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Treats Yin deficiency leading to insufficient Kidney Water, presenting with fever and thirst. (Yin deficiency generates internal heat; fluid depletion causes thirst.) Qi stagnation causing phlegm cough, (Kidney deficiency fails to grasp Qi returning to the source; Dragon-Lion Fire flares upward; Liver Blood deficiency leads to dizziness and blurred vision; Yin deficiency with Phlegm-Fire ascending causes deafness.) Dry throat and painful tongue, loose teeth, (The throat and root of the tongue are pathways of the Kidney Meridian; the Kidney governs bones, and teeth are the surplus of bones, representing the exterior manifestation of the Kidney. Exhaustion of essence and marrow causes gums and alveolar bones to lose moisture, similar to how joints loosen in dry, rotting wood but tighten when wet.) Soreness and pain in the lower back, spine, legs, and calves. (The waist is the mansion of the Kidney; the Kidney Meridian ascends along the medial malleolus to the posterior aspect of the thigh, piercing the spine. Depletion of Kidney Essence results in soreness and weakness.) Epistaxis, hematochezia, and hematemesis, (All bleeding conditions belong to Heat syndromes; caused by hyperactivity of Ministerial Fire and Heart Fire, which scorch and force blood to overflow from various orifices.) Night sweats and aphonia, (Waking belongs to Yang; sleeping belongs to Yin. Yin deficiency causes sweat to escape during sleep due to dysfunction of the Zang organs. Kidney deficiency prevents the meridian from ascending to the throat and encircling the tongue root, causing aphonia.) Water overflowing transforming into phlegm, (Yin deficiency triggers vacuous fire, boiling water and causing it to surge upward as phlegm.) Dysuria and urinary retention, (Dysuria refers to painful, dribbling urination; retention refers to inability to urinate. The Kidney controls opening and closing; deficiency leads to loss of function. As stated in *Jingui Yaolue*: Heat in the Lower Jiao causes hematuria and dysuria/retention.) Nocturnal emission and spermatorrhea, (Yin deficiency causes erratic movement of Ministerial and Heart Fire.) Dryness and heat in the soles of the feet, heel pain, (The Kidney Meridian traverses the sole of the foot and enters the heel.) Irregular menstruation, amenorrhea due to blood exhaustion, (Due to damage to the Chong and Ren meridians.)

Prepared Rehmannia Root (*Shu Di Huang*) (Supplements marrow and fills essence, 8 liang) Cornus Fruit (*Yu Rou*) (Tonifies Kidney Qi and secures primal essence, 4 liang) Chinese Yam (*Shan Yao*) (Enters the Taiyin Lung Meridian, moistens skin, clears and descends Yang within Yang, 3 liang) Alisma Rhizome (*Ze Xie*) (Salty and penetrating to descend Yin within Yin, 3 liang) Add Ophiopogon Tuber (*Mai Dong*) (Moistens dry Metal and clears the water source, 6 liang) and Schisandra Berry (*Wu Wei Zi*) (Upper body gathers dissipating Lung Qi; lower body nourishes deficient Kidney Water, 3 liang). This formula is named Eight Immortals Longevity Pill (*Ba Xian Chang Shou Wan*). Adding Ginseng Radix (*Ren Shen*) combines it with the Pulse-Generating Decoction (*Sheng Mai San*). Processed honey pills the size of paulownia seeds, taken on an empty stomach with light salt water (4–5 qian). If decocted, reduce the dosage. For fever and thirst, add Turtle Shell (*Bie Jia*), Winter Ophiopogon (*Dong Mai Dong*), Summer Ophiopogon (*Xia Mai Dong*), and Trichosanthes Root (*Hua Fen*). For Qi stagnation, add Ambergris (*Chen Xiang*), Amomum Fruit (*Sha Ren*), and Ophiopogon Tuber (*Mai Dong*). For phlegm cough, add Fritillaria Bulb (*Bei Mu*), Trichosanthes Root (*Hua Fen*), Lily Bulb (*Bai He*), and Ophiopogon Tuber (*Mai Dong*). For dizziness, add Chrysanthemum Flower (*Gan Ju*), Uncaria Ramulus cum Uncis (*Gou Teng*), and Lycium Fruit (*Gou Qi Zi*). For tinnitus and deafness, add Magnetite (*Ci Shi*), Sheep Kidney (*Yang Shen*), and Trichosanthes Root (*Hua Fen*). For dry throat and painful tongue, add Winter Ophiopogon (*Dong Mai Dong*), Summer Ophiopogon (*Xia Mai Dong*), and Scrophularia Root (*Yuan Shen*). For loose teeth, add Deer Antler Velvet (*Mi Rong*), Pig Marrow (*Zhu Ji Sui*), Cow Marrow (*Niu Ji Sui*), Ophiopogon Tuber (*Mai Dong*), and Schisandra Berry (*Wu Wei Zi*). For lower back