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Chen Shiduo said: The qi and blood of the elderly have already declined, and their treatment cannot follow the same methods as those for the young. Therefore, excessive eating leads to fullness and chest oppression; insufficient eating leads to fatigue and hunger; consuming cold foods causes abdominal pain; and consuming hot foods results in intestinal dryness. These are the most difficult conditions to regulate and treat in the elderly, and physicians must know the appropriate prescriptions when prescribing medication. Among pill formulations, none is more exquisite than Liuwei Wan (Six-Ingredient Pill with Rehmannia). By adding 3 liang of Maidong (Ophiopogonis Radix) and 1 liang of Bei Wuweizi (Schisandrae Chinensis Fructus), and having the elderly take it regularly, they will be relieved of the suffering of intestinal dryness and constipation, and the stomach will enjoy the pleasure of appetite. The brilliance of this prescription lies in its ability to sustain regular use from age sixty to one hundred, without interruption throughout the year. This is because the deficiency of qi and blood in the elderly stems entirely from the depletion of Kidney Water (Jin-Ye/Kidney Yin). Liuwei Wan is exquisite because it strongly tonifies Kidney Water, strengthens the Qi of the Spleen and Stomach, clears pathogenic fire from the Kidneys, and generates the True Yang within the Kidneys; thus, it is most suitable for the elderly. However, the elderly are least willing to regulate their diet. How then should this be treated? I have now newly formulated a prescription that can comprehensively manage symptoms of food stagnation and excessive phlegm. The formula consists of: Renshen (Ginseng Radix et Rhizoma) 5 fen, Fuling (Poria) 1 qian, Baijiezi (Brassicae Seminium) 1 qian, Maidong (Ophiopogonis Radix) 3 qian, Yiren (Coicis Semen) 5 qian, Shanyao (Dioscoreae Rhizoma) 2 qian, Chenpi (Citri Reticulatae Pericarpium) 3 fen, Maiya (Hordei Fructus Germinatus) 5 fen, Shanzha (Crataegi Fructus) 3 pieces, Shenqu (Massa Medicata Fermentata) 3 fen, Luobozhi (Raphani Semen) 3 fen, Gancao (Glycyrrhizae Radix et Rhizoma) 5 fen. Decoct in water and take orally. If there is heat/fire, add Yuanshen (Scrophulariae Radix) 2 qian; if there is cold, add Rougui (Cinnamomi Cortex) 5 fen; if there is phlegm, add Banxia (Pinelliae Rhizoma) 5 fen; if there is food stagnation, add Shanzha and Maiya; if there is dampness, add Zexie (Alismatis Rhizoma) 1 qian; if there is summerheat, add Xiangru (Elsholtziae Herba) 5 fen; if there is dryness, add Maidong 5 qian and Sueye (Perillae Folium) 5 fen; if there is insomnia, add Zaoren (Ziziphi Spinosomi Semen) 1 qian; if there is hypochondriac pain, add Baishao (Paeoniae Radix Alba) 3 qian; if there is heart pain, add Zhizi (Gardeniae Fructus) 1 qian; if there is cough, add Jiegeng (Platycodonis Radix) 1 qian; if there is soreness and weakness of the lower back, add Shudi (Rehmanniae Radix Preparata) 5 qian and Duzhong (Eucommiae Cortex) 5 qian; if there is weakness in the feet, add Niuxi (Achyranthis Bidentatae Radix) 1 qian. For other conditions, no further additions are necessary. From this, one can understand the principles of treating the elderly.

Mr. Zhang said: The therapeutic principles for the elderly are the most stable and appropriate; there is no need to establish new prescriptions.

Mr. Hua said: None.

Additionally, there is another prescription that is most effective for treating insomnia in the elderly. Take one batch of Liuhuang Dihuang Wan (Six-Ingredient Rehmannia Pill), add Maidong 4 liang, Chao Zaoren (Fried Ziziphi Spinosomi Semen) 5 liang, Huanglian (Coptidis Rhizoma) 3 qian, Rougui 5 qian, Danggui (Angelicae Sinensis Radix) 3 liang, Baishao 5 liang, Ganjuhua (Chrysanthemi Flos) 3 liang (preferably home-grown), and Baijiezi 2 liang. Grind into fine powder and form pills with honey. Take 5 qian daily with plain boiled water, followed by a meal. The elderly can take this prescription until the age of one hundred.