach; in this formula, Wu Zhu Yu warms the stomach and dispels cold, while also descending the rebellious qi of the Three Yin, serving as the primary remedy. Sheng Jiang warms the stomach, dispels cold, and descends rebellious qi to stop vomiting, working in tandem with the primary herb, doubling the effects of dispersing cold and descending rebellious qi—and thus serving as an auxiliary ingredient. Ren Shen and dates nourish qi and strengthen the spleen, providing complementary treatment. The entire formula works by warming the middle burner and descending rebellious qi, strengthening the spleen and stomach, and allowing the Heart and Kidney to find peace.

[Clinical Adjustments] For severe stomach pain, add Dan Shen, Mu Xiang, and Sha Ren; for severe vomiting, add Ban Xia and Sheng He Shi; for severe headaches, add Chuan Xiong, Bai Zhi, Gao Ben, and Xi Xin; for cold hands and feet, and agitation, add Si Ni Tang.

[Reference Materials]

① “Dry vomiting of saliva and head pain indicate that cold qi from Jue Yin is rising upwards; diarrhea and cold hands and feet signify that cold qi is abundant within the body; agitation leading to death indicates that yang qi is in conflict within the body; nausea after eating suggests that the stomach is cold and unable to receive food. When treating these three conditions with this formula, Wu Zhu Yu is used as the principal herb to descend the rebellious qi of the Three Yin, while Sheng Jiang dispels cold—these two herbs serve as the secondary components, harmonizing the overall qi.” (From “Nei Tai Fang Yi”)

② “Fu × Chun, male, 26 years old. He visited the clinic due to headache, with a thin pulse, pale tongue, cold hands and feet, clear and easy-to-pass urine, and occasional dry vomiting of saliva. This case involved Jue Yin Liver Qi rising upwards; because its meridians intersect with the Du Meridian at the crown of the head, he experienced headache—commonly known as ‘phlegm-induced headache.’ He was treated with 4 qian of Wu Zhu Yu, 6 qian of Sheng Jiang, 3 qian of Ren Shen, and 4 dates, and his condition improved after just one dose.” (From “Fujian Chinese Medicine,” 1964, May)

③ “Lin × Sao, female, in her forties. She had long suffered from stomach cold, and yesterday she vomited saliva, felt cold in her mouth, even when drinking water she would vomit. Her pulse was thin and wiry, her tongue was pale without coating, her hands and feet were cold, but she didn’t feel thirsty. This case was caused by turbidity of Yin qi stirring Liver Qi; after taking a single dose of Wu Zhu Yu Tang, her condition improved.” (From “Fujian Chinese Medicine,” 1964, May)

[Commentary] This formula, when adjusted, can be used for chronic gastritis, ulcerative diseases, neural headaches, acute gastroenteritis, pregnancy-induced vomiting, gastrointestinal neurosis, Meniere’s disease, and vomiting due to drug allergies.

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Da Jianzhong Tang

From “Jin Gui Yao Lü”

[Composition] 3 grams of Shu Jiao (2 liang, roasted to remove moisture), 4.5 grams of Gan Jiang (4 liang), 9 grams of Ren Shen (2 liang), 30 grams of Yi Tang (1 sheng).

[Administration] Brew the herbs in water, remove the residue, add Yi Tang, and simmer over low heat for a few moments before taking warm. It is best to drink a bowl of porridge before taking the medicine.

[Indications] Accumulation of Yin cold, severe abdominal pain.

[Indications] Severe cold pain in the chest and abdomen, inability to eat, upward movement of cold air, visible in the head and feet, pain extending from the upper to the lower parts of the body.

[Functions] Warm the middle burner, dispel cold, relieve pain, and descend rebellious qi.

[Formula Explanation] As stated in “Su Wen · Bi Lun,” “Pain arises from excessive cold; it is caused by cold.” Thus, cold is the primary cause of pain. When Yin cold stagnates internally, severe cold pain appears in the chest and abdomen, with pain extending from the upper to the lower parts of the body—when cold rises upward, it is visible in the skin, reaching the head and feet. When cold stagnates in the middle burner, it leads to inability to eat. All these symptoms originate from internal cold; in this formula, Shu Jiao warms the middle burner, dispels cold, and relieves pain while descending rebellious qi, addressing both the root cause and the symptoms; Gan Jiang warms the middle burner, dispels cold, and also helps to descend rebellious qi, working in harmony with the other herbs. Ren Shen nourishes qi and strengthens the spleen, providing complementary treatment. Yi Tang, which nourishes qi and replenishes the middle burner, also serves as a complementary treatment, harmonizing the herbs and acting as a guide to facilitate the process.

[Clinical Adjustments] For stomach pain, add Dan Shen, Mu Xiang, and Cao Kou; for bilateral flank pain, add Chai Hu, Zhi Ke, Bai Shao, and Gan Cao; for diarrhea and intestinal rumbling, add Gan Jiang and Fu Pi; for yellow tongue and constipation, add Huang Lian and Huang Lian; for poor digestion, add Bai Zhu and Fu Ling.

[Reference Materials]

① “Shu Jiao is pungent and warm, entering the Lung to disperse cold, entering the Spleen to warm the stomach, entering the Kidney to replenish fire; Gan Jiang is pungent and warm, opening the Heart to assist Yang, dispelling cold and descending rebellious qi; Ren Shen is sweet and warm, greatly replenishing the Qi of the Spleen and Lung; Yi Tang is sweet and capable of nourishing Earth and soothing the middle burner—because humans rely on the middle burner as the primary force, using spicy, warm herbs to warm the Yang of the inner organs, thereby dispelling the turbidity of the rebellious qi rising upward.” (From “Cheng Bian Fang Du”)

② The “Jia Wei Da Jianzhong Tang” was used to treat 45 cases of biliary ascariasis. The formula consisted of 3 liang of Gan Jiang, Shu Jiao, Wu Mei, Kǔ Lián Pi, Bin Lang, and Ren Shen each, along with 2 liang of sugar, 1.5 liang of Huang Lian and 1.5 liang of Zhì Gan Cao—children’s doses were halved. All 45 cases were confirmed by Western medical examinations; among them, 39 cases were cured (symptoms completely disappeared, blood tests returned to normal), 4 cases showed improvement (clinical symptoms eased, blood tests returned to normal), and 2 cases progressed slowly (clinical symptoms were barely noticeable, but blood tests remained normal). (From “Zhejiang Chinese Medicine Magazine,” 1964, No. 2)

[Commentary] This formula, when adjusted, can be used for chronic gastritis, ulcerative diseases, chronic pancreatitis, chronic cholecystitis, biliary ascariasis, and intestinal tuberculosis.

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II. Returning Yang and Rescuing Rebellious Qi

Returning Yang and rescuing rebellious qi is a method for saving those who have lost Yang. As stated in “Su Wen · Sheng Qi Tong Tian Lun,” “When Yin is peaceful and Yang is hidden, spirit is able to thrive; when Yin and Yang are separated, essence and qi are lost.” When a patient’s Yang qi weakens and Yin cold becomes rampant, symptoms include cold extremities, a weak and almost nonexistent pulse, and profuse watery diarrhea. Additionally, cases where Yang deficiency prevents water metabolism, or where floating Yang rises excessively, or where Yang is trapped externally, can all be treated with this method.

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Si Ni Tang

From “Shanghan Lun”

[Composition] 9 grams of Fuzi (1 piece, used raw, broken into eight pieces), 9 grams of Gan Jiang (1.5 liang), 4.5 grams of Gan Cao (2 liang).

[Administration] Brew the herbs in water, remove the residue, and take warm.

[Indications] Weak kidney Yang, sluggish spleen Yang.

[Indications] Cold extremities, a weak and almost nonexistent pulse, profuse sweating, cold abdominal pain, vomiting and diarrhea with clear water, and feeling cold throughout the body.

[Functions] Return Yang and rescue rebellious qi.

[Formula Explanation] When kidney Yang is weak, cold extremities appear, the pulse is weak and nearly nonexistent, profuse sweating occurs, and the body feels cold. When spleen Yang is sluggish, cold abdominal pain and clear watery diarrhea arise. The spleen Yang relies on kidney Yang’s warmth to flourish; in this formula, Fuzi warms the kidneys and strengthens Yang, serving as the primary remedy for returning Yang and rescuing rebellious qi. Gan Jiang warms the middle burner and dispels cold, acting as an auxiliary remedy for returning Yang and rescuing rebellious qi. Gan Cao harmonizes the herbs, acting as a guide to facilitate the process. Both Gan Jiang and Fuzi possess strong warming properties, helping to dispel deep-seated cold and cold stagnation, drawing Yang away from the brink of death and restoring it—combined with the sweetness of Gan Cao to soothe and harmonize the herbs, creating a warm and sweet formula that aligns with the principle in “Nei Jing” that “Cold invades the interior, treat it with sweet and warm remedies.”

[Clinical Adjustments]

① Increase the amount of Gan Jiang by double, naming it Tong Mai Si Ni Tang (from Shanghan Lun), to treat Si Ni, a weak and almost nonexistent pulse—by using more Gan Jiang to warm Yang and preserve the middle burner, the efficacy of returning Yang is enhanced.

② Add Ren Shen, naming it Si Ni Jia Ren Shen Tang (from Shanghan Lun), to treat Si Ni with cold and chills, a weak pulse that returns to normal, and when the diarrhea stops but blood loss occurs.

③ Add Poria and Ren Shen, naming it Poria Si Ni Tang (from Shanghan Lun), to treat cases where fever from Shanghan is still present, but the illness persists despite treatment, and the patient experiences agitation.

④ Add Scallions, naming it Bai Tong Tang (from Shanghan Lun), to treat cases of diarrhea due to Shaoyin, with a weak pulse.

⑤ Add Scallions and pig bile, naming it Bai Tong Jia Pig Bile Tang, to treat cases where diarrhea continues after taking Bai Tong Tang, with cold extremities, no pulse, and severe vomiting.

⑥ Add Pinellia, Baizhi, and Cinnamon powder, naming it Jiang Shui San (from Bao Ming Ji), with each dose being 10 grams—brew the herbs in water, remove the residue, and take warm, to treat sudden diarrhea resembling water, with sweat all over the body, extreme coldness throughout the body, and a weak pulse.

[Reference Materials]

① “In the pathogenesis of Yin excess and Yang deficiency, there are different degrees of severity; when using Si Ni Tang, adjustments should be made according to the individual’s condition. For example, in the case of Si Ni Jia Ren Shen Tang, the diarrhea may stop suddenly, but the cold and chills remain—this is not a sign of Yang returning, but rather a depletion of Yin fluids, leading to cessation of diarrhea. In such cases, if Si Ni Tang alone is used, it will not only fail to achieve the desired effect but may even accelerate death. Therefore, it is advisable to add Ren Shen to Si Ni Jia Ren Shen Tang, to restore Yang and return Yin. If the patient experiences excessive sweating and diarrhea after treatment, and is agitated, adding Poria to Si Ni Jia Ren Shen Tang can enhance the effect—adding Poria to Si Ni Jia Ren Shen Tang creates a formula that restores Yang and regulates rebellious qi. If the patient suffers from Shaoyin cold, with diarrhea and cold extremities, flushed face, and agitation, adding human urine or pig bile to Bai Tong Tang can help resolve the blockage between Yang and Yin, preventing resistance to warm medicines—this is in line with the principle in “Su Wen · Zhi Zhen Ya Da Lun,” ‘Use cold to treat heat,’ ‘When the heat is severe, follow the heat.’” (From Jiangsu New Medical College: “Chinese Medicine Formulas”)

② Si Ni Tang with Huang Lian was used to treat 70 cases of infantile diarrhea. All patients were infants aged 45 days to 1.5 years, with the shortest duration of illness being 8 days and the longest being 64 days. Among these cases, 53 patients had previously failed to improve with traditional Chinese medicine and Western medicine, while 17 patients had never taken any medication. All cases were treated with Si Ni Tang combined with Huang Lian (first, add 5 fen of Fuzi, 3 liang of Gan Jiang and Gan Cao, pour 300 ml of water, simmer over low heat until 150 ml remains, then add 3 liang of Huang Lian, continue simmering over low heat until 80 ml remains, filter, add appropriate amount of sugar, bring to a boil, and set aside). For infants under 5 months, the dosage was 3–5 ml per dose; for infants aged 6–10 months, the dosage was 5–8 ml per dose; for infants aged 1–1.5 years, the dosage was 8–10 ml per dose, taken every four hours. Treatment outcomes: 58 patients were cured, 8 patients showed near-cure, and 4 patients did not respond to treatment. The longest treatment duration for cured patients was 7 days, while the shortest was 1 day, with an average of 4 days. (From “Zhejiang Chinese Medicine Magazine,” 1964, No. 8:14)

③ Si Ni Tang injection solution could enhance the contractile force of the beating heart in anesthetized rabbits; clinical observations showed that using Si Ni Tang injection solution to rescue shock could increase blood pressure. (From “Tianjin Medical Communications,” 1972, No. 11)

[Commentary] This formula is used for infantile diarrhea and chronic colitis; it can also be used in cases of pulmonary heart disease, pneumonia, or dehydration leading to hypotension and collapse.

Hui Yang Jiu Ji Tang

From “Shanghan Liu Shu”

[Composition] 9 grams of cooked Fuzi, 4.5 grams of dried Gan Jiang, 3 grams of cinnamon, 6 grams of Ren Shen, 9 grams of Bai Zhu, 9 grams of Poria, 6 grams of Chen Pi, 4.5 grams of Gan Cao, 3 grams of Wu Wei Zi, and 9 grams of Zhì Ban Xia.

[Administration] Brew the herbs in water, add three slices of fresh ginger, and take the medicine after mixing in 0.1 grams of musk. After taking the medicine, the hands and feet will feel warm—do not take additional medication.

[Indications] Cold enters the Three Yin, Yin is abundant while Yang is weak.

[Indications] Cold extremities, a weak and almost nonexistent pulse, coldness in the body, cold abdominal pain, vomiting and diarrhea with clear water, and bluish-purple nails.

[Functions] Restore Yang and rescue emergency.

[Formula Explanation] When cold directly affects the Three Yin, Yin is abundant while Yang is weak, leading to this condition. The Three Yin are the Foot Tai Yin Spleen, the Foot Shaoyin Kidney, and the Foot Jue Yin Liver—among them, the Kidney is the seat of Yuan Yang. When cold enters the Kidney, it takes time for the Kidney Yang to decline; when cold enters the Spleen, the Spleen Yang becomes sluggish, leading to cold abdominal pain and vomiting and diarrhea with clear water. When cold enters the Liver, cold accumulates in the Liver Meridian, leading to bluish-purple nails.

Fuzi and cinnamon enter the Kidney to dispel cold, helping to draw Yang away from the brink of death—these are the primary remedies. Gan Jiang enters the Spleen to dispel cold, supporting the sluggish Spleen Yang as an auxiliary remedy. The Liver and Kidney share a common origin; when Kidney Yang recovers, the cold in the Liver Meridian also dissipates. Six君子 Tang, which builds the Spleen and nourishes Qi, can be considered a complementary treatment; Wu Wei Zi nourishes Lung Qi, consolidates Kidney Yin, embodying the principle of mutual generation between Metal and Water, also serving as a complementary treatment. Musk’s fragrance moves through the channels, breaking through barriers and guiding the herbs directly into the Three Yin as a guide to harmonize; fresh ginger’s pungency aims to open and distribute Yang Qi, also serving as a guide to harmonize. In this formula, the Three Yin are all weak, but the Yang is gradually restored—He Xiushan said, “This is the first good formula for restoring Yang and securing the body from collapse, as well as for nourishing Qi and generating new life.”

[Clinical Adjustments]

① For vomiting of saliva or abdominal pain in the lower abdomen, add salt-roasted Wu Zhu Yu; for those without a pulse, add a spoonful of pig bile; for severe diarrhea, add Sheng Ma and Huang Qi; for persistent vomiting, add ginger juice.

② Remove Six君子 Tang, Wu Wei Zi, and cinnamon, and add Soapberry, naming it Zheng Yang San (from Taiping Sheng Hui Fang), to treat Yin toxicity from cold, with a bluish face, open-mouth breathing, a heavy heart, cold extremities, and sweat on the forehead.

[Reference Materials]

① “These are formulas for the Three Yin. When cold enters the Three Yin, Yin is abundant while Yang is weak, so using pungent and warm herbs like Fuzi, Gan Jiang, and cinnamon to dispel cold, while using Six君子 to warm and nourish Yang Qi, and combining Wu Wei Zi with Ren Shen to generate Qi, and adding musk to open the channels—this is the key to the formula.” (From “Yi Fang Ji Jie”)

② “Emergency Hui Yang Tang from Medical Records: 24 grams of Ren Shen, 30 grams of Sheng Yang, 15 grams of Shang Hang Shao, 24 grams of Shan Yu Rou, 9 grams of Zhì Gan Cao, 12 grams of Zhu Sha, 1.5 grams of Zhu Sha, heated with half a cup of children’s urine, followed by the addition of Zhu Sha, then continuing to take the herbal medicine. This formula was used to treat cases of cholera with severe vomiting and diarrhea, with a dazed mind, faint breathing, and a critical condition.”

[Commentary] This formula is used for chronic colitis, chronic diarrhea, Salmonella infections, toxic dysentery, and other conditions that lead to peripheral circulatory failure.

Canfu Tang

From “Shi Yi De Xiao Fang”

[Composition] 10 grams of Ren Shen, 6 grams of Fuzi (roasted).

[Administration] Brew the herbs in water.

[Indications] Sudden loss of Yang Qi.

[Indications] Diminished consciousness, cold extremities, cold sweat on the forehead, and a weak or nearly nonexistent pulse.

[Functions] Restore Yang and rescue from collapse.

[Formula Explanation] As stated in “Su Wen · Sheng Qi Tong Tian Lun,” “Yang Qi is like the sky and the sun—when it is lost, life is shortened and cannot flourish.” Thus, Yang Qi is of great importance to the survival of life. Sudden loss of Yang Qi is what we call Yang deficiency—a sign that Yin and Yang are about to separate; this manifests as diminished consciousness, cold extremities, cold sweat on the forehead, and a weak pulse. In such emergencies, large doses of warm and tonifying herbs are insufficient to restore Yang and rescue from collapse. In this formula, Ren Shen greatly replenishes original Qi; when Qi is sufficient, Yang naturally recovers—this formula focuses on treating the root cause, making Ren Shen the primary remedy; Fuzi is pungent and warm, boosting Yang, and its pungency helps to open Yang Qi, serving as an auxiliary remedy. The two herbs work together to treat both the root cause and the symptoms, achieving comprehensive healing.

[Clinical Adjustments]

① For those with facial redness due to Yang deficiency, add children’s urine; for severe cases, add pig bile; for those with a weak pulse, add dried ginger; for those who struggle to recover Yang, you can add Wu Wei Zi, Shu Di, and other herbs to tonify Yin and nourish Yin.

② Remove Ren Shen and add Huang Qi, naming it Huang Qi Canfu Tang (from Wei’s Family Treasury Formula), to treat night sweats.

③ Remove Ren Shen and add Bai Zhu, naming it Bai Zhu Canfu Tang (from Yizong Jin Jian), to treat cold-dampness coexisting with physical pain.

[Reference Materials]

① “There is no better way to replenish postnatal Qi than Ren Shen, and no better way to replenish original Qi than Fuzi—this is why Canfu Tang is so effective… When these two herbs are used together and applied appropriately, they can instantly transform Qi in a place where it seems impossible, and within moments, generate Yang within the Life Gate—this is the most efficient method.” (From “Xuan Bu Ming Yi Fang Lun”) ②"For patients with heart failure who experience side effects after using digitalis, or who have failed to respond to long-term digitalis treatment, the Shenfu Decoction with additions and modifications also proves effective. Regarding the dosage ratio of Shen and Fu, we believe that since the primary focus is on using Shen and Fu to restore yang and rescue the body from collapse, the two herbs can be used in equal amounts." (Shanghai Journal of Traditional Chinese Medicine, 1965.11)

[Commentary] This formula is used for shock caused by various factors, such as hemorrhagic shock and toxic shock; it can also be employed for congestive heart failure and vegetative nervous system disorders of the gastrointestinal tract.

Zhenwu Decoction

From "Shanghan Lun"

[Composition] White Peony Root 9 grams (3 liang), Atractylodes Macrocephala Rhizome 6 grams (2 liang), Poria 9 grams (3 liang), Aconite 6 grams (1 piece, peeled), Fresh Ginger 9 grams (3 liang)

[Usage] Brew with water and take while warm.

[Indications] Yang deficiency with water retention.

[Indications] Feeling cold and weak, spontaneous sweating, difficulty urinating, heavy pain in the limbs, edema, abdominal pain with diarrhea, palpitations, dizziness, tremors, a tongue that is swollen and coated white, and a pulse that is deep and slow.

[Functions] Warm yang and promote water metabolism.

[Formula Explanation] The kidneys govern water; when kidney yang is deficient, qi fails to transform water—this is known as "when yang does not transform qi, fluid cannot be distributed." When yang is deficient, one feels cold and weak, and there is spontaneous sweating; when water accumulates externally, the limbs become heavy and swollen; when water accumulates internally, abdominal pain with diarrhea and difficulty urinating occur, along with a deep and slow pulse; when water overcomes the heart, dizziness and palpitations arise. The tongue is swollen and covered with white coating, and the pulse is deep. The formula's function is to warm the kidneys and restore yang to treat the root cause; Poria and Atractylodes macrocephala strengthen the spleen and drain dampness to treat the symptoms. Fresh ginger is pungent and warm, while White Peony Root is bitter and cold, entering the interior; one dispels external water, while the other gathers internal dampness, allowing for combined treatment.

[Clinical Additions and Subtractions]

① If the patient coughs, add Schisandra, Asarum, and Dried Ginger; if urination is normal, remove Poria; if diarrhea occurs, remove Peony Root and add Dried Ginger; if vomiting occurs, remove Aconite and increase the amount of Fresh Ginger.

② Remove Fresh Ginger and add Codonopsis, forming the Aconite Decoction (from "Shanghan Lun"), which treats yang deficiency with cold-dampness invading the body, causing pain in the joints and bones.

③ Add Pinellia Ternata, Cardamom, and Alisma to this formula for treating simple abdominal distension.