pain, add Lycium Fruit (*Gou Qi Zi*) and Eucommia Bark (*Du Zhong*). Deer antler can be shaved into the decoction or baked in wine. Tortoise Plastron (*Gui Jia*) is roasted in the decoction or prepared as a paste for pills. Leg and calf soreness is treated similarly, adding Achyranthes Root (*Niu Xi*) and Tiger Tibia Bone (*Hu Jing*). For bleeding from gum margins, add Ophiopogon Tuber (*Mai Dong*), Child's Urine (*Tong Bian*), and Drynaria Rhizome (*Gu Sui Bu*; rinse frequently with Ophiopogon decoction). For hematochezia, add Ophiopogon Tuber (*Mai Dong*), Tortoise Plastron (*Gui Jia*), Schisandra Berry (*Wu Wei Zi*), and White Peony Root (*Bai Shao*); if bleeding persists, tonify Stomach Qi and add Ginseng Radix (*Ren Shen*). For hematuria with pain (Blood Dysuria), add Achyranthes Root (*Niu Xi*). If accompanied by frequent penile erection and distending pain in the urethra, add Phellodendron Bark (*Huang Bo*) and Anemarrhena Rhizome (*Zhi Mu*); if painless (Hematuria), add Ophiopogon Tuber (*Mai Dong*), White Peony Root (*Bai Shao*), Achyranthes Root (*Niu Xi*), and Costus Root (*Xiang Fu*), mixed with child's urine, lotus rhizome juice, Ginseng Radix (*Ren Shen*), and Sedge Rhizome Juice (*Mao Gen Zhi*) (one cup each). For night sweats, add Sour Jujube Seed (*Zao Ren*), Schisandra Berry (*Wu Wei Zi*), White Peony Root (*Bai Shao*), and Longan Aril (*Yuan Rou*). For aphonia, add Ophiopogon Tuber (*Mai Dong*), raw chicken egg (*Sheng Ji Zi*), human milk (*Ren Ru*), Bamboo Sap (*Zhu Li*), and pear juice (*Li Zhi*). For water overflowing as phlegm, double the dose of Poria (*Fu Ling*). For dysuria and retention, add Winter Ophiopogon (*Dong Mai Dong*), Summer Ophiopogon (*Xia Mai Dong*), Achyranthes Root (*Niu Xi* [Chief Herb]), and Plantago Seed (*Che Qian*). For pain in the penis shaft, add Licorice Root Tip (*Gan Cao Shao*). For nocturnal emission and spermatorrhea, add Lotus Stamen (*Lian Xu*), Schisandra Berry (*Wu Wei Zi*), Dragon Bone (*Long Chi*), Oyster Shell (*Mu Li*), and Fish Maw (*Biao Jiao*). For hyperactive Ministerial Fire and easy erection, add Salt-fried Phellodendron Bark (*Huang Bo*). For dry heat in soles, add Winter Ophiopogon (*Dong Mai Dong*), Summer Ophiopogon (*Xia Mai Dong*), Achyranthes Root (*Niu Xi*), and Tortoise Plastron (*Gui Jia*). For heel pain, add Achyranthes Root (*Niu Xi*), Deer Horn (*Lu Jiao*), Tortoise Plastron (*Gui Jia*), and Tiger Tibia Bone (*Hu Jing Gu*). For irregular menstruation and amenorrhea due to blood exhaustion, refer to the modification methods of Gui Pi Tang later. The above modifications apply similarly to Bao Yin Jian and Zuo Gui Wan. This is a formula of pure Yin, heavy flavor, and descending nature. Pure Yin corresponds to the Qi of the Kidney; heavy flavor corresponds to the substance of the Kidney; descending corresponds to the nature of the Kidney. In the Song Dynasty, Qian Yi used this formula to treat children with delayed tooth eruption, delayed speech, weak legs and gait, unclosed fontanelles, and Yin deficiency fever, as these all belong to Kidney deficiency. Considering children have tender Yang and pure Qi, he removed Cinnamon Twig (*Gui Zhi*) and Aconite Root (*Fu Zi*) from Zhang Zhongjing's Eight-Ingredient Pill, supplementing only True Yin, achieving immediate effects. In the Ming Dynasty, Xue Lizhai realized that for adult Yin deficiency, when Zhu Danxi's Yin-nourishing methods failed, substituting this formula yielded immediate results. Xue had many modifications; for example, removing Alisma (*Ze Xie*) and adding Astragalus Root (*Huang Qi*) to combine with blood-nourishing efficacy. This is because for fever, thirst, and urinary dysfunction, one should avoid further depleting fluids, hence removing Alisma. Adding Sheng Mai San generates Metal to nourish Water, following the principle of "tonifying the mother when deficient." Combining it with Yi Gong San strengthens Earth to generate Metal, supplementing the mother's external home, renamed Ren Shen Bu Qi Tang. Modifications are infinite, like a dragon playing in the sea. Learners should grasp the principles and apply them flexibly. Zhao Yangkui's *Yi Guan* benefited from *Xue Shi Yi An*, further elucidating its meaning and applying it broadly to exogenous pathogens and miscellaneous diseases, expanding the use of Liu Wei. He