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Ren Shen (Ginseng Radix et Rhizoma), anciently written as "Shen". It is sweet and bitter in taste, slightly warm in nature, and non-toxic. The variety produced in Gao Li (Korea) is of the best quality. It is incompatible with Luan Lu (Veratrum nigrum) and fears Lu Yan (halite). For patients with Yin deficiency and flaming fire, coughing, and wheezing, it should be processed with Qing Yan (blue vitriol/green salt).

*Shennong Bencao Jing* records: Ren Shen can tonify the Five Viscera, calm the Spirit (Shen), stabilize the Hun and Po, stop palpitations and fright, eliminate pathogenic factors, brighten the eyes, open the mind, enhance intelligence, and with long-term use, make the body light and prolong life.

[Invention] Ren Shen is sweet and warm, with a thin Qi and strong flavor, belonging to Yang with slight Yin properties. It can tonify the Yuan Qi (Original Qi) in the Lung. When Lung Qi is vigorous, the Qi of the other four Zang organs also becomes vigorous; Essence is naturally generated, and the physical form naturally prospers, because the Lung governs all Qi in the body. In ancient times, for blood depletion, Qi-tonifying methods were used. This is because blood cannot generate itself; it requires herbs that tonify Yang Qi to generate it. When Yang generates, Yin grows, and blood becomes abundant. If only blood-tonifying herbs are used alone, blood cannot be produced. *Suwen* states: "Without Yang, Yin has no basis for generation; without Yin, Yang has no basis for transformation." Therefore, when tonifying Qi, Ren Shen must be used; when tonifying Blood, it must be used in conjunction. Zhang Zhongjing stated that after sweating, if patients present with fever, blood loss, deep and slow pulse, diarrhea, coolness of the body, faint pulse, and blood deficiency, Ren Shen should be added. This is because tangible Blood cannot be generated immediately, whereas subtle Qi must be urgently secured; this utilizes intangible Qi to generate tangible form. Zhu Danxi said: "Deficient Fire can be treated with tonification, such as Ren Shen and Huang Qi (Astragalus); Excess Fire can be treated with purgation, such as Huang Qin (Scutellaria) and Lian Zi (Coptis)." Later generations, failing to investigate, generally claimed that Ren Shen tonifies Fire, which is erroneous. Fire and Yuan Qi are mutually exclusive; when Righteous Qi prevails, Pathogenic Qi retreats. If Ren Shen were to tonify both Yuan Qi and Pathogenic Fire, it would be a treacherous person, and how could it form the Si Jun Zi Tang (Four Gentlemen Decoction) with Gan Cao (Licorice Root), Fu Ling (Poria), and Bai Zhu (Atractylodes Macrocephala Rhizome)? For those with white, yellow, or dark blueish-withered complexions, indicating insufficiency of Spleen, Lung, and Kidney Qi, Ren Shen can be used. For those with red or black complexions, indicating robust Qi and strong Spirit, it should not be used. Pulses that are floating and Kong (hollow), Ru (soft), Xu (deficient), large, slow, weak, or deep, slow, choppy, wiry, fine, small, weak, knotted, intermittent, or weak at the Guan position on the right hand, are indications for use. If the pulse is wiry, strong, tight, solid, slippery, rapid, full, large, forceful, or exclusively solid on the right hand, these indicate internal Fire stagnation and excess, and Ren Shen should not be used. Li Dongyuan (Jiegu) stated that Ren Shen is not used for wheezing and coughing due to Phlegm-Excess and Qi obstruction; however, for shortness of breath and wheezing due to Kidney deficiency, it is essential. Zhang Zhongjing stated that Ren Shen is not used for cold-Lung cough due to cold binding and heat stagnation in the Lung; however, for spontaneous sweating, aversion to cold, and cough, it is essential. Li Dongyuan stated that Ren Shen is not used for chronic disease with stagnant Heat in the Lung, as Fire is stagnant internally and should be dispersed rather than tonified; however, for Lung deficiency with flaming Fire, shortness of breath, and spontaneous sweating, it is essential. Zhu Danxi stated that Ren Shen should not be abruptly used for various pains when Pathogenic factors are sharp and strong, requiring dispersion rather than tonification; however, for interior deficiency causing vomiting and diarrhea, or chronic disease with weak Stomach, dull pain relieved by pressure, it is