[References]

① "The Xiaoqinglong Decoction treats conditions where exterior symptoms are not resolved but water retention exists, with both exterior and interior coldness present; the Zhenwu Decoction treats conditions where exterior symptoms have already been resolved but water retention persists, with both exterior and interior coldness present. Zhenwu refers to the deity of water in the north. The name 'Zhenwu' was chosen to symbolize the control of water. In the human body, the spleen controls water, while the kidneys regulate water; the kidneys serve as the gatekeeper of water, collecting water and preserving its form. If there is no yang in the kidneys, although the spleen may still function, the kidneys’ gatekeeper remains closed, allowing water to flow freely without proper regulation, leading to excessive and uncontrolled water accumulation—and thus these symptoms appear. By using the pungent and warm properties of Aconite to warm the kidneys and restore yang, the root cause is treated as the primary focus; Poria and Atractylodes macrocephala strengthen the spleen and drain dampness to treat the symptoms as secondary treatments. Fresh Ginger’s pungency helps to disperse water outside, while Poria’s bitterness helps to control dampness inside, allowing for combined treatment."

② This formula, with doubled doses of Aconite and roasted Cardamom, enhances the ability to warm the kidneys and regulate water. For conditions such as edema, asthma, hernia, and other ailments, whenever the pulse is deep and slow, or even faint and distant, the tongue is white and coated with moisture, or dark and slippery, accompanied by palpitations, shortness of breath, nausea, vomiting, dizziness, abdominal fullness or pain, or difficulty urinating or clear urination—indicating yin excess and yang deficiency, with water being uncontrolled—then Zhenwu Decoction can be used to restore yang, transform qi, eliminate yin, nourish fire, and benefit earth to promote water metabolism. (Chinese Medical Journal, 1965.7:40)

③ This formula, with increased doses of Aconite and roasted Cardamom, doubles the effect of warming yang and regulating water. For conditions like edema, asthma, and hernia, as long as the pulse is deep and slow, or even faint and distant, the tongue is white and coated with moisture, or dark and slippery, accompanied by palpitations, shortness of breath, or nausea and dizziness, abdominal fullness or pain, or difficulty urinating or clear urination—indicating yin excess and yang deficiency, with water being uncontrolled—then Zhenwu Decoction can be used to restore yang, transform qi, eliminate yin, nourish fire, and benefit earth. (Chinese Medical Journal, 1965.7:20)

[Commentary] This formula can be adjusted for chronic colitis, chronic nephritis, cardiac edema, intestinal tuberculosis, Meniere’s syndrome, hypertension, and other conditions.

III. Other Treatments

In addition to coldness in the spleen and stomach and the decline of kidney yang, cold energy can also accumulate in the middle burner, forming dampness in the middle burner; cold energy can also gather in the meridians, causing blockages in the blood vessels; cold energy can also concentrate in the right kidney, leading to a decline in the fire of the Mingmen.

Houpu Warming Middle Decoction

From "Internal and External Injury Diagnosis and Confusion"

[Composition] Dried Ginger 2.4 grams, Orange Peel 30 grams, Poria 15 grams, Licorice 15 grams, Roasted Houpu 30 grams, Cardamom 15 grams, Agarwood 15 grams

[Usage] Combine all ingredients into coarse powder; take 15 grams per dose, add three slices of fresh ginger, brew with water, remove the residue, and take while warm. Avoid eating cold foods.

[Indications] Coldness in the spleen and stomach, dampness in the middle burner.

[Indications] Hidden pain in the epigastric region, abdominal distension and fullness.

[Functions] Warm the middle burner, dispel cold, dry dampness, and relieve fullness.

[Formula Explanation] According to "Suwen · Bi Lun," "Pain arises from excessive cold; it is due to cold, hence the pain." When cold accumulates in the spleen and stomach, there is hidden pain in the epigastric region; according to "Suwen · Zhi Zhen Yao Da Lun," "All swelling and fullness due to dampness belong to the spleen." When dampness accumulates in the middle burner, there is abdominal distension and fullness. Among the two factors—cold and dampness—because cold accumulates in the spleen and stomach, the spleen’s function is impaired, leading to dampness in the middle burner, just as "Suwen · Yin Yang Ying Xiang Da Lun" states: "Cold energy generates turbidity; when turbidity rises to the upper part of the body, it causes bloating and fullness." In this formula, Houpu warms the middle burner and dispels cold to treat the root cause, while drying dampness and relieving fullness address the symptoms; combining both approaches makes Houpu the primary medicine. Cardamom and two types of ginger warm the middle burner and dispel cold as auxiliary medicines. Poria strengthens the spleen and drains dampness, Orange Peel strengthens the spleen and promotes qi circulation, while Agarwood promotes qi flow and relieves pain—both serving as complementary treatments.

[Clinical Additions and Subtractions]

① Add Mulberry Bark, forming the Duojin Drink (from "Cheng Fang Qie Yong"), which treats dampness in the spleen and stomach, abdominal distension and heaviness, loss of appetite, and sore limbs and swollen skin.

② Remove Cardamom, Fresh Ginger, and Poria, forming the He Wei Drink (from "Cheng Fang Qie Yong"), which treats cold-dampness affecting the spleen, cholera with vomiting and diarrhea, phlegm and water retention, and abdominal distension and fullness.

③ For severe stomach pain, add Salvia Miltiorrhiza; for flank pain and acid reflux, add Zuo Jin Pill; for indigestion, add Roasted Three Herbs.

[References]

① The Houpu Warming Middle Decoction was used to treat two cases of peptic ulcers. Both cases were confirmed by barium meal X-ray; one case was gastric ulcer, and the other was duodenal bulb ulcer. For gastric ulcers, use Houpu, Dried Ginger, Turmeric, White Peony Root, Cardamom, Frankincense, Myrrh, Agarwood, Roasted Licorice, and Purple Snakehead Powder (to be taken orally). Brew with water and take one dose daily, divided into two doses; symptoms were fully resolved after three doses, and after more than 30 doses, all symptoms had disappeared. At 52 doses, X-ray barium meal showed no abnormalities. For duodenal bulb ulcer, use Houpu, Amomum Villosum, Agarwood, Dried Ginger, White Peony Root, Turmeric, Cuttlebone, Frankincense, Cardamom, Poria, Atractylodes Macrocephala, and Licorice. Brew with water and take one dose daily; symptoms were relieved after four doses, pain significantly reduced after ten doses, and all symptoms were completely eliminated after 30 doses, with X-ray barium meal showing complete normality. (Zhejiang Journal of Traditional Chinese Medicine, 1964.5:37)

② "This formula is found in 'Internal and External Injury Diagnosis and Confusion' (the 'China Medical Dictionary' mistakenly lists it as a formula from 'Shen's Zunsheng Book')." Clinical applications emphasize focusing on central coldness. For those with mild stomach coldness, good ginger can replace Dried Ginger. (A Study on Li Gao's Contributions to Formulas, Institute of Chinese Medicine History and Literature Research, 1979.4)

[Commentary] This formula is used for chronic gastritis, gastric and duodenal bulb ulcers, gastrointestinal neurosis, chronic pancreatitis, and other conditions.

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Danggui Suiyin Decoction

From "Shanghan Lun"

[Composition] Danggui 9 grams (3 liang), Cinnamon Twig 6 grams (3 liang, peeled), White Peony Root 9 grams (3 liang), Asarum 3 grams (3 liang), Ligusticum Chuanxiong 3 grams (2 liang), Roasted Licorice 3 grams (2 liang), 8 Jujubes (25 pieces, split)

[Usage] Brew with water and take while warm.

[Indications] Coldness obstructing the meridians, blood vessel blockage.

[Indications] Pain in the limbs, coldness in the hands and feet, a pulse that is thin and faint.

[Functions] Warm the meridians, dispel cold, open the pulse and restore yang.

[Formula Explanation] When cold obstructs the meridians, there is pain in the limbs; when blood vessels are blocked, there is coldness in the hands and feet, and a pulse that is thin and faint. Cold leads to blood stasis; cold is the root cause, while stasis is the symptom. In this formula, Cinnamon Twig and Asarum warm the meridians, dispel cold, and open the pulse to restore yang—this approach addresses both the root cause and the symptoms. "When evil gathers, its qi must be weak," and the meridians are where vital energy and blood circulate; when cold accumulates in the meridians, it often appears in patients with a pre-existing blood deficiency. Danggui and White Peony Root nourish the blood and support the body’s defenses, allowing blood to flourish and qi to recover, so cold energy has nowhere to enter; these herbs serve as auxiliary medicines. Jujubes nourish qi and strengthen the spleen, while Ligusticum Chuanxiong opens the meridians and removes stagnation—both serve as complementary treatments. Licorice harmonizes all the herbs and acts as a conductor. The formula is named Danggui Suiyin Decoction, emphasizing the importance of Danggui in nourishing the blood and supporting the body’s defenses, making it the first among auxiliary medicines, second only to Cinnamon Twig and Asarum in their role of dispelling cold and restoring the pulse.

[Clinical Additions and Subtractions]

① Add Wu Zhu Yu and Fresh Ginger, brew with water and alcohol in equal parts, forming the Danggui Suiyin with Wu Zhu Yu and Fresh Ginger Decoction (from "Shanghan Lun"), which treats coldness in the hands and feet, a pulse that is thin and faint, and individuals with long-standing coldness.

② Add Wu Yao, Fennel, Good Ginger, and Agarwood, which treat cold pain in the lower abdomen and heavy sensation in the testes.

[References]

① "The Si Yin Decoction is entirely based on restoring yang; the Si Yin San is entirely based on harmonizing the exterior and interior." (Qing Dynasty, Zhou Yangjun)

② Yang ××, male, 2 years old. After a fever, his limbs lost movement; Western medicine diagnosed him with poliomyelitis—a stage of paralysis. Prescription: Danggui, Cinnamon Twig, Red Peony Root, Ligusticum Chuanxiong each one qian, Asarum and Licorice each seven fen, one jujube. After taking a total of 17 doses, the child was able to learn to walk with support, his limb muscles were fuller and more robust than before, and his complexion and pulse returned to normal. At 11 months later, follow-up showed that the treatment had been sustained. (Chinese Medical Journal, 1965.9:24)

[Commentary] This formula is effective for peripheral nerve disorders and peripheral vascular diseases, such as polyneuritis, post-polio syndrome, peripheral vein inflammation, obliterating vasculitis, and lower limb varicosities; it can also be used for frostbite, hernia, testicular disorders, and chronic lower limb ulcers.

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Si Shen Pill

From "Internal Medicine Abstracts"

[Composition] Psoralea Corylifolia 120 grams, Schisandra 60 grams, Nutmeg 60 grams (oil removed), Wu Zhu Yu 30 grams (ground), Fresh Ginger 120 grams, Jujubes 50 pieces

[Usage] Boil Ginger and Jujubes together, remove the Ginger, then mix the Jujube pulp with the ground herbs (sifted) to form pills, about the size of a Chinese chestnut. Take five or seventy pills at a time, on an empty stomach or before meals. Modern usage: take six to nine grams per dose, with plain boiled water.

[Indications] Decline of Mingmen Fire.

[Indications] Lower back pain and cold limbs, frequent diarrhea in the fifth watch of the night, loss of appetite, indigestion, fatigue, and a pulse that is deep and slow.

[Functions] Warm and tonify Mingmen, warm the spleen and stop diarrhea.

[Formula Explanation] The kidneys govern the yang energy of the entire body; the spleen’s yang relies on the warmth of kidney yang to facilitate digestion. In this condition, because kidney yang is weakened (decline of Mingmen Fire), spleen yang becomes sluggish. When kidney yang is weak, there is lower back pain and cold limbs, frequent diarrhea in the fifth watch of the night; when spleen yang is sluggish, there is loss of appetite, indigestion, and fatigue. In this formula, Psoralea Corylifolia warms the kidneys and restores yang, greatly replenishing Mingmen Fire as the primary treatment; Nutmeg warms the middle burner and dispels cold, reinforcing spleen yang as a secondary treatment. Wu Zhu Yu enters the liver to dispel cold; since liver and kidney share the same origin, dispersing cold in the liver also serves to strengthen Mingmen Fire—this can be considered a complementary treatment. Schisandra’s sour taste stops diarrhea, entering the lungs to gather qi; the lungs govern all the meridians, and when lung qi is gathered, all yang returns and does not scatter again, also serving as a complementary treatment. Ginger and Jujubes harmonize the vital energy and defensive qi, acting as conduits. The purpose of this formula is to warm and tonify Mingmen; as stated in "Yi Fang Ji Jie," "Long-term diarrhea often results from a decline in Mingmen Fire, and one cannot solely blame the spleen; therefore, we should greatly replenish the lower burner’s yang energy, so that fire flourishes and earth becomes strong, enabling us to control water without letting it flow excessively."

[Clinical Additions and Subtractions]

① Remove Schisandra and Wu Zhu Yu, add Fennel and Agarwood, forming Dan Liao Si Shen Pill (from "Zheng Zhi Zhuan Sheng"), which has similar indications.

② Remove Schisandra and Wu Zhu Yu, forming Er Shen Pill (from "Shi Bei Fang"), which treats spleen and kidney weakness, with a lack of appetite.

③ Remove Broken Paper and Nutmeg, forming Wu Zi San (from "Shi Bei Fang"), which treats kidney deficiency-related diarrhea.

④ For those with prolonged diarrhea and prolapse of the rectum, combine with Bu Zhong Yi Qi Tang; for those with excessive diarrhea, add Aconite and Cinnamon.

[References]

① The Si Shen Pill from "Shen's Zunsheng Book" consists of Wu Zhu Yu, Bichengqie, Qing Mu Xiang, and Xiang Fu, and is used to treat coldness obstructing the liver meridian, resulting in hernia.

② "When Mingmen lacks fire, it cannot properly digest and transform water and food; when kidney qi is not secure, who will continue to oversee the storage and containment functions? Thus, when wood energy begins to grow, it does not release but instead also releases. Although wood energy harms earth, it actually means that the kidneys are overworking the spleen. At this point, we should tonify both spleen and kidney, strengthen the qi and tighten the bowels—thus, Psoralea Corylifolia warms the kidneys, Nutmeg nourishes the spleen, Schisandra tightens the qi, Wu Zhu Yu relaxes the liver, and the kidneys warm while qi rises, the liver becomes calm and the spleen flourishes, the gates close and water and food are properly digested." (Yi Zong Jin Jian)

③ Xiong, male, 41 years old. Diarrhea for nine years, 3–5 times a day, without pus or blood in the stool or a feeling of urgency or heaviness in the intestines. X-ray barium meal: the colon appeared relatively slender, with shallow colon pouches, especially in the sigmoid colon, descending colon, and transverse colon. Diagnosis: allergic colitis. Tongue was pale, pulse was deep and fine; after using the Shen Ling Bai Zhu San for a short time, followed by Si Shen Pill, three times a day, two qian each time, for a total of 30 days, the patient recovered. Follow-up one month later showed no recurrence. (Shanghai Journal of Traditional Chinese Medicine, 1965.10:3)

[Commentary] This formula can be used for allergic colitis, chronic colitis, intestinal tuberculosis, gastrointestinal neurosis, malabsorption syndrome, and other conditions.

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Chapter Nine: Digestive and Accumulation-Resolving Agents

Digestion and accumulation are related: digestion resolves food and eliminates stagnation, while accumulation transforms and grinds up accumulated substances. Stagnation is invisible; digestion and elimination resolve it. Accumulation is visible; transformation and grinding up accumulated substances are required. Whether it’s food stagnation or accumulated substances, they all obstruct the smooth flow of qi and affect the circulation of blood, leading to symptoms like bloating, accumulation, and masses. The methods of treatment collectively called “digestion” are one of the eight major therapeutic approaches in traditional Chinese medicine. As stated in "Yi Xue Xin Wu," "There is no such thing between organs, meridians, and muscles—only through digestion can balance be achieved." It is evident that digestive and accumulation-resolving agents, like purgatives, share the common goal of eliminating visible, solid pathogenic factors; however, in clinical application, the two differ. Purgatives are suitable for sudden, solid pathogenic factors; digestive and accumulation-resolving agents are better suited for gradual, accumulating symptoms. Although digestive and accumulation-resolving agents are milder than purgatives, they are still agents that eliminate, and should be avoided in patients with pure deficiency and no solid pathogenic factors.

I. Digestion and Stagnation Resolution

The target of digestion and stagnation resolution is patients whose food is not digested and remains trapped in the spleen and stomach. When food is not digested, there is belching with foul odor and acid reflux; when food stagnates in the spleen and stomach, there is abdominal distension and fullness; if the spleen and stomach fail to regulate their upward and downward movements, symptoms such as vomiting, diarrhea, and intestinal rumbling may appear.

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Baohé Wan

From "Dan Xi Xin Fa"

[Composition] Hawthorn 180 grams, Shen Qu 60 grams, Pinellia Ternata 90 grams, Poria 90 grams, Orange Peel 30 grams, Forsythia 30 grams, Raphanum Seed 30 grams

[Usage] Combine all ingredients into coarse powder, form pills like walnuts, take seven or eighty pills at a time, and take with warm water after meals. Modern usage: take pills, swallow 9–12 grams with boiling water, or prepare a decoction by brewing with water.

[Indications] Food is not digested, with dampness and heat mixed in.

[Indications] Chest and abdominal fullness, abdominal pain with distension, belching with foul odor and loss of appetite, diarrhea with food, yellowish greasy coating on the tongue, and a pulse that is slippery and rapid.

[Functions] Digestion and neutralization, clearing heat and draining dampness.

[Formula Explanation] When food is not digested, there is chest and abdominal fullness, abdominal pain with distension; dampness arises from stagnation, and when dampness combines with heat, belching with foul odor and loss of appetite, diarrhea with food, yellowish greasy coating on the tongue, and a pulse that is slippery and rapid appear. In this formula, Hawthorn resolves meat-based food, Shen Qu resolves food accumulation, and together they work to digest and neutralize. Forsythia clears heat, and the two Chen herbs eliminate dampness, working together to clear heat and eliminate dampness as secondary treatments. Raphanum Seed broadens the intestines and regulates qi, providing a complementary treatment.

[Clinical Additions and Subtractions]

① Add Atractylodes Macrocephala, forming Da An Wan (from "Dan Xi Xin Fa"), which treats food stagnation combined with spleen deficiency, and food accumulation in children.

② Remove Pinellia Ternata, Raphanum Seed, and Forsythia, adding Atractylodes Macrocephala and White Peony Root, forming Xiao Baohé Wan (from "Yi Fang Ji Jie"), which treats food accumulation and stagnation, with chest and abdominal fullness.

③ Add malt, forming Baohé Wan (from "Yi Ji"); add Atractylodes Macrocephala, Fragrant Herb, Citrus Fruit, Immature Bean, and Scutellaria, also known as Baohé Wan (from "Gujin Yijian"), which shares many similarities with this formula.

[References] "The symptom of food stagnation arises from overeating, indulging in rich foods like wine, meat, and oil—just as described in 'Suwen · Bi Lun': 'When food is consumed in excess, the spleen’s function is impaired, and food stagnation inevitably occurs.' Overeating causes the spleen’s function to fall short, leading to food stagnation. In clinical practice, when food stagnates in the upper abdomen, there is a tendency toward upward reversal, so we should use vomiting to guide the food upwards; when food stagnates in the lower abdomen, there is a hard, constricted form, so we should use laxatives to break it down; when food stagnates in the middle abdomen, the accumulation is not yet severe, but there is fullness and discomfort in the middle abdomen, belching with foul odor and loss of appetite, and abdominal distension—there is neither upward reversal nor a hard, constricted form. In such cases, both vomiting and laxatives are inappropriate; instead, we should use gentle, harmonizing agents to digest and resolve the issue. Therefore, this formula is named Baohé." (Jiangsu New Medical College: "Traditional Chinese Medicine Formulaology")

[Commentary] This formula can be used for acute gastroenteritis and acute attacks of chronic gastritis.

Zhishi Daozhi Wan

From "Internal and External Injury Diagnosis and Confusion"

[Composition] Rheum 30 grams, Scutellaria 9 grams, Coptis 9 grams, Poria 9 grams, Atractylodes Macrocephala 9 grams, Alisma 6 grams, Citrus Fruit 15 grams (roasted in bran), Shen Qu 15 grams

[Usage] Grind the herbs into powder, steam them into pills the size of a Chinese chestnut, take five to seventy pills at a time, and take with warm water. Modern usage: take pills, swallow 6–12 grams with boiling water, or prepare a decoction by brewing with water.

[Indications] Food stagnation in the middle burner, combined with dampness and heat.

[Indications] Chest and abdominal fullness, abdominal pain with diarrhea, urgency and heaviness in the intestines, or constipation, red and yellow urine, yellowish greasy coating on the tongue, and a pulse that is slippery and rapid.

[Functions] Digestion and accumulation resolution, clearing heat and draining dampness.

[Formula Explanation] When food stagnates in the middle burner, there is chest and abdominal fullness; when stagnation leads to dampness, and dampness combines with heat, symptoms like diarrhea with abdominal pain, urgency and heaviness in the intestines, or constipation, red and yellow urine, yellowish greasy coating on the tongue, and a pulse that is slippery and rapid appear. In this formula, Zhishi Daozhi resolves food stagnation and treats the root cause as the primary treatment; Rheum, Scutellaria, and Coptis clear heat and dry dampness as secondary treatments; Atractylodes Macrocephala and Poria strengthen the spleen and dry dampness, while Alisma drains water and eliminates dampness—these three herbs achieve dampness-reducing effects from different angles, making them complementary treatments. This formula treats food stagnation, using Shen Qu to digest food accumulation, acting as a conduit.

[Clinical Additions and Subtractions] ① Add Agarwood and Areca Nut, steam them into pills and form Agarwood Daozhi Wan (from "Song Ya Yi Jing"), which treats food stagnation, bloating, and restlessness. ② Add Agarwood and Areca Nut to treat red and white diarrhea.

[References] This formula, like Baohé Wan, treats food stagnation with dampness and heat. Baohé Wan is suitable for new onset, not yet formed stagnation, so it needs to digest and neutralize; this formula is suitable for long-standing stagnation, so it needs to digest and resolve food stagnation. Both formulas share the function of clearing heat and draining dampness, but Baohé Wan is better suited for new onset dampness and heat, so Forsythia clears them, while the two Chen herbs work together; this formula is better suited for long-standing dampness and heat, so the three Huang herbs clear them, while Poria, Atractylodes Macrocephala, and Alisma drain dampness.

[Commentary] This formula is used for gastrointestinal neurosis and chronic dysentery.

Zhishi Xiao Pi Wan

From "Lan Shi Mi Zang"

[Composition] Ginseng 9 grams, Atractylodes Macrocephala (fried in soil) 6 grams, Wheat Germ 6 grams, Poria 6 grams, Licorice 6 grams, Pinellia Ternata 9 grams, Citrus Fruit 15 grams, Houpu 12 grams, Dried Ginger 3 grams, Coptis 15 grams (stir-fried in ginger).

