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The human body generally has insufficient Yin and excessive Yang. Moreover, those who restrain their desires are few, while those who indulge excessively are many. Once essence and blood are depleted, the Ministerial Fire (Xiang Huo) inevitably becomes hyperactive. Hyperactivity of fire leads to further consumption of Yin, resulting in the onset of conditions such as consumptive disease (Lao Zhai), coughing, hemoptysis, and hematemesis. Therefore, it is advisable to frequently tonify Yin to achieve a balance between Yin and Yang. When water can control fire, and water ascends while fire descends (Shui Sheng Huo Jiang), illness will be avoided. Thus, Mr. Danxi expounded on the theory of tonifying Yin, asserting that one should specifically tonify the Kidney Water governed by the left Chi pulse. Ancient tonic formulas simultaneously tonified both the right Chi pulse's Ministerial Fire, failing to recognize that the left Chi is originally deficient while the right Chi is originally hyperactive. If both sides are tonified equally, fire will still prevail over water; only by tonifying the left to constrain the right can water and fire be balanced. Although the Ministerial Fire of the right Chi should not be deficient, if it is indeed deficient, tonifying fire is appropriate. However, nine out of ten people in the world suffer from diseases caused by hyperactive fire, while less than two out of ten suffer from diseases caused by deficient fire. Furthermore, in youth, Kidney Water is robust, seemingly requiring no supplementation. Yet, desires are intense at this stage, and excessive indulgence occurs. By middle age, although desires diminish, the losses incurred in youth cannot easily be restored. In old age, innate vitality gradually fades, leaving only isolated Yang. Therefore, Yin-tonifying medicines are indispensable from youth to old age. Mr. Danxi elucidated the intent of the Sages, correcting millennium-old errors; his merit is immense! Now, the formula for Buyin Wan (Tonify Yin Pill) is established, with modification methods listed below.

Huangbai (Phellodendri Cortex, peeled, stir-fried with wine until brown) Zhimu (Anemarrhenae Rhizoma, peeled, stir-fried with wine, avoid iron) Baiguiban (Testudinis et Carapax et Plastrum, roasted with butter until thorough, each 3 liang) Suoyang (Cynomorii Herba, roasted with butter until dry) Gouqizi (Lycii Fructus, each 2 liang) Shudihuang (Rehmanniae Radix Praeparata, steamed with wine, avoid iron, 5 liang) Wuweizi (Schisandrae Fructus, 1 liang) Baishao (Paeoniae Radix Alba, stir-fried with wine) Tianmendong (Asparagi Radix, heart removed, each 2 liang) Ganjiang (Zingiberis Rhizoma, stir-fried until purple, 3 qian; increase to 5 qian in cold months).

Grind the above into powder. Add refined honey and three pig spinal cords. Mix evenly with the powder and pound into pills the size of paulownia seeds. Take 80–90 pills per dose on an empty stomach, washed down with light salt water. In cold months, warm wine may be used.

My commentary: Regarding the aforementioned symptoms, if they are caused by insufficiency of Yin essence in the Kidney meridian, leading to a lack of transformation of Yang and reckless movement of deficient fire, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) should be used to tonify, so that when Yin is robust, Yang transforms. If they are caused by dryness and heat in the Kidney meridian, preventing the generation of Yin and internal movement of deficient fire, Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) should be used to tonify, so that when Yang is robust, Yin generates. If they are caused by deficiency of Spleen and Lung failing to generate Kidney Qi, resulting in dual deficiency of Yin and Yang, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwei Dihuang Wan should be used to cultivate primordial Qi and nourish Kidney Water. If they are caused by injury to the Yin-Yang collaterals, with blood following rebellious Qi to flood the channels and causing various bleeding disorders, Sijunzi Tang (Four Gentlemen Decoction) plus Danggui (Angelicae Sinensis Radix) should be used to purely tonify Spleen Qi to contain blood and return it to the vessels. Mr. Taipu (Li Zhongzi) stated: "When severe cold prevails and heat therapy fails to warm, it indicates absence of Fire." "When severe heat prevails and cold therapy fails to cool, it indicates absence of Water." He also said: "Sudden alternation of cold and heat, occurring intermittently, indicates absence of Water." "Symptoms appearing during the day and subsiding at night, or vice versa, moving irregularly, indicate absence of Fire." One must seek the root nature and treat accordingly: For absence of Fire, benefit the source of Fire to dissipate Yin shadows; for absence of Water, strengthen the master of Water to suppress solar glare. Do not rigidly employ heavy cold agents.