essential. Jiezai stated that Ren Shen is not used for hematemesis due to Yin deficiency and flaming Fire, specifically when there is blood deficiency with hyperactive Fire, good appetite, and strong pulse, as taking Ren Shen would further strengthen Yang and consume Yin, inevitably leading to massive hemorrhage; however, for spontaneous sweating, shortness of breath, cold limbs, and deficient pulse, it is essential. In treating consumption (Lao Bing), Ge Kejiu was unsurpassed; his Du Shen Tang (Single Ginseng Decoction) and Bao Zhen Tang (Preserve Truth Decoction) never discarded Ren Shen. Only in the initial stage of measles, when the body is feverish but spots have not yet appeared, or in the initial stage of Shang Han (Cold Damage) where the syndrome is undetermined and Heat pathogens are raging, should it not be used. Yu Jiayan said: In Shang Han, there are cases suitable for adding Ren Shen. During sweating, if Yuan Qi is vigorous, external pathogens exit with the momentum. If a person's Yuan Qi is inherently weak, although the medicine acts outwardly, the internal Qi collapses. In mild cases, pathogens remain half-out, lingering and causing distress; in severe cases, pathogens retreat inward with the collapsing Qi, causing continuous fever. Thus, weak persons must use it. When Ren Shen is added to exterior-releasing formulas, it empowers the medicine to expel pathogens forcefully, not for the purpose of nourishment. Even in harmonizing formulas, with the powerful presence of Ren Shen mediating, external pathogens encounter Righteous Qi and naturally retreat without contention, not for the purpose of tonifying one side exclusively. Ignorant people believe Shang Han has no tonification method, fearing that tonification will intensify pathogens, and dare not use it. Common folk advise against taking Ren Shen, and doctors, avoiding suspicion and blame, ignore all chances of survival, severely violating the *Bencao Jing*'s principle of "eliminating pathogens." Ancient and modern formulas use Shen Su Yin (Ginseng and Perilla Decoction) and Bai Du San (Eliminate Toxins Powder) for releasing the exterior, Xiao Chai Hu Tang (Minor Bupleurum Decoction) for harmonizing, Bai Hu Jia Ren Shen Tang (White Tiger plus Ginseng Decoction) and Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) for clearing Heat, and Huang Long Tang (Yellow Dragon Decoction) for purging, all guiding Ren Shen deep to drive out pathogens, resulting in cleared Heat and spirit. From Zhang Zhongjing to the present, enlightened medical texts all use Ren Shen. Why do today's physicians reject it entirely, seeking favor through flattery, completely losing the lineage's宗旨 (principle)? It is unknown that errors killing patients with Ren Shen are caused by its concurrent use with Huang Qi (Astragalus), Bai Zhu, Gan Jiang (Dried Ginger), Dang Gui (Angelica Sinensis), Rou Gui (Cinnamon Bark), and Fu Zi (Aconite Root) for warm tonification; not by failing to use it concurrently with Qiang Huo (Notopterygium), Du Huo (Angelica Pubescens), Chai Hu (Bupleurum), Qian Hu (Peucedanum), Xiong Qiong (Ligusticum), Ban Xia (Pinellia), Zhi Ke (Bitter Orange), and Jie Geng (Platycodon) for sweating and harmonizing methods. How can Ren Shen be viewed like arsenic, poison, blades, or swords, stubbornly unused? Furthermore, regarding variola (smallpox), Ren Shen should not be lightly used because green, dry, purple, black, and sunken lesions indicate Blood Heat and盛 (abundant) toxins. However, for Qi deficiency with sunken lesions, pale color, thin skin, diarrhea with clear pus, it is essential. Thus, *Boxin Aijian* treats smallpox using Bao Yuan Tang (Preserve Origin Decoction) as a key herb. With Sheng Ma (Cimicifuga), Ren Shen tonifies Upper Jiao Qi and drains Middle Jiao Fire. With Fu Ling, it tonifies Lower Jiao Qi and drains Kidney Fire. Li Dongyuan's Jiao Tai Wan uses Ren Shen and Zao Jiao (Gleditsia Sinensis Spine), indicating apparent incompatibility but actual compatibility. Si Wu Tang (Four Substances Decoction) plus Ren Shen and Wu Ling Zhi (Trogopterus Dung) treats amenorrhea, indicating apparent fear but actual lack thereof. For Phlegm in the chest and diaphragm, Ren Shen and Luan Lu (Ginseng Stem) are used together to induce vomiting, stimulating its aggressive nature. Only when the right hand pulse is exclusively solid, indicating inherent Lung Fire, is it unsuitable. If the right hand pulse is deficient and large with cough, although there is Fire pathogen, this is Deficient Fire flaming upward due to insufficient Kidney Water, i.e., Kidney Fire punishing Metal, not Lung Metal Fire. Ren Shen should be used to save the Lung, but in large doses to be effective; small doses will increase distension. *Bencao Jing* says it calms the Five Viscera, stabilizes Hun and Po, stops palpitations, brightens eyes, opens the mind, and enhances intelligence because when Visceral Qi is harmonious and Spirit is calm, there is no worry of palpitations or confusion. Its ability to "eliminate pathogens" relies on its sweet-warm power assisting exterior herbs to aid the Stomach and dispel pathogens, like having a gentleman seated, leaving no room for villains. Miao Xiyong in *Jingshu* said: Regarding the broad functions of Ren Shen as described in *Bencao Jing*, it is indeed not empty talk, but its nature has unsuitabilities. Those recording its strengths may omit its weaknesses; those picking flaws may discard its virtues. Thus, sometimes it is used late when appropriate, or improperly administered, or its benefits lead to harm. Both errors result in the same loss: good medicines lose public trust. Crude practitioners babble, unaware that Ren Shen originally tonifies the True Yang Qi of the Five Viscera. As for emaciation, weakness, injury from labor or irregular diet, excessive effort causing blood loss leading to Qi deficiency sinking into the Yin layer, fever, fatigue, and limb weakness. Or summerheat injuring Qi, making Qi unable to move. Or vomiting, diarrhea, cholera with cramps, weak Stomach refusing food, weak Spleen failing to transform. Or decline of True Yang, exhaustion of Kidney Qi, impotence. Or wind-stroke with aphasia, postpartum asthma, pediatric slow convulsion, Qi deficiency after smallpox, ulcers failing to granulate—administering Ren Shen yields immediate effects in all these cases. It is solely unsuitable for Lung Heat with coughing and expectoration, hematemesis, epistaxis, bone-stealing consumption, and signs of Yin deficiency with flaming Fire. Because the Lung is a pure and descending organ; if True Qi is unimpaired, it remains peaceful and quiet, receiving the steaming of generating Qi and governing the hundred vessels. If desires are indulged, depleting True Yin, Fire erupts from emptiness. Heat rises from below, Fire scorches above, so the Lung suffers first. Fire is the thief-pathogen of the Lung; when pathogenic Qi prevails, it becomes excess, leading to Lung Heat stagnation, phlegm-cough, and reckless bleeding from upper orifices due to Blood Heat. This is what Wang Haogu meant by "Lung Heat further injures the Lung." Misadministration rarely escapes disaster. This is an error of "tonifying excess," what fault does Ren Shen have? Ren Shen produced in the Taihang Mountains of Shanxi is named Shang Dang Ren Shen. Although it lacks the potent sweet-warm tonifying power, it has sweet-pure Lung-clearing strength, unlike Sha Shen (Glehnia or Adenophora) which is cold and specifically drains Lung Qi. Shen Lu (Ginseng Stem) consumes Qi and is specialized for emetic formulas, suitable for inducing vomiting of clear fluids above the diaphragm in deficient persons; for salt-asthma, inducing vomiting with Shen Lu is excellent. Shen Lu induces vomiting, while Shen Xu (Ginseng Fibrous Roots) promotes downward drainage, differing from the concept of Dang Gui head stopping bleeding, body harmonizing blood, and tail breaking blood. Shen Xu is cheap, often used by the poor. It treats Stomach deficiency with retching, coughing, and hemoptysis effectively due to its downward-nourishing nature. However, for chronic dysentery, spermatorrhea, metrorrhagia, and hematochezia, it often exacerbates conditions due to its bitter, draining nature. Shen Lu is rarely known or used, except in Jiangxi where it is called Zhu Jie Shen (Bamboo Joint Ginseng). Recently, people in our Wu region also use it. It treats dysentery with pus and blood, metrorrhagia, leukorrhea, and spermatorrhea without hindrance. However, for Qi deficiency with flaming Fire causing wheezing, retching, coughing, and hemoptysis, misuse worsens the condition. Ancients used it for vomiting, taking advantage of its ascending nature which contains draining within tonification. This meaning was not previously elucidated; I record it here due to repeated verification.