[Usage] Grind the herbs into fine powder, steam them into pills, take 9–12 grams at a time, and take with warm water.

[Indications] Spleen deficiency with qi stagnation, cold and heat combined.

[Indications] Loss of appetite, fatigue, fullness under the heart, abdominal pain throughout the abdomen, difficulty in defecation.

[Functions] Strengthen the spleen and boost qi, resolve stagnation and relieve fullness. [Fangjie] If one’s vital energy is inherently weak and its transformation and circulation are impaired, cold and heat may become trapped in the lower abdomen. When vital energy is weak, symptoms such as yellowish complexion, poor appetite, and fatigue and weakness may appear. If cold and heat become entangled in the lower abdomen, one may experience fullness and discomfort in the chest and abdomen. Because cold and heat are intertwined, qi flow becomes obstructed, leading to abdominal distension and fullness, as well as constipation. The formula primarily uses Zhishi to break up the obstruction and eliminate the fullness. The formation of fullness and obstruction is often due to the entanglement of cold and heat; Coptis chinensis clears heat to disperse the heat within the obstruction; Pinellia ternata and Dried Ginger warm and disperse to remove the cold from the obstruction. Together, these three herbs clear heat and disperse cold, assisting the main herb in breaking up the obstruction and eliminating the fullness—this serves as an auxiliary treatment. Houpo moves qi and opens the middle burner, while Maiya aids digestion and harmonizes the middle burner; the Four Gentlemen tonifies qi and nourishes the middle burner, forming a comprehensive treatment. Licorice harmonizes all the herbs and acts as a guiding agent for harmony.

[Clinical Additions and Subtractions] ① Remove Coptis chinensis and add Chenpi and Sharen to strengthen the stomach and eliminate phlegm, treating phlegm and fluid accumulation in the chest. ② Add Shijunzi, Zhi Zi, and Binglei to expel parasites and eliminate accumulated toxins.

[Reference Materials] "For treating lower abdominal fullness and discomfort, poor appetite, and sluggishness, with a wiry pulse at the right wrist. When the spleen is deficient and unable to transport qi, fullness and poor appetite arise; the spleen governs the limbs, and because it is deficient, one feels sluggish and tired. The right wrist corresponds to the spleen, and a wiry pulse indicates spleen deficiency coupled with excessive wood energy. As the Classic says: 'When the Tai Yin reaches its peak, it leads to fluid accumulation, fullness, and obstruction—these are all manifestations of yin overpassing yang. The organs affected by these conditions are the heart and the spleen; when cold and dampness accumulate, it leads to fullness.' This is because the heart's yang fire governs blood, while the spleen's yin earth governs warmth. When yang is damaged, fire becomes stagnant and blood clots; when yin is damaged, earth becomes congested and damp accumulates. The distinction between yin and yang requires different approaches to treatment." (From "Chengfang Qie Yong")

[Commentary] This formula can be used for chronic gastritis, chronic bronchitis, chronic dysentery, and gastrointestinal neurosis.

Muxiang Binglang Wan From "Rumen Shiqin"

[Composition] Muxiang 30g, Binglang 30g, Qingpi 30g, Chenpi 30g, Ezhong 30g, Coptis chinensis 30g, Huangbo 90g, Dahuang 90g, Xiangfu 120g (stir-fried), Qianiu Zi 120g

[Dosage] Grind all ingredients into a fine powder. Make pills about the size of small beans, taking 30 pills per dose, and administer them after meals with ginger soup. Modern usage: Use pills, 6–9 grams per dose, twice daily with warm water; or prepare a decoction by boiling the herbs in water and drinking the resulting liquid warm.

[Indications] When damp-heat combine and stagnate in the middle burner.

[Suitable Symptoms] Abdominal fullness, bloating, and pain; constipation; or red and white diarrhea, urgency and tenesmus, yellow and greasy tongue coating, and slippery, rapid pulse.

[Functions] Moves qi and guides stagnation, clears heat and eliminates dampness.

[Formula Explanation] When damp-heat combine in the middle burner, qi flow becomes obstructed, leading to abdominal fullness, bloating, and urgency and tenesmus. When heat predominates over dampness, constipation occurs; when dampness predominates over heat, red and white diarrhea develops. Yellow and greasy tongue coating and a slippery, rapid pulse both indicate the combination of damp-heat. While damp-heat is the root cause of this condition, qi obstruction is the symptom that appears first—but it is urgent. For urgent conditions, treat the symptom of obstruction; the primary remedy is the main herb. In this formula, Muxiang, Binglang, Xiangfu, and Qingpi move qi and relieve pain as the main treatments. Coptis chinensis and Huangbo clear heat and dry dampness as auxiliaries. Chenpi strengthens the spleen, Ezhong transforms symptoms, and Qianiu Zi promotes water elimination—all serving as complementary treatments. Dahuang purges the intestines and clears heat, allowing damp-heat to descend, fulfilling the principle of “using the excess to treat the deficiency,” which also serves as a guiding agent. Ginger soup is administered to help dispel cold and dampness, embodying the same principle of guiding and harmonizing.

[Clinical Additions and Subtractions] ① Add Zhike, also known as Muxiang Binglang Wan (from "Danxi Xinfa"), to treat the same condition as this formula. ② Add Zhike, Sanling, Mangxiao, and Danggui, also known as Muxiang Binglang Wan (from "Yifang Jiejie"), to treat the same condition as this formula, though with even stronger qi-moving and stagnation-dissipating properties.

[Reference Materials] "When damp-heat resides in the qi division of the Three Jiao, herbs like Muxiang and Xiangfu can open the Three Jiao and resolve the Six Obstructions. Chenpi regulates the lung qi in the upper jiao, Qingpi calms the liver qi in the lower jiao, Zhike widens the intestines and promotes qi flow, while Heichou and Binglang are among the fastest in promoting qi. When qi flows, there is no longer any discomfort from fullness or heaviness. Furthermore, Coptis chinensis and Huangbo dry dampness and clear heat, while also treating diarrhea—because damp-heat accumulates, qi and blood become unbalanced. When qi flows, blood flows; when qi is blocked, blood stagnates. Therefore, Sanling and Ezhong break up qi stagnation in the blood, Dahuang promotes the passage of accumulated toxins, and when damp-heat and stagnation are gone, bowel movements return to normal, and the Three Jiao become clear and unobstructed. After all, if old deposits are not cleared, the clear yang cannot rise, so we must use methods to push and stir things along—this is precisely the meaning of ‘using the excess to treat the deficiency.’ However, we should not lightly prescribe remedies for actual accumulations." (From "Yifang Jiejie")

[Commentary] This formula, with additions and subtractions, can treat acute and chronic bacterial dysentery, acute and chronic hepatitis, and acute and chronic cholecystitis.

Zhishi Wan (From "Weizhi Lun," citing Zhang Jiegǔ's formula)

[Composition] Zhishi (fried until golden brown, removing the inner membrane) 30g, Baizhu 60g

[Dosage] Grind all ingredients into a fine powder. Wrap in lotus leaves and roast in rice to form pills, about the size of a Chinese chestnut. Take 50 pills per dose, dissolving them in plain water. Modern usage: Take 6–9 grams per dose, dissolving them in hot water.

[Indications] Stagnation and fullness due to spleen deficiency.

[Suitable Symptoms] Fatigue, poor appetite, abdominal distension and fullness.

[Functions] Strengthens the spleen and eliminates fullness.

[Formula Explanation] When spleen qi is deficient, its transformation and circulation are impaired; clear qi does not rise, and turbid qi does not descend, causing clear and turbid substances to become entangled in the lower abdomen, leading to fullness and discomfort. With spleen deficiency, patients often feel fatigued and have poor appetite; when clear and turbid substances become entangled, they experience abdominal distension and fullness. In this formula, Baizhu is used in double the amount of Zhishi, aiming to strengthen the spleen and replenish qi, supporting the body’s defenses against evil while clearing the pathogen—two herbs working together, combining elimination with supplementation, clearing evil without harming the body, and supporting the body’s defenses without hindering the pathogen. As the "Medical Formula Commentary" says: "One treats the spleen, the other removes evil; it is simple yet effective, do not overlook its simplicity just because it is mild." Lotus leaves, with their light fragrance, help elevate clear qi—this serves as a guiding agent.

[Clinical Additions and Subtractions] ① Double the amount of Baizhu in Zhishi, then prepare a decoction, called Zhishi Tang (from "Jinkui Yaolüe"), treating cases where the lower abdomen feels hard and large, with edges resembling spinning wheels, caused by fluid retention. ② Add Shenqu and Maiya, creating Quemai Zhishi Wan (from "Yixue Zhenguan"), treating cases of excessive food intake, abdominal distension, and discomfort. ③ Add Banxia and Chenpi, creating Juohan Zhishi Wan (from "Yixue Menjin"), treating spleen deficiency with phlegm buildup, poor appetite, and qi stagnation causing discomfort. ④ Add Muxiang and Sharen, creating Xiangsha Zhishi Wan (from "She Sheng Mi Pao"), capable of breaking qi stagnation, eliminating accumulated food, and stimulating appetite.

[Reference Materials] ① Li Dongyuan said: "Baizhu is sweet and warm, nourishing the original qi of the spleen and stomach. Its taste is bitter, eliminating damp-heat in the stomach and benefiting the blood between the waist and the navel—its potency is equal to that of Zhishi, but twice as strong. Zhishi is bitter and cold, relieving abdominal fullness and discomfort in the stomach, transforming damage in the stomach; first nourish the deficiency, then transform the damage, so it is not overly harsh. Lotus leaves are hollow and green, shaped like a rising thunderbolt—humanly speaking, they represent the Shaoyang gallbladder. The qi of the stomach, the original qi, the grain qi—the ascending qi of the Jia Gallbladder—are all vital energies; when food and medicine stimulate these energies, why should the stomach’s qi worry about failing to rise? Roasting rice with Baizhu works in synergy, nourishing the grain qi, thickening the stomach, preventing further damage—and its benefits are vast." (From "Chengfang Qie Yong") ② Modern pharmacological research shows that Zhishi enhances gastrointestinal peristalsis, making it an essential drug in the treatment of gallstones, gastric prolapse, uterine prolapse, and gastrointestinal dysfunction. In recent years, clinical reports have shown that Zhishi Tang is more effective than Zhishi Wan in treating gastric prolapse. Therefore, it can be considered that Zhishi should be heavily used in the treatment of gastric prolapse. (Shanghai College of Traditional Chinese Medicine: "Clinical Handbook of TCM Formulas")

[Commentary] This formula, with additions and subtractions, is used for chronic gastritis, gastric and duodenal bulb ulcers, and gastric prolapse.

Jianpi Wan From "Zhengzhi Zhuansheng"

[Composition] Ginseng 45g, Baizhu (stir-fried) 75g, Fuling (peeled) 60g, Licorice 22g, Shenqu 30g, Chenpi 30g, Shan Yao 30g, Shan Zha 30g, Mai Ya 30g, Nutmeg 30g, Coptis chinensis 22g

[Dosage] Grind all ingredients into a fine powder. Form pills using steamed cakes, about the size of mung beans. Take 50 pills per dose, on an empty stomach, twice daily with rice water. Modern usage: Take pills, 9–12 grams per dose, dissolving them in hot water; or prepare a decoction by boiling the herbs in water.

[Indications] Spleen deficiency and poor transportation of qi.

[Suitable Symptoms] Fatigue and poor appetite, difficulty digesting food, abdominal distension and fullness, loose stools, greasy tongue coating, and a thin, delicate pulse.

[Functions] Strengthens the spleen and replenishes qi, regulates qi and moves stagnation.

[Formula Explanation] When spleen qi is deficient, fatigue and poor appetite, and a thin, delicate pulse appear; when qi is not transported properly, digestion is impaired, abdominal distension and fullness occur, and stools are loose with greasy tongue coating. Spleen deficiency is the root cause, while qi obstruction is the symptom—this formula uses Ginseng, Baizhu, Fuling, Licorice, and Chenpi to strengthen the spleen and replenish qi as the main treatments. Muxiang, Nutmeg, and Sharen are used to regulate qi and move stagnation as auxiliaries. Shan Zha, Mai Ya, and Shenqu aid digestion and promote the passage of stagnation; when stagnation persists, dampness arises, and when dampness persists, heat arises; when heat persists, yin is harmed. In this formula, Coptis chinensis clears heat and dries dampness, Shan Yao nourishes spleen yin—both serve as complementary treatments. Licorice harmonizes all the herbs and acts as a guiding agent.

[Clinical Additions and Subtractions] If there is heat but no cold, remove Coptis chinensis and add Bo Jiang; if constipation occurs, increase Dahuang; if there is pain in the epigastric region, add Danshen; if nausea and vomiting occur, add Sheng Ozu, Ginger, and Banxia.

[Reference Materials] "The stomach is the official repository of food; when the stomach is deficient, it cannot accommodate food, so one does not feel hungry. When the spleen is deficient, it cannot transport qi, so stagnation occurs. The reason for this is qi deficiency. Ginseng and Baizhu replenish qi, Chenpi regulates qi; when qi flows, the spleen becomes strong and the stomach becomes resilient. Shan Zha helps digest meat, Mai Ya helps digest grains; because Wu and Ji are insufficient, these two herbs assist in transformation. Zhishi is powerful and able to eliminate stagnation and eliminate fullness—when combined with Ginseng and Baizhu, the effect is even faster, while still avoiding harm to qi. When the spleen and stomach are injured, we must replenish them; when digestion is difficult, we should aid digestion. Combining these two approaches is how we strengthen the spleen." (From "Yifang Jiejie")

●165·

[Commentary] This formula can be used for chronic gastritis, gastric and duodenal bulb ulcers, chronic bacterial dysentery, ulcerative colitis, and gastrointestinal vegetative nervous system disorders.

II. Transforming and Eliminating Accumulation

The focus of the method of transforming and eliminating accumulation is on conditions characterized by accumulation and masses. These conditions are often rooted in deficiency combined with excess; when we attack the problem directly, the body may not be able to cope, and when we try to replenish the body, the accumulation does not disappear. Clinically, it is most appropriate to adopt a gradual, dissipating approach, allowing the accumulation to dissolve silently and imperceptibly.

Chan Sha San From "Jiangnang Sheyao"

[Composition] One large toad, with an unspecified amount of Sandren.

[Dosage] Grind Sandren into a powder, fill the toad’s belly, seal the opening, wrap the toad entirely in clay, then char it in charcoal until red. Once cooled, remove the clay. Combine toad and Sandren into three doses, administering each with Chenpi soup.

[Indications] Infantile malnutrition (accumulation in the middle burner, spleen and stomach deficiency).

[Suitable Symptoms] Yellowish complexion, emaciation, thin and dry limbs, a large belly with visible veins, and masses or lumps.

[Functions] Eliminate accumulation and strengthen the spleen.

[Formula Explanation] Malnutrition refers to dryness; when the face is yellow and thin, and the limbs are emaciated, we speak of accumulation. From "Zhengzhi Zhuansheng," it is said: "Accumulation is the mother of malnutrition"—malnutrition arises from accumulation. Treatment should focus on eliminating accumulation, while addressing malnutrition as a secondary concern. From "Children's Medicinal Evidence Direct Decree," it is said: "Malnutrition is a disease of the spleen and stomach, arising from the loss of fluids and nutrients"—malnutrition is a manifestation of spleen and stomach deficiency, so when treating malnutrition, we should also support the spleen through strengthening methods. In this formula, the toad travels to the Yangming meridian to eliminate accumulation and break up stagnation, serving as the main treatment. Sandren and Chenpi move qi and strengthen the spleen as auxiliaries. The toad also has the ability to clear heat and detoxify, preventing heat from arising from accumulation and toxic substances from accumulating.

·166·

[Clinical Additions and Subtractions] This formula, combined with Hawthorn, Zhishi, Chenpi, Binglei, Huilian, Leimian, Shijunzi, Mai Ya, Danggui, and Baizhu, is ground into a fine powder, formed into pills about the size of rice grains, coated with roasted licorice powder, and named Xiaokan Jin Tian Wan—effective for treating infantile malnutrition. Take 10–15 pills per dose, swallowing them with sugar water on an empty stomach at the fifth watch.

[Reference Materials] "Sandren is inserted into the toad’s belly (that is, the toad’s belly), wrapped in straw, then covered with yellow clay, dried, and the toad is ground into a fine powder. Each time, take five to one qian, mixed with red sugar water, twice daily." (From "Pu Fu Zhou’s Medical Experience," a single case study on pediatric indigestion)

[Commentary] This formula can be used for childhood malnutrition, chronic digestive issues in children, and intestinal worms in children.

Bie Jia Jian Wan From "Jinkui Yaolüe"

[Composition] Bie Jia 25g (stir-fried to twelve parts), Wushan 6g (burnt to three parts), Huangqin 6g (three parts), Chaihu 12g (six parts), Shuofu 6g (burnt to three parts), Ganjiang 6g (three parts), Dahuang 6g (three parts), Shaoyao 10g (five parts), Gui Zhi 6g (three parts), Lianli 2g (one part burnt), Shi Wei 6g (three parts removed of hair), Houpo 6g (three parts), Mudan Pi 10g (five parts removed of the core), Qumai 4g (two parts), Ziwu 6g (three parts), Banxia 2g (one part), Ren Shen 2g (one part), Zhe Chong 10g (five parts burnt), A Jiao 6g (three parts burnt), Tao Ren 4g (two parts), Feng Ke 8g (four parts burnt), Chi Niao 24g (twelve parts), Jing Lang 12g (burnt).

[Dosage] Use an appropriate amount of clear wine, add a small amount of calcined hearth ash, first simmer Bie Jia to extract the juice, then grind all remaining herbs into a fine powder. Mix the powder with the medicinal juice to form small pills, taking 6–9 grams per dose on an empty stomach; or prepare a decoction, simmering 15–18 grams.

[Indications] Malaria patient.

[Suitable Symptoms] Chronic malaria that does not heal, with a hard mass in the flank area.

[Functions] Dissolve blood stasis and break up masses, eliminate harmful pathogens.

[Formula Explanation] Chronic malaria that does not heal means that the pathogen remains embedded in the body’s tissues; treatment should focus on eliminating the harmful pathogens. When pathogen and qi combine and coagulate into masses, hard masses appear—treatment should focus on dissolving blood stasis and breaking up masses. The malaria pathogen is the root cause of the illness, while the masses are the symptoms of the disease. In this formula, Bie Jia softens and breaks down masses to eliminate the masses, while entering the liver to search for and eliminate pathogenic factors—this formula treats both the root cause and the symptoms, making it the main treatment. When pathogen and heat persist, they inevitably spread throughout the three yang channels; Chaihu, Huangqin, Danggui, and Banxia act as little Chaihu formulas to resolve the heat in the Shaoyang channel; Gui Zhi and Bai Shao act as Guizhi formulas to dispel the heat in the Taiyang channel; Dahuang and Chi Niao act as Chengqi formulas to resolve the heat in the Yangming channel. The herbs enter the three yang channels, working together to resolve the harmful pathogens and serve as auxiliaries. Shi Wei, Qumai, and Lianli promote water drainage and eliminate pathogenic factors; Ganjiang warms yang, and A Jiao nourishes yin—both serve as complementary treatments. Clear wine, with its spicy and warming nature, moves qi into the blood vessels, acting as a guiding agent. This formula combines cold and heat, focusing on both attack and replenishment, treating qi and blood together, and employing multiple approaches to achieve the goal of resolving symptoms and eliminating accumulation, and eliminating harmful pathogens.

[Clinical Additions and Subtractions] This formula is complex, consisting only of pills—not decoctions; therefore, clinical applications often lack flexibility.

[Reference Materials]

① "When using Bie Jia to treat illnesses, Bie Jia enters the liver to eliminate pathogenic factors and nourish the body, combined with calcined hearth ash to eliminate masses—this makes it the main herb. Little Chaihu, Guizhi formulas, and Chengqi are the main herbs for the three yang channels; wine serves as a minister, but licorice is too gentle and reduces the herbal power, while Zhishi is too aggressive and causes direct descent—so it is removed. Additionally, Ganjiang and A Jiao help supplement the human body with warmth and nourishment as assistants. Since masses are often based on blood stasis and phlegm, four types of worms and Tao Ren combined with Banxia help eliminate blood stasis and resolve phlegm. All accumulations are caused by qi stagnation; when qi flows, blood moves, so Wushan and Lianli benefit the lungs, while Shi Wei and Qumai clear pathogenic heat and transform qi. Because pathogen and heat linger, the flowers of Peony and Purple Vine remove hidden fire in the blood and reduce real heat in the diaphragm." (Xu Zhongke: "Commentary on Jinkui Yaolüe")

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② "The true magic of this formula lies in using Bie Jia’s ash to boil with wine like glue—it not only helps eliminate accumulation, but the wine-soaked ash also effectively eliminates accumulation, achieving results a hundred times better than using Malaria Mother Pill with vinegar." (Zhang’s Medical Guide)

[Commentary] This formula is used for chronic hepatitis, early-stage liver cirrhosis, malaria, and black fever.

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Chapter Ten: Tonifying Agents

Formulas that nourish the body’s qi, blood, yin, and yang are collectively referred to as tonifying agents. The application of tonifying agents falls under the Eight Methods of Tonification, with the principle of "Tonify when deficiency exists," as stated in "Suwen: 'When qi is deficient, replenish it.'" Tonification is typically divided into five categories: qi tonification, blood tonification, yin tonification, yang tonification, and dual qi and blood tonification. Although each category has its own emphasis, they are closely interconnected. Take qi tonification and blood tonification as examples: Li Dongyuan believed that "Blood does not arise on its own; it requires medicines that generate yang qi to make blood flourish." He also said, "When blood is deficient, use ginseng to replenish it—when yang is strong, it can generate yin blood." It is evident that to achieve blood tonification, it is necessary to add qi tonifying herbs to blood-tonifying medicines for greater effectiveness. When blood is lost excessively, it often leads to yang deficiency; only by tonifying qi and consolidating the yang can we save the patient from this life-threatening situation—and this also illustrates the importance of this issue. Patients with qi deficiency generally do not take blood-tonifying herbs, because blood-tonifying herbs tend to be sticky and gentle, easily blocking qi. Yin tonification and yang tonification are also interconnected: Zhang Jingyue said, "Those who are good at tonifying yang must seek yang within yin; those who are good at tonifying yin must seek yin within yang." The "Zhongzangjing" states, "When fire comes to the Kan gate, water arrives at the Li door"—this means that when tonifying yin and yang, we should not emphasize only one aspect while neglecting the other; instead, while emphasizing one aspect, we should also consider the other. In short, the methods of qi, blood, yin, and yang tonification are interconnected; to master these methods, we must understand their characteristics, focus on the primary treatment while also considering the supplementary aspects, so that we can address the root cause of the illness.

