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Tonification refers to supplementing what is deficient in the body; nurturing refers to cultivating and protecting, allowing the vital energy (Qi) and blood to flow smoothly and prosperously, without suffering damage. Human innate constitution rarely achieves absolute balance; some are prone to Yang excess with Yin deficiency, while others are prone to Yin excess with Yang deficiency. Therefore, it is necessary to rely on herbs to nourish and assist.

Qian Yi (courtesy name Zhongyang), because Zhang Zhongjing's Ba Wei Wan (Jin Gui Shen Qi Wan) contains Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root), which are large heat herbs, considering that children's constitutions are "pure Yang," he removed these two herbs to treat pediatric conditions. Today, this formula is used universally for both adults and children of various syndromes. This formula treats Liver and Kidney deficiency, depletion of True Yin, exhaustion of Essence and Blood, emaciation and weakness, lower back pain and soreness of the feet, spontaneous sweating and night sweats, and water retention transforming into Phlegm. (Zhang Zhongjing stated: For Phlegm generated by Qi deficiency, one should use Shen Qi Wan to tonify and expel pathogens. Zhu Danxi stated: In chronic illness, Yin Fire rises, causing fluids to condense into Phlegm rather than generating Blood; one should tonify Blood to control Ministerial Fire, and the Phlegm will naturally resolve.) Fever and cough (Kidney deficiency allows empty heat to transfer to the Lung, causing cough. If pressing down to the bone feels scorching hot, and the bones feel exhausted and unable to bear weight, this is Kidney Heat). Dizziness and vertigo (*Zhizhi Fang* states: Excessive sexual activity prevents Kidney Qi from returning to its origin, causing Qi-deficiency dizziness; hematemesis, epistaxis, or metrorrhagia due to Spleen failing to control Blood, causing reckless bleeding, causes Blood-deficiency dizziness). Tinnitus and deafness, spermatorrhea and bloody stool, Xiao Ke (Wasting-Thirst syndrome) with dribbling, loss of voice due to hemorrhage, dry tongue and sore throat, false-fire toothache, heel pain, sores and ulcers in the lower body, etc. (All these syndromes are caused by insufficient Kidney Water and rising False Fire. Detailed annotations are found in respective sections).

Di Huang (Rehmanniae Radix Praeparata, mixed with Sha Ren (Amomi Fructus) wine, steamed and sun-dried nine times, 8 liang), Shan Zhu Yu (Corni Fructus, moistened with wine), Shan Yao (Dioscoreae Rhizoma, 4 liang), Fu Ling (Poria, mixed with milk), and Mu Dan Pi (Moutan Cortex) serve as the Sovereign herbs; if symptoms include seminal emission, dizziness, Heart deficiency with excessive fire, and blood stasis, Mu Dan Pi serves as the Sovereign, and Di Huang is used only at the minister dosage.

