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Prepared Rehmannia Root (Shu Di Huang, *Rehmanniae Radix Praeparata*) (8 liang)
Cornus Fruit (Shan Zhu Yu, *Corni Fructus*) (pitted)
Chinese Yam (Shan Yao, *Dioscoreae Rhizoma*) (4 liang each)
Moutan Bark (Mu Dan Pi, *Moutan Cortex*) (woody parts removed)
Poria (Bai Fu Ling, *Poria*)
Alisma Rhizome (Ze Xie, *Alismatis Rhizoma*) (3 liang each)

This formula is indicated for cases of impotence (Yin Wei, 阴痿) caused by excessive sexual intercourse leading to flaccidity of the sinews of the genitalia.

The Kidney corresponds to the Kan trigram (Kan Xiang, 坎象). Kan is formed by one Yang line situated between two Yin lines; thus, the Fire of the Gate of Life (Ming Men Huo, 命门之火) resides within the Kidney. In individuals who engage in excessive sexual activity and experience persistent hypersexuality or forced erection, this indicates a deficiency of Kidney Water allowing the Ministerial Fire to dominate alone. Conversely, if there is flaccidity and inability to erect, it signifies that both Kidney Water is deficient and the Fire of the Gate of Life is also failing. Zhu Danxi stated: "Without this Fire, Heaven cannot generate all things; without this Fire, humans cannot sustain life. How can one claim that Fire is unnecessary?" In this formula, Aconite Root (Fu Zi, *Aconiti Lateralis Radix Praeparata*) and Cinnamon Bark (Rou Gui, *Cinnamomi Cortex*), being pungent, hot, and possessing strong flavors, penetrate into the Yin aspect. Their pungency and heat tonify the Fire; therefore, they enter the Shaoyin channel and augment the Fire of the Gate of Life. Prepared Rehmannia Root and Cornus Fruit, being rich in flavor and moist in nature, nourish Yin and strengthen Water; thus, they tonify the Shaoyin and reinforce the True Water within the Kan palace. To solidify the Water, the salty and sour properties of Alisma Rhizome and Moutan Bark can guide and drain excesses (or clear damp-heat to preserve true Yin). To consolidate the Water, the sweet and bland properties of Chinese Yam and Poria can leach out dampness and restrain imbalance. When Water and Fire are properly nurtured, the function of the Kidney organ remains robust, the Fire of the Gate of Life does not fail, and the official responsible for strength and vigor fulfills its duties.

Wei syndrome (Atrophy Syndrome, 痿证) is predominantly characterized by Heat, while Bi syndrome (Obstruction Syndrome, 痹证) is predominantly characterized by Cold. However, Wei syndrome may also present with Cold, and Bi syndrome may present with Heat; one must not adhere rigidly to these generalizations. The *Neijing* states: "When pathogenic factors cause panting, the Bi pathogen gathers in the Lung. When they cause worry and rumination, the Bi pathogen gathers in the Heart. When they cause enuresis, the Bi pathogen gathers in the Kidney. When they cause exhaustion of essence, the Bi pathogen gathers in the Liver. When they cause muscle atrophy, the Bi pathogen gathers in the Spleen." These five patterns require warming herbs for treatment; one should judiciously select from herbs such as Tianxiong (*Aconiti Kusnezoffii Radix*), Aconite Root (Fu Zi), Chuanwu (*Aconiti Radix*), Sulfur, Shuzhuo (*Zanthoxyli Pericarpium*), Shechuangzi (*Cnidii Fructus*), Jiuzi (*Allii Tuberosi Semen*), and Xiaohuixiang (*Foeniculi Fructus*).

Preface: Jue syndrome (Jue Zheng, 厥证) exists in all six channels, generally arising from Fire. Here, several cases of Jue syndrome from miscellaneous diseases are presented to illustrate the major principles. For Yin Jue and Yang Jue resulting from Cold Damage (Shanghan, 伤寒), please refer to *Yi Fang Kao* on Shanghan formulas.