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The bones are able to support the body because they are driven by Yang Qi; if there is pure Yin without Yang, generation cannot occur, so Suoyang (Cynomorii Fructus) is added to warm it. Mutton is formed into pills to tonify using the flavor of food. Taking them with light salt water accelerates their entry into the Kidney. These all illustrate the meaning of "Qian" (sinking/penetrating).

Zishen Wan (Nourishing the Kidney Pill), also known as Tongguan Wan (Passage-Opening Pill): Treats heat in the Lower Jiao causing longbi (dysuria or urinary retention), but without thirst.
Huangbai (Phellodendri Cortex, stir-fried with wine, 2 liang) Zhimu (Anemarrhenae Rhizoma, soaked in wine, stir-fried, 2 liang) Rougui (Cinnamomi Cortex, 1 qian)
Grind the above into fine powder, make pills with cooked water, size of paulownia seeds. Take 50 pills each time on an empty stomach.

[Collected Annotations] Li Guo said: Urination is governed by the Foot-Taiyang Bladder channel and originates from Lung Metal. If latent heat exists in the Lungs, water cannot be generated, which cuts off the source of urine; thirst accompanied by urinary obstruction indicates that Lung Qi fails to descend. Therefore, drugs with thin aroma and mild diuretic properties that clear dryness and transform Metal are used to purge fire, clear the Lungs, and nourish the source of water. If heat is in the Lower Jiao without thirst, the flow is cut off and urine does not drain. One must use drugs with strong aroma and flavor, belonging to Yin within Yin. The *Suwen* states: "Without Yang, Yin cannot be born; without Yin, Yang cannot transform." It also states: "The Bladder is the official of the Zhou Du, where fluids are stored; only through Qi transformation can they be excreted." Longbi due to lack of fluid means Yin is insufficient for Yang to transform. One must use Zhimu and Huangbai, large bitter-cold agents, with 1 qian of Rougui as a guide. Shortly after taking it, the anterior yin feels like being pierced by a knife or burned by fire, and urine flows out like a gushing spring, leading to recovery. This syndrome has two types: one is in the Upper Jiao Qi level with thirst, the other is in the Lower Jiao Blood level without thirst. The difference between the two is very easy to distinguish.

Ke Qin said: Water is the substance of the Kidney, Fire is the function of the Kidney. People know that water in the Kidney can control fire, but do not know that fire in the Kidney is what generates water. Heaven generates water with 'One'; 'One' refers to Yang Qi, which is Fire. Qi is the mother of Water, Yang is the root of Yin. Only when Fire has its return path can Water have its master. Therefore, Rougui's sweet-warm nature is used as a counter-agent to guide Zhimu and Huangbai into the Kidney to achieve efficacy. This is the profound interdependence of mutual assistance, and also the principle of mutual restraint.

Qiongyu Gao (Jade-Jade Paste): Treats dry cough caused by deficiency-labor.
Shengdihuang (Rehmanniae Radix Praeparata, 4 jin) Baifuling (Poria, 13 liang) Baimi (White Honey, 2 jin) Renshen (Ginseng Radix et Rhizoma, 6 liang)
Boil the juice of Shengdihuang together with honey, filter through silk cloth. Grind Renshen and Baifuling into fine powder, mix evenly into the previous liquid. Store in a porcelain bottle, cover the mouth with ten layers of cotton paper, add bamboo leaves to seal, place in a clay pot, submerge the neck in running water, boil with mulberry wood fire for three days and nights. Remove, change paper to tie the mouth, seal with wax, hang in a well. Take out after one day, boil again for half a day, take mixed with water decoction.

[Collected Annotations] Li Zhongzi said: Dry cough produces sound but no phlegm; this is Fire attacking Metal, where Metal reaches extremity and rings. This is a disease of the primordial origin, difficult to succeed without gradual conditioning; if bitter-cold drugs are mistakenly used, Spleen Earth is damaged, and Metal loses its mother. Therefore, Danxi uses Shengdihuang as the sovereign drug, allowing abundant Water to extinguish Fire naturally. Furthermore, "damage the Lung, benefit its Qi," so Renshen is used to stimulate the origin of generation. "Deficiency tonifies its mother," so Baifuling is used to cultivate the root of all things. White honey is the essence of hundred flowers, sweet in taste enters the Spleen, moistening in nature pleases the Lung, and it soothes dryness-induced urgent fire. These four items are all warm, kind, harmonious, and rich substances, truly worthy of treasure. Guo Ji said: It cures my severe consumptive disease, precious as jade. Hence the name Qiongyu.

Guilu Erxian Jiao (Tortoise and Deer Two Immortals Glue): Greatly tonifies essence and marrow, benefits Qi and nourishes Shen.
Lujiao (Deer Antler, blood type, 10 jin) Guiban (Tartaric Testudo Carapace and Plastron, naturally deceased, 5 jin) Gouqizi (Lycii Fructus, from Ganzhou, 30 liang) Renshen (Ginseng Radix et Rhizoma, 15 liang)
Use a lead jar, prepare glue according to method. Initial dose: dissolve 1.5 qian in wine, gradually increase to 3 qian, take on an empty stomach.