In addition, when applying tonification methods, we must also consider the unique characteristics of each organ. According to the principles of tonification outlined in "Nan Jing," "When you weaken the lungs, you should nourish their qi; when you weaken the heart, you should regulate its yin and yang; when you weaken the spleen, you should adjust its diet and match its temperature and humidity; when you weaken the liver, you should soothe its energy; when you weaken the kidneys, you should nourish their essence." (14 Nan), we should treat each organ accordingly. Among the five internal organs, the spleen is the foundation of postnatal growth, while the kidneys are the foundation of prenatal growth—both are crucial organs in the human body. The spleen governs central qi, while the kidneys govern original qi, forming the fundamental basis of the body’s righteous qi. Given the great importance of these two organs to the human body, the methods of tonifying these two organs are called methods of reinforcing the body’s foundations and strengthening the body’s roots. While practicing tonification, we must also pay attention to the relationship between the local and the whole: as the ancients said, "Great fullness often indicates a state of weakness, while extreme deficiency often indicates a state of abundance." This requires careful assessment of the condition: we should attack the "great fullness" in the local area, nourish the "weakness" in the whole, replenish the "extreme deficiency" in the local area, and eliminate the "abundance" in the whole. As for the ratio between attack and replenishment, we must adapt to the clinical situation; sometimes we need to rely solely on attack—when "great fullness" is eliminated, "weakness" can be restored; sometimes we need to rely solely on replenishment—when "extreme deficiency" is replenished, "abundance" naturally dissipates.

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Tonifying agents are also classified as either "harsh tonification" or "moderate tonification." For severe conditions, such as qi and blood depletion, we should use harsh tonification to quickly save the patient from danger; for milder conditions, such as qi deficiency with low blood volume or imbalanced yin and yang, we should take a long-term approach and opt for moderate tonification. Harsh tonification formulas usually contain large doses of herbs and few flavors, striving for high efficacy and broad effects; moderate tonification formulas usually contain small doses of herbs and many flavors, aiming for consistent use over a long period to ensure safety and stability.

I. Qi Tonification

Qi tonification refers to the nourishment of righteous qi. Righteous qi is also called true qi, encompassing both innate and acquired aspects. The innate qi is called yuan qi, originating from the two kidneys and also known as kidney qi; the acquired qi originates from the spleen and stomach and is also known as middle qi. Some of the middle qi merges with the qi of breathing, accumulating in the qi sea in the chest, known as "zong qi," which provides the dynamic force for blood circulation and respiration; some of the middle qi originates in the middle burner and flows within the meridians, possessing a gentle and smooth nature, known as ying qi, which nourishes the body; some of the middle qi originates in the upper burner and flows outside the meridians, possessing a swift and smooth nature, known as wei qi, which protects the body from external pathogens. The body’s "righteous qi" is distributed throughout the various organs and systems to maintain their normal functions—such as liver qi, kidney qi, heart qi, lung qi… etc. In short, qi tonification is a method of nourishing righteous qi, suitable for patients with qi deficiency. When middle qi is insufficient, symptoms often include yellowish complexion, poor appetite, fatigue, and reluctance to speak. When original qi is insufficient, symptoms often include dizziness, tinnitus, lower back pain, and leg discomfort.

Si Jun Zi Tang From "He Ji Ju Fang"

[Composition] Ginseng (removed from the root), Baizhu (stir-fried), Fuling (peeled), Licorice—each in equal portions.

[Dosage] Grind all ingredients into a fine powder. Take 6 grams per dose, decocted in water. Modern usage: decoct in water; or prepare pills, taking 6 grams per dose, dissolving them in hot water.

[Indications] Spleen and stomach qi deficiency.

[Suitable Symptoms] Yellowish complexion, poor appetite, fatigue, reluctance to speak.

[Functions] Strengthen the spleen and replenish qi.

[Formula Explanation] The spleen and stomach reside in the center, belonging to earth and colored yellow; when qi is deficient, the complexion becomes yellowish. The spleen governs thought and also controls the transformation and circulation of food and water; when qi is deficient, appetite is poor. The spleen governs muscles; when qi is deficient, fatigue and weakness occur. When qi is deficient, there is a lack of energy and reluctance to speak. In this formula, ginseng’s sweetness is a superior choice for strengthening the spleen and replenishing qi, making it the primary herb. The spleen hates dampness; when spleen qi is deficient, yang qi is also deficient, and when yang qi is deficient, water tends to overflow. Baizhu is bitter and warm, helping to strengthen the spleen and dry dampness as an auxiliary herb. Fuling’s sweetness and mild flavor help drain dampness and promote water elimination; together with Baizhu, they treat water and dampness as a complementary treatment. Licorice harmonizes all the herbs and acts as a guiding agent.

[Clinical Additions and Subtractions] ① Add citron peel; the formula is “Addition of Chenpi,” known as “Xing Gong San” (from “Children’s Medicine Testimony”), used to treat spleen and stomach weakness, as well as chest and diaphragm fullness.

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③ Add citron peel, Pinellia, Agarwood, and Amomum villosum; the formula is “Fragrant Citron Peel Six-Ginseng Decoction” (from “He Ji Ju Fang”), used to treat spleen and stomach weakness, and abdominal pain in the chest and abdomen.

④ Add Broad Bean, Astragalus, Ginger, and Jujube; the formula is “Six Divine Powder” (from “Effective Good Formulas”), used to treat spleen and stomach weakness, deficiency of body fluids and qi, and fatigue with fever.

[Reference Materials]

① “When a person’s complexion is pale and sallow, one can discern their qi deficiency just by looking at them; when their speech is soft and faint, one can sense their qi deficiency through hearing; when their limbs are weak, one can learn about their qi deficiency through asking them; when their pulse is weak and feeble, one can feel their qi deficiency upon palpation—only then should one focus on tonifying qi.” (From “Medical Formula Examination”)

② Zhuang ××, female, suffered from prolonged low-grade fever. She visited the clinic on July 24th, with a temperature of 37.5°C, a weak and rapid pulse, a thin white coating on her tongue, and occasional abdominal distension and pain. It was determined that she had spleen deficiency, so she was treated with “Four Ginseng Decoction” combined with Chinese yam. A follow-up visit one week later showed that both the low-grade fever and abdominal distension had subsided. She continued taking the prescription until August 14th, during which both the low-grade fever and abdominal discomfort were completely resolved. She continued taking the medicine until August 14th, and by then, the low-grade fever and abdominal distension had fully recovered. (From “Collection of Yue Mei’s Traditional Chinese Medicine Cases”)

③ Chen ××, female, 28 years old, an office worker. In the summer of 1962, she first noticed lower back soreness and fatigue, followed by loss of appetite, cloudy urine resembling rice-washing fluid with sediment like cream, sometimes accompanied by blood streaks, lower back pain, normal bowel movements, a white and slippery tongue coating, and a weak, soft pulse. She was diagnosed with spleen deficiency and was treated with “Four Ginseng Decoction” combined with “Feng Miao Dan.” After ten doses, the cloudy urine gradually decreased, her appetite improved, her spirits slightly recovered, and after another three doses, her urine became clear. She continued taking the medicine for ten more doses and recovered completely. (From “Fujian Traditional Chinese Medicine,” May 1964)

[Commentary] This formula serves as a foundational remedy for all chronic gastrointestinal disorders, such as chronic gastritis, gastric and duodenal ulcers, chronic colitis, chronic hepatitis, and chronic pancreatitis.

Shen Ling Bai Zhu San

From “He Ji Ju Fang”

[Composition] 1,000 grams each of Codonopsis, White Atractylodes Rhizome, Poria, Licorice Root (stir-fried), and Chinese Yam; 500 grams of Broad Bean (soaked in ginger juice, peeled, and lightly stir-fried); 500 grams each of Lotus Seed Meat, Platycodon Root (stir-fried), Coix Seed, and Amomum Villosum.

[Usage] All ingredients are finely ground, 6 grams per dose, taken with jujube soup. Modern usage: decocted into a herbal tea for consumption; some also use it in pill form.

[Indications] Spleen and stomach qi deficiency, dampness obstructing the middle burner.

[Indications] Pale complexion, loss of appetite, fatigue, lack of energy, shortness of breath and talkativeness, abdominal distension and fullness, intestinal rumbling and diarrhea.

[Functions] Strengthen the spleen and replenish qi, harmonize the stomach and eliminate dampness.

[Formula Explanation] When spleen and stomach qi are deficient, the face becomes pale and sallow, appetite is poor, fatigue sets in, and one feels short of breath and reluctant to speak; when dampness obstructs the middle burner, abdominal distension and fullness, intestinal rumbling and diarrhea occur. When spleen and stomach qi are deficient, digestion and metabolism fail, leading to dampness obstructing the middle burner. The Four Ginseng Decoction in this formula strengthens the spleen and replenishes qi, serving as the primary treatment for the underlying condition. Coix Seed helps to harmonize the stomach and eliminate dampness, acting as a supporting remedy for the symptoms. Over time, if qi deficiency persists, yin fluids cannot circulate properly; Broad Bean, Chinese Yam, and Lotus Seed nourish the stomach and nourish yin, providing complementary treatment. When dampness obstructs the middle burner, it blocks the flow of qi; Amomum Villosum promotes qi circulation and warms the stomach, also serving as a complementary treatment. Platycodon Root carries the herbs upward to reach the affected areas, acting as a guide for harmony.

[Clinical Additions and Subtractions]

① Add citron peel; also known as “Shen Ling Bai Zhu San” (from “Medical Formula Collection”), it is suitable for those with spleen and stomach qi deficiency, dampness obstructing the middle burner, and accompanying cough due to phlegm.

② Remove the jujube, add Ho Xiang, Tangerine Peel, Coptis Chinensis, Alisma, Euryale Seed, Hawthorn, Malt, and White Cardamom; the formula is “Zi Sheng Wan” (from “First Awakening Academy’s Medical Notes”), used to treat pregnancy in the third month, where the Yangming meridian is weakened and the fetus has fallen.

[Reference Materials]

① “To treat the spleen and stomach, one must tonify their deficiency, eliminate dampness, remove stagnation, and regulate qi. Ginseng, White Atractylodes Rhizome, Poria, Licorice Root, Chinese Yam, Coix Seed, Broad Bean, and Lotus Seed are all medicines that tonify the spleen. However, Poria, Chinese Yam, and Coix Seed help to regulate the spleen while also eliminating dampness; Amomum Villosum and Citron Peel regulate qi and dispel stagnation. Together, these herbs warm the stomach and tonify the middle burner. Platycodon Root carries the herbs upward to reach the affected areas, acting as a guide for harmony.”

② Zhou ××, female, 48 years old, with a history of diarrhea and frequent abdominal pain and intestinal rumbling. In recent months, she had loose stools two or three times daily, poor appetite, a lack of flavor in food, emaciation, fatigue, a pale tongue with a white coating, and a weak, slow pulse. Her spleen was deficient and dampness had accumulated; the treatment should focus on strengthening the spleen and eliminating dampness. Prescription: 3 qian of Codonopsis, 3 qian of Roasted White Atractylodes Rhizome, 3 qian of White Poria, 4 qian of Chinese Yam, 3 qian of Stir-fried Broad Bean, 4 qian of Coix Seed, 1 qian of Bitter Platycodon Root, 8 fen of Amomum Villosum, 3 qian of Stir-fried Lotus Seed, and 1 qian of Roasted Licorice Root. After three doses of the prescription, her abdominal diarrhea stopped; after seven more doses, her appetite improved, and her bowel movements returned to normal. (From “Fujian Traditional Chinese Medicine,” May 1965)

[Commentary] This formula can be used for chronic colitis, chronic pancreatic diarrhea, and simple indigestion in children. In recent years, this formula, modified with additional herbs, has been used to treat chronic gastritis, chronic nephritis, infiltrative pulmonary tuberculosis, and chronic bronchitis.

Bu Zhong Yi Qi Tang

From “The Discussion on Spleen and Stomach”

[Composition] 15 grams of Astragalus (1 qian), 12 grams of Codonopsis (3 fen), 12 grams of White Atractylodes Rhizome (3 fen), 6 grams of Roasted Licorice Root (5 fen), 9 grams of Dang Gui (2 fen), 3 grams of Chen Pi (3 fen), 3 grams of Sheng Ma (3 fen), and 3 grams of Chai Hu (3 fen).

[Usage] Chew the herbs, decocted in water, remove the residue, and take the liquid slightly warm after meals. Modern usage: decocted in water for consumption; or taken in pill form.

[Indications] Deficiency of middle qi.

[Indications] Pale complexion, loss of appetite, fatigue, shortness of breath and talkativeness; or accompanied by sweating, thirst and preference for warm drinks, headache and fear of cold, a weak, large pulse; or accompanied by prolapse of the rectum or uterine prolapse; or accompanied by vomiting blood, nosebleeds, bloody stools, or hematuria.

[Functions] Tonify the middle qi and benefit qi.

[Formula Explanation] This formula is a representative formula of Li Dongyuan, whose basic indication is deficiency of middle qi. Li believed that “a person’s stomach qi is the foundation.” “When the spleen and stomach are damaged, five organs become chaotic.” “Once the qi of the spleen and stomach is damaged, the original qi cannot be replenished, and this is how various diseases arise.” Based on this perspective, Li’s Bu Zhong Yi Qi Tang focuses primarily on tonifying the middle qi and benefiting qi, achieving multifaceted effects in clinical practice. Pale complexion, loss of appetite, fatigue, and shortness of breath are the basic symptoms of middle qi deficiency; accompanied by fever with sweating, thirst and preference for warm drinks, and headache and fear of cold, this is qi deficiency with fever; accompanied by uterine prolapse or gastric prolapse, this is middle qi descent; accompanied by vomiting blood, nosebleeds, or bloody stools, this is qi failing to control blood—such conditions all stem from middle qi deficiency, so this formula serves as the main treatment.

① Why does qi deficiency lead to fever? Li believed that fire is the enemy of original qi; fire and original qi do not oppose each other—when one prevails, the other declines. When fire is strong, original qi is harmed; when original qi is replenished, fire can be subdued. Bu Zhong Yi Qi Tang uses this very principle to reduce fever. This method is called “sweet warmth to remove excessive heat.” ② Middle qi is the root of postnatal life; when its qi is abundant, the five internal organs are harmonious. If qi descends, the internal organs may experience slippage and prolapse. Bu Zhong Yi Qi Tang can uplift the yang qi of the spleen and stomach, helping the slipped organs return to their proper positions. ③ Qi governs blood; when qi is deficient, blood lacks regulation and will inevitably wander. Bu Zhong Yi Qi Tang greatly replenishes middle qi and strengthens blood’s ability to regulate, thereby controlling wandering blood. In this formula, Astragalus is the top choice for tonifying the middle qi and benefiting qi, serving as the primary herb. Codonopsis and White Atractylodes Rhizome both have sweet, warming properties that benefit qi; when used together with Astragalus, their qi-tonifying and middle qi-enhancing effects are further amplified, making them auxiliary herbs. When spleen and stomach qi are deficient, digestion and metabolism fail, and qi flow becomes difficult. Chen Pi promotes qi circulation and strengthens the spleen to aid digestion; over time, qi deficiency often leads to blood deficiency, so Dang Gui nourishes and replenishes blood. When middle qi is deficient, one may see spleen deficiency and qi descent; Chai Hu rises yang qi to the highest points of the Taiyang meridian. These herbs all serve as complementary treatments. Licorice harmonizes all the herbs and acts as a guide for harmony. [Clinical Additions and Subtractions]

① Remove Dang Gui, add Wood Odor, and replace White Atractylodes Rhizome with Cang Zhu, creating “Adjusting Middle Qi Tang” (from “The Discussion on Spleen and Stomach”), used to treat qi deficiency, dampness in the spleen and stomach, and poor qi flow causing chest fullness and fatigue. ② Add Mai Men Dong, Cang Zhu, Huang Bo, and Stir-fried Yeast, creating “Astragalus and Ginseng Decoction” (from “The Discussion on Spleen and Stomach”), used to treat severe summer heat, where heat damages original qi, causing fatigue, drowsiness, fever, and loss of appetite; with excessive sweating. ③ Remove Sheng Ma, add Ban Xia, Qiang Huo, Du Huo, White Peony, Fang Feng, Poria, Alisma, Coptis Chinensis, Ginger, and Jujube, creating “Rising Yang and Benefiting Stomach Decoction” (from “Lan Shi Mi Zang”), used to treat spleen and stomach qi deficiency, abdominal discomfort, and joint pain. ④ Modify this formula according to “The Discussion on Spleen and Stomach”: add White Peony and Roasted Licorice Root for abdominal pain; add Peel-Cinnamon (Cinnamon Heart) for cold and painful sensations; add White Peony, Roasted Licorice Root, and Scutellaria for hot and cold-induced abdominal pain; remove Peony from the formula when the abdomen is cold, adding Yizhi Ren instead, or adding Ban Xia and Ginger; add Rehmannia Root when lower abdominal pain persists; add Cinnamon when chest pain is severe, or remove Peony if the patient cannot eat; add Qing Pi when chest qi stagnation occurs, and remove it if breathing is labored; add Qing Pi when there is chest tightness, and remove it if the patient cannot eat; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences chest tightness; add Qing Pi when there is chest qi stagnation, and remove it if the patient experiences......① Add citron peel, known as “Jin Gong San” (from “Xiao Er Yao Zheng Zhi Jue”), to treat spleen and stomach weakness, as well as fullness in the chest and diaphragm.

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③ Add citron peel, Pinellia, Wood Odor, and Amomum Villosum to form “Xiang Sha Liu Jun Zi Tang” (from “He Ji Ju Fang”), which treats spleen and stomach weakness and abdominal pain.

④ Add Broad Bean, Astragalus, Ginger, and Jujube to create “Li Shen San” (from “Xiao Liang Fang”), used to treat spleen and stomach weakness, deficiency of body fluids and qi, and fatigue with fever.

[Reference Materials]

① “When a person’s complexion is pale and sallow, one can discern their Qi deficiency just by looking at them; when their speech is soft and faint, one can recognize their Qi deficiency through hearing; when their limbs are weak, one can understand their Qi deficiency by asking them about it; when their pulse is weak and feeble, one can feel their Qi deficiency upon palpation. In such cases, it is appropriate to tonify Qi.” (From “Yi Fang Kao”)

② Zhuang ××, a woman, suffered from prolonged low-grade fever. She visited the clinic on July 24th, with a temperature of 37.5°C, a weak and rapid pulse, a thin white coating on her tongue, and occasional abdominal distension. It was determined that she had spleen deficiency, so she was treated with Si Jun Zi Tang combined with Chinese yam. A follow-up visit one week later showed that both the low-grade fever and abdominal distension had subsided. She continued taking the prescription until August 14th, during which time both the fever and abdominal discomfort were completely resolved. (From “Yue Mei Chinese Medicine Case Collection”)

③ Chen ××, a 28-year-old female office worker, first experienced lower back soreness and fatigue in the summer of 1962. She subsequently lost her appetite, and her urine became cloudy, resembling rice-water-like fluid with sediment resembling thick paste, sometimes accompanied by blood streaks. She also experienced lower back pain, regular bowel movements, a white, slippery tongue coating, and a weak, soft pulse. She was treated using a formula that focused on strengthening the spleen and nourishing the kidneys, combining Si Jun Zi Tang with Feng Mui Dan. After ten doses, the cloudy urine gradually improved, her appetite returned, her energy began to recover slightly, and after another three doses, her urine became clear. She continued taking the formula for ten more doses and recovered fully. (From “Fujian Traditional Chinese Medicine,” May 1964)

[Commentary] This formula serves as a foundational remedy for all chronic gastrointestinal disorders, including chronic gastritis, gastric and duodenal ulcers, chronic colitis, chronic hepatitis, and chronic pancreatitis.

Can Ling Bai Zhu San

From “He Ji Ju Fang”

[Composition] 1,000 grams each of Codonopsis Pilosula, Atractylodes Macrocephala, Poria Cocos, Licorice Root (stir-fried), and Chinese Yam; 500 grams of Broad Bean (soaked in ginger juice, peeled, then lightly stir-fried); 500 grams each of Lotus Seed Meat, Platycodon Grandiflorus (stir-fried), Coix Seed, and Amomum Villosum.

[Usage] All ingredients are finely ground, and 6 grams are taken per dose, dissolved in jujube soup. Modern usage: decocted into a herbal tea for consumption; some formulations are also made into pills.

[Indications] Spleen and stomach Qi deficiency, dampness obstructing the middle burner.

[Suitable Symptoms] Yellowish complexion, poor appetite, fatigue, lack of energy, shortness of breath and talkativeness, abdominal distension and bloating, intestinal rumbling and diarrhea.

[Functions] Strengthen the spleen and replenish Qi, harmonize the stomach and eliminate dampness.

[Formula Explanation] When spleen and stomach Qi are deficient, the complexion becomes yellowish, appetite diminishes, energy is lacking, and one feels short of breath and reluctant to speak. When dampness obstructs the middle burner, abdominal distension and bloating, intestinal rumbling and diarrhea occur. When spleen and stomach Qi are deficient, their function of transportation and transformation is impaired, leading to dampness obstructing the middle burner. The Four Gentlemen Decoction in this formula strengthens the spleen and replenishes Qi, serving as the primary treatment for the root cause. Coix Seed helps to harmonize the stomach and eliminate dampness, acting as an auxiliary treatment for the symptoms. Over time, if Qi deficiency persists, the Yin fluids cannot be properly distributed; Broad Bean, Chinese Yam, and Lotus Seed nourish the stomach and nourish Yin, providing complementary treatment. When dampness obstructs the middle burner, it blocks the flow of Qi; Amomum Villosum and Citron Peel regulate Qi and warm the stomach, also serving as complementary treatments. Platycodon Grandiflorus carries the medicine upward to reach the affected areas, acting as an intermediary for harmonization.

[Clinical Additions and Subtractions]

① Add Citron Peel, also known as Can Ling Bai Zhu San (from “Yi Fang Ji Jie”), suitable for those with spleen and stomach Qi deficiency, dampness obstructing the middle burner, and accompanying cough due to phlegm.

② Remove the Jujube, add Ho Xiang, Tangerine Peel, Coptis Chinensis, Alisma, Euryale, Hawthorn, Malt, and White Cardamom to create Zisheng Wan (from “Xian Xing Zai Medical Records”), used to treat pregnancies in the third month when Yangming Qi is weakened and the fetus has fallen.

