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Among all substances, only Ginseng Radix et Rhizoma (Renshen) is most subject to both praise and blame. Those fond of tonification often praise it, while those fond of purging often condemn it; among those who praise it, there are further disagreements on whether it tonifies Yin or Yang, yet none of these views are correct. Xu Huixi and Zou Run'an truly grasped the nature and function of this substance. Mr. Xu stated: "Ginseng absorbs the pure and exquisite Qi of Heaven and Earth; it tonifies Qi without causing rigid dryness, and can also enter the Yin aspect." Mr. Zou stated: "All Yin substances prefer high and dry places and dislike low and damp ones; all Yang substances dislike bright and crisp environments and prefer shady and obscured ones. Ginseng does not grow in low, wet marshes but in mountain valleys, indicating its body is Yin; yet it grows under trees and dislikes wind and sunlight, making it 'Yin containing Yang.' In the human body, the Qi of the five Zang organs transforms and circulates as Yang, and stores without leaking as Yin. Ginseng possesses both transformative and storing functions. Moreover, its color is yellow, taste is sweet, nature is cool, and texture is moist, conforming to the virtue of the Central Earth Spleen. This is how it enters the Post-Heaven (Spleen/Stomach) to cultivate the Pre-Heaven (Kidney/Essence)." Regarding why diseases require Ginseng and how it cures them, neither scholar provided a precise explanation. However, Tao Hongjing's statement that Ginseng's efficacy is similar to Licorice Root (Gancao) shows insight. Licorice produces shoots in spring, leaves in summer, flowers in autumn, and fruit in winter, possessing the completeness of the Four Seasons. Its yellow color and sweet taste surpass other yellow and sweet substances, allowing it to be neither biased toward Yang nor Yin, residing in the Central Palace (Middle Jiao), unblocking meridians, and harmonizing various pulses, sharing similarities with Ginseng. I believe that understanding this one point allows one to gauge the full measure of Ginseng. Nevertheless, for diseases that cannot be treated without Ginseng, Licorice cannot replace it. Licorice is Licorice, Ginseng is Ginseng. To know the true nature of Ginseng, one must integrate and carefully distinguish Zhang Zhongjing's formulas; otherwise, hope is slim.

Shaoyang is the pivot of the Three Yang channels, and Shaoyin is the pivot of the Three Yin channels. Anything called a "pivot" implies that within one channel, there is both Yin and Yang: entering makes it Yin, exiting makes it Yang, much like the shifting of a hinge. Shaoyin is a Water organ containing Ministerial Fire, thus inherently possessing both Yin and Yang. Shaoyang seems to have only Yang and no Yin, but it resides within the liver lobes; it is the initial birth of Yang, still inseparable from Yin, so these two channels interact easily. Liver heat carries Gallbladder fire; Gallbladder cold carries Liver wind. Liver Qi ascending becomes Gallbladder Qi; Gallbladder Qi descending becomes Liver Qi. Chills and fever alternating, though symptoms of Shaoyang disease, do not entirely exclude the Liver. Because Yang is tender, it cannot completely distance itself from Yin, resulting in a phenomenon of contention between entry and exit. Contention requires resolution and harmony. People know Xiao Chaihu Tang (Minor Bupleurum Decoction) is a Shaoyang harmonizing formula, but they do not know that Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix) specifically resolve pathogenic factors, while Renshen (Ginseng Radix et Rhizoma) is used to harmonize. When a disease involves both Yin and Yang, how is it harmonized? Is it only with cold herbs? This is partly because Shaoyang pathogen is dominant; resolving Shaoyang causes Jueyin to settle naturally. Furthermore, with Renshen mediating between them, why worry about unresolved chills and fevers? There is solid evidence that Renshen is a Shaoyang herb: in Xixin Tang (Three Heart Decoction), if there is heart vexation, Renshen is omitted; but if there is water qi under the hypochondrium, it is included. In formulas for Chest Bi (Chest Impediment), Renshen is usually omitted; but if Qi rebels upward seizing the heart, it is included. Even in Xiao Chaihu Tang, which has modification rules, Renshen is retained when there is vomiting, thirst, or hardness/fullness under the hypochondrium. This shows Renshen is a specialized herb for harmonizing Shaoyin.