For cases of nocturnal emission with dreams or spermatorrhea, add Muli (Ostreae Concha, processed with child's urine) and Baizhu (Atractylodis Macrocephalae Rhizoma), each 1 liang; Shanzhuyu (Corni Fructus) and Chun Gen Bai Pi (Toosendan Cortex, stir-fried), each 7 qian.
For cases of red or white turbid discharge, add Baizhu and Baifuling (Poria, each 1.5 liang); Shanzhiren (Gardeniae Semen) and Huanglian (Coptidis Rhizoma, stir-fried), each 5 qian.

My commentary: The aforementioned symptoms are caused by deficiency of the Foot Three Yin meridians (Liver, Spleen, Kidney). The Kidney governs closure and storage, while the Liver governs dispersion and excretion. For Liver-Kidney deficient heat, use Siwu Tang (Four Substances Decoction) plus Chaihu (Bupleuri Radix), Shanzhi (Gardeniae Fructus), Shanzhuyu, and Shanyao (Dioscoreae Rhizoma). For Spleen-Stomach Qi deficiency, use Buzhong Yiqi Tang plus Shanzhuyu and Shanyao. For Spleen injury due to overthinking, combine Guipi Tang (Restore the Spleen Decoction) with Shanzhuyu and Shanyao. For Liver-Kidney deficiency, use Liuwei Dihuang Wan. For true Yang deficiency and collapse, use Bawei Dihuang Wan. For Heart-Kidney non-interaction, use Bixie Fenqing Yin (Nettle Seed Decoction to Separate the Turbid). For Heart Qi deficiency with heat, use Qingxin Lianzi Yin (Clear the Heart with Lotus Seed Decoction).

Director Zhu had inherent Yin deficiency, suffering from spermatorrhea after exertion and toothache. He was treated with Buzhong Yiqi Tang plus Banxia (Pinelliae Rhizoma), Fuling (Poria), Shaoyao (Paeoniae Radix), Shanzhuyu, and Shanyao, showing slight improvement. Later, he was completely cured using Shiquan Dabu Tang (Ten Complete Tonifying Decoction) plus Wuweizi and Maidong (Ophiopogonis Radix).

A scholar suffered from this condition accompanied by heel pain, dry mouth and thirst, dry stool, and severe afternoon fever. He was cured using Buzhong Yiqi Tang plus Shaoyao and Xuanshen (Scrophulariae Radix), along with Jiaban Bawei Wan (Modified Eight-Ingredient Pill).

For weakness and powerlessness in the legs, add Niuxi (Achyranthis Bidentatae Radix, wine-washed) 2 liang, Hu Jing Gu (Tigiris Os, roasted with butter until thorough) 1 liang, Fangji (Stephaniae Tetrandrae Radix, wine-washed) and Mugua (Chaenomelis Fructus), each 5 qian.

My commentary: The aforementioned symptoms are mostly due to deficiency and depletion of the Foot Three Yin meridians. For weakness due to Spleen-Kidney insufficiency, use Huanshao Dan (Return to Youth Pill). For leg weakness due to Liver-Kidney deficient heat, use Liuwei Dihuang Wan. If ineffective, urgently use Bawei Dihuang Wan.

