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Yellow sweat (sweat with yellow discoloration caused by damp-heat stagnation) has appeared. However, if the Cun position pulse (the radial pulse at the wrist crease, governing the Kidney and lower Jiao) of the patient is slow and forceless, one must not lightly employ diaphoresis (sweating therapy), because this is due to the deficiency of Qi and Blood in Ying (Nutritive) and Wei (Defensive) levels. When Qi and Blood are deficient, they cannot withstand the consumption of diaphoresis. One must still use Mahuang Tang (Ephedra Decoction) but add a large amount of Renshen (Ginseng Radix et Rhizoma) to tonify, so that Yuan Qi (Original Qi) becomes sufficient and can generate Qi and Blood from the void (Wu He You Zhi Xiang). Only then is it acceptable. If Renshen is used sparingly while Mahuang (Ephedrae Herba) is increased, the Yuan Qi is already deficient, and the body will struggle to bear the force of diaphoresis; this is also a path to failure. ([Commentary] Using Renshen in the context of Shanghan diseases opens a new pathway.)

A question arises: Can Renshen be used to treat Zangjie (Visceral Knotting) in Shanghan? The disease of Zangjie results from Yin deficiency compounded by the contraction of Yin pathogens. It is originally a fatal condition, not something Renshen can save. Yet, apart from Renshen, there is no other herb to effect a cure. This is because Renshen can penetrate up and down, restore the nearly extinct Yuan Yang (Original Yang), and return Yin to the Dantian. Although it cannot guarantee survival for everyone, it can treat those who would otherwise die, saving them from death.

Another question: Can Renshen be used for irritability and restlessness (Fan Zao) in Shanghan? Irritability varies. There is irritability occurring after purgation (Xia fa), and there is irritability without prior purgation. Irritability arising without purgation is caused by pathogenic factors and Renshen must absolutely not be used. If irritability occurs after purgation, it is due to extreme deficiency of Yin and Yang, failing to nourish the Heart and Danzhong (Pericardium region). In such cases, Renshen must be used. However, distinctions between Yin deficiency and Yang deficiency must be made. For Yin deficiency, Renshen should be added in small amounts within formulas that tonify Yin. For Yang deficiency, Renshen should be added in large amounts within formulas that tonify Yang. How can one distinguish between Yin and Yang deficiency? In Yin deficiency, symptoms worsen at night and improve during the day. In Yang deficiency, symptoms worsen during the day and improve at night.

Question: In Yangming disease, delirium (Chan Yu) accompanied by tidal fever (Chao Re) presents with a slippery and rapid pulse, clearly indicating excess pathogen. After using Chengqi Tang (Bowel-Unblocking Decoction), if stool remains unpassed and the pulse changes to faint, choppy, and weak, does this not indicate fluid dryness due to pathogenic invasion? When attacking the pathogen further exacerbates Zheng Qi (Upright Qi) deficiency, and tonifying Zheng Qi fails to disperse the pathogen, can Renshen be used at this juncture? Alas! Apart from Renshen, what else can snatch life back? One uses Renshen but dares not claim certainty of survival. The method is to decoct 1 liang of Renshen with 1 qian of Dahuang (Rhei Radix et Rhizoma) together. If bowel movement is achieved and Qi does not collapse, the patient lives; otherwise, survival cannot be guaranteed.

Question: You stated that Huai Zheng (Complicated/Failed Conditions of Shanghan) particularly suits the use of Renshen. Why? Huai Zheng results from inappropriate diaphoresis, emesis, or purgation when these methods were contraindicated. All three damage Stomach Qi. To rescue damaged Stomach Qi, what else but Renshen can achieve success? Therefore, if diaphoresis was inappropriate, Renshen must be used for sweating to cease; if emesis was inappropriate, Renshen must be used for vomiting to stop; if purgation was inappropriate, Renshen must be used for diarrhea to halt. Using Renshen turns danger into safety and death into life. However, without increasing the dosage, the efficacy is limited, and it may not fully rescue the damage caused by improper sweating, vomiting, or purging.

Question: When Shanghan transmits to the Shaoyin channel, presenting with cold limbs (Si Ni), aversion to cold, vomiting, lethargy, absent pulse, and restlessness without irritability, this indicates Yang floating outward and Yin nearing extinction. Can adding Renshen to Fuzi (Aconiti Lateralis Radix Praeparata) effect a cure? Alas! Extinction of both Yin and Yang is fundamentally incurable. Yet, combining Renshen with Fuzi often yields survivors. This is because True Yin and True Yang are prone to leakage but difficult to completely extinguish. As long as a thread of root remains, rescuing Yang brings Yang back immediately, and rescuing Yin reconnects Yin immediately. Since True Yin and True Yang are formless, they differ from material forms. It is better to use Renshen and Fuzi to generate Qi and Blood in the void than to prematurely dismiss their efficacy and discard Renshen entirely, causing the souls of the dead to weep at night.

Question: When Shanghan transmits to Shaoyin, presenting with a faint, thin, nearly imperceptible pulse, sweating without irritability, upper vomiting, and lower diarrhea, this is an untreatable condition. Can Renshen be used to save it? Apart from Renshen, how else can it be saved? However, Lizhong Tang (Regulate the Middle Decoction) must be added to urgently secure the Yang in the Kidneys. Otherwise, True Yang will be disturbed and scatter instantly. Relying solely on Renshen is of no benefit. ([Commentary] This elucidation is exquisite.)

Question: In Shanghan diarrhea occurring more than ten times daily, excessive loss leads to Yin depletion, and the pulse should be deficient. Now, instead of being deficient, it appears excess. Can Renshen be used to tonify the deficiency? Given severe diarrhea, a pulse appearing "excess" rather than "deficient" does not indicate robust Zheng Qi, but rather abundant Pathogenic Qi. Although excess pathogens seem incompatible with tonifying Zheng Qi, it is unknown that severe Zheng Qi deficiency manifests as apparent pathogenic excess. If Zheng Qi is not urgently tonified, overwhelming pathogens will cause Zheng Qi to collapse. Discussing this case, it is also a fatal condition. To seek life amidst death, apart from Renshen, there is truly no other medicine. Nevertheless, using Renshen alone without herbs that drain water-dampness as adjuncts will not yield extraordinary results. It is appropriate to use 1–2 liang of Renshen combined with 5–6 qian of Fuling (Poria) taken together, so that Zheng Qi does not collapse and water-dampness pathogens can be stopped. ([Commentary] Investigating the root and tracing the source allows mastery of variations.)

Master Lu’s General Commentary: People today are not as robust as ancients. Even when healthy, one cannot lack Renshen to tonify Qi, let alone during illness when True Qi is being consumed. Thus, Renshen is not only suitable for use but ideally suited for frequent use. However, ignorance of Renshen’s functions leads to reckless application that misses the mark, often resulting in harm rather than benefit from Renshen. Mr. Chen Yuangong, pitying the world, sought to clarify the functions of Renshen to inform the public. He wrote the chapter on Renshen, leading to the composition of *Bencao Xinbian* (New Compendium of Materia Medica). I read it and marveled at its novelty, commenting line by line with admiration but no bias. His arguments are balanced and orthodox, not one-sided.