The value of Shaoyin lies in "harmony," manifested by restlessness (Zao). Vexation (Fan) originates from the Heart; restlessness originates from the Kidney. Therefore, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) and Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction) treat vexation without Renshen. Vexation need not accompany restlessness, but restlessness always accompanies vexation. When vexation and restlessness coexist, there are Yang and Yin syndromes. Yang syndromes involve Taiyang exterior excess or Yangming interior excess invading the Kidney, not a primary Kidney disease; thus, Da Qinglong Tang (Major Green Dragon Decoction) and Dachengqi Tang (Major Order the Qi Decoction) treat restlessness/vexation without Renshen. Yin syndromes involve Kidney disease affecting the Heart; Kidney Yang is nearly exhausted, so how can Kidney Yin remain intact? Thus, Wuzhuyu Tang (Evodia Decoction) and Fuling Sini Tang (Poria and Replenish the Extremities Decoction) treat restlessness/vexation with Renshen. This again confirms Renshen as a specialized herb for harmonizing Shaoyin.

Using Renshen for "harmonization" includes harmonizing the Yin-Yang of its own Fu and Zang organs, such as Shaoyang and Shaoyin. Ganjiang Huanglian Huangqin Renshen Tang (Ginger, Coptis, Scutellaria, and Ginseng Decoction) harmonizes due to mixed cold-heat symptoms; Mufangji Tang (Stephania and Tripterygium Decoction) harmonizes due to mixed cold-heat ingredients; Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction) connects exterior-interior disharmony; Shengjiang Xiexin Tang (Fresh Ginger and Three Heart Decoction) connects upper-lower disharmony; Dajianzhong Tang (Great Construct the Middle Decoction) uses the warm-drying properties of Sichuan Pepper and Ginger to transform into harmony. The ways of harmonizing are diverse. If misused...

The Heart is a Yang (Mu) organ. Tonifying during vexation exacerbates it. However, in Xiao Chaihu Tang, if vexation accompanies vomiting, Renshen is not contraindicated (Note: If vexation occurs without vomiting, Banxia and Renshen are removed; meaning if vomiting accompanies vexation, they are kept. Mr. Xu's annotation in *Shanghan Leifang* is erroneous). In Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction), if vexation accompanies thirst, Renshen is not contraindicated, because vomiting and thirst are caused by Shaoyang Wood-Fire.

For fullness/hardness in the chest and hypochondrium, and vomiting, there are specific treatments; Renshen is used specifically to harmonize Yin and Yang. However, generating fluids and quenching thirst is Renshen's specialty, not limited to Shaoyang. Thus, for Yangming syndrome where fluids are depleted by heat, Baihu Jia Renshen Tang uses it. For Taiyin syndrome where Spleen deficiency fails to generate fluids, Lizhong Wan (Regulate the Middle Pill) uses it. However, if thirst is accompanied by water retention in the middle and difficult urination, Renshen is ineffective.

There are cases of quenching thirst that do not require Renshen, but for generating pulse Qi (Mai), Renshen is uniquely capable. Pulse arises from Ying (Nutritive) Blood, which belongs to the Heart. The Heart's substance is Yin, its function is Yang. Only the mild and nurturing Renshen can tonify it. Thus, in Baihu Jia Renshen Tang for summerheat disease with weak pulse (a non-weak pulse implies concurrent syndromes, not pure summerheat); in Sini Jia Renshen Tang for faint pulse; in Tongmai Sini Tang for absent pulse; and in Zhigancao Tang (Roasted Licorice Decoction) for knotted/intermittent pulse, Renshen is essential. Renshen's influence is lighter in the Kidney and heavier in the Heart. Thus, Foot Shaoyin receives harmony, Hand Shaoyin receives tonification, serving as proof of "Yin containing Yang."