[Reference Materials]

① “To treat the spleen and stomach, one must tonify their deficiency, eliminate dampness, remove stagnation, and regulate Qi. Ginseng, Atractylodes Macrocephala, Poria Cocos, Licorice Root, Chinese Yam, Coix Seed, Broad Bean, and Lotus Seed are all medicines that tonify the spleen. However, Poria Cocos, Chinese Yam, and Coix Seed help to tonify the spleen while also eliminating dampness; Amomum Villosum and Citron Peel regulate Qi and move stagnation. Together, these herbs warm the stomach and strengthen the middle burner. Platycodon Grandiflorus is bitter and sweet, entering the lungs, carrying the medicine upward while also facilitating the circulation of Qi in the airways, enabling Qi to rise and fall, thus promoting harmony and protecting the lungs from dryness.” (From “Yi Fang Ji Jie”)

② Zhou ××, a 48-year-old woman with a history of diarrhea, often experiencing abdominal pain and intestinal rumbling. In recent months, she had loose stools two or three times daily, poor appetite, a lack of flavor in food, emaciation, fatigue, a pale tongue with a white coating, and a weak, slow pulse. Her condition was characterized by spleen deficiency and dampness accumulation; the treatment should focus on strengthening the spleen and eliminating dampness. Prescription: 3 qian of Codonopsis Pilosula, 3 qian of Atractylodes Macrocephala, 3 qian of Poria Cocos, 4 qian of Chinese Yam, 3 qian of Stir-fried Broad Bean, 4 qian of Coix Seed, 1 qian of Bitter Platycodon Grandiflorus, 8 fen of Amomum Villosum, 3 qian of Stir-fried Lotus Seed, and 1 qian of Roasted Licorice Root. After three doses of this formula, her abdominal diarrhea stopped; after seven more doses, her appetite improved, and her bowel movements returned to normal. (From “Fujian Traditional Chinese Medicine,” May 1965)

[Commentary] This formula can be used for chronic colitis, chronic pancreatic diarrhea, and simple digestive disorders in children. In recent years, this formula, modified with additional herbs, has been employed to treat chronic gastritis, chronic nephritis, infiltrative pulmonary tuberculosis, and chronic bronchitis.

Bu Zhong Yi Qi Tang

From “Wei Wei Lun”

[Composition] 15 grams of Astragalus (1 qian), 12 grams of Codonopsis Pilosula (3 fen), 12 grams of Atractylodes Macrocephala (3 fen), 6 grams of Roasted Licorice Root (5 fen), 9 grams of Angelica Sinensis (2 fen), 3 grams of Citron Peel (3 fen), 3 grams of Shengma (3 fen), and 3 grams of Chai Hu (3 fen).

[Usage] Chew the herbs, decoct in water, filter out the residue, and take slightly warm after meals. Modern usage: decocted into a herbal tea for consumption; or taken in pill form.

[Indications] Deficiency of central Qi.

[Suitable Symptoms] Yellowish complexion, poor appetite, fatigue, shortness of breath and talkativeness; or accompanied by sweating, thirst for warm drinks, headache and cold sensitivity, a weak, large pulse; or accompanied by rectal prolapse, uterine prolapse; or accompanied by vomiting blood, nosebleeds, bloody stools, or hematuria.

[Functions] Tonify central Qi and benefit Qi.

[Formula Explanation] This formula is a representative formula of Li Dongyuan, whose basic indication is deficiency of central Qi. Li believed that “a person’s stomach Qi is the foundation. When the spleen and stomach are damaged, five organs become chaotic.” “Once the spleen and stomach are harmed, the five organs begin to malfunction.” “When the Qi of the spleen and stomach is damaged, the original Qi also cannot be fully replenished, and this is where many diseases originate.” Based on this perspective, Li’s Bu Zhong Yi Qi Tang primarily aims to tonify central Qi and benefit Qi, achieving multifaceted effects in clinical practice. Yellowish complexion, poor appetite, fatigue, and shortness of breath are the basic symptoms of central Qi deficiency; accompanied by fever with sweating, thirst for warm drinks, and headache and cold sensitivity, this is Qi deficiency with fever; accompanied by uterine prolapse or gastric prolapse, this indicates central Qi descent; and accompanied by vomiting blood, nosebleeds, or bloody stools, this signifies Qi failing to control blood flow. All of these conditions arise from central Qi deficiency, so this formula serves as the primary treatment.

① Why does Qi deficiency lead to fever? Li believed that fire is the enemy of original Qi; fire and original Qi do not oppose each other—when one prevails, the other declines. When fire is strong, original Qi is damaged; when original Qi is replenished, fire can be subdued. Bu Zhong Yi Qi Tang uses this very principle to reduce fever. This method is called “sweet warmth to eliminate excessive heat.” ② Central Qi is the foundation of postnatal life; when its Qi is abundant, the five internal organs are harmonious. If Qi descends, various organs may experience slippage or prolapse. Bu Zhong Yi Qi Tang can uplift the yang Qi of the spleen and stomach, helping the descending organs return to their proper positions. ③ Qi governs blood; when Qi is deficient, blood lacks regulation and will tend to wander. Bu Zhong Yi Qi Tang greatly replenishes central Qi and strengthens blood’s ability to regulate, thereby controlling wandering blood. In this formula, Astragalus is the top-tier herb for tonifying central Qi and benefiting Qi, making it the primary ingredient. Codonopsis Pilosula and Atractylodes Macrocephala both have sweet, warming properties that benefit Qi; when used together with Astragalus, their Qi-tonifying and central Qi-enhancing effects are further amplified, making them auxiliary herbs. When spleen and stomach Qi are deficient, their function of transportation and transformation is impaired, and Qi flow becomes difficult. Citron Peel regulates Qi and strengthens the spleen to aid in transportation; over time, if Qi deficiency persists, blood deficiency will inevitably occur, so Angelica Sinensis nourishes and replenishes blood. When central Qi is deficient, we may see spleen deficiency and Qi descent; Chai Hu rises yang Qi to the highest points of the Taiyang meridian, and all these herbs serve as complementary treatments. Licorice Root harmonizes all the herbs and acts as an intermediary for harmonization. [Clinical Additions and Subtractions]

① Remove Angelica Sinensis, add Wood Odor, and replace Atractylodes Macrocephala with Coptis Chinensis, forming “Tiao Zhong Yi Qi Tang” (from “Wei Wei Lun”), used to treat Qi deficiency, dampness obstruction in the spleen and stomach, and sluggish Qi flow resulting in chest fullness and fatigue. ② Add Mai Men Dong, Coptis Chinensis, Phellodendron Amurense, and Stir-fried Yeast, forming “Huang Qi Ren Shen Tang” (from “Wei Wei Lun”), used to treat severe summer heat, where heat damages original Qi, causing fatigue, drowsiness, fever, and loss of appetite; with excessive sweating. ③ Remove Sheng Ma, add Half-Seasoned Ginger, Qiang Huo, Duhuo, White Peony, Fang Feng, Poria Cocos, Alisma, Coptis Chinensis, Fresh Ginger, and Jujube, forming “Sheng Yang Yi Wei Tang” (from “Lan Shi Mi Cang”), used to treat spleen and stomach Qi deficiency, abdominal discomfort, and joint pain. ④ Modify this formula according to “Wei Wei Lun”: add White Peony and Roasted Licorice Root for abdominal pain; add Peel-Cinnamon (Cinnamon Heart) for cold-related pain and abdominal discomfort; add White Peony, Roasted Licorice Root, and Scutellaria Baicalensis for heat-induced fever and cold-related abdominal pain; remove White Peony from the formula when the abdomen is cold, adding Gou Qi Yuan instead; add Amomum Villosum if the pain persists, or add Half-Seasoned Ginger and Fresh Ginger; add Rehmannia Root if there is pain below the navel; if the pain continues, add Cinnamon; add Qing Pi if there is chest Qi stagnation, and remove it if you feel short of breath; add Qing Pi if there is chest tightness, and remove it if you feel short of breath; add Chai Hu if there is chest discomfort; add Huang Lian if you cannot eat, and avoid adding the Three Immortal Herbs. [Reference Materials]

① “For treating central Qi deficiency, weak Ying and Wei, susceptibility to wind-cold, headaches, fever, and internal injuries caused by exhaustion, as well as cases where true yang Qi is sinking—though the true yang Qi resides within the two kidneys, it has always relied on the spleen and stomach to be replenished and strengthened since birth. Therefore, Dongyuan developed the theory of spleen and stomach, which he explained in great detail. If the spleen and stomach are weak, the source of yang Qi’s generation and transformation is diminished, and the channels through which it flows are also hindered. As a result, yang Qi sinks, and Wei Qi is not firmly anchored, making it easier for external evils to invade. However, these fevers and chills are often caused by excess evil and deficiency, so we should support the body’s own defenses to repel the evil… Dongyuan’s approach to treating exhaustion and internal injury was based on treating external infections.” (From “Cheng Bian Fang Du”) ② “The Classic says: ‘Warm the weary,’ ‘Benefit the depleted.’ Based on this principle, Li Dongyuan developed the famous Bu Zhong Yi Qi Tang, which primarily focuses on sweet warmth. The original formula contained 1 qian of Astragalus, 5 fen of Roasted Licorice Root, 3 fen each of Ginseng and Atractylodes Macrocephala, 2 fen of Angelica Sinensis, 2 fen each of Citron Peel, Sheng Ma, and Chai Hu—taken once in a decocted form, slightly warm. This formula was used to treat qi deficiency, fever with sweating, thirst for warm drinks, headache and cold sensitivity, restlessness and talkativeness, lack of appetite, fatigue in the limbs, inability to work hard, shortness of breath with activity, chronic malaria and chronic diarrhea, as well as cases of blood vomiting, nosebleeds, bloody stools, or rectal prolapse caused by central Qi deficiency, or uterine prolapse, and all other conditions involving organ descent.” (Mao Yuxian’s Experience) ③ Bu Zhong Yi Qi Tang cured one case of fever due to Qi deficiency. The patient had long-term fever, slight improvement in the afternoon, poor sleep at night, headache and fatigue, limb weakness, mild swelling on the face and forehead, abdominal distension, thirst but unwillingness to drink, a pale tongue with a thin, white, slippery coating, and a deep, fine pulse. After three doses of Bu Zhong Yi Qi Tang, the fever subsided, and after ten doses, the fever was gone. (From “Fujian Traditional Chinese Medicine,” March 1964) ④ Bu Zhong Yi Qi Tang was used to treat 103 cases of gastric prolapse. All patients were diagnosed via X-ray barium meal radiography, with the gastric apex located between 5–17 centimeters below the iliac crest. The formula consisted of Bu Zhong Yi Qi Tang combined with Zhike, Chicken Gizzard, Turmeric, Chinese Yam, and Hawthorn. For severe gastric pain, added Yuan Hu; for liver and spleen prolapse, added Turtle Shell; for combined ulcers, added Bai Ji and Uchi Gu. One dose was taken daily, divided into two doses, decocted strongly, and taken warm. Treatment outcomes: 54 cases were cured, 25 showed marked improvement, 22 were effective, and 2 were ineffective. The treatment duration ranged from 60 days to 15 days, with an average of 35 days. (From “New Pharmaceutical Journal,” November 1974) ⑤ Bu Zhong Yi Qi Tang was used to treat spleen deficiency and Qi descent, along with long-term hematuria. Hu ××, a 28-year-old woman, experienced intermittent hematuria starting at age 22, with a pale complexion and a pale, white tongue. The formula used Bu Zhong Yi Qi Tang combined with Anemarrhena Asphodeloides and Phellodendron Amurense. After four and a half months of treatment, 10 doses of the formula were administered, along with 20 bags of Bu Zhong Yi Qi Pills. The hematuria disappeared, though occasional lower abdominal pain remained; after more than 10 doses of Anemarrhena Asphodeloides and Paeonia Radix Paeoniae, the condition improved. (From “Yue Mei Chinese Medicine Case Collection”) ⑥ Bu Zhong Yi Qi Tang was used to treat postpartum urinary retention. Lai ×× underwent a mid-position forceps delivery, followed by urinary obstruction. Despite various diuretic treatments, the condition did not improve; a traditional Chinese medicine consultation revealed a pale complexion, shallow breathing, palpitations, dizziness, blurred vision, fatigue, poor appetite, a pale tongue, and a weak pulse. The formula used Bu Zhong Yi Qi Tang combined with Plantago Major, Aristolochia Foderata, Platycodon Grandiflorus, and Shepherd’s Purse Flowers; after two doses, the condition improved, and after four doses, the patient recovered fully. (From “Chinese Medicine Magazine,” June 10) ⑦ The main components of this formula have been shown in animal experiments to enhance the phagocytic function of the reticuloendothelial system; in contrast, other formulas like Panax ginseng, Lily, Fritillaria, and Scutellaria Baicalensis, which nourish Yin and clear Heat, did not exhibit this effect. (From “New Pharmaceutical Journal,” August 1974, p. 15) [Commentary] This formula can be used to treat fever of unknown origin, hypotension, neurasthenia, uterine prolapse, gastric prolapse, various bleeding disorders, menstrual irregularities in women.

Sheng Mai San

From “Nei Wai Shang Bian Hua Lun”

[Composition] 4.5 grams of Ginseng, 4.5 grams of Ophiopogon japonicus, 7 berries of Schisandra chinensis

[Usage] Decocted in water and taken orally.

[Indications] Lung damage from summer heat, deficiency of both Qi and Yin.

[Suitable Symptoms] Sweating and fatigue, shortness of breath and thirst, weak pulse, dry mouth and throat, cough with little phlegm, even shortness of breath, and a weak, almost absent pulse.

[Functions] Nourish Qi and nourish Yin, protect the lungs and restore Qi.

[Formula Explanation] According to “Su Wen · Six Elements’ True Record,” “When fiery heat moves, extreme summer heat arrives, and people suffer from shortness of breath.” According to “Su Wen · Qi Exchange’s Great Discussion,” “When the year’s fire is excessive, fiery heat spreads, and the lungs are invaded by evil.” According to “Su Wen · Five Movements’ Great Discussion,” “In heaven, it is heat; on earth, it is fire, and its nature is summer heat.” Thus, summer heat and heat share characteristics of damaging the lungs, depleting Qi, and harming Yin. In this formula, the symptoms of sweating and fatigue, and shortness of breath and thirst indicate Qi depletion; dry mouth and throat, cough with little phlegm indicate Yin deficiency; the lungs are the gateway to all the vessels, and when Qi and Yin are depleted, the pulse becomes weak and the pulse is almost absent. In this formula, Ginseng is sweet and warm, nourishing Qi and Yin, restoring the lungs and generating Qi—making it the primary ingredient. Ophiopogon japonicus is sweet and cool, greatly nourishing lung Yin, serving as an auxiliary herb; Schisandra chinensis is sour and warm, constricting lung Qi, also acting as an auxiliary herb. Together, these three herbs work to nourish Qi, nourish Yin, and protect the lungs—ensuring that lung Qi is preserved, allowing all the vessels to recover, which is why it is named Sheng Mai San. [Clinical Additions and Subtractions]

If cough is prominent, add Lily and Winter Flower; if heart palpitations and insomnia occur, add Sour Jujube, Night-Blooming Jasmine, and Albizia Bark; if excessive sweating occurs, add Floating Wheat and Ephedra Root; if irritability and restlessness appear, add Raw Dragon's Blood and Ostrich Egg; if the pulse is irregular, add Cinnamon Twig, Collagen, Roasted Licorice Root, and Bitter Neem Root. [Reference Materials]

① “To treat heat damage to original Qi, shortness of breath and fatigue, excessive thirst and sweating, and cough due to lung deficiency. The lungs govern the Qi of the entire body, and all the vessels converge upon them; when lung Qi is strong, the Qi of the internal organs is also strong, essence is generated, and form flourishes—pulses are never interrupted. Once exposed to the heat of summer, when the metal is punished by fire, lung Qi becomes exhausted, and the above symptoms emerge one after another. However, summer heat is the true evil of the summer months; those with abundant original Qi can remain healthy, so when evil gathers, Qi inevitably becomes deficient. This formula only focuses on strengthening lung Qi, nourishing lung Yin with Ophiopogon japonicus, and constricting Qi with Schisandra chinensis. If you treat the heat without addressing the root cause, and treat summer heat as an invisible evil, then if there is no dampness in the heat, there will be no lingering problems. If there is no high fever, then even clearing the heat is futile—thus, the method of protecting the lungs is precisely to dispel the heat.” (From “Cheng Bian Fang Du”) ② Li ××, a 46-year-old man diagnosed with rheumatic heart disease, mitral stenosis, left ventricular enlargement, and pulmonary congestion. He experienced palpitations, shortness of breath, insomnia, frequent dreams, lower limb edema, a pale complexion, flushed cheeks, purple lips, a pale tongue, and a tense, slow pulse. He was treated with Sheng Mai San combined with Long Dragon’s Blood, Angelica Sinensis, White Peony, Uncaria Rhynchophylla, Goji Berries, and Licorice Root. After four visits, the formula was adjusted and progressed, totaling 30 doses. His pulse shifted to a slower, smoother rhythm, his lips turned rosy, his heartbeat became steady, his sleep improved, his physical strength slightly recovered, and the murmurs in the apical region disappeared upon auscultation. After four weeks of taking Ren Shen Gui Pi Pills, he resumed work. (From “Zheng Qiao Medical Case Selection,” People’s Health Edition, 1978, Volume 6) ③ Animal experiments have shown that Sheng Mai San injection solution: ① has a significant pressor effect on dogs experiencing acute hemorrhagic shock, with no noticeable impact on normal blood pressure; ② enhances the contractile force of the beating hearts of rabbits under anesthesia; ③ when shock occurs, administering Sheng Mai San injection solution can help animals become calmer. Clinical observations show that administering Sheng Mai San injection solution can help rescue patients suffering from shock, raising blood pressure. (From “Tianjin Medical Communications,” November 1972) [Commentary] This formula, with modifications, can be used for summer heatstroke, chronic bronchitis, pulmonary tuberculosis, neurasthenia, rheumatic heart disease, arrhythmia, and hypotension; in the rescue of patients with myocardial infarction and peripheral circulatory failure, the drip infusion of Sheng Mai San injection solution can achieve certain therapeutic effects.

Yu Ping Feng San

From “Shi Yi De Xiao Fang”

[Composition] 180 grams of Astragalus, 60 grams of Atractylodes Macrocephala, 60 grams of Ledebouriella Divaricata

[Usage] Grind all ingredients into a fine powder, take 10 grams per dose; or decoct into a herbal tea, reducing the dosage accordingly.

[Indications] Qi deficiency and weak defensive Qi.

[Suitable Symptoms] Pale complexion, spontaneous sweating and aversion to wind, susceptibility to wind and cold, pale tongue, and a floating, slow pulse.

[Functions] Nourish Qi and strengthen the exterior.

[Formula Explanation] When Qi is deficient, the complexion appears pale and the tongue is pale; when Qi is deficient and unable to defend against external factors, the skin’s pores become open, leading to spontaneous sweating and aversion to wind, increased susceptibility to wind and cold, and a floating, slow pulse. In this formula, Astragalus greatly nourishes lung Qi, strengthening the skin and firming the pores, making it the primary ingredient. Atractylodes Macrocephala nourishes the middle Qi, allowing soil to generate metal, and when combined with Astragalus, its Qi-nourishing and exterior-strengthening effects are further enhanced, making it an auxiliary herb. Ledebouriella Divaricata travels to the surface to dispel wind evil, serving as an auxiliary treatment. This formula’s purpose is to nourish Qi and strengthen the exterior, making the Great Wall strong enough to resist enemies—this is a typical formula for supporting the body’s natural defenses to eliminate evil, fully reflecting the guiding principle of “where evil gathers, Qi inevitably becomes deficient” in formula-based medicine. [Clinical Additions and Subtractions]

① For colds in individuals with Qi deficiency, add Bu Zhong Yi Qi Tang; if excessive sweating persists, add Floating Wheat, Raw Dragon’s Blood, and Schisandra chinensis; for low blood pressure, add Sheng Mai San.

② Take all three herbs in equal amounts and decoct in water, naming it Astragalus Decoction (Zhang Jie Gu), used to treat wind and cold with weak exterior defense.

[Reference Materials]

① “Generally speaking, when the exterior is weak and unable to defend against external factors, one should first establish central Qi. Therefore, Atractylodes Macrocephala’s role in nourishing the spleen and establishing central Qi is the principal component; when the spleen is strong, the Qi of the four organs can receive nourishment, the exterior is secured, and evil cannot take hold. Then, Astragalus strengthens the exterior and benefits the defense, while Ledebouriella Divaricata’s good movement and circulation ensure that the formula works effectively.” (From “Cheng Bian Fang Du”) ② “Old Physician Pu Fu Zhou treated this condition—external deficiency with spontaneous sweating—with powdered formulas, taking 9 grams daily, persisting for a month. Not only did the sweating stop, but the therapeutic effect was sustained, and the condition did not recur. I suddenly realized that external deficiency with spontaneous sweating is a relatively chronic physiological weakening of the skin and exterior. To change and restore physiology through medication, one must allow it to progress from quantitative change to qualitative change—3–5 doses of herbal tea, how could one expect to restore physiology overnight? Even if recovery occurs, it is a manifestation of medicinal power, not a restoration of physiology itself. Therefore, whenever I encounter cases of external deficiency with spontaneous sweating, I only use powdered formulas for continuous treatment; after long-term use, the results are satisfying.” (From “Yue Mei Chinese Medicine Case Collection”) [Commentary] This formula, with additions and modifications, is often used for habitual colds, vegetative nervous system disorders, hyperthyroidism, and spontaneous sweating associated with rheumatic diseases.

Bao Yuan Tang

From “Bo Xin Ai Jian”

[Composition] 9 grams of Astragalus, 9 grams of Ginseng, 3 grams of Licorice Root, 2 grams of Cinnamon

[Usage] Add a slice of fresh ginger, decoct in water and take warm.

[Indications] Deficiency of righteous Qi.

[Suitable Symptoms] Pale complexion, fatigue, poor appetite, spontaneous sweating and weakness, lower back pain and leg discomfort, pale tongue and weak pulse.

[Functions] Nourish righteous Qi.