Da Yin Xu Keming, due to improper diet, experienced evening fever, dry mouth, fatigue, dark and scanty urination, and soreness/pain in both legs. Knowing medicine, he self-administered Siwu Tang, Huangbai, and Zhimu, which instead caused dizziness, red eyes, tinnitus, dry lips, alternating chills and fever, surging phlegm, hot painful defecation, and dark scanty urination. He then took Siwu Tang, Huangqin (Scutellariae Radix), Huanglian, and Zhishi (Aurantii Fructus), resulting in chest/epigastric fullness, poor appetite, and profuse sweating like water. He subsequently took Erchen Tang (Two-Aged Decoction), Huangqin, Huanglian, Huangbai, Zhimu, Maimendong (Ophiopogonis Radix), and Wuweizi, leading to delirious speech and flailing hands. I reasoned that excessive sweating led to loss of Yang, leaving the Spirit without foundation. I prescribed Renshen (Ginseng Radix) and [missing herb] each 5 qian, Danggui and Baizhu each 3 qian, Yuanzhi (Polygalae Radix), Fushen (Poria with Hostwood), Suanzaoren (Ziziphi Spinosae Semen), and Zhi Cao (Prepared Licorice Root) each 1 qian. After taking it, he slept soundly for a long time and improved slightly after four doses. He was then cured by regulating and tonifying with Bazhen Tang (Eight-Treasure Decoction).

A scholar, due to frequent marriages, suffered from soft/painful legs, black complexion, reduced appetite, aversion to cold, foot swelling, lower abdominal distension/pain, and upward rushing Qi with phlegm/wheezing. I diagnosed this as Shaoyin deficiency with Yang deficiency and cold. He took decoctions of Bawei Dihuang Wan material, and all symptoms vanished instantly. He continued taking pills for half a year, gradually replenishing primordial Qi and restoring his physique.

A woman suffered from fever, dry mouth, and irregular menstruation. Half a year later, her legs became weak. After taking wind-dispelling and dampness-resolving agents, her legs swelled and pained more, she became more fatigued, and menstruation ceased. I diagnosed Liver-Spleen-Kidney deficiency-cold and prescribed concurrent use of Liuwei Dihuang Wan and Bawei Dihuang Wan. After two months, all symptoms gradually resolved.

For hernia (Shan) conditions, add Cangzhu (Atractylodis Rhizoma, salt-water stir-fried) 1.5 liang, Huanglian (Coptidis Rhizoma, ginger-juice stir-fried) and Shanzhi (Gardeniae Fructus, stir-fried), each 6 qian, Chuanxiong (Chuanxiong Rhizoma) 1 liang, Wuzhuyu (Evodiae Fructus, stir-fried) and Qingpi (Citri Reticulatae Pericarpium, pulp removed), each 5 qian.

My commentary: Hernia conditions mostly pertain to the Liver meridian. For example, if Wind-Warmth or Cold dominates the governing or ruling phases, Wood Qi contracts and restricts this meridian; if Dryness dominates the ruling phase, Wood Qi is depressed in this meridian; if anger or sorrow causes emotional suppression and stagnation, it knots in this meridian; or if medicinal toxicity causes external constriction, closing the orifices and retaining essence, it obstructs this meridian. The manifestations differ thus. Enuresis, strangury, impotence, bladder bi, spermatorrhea, and leukorrhea in men are all types of male hernia; do not wrongly attribute them to Kidney cold. Blood exhaustion with amenorrhea, heat above waist/knees after menses cease, heel pain, dry throat, strangury, abdominal masses (fixed or migrating), protrusion of the anterior yin, and hemorrhoids at the posterior yin are all types of female hernia. However, females are not called 'hernia' but 'mass' (Jia). If contracted in youth, regardless of gender, it leads to infertility. Thus, these hidden matters are unrelated to the Bladder, Kidney, or Small Intestine, but are disorders of the Foot Jueyin Liver meridian. I believe that if the aforementioned symptoms are due to Liver meridian damp-heat, use stir-fried Shanzhi, Fuling, Huangbai, Zexie (Alismatis Rhizoma), Chuanxiong, Danggui, Wuzhuyu, Huanglian, and Shanzha (Crataegi Fructus). If due to Liver-Kidney dual meridian damp-heat, use Liuwei Dihuang Wan material plus Chaihu and Shanzhi. If due to Liver-Spleen dual meridian Yin deficiency with damp-heat, use Buzhong Yiqi Tang plus stir-fried Shanzhi, charred-black Huanglian, and Wuzhuyu. There are seven names for hernia, with different forms, symptoms, and etiologies, hence different treatments; consult *Yuji Wei Yi* for details.