Renshen's merit lies in tonifying deficiency. Although quenching thirst is also a form of tonification, these are merely prominent symptoms; Renshen's tonification extends far beyond this. Its yellow color and sweet taste focus its spirit on the Spleen, expanding to reach everywhere. Hence, Jianzhong Tang (Construct the Middle Decoction) is named after Yi (Maltose), not Renshen, because Renshen cannot be defined by a single name. Briefly listing Zhang Zhongjing's formulas using Renshen for tonification: Tonifying Spleen like Lizhong Wan, Huanglian Tang (Renshen treats abdominal pain); Tonifying Stomach like Banxia Houpo Tang (note: text says Banxia Tang, likely referring to Banxia Houpo or similar context, but text says Banxia Tang) and Ganxiao Xiexin Tang (Xu's Neitai Fang includes Renshen); Tonifying Lung-Stomach like Zhuyeshigao Tang (Leaf, Bamboo Sheath, and Gypsum Decoction); Tonifying Liver like Wumei Wan (Mume Pill) and Wuzhuyu Tang; Tonifying Heart listed above. Others like Shuyu Wan (Dioscorea Pill) and Wenjing Tang (Warm the Meridian Decoction) offer countless examples. Is Renshen's tonification not extensive? Heart Pi (fullness/stuffiness) generally forbids Renshen, but combined with Xuanfu, Jiang, and Xia, Renshen can dissipate Pi. Abdominal distension generally forbids Renshen, but combined with Houpo, Jiang, and Xia, Renshen can remove distension. Renshen consolidates the exterior and stops sweating, so it is contraindicated in exterior syndromes; however, if sweating is followed by unresolved vexation/thirst, using it in cold formulas is acceptable. Renshen can trap pathogens and retain fluid retention, so it is contraindicated in coughs; however, if Lung deficiency exists with damaged fluids, using it in formulas that disperse pathogens and eliminate fluid retention is acceptable. Renshen treats alternating chills/fever resembling malaria; however, if slight exterior heat exists, Renshen is removed. *Waitai Mi Yao* excludes Renshen for pure cold, pure heat, or cold-predominant malaria, using it only when thirst accompanies malaria. This is because tonifying deficiency aids pathogens; if cold/heat are uneven, immediate harmonization is impossible. Renshen quenches thirst, assisting Huangqin and Gualougen where they fall short; Renshen benefits Yin, thus generating fluids. If diarrhea persists, even with a faint pulse nearing extinction, Renshen is not added, because diarrhea indicates Yin excess, and Renshen would further benefit Yin. However, if diarrhea accompanies vomiting, or follows vomiting/diarrhea, the interior is deficient and fluids damaged; Renshen is necessary. If the Middle Earth has authority, the upper and lower follow its norms.

Mr. Xu Huixxi determined the use of Renshen based on the separation/conjunction of Pathogen and Righteous Qi. Mr. Zou Run'an pointed out that removing Renshen from Xiao Chaihu Tang indicates pathogen conjunction; including it in Guizhi Xinjia Tang indicates pathogen separation. The argument seems refined but is actually incorrect. Slight exterior heat means the pathogen is still at the exterior; adding exterior-consolidating Renshen would make the pathogen more stubborn, so it must be removed. Xinjia Tang is used after sweating when the exterior is deficient; there is no fear of Renshen consolidating the exterior. With a deep/slow pulse, Renshen is suitable to generate pulse Qi. Body ache indicates residual exterior pathogen, requiring Guizhi Tang to expel it. Guizhi Tang alone cannot收敛 (gather) dispersed Qi or 振 (rouse) sunken Yang. Adding Shaoyao gathers the dispersed; adding Shengjiang rouses the sunken. Adding Renshen ensures the pulse is not deep/slow and the exterior is not deficient, harmonizing interior and exterior. Mr. Xu and Mr. Zou missed this reasoning. One must understand that Renshen excels at harmonizing Yin-Yang, specifically harmonizing Righteous Qi, not expelling pathogens. Adding Renshen during pathogen expulsion is dangerous if mishandled. Only when other expelling herbs in a formula (like Xinjia Tang) prevent Renshen from hindering efficacy, and Renshen helps other herbs bridge gaps, is it true mastery of Renshen. Furthermore, pathogen/righteous separation should be judged by the movement of pathogen between channels and the rise/fall of disease energy, not by a single symptom or pulse. It is rare for Shanghan pathogen to sink with Righteous Qi and stay at the exterior forever; Mr. Zou's oversight is significant.