[Formula Explanation] Righteous Qi includes both innate kidney Qi and acquired spleen Qi. The spleen Qi, working in conjunction with the respiratory Qi governed by the lungs, forms Zong Qi, which serves as the driving force behind human respiration and circulation. From this perspective, the spleen, kidneys, and lungs are the organs most closely related to human righteous Qi. In this formula, the complexion is pale, spontaneous sweating and shortness of breath are symptoms of lung deficiency; fatigue and poor appetite are symptoms of spleen deficiency; lower back pain and leg discomfort are symptoms of kidney deficiency. Ginseng is used to strengthen the spleen and nourish Qi, as spleen Qi resides in the center, governing all things; when spleen Qi is replenished, lung Qi is generated, and kidney Qi is strengthened, making Ginseng the primary ingredient. The lungs are the canopy of the five internal organs and six viscera, the gateway to all the vessels; when lung Qi is replenished, Zong Qi flows, and Qi and blood can circulate throughout the body. Astragalus is sweet and warm, nourishing the lungs, making it an auxiliary herb; Cinnamon warms kidney yang, helping to strengthen kidney Qi, also acting as an auxiliary herb. Licorice Root harmonizes all the herbs, acting as an intermediary for harmonization; a slice of fresh ginger is intended to disperse and move Qi, preventing the stagnation of Ginseng and Cinnamon and allowing for smoother movement, also serving as an intermediary for harmonization. This formula nourishes the spleen, lungs, and kidneys, helping righteous Qi to recover, making it a fundamental formula for supporting the body’s natural defenses and strengthening the roots.” [Clinical Additions and Subtractions]

① Remove Cinnamon and fresh ginger, naming it Astragalus Soup (Li Dongyuan), used to treat spleen and lung Qi deficiency, with fatigue and poor appetite.

② Remove Cinnamon and fresh ginger, adding Hedysarum Macrophyllum, Kudzu Root, Phellodendron Amurense, White Peony, and Shengma, forming the Qi-Nourishing and Intelligent Soup (Li Dongyuan), used to treat weakness and fatigue, and to alleviate headaches and tinnitus. ③ Remove Cinnamon and fresh ginger, adding Qiang Huo, Duhuo, Half-Seasoned Ginger, Citron Peel, Poria Cocos, Chai Hu, Fang Feng, Alisma, and Coptis Chinensis, forming the Rising Yang and Benefiting Stomach Soup (Li Dongyuan), used to treat spleen and stomach weakness and rheumatic interactions. [Reference Materials] "For acne with yang deficiency and depressed apex, and for blood deficiency with clear fluid, this formula is also employed to leverage the principle of yang generating yin and yin promoting yang… Wei’s experience from practice showed that using Si Jun Zi Tang with Huang Qi and Zicao can indeed help acne develop fully and resolve, but when the condition involves severe cases where the fluid fails to form a clear layer, leading to dryness and eventual death, it is not uncommon. Upon deeper investigation, it was discovered that Bai Zhu can dry dampness, while Fu Ling has a mild diuretic effect—both are not conducive to bodies with qi and blood deficiency; by removing Fu Ling and Bai Zhu, the desired results can be achieved quickly. However, these herbs have a relatively slow action, making it difficult to achieve rapid effects in treatment. Therefore, Guan Gui was added to enhance the medicinal power." (Jiangsu New Medical College: “Traditional Chinese Medicine Formulas”)

[Commentary] This formula was originally developed to treat smallpox, where yang energy is deficient, acne presents with depressed apex, fluid is thin and unclear, preventing proper development and formation of scabs, and making it challenging to close the lesions. In modern times, this formula has been adopted as a foundational formula for strengthening the body and nurturing original qi, and is widely used for various conditions characterized by qi and blood deficiency and exhaustion.

II. Blood Tonification

The method of treating blood deficiency is known as blood tonification. The Su Wen, in the section on the Formation of the Five Organs, states: “All blood belongs to the Heart.” Consequently, symptoms of blood deficiency often first appear in the Heart, such as palpitations, shortness of breath, insomnia with frequent dreams, and a pale complexion (the Heart governs blood vessels, and its manifestation is reflected in the face). Furthermore, due to the relationship between the Liver governing the storage of blood and the Liver and Kidney sharing a common origin, symptoms of blood deficiency can also manifest in the Liver and Kidney organs—such as dizziness, blurred vision, lower back pain, and tinnitus. For this reason, formulas for blood tonification often include Fu Shen, Yuan Zhi, and Zao Ren to nourish the Heart and calm the spirit; Dang Gui, Sheng Di, and Bai Shao are commonly used to nourish the Liver and benefit the Kidneys. Additionally, based on the principle that “Qi leads blood, and blood is the mother of Qi,” formulas like Dang Shen, Bai Zhu, Huang Qi, and Gan Cao are frequently employed to tonify Qi.

Sibu Tang

From the He Ji Ju Fang

[Composition] Dang Gui (stir-fried in wine), Chuan Xiong, Bai Shao (stir-fried in wine), Sheng Di (steamed in wine)

[Usage] The herbs are finely ground; each dose is 9 grams, prepared by boiling in water, straining the residue, and taking warm on an empty stomach. In modern times, the formula is prepared as a decoction, with dosages adjusted accordingly.

[Indications] Deficiency of Ying and Qi, disharmony between Chong and Ren channels.

[Indications] Irregular menstrual cycles, abdominal pain around the navel, metrorrhagia or leukorrhea, blood stasis causing masses, pale complexion, pale tongue with thin coating, and a deep, fine pulse.

[Functions] Nourishes blood and replenishes Ying, regulates Chong and Ren channels.

[Formula Explanation] When Ying and Qi are deficient, the face appears pale, the tongue is pale with a thin coating, and the pulse is deep and fine. When Chong and Ren are out of balance, menstrual cycles are irregular, abdominal pain occurs around the navel, metrorrhagia or leukorrhea occur, and blood stasis causes masses. Deficiency of Ying and Qi is attributed to the Heart (all blood belongs to the Heart); disharmony of Chong and Ren is attributed to the Liver (the Liver governs Chong and Ren). Ke Qin said: “This formula is specifically designed to regulate blood flow in the Liver channel—it is not the primary formula for generating blood in the Heart channel.” It is evident that regulating Chong and Ren is the main function of this formula. In the formula, Dang Gui is sweet and warm, entering the Liver to nourish blood, activate blood circulation, and regulate blood flow; it nourishes without stagnation, moves smoothly, and serves as the primary herb for regulating Chong and Ren. Since the Liver and Kidney share a common origin, the vitality of Liver blood relies entirely on the nourishment of Kidney Yin; Sheng Di, sweet and cold, enters the Kidney to nourish Yin and nourish blood, serving as an auxiliary herb. Bai Shao has a sour and astringent nature, tonifying Yin and soothing the Liver while regulating blood flow; Chuan Xiong, with its spicy and warm properties, enters the Liver to move Qi and activate blood circulation, acting as both a treatment and a complementary remedy.

[Clinical Additions and Subtractions] Adding Jiao E, Ai Ye, and Gan Cao creates Jiao Ai Tang, which treats pregnancy-related issues and metrorrhagia; adding Tao Ren, Hong Hua, and Bai Shao instead of Chi Shao transforms the formula into Tao Hong Si Wu Tang, which treats blood deficiency combined with blood stasis; adding Zhimu and Huang Bo transforms the formula into Zhi Bo Si Wu Tang, which treats blood deficiency accompanied by Yin deficiency and internal heat; this formula, made into honey pills under the name Kan Li Wan, shares similar functions to the decoction; adding Ai Ye and Xiang Fu, mixed with vinegar into pills, creates Ai Fu Nuan Gong Wan, which treats blood deficiency combined with cold uterus and infertility; adding Da Huang, Mang Xiao, and Gan Cao creates Yu Zhu San, which treats amenorrhea with abdominal pain and refusal to press, with a strong pulse; removing Sheng Di and Bai Shao creates Fo Shou San, which treats women’s blood deficiency caused by cold uterus, pregnancy-induced bleeding, and fetal death in the womb. Adding Si Jun Zi Tang creates Ba Zhen Tang, which treats both Qi and Blood deficiency; adding Si Jun Zi Tang, Cinnamon, and Huang Qi creates Shi Quan Da Bu Tang, which treats Qi and Blood deficiency, as well as both Yin and Yang deficiency in the body.

[Reference Materials]

① “Dang Gui is pungent, sweet, and warm, entering the Heart and Spleen to generate blood as the chief herb; Sheng Di is sweet and cold, entering the Heart and Kidney to nourish blood as the assistant herb; Bai Shao is sour and cold, entering the Liver and Spleen to soothe Yin as the auxiliary herb; Chuan Xiong is pungent and warm, moving up and down to circulate Qi within the blood as the master herb.” (Yi Fang Ji Jie)

② The Jiawei Jiao Ai Si Wu Tang cured 15 cases of threatened abortion and 4 cases of habitual abortion. All cases of threatened abortion were characterized by intermittent abdominal pain, a feeling of pressure in the lower abdomen, and vaginal bleeding; habitual abortions were similar in symptomatology, but they invariably had a history of miscarriage. The prescription included Dang Shen, Sheng Ma, Bai Zhu, Huang Qin, and Sang Ji Sheng. In cases of severe bleeding, five qian of Gao Li Shen were first decocted and taken warm, followed by the use of the above formula. For those with significant Qi deficiency, Huang Qi was added; for excessive blood loss, Deyu Tan was used; for lower back pain, Du Zhong was added; for a strong, tense pulse, Chrysanthemum was added. (Chinese Medicine Magazine, 65.3)

③ The Jiawei Si Wu Tang cured four cases of pharyngeal tonsil enlargement (pharyngeal tonsil hypertrophy) in children under twelve years old. Symptoms included narrowness of the throat, enlarged tonsils pressed against each other, affecting breathing—mild cases involved difficulty swallowing, while severe cases led to respiratory and vocal difficulties. The prescription included Chuan Xiong, 1.5 qian; Sheng Di, 9 grams; Dang Gui, Bai Shao, roasted Shan Jia, Kui Jing, and She Gan, each 2 qian. After six to nine doses, all four patients recovered, and their enlarged tonsils returned to normal. (Zhejiang Chinese Medicine Magazine, 1965.7)

[Commentary] This formula has a wide range of applications; it can be used for gynecological disorders such as menstrual irregularities, uterine fibroids, ovarian cysts, and chronic ectopic pregnancies; additionally, it can be extensively applied to surgical injuries, post-operative orthopedic procedures, as well as coronary heart disease, liver diseases, skin conditions, and more.

Gui Pi Tang From the Jisheng Fang

[Composition] Bai Zhu, Fu Shen, Huang Qi, Long Yan Rou, and Suo Zao Ren, each 30 grams; Ren Shen and Mu Xiang, each 15 grams; Gan Cao, 7.5 grams; Dang Gui and Yuan Zhi, each 3 grams

[Usage] The herbs are finely chopped; each dose is 12 grams, with five slices of fresh ginger and one jujube added, boiled in water, strained, and taken warm.

[Indications] Deficiency of both the Heart and Spleen.

[Indications] Palpitations, forgetfulness, insomnia with frequent dreams, pale complexion, poor appetite, and a weak, fine pulse.

[Functions] Strengthens the Spleen and Qi, nourishes the Heart and calms the spirit.

[Formula Explanation] This formula represents a combination of Spleen Qi deficiency and Heart Blood deficiency. Spleen Qi deficiency manifests as pale complexion, poor appetite, fatigue, and lack of energy with little talk or effort; Heart Blood deficiency is characterized by palpitations, forgetfulness, and insomnia with frequent dreams. The Spleen resides in the center, nourishing the four directions; Spleen Qi deficiency leads to Heart Blood deficiency. In the formula, Ren Shen, Bai Zhu, and Huang Qi are sweet and warm, nourishing the Spleen and strengthening Qi as the primary treatment; Fu Shen, Yuan Zhi, Zao Ren, and Long Yan Rou nourish the Heart and calm the spirit as supplementary treatments; Mu Xiang moves Qi, Dang Gui activates blood circulation, allowing the herbs to act freely without stagnation; Ginger and Jujube harmonize the Qi and Blood, serving as complementary remedies; Gan Cao harmonizes all the herbs and acts as a guide and mediator.

[Clinical Additions and Subtractions]

① Adding Musk, Cinnabar, Yam, and Kui Jing creates Miao Xiang San (from the He Ji Ju Fang), which treats insufficient Heart Qi, unstable willpower, palpitations and fear, and frequent changes in mood.

② Adding Mai Dong and Wu Wei Zi treats lung and kidney damage, cough, and night sweats; adding Chai Hu, Dan Pi, and Shan Zhi treats liver Qi stagnation, flank pain, and bitter, hot mouth; adding Sheng Di, Wu Wei Zi, Bai Shao, and Muliu treats heart-kidney imbalance, leading to spontaneous sperm leakage; adding Huang Lian, Sheng Di, and Bei Mu treats excess Heart Fire, causing restlessness and fever; adding Huang Bo, Zhi Mu, and Mai Dong treats excessive Fire in the Heart, leading to bone-dryness and nocturnal emission.

[Reference Materials]

① “When blood does not return to the Spleen, it flows excessively; the sweetness and warmth of Ren Shen, Bai Zhu, Huang Qi, and Gan Cao nourish the Spleen; the sweetness and sour-bitter qualities of Fu Shen, Yuan Zhi, Zao Ren, and Long Yan Rou nourish the Heart. The Heart is the mother of the Spleen; Dang Gui nourishes Yin and nourishes blood, Mu Xiang moves Qi and relaxes the Spleen—both help to move stagnant Qi in the blood while also aiding Ren Shen and Bai Zhu in nourishing Qi. When Qi is strong, it can retain blood, and blood returns to its channels, eliminating all symptoms.” (Yi Fang Ji Jie)

② Adding Jiawei Gui Pi Tang treated two cases of gastric ulcers. Both cases were diagnosed via X-ray barium meal imaging, with key symptoms including a dull complexion, severe stomach pain, dizziness and sluggish speech, palpitations and insomnia, a weak, fine, or even large and rapid pulse. After adjusting the formula according to individual symptoms, all symptoms were alleviated. (Zhejiang Chinese Medicine Magazine, 64.6)

③ Zhao ××, female, 50 years old, presented with frequent nosebleeds, gum bleeding, and purpura throughout the body. She was later hospitalized due to heavy vaginal bleeding, and was diagnosed with thrombocytopenic purpura. She experienced fatigue, poor appetite, palpitations, poor sleep, a weak, fine pulse. The prescription included: Ren Shen, 5 fen; Bai Zhu, 3 qian; Yun Ling, 3 qian; Zao Ren, 5 qian; Mu Xiang, 2 qian; Dang Gui, 3 qian; Sheng Huang Qi, 3 qian; Long Yan Rou, 3 qian; Sheng Di, 3 qian; Mai Dong, 3 qian; Dan Pi, 3 qian; Yin Yang Huo, 3 qian; Chuan Duan, 3 qian; Bu Gu Zhi, 3 qian; Ba Ji Tian, 3 qian. After 23 doses, her platelet count increased from 56,000 to 146,000, and the skin purpura, nosebleeds, gum bleeding, and vaginal bleeding all disappeared. (Shanghai Chinese Medicine Magazine, 1964.10)

[Commentary] This formula is used for neurasthenia, anemia, aplastic anemia, thrombocytopenic purpura, chronic gastritis, gastric and duodenal bulb ulcers, menstrual irregularities and functional uterine bleeding in women, early-stage rheumatic heart disease, hypotension, and other conditions.

Zhu Gan Cao Tang (Fuxin Tang) From the Shang Han Lun

[Composition] Zhu Gan Cao, 9 grams (four liang); Da Zao, 6 pieces (30 pieces); A Jiao, 9 grams (two liang); Sheng Jiang, 9 grams (three liang); Ren Shen, 6 grams (two liang); Sheng Di Huang, 30 grams (one jin); Gui Zhi, 6 grams (two liang); Mai Dong, 9 grams (half a sheng); Ma Ren, 9 grams (half a sheng)

[Usage] Boil in wine, add water in equal parts, strain the residue, then dissolve the A Jiao in the liquid and take warm.

[Indications] Deficiency of both the Heart and Lung, with a weak, slow pulse.

[Indications] Palpitations, shortness of breath, spontaneous sweating, a weak, slow pulse, dry throat and mouth, dry cough with heat, sticky phlegm, blood in phlegm, restlessness and insomnia, night sweats, a tongue that is bright with little coating.

[Functions] Nourish the Heart and strengthen the Lung, open Yang and restore the pulse.

[Formula Explanation] “The Heart governs blood vessels. The Lung governs all the veins.” When the Heart and Lung are deficient, the pulse becomes weak and slow; the Shang Han Lun states, “When the pulse is slow and the heartbeat is irregular, Zhu Gan Cao Tang is the primary remedy.” This shows that the core focus of this formula lies in “restoring the pulse.” The key symptoms of this formula—palpitations, shortness of breath, spontaneous sweating, and a weak, slow pulse—are due to Heart Qi deficiency; dry throat and mouth, dry cough with heat, sticky phlegm, blood in phlegm, restlessness and insomnia, night sweats, and a tongue that is bright with little coating indicate Lung Yin deficiency. In the formula, Zhu Gan Cao is sweet and warm, warming and nourishing Heart Qi, while its sweetness moistens Lung Yin; nourishing both the Heart and Lung, replenishing Qi and generating blood, it serves as the primary treatment of this formula. Gui Zhi warms and opens Heart Yang, providing support as a complementary remedy. Ren Shen and Da Zao strengthen Qi and nourish the Spleen, consolidating the foundation of all Qi; Sheng Di, A Jiao, Mai Dong, and Ma Ren nourish the Lung and Kidney, nurturing the original Yin, serving as complementary treatments. The addition of wine in the decoction reflects the intention of warming and dispersing, acting as a guide and mediator.

[Clinical Additions and Subtractions]

① Removing Ginger, Gui Zhi, Ren Shen, and Zao Ren, and adding Bai Shao creates Jia Jian Fu Xin Tang (from the Wen Bing Tiao Bian), which treats prolonged exposure to external pathogens in Yangming, with body heat, flushed face, dry mouth and throat, a weak, large pulse, and hot palms and soles.

② For severe palpitations, add Sheng Long Qi and Zhu Sha; for pronounced pulse abnormalities, add Tea Tree Root, Dan Shen, Sandalwood, and Yuan Hu; for a fine pulse, add Wu Wei Zi; for edema, add Fu Ling and Che Qian Zi; for Yang deficiency and spontaneous sweating, and coldness, add Fuzi; for loose stools, remove Ma Ren.

[Reference Materials]

① “The Heart is the lord of all things; it does not accept evil influences, and in terms of form, it is located in the Li, the Sun of Yang—but within Li there is Yin; one Yin resides within two Yangs. Though the Heart is a male organ, it is the source of blood and the source of pulses—and all of these belong to the Heart. If the Heart lacks Yin and blood, and is harmed by cold evil, then the above symptoms will appear. In the formula, Sheng Di, A Jiao, and Mai Dong nourish the Yin of the Heart; Ren Shen and Gan Cao nourish the Yang of the Heart; Gui Zhi, Sheng Jiang, and Clear Wine disperse external cold evils; Ma Ren and Da Zao moisten the dryness of the internal organs—these formulas often treat pulmonary emphysema, and readers may find further insight by carefully examining the Jin Gui.” (Cheng Fang Jian Du)

② “This formula is a major blood-tonifying formula. Our predecessor Yang Xi Shan once warned against over-treating this formula, but unfortunately, he did not clearly explain its meaning. I have observed that in this formula, the middle burner receives Qi and transforms it into red juice—this is the essence of blood. Ginger, Jujube, Ren Shen, and Grass extract the juices from the middle burner; Gui Zhi enters the Heart to transform Qi and turn it red—but Gui’s nature is pungent and can harm blood, so we emphasize the use of Sheng Di, Mai Dong, and Sesame seeds to cleanse and moisten, transforming Gui Zhi’s strong, pungent energy into a gentle one, allowing blood to be generated without harming the blood; at the same time, A Jiao hides the blood vessels, allowing blood to flow to the Blood Sea and be stored in the Liver. Together, this formula provides the source of blood, guides the flow of blood, and is truly the first formula for blood tonification.” (Xue Zheng Lun)

③ “Wang ××, male, suffered from palpitations, a weak, fine pulse, and sore legs. He was prescribed Zhu Gan Cao Tang (12 grams of Zhu Gan Cao, 9 grams of Gui Zhi, 9 grams of Sheng Jiang, 18 grams of Mai Dong, 9 grams of Zao Ren, 6 grams of Ren Shen, 6 grams of A Jiao, 48 grams of Sheng Di Huang, 10 jujubes split), with 4 cups of water and 3 cups of wine. First, boil all eight ingredients together, then take 2 cups, remove the residue, dissolve the A Jiao, and divide the mixture into two warm doses.” After 4 doses, his legs felt stronger, and after another 4 doses, his palpitations were largely gone. (Yue Mei Chinese Medicine Case Collection)

[Commentary] This formula is used for various types of cardiac arrhythmias seen in heart disease; it can also be used for palpitations and shortness of breath seen in neurasthenia; it can also be appropriately used in cases of anemia and hemorrhagic disorders.

Dang Gui Bu Xue Tang From the Nei Wu Shang Bian Huan Lun

[Composition] Huang Qi, 30 grams; Dang Gui, 6 grams (washed in wine)

[Usage] Brew in water and take.

[Indications] Deficiency of Yin and Blood.

[Indications] Body heat, flushed face, thirst and desire to drink, a pulse that is large and weak.

[Functions] Nourish Qi and generate blood.

[Formula Explanation] When Yin is deficient due to internal injury, fatigue, or postpartum blood loss, resulting in Yin and Blood deficiency, this condition arises. Yin deficiency leads to excess Fire, while Blood deficiency leads to excess Yang; body heat, flushed face, thirst and desire to drink, a large and weak pulse—all these are signs of excess Fire rising and excess Yang escaping outward. The blood, though visible, cannot be generated quickly; the Qi, though invisible, must be firmly secured. As the Cheng Fang Jian Du said, “Visible blood cannot be generated quickly, but invisible Qi must be firmly secured.” Thus, Huang Qi greatly replenishes the original Qi of the Lung and Spleen, enabling Yang to be generated and Yin to grow, while Qi is strengthened and blood is generated—this is the primary treatment of this formula. Gui Zhi warms and opens Heart Yang, allowing Yang to be generated and Yin to grow, and Qi to be strengthened and blood to be generated, serving as the primary treatment. Dang Gui nourishes blood and replenishes Ying as a supplementary treatment. The combination of these two herbs aims to support Yang to preserve Yin, ensuring Yin is stable and Yang is secure, and allowing excess Heat to subside.

[Clinical Additions and Subtractions]

This formula is a foundational formula for Qi and Blood tonification; it is included in commonly used formulas such as Bu Zhong Yi Qi Tang, Gui Pi Tang, Sheng Yu Tang, Dang Gui Liu Huang Tang, and Bu Yang Huan Wu Tang. By mastering the key principle of “nourishing Qi and generating blood,” this formula can be widely used in clinical practice in conjunction with other formulas.

