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Treats extreme deficiency and sinking of Spleen Qi (Spleen Qi), resulting in incontinence of urine.

Raw Astragali Radix (Sheng Huangqi, 4 qian) Atractylodis Macrocephalae Rhizoma (Baizhu, 4 qian) Taxilli Herba (Sangjisheng, 3 qian) Datiscae Radix (Chuan Xuduan, 3 qian) Corni Fructus (Yurou, 4 qian, seeds removed completely) Dragon Bone (Longgu, 4 qian, crushed) Oyster Shell (Muli, 4 qian, crushed) Dioscoreae Hypoglaucae Rhizoma (Chuan Bixie, 2 qian) Glycyrrhizae Radix et Rhizoma (Gancao, 2 qian, honey-fried)

The *Neijing* (Yellow Emperor's Inner Canon) states: "When drink enters the stomach, its essence floats and overflows, is transported upward to the Spleen; the Spleen scatters the essence, sending it upward to return to the Lung, which regulates the water passages and transports them downward to the Bladder." This indicates that the Spleen, originally situated in the Middle Jiao, serves as the pivot for the ascending and descending of fluids. If this pivot function is not vigorous, fluids will descend directly without ascending first; this is the reason for incontinence of urine. However, there are multiple pathways for the descent of fluids. The *Neijing* also states: "In cases of Liver Heat disease, the urine turns yellow first," and again: "Liver congestion causes fullness in both hypochondria; lying down leads to palpitations and fright, and an inability to urinate." Furthermore, Paeoniae Radix (Shaoyao) is the primary herb for regulating the Liver, yet it is excellent at promoting urination. From this perspective, fluids enter the Liver from the Stomach and then descend to the Bladder. As for the remaining fluids in the Stomach, they are transmitted to the Small Intestine where they exude; this is common knowledge.

Therefore, in this formula, Astragalus (Huangqi), Atractylodes (Baizhu), and Licorice (Gancao) are used to raise and tonify Spleen Qi; simultaneously, Astragalus is combined with Taxillus (Sangjisheng) and Datisc Root (Xuduan) to raise and tonify Liver Qi; additionally, Dragon Bone (Longgu), Oyster Shell (Muli), Cornus Fruit (Yurou), and Dioscorea Hypoglauca Rhizome (Bixie) are used to astringe the Small Intestine. Moreover, when the Great Qi (Daqi) in the chest is vigorous, it naturally absorbs and controls the Qi transformation of the whole body, preventing it from sinking. The combination of Astragalus and Taxillus is also a key remedy for replenishing the Great Qi.

One might ask: Astragalus is an herb that tonifies the Lung and Spleen; why is it said to tonify Liver Qi? The answer is: The Liver belongs to Wood and corresponds to the Spring season; its nature is warm and it prefers free flow and unobstructedness. Astragalus is warm in nature and has an ascending property. Using it to tonify the Liver possesses the subtle efficacy of seeking resonance between similar energies. Since I began clinical practice, whenever I encounter cases of weak Liver Qi unable to flow freely, where all other Liver-tonifying herbs fail, I heavily rely on Astragalus as the main ingredient, assisted by a small amount of Qi-regulating herbs. Upon ingestion, effects are seen within moments (for detailed case records, see the analysis under Astragalus). Thus, those who claim there is no method to tonify Liver Deficiency have not truly understood the Dao of medicine.

One might ask: The *Shennong Bencao Jing* (Divine Farmer's Materia Medica) states that Taxillus can treat lower back pain, strengthen teeth and hair, and promote the growth of beard and eyebrows; thus, it should be considered a herb for tonifying the Liver and Kidneys. Why is it said to tonify the Great Qi in the chest? The answer is: Taxillus roots do not touch the soil but grow on trees, making it most adept at absorbing the clear Qi of the air to nourish itself. Therefore, its Qi transformation properties are actually of the same category as the Great Qi in the chest. I have observed that some people take herbs to tonify the Liver and Kidneys; after prolonged use, they often feel chest fullness and oppression. There is no other reason than their Great Qi in the chest being sufficient, so they cannot accept the tonification from Taxillus. Furthermore, does the *Shennong Bencao Jing* not mention its treatment of carbuncles and swellings? However, when a carbuncle or swelling first arises, taking it is invariably ineffective. Only after the carbuncle ulcerates and tissue regeneration is slow does its use become very effective. In this regard, it is similar to Astragalus, which treats severe cases of carbuncles and ulcers; thus, its nature being close to that of Astragalus can be inferred.

One might ask: Physicians of the world often use Dioscorea Hypoglauca Rhizome (Bixie) to treat Lin syndrome (dysuria), which primarily focuses on promoting free flow, presumably because Bixie promotes urination. In this formula, it is used to astringe urine. Is its nature indeed astringent for urine, or is it diuretic? The answer is: Bixie is a crucial herb for astringing the Lower Jiao. Its ability to treat urinary incontinence is explicitly recorded in the *Mingyi Bielu* (Record of Famous Physicians). Contemporary physicians, due to the ancient formula *Bixie Fenqing Yin* (Dioscorea Hypoglauca Rhizome Decoction for Separating the Clear), mistakenly believe Bixie is a key herb for promoting urination, and thus use it frequently for conditions such as difficult urination and dysuria. I have seen cases where using it to promote urination resulted in urinary retention (longbi); using it to treat Lin syndrome led to点滴不通 (scanty dripping or complete obstruction). How can such errors harming patients be fully recounted! Originally, the chief herb Bixie in *Bixie Fenqing Yin* was intended to treat frequent urination where the urine turns white like oil immediately upon exiting; this is a pattern of Lower Jiao deficiency-cold and failure of Qi transformation to secure. Observing the accompanying herbs—Alpinia Oxyphylla Fruit (Yizhi) to reduce urination frequency and Lindera Aggregate Root (Wuyao) to warm the Lower Jiao—its intent is clear. It was merely a lack of careful consideration in naming at that time that led mediocre physicians to misunderstand, causing endless harm. Can one not be cautious?