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Cistanche (Rou Cong Rong), with a sweet, warm flavor and notes of salty and sour, is non-toxic. It enters the Kidney meridian. It excels at invigorating Yang and stopping metrorrhagia and metrostaxis (abnormal uterine bleeding). Long-term use enables men and women to conceive offspring and warms the waist and knees.

However, it specifically tonifies the water and fire (Yin and Yang) within the Kidney, having no other uses. If used in large doses, it can cause lubrication of the Large Intestine. The ancients treated constipation in deficient patients by using one liang of Cistanche, washing off the saline taste, boiling it in clean water, and administering it orally, which would induce bowel movement; this precisely utilizes its ability to tonify deficiency while lubricating the intestines. Nevertheless, although it tonifies the Kidney, it should not be used exclusively. When combined with herbs such as Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Rehmanniae Radix Praeparata (Shudi), and Corni Fructus (Shanzhuyu)—herbs that tonify Yin and Yang—it yields substantial benefits. It makes the male organ robust and magnificent; when used together with Donkey Penis (Lv Bian), the effect is even more remarkable. However, Euryale Seed (Suo Yang) should not be used. This is because Suo Yang cannot compare to Cistanche; Cistanche is transformed from horse essence, thus possessing miraculous efficacy, whereas Suo Yang is not derived from horse essence. Although it can tonify Yin and invigorate Yang, its efficacy is very weak, so it was despised and excluded by Shennong in the *Shennong Bencao Jing*. In recent times, people have abandoned Cistanche in favor of Suo Yang, which is why I distinguish between them. As for Grass Cistanche (Cao Rou Cong Rong), it must absolutely not be used. Whenever using Cistanche, one must select specimens that are plump and possess scales; only then are they suitable for medicinal use. Otherwise, they are likely Grass Cistanche passed off as genuine, so careful inspection is necessary at the time of purchase.

A question arises: Since Cistanche is highly tonifying, warm in nature, and non-toxic, why does excessive use, which should benefit the Kidney, instead cause loose stools? One must understand that the fleshy part of Cistanche is a substance transformed from horse essence. Horses have a most lustful nature, hence Cistanche can invigorate Yang. Horse essence originates from the Kidney, hence it also nourishes Yin. However, the nature of horses is also most active/restless; therefore, sudden and heavy use easily disturbs the bowels, not because of its slippery taste. ([Commentary] This is a statement consistent with human nature and logical reasoning.)

Another question: Does Cistanche’s tendency to loosen the bowels suggest it is a purgative rather than a tonic? Cistanche is born from tangible essence, truly tonifying rather than draining. Observe elderly patients suffering from constipation; using Cistanche to unblock their bowels reveals that their obstruction stems from insufficiency of essence and blood, not from an excess of pathogenic fire. Can we not deduce from this that it is a tonic and not an attack?

Another doubt: Given that Cistanche is slippery and moves the bowels, can it be used for those with already slippery intestines, or is it contraindicated? Those with slippery intestines often suffer from a lack of Fire in the Kidney. Cistanche invigorates Yang and is a substance that tonifies Fire. How could tonifying Fire fail to firm up the Large Intestine? Thus, while sudden use may cause slipperiness, long-term use will naturally lead to astringency.

Another skepticism: Is Cistanche necessarily produced from horse essence? This herb grows in the sandy soil of border regions year after year like grass; how can there be enough horse essence for this?

The answer is: Cistanche is generated from horse essence. Whether it is or not, how could I determine it? But this theory actually originates from Shennong’s *Bencao Jing*, not from later personal speculation. If Cistanche did not receive the Qi of horse essence, growing in the bitter cold beyond the borders, how could it invigorate Yang and tonify Water and Fire?

A question asks: Wang Haogu once said, “Taking Cistanche to treat the Kidney will inevitably hinder the Heart.” Why have you overlooked this? The response is: This is Wang Haogu’s ignorant and reckless warning due to his lack of understanding of Cistanche. Any herb that tonifies the Kidney must communicate upward to the Heart. Only when the Heart receives the essence of the Kidney can it avoid the affliction of dryness and withering. Cistanche greatly tonifies the essence of the Kidney, which is equivalent to tonifying the Qi of the Heart. What hindrance could there possibly be? ([Commentary] Indeed true.)