This formula acts on the Foot-Shaoyin Kidney Meridian and Foot-Jueyin Liver Meridian. Shu Di Huang (Prepared Rehmannia Root) nourishes Yin and tonifies the Kidney, generating Blood and Essence; Shan Zhu Yu warms the Liver and dispels Wind, astringing Essence and securing Qi; Mu Dan Pi clears Ministerial Fire; Shan Yao clears empty heat in the Lung and Spleen, tonifies the Spleen and secures the Kidney, and can astringe Essence; Fu Ling leaches out damp-heat in the Spleen and facilitates communication between the Heart and Kidney; Ze Xie (Alismatis Rhizoma) drains water-pathogens from the Bladder and benefits hearing and vision (explanation see later notes). It treats all six meridians but focuses specifically on the Kidney and Liver; it is neither cold nor drying, and tonification extends to both Qi and Blood. If taken regularly, its merits are hard to fully describe. (Some say Shen Qi Wan is a formula for replenishing Water because Shu Di Huang greatly tonifies Essence and Blood; they do not know that when Essence and Blood are sufficient, True Yang arises naturally. Moreover, Shan Yao and Shan Zhu Yu can astringe Essence and secure Qi. Qi is Fire; the Fire within Water is True Yang. This formula tonifies both Water and Fire, neither cold nor drying, extremely plain yet miraculous. Some say Shen Qi Wan actually tonifies the Liver, because the Kidney is the Mother of the Liver; according to the principle of tonifying the Mother when the Child is deficient, ancient texts state that diseases of the Liver and Kidney share the same treatment. Wang Ang notes: In Shen Qi Wan, Shu Di Huang is warm and Mu Dan Pi is cool, Shan Yao is astringent and Fu Ling is draining, Shan Zhu Yu is collecting and Ze Xie is purging; it tonifies the Kidney while also tonifying the Spleen. There is tonification and there is purging, harmonizing and assisting each other to achieve balanced tonification. This is the subtlety within plainness, making it an excellent formula unchanging since ancient times. Even with modifications, it usually involves only one or two herbs, up to three or four at most. Modern practitioners often arbitrarily add herbal tonics, tonifying without purging, and letting the guest herbs exceed the sovereign herbs in dosage, losing focus, thereby diminishing the efficacy of the Six Ingredients and deviating from the original intent of the prescription. This is the error of mediocre physicians of later generations. Li Shicai said: There are four mistakes in using this formula: If Di Huang is not from Huaqing, its potency is weak; if not steamed and dried nine times, it is not sufficiently processed; some doubt Di Huang's cloying nature and reduce its dose, weakening the sovereign herb; some dislike Ze Xie's draining action and reduce its dose, weakening the envoy's power, yet blame the drug for ineffectiveness—is this not foolish? Note: Ze Xie, according to *Shennong Bencao Jing*, benefits hearing and vision because it leaches damp-heat from the Lower Jiao. Once damp-heat is removed, clear Qi ascends, thus nourishing the Five Viscera, raising Yin Qi, tonifying deficiencies, and stopping dizziness, hence its benefit to hearing and vision, which is why ancients used it. Modern people suspect it due to blurred vision, likely because of excessive consumption. If the Kidney...

Decocting this formula yields Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Decoction). The indications are the same. (Zhao Yangkui wrote *Yi Guan*, using this decoction in large doses to treat diseases, stating: Taking thirst in Shang Han (Cold Damage) as an example, pathogenic heat enters the Stomach Fu, consuming fluids, causing thirst. Fearing the Stomach juices are dry, one must purge urgently to preserve fluids. Those of secondary understanding say that if the patient desires water, give it, but not too much, with no other treatment method. Even those who treat it only know to use Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), Zhi Zi (Gardenia Fruit), Huang Bai (Phellodendron Bark), Mai Dong (Ophiopogon Tuber), Wu Wei Zi (Schisandra Berry), Tian Hua Fen (Trichosanthes Root), and even Shi