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Treats insufficiency of Kidney Yin, resulting in flaccidity and weakness of the sinews and bones, and inability to walk.

Gui Ban (Testudinis Carapax et Plastrum), Huang Bo (Phellodendri Cortex) each 4 liang; Zhi Mu (Anemarrhenae Rhizoma), Shu Di Huang (Rehmanniae Radix Praeparata) each 2 liang; Niu Xi (Achyranthis Bidentatae Radix) 3 liang 5 qian; Bai Shao (Paeoniae Radix Alba) 1 liang 5 qian; Suo Yang (Cynomorii Herba) 1 liang; Hu Gu (Pantheris Os) 1 liang; Dang Gui (Angelicae Sinensis Radix) 1 liang; Chen Pi (Citri Reticulatae Pericarpium) 7 qian 5 fen. The above herbs are ground into fine powder. Cooked male castrated sheep meat is used to mash and mix with the powder to form pills, sized like wu tong seeds. Take with light salt water.

[Collected Annotations] Wang Youyuan states: The Kidney is the official of strength and vigor (Zuo Qiang), relying on Jing (Essence) and Blood to maintain its robustness. If Kidney deficiency leads to the exhaustion of Jing, Blood will inevitably follow, causing a simultaneous decline of both Jing and Blood. Damp-heat and wind-toxins then take the opportunity to invade. Consequently, symptoms such as inability to walk, soreness and weakness of the lower back, and contraction of the sinews arise. Furthermore, the Kidney encompasses both Water and Fire. If Fire becomes excessive and scorches Yin, and damp-heat intertwines, it is natural for the sinews and bones to lose their function due to lack of nourishment. In this formula, Huang Bo is selected to clear deficient fire within the Yin aspect and dry dampness between the bones. Since bitter flavor can firm the Kidney, it serves as a crucial herb for treating Wei syndrome (Flaccidity Syndrome) and is thus designated as the Sovereign (Jun) herb. Hu Gu removes wind-toxin and strengthens the sinews and bones, serving as the Minister (Chen) herb. Because the water from the high source (Lung Metal) does not descend, when the Mother organ (Lung) is deficient, the Child organ (Kidney) also becomes deficient. When Liver blood fails to return and store, the child's disease exacerbates the mother's condition. Therefore, Zhi Mu is used to clear Lung Yuan (source Qi), while Dang Gui and Bai Shao nourish Liver blood, guiding them back to the Kidney. Gui Ban possesses profound Yin energy from heaven and earth, swallowing without regurgitating, symbolizing its role in stabilizing the North (the seat of the Kidney). Additionally, Shu Di Huang, Niu Xi, Suo Yang, and mutton constitute a group of substances that tonify water and essence, allowing for dual supplementation of Jing and Blood. As for Chen Pi, it regulates blood flow and moves Qi. Here lies the subtle interaction where Qi transformation generates Blood and Blood movement aids Qi. Thus, the sinews and bones will surely become strong and vigorous, powerful like a tiger. The "Daoist Scriptures" state: "The tiger is born from water," which embodies the meaning of "Qian" (Submerge/Hide). Hence, the name "Hu Qian Wan" (Tiger Submerging Pill) is given. Ye Zhongjian states: Although Wei syndrome originates from the five Zang organs, its root lies in the Kidney, and its manifestation lies in the Lung. The "Nei Jing" (Inner Canon) states: When the lungs suffer heat causing the leaves to wither, Wei Bi (flaccid paralysis) ensues. It also says: When Yang qi invades internally and Water cannot overcome Fire, bone flaccidity and marrow emptiness occur, rendering the feet unable to support the body. Bone flaccidity arises from intense heat. If mistaken for deficiency-cold and treated with Gui Zhi (Cinnamomi Ramulus) or Fu Zi (Aconiti Lateralis Radix Praeparata), it often leads to untreatable conditions. This formula uses "Tiger" in its name because the tiger, among beasts, embodies the most rigid Metal Qi. Its roar generates wind, specifically symbolizing Lung Metal. The term "Qian" implies that Metal is nourished by Water, the mother hides within the fetus; thus, the generator of Metal must rely on Liushui (clear water/Kidney Water), intending to guide Qi back to the Kidney. The turtle corresponds to the image of the North, possessing the thickest Yin energy. Its head often tucks into its abdomen, facilitating the Ren Mai (Conception Vessel), and greatly tonifies True Yin. This pathology deeply embodies the meaning of "Qian." Huang Bo has a heavy taste and belongs to Yin within Yin, specifically tonifying the insufficient Yin of the Kidney and Bladder, enabling strength to surge in the feet and knees. Therefore, these two herbs must be used as Sovereigns for treating flaccidity: one to secure the root, the other to treat the branch. Fearing that odd-numbered prescriptions may fail, even-numbered combinations are employed. Shu Di Huang fills the Essence of Shaoyin (Kidney), assisting Gui Ban; Zhi Mu clears the Qi of Taiyin (Lung), assisting Huang Bo; Niu Xi enters the Liver to relax sinews; Dang Gui and Bai Shao assist in ensuring Liver blood has a place to reside; Chen Pi regulates to ensure the free flow of Qi and Blood, making bones upright and sinews flexible. Furthermore, fearing that extreme heat generates wind which lingers in the joints, Hu Gu is used to disperse it. Pure Yin without Yang cannot generate vitality, so Suo Yang is added to warm. Mutton is used to make pills, tonifying through flavor. Light salt water is used for administration to urgently direct the medicine into the Kidney. All these illustrate the meaning of "Qian."