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The life and death of all things fundamentally stem from Yang Qi; yet today, nine or ten out of ten people suffer from Yin deficiency. How should this be explained? It is unknown that this character "Yin" is precisely the root of Yang Qi. Indeed, Yin cannot exist without Yang; without Qi, Form cannot be generated. Yang cannot exist without Yin; without Form, Qi cannot be borne. Therefore, the generation of things comes from Yang, and their completion/form is achieved through Yin. This is what is referred to as Primordial Yin and Primordial Yang, also called True Essence and True Qi. The previous chapter discussed the generating and destroying aspects of Yin and Yang, describing their nature and function in terms of Cold and Heat; this chapter discusses the generating and completing aspects of Yin and Yang, describing their physical form in terms of Qi and Substance. Nature and function wield the power of waxing and waning, while the physical body is the foundation of existence and destruction. To understand the cause of death, one must observe Yang; observing Yang means observing whether it is declining or not. To understand the cause of destruction, one must observe Yin; observing Yin means observing whether it is deteriorating or not. This is the essential method for preserving life. Examining the views of predecessors, there are many errors; they fail to recognize the true face of True Yin and often force their arguments. Since Liu Hejian's theory of Fire became prevalent, Zhu Danxi advocated using bitter-cold substances to tonify Yin, a practice followed by the world and difficult to stop. Investigating the cause, it is likely because Heat syndromes are obvious and easily seen by people, whereas Cold syndromes are subtle and largely unknown. Moreover, distinguishing between Deficient Fire and Excess Fire is particularly difficult. Who knows that diseases caused by Excess Heat account for only three or four out of ten, while diseases caused by Deficient Fire account for six or seven out of ten? Excess Heat is merely ordinary Fire. When ordinary Fire is excessive, Yuan Qi (Original Qi) is not inherently damaged, so it can be subdued with bitter-cold herbs. One can prescribe freely, what difficulty is there? However, once the heat is gone, treatment must stop; overuse will inevitably damage Yuan Qi. How can one mistakenly treat it as Fire? Deficient Fire is caused by the depletion of True Yin. If True Yin is insufficient, how can bitter and harsh substances fill it? Furthermore, the nature of deep-cold herbs lacks vitality; they not only fail to tonify Yin but also destroy True Fire. Frequent use often leads to cold essence and infertility, and invariably暗损s longevity, though due to the gentle and slow nature of Yin, people do not notice it gradually. I have observed that many long-lived people carefully avoid raw and cold foods, thereby preserving their Yang Qi. Even elderly people who prefer coolness do so because their Primordial Yang is sufficient, allowing them to tolerate cold; it is not that coldness makes them live longer. Thus, it is evident that my words are not erroneous. Since I had memory, I have witnessed countless harms caused by bitter-