For Spleen Qi deficiency with aversion to cold and easy diarrhea, add Baizhu 3 liang, Chenpi (Citri Reticulatae Pericarpium) 1 liang, and Ganjiang (Zingiberis Rhizoma, stir-fried) increased to 7 qian.

My commentary: The aforementioned symptoms may also stem from Spleen-Stomach deficiency, Spleen-Stomach deficiency-cold, or Mingmen (Gate of Life) fire decline. For Spleen-Stomach deficiency with aversion to cold and easy diarrhea, use Liujunzi Tang (Six-Gentlemen Decoction) plus Buguzhi (Evodiae Fructus) and Roudoukou (Myristicae Semen). For Spleen-Stomach deficiency-cold with aversion to cold and easy diarrhea, use Liujunzi Tang, Roudoukou, and Muxiang (Aucklandiae Radix). For Mingmen fire decline failing to generate Spleen Earth, use Bawei Dihuang Wan.

Da Yin Shen suffered from diarrhea every fifth watch (early morning). I diagnosed it as Kidney diarrhea and prescribed Wuweizi San (Schisandra Powder). After several doses, he was cured. Later, due to careless living and unregulated diet, the diarrhea recurred, day and night without limit, with aversion to cold, difficulty digesting food, and daily emaciation. I said: This has transformed into a Fire-deficient syndrome. I then gave Bawei Dihuang Wan. The diarrhea stopped, and appetite returned.

For dim vision, add Danggui (Angelicae Sinensis Radix, wine-washed), Chuanxiong, and Juhua (Chrysanthemi Flos), each 1 liang; Chaihu, Huanglian (Coptidis Rhizoma, wine-stir-fried), and Wuxijiao (Rhinocerotis Cornu, now substituted with Buffalo Horn Shuiniujiao in modern practice, but translated here as Black Rhinoceros Horn per text), each 5 qian; Manjingzi (Vittariae Spora) and Fangfeng (Saposhnikoviae Radix), each 3 qian.

My commentary: The eyes are the splendor of the Five Zang organs, receiving nourishment from Qi and Blood essence. Dimness or black spots indicate Kidney meridian insufficiency; use Ziyin Shenqi Wan (Nourish Yin Kidney Qi Pill). Scattered vision or seeing unusual shapes indicate Yin-Blood deficiency; use Ziyin Dihuang Wan (Nourish Yin Rehmannia Pill). Dimness of both eyes with limb fatigue indicates Spleen deficiency where essence of Five Zang cannot ascend; use Dongyuan Yiqi Congming Tang (Dongyuan's Qi-Augmenting Brightening Decoction). Tight/small eyes, photophobia, weak vision, limb fatigue, or numbness of head/face indicate Spleen-Lung Qi deficiency failing to ascend; use Dongyuan Shenxiao Huangqi Tang (Dongyuan's Miraculous Ephedra/Astragalus Decoction - note: text says 'Shenxiao Huang [missing]', likely Huangqi Astragalus). Inability to see after illness, or in the evening/under lamplight, indicates Yang deficiency sinking with Yin excess; use Jueming Yeguang Wan (Bright Eye Night Light Pill) or Zhenyin Shengyang Tang (Suppress Yin Raise Yang Decoction).

For those with concurrent Qi deficiency, add Renshen (Ginseng Radix) and Huangqi (Astragali Radix, honey-roasted), each 2 liang. If the left Chi pulse is deficient and the right Chi pulse is also faint, indicating Mingmen fire decline and impotence, add Heifuzi (Aconiti Lateralis Radix Praeparata, soaked in urine, fried, peeled) and Rougui (Cinnamomi Cortex, peeled), each 7 qian, and Chenxiang (Aquilariae Lignum Resinatum) 5 qian.

My commentary: If the aforementioned symptoms indeed present with a deficient left Chi pulse, use Liuwei Dihuang Wan to nourish the source of Water. If the right Chi pulse is deficient, use Bawei Dihuang Wan to benefit the master of Fire.