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(Mountain Herbs) Tonifies Lung Qi to generate Yin fluids.

Ren Shen (Ginseng Radix et Rhizoma) (Enters the Lung Meridian specifically, and also enters the Spleen Meridian). Its nature is neutral and balanced, neither cold nor dry. Its shape resembles a human, and its qi ranks supreme among herbs. It can restore the primordial qi of the Lung that is on the verge of extinction. (Feng Chuzhan said: Ren Shen can restore Yang qi when it is on the verge of extinction, and dispel deficiency pathogens in an instant. Li Shizhen said: Ren Shen that has grown for many years and gradually matures, with roots resembling the human form, possesses spiritual energy, hence it is called Ren Shen or Shen Cao. The character "Shen" derives from "Jin" (soak/immersion), implying gradual growth. "Shen" is essentially the character "Jin". Because the characters "Shi Yin" were too complex, the character "Shen" from the star name was used instead for simplicity. Huang Gongxiu examines this explanation as reasonable.) However, people fear Ren Shen, often regarding it as aiding fire and qi. Whenever encountering symptoms such as fever due to Shanghan (Cold Damage) or fever due to labor injury and internal damage... (Fever can be caused by both internal injury and external contraction. Only by observing the pulse can one distinguish: floating and rapid with strength indicates external heat; deep and large with strength indicates internal heat; deep and fine with strength indicates excess syndrome; floating and large without strength indicates deficiency syndrome. Fever with a full pulse indicates heat injury and excess syndrome; fever with a floating pulse indicates summerheat injury and deficiency syndrome. Fever accompanied by the ability to speak with strength indicates excess; fever accompanied by reluctance to speak and weakness indicates deficiency. Fever with extreme thirst for cold water indicates excess; fever with slight thirst for warm soup indicates deficiency. Fever that becomes hotter upon prolonged palpation indicates interior heat penetrating the exterior (excess); fever that does not become hotter upon prolonged palpation indicates interior Yang floating to the exterior (deficiency). Fever feeling like burning iron, constant throughout head, feet, and body indicates excess; fever that comes and goes, with hot head but cold feet indicates deficiency. Fever without sweat and blocked urination and defecation indicates excess; fever with sweat and free urination and defecation indicates deficiency. Fever with interior symptoms indicates interior heat; fever with exterior symptoms indicates exterior heat. Fever occurring in autumn and winter, seasons of convergence and storage, tends to be excess; fever occurring in spring and summer, seasons of rising and dispersing, tends to be deficiency.) They fear Ren Shen as if it were poison, believing that since there is already internal heat, administering drugs that aid fire and heat will only make the heat worse. How could they know that Ren Shen is used to tonify deficiency, not to fill excess? In cases of external contraction, if the righteous qi is strong, combining Ren Shen with Huang Qi (Astragali Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata), and Gui Zhi (Cinnamomi Ramulus) indeed aids fire and intensifies it. However, if the primordial qi has always been deficient and pathogens are latent, it is precisely appropriate to use Ren Shen as an assistant. For example, in ancient formulas such as Can Su Yin (Ginseng and Perilla Decoction), Bai Du San (Detoxification Powder), Xiao Chai Hu Tang (Minor Bupleurum Decoction), Bai Hu Jia Ren Shen Tang (White Tiger Plus Ginseng Decoction), Shi Gao Zhu Ye Tang (Gypsum and Bamboo Leaf Decoction), and Huang Long Tang (Yellow Dragon Decoction), Ren Shen is included to lead pathogens outwards. (Yu Jiayan said: In Shanghan, Ren Shen should be used; the differentiation must be clear. Generally, when humans contract external pathogens, sweating must first be induced to drive them out. Only those with robust primordial qi can expel external pathogens with the help of medicinal force. If the person is inherently weak, although the medicine acts outwardly, the qi within becomes depleted. In mild cases, half the pathogen exits and half remains; in severe cases, the pathogen retreats inward following the depletion of qi, causing continuous fever. Therefore, for individuals with weak constitutions, 3-5 fen to 7 fen of Ren Shen must be added to exterior-releasing medicines to slightly assist the primordial qi as the main force driving out pathogens, allowing pathogens to surge out with the drug's power. This is entirely not for the purpose of nourishing weakness.) Moreover, what about fevers not caused by external contraction, but solely due to labor injury? Can Ren Shen be omitted? The reason Ren Shen benefits people is precisely because its power can tonify deficiency. Indeed, if one presents with shortness of breath, diarrhea, fright, fatigue, spontaneous sweating, dizziness, abdominal fullness with food stagnation due to deficiency, it is certainly appropriate to use Ren Shen to fill the deficiency. Even if one presents with coughing blood, strangury and retention, lower bleeding and blood loss, or panting, fullness, irritability, thirst, and constipation due to deficiency, how can one fail to treat these as deficiency syndromes and not use Ren Shen? Furthermore, texts state: Ren Shen combined with Sheng Ma (Cimicifugae Rhizoma) can drain Lung fire; combined with Fu Ling (Poria) it can drain Kidney fire; combined with Mai Dong (Ophiopogonis Radix) it can generate the pulse; combined with Huang Qi and Gan Cao (Liquiritiae Radix) it can reduce fever. (From Zhang Yuansu) Thus, Ren Shen is even more a formula for draining fire. Why then should it not be used? The key lies in the two characters "Excess" and "Deficiency". If these are clearly distinguished beforehand, medication will naturally avoid error. (The crucial point of treating diseases.) Jiegu stated that Ren Shen should not be used for wheezing and coughing because of phlegm-excess and qi-stagnation. But if it is Kidney-deficiency causing shortness of breath and panting, how can it be forbidden? Zhongjing stated that Ren Shen should not be used for cough due to Lung-cold because cold binds heat pathogens, causing stagnation in the Lung. But if there is spontaneous sweating, aversion to cold, and cough, how can it be forbidden? Dongyuan stated that Ren Shen should not be used for long-standing stagnant heat in the Lung because fire stagnating internally is unsuitable for tonification. But if there is Lung-deficiency with hyperactive fire, shortness of breath, and sweating, how can it be forbidden? Danxi stated that Ren Shen should not be suddenly used for various pains because pathogens are sharp and tonification is unsuitable. But if there is interior deficiency with vomiting and diarrhea, or long-standing stomach weakness, or pain due to deficiency that prefers pressure, how can it be forbidden? Jiezhai stated that Ren Shen should not be used for hemoptysis due to Yin-deficiency with hyperactive fire because of blood-deficiency and hyperactive fire. But if there is spontaneous sweating, shortness of breath, cold limbs, and a deficient pulse, how can it be forbidden? The concepts of Excess and Deficiency must be compared most carefully. (Yan Wen said: Those with white, yellow, green, or sallow faces all have insufficient Qi of the Spleen, Lung, and Kidney, and can use Ren Shen. Those with red or black faces have strong Qi and spirit, and cannot use it. Pulses that are floating and knotted, soggy, deficient, large, slow, and weak; or deep, slow, choppy, thin, fine, knotted, or intermittent and weak, all indicate deficiency and insufficiency, and can be used. If the pulse is wiry, long, tight, solid, slippery, rapid, and strong, it indicates fire stagnation and interior excess, and cannot be used.) If there is truly Qi-depletion and fire-extinction, then Ren Shen, even when combined with Fu Zi and Gui Zhi, can be administered. If fire is hyperactive and breathing is rapid, then Ren Shen, even when combined with Zhi Mu (Anemarrhenae Rhizoma) and Huang Bo (Phellodendri Cortex), must be strictly avoided. As for situations where Yin qi is slightly deficient and Yang qi is weaker, such that Yin cannot withstand fire steaming, Ren Shen can be used as the Sovereign herb. When Yin qi is slightly declining and Yang qi is weaker, yet fire appears slightly prominent, Ren Shen can be used as an Assistant herb. This is because Yang has the function of generating Yin, while Yin has no principle of benefiting Yang. Although Ren Shen is known for tonifying Yang and assisting Qi, it can also nourish Yin and generate Blood. Therefore, ancients used Si Wu Tang (Four Substance Decoction) to tonify Blood, but always combined it with Ren Shen; the rationale is based on this. (Guo said: Ancients treated blood loss by tonifying Qi, because Blood does not generate itself; it requires drugs that generate Yang Qi to produce it. When Yang generates, Yin grows, and Blood becomes abundant. If only blood-tonifying drugs are used alone, Blood has no way to generate. The Su Wen states: Without Yang, Yin cannot be generated; without Yin, Yang cannot be transformed. Therefore, for tonifying Qi, Ren Shen must be used; for Blood deficiency, Ren Shen must also be used.) This is unlike Huang Qi, whose nature is purely Yang with very little Yin, making it unsuitable for conditions with hyperactive fire and dry Blood. Sha Shen (Glehniae Radix) is sweet, bland, and cold, specializing in draining Lung fire, with very little tonifying effect. Xuan Shen (Scrophulariae Radix) is bitter, salty, cold, and slippery, black entering the Kidney, only treating rootless fire of the Kidney meridian attacking the throat, offering no benefit to Qi. Wei Yu (Polygonati Odorati Rhizoma) is sweet and neutral; although it can tonify Middle and assist Qi, its moist texture and bland taste only allow it to moisten the Lung and stop cough, and treat wind-dampness; it is still not a Qi herb for the Lung. Therefore, texts record that Ren Shen benefits Earth to generate Metal, brightens the eyes, opens the mind, enhances wisdom, adds essence, assists spirit, calms fright, and stops palpitations. (When Righteous Qi is tonified, Evil Fire recedes naturally.) Relieves thirst and removes irritability. (When Qi is tonified, Fire does not float, and irritability is removed; when Qi is tonified, Jin Ye rises, and thirst stops.) Unblocks meridians and generates the pulse. (When Qi is tonified, Blood follows Qi, and the pulse arrives.) Breaks accumulations and eliminates phlegm. (When Qi moves, food digests naturally, and accumulations break; when Qi is vigorous, fluids are promoted, and phlegm disappears.) Fever and spontaneous sweating. (Qi is tonified, and Yang is secured.) Frequent dreams. (Qi is tonified, and Spirit gathers.) Vomiting, hiccup, regurgitation, deficiency-cough, and panting. (Qi is tonified, and Lung and Stomach are pacified.) Long-standing chronic diarrhea. (Qi is tonified, and Clear Qi rises.) Strangury and distension/fullness. (Qi is tonified, and Turbid Qi descends.) Summerheat stroke and wind-stroke. (Qi is tonified, and pathogens are resolved externally.) All symptoms of Qi deficiency and Blood damage. (Qi is tonified, and Blood is secured internally.) These are all essential uses. Regarding the statement that Ren Shen fears Ling Zhi (Glycyrrhizae Radix et Rhizoma with Honey-frying? Note: Ling Zhi usually refers to Glycyrrhiza, but in compatibility contexts, it might refer to other interactions, here likely referring to traditional incompatibilities), there are cases where Ren Shen is used together to treat amenorrhea; this is "fearing but not fearing". Ren Shen dislikes Zao Jia (Gleditsiae Sinensis Fructus), yet there is the Jiao Tai Wan (Peaceful Intersection Pill) using them together; this is "disliking but not disliking". Ren Shen is incompatible with Li Lu (Veratri Radix), yet there are cases using them together to induce vomiting; this borrows the antagonism to provoke its anger, so although contrary, they do not contradict. However, only those deeply versed in medicine can know these mysteries. (From Yan Wen's family). But Ren Shen is originally warm; accumulated warmth can become heat. Therefore, it is strictly contraindicated for Yin-deficiency with hyperactive fire, cough, and panting. Ren Shen is best when yellow, moist, tight, solid, and resembling a human. Shangdang is the authentic production area for Ren Shen, but locals have long ceased harvesting it. (Li Shizhen said: Shangdang is now Luzhou. Locals consider Ren Shen a local hazard and no longer harvest it. What is used now is all Liaoshen [Liaoning Ginseng].) What is now called Dang Shen (Codonopsis Radix) is all fake. (Li Shizhen said: Fakes are made from Sha Shen, Qi Ni (Adenophorae Radix?), and Jie Geng (Platycodonis Radix), harvested and processed to confuse. Sha Shen is hollow and bland; Qi Ni is hollow; Jie Geng is solid with a heart and bitter; Ren Shen is solid and sweet, slightly bitter.) Next is Ren Shen from Baekje, which is weaker than Shangdang. Then comes Ren Shen from Goryeo and Liaodong, which is weaker than Baekje. Iron must be avoided during use. For long-term storage over a year, it must be dried with ash-leached water or stored in porcelain jars mixed with fried rice. Ren Shen Xu (Ginseng Fibers) primarily directs downward and drains, similar to Zi Wan (Asteris Radix) and Dang Gui Wei (Angelicae Sinensis Radix Tail) in breaking blood. It is contraindicated for sliding/loose conditions. Ren Shen Lu (Ginseng Stems) primarily directs upward and induces vomiting; it is also contraindicated for Qi deficiency with flaming fire. However, for body deficiency with phlegm congestion, it can substitute Gua Di (Melonis Fructus). New Dang Shen from the Taihang Mountains in Shanxi only clears the Lung and has no tonifying effect, completely different from the authentic, long-sealed Dang Shen. Further details are in the Dang Shen discussion; they should be examined together.