Gao (Gypsum) and Zhi Mu (Anemarrhenae Rhizoma). These are all tangible waters trying to extinguish intangible fire; how can they nourish the True Yin in the Kidney? If using Liu Wei Di Huang... also Zhao... Wang Bing said "Tonify the source of Fire to eliminate Yin shadows"; suitable for those with weak Chi pulse. (Li Shicai said: The Kidneys are two, both belonging to Water, initially having no distinction between Water and Fire. *Xian Jing* says: The two kidneys are identical, with a point of Yang Essence in the middle. Between the two kidneys lies the Mingmen (Gate of Life) acupoint, where Ministerial Fire resides. One Yang arises between two Yins, forming the Kan trigram located in the North. Li Shizhen said: Mingmen is the organ storing Essence and connecting to the uterus. Its substance is neither fat nor flesh, wrapped in white membrane, located centrally between the two kidneys at the seventh thoracic vertebra, attached to the spine, connecting downward to the two kidneys, upward to the Heart and Lungs, and penetrating the brain. It is the origin of life, master of Ministerial Fire, and residence of Essence and Qi. Humans and animals possess it; human reproduction and biological growth all originate from here. This corresponds to the *Nei Jing* statement "beside the seventh vertebra lies the 'Small Heart'." Because Ministerial Fire acts on behalf of the Heart Monarch, it is called "Small Heart." Wang Ang notes: Conception relies on this Mingming Fire; a person's fortune, longevity, and lifespan all root here. It is the innate intangible Fire, governing actions and responding to all matters, steaming dregs into essence. Without this True Yang Fire, spiritual mechanisms cease, and vital energy perishes. Only Fu Zi (Aconite Root) and Rou Gui (Cinnamon Bark) can enter the Kidney-Mingmen area to tonify it; thus added to Liu Wei Wan, it becomes a Fire-tonifying formula. For Kidney deficiency with Fire not returning to its origin, presenting with severe heat, irritability, thirst, red eyes, cracked lips, thorns on the tongue, throat feeling like fire/smoke, soles of feet burning, and a flooding pulse that is forceless upon deep pressure, one should use Shi Quan Da Bu Tang (Ten Great Tonifying Decoction) to swallow Ba Wei Wan. Someone asked: With such dryness and heat, adding Fu Zi and Gui Zhi is not adding fire to fire? I reply: Pericardium Ministerial Fire attaches to Mingmen; men store Essence, women connect to the Uterus. Due to excessive desire exhausting them, Fire has no attachment, thus rebellious and rising upward; moreover, Fire originates from the Kidney, it is Fire within Water. Fire can be extinguished by Water; Fire within Water cannot be extinguished by Water. Gui Zhi and Fu Zi share the same Qi as Fire and are pungent/warm; they can open the interstices, generate fluids, and unblock pathways, occupying the lair to attract Fire. Like attracts like, so Fire must descend. Thus, Gui Zhi and Fu Zi are indeed the correct medicines for treating Ministerial Fire. Ba Wei Wan uses Ze Xie; Kou Zongshi claimed it guides Gui Zhi and Fu Zi back to the Kidney Meridian. Li Shizhen said: It is not guiding; Fu Ling and Ze Xie are used to drain pathogenic Qi from the Bladder. Ancients always combined draining herbs with tonics; once pathogens are gone, tonics work effectively. Closing and opening—this is the mystery. Later generations did not understand this, focusing solely on tonification, leading to imbalance. Zhang Zhongjing used this pill to treat Emperor Wu of Han's Xiao Ke. Yu Jiayan said: In Lower Xiao Ke, drinking one dou results in urinating one dou; thus this formula is used to curb the water, preventing it from flowing downward recklessly. When Kidney Water flows downward, wasting occurs; when it does not ascend, thirst arises. From where else can we treat this? *Jin Gui Yao Lue* also uses this formula for Jiao Qi (Foot Weakness) ascending to the lower abdomen causing insensitivity; and for women with Zhuan Bao (displacement of the bladder) causing urinary retention; renaming it Shen Qi Wan, implying the meaning of gathering and returning Kidney Qi to its origin.