[Collected Annotations] Li Zhongzi said: Humans have three wonders: Jing (Essence), Qi (Vital Energy), and Shen (Spirit), which are the roots of life. Damage to Jing prevents generating Qi; damage to Qi prevents generating Shen. For insufficiency of Jing, tonify with flavorful substances. The Deer receives the most complete Yang Qi of heaven and earth, excels in connecting the Du Mai, and those abundant in Jing can be promiscuous yet live long; the Tortoise possesses the most substantial Yin Qi of heaven and earth, excels in connecting the Ren Mai, and those abundant in Qi can lie dormant and breathe slowly yet live long. These two belong to Qi and Blood, with the purest and richest flavors, obtaining the subtleties of creation. They are sentient beings of different species, employing the method of "repairing bamboo with bamboo." Renshen benefits Qi, Gouqizi generates Jing, assisting Guiban and Lujiao to tonify Yin and Yang without fear of excess; entering both Qi and Blood, possessing the beauty of harmony. Thus, Jing is generated, Qi becomes vigorous, Qi being vigorous leads to flourishing Shen, approaching the years of tortoise and deer. Hence called Two Immortals.

Sishen Wan (Four Spirits Pill): Treats dual deficiency of Spleen and Kidney, diarrhea occurring after midnight (cockcrow to dawn), loss of appetite, and indigestion.
Rouguo (Myristicae Semen, 2 liang) Buguzhi (Psoraleae Fructus, stir-fried, 4 liang) Wuweizi (Schisandrae Fructus, 2 liang) Wuzhuyu (Evodiae Fructus, processed, 2 liang)
Grind into powder. Use 49 red dates, 4 liang sliced fresh ginger, boil in water. When dates are cooked, remove ginger, mash date flesh, mix with medicine to form pills, size of paulownia seeds. Take on an empty stomach with salt water.

Ershen Wan (Two Spirits Pill): Removes Wuzhuyu and Wuweizi.
Wuweizi San (Schisandra Powder): Removes Rouguo and Buguzhi.

[Collected Annotations] Ke Qin said: Diarrhea is an abdominal disease, and the abdomen is the confluence of the Three Yin channels. If one organ is dysfunctional, diarrhea can result. Therefore, for Three Yin diarrhea, Zhang Zhongjing created separate formulas: Taiyin has Lizhong Tang and Sini Tang, Jueyin has Wumei Wan and Baitouweng Tang, Shaoyin has Taohua Tang, Zhenwu Tang, Zhu Ling Tang, Zhufu Tang, Sini San, Baotong Tang, Tongmai Sini Tang, etc. This fully covers the pathology and includes various methods. However, these legislate for only one organ. If three organs are related and the condition persists unresolved, such as diarrhea at dawn, it has not been addressed. From cockcrow to dawn is the Yin period of heaven, Yin containing Yang. Because Yang Qi should arrive but does not, pathogenic emptiness remains and does not depart, causing diarrhea at dawn. There are four causes: First, Spleen deficiency fails to control Water; Second, Kidney deficiency fails to move Water. Thus, Ershen Wan uses Buguzhi's pungent-dry nature as sovereign to tonify Kidney and move Water, assisted by Rouguo's pungent-warm nature to tonify Spleen and control Water, made into pills with Ginger and Date, which are pungent-sweet to generate all Yangs. Third, Mingmen Fire decline fails to generate Earth; Fourth, Shaoyang Qi deficiency fails to promote growth. Thus, Wuweizi San uses Wuweizi's sour-warm nature as sovereign to gather scattered Fire of Kan Palace, allowing Minor Fire to generate Qi to cultivate Earth, assisted by Wuzhuyu's pungent-warm nature to follow the Liver Wood's tendency to scatter, opening a path for Water generation to serve Spring growth. Although the etiologies of these four differ, the manifestations are the same, all involving Water hyperactivity causing harm. Ershen Wan is a controlling agent, Wuweizi San is a transforming agent. Their principles differ but applications are similar, so they can be used interchangeably to enhance efficacy or combined to achieve results. Combined as Sishen Wan, it is a controlling-and-generating agent. Controlling leads to transformation and generation, and chronic diarrhea will heal itself. Is it called Four Spirits because it acts faster than Lizhong Tang and Bawei Wan?

[Note] Without Mingmen Fire, the Middle Jiao cannot rot and ripen food and drink; without secure Kidney Qi, who performs the duty of closure and storage? Thus, when Wood Qi begins to sprout, even without venting, it vents. Although this is Wood evil invading Earth, it is essentially Kidney insulting Spleen. At this time, one should tonify both Spleen and Kidney, astringe and calm Liver. Therefore, Buguzhi warms the Kidney, Rouguo tonifies the Spleen, Wuweizi astringes, and Wuzhuyu drains the Liver. With a warm Kidney and steaming Qi, a calm Liver and robust Spleen, the gate closes and food and drink are properly digested.