[Reference Materials]

① “In cases of blood deficiency with fever, the pattern is similar to that of White Tiger, but the pulse is not long and firm—misusing White Tiger could lead to death.” (Wei Mi Lun)

② “When blood is abundant, the body feels cool; when blood is deficient, the body feels hot. This is because hunger, fullness, and labor can damage Yin and Blood, causing excess Yang to prevail, leading to body heat and thirst—though the White Tiger pattern is associated with external infections and internal heat, the pulse is large and long, with strong force; this pattern is caused by internal injury, blood deficiency with fever, and a large, weak pulse. As the Inner Classic says, ‘Weak pulse, blood deficiency’—misusing White Tiger soup would surely result in death.” (Cheng Fang Qie Yong)

[Commentary] This formula is used for anemia, allergic purpura, functional uterine bleeding, leukopenia, neurasthenia, and other conditions.

III. Yin Tonification

The Su Wen, in the section on Regulating Menstruation, states: “When Yin is deficient, internal heat arises.” It is evident that the clinical manifestations of Yin deficiency are often characterized by internal heat—such as bone-dryness and hot flashes, and five hearts feeling restless. Additionally, since Yang energy tends to reside internally at night, and the external defensive Qi is not fully established, combined with internal heat driving fluids, Yin deficiency often presents as night sweats. The treatment for this condition is called Yin tonification, also known as Yin-nourishing and Fire-regulating therapy. The Su Wen, in the section on the Great Principles of True Essence, states: “For all cold conditions that cause heat, treat them with Yin.” Wang Bing said: “Strengthen the Water’s Master to control the Sun’s energy.” These statements all refer to Yin-nourishing and Fire-regulating therapies.

Liu Wei Di Huang Wan From the Xiao Er Yao Zheng Zhi Jue

[Composition] Sheng Di, 24 grams; Shan Yu Rou, 12 grams; Shan Yao, 12 grams; Dan Pi, 9 grams; Fu Ling, 9 grams; Ze Xie, 9 grams

[Usage] Grind all ingredients into powder, mix with honey to form pills, sized like walnuts. Take three pills each time, dissolved in warm water. In modern times, the formula is prepared as a decoction.

[Indications] Deficiency of Kidney Yin.

[Indications] Dizziness, blurred vision, tinnitus, lower back pain, leg discomfort, bone-dryness and hot flashes, five hearts feeling restless, night sweats.

[Functions] Nourish Yin and nourish the Kidney.

[Formula Explanation] When the Kidney is deficient, symptoms include dizziness, blurred vision, tinnitus, lower back pain, and leg discomfort; when Yin is deficient, symptoms include bone-dryness and hot flashes, five hearts feeling restless, and night sweats—when these two conditions combine, they indicate Kidney Yin deficiency. The primary treatment for this condition is to “strengthen the Water’s Master,” and this formula comprehensively nourishes the Three Yins, focusing on the Kidney as the primary site of action. Sheng Di, sweet and cold, enters the Kidney to nourish the Kidney and strengthen the Water’s Master, thus serving as the primary treatment. Shan Yu, with its pungent and sweet properties, enters the Liver to tighten Liver Yin; Shan Yao, with its sweet and neutral nature, moves through the Spleen to nourish Spleen Yin. Since the Liver and Kidney share a common origin, nourishing the Liver also means nourishing the Kidney; earth gives rise to all things, and nourishing the Spleen can also benefit the Kidney—these two herbs work together to help Sheng Di nourish Kidney Yin, serving as complementary treatments. All three herbs are rich in fat and viscous substances; Ze Xie, with its ability to drain renal turbidity, prevents Sheng Di’s stagnation; Dan Pi clears Liver Fire, removing Shan Yu’s stagnation; Fu Ling, with its mild diuretic effect, drains spleen dampness, avoiding Sheng Di’s stagnation. Together, these three herbs distribute the Three Yins, allowing this formula to have both dispersing and nourishing properties, becoming a great formula for nourishing Original Yin. Since Original Yin originates in the Kidney, this formula focuses specifically on the Kidney, making it the leading formula for Yin-nourishing and Kidney-tonifying.

[Clinical Additions and Subtractions]

① Adding Zhimu and Huang Bo creates Zhimu Bai Di Huang Wan (from the Yi Zong Jin Jian), which treats Yin deficiency with excess Fire, with intense internal heat.

② Adding Gou Qi and Chrysanthemum creates Gou Qi Bai Di Huang Wan (from the Yi Ji), which treats Liver and Kidney Yin deficiency, with blurred vision and eye discomfort.

③ Adding Wu Wei Zi creates Du Qi Wan (from the Yi Zong Yi Ren Bian), which treats Kidney’s inability to retain Qi, leading to difficulty breathing.

④ Adding Mai Dong and Wu Wei Zi creates Ba Xian Chang Shou Wan (from the Yi Ji), which treats lung and kidney Yin deficiency, with frequent wheezing and coughing.

⑤ Removing Dan Pi, adding Gou Qi and roasted Gan Cao creates Zuo Gui Yin (from the Jing Yue Quan Shu), which treats Kidney Water deficiency, Yin fluid loss, lower back pain, nocturnal emission, dry mouth and thirst, or blackened lips and tongue, with excessive thirst and frequent drinking.

[Reference Materials]

① “This formula nourishes the Liver, Spleen, and Kidney, addressing deficiencies in true Yin and blood loss in the body. Ancient practitioners believed that when nourishing, one must also eliminate pathogenic factors—once the pathogenic factors are removed, nourishing becomes effective. Thus, Sheng Di is used to nourish the kidneys’ essence and blood as the primary treatment; Zhe Xie is used to drain pathogenic toxins from the kidneys and bladder as a secondary treatment. Shan Yu nourishes the Liver and strengthens the essence; Dan Pi clears the Jue Yin and Shao Yang fire. Next, Shan Yao nourishes Spleen Yin; Fu Ling drains spleen dampness, working in harmony and complementarity, neither drying nor cooling—this is a wise formula.” (Cheng Fang Jian Du)

② This formula treats the following seven conditions through differentiated diagnosis and treatment:

1. Hemorrhagic Disorders: Liver and Kidney Yin deficiency, with blood heat running rampant, presenting as bright red blood; this formula removes Zhe Xie and adds Dry Lotus Leaf, Side-Tree Leaves, Motherwort, and Lotus Seed Charcoal to cool blood and stop bleeding; Cistanche, Dragon Bone, and Oyster Shell nourish the Liver and Kidney, benefiting Yin and stopping bleeding.
2. Hypertension with Dizziness: Headaches, dizziness, blurred vision, a pulse that is tense and strong; this formula adds Stone Deciduous, Turtle Shell, Zhimu, Huang Bo, Earth Worm, and Hook Vine.
3. Stone Urinary Tract: Wet heat accumulates in the lower burner, causing impurities in urine to clump together into stones, making urination difficult and painful, with blood in the urine; this formula adds Blood Pearl, Golden Needle Grass, Codonopsis, and Sandalwood (to be taken as a decoction).
4. Chronic Otitis Media in Children: Long-term heat from Kidney, with pus draining from both ears; this formula adds Peppermint, Dandelion, Huang Bo, and Zhimu.
5. Throat Pain: Yin deficiency with excess Fire, with throat pain that persists for a long time; this formula adds Yuan Shen, Mai Dong, Gan Cao, Kui Jing, and Tu Niu Xi.
6. Diabetes and Diabetes Insipidus: Yin deficiency with excess Fire, with damaged Yin fluids, excessive drinking, excessive eating, and frequent urination; this formula adds Yuan Shen, Zhimu, Huang Bo.
7. Hair Loss: Kidney Yin deficiency, with blood having accumulated heat; this formula removes Fu Ling and adds Dry Lotus Leaf, Dan Shen, and Shou Wu. (Guangzhou College of Traditional Chinese Medicine: “Selected Cases and Medical Talks from Veteran Chinese Medicine Practitioners”)

③ Clinical Additions and Subtractions for Liu Wei Di Huang Wan: Case 1: Chronic Pyelonephritis: Dizziness, tinnitus, lower back pain, frequent dreams, and swelling. Urinalysis: Protein (+), pus cells (++), red blood cells (+). This formula added Gou Qi and Tussilago, and after 14 doses, all symptoms were alleviated. Later, this formula was alternated with Jin Gui Shen Qi Wan, along with Fu Ling, Lotus Seeds, Euryale, Shan Yao, and Coix Seed, stewed with pig stomach, for two months—after which all symptoms subsided, and urinalysis returned to normal. Case 2: Chronic Hepatitis: Pale complexion, bitter taste in the mouth, right flank discomfort, with liver palpation 2.5 centimeters below the ribs, and tenderness upon pressure; the liver function test showed “brain絮” (++), “shock絮” (+). This formula added Dan Shen, Bai Shao, and Sanqi, and after one week, liver pain lessened, appetite improved; later, the formula was taken as pills, three qian per dose, three times a day; combined with Ren Shen Yang Rong Wan, two qian per dose, three times a day—after three months of medication, symptoms were basically gone, liver function returned to normal. Case 3: Hypertension: Dizziness, blurred vision, tinnitus, palpitations, insomnia, lower back pain, numbness in the limbs, blood pressure between 150–160/96–110 mmHg. This formula added Zao Ren, Stone Deciduous, Earth Worm, and Double Hook, and after two weeks, blood pressure dropped to normal. Afterwards, continued taking Gou Qi Bai Di Huang Wan for two months to maintain the benefits. (Fujian Chinese Medicine) ④Six-Flavor Rehmannia Decoction has a significant antihypertensive effect on experimental renal hypertension and can improve renal function while reducing mortality. Therefore, it is believed that Liu Wei Di Huang Wan may directly or indirectly improve renal blood flow and possibly promote tubular secretion through metabolism. (Zhonghua Nei Ke Zazhi, 1964.1)

⑤In a study treating 46 patients with severe epithelial hyperplasia of the esophagus using Liu Wei Di Huang Wan (including 7 cases suspected of cancer), follow-up assessments after one and a half years showed improvement in 41 cases. (Chinese Academy of Traditional Chinese Medicine: Selected Research on Tumor Prevention and Treatment, 1977.1)

[Commentary] This formula, when modified and adjusted, can be used for congenital developmental delays in children, glaucoma, diabetes, hypertension, chronic nephritis, chronic hepatitis, lupus erythematosus, emphysema, pulmonary heart disease, and menstrual irregularities in women.

Da Bu Yin Wan From “Dan Xi Xin Fa”

[Composition] Zhimu (stir-fried in wine) 120g, Huangbo (stir-fried) 120g, Shu Di (steamed in wine) 180g, Guibian (roasted until crispy) 180g

[Usage] Grind the ingredients into powder. Steam pig spinal cord until cooked, then mix with honey to form pills, sized like walnuts. Take 70 pills each time, taken on an empty stomach with saltwater. In modern times, the formula is prepared as a decoction and taken by boiling in water.

[Indications] Yin deficiency with excessive fire.

[Indications] Bone heat and hot flashes, night sweats, restlessness in the five centers, red tongue with little coating, dry throat and dry mouth, lung heat causing cough, hemoptysis, vomiting blood, burning pain in the feet and knees, and a pulse that is rapid and forceful.

[Functions] Nourish Yin and descend Fire.

[Formula Explanation] When Yin is deficient, bone heat and hot flashes, night sweats, and restlessness in the five centers occur; when fire is excessive, the throat becomes dry and the tongue is dry, lung heat causes cough, hemoptysis, and burning pain in the feet and knees, while the pulse is rapid and forceful. This condition arises from Yin deficiency leading to excess fire. Zhu Danxi said, “Yin is often insufficient, but Yang is often abundant; we should nourish Yin regularly. When Yin and Yang are balanced, water can control fire, and thus no illness will arise.” It is evident that the key to this formula lies in nourishing Yin. Shu Di enters the kidneys to replenish water, serving as the primary ingredient in nourishing Yin. When Yin is deficient, fire lacks control; Zhimu and Huangbo, with their bitter and cooling properties, enter the kidneys to directly clear the excess fire in the lower burner, acting as auxiliary agents. Turtle shell is known for its ability to store essence, and turtle plate belongs to the category of intermediates—its use in nurturing Yang also carries the meaning of controlling fire, making it a complementary treatment. Pig spinal cord is used to open the kidneys and enhance essence, serving as a vehicle to guide the formula’s effects.

[Clinical Adjustments]

① Remove Guibian and Shu Di, and add Cinnamon to create Gongtong Wan (from “Lan Shi Mi Cang”), which treats heat in the lower burner affecting blood vessels, where the patient does not feel thirsty but experiences urinary retention.

② Remove Shu Di and Guibian, and add Slaked Lime and Han Shao to create Han Tong Tang, which treats bladder stones and prostate enlargement in elderly patients accompanied by painful urination and difficulty in urination.

③ Add Chen Pi, Bai Shao, Su Yang, Tiger Bone, and Dang Gui, then form pills with honey, naming them Hu Qian Wan. This formula is used for liver and kidney deficiency, leading to weak tendons and bones, thin legs and feet, fatigue during walking, and lower back pain due to essence depletion.

④ For obvious night sweats, add Glutinous Rice Root, Oyster, and Floating Wheat; for coughing up blood due to deficiency, add Xian He Cao, Ce Bai Ye, and A Jiao; for restlessness and insomnia, add Chuan Xiong, Fu Ling, and Sour Jujube Seed.

[References] “The excess of ‘Xiang Huo’ is often due to insufficient kidney water; therefore, Shu Di is used to greatly nourish kidney water as the principal herb. However, when fire is excessive, the lesser fire transforms into the greater fire, which consumes qi. If we merely nourish Yin with Water and Yang together, how can we truly suppress the rampant fire? Thus, it is essential to use Huangbo and Zhimu, with their bitter and cooling properties that enter the kidneys and directly clear the fire in the lower burner to bring it under control. Turtle is a divine aquatic creature of the north; using its bone marrow aims to open the kidneys and nourish essence, using tangible essence to replenish the body—making the pill with honey a means to deliver the medicine to the lower burner and allow it to work gradually.” (Cheng Fang Bian Du)

[Commentary] This formula, when modified and adjusted, can be applied to conditions such as pulmonary tuberculosis, blood disorders, diabetes, and neurasthenia.

Tian Wang Bu Xin Dan From “Cui Sheng Mi Pao”

[Composition] Ren Shen (removed from its roots), Xuan Shen (stir-fried), Dan Shen (lightly stir-fried), Yuan Zhi (removed from its core and stir-fried), Gou Jing (each 15g), Wu Wei Zi (stir-fried), Dang Gui Shen (washed in wine), Fu Ling (peeled), Tian Dong (removed from its core), Mai Dong (removed from its core), Bai Zi Ren (stir-fried), Suo Ya Ren (stir-fried) each 30g, Shu Di 120g

[Usage] Combine all ingredients into a powder, form into pills the size of walnuts, coated with Cinnabar, and take 9g per dose on an empty stomach.

[Indications] Yin deficiency with excessive fire, leading to loss of mental focus.

[Indications] Sores on the lips and tongue, constipation, bone heat and hot flashes, restlessness in the five centers, red tongue with little coating, a pulse that is fine and rapid; restlessness and insomnia, frequent nightmares and palpitations.

[Functions] Nourish Yin and clear heat, nourish the heart and calm the mind.

[Formula Explanation] When Yin is deficient and fire is excessive, sores appear on the lips and tongue, constipation occurs, bone heat and hot flashes are present, restlessness in the five centers is observed, the tongue is red with little coating, and the pulse is fine and rapid; when the mind is restless, there is restlessness and insomnia, frequent nightmares and palpitations. When Yin is deficient, fire is excessive; when fire is excessive, it disturbs the mind. As stated in “Su Wen – Bi Lun,” “When Yin qi is still, the spirit resides in the body; when it is agitated, it is lost.” This indicates that the root cause of this condition lies in Yin deficiency and excessive fire. The formula uses Shu Di, Xuan Shen, and Mai Dong as the main ingredients of the “Zeng Ye Tang,” whose purpose is to nourish Yin and clear fire to treat the root cause; Fu Ling, Yuan Zhi, Bai Zi Ren, Suo Ya Ren, and Wu Wei Zi nourish the heart and calm the mind to treat the symptoms as auxiliary agents. When fire is excessive, it consumes Qi; therefore, Dang Gui and Dan Shen are used to strengthen the spleen and benefit Qi; when fire is excessive, it depletes blood; therefore, Dang Gui and Dan Shen nourish blood and promote circulation, working together as complementary treatments. Gou Jing serves as a vessel within the formula, carrying the medicine upward—this can be seen as a vehicle to guide the formula’s effects; Cinnabar is used as a coating, entering the heart to calm the mind and also serving as a vehicle to guide the formula’s effects.

[Clinical Adjustments]

For those with severe palpitations, add Sheng Long Mu; for those who dream frequently at night, add Ye Jiao Teng and He Huan Pi; for those who sweat excessively, add Floating Wheat and Ma Huang Gen; for those with a fine pulse, add Huang Qi.

[References]

① “The heart is the fire of Li, containing true water within. When we read, chant, or overthink, we damage the Yin within the Li, and we must replenish it with true water. Therefore, Shu Di and Xuan Shen nourish kidney water; the two winters nourish the source of water. Although Dang Gui and Dan Shen enter the heart to nourish blood, they are ultimately tools for movement; only with the powerful influence of Ren Shen can we achieve the harmony of yin and yang. Fu Ling and Yuan Zhi drain heart heat and calm the heart and mind, clearing phlegm and eliminating dampness, opening the channels to allow the medicine to work effectively—but if we overthink, our heart qi becomes stagnant. Therefore, the aromatic and moistening properties of Bai Zi Ren enter the heart to soothe the spirit and clear the diaphragm. Suo Ya Ren and Wu Wei Zi absorb the dissipating energy, while Gou Jing guides the other herbs upward to reach the heart; the coating with Cinnabar takes on the weight to calm fear, the cold to subdue floating yang, and because they share similar qualities, they are naturally drawn to each other.” (Cheng Fang Bian Du)

② “Guibi Tang and this formula both belong to the category of medicines that nourish the heart and calm the mind; both treat forgetfulness, palpitations, and insomnia. However, the former focuses on strengthening the spleen and benefiting Qi, making it suitable for qi-deficiency conditions; the latter focuses on nourishing Yin and clearing heat, making it more appropriate for those with Yin deficiency and blood heat.” (Jiangsu New Medical College: Chinese Medicine Formulaology)

③ The Tian Wang Bu Xin Dan, when modified and adjusted, cured 4 cases of chronic urticaria (rash-like lesions), with widespread rashes covering the entire body, severe itching, recurrent attacks that persisted for years, accompanied by palpitations and easy fright, inability to sleep at night, red tip of the tongue, thin white coating, and a fine, rapid pulse. Based on the principle that “all pain and itching are related to the heart,” this formula proved effective in treating these conditions. (Shanghai Journal of Traditional Chinese Medicine, 65.8)

[Commentary] This formula is effective for early-stage heart disease characterized by palpitations and shortness of breath; it is also effective for various types of anemia, including pallor and palpitations; it can also be used for neurasthenia, menopausal syndrome in women, and chronic urticaria.

Gan Mai Da Zao Tang From “Jin Kui Yao Lü”

[Composition] 4.5g of Licorice (three liang), 15g of Wheat (one sheng), 4 dates (ten pieces)

[Usage] Brew with water and drink warm.

[Indications] Deficiency of Yin in the body, restlessness of the mind.

[Indications] Joyful sadness, longing to cry, as if possessed by spirits, and frequent sighs.

[Functions] Nourish Yin and replenish Yin, calm the mind and soothe the heart.

[Formula Explanation] This formula is a specialized remedy from “Jin Kui Yao Lü” for treating visceral agitation. The underlying mechanism of visceral agitation is Yin deficiency in the body and restlessness of the mind, manifested as joyful sadness, longing to cry, and frequent sighs. When Yin is deficient, Yin does not support Yang, and when floating Yang overcomes the body, the mind becomes restless. The wheat in this formula has a sweet taste and slightly cool properties, nourishing Yin and replenishing Yin while calming the mind and soothing the heart as the primary ingredients. Yin and Yang originate from food and water, and are born in the spleen and stomach; the dates and licorice nourish the middle burner and benefit Qi, helping to replenish the original source of Yin and serving as auxiliary agents.

[Clinical Adjustments]

① Add Peony and Purple Stone, creating Gan Mai Da Zao Tang (from “Shen’s Women’s Medical Collection”), which treats visceral agitation characterized by muscle tension.

② When abdominal examination reveals tightness in the right rectus abdominis muscle, or stiffness in the right flank near the navel with a palpable mass, adding Dang Gui, Bai Shao, Fu Ling, Suo Ya Ren, Long Chi, Oyster, and Bai Zi Ren to this formula enhances therapeutic efficacy. (Jiangsu Traditional Chinese Medicine, 1958.8)

[References]

① “Wheat can harmonize the heat of Liver Yin and nourish the heart’s fluid, while also relieving irritability, promoting urination, and stopping sweating—thus serving as the principal herb. Licorice clears heart fire and harmonizes the stomach to generate fluids, making it the secondary herb. Dates regulate the stomach and help transport fluids, alleviating dryness in the upper part of the body—thus serving as the auxiliary herb. Since the root of the disease lies in blood, and the heart is the master of blood, being the son of the liver, when heart fire is cleared and earth qi is harmonized, stomach qi descends, liver qi is moistened, and lung qi is regulated, dryness is relieved and the disease is naturally cured.” (Cheng Fang Qie Yong)

② The Compound Gan Mai Da Zao Tang was used to treat 34 cases of neurasthenia. All patients presented with insomnia and frequent dreams, palpitations and easy fright, memory impairment, and some even experienced headaches, nocturnal emission, excessive sweating, low-grade fever, and tremors. The prescription included 50g–100g of roasted licorice, 200g of wheat, 8 dates, 100g of medicinal leaves, 10g–15g of Suan Ye, 30g of ginger, 40g of Phellodendron, 40g of Magnetite (first boiled in water), and 100g of Phellodendron. One dose per day, brewed with water and served warm. Treatment results were effective in 30 cases, accounting for 88.2%; ineffective in 4 cases, accounting for 11.8%. (New Pharmaceutical Journal, 1974.7)

③ Liu, a 38-year-old woman, was quick-tempered and prone to anger and restlessness. Over the past six months, she had experienced depression, hypersensitivity, occasional worry and anger, and moments of silence. After arguing with someone a month ago, she initially remained silent, then began to feel unusually sad. Recently, she developed feelings of fear, withdrawing into herself, avoiding others, and becoming startled and fleeing upon encountering strangers. She was treated with 30g of powdered licorice, 15g of fried Citrus Aurantium, 20g of Zhu Fu Ling, 50g of roasted wheat, 30g of roasted Gardenia, 8 dates, 20g of fresh Bamboo Shoot, and 30g of Shu Di. Additionally, she took 15g of Magnetic Red Pill morning and evening, dissolved in hot water. After more than ten doses, her symptoms completely disappeared, and she was able to return to work and production. (Shanghai Journal of Traditional Chinese Medicine, 1962.9)

[Commentary] This formula, when modified and adjusted, is used for neurasthenia, hysteria, and mild cases of schizophrenia.