Adding Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma), each 2 liang, to this formula creates Zhi Bai Ba Wei Wan (Anemarrhena and Phellodendron Eight-Ingredient Pill): Treating Yin deficiency with moving Fire, bone atrophy, and marrow exhaustion. Wang Bing described this as "Strengthening the Master of Water to control the Sunlight"; suitable for those with vigorous Chi pulse. (This tonifies the Water born from Heaven One. Zhu Danxi said: Jun Fire is Heart Fire, human fire; it can be extinguished by water or directly折 (broken); herbs like Huang Lian can control it. Xiang Fire is Heavenly Fire, Dragon-Lei Fire, Yin Fire; it cannot be broken by wet/cold water, but should be subdued by following its nature; only herbs like Huang Bo can descend it. Note: Zhi Bai Ba Wei Wan and Gui Fu Ba Wei Wan have opposite cold/heat properties, yet both are effective because human constitutions differ; thus tonifying Yin and Yang have their appropriate uses. Herbs are originally set to correct imbalances and save from defects. *Yi Guan* says: A void, fine, and rapid pulse at the Left Chi indicates insufficiency of True Yin in the Kidney; use Liu Wei Wan to tonify Yin. A deep, fine, and rapid pulse at the Right Chi indicates insufficiency of Ministerial Fire in Mingmen; use Ba Wei Wan to tonify Yang. If both Chi pulses are weak, it indicates dual deficiency of Yin and Yang; use Shi Bu Wan (Ten-Tonifying Pill). All these nourish the congenital source of transformation. Since worldly practitioners of Yin-tonification mostly use Zhi Bai, damaging the Spleen and Stomach, often leading to death, regret is inevitable, so I specifically highlight this. Also: Wang Jiezhai said, for those whose Lung-Kidney True Yin is damaged by excessive alcohol and sex, Ginseng should not be overused; excessive use leads to death, fearing Yang prosperity consumes Yin. Since this theory spread, those treating Yin-deficiency cough view Ginseng as arsenic, regarding Zhi Bai as a miracle pill, leaving patients with zero chance of survival, which is truly sad. Illness arising from sexual fatigue causes True Yin depletion; empty-Yin Fire flares causing cough. One must first use Liu Wei Wan to tonify True Yin, allowing Water to rise and Fire to descend, then use Ginseng to rescue the Lung, tonifying the Mother of Metal, so Metal and Water generate each other, making recovery easier. Practitioners using cold/cool herbs are unworthy of mention. Those who occasionally know to use Ginseng, failing to first strengthen Water to control Fire, and abruptly administering Ginseng to tonify Yang, instead make Yang Fire prosperous and injure Metal further; this is a mistake in knowing sequence.

Adding Gui Zhi (Cinnamon Twig) 1 liang to this formula creates Qi Wei Di Huang Wan (Seven-Ingredient Rehmannia Pill), guiding rootless Fire to descend and return to its origin. Adding Wu Wei Zi (Schisandra Berry) 3 liang creates Du Qi Wan (Duqi Pill): Treating Lao Sou (consumptive cough) (Benefiting Lung source to generate Kidney Water. Adding Gui Zhi also treats Xiao Ke). Adding Wu Wei Zi 2 liang and Mai Dong 3 liang creates Ba Xian Chang Shou Wan (Eight Immortals Longevity Pill). Adding one Placenta (Zi He Che) also treats deficiency damage and labor fever (Placenta, named Hun Dun Pi, is generated from human Qi and Blood, thus greatly tonifying Qi and Blood). Adding Du Zhong (Eucommia Bark, stir-fried with ginger) and Niu Xi (Achyranthes Root, washed with wine), each 2 liang, treats Kidney deficiency with soreness and pain in waist and knees. Removing Ze Xie and adding Yi Zhi Ren (Alpinia Oxyphylla Fruit) 3 liang (salted and wine-fried) treats frequent urination (Yi Zhi Ren is pungent-warm, astringing Essence and securing Qi). Using Shu Di Huang 2 liang, Shan Yao, Shan Zhu Yu, Mu Dan Pi, Dang Gui Wei (Angelica Sinensis Root Tail), Wu Wei Zi, Chai Hu (Bupleuri Radix) each 5 qian, Fu Shen (Poria with Hostwood), and Ze Xie each 2.5 qian, honey-pilled, coated with Cinnabar, creates Yi Yin Shen Qi Wan (Nourishing Yin Shen Qi Pill) (also known as Ming Mu Di Huang Wan (Bright-Eye Rehmannia Pill), created by Li Dongyuan): Treating blurry vision due to Kidney deficiency (Chai Hu is added to raise Yang upward). Adding Che Qian Zi (Plantago Seed) and Niu Ai to Gui Fu Ba Wei Wan creates Shen Qi Wan (*Ji Sheng Fang* version): Treating Gu Zhang (abdominal distension with fluid accumulation) (see Wetness section separately).