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Source: Jīn Guì Yào Lüè 金匮要略

Ingredients:

• Shú dì huáng (熟地黄 Rehmanniae Radix Praeparata, cooked rehmannia [root]) 240g
• Shān yào (山药 Dioscoreae Rhizoma, dioscorea [root]) 120g
• Shān zhū yú (山茱萸 Corni Fructus, cornus [fruit]) 120g
• Zé xiè (泽泻 Alismatis Rhizoma, alisma [tuber]) 90g
• Fú líng (茯苓 Poria , poria) 90g
• Mǔ dān pí (牡丹皮 Moutan Cortex, moutan [bark]) 90g
• Guì zhī (桂枝 Cinnamomi Ramulus, cinnamon twig) 30g
• Fù zǐ (附子 Aconiti Radix Lateralis Praeparata, aconite [accessory root]) (blast–fried) 30g

Action: Warms and supplements kidney yáng.

Indication: Insufficiency of kidney yáng with lumbar and knee pain, tension in lesser abdomen, water swelling, inhibited urination, frequent urination or enuresis, phlegm-rheum cough, dispersion-thirst (xiāo kě), and leg qì (jiǎo qì), and a weak cubit (chǐ) pulse. Can also be used water flood resulting from insufficient kidney yáng failing to transform water and manifesting in phlegm-rheum or water swelling patterns, or for dispersion-thirst (xiāo kě) due to insufficient kidney yáng failing to steam the fluids.

Category: Supplementing formulas / Yáng-supplementing formula

Method: Grind to a powder, mix with processed honey, and form unto pills the size of firmiana seeds.

Dosage: Take 15 pills (6g) or up to 25 pills (10g) with wine twice a day. Can also be made as a decoction.

Warnings: Do not use this formula for pure yīn vacuity (red tongue, dry mouth).

Rationale: Although this formula warms and supplements kidney yáng, it is actually Liù wèi dì huáng wán (六味地黄丸 Six-Ingredient Rehmannia Pill)with small amounts of Guì zhī and Fù zǐ. Working on the principle of yīn-yáng interdependence, it aims to give a gentle stoking of the fire, rather than addressing desertion patterns requiring emergency action to return yáng and stem counterflow. Nowadays, Shú dì huáng is often used instead of the raw form, and Ròu guì is used instead of the twig.

Variations:

• To shift the emphasis to warming and supplementing kidney yáng, replace Guì zhī (桂枝 Cinnamomi Ramulus, cinnamon twig) with Ròu guì (肉桂 Cinnamomi Cortex, cinnamon bark).
• Kidney vacuity enuresis: Add Fù pén zǐ (覆盆子 Rubi Fructus, rubus [berry]) and Sāng piāo xiāo (桑螵蛸 Mantidis Oötheca, mantis egg case).
• Kidney vacuity impotence: Add Yín yáng huò (淫羊藿 Epimedii Herba, epimedium) and Gǒu qǐ zǐ (枸杞子 Lycii Fructus, lycium [berry]).
• Kidney vacuity wheezing and panting: Add Wǔ wèi zǐ (五味子 Schisandrae Fructus, schisandra [berry]) and Gé jiè (蛤蚧 Gecko , gecko).
• Rootless fire straying outward: Add Rén shēn (人参 Ginseng Radix, ginseng).
• Rising of vacuous yáng with bleeding from the nose and mouth, cold limbs, and hasty rapid breathing: Add Tóng biàn (童便 Infantis Urina, child's urine).
• Diabetes mellitus: Add Niú xī (牛膝 Achyranthis Bidentatae Radix, achyranthes [root]): Add Niú xī (牛膝 Achyranthis Bidentatae Radix, achyranthes [root]), Chē qián zǐ (车前子 Plantaginis Semen, plantago seed), Tài zǐ shēn (太子参 Pseudostellariae Radix, pseudostellaria [root]), and Bái zhú (白朮 Atractylodis Macrocephalae Rhizoma, white atractylodes [root]).

Notes: Also called Jīn guì shèn qì wán (金匮肾气丸 Golden Cabinet Kidney Qì Pill) and Bā wèi wán (八味丸 Eight-Ingredient Pill).

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