noted: Among true Yin deficiency fevers, six out of ten cases resemble exogenous patterns. I treated patients with red face, heat sensation, thirst, and irritability using large doses of Liu Wei Decoction with success. He also stated: Yin deficiency with fire agitation causes water to boil and surge as phlegm; this phlegm is heavy, turbid, and frothy, unlike the clear water phlegm of Fire decline and water overflow. Fire moving from the Kidney is like Dragon Fire rising from the sea, where water follows the dragon; fire moving from the Liver is like Thunder Fire erupting from the earth, where rain follows thunder. Using Liu Wei Decoction to nourish Yin and descend fire treats the root of phlegm, not the branch. After treating the root, tonifying the Spleen to control water is the proper method. Regarding cough: Although cough is attributed to the Lung, treatment focuses on the Spleen, ultimately governed by Liu Wei Decoction. Do not merely treat the Lung; the Lung governs exhalation and is the master of Qi, while the Kidney governs inhalation and is the root of Qi. The Kidney is the son of the Lung; deficiency requires tonifying the son. Most Yin deficiency coughs stem from sexual excess, where fire insults Metal, injuring Lung Metal. First, use Liu Wei to strengthen Water, allowing Water to rise and Fire to descend, then use Ginseng and Astragalus to repair injured Lung, combining "tonifying the mother" with a two-fold benefit. If one does not first strengthen Water to suppress Fire, but hastily uses Ginseng/Astragalus to tonify Yang, Fire will worsen and Metal suffer further. This is ignorance of priority. If Fire does not descend, Ginseng/Astragalus cannot be used, making Yin deficiency difficult to treat. For severe cough leading to asthma due to Yin deficiency, use Liu Wei Wan with Ophiopogon, Schisandra, and Achyranthes in large doses. Asthma in Yin syndromes is critical; survival depends on the Mingmen root. Skilled treatment aids Yuan Qi and uses heavy, sinking herbs to return to the origin, but must not be too harsh. For Yin deficiency sore throat (Shaoyin disease), the Shaoyin Fire surges like a runaway horse to the throat, causing constriction, pain, swelling, internal heat, dry mouth, red face, and profuse saliva. The Chi pulse is rapid and forceless. Use large doses of Liu Wei with Ophiopogon and Schisandra, following Chu Shi's principle of treating upper disorders by addressing the lower. Regarding Yin deficiency bleeding: Vomiting blood may originate from Stomach or Liver; spitting blood from Kidney or Pericardium; coughing blood from Liver; spitting saliva-blood from Kidney or Stomach; epistaxis from Lung or Stomach; bloody sputum from Spleen. Collectively, all belong to the Kidney. When True Water in the Kidney is dry, True Fire flares, blood boils and wanders, exiting through orifices. Chu Shi said cold-cooling herbs rarely save lives, while drinking urine rarely kills. I believe Liu Wei Decoction uniquely tonifies Kidney Water without being cold-cooling or damaging the Spleen/Stomach. Long-term use raises Water and descends Fire. Ginseng should be added later to tonify Spleen/Stomach for completion. Initially, avoid Ginseng to prevent aiding Yang; once Fire returns to its source, Ginseng is permissible, especially combined with Yin-nourishing herbs. For Yin deficiency urinary obstruction due to excessive sweating and internal dryness, forcing diuresis is futile like begging a beggar. Only Liu Wei nourishes Water, restoring normal urination; avoid bland draining herbs. For Yin deficiency constipation due to depleted Kidney fluids, use Liu Wei with Winter/Summer Ophiopogon, human milk, and cow milk to nourish Yin and moisten dryness. The Kidney stores Essence; Yin deficiency fails to store Essence. The Liver governs dispersion; Yang hyperactivity fails to seal Fire. Unsealed Fire attacks unstored Essence, causing emission during dreams. Liu Wei nourishes Water; even with Ministerial Fire, Water nourishes Wood, and Wood-Fire subsides as Water rises. Shen stated that mental arousal triggers Ministerial Fire, causing dream emission and Qi disturbance. Treatment always focuses on tonifying Kidney Water, securing Primal Essence, and calming the Spirit. I elaborate these points because people often use Liu Wei without understanding its principles.