Suan Zao Ren Tang From “Jin Kui Yao Lü”

[Composition] 15g of Suan Zao Ren (two sheng), 3g of Licorice (one liang), 4g of Zhimu (two liang), 6g of Fu Ling (two liang), 3g of Chuan Xiong (two liang)

[Usage] First brew the Suan Zao Ren, then add the other herbs, remove the residue, and serve warm.

[Indications] Liver Yin deficiency, rising of Heart Qi.

[Indications] Dizziness, blurred vision, bone heat and night sweats, dry throat and dry mouth, restlessness and insomnia.

[Functions] Nourish Yin and calm the mind.

[Formula Explanation] When Liver Yin is deficient, dizziness and blurred vision occur; bone heat and night sweats are common symptoms. When Heart Qi rises, dry throat and dry mouth, restlessness and insomnia are also present. This condition arises from deficiency; prolonged deficiency leads to Yin depletion, and when Liver Yin is insufficient, Yin does not support Yang, causing Heart Qi to rise. In this formula, Suan Zao Ren enters both the Liver and Heart meridians; entering the Liver nourishes Yin, entering the Heart calms Qi—and thus the primary function of nourishing the heart and calming the mind is emphasized. When Yin is deficient, fire is excessive; Zhimu, with its bitter and cooling properties, enters the kidneys to specifically nourish Yin and clear fire, serving as an auxiliary agent. The stomach is the sea of food and water, the spleen is the origin of Ying and Xue; Fu Ling strengthens the spleen and benefits the stomach, serving as a beautiful auxiliary. Chuan Xiong enters the Liver to move blood, allowing Suan Zao Ren to nourish the Liver without stagnation—and also serves as a complementary treatment. Licorice harmonizes all the herbs, acting as a vehicle to guide the formula’s effects.

[Clinical Adjustments]

For those with prominent Yin deficiency, add Dry Lotus Leaf, Ligustrum Lucidum, Bai Shao, and Shu Di; for those with severe night sweats, add Wu Wei Zi and Floating Wheat; for those with frequent palpitations, add Sheng Long Mu; for those with poor sleep at night, add Long Chi and Ye Jiao Teng.

[References] ① “Restlessness in the heart arises from turmoil and frustration, caused by excessive fluid loss, dryness in the five internal organs, or insufficient Ying and Xue, with Yang prevailing over Yin.” (Ye’s Tong Zhi) ② “Restlessness in the heart often stems from Liver deficiency and the resulting excess of Fire; therefore, Suan Zao Ren primarily calms the Liver and Gallbladder, with a slight addition of Chuan Xiong to regulate blood flow and nourish the Liver, Fu Ling and Licorice to nurture the Earth and nourish Wood, and Zhimu to clear fire and relieve restlessness—this formula balances the Liver and Spleen.” (Zhang’s Medical Guide)

[Commentary] This formula, when modified and adjusted, is used for various heart diseases and blood disorders, particularly for palpitations and insomnia; it can also be used for neurasthenia and autonomic nervous system dysfunction, primarily characterized by Yin deficiency and insomnia.

Da Zao Wan From “Fu Shou Jing Fang”

[Composition] One piece of Purple River Carcass (washed, dried), 60g of Turtle Shell, 45g of Huang Bo (salt-soaked and stir-fried), 45g of Du Zhong (roasted until crispy), 36g of Niuxi (soaked in wine and dried), 36g of Mai Dong (removed from its core), 36g of Tian Dong (removed from its core), Shu Di (mixed with 18g of Sandren Powder and 60g of Fu Ling, boiled seven times with wine, discarding the Fu Ling and keeping only the Shu Di), 30g of Ren Shen.

[Usage] Brew Shu Di juice into a paste, combine the remaining herbs into a powder, mix with wine to form pills, shaped like small beans, and take 9–12g per dose, taken with hot water in the morning.

[Indications] Lung and Kidney Yin deficiency.

[Indications] Bone heat and hot flashes, restlessness in the five centers, night sweats; cough with phlegm and wheezing, sticky phlegm that is difficult to expel, blood in the phlegm; dizziness and tinnitus, lower back pain and leg discomfort.

[Functions] Nourish the Kidneys and Tonify the Lungs.

[Formula Explanation] The Lung belongs to Metal, the Kidney to Water; when Metal and Water are in harmony, Kidney Yin deficiency leads to Lung Yin deficiency. Bone heat and hot flashes, restlessness in the five centers, and night sweats are common symptoms of Yin deficiency; cough with phlegm and wheezing, sticky phlegm, and blood in the phlegm indicate problems in the Lung; dizziness and tinnitus, lower back pain and leg discomfort indicate problems in the Kidney. These symptoms can be summarized as Kidney and Lung Yin deficiency. In this formula, Purple River Carcass nourishes the Lung and Kidney, nourishes Yin and generates essence—this is the primary herb. This herb is rich in essence and flavor, embodying the principle of “when essence is lacking, nourish it with flavor,” as described in “Su Wen.” Tian Dong and Mai Dong nourish Yin and tonify the Lung; Shu Di and Turtle Shell nourish Yin and tonify the Kidney; the four herbs, combined with Purple River Carcass, enhance the functions of nourishing Yin, tonifying the Lung, and nourishing the Kidney. “Solitary Yin cannot be born, solitary Yang cannot last”—Yin deficiency inevitably leads to Yang deficiency; therefore, Ren Shen is used to boost Qi; when Yin is deficient, the excess Fire becomes dominant; Huang Bo is used to clear the excess Fire. The Liver and Kidney share a common origin; when Kidney Yin is deficient, Liver Yin is also likely to be damaged; therefore, Du Zhong and Niuxi are used to nourish the Liver and Kidney. All these herbs serve as complementary treatments. Sandren and Fu Ling, paired with the aforementioned tonics, nourish without being heavy or greasy, without harming the stomach’s Qi—these are considered vehicles to guide the formula’s effects.

[Clinical Adjustments] ① Remove Ren Shen, Sandren, and Fu Ling, then refine the mixture into pills, also known as He Che Da Zao Wan (from “Jing Yue Quan Shu”), treating Liver and Kidney deficiency, nocturnal emission, bone heat and hot flashes, and sore and weak lower back. ② Remove Ren Shen, Sandren, Fu Ling, and Turtle Shell, and add Whole Dang Gui, Su Yang, Wu Wei Zi, Dang Rong, Shu Di, and Goji Berries, also known as He Che Da Zao Wan (Wu Qiu), used to treat cough with lingering phlegm and wheezing.

[References] ① “In terms of the overall function of this formula, it uses rich, vital ingredients to restore damaged tissues, invigorate life, and treat the root cause; it also clears excess Fire, eliminates bone heat, moistens dryness, and calms the lungs—treating the symptoms as well. The combination is highly effective, suitable for conditions involving deficiency, injury, great loss of essence and blood, excessive Fire, cough with hot flashes, and emaciation.” (Jiangsu New Medical College: Chinese Medicine Formulaology) ② Peng ××, a 15-year-old female, was born seven months after birth. Due to a cold, she developed lingering phlegm, which would trigger cough and wheezing whenever the weather changed, persisting for years. Her development was delayed, and after school, she would often become ill when she exerted herself. Her father knew doctors and often treated her with Xiao Qinglong Tang, Er Chen Tang, and other formulas. For more than 10 years, she repeatedly fell ill and recovered, yet the condition kept recurring. In the summer of 1970, her father went out and instructed me to care for her whenever she caught a cold or experienced coughing and wheezing. I would temporarily give her formulas to resolve qi and clear the lungs, and after recovery, I would advise her to continue taking He Che Da Zao Wan without interruption. Six months later, her physical condition improved significantly; by the summer of 1971, her development was rapid, and the lingering phlegm had been cleared. After another year of observation, she only occasionally experienced coughing during a flu season, without developing wheezing. (Chinese Academy of Traditional Chinese Medicine: Yue Mei’s Chinese Medicine Case Collection)

[Commentary] This formula can be used during the recovery phase of various chronic illnesses, such as pulmonary tuberculosis, chronic bronchitis, emphysema, neurasthenia, and endocrine disorders in women.

Bu Fei A Jiao Tang From “Xiao Er Yao Zheng Zhi”

[Composition] A Jiao (fried in bran) 45g, Mado Ling (roasted) 15g, Niu Bang Zi (stir-fried), Roasted Licorice 7.5g each, Apricot Kernel (peeled and roasted) 7 kernels, Sticky Rice (stir-fried) 30g

[Usage] Grind the ingredients into powder, take 6g per dose, brew with water and drink; nowadays, it is often prepared as a decoction.

[Indications] Lung Yin deficiency, excessive Fire, and blood overflow.

[Indications] Dry throat, cough with a feeling of something stuck in the throat, sticky phlegm that is difficult to expel, blood in the phlegm, bone heat and hot flashes, restlessness in the five centers, red tongue with little coating, a pulse that is fine and rapid.

[Functions] Nourish Yin and Tonify the Lung, clear Fire and stop bleeding.

[Formula Explanation] When Lung Yin is deficient, the throat becomes dry, the cough feels stuck in the throat, bone heat and hot flashes occur, restlessness in the five centers is present, the tongue is red with little coating, and the pulse is fine and rapid; when Fire is excessive and blood flows, the phlegm becomes sticky and difficult to expel. When Yin is deficient, Fire becomes excessive; when Fire is excessive, blood flows. In this formula, A Jiao nourishes Yin and Tonifies the Lung to treat the root cause, while also having the effect of stopping bleeding—thus serving as the primary herb. Niu Bang Zi and Mado Ling clear Heat and reduce Fire to treat the symptoms as auxiliary agents. “The Lung is the source of cough”; when the Lung is deficient or overheated, it leads to wheezing and coughing. Apricot Kernel can help relieve cough and ease breathing—this is a complementary treatment; Earth can generate Metal, and strengthening the spleen can also treat the Lung; Sticky Rice strengthens the spleen and nourishes the Lung—also a complementary treatment. Licorice harmonizes all the herbs, acting as a vehicle to guide the formula’s effects.

[Clinical Adjustments] For those with severe hemoptysis, add Bai Ji; for those with constipation, add Rhubarb; for those with severe lung heat and thick, greasy tongue coating, add Scutellaria Baicalensis; for those who sweat excessively, add Floating Wheat and Ma Huang Gen; for those with palpitations and shortness of breath, add Sheng Long Mu; for those with poor sleep and frequent dreams, add Ye Jiao Teng, He Huan Pi, and Sour Jujube Seed.

[References] “Mado Ling clears Heat and reduces Fire, Niu Bang Zi helps to clear the diaphragm and loosen phlegm, Apricot Kernel moistens dryness and dispels wind, A Jiao clears the Lung and nourishes the Kidney, and the Qi is smooth, so there is no obstruction; the Fluid is replenished, so the Essence is generated, and the Fire subsides, the cough becomes calm. Earth is the mother of Metal, so adding Licorice and Sticky Rice to nourish the Spleen and Stomach is beneficial.” (Cheng Fang Qie Yong)

[Commentary] This formula is used for pulmonary tuberculosis and bronchiectasis with hemoptysis.

Yue Hua Wan From “Yi Xue Xin Wu”

[Composition] Baibu 30g, Sha Shen 60g, Chuan Bei 40g, Lao Gan 65g, Tian Dong 50g, Mai Dong 50g, Sang Ye 30g, Ju Hua 60g, Shu Di 60g, Shu Di 60g, Guang San Qi 15g, A Jiao 40g, Fu Ling 50g

[Usage] Refine the ingredients into pills, weighing 6g each, take two pills daily, once in the morning and once in the evening.

[Indications] Lung damage due to exhaustion, Yin deficiency with excessive Fire.

[Indications] Cough with phlegm, sticky phlegm that is difficult to expel, blood in the phlegm; dry throat and dry mouth, bone heat and hot flashes, restlessness in the five centers, night sweats.

[Functions] Kill parasites, replenish deficiency, nourish Yin and clear Fire.

[Formula Explanation] This condition arises from exhaustion; exhaustion leads to deficiency in the Five Laborers, and parasitic infections lead to illness. Lung damage due to exhaustion results in Yin deficiency and excessive Fire. In cases of lung damage due to exhaustion, there is cough with phlegm, sticky phlegm that is difficult to expel, and blood in the phlegm; in cases of Yin deficiency and excessive Fire, there is bone heat and hot flashes, restlessness in the five centers, and night sweats. In this formula, Lao Gan and Baibu kill parasites and replenish deficiency—these are the primary herbs. Sha Shen, Er Dong, and Er Di nourish Yin and clear Fire as auxiliary herbs. Beimu clears Heat, relieves cough, and dissolves phlegm—this is a complementary treatment; Fu Ling and Yam cultivate the Earth and generate Metal—also as complementary treatments; Sang Ye and Ju Hua calm the Liver and reduce Fire—also as complementary treatments; A Jiao nourishes the Lung and stops bleeding, while San Qi dissolves blood and stops bleeding—all as complementary treatments.

[Clinical Adjustments] If Lao Gan is lacking, duck liver can be used as a substitute; if there is no hemoptysis, remove San Qi; for chest tightness and pain, add Gua Lou; for poor appetite and digestion, remove Er Di, and add Sandren, Neijin, and Roasted Hawthorn; if the tongue is yellow and the phlegm is thick, add Scutellaria Baicalensis; for afternoon fever, add Artemisia and Ground Bone Peel; for severe night sweats, add Floating Wheat.

[References] “Lao Gan changes shape every month, growing one leaf each month; in full moon months, it forms a single leaf, and because its transformation is unpredictable, it also has the property of killing parasites. Even those who harbor hidden parasites can be treated with this mysterious substance—a traditional medicine passed down through generations, named Yue Hua. The origin of the parasite lies in blood stasis, so using San Qi to dissolve blood stasis is a natural way to treat parasites; and because phlegm and heat are transformed, the remaining herbs are used to moisten and clear phlegm and heat. However, to kill parasites, just Lao Gan alone is sufficient; to eliminate blood stasis, just San Qi alone is enough—but if you want to use multiple herbs, combining both nourishment and treatment, addressing both the root cause and the symptoms, you’re truly a master of complete healing.” (Blood Syndrome Theory, Volume 7)

[Commentary] This formula is an effective treatment for pulmonary tuberculosis, and it can alleviate symptoms in cases with obvious toxic symptoms and accompanying hemoptysis.

Yi Guan Jian From “Liu Zhou Yi Hua” [Composition] 9 grams each of North Sand Ginseng, Mai Dong, and Dang Gui; 30 grams of Sheng Di; 15 grams of Gan Qi Zi; and 4 grams of Chuan Lian Zi.

[Usage] Brew with water, remove the residue, and take warm.

[Indications] Yin Deficiency with Liver Stagnation.

[Suitable Symptoms] Dry throat and bitter mouth, irritability and quick temper, chest and flank discomfort, fullness in the five centers, hot and dry palms and soles, red tongue with little coating, and a rapid, tense pulse.

[Functions] Nourish Yin and soothe the Liver.

[Formula Explanation] When Kidney Yin is deficient, there is heat in the five centers, a red tongue with little coating, and a tense, rapid pulse; when Liver Qi is stagnant, there is bitter mouth and dry throat, irritability and quick temper, and chest and flank discomfort. The Liver and Kidneys share a common origin—Liver Wood relies on Kidney Water to be nourished. When Kidney Water is insufficient, the Liver loses its nourishment, and Liver Wood loses its smooth flow, leading to stagnation. In this formula, Sheng Di and Gan Qi nourish and replenish Kidney Water to treat the root cause, serving as the primary herbs. Chuan Lian Zi soothes the Liver and regulates Qi to treat the symptoms at the surface, acting as an auxiliary herb. Sha Shen and Mai Dong nourish Lung Yin, supporting the upper source of Kidney Water, embodying the principle of mutual generation between Metal and Water, which can serve as a complementary treatment. Dang Gui nourishes Blood and activates the Liver, preventing Qi from entering the Blood, also serving as a complementary treatment.

[Clinical Additions and Subtractions]

① Add Fu Zi, Bie Jia, Mu Li, and Hong Hua to form the Yi Gui Tong Yuan Drink (Zhou Ruolan), used for patients with non-hemolytic hepatitis (acute, prolonged, or chronic) who experience Yin Deficiency-related liver pain.

② If constipation occurs, add Wei Ren; if excessive heat and sweating are present, add Di Gu Pi; if there is excessive phlegm, add Bei Mu; if the tongue is red and dry with no coating, add Shi Hu; if there is chest and flank distension with hard palpation, add Bie Jia; if there is restlessness and thirst, add Zhi Mu and Shao Gou; if abdominal pain occurs, add Shao Yao and Gan Cao; if leg weakness is present, add Niu Xi and Yi Ren; if insomnia occurs, add Zao Ren. (Liu Zhou Medical Talks)

[Reference Materials]

① “For treating Liver and Kidney Yin Deficiency, Liver Qi Stagnation, with symptoms such as chest and flank discomfort or pain, dry mouth, and a red tongue with little moisture. It is also used for chronic hepatitis with liver area pain due to Liver and Kidney Yin Deficiency.” (Brief Dictionary of Traditional Chinese Medicine)

② “It is often used for chronic hepatitis, yielding good results, but it is most effective when the patient has dryness and a fine, rapid pulse, with internal heat due to Yin Deficiency. Generally, Dang Gui can be omitted, replaced with Dan Shen and Bai Shao to soothe the Liver and regulate Blood, softening the Liver and relieving pain; if stomach distension occurs after meals, add Su Xin Hua and Jin to promote Qi circulation, relieve bloating, and aid digestion; if insomnia is present, add Bai Zi Ren, Suo Zao Ren, and Wu Wei Zi to nourish the Heart and calm the Spirit.” (Guangdong College of Traditional Chinese Medicine: Formula Studies)

[Commentary] This formula can be used to treat chronic gastritis, as well as gastric and duodenal ulcers in cases of Yang Deficiency; it can also be used for prolonged hepatitis, chronic hepatitis, and gastrointestinal neurosis.

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Yu Ye Tang

From "Medical Secrets of the East and West"

[Composition] 9 grams of Wu Wei Zi, 18 grams of Zhi Mu, 6 grams of Sheng Ji Nei Jin, 9 grams of Tian Hua Fen, 15 grams of Sheng Huang Qi, 30 grams of Shan Yao, and 4.5 grams of Ge Gen.

[Usage] Brew with water and take.

[Indications] Diabetes Mellitus (when Original Qi fails to rise, and fluids fail to ascend).

[Suitable Symptoms] Weight loss and fatigue, frequent urination with clear urine, and excessive thirst.

[Functions] Elevate and tonify Original Qi, nourish True Yin.

[Formula Explanation] When Original Qi fails to rise, weight loss and fatigue occur, along with frequent urination with clear urine; when fluids fail to ascend, excessive thirst arises. Original Qi refers to both Yin and Yang, originating in the two kidneys, residing in the Dantian, and being distributed throughout the body via the Three Jiao, serving as the source of life’s energy. When Original Qi fails to rise, fluids cannot be distributed throughout the body, resulting in the condition of fluids failing to ascend. In this formula, Huang Qi greatly tonifies Original Qi, while Ge Gen elevates and distributes Original Qi; these two herbs work together to fulfill the great task of elevating and tonifying Original Qi as the main component. Shan Yao nourishes Spleen Yin, Zhi Mu nourishes Kidney Yin, and Hua Fen nourishes Lung Yin. The lungs, spleen, and kidneys are the pathways through which the body’s Yin and Qi are transmitted; the combination of these three herbs nourishes the True Yin of the three organs, making them auxiliary herbs. Ji Nei Jin strengthens the Spleen, aids digestion, and generates fluids, while Wu Wei Zi’s sour and astringent properties help to retain fluids, serving as complementary treatments.

[Clinical Additions and Subtractions] If fatigue and weakness due to Qi deficiency are severe, add Ye Tai Shen; if dryness and thirst persist despite drinking water, add Shao Gou and Zhi Mu; if kidney fire is weak and the kidney’s gate is not secure, causing frequent cold urination, add Gui Fu Ba Wei; if damp-heat accumulates in the middle burner, the tongue is yellow and greasy, and the abdomen feels full, add Er Miao San.

[Reference Materials]

① “In cases of diabetes mellitus, many patients experience a failure of Original Qi to rise; this formula elevates Original Qi to stop thirst. Huang Qi serves as the main herb, and Ge Gen helps elevate Original Qi. Shan Yao, Zhi Mu, and Hua Fen are added to greatly nourish True Yin, allowing Yang to rise and Yin to respond, achieving the wonderful effect of clouds moving and rain falling.” (Medical Secrets of the East and West)

② “A certain individual, in their twenties, was trading in Tianjin when they developed diabetes mellitus. They sought treatment from doctors in Tianjin, but after three months of treatment and more than ten different physicians, their condition did not improve. They returned home and consulted an old physician. His pulse was very fine and faint. They would drink water and then urinate frequently, only to need to urinate again after a short time. After administering this decoction with four qian of Ye Tai Shen, their thirst subsided after several doses, though they still urinated frequently. Adding five qian of Yu Rou, they continued taking the medicine for ten doses and recovered.” (Medical Secrets of the East and West)

[Commentary] This formula is specifically designed for treating diabetes; however, it can also be used for polyuria, excessive sweating, and thirst associated with autonomic dysfunction.

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IV. Tonifying Yang

The Classic of Internal Medicine states: “When all heat is treated with cold, it is necessary to focus on Yang.” Wang Bing said: “To replenish the source of Fire, thereby dispelling Yin’s obscurations.” This approach aims to tonify Yang. Tonifying Yang is a method for treating Yang Deficiency, which can manifest as Spleen Yang Deficiency, Kidney Yang Deficiency, or Heart Yang Deficiency. The sections on Spleen and Spleen Yang Deficiency have already been discussed; here, we will focus on Kidney Yang Deficiency. The clinical manifestations of this condition include dizziness and tinnitus, lower back soreness and leg fatigue, feeling cold and shivering, spontaneous sweating, a weak pulse at the wrist, or accompanying symptoms such as impotence, nocturnal emission, or premature ejaculation.

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