In Shanghan and Wenre (Warm Heat) diseases, the use of Renshen is critical, and Zhang Zhongjing's methods are strict. Correct use yields results; incorrect use fails, sometimes obviously. In Shanghan with exterior syndromes, Zhang Zhongjing never uses Renshen. Not only Mahuang Tang, Qinglong Tang, Guizhi Tang avoid it, but even Xiao Chaihu Tang removes it if slight exterior heat exists. Huanglian Tang contains Guizhi but has no exterior syndrome. Guizhi Renshen Tang has an exterior syndrome, but Renshen is not for releasing the exterior. Chaihu Guizhi Tang treats mild exterior-interior pathogens, treating both, hence using Renshen to harmonize. This is the fixed method for Shanghan. For Wenbing (Warm Diseases), Zhang Zhongjing's formulas are incomplete, but principles are clear. Huangqin Tang, revered as the main Wenbing formula, never contains Renshen. Baihu Tang treats Yangming heat excess effectively, also never containing Renshen; it is used only for spontaneous sweating, thirst, and absence of exterior syndrome. This is the fixed method for Wenbing. Since Sui/Tang, Zhang's methods were neglected. Formulas like Ren Shen Shunqi San and Duhuo San in *Huren Shu* show no indication for Renshen. Xu Shumi argued against adding Renshen to Baihu Tang for Zhongshu (Heatstroke), which is debatable. However, many modified formulas retaining Zhang's essence exist. Using Qianghuo/Fangfeng for Shanghan sweat, Congchi for Wenbing sweat, without Renshen. Those with Renshen: Wuji San treats exterior-interior pathogens, attacking pathogen while harmonizing righteousness; Gualou Gen Tang uses Renshen for severe thirst; Renshen Su Yin Tang uses it for weak pulse; Shengma Gengen Tang uses it for weak pulse and thirst. Weiru Yin treats wind-heat with neck stiffness and limb heat; Renshen seems inappropriate, but combined with Congchi dispersing exterior and Weiru clearing interior, since wind-heat scorches fluids, Renshen harmonizes exterior-interior and generates fluids. All good inherited formulas stay within Zhang's scope. Baiku San sometimes lacks Renshen in texts, but the original contained it. Without proper exterior-interior-upper-lower harmonization, attempting to support righteousness to expel pathogen is excessive. However, Yu Xichang used double Renshen for a plague with success. This is "method beyond method," based on Zhang's formulas. Why? After famine and war, Righteous Qi was ruined. Fortunately, the deficiency was not chronic consumption, and it was used with many exterior-releasing herbs, so tonification worked. Zhang Zhongjing adding Renshen to Baihu Tang for deficiency aligns with this. However, deficiency in Shanghan with exterior syndrome differs from deficiency in Wenbing with heat; the difference between disaster and blessing is subtle. Differentiation is difficult. Those who deleted Renshen from original formulas likely saw this.

The above applications apply to genuine large Ginseng, which is very effective. Modern Dangshen (Codonopsis Radix) is sweet without bitterness, lacking Ginseng's potency. Other Ginseng varieties also lack the "mild and nurturing" quality. Generally, they are similar to Ginseng for tonification, so precautions against misuse should apply to them equally.