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Substitute Mu Xiang (Aucklandiae Radix) with Dang Gui (Angelicae Sinensis Radix), and Cang Zhu (Atractylodis Rhizoma) with Bai Zhu (Atractylodis Macrocephalae Rhizoma).

When Spleen Yang (Spleen Yang) is disordered, symptoms such as borborygmus (intestinal rumbling), Sun Xie (diarrhea with undigested food), and abdominal distension often occur. When Spleen Yin (Spleen Yin) is insufficient, manifestations include mental fatigue, dim vision, and a weak voice. Sweet and warm substances can tonify deficiency and weakness; therefore, Ren Shen (Ginseng Radix et Rhizoma), Di Huang (Rehmanniae Radix), and Gan Cao (Glycyrrhizae Radix et Rhizoma) are used. Bitter and drying substances can level excessive dampness; thus, Cang Zhu (Atractylodis Rhizoma) and Sheng Ma (Cimicifugae Rhizoma) are employed. Light and clear herbs can lift sunken Qi depression; Chai Hu (Bupleuri Radix) serves this purpose. Aromatic substances can dispel stagnant and stale Qi in the middle jiao; Ju Pi (Citri Reticulatae Pericarpium) fulfills this role. Since stale Qi is dispelled, excess is leveled, sunken Qi is lifted, and deficiency is tonified, how could there be any failure to benefit Qi or harmonize the Middle Jiao? Hence the name of the decoction is indeed appropriate.

Sun Xie is also known as Chang Feng (Intestinal Wind). Generally, when Wind Pathogen (Wind) injures the body, it must enter the empty cavities, among which the intestines and stomach are most prominent. Once Wind resides within, the mechanism of guiding the pathology is like sailing with the current; it does not wait for the Spleen's transformation and transportation function. Food enters and immediately exits, resulting in defecation shortly after eating. Those who do not understand this mistake it for Spleen Deficiency causing undigested food in stool, and hastily treat it as Cold invading the Middle during late summer causing Dong Xie (profuse watery diarrhea) or Winter Sun Xie using hot formulas to greatly tonify. This makes the Wind pathogen more vigorous, leading to worsening conditions without end, often leaving one helpless. In fact, by adding Gui Zhi (Cinnamomi Ramulus) in double dosage to this formula, the Wind is led out from the muscle layer, and recovery occurs after one or two doses. Furthermore, Lung Dryness (Lung Dryness) damaging the Lungs also harms against Sun Xie, which is what is meant by "Lung transferring Heat to the Large Intestine, long-term becoming Chang Pi (Dysentery)." When Lung Qi becomes clear, diarrhea stops immediately. If one only considers Spleen Deficiency and uses drying herbs to increase dryness, the condition will transform into Dysentery, then into Constipation, where one desires defecation but cannot achieve it, what then? Occasionally having some thoughts, I add this note here; students should remember it. Adding Wu Wei Zi (Schisandrae Fructus) and Shao Yao (Paeoniae Radix) to this formula introduces restraint within dispersion, also named Tiao Zhong Yi Qi Tang (Regulate the Middle and Boost Qi Decoction).

Poem: For Bu Zhong Yi Qi, Ginseng is permitted, [Note: Original text seems to imply specific ingredients], Orange peel, Licorice, Sheng Ma, Chai Hu, Atractylodes, and Angelica; Swapping Bai Zhu for Cang Zhu and Angelica for Atractylodes, one must know Tiao Zhong Yi Qi well.

Di Huang (Rehmanniae Radix), Fu Zi (Aconiti Lateralis Radix Praeparata - slightly washed to remove pungency, wrapped with Sheng Jiang (Zingiberis Rhizoma Recens) and steamed until very soft), Bai Zhu (Atractylodis Macrocephalae Rhizoma - slightly washed to remove oil, stir-fried with honey), Wu Wei Zi (Schisandrae Fructus), Ren Shen (Ginseng Radix et Rhizoma), Mai Men Dong (Ophiopogonis Radix - heart removed), Huai Niu Xi (Achyranthis Bidentatae Radix).

Among the above, Di Huang (Rehmanniae Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) are premier choices for the Pre-Heaven and Post-Heaven roots. Their functions specialize in tonifying Spleen Yang and Kidney Yin, but their properties are uncoordinated regarding dryness and dampness. The brilliance lies in Wu Wei Zi (Schisandrae Fructus), Mai Men Dong (Ophiopogonis Radix), and Niu Xi (Achyranthis Bidentatae Radix) guiding the action into Lung Metal, thereby grasping Qi and nourishing the source of transformation. Mutual restriction actually facilitates mutual completion. Additionally, Ren Shen (Ginseng Radix et Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata) drive the medicinal power, assisting True Yuan (True Primordial Qi), naturally causing Fire to interact below and Water to distribute above. Once the image of Ji Ji (Completed Transition) is achieved, the tendency of excessive dryness and depletion recedes. Indeed, this is an excellent formula for hiding Yang within Earth and tonifying Fire within Water. It is suitable for all cases of Deficiency-Labor fever, panting, coughing, hematemesis, and epistaxis, especially when taking heat-clearing and phlegm-resolving agents causes red, painful eyes like needle pricks. Taking this formula not only addresses the symptoms but also hopes to eliminate the root cause subtly.

Poem: The intent of Quan Zhen Formula originates from Gui Zang, Atractylodes, Aconite, Ginseng paired with Rehmannia; Ingeniously entering Ophiopogon, Achyranthes, and Schisandra, Mutual generation and restriction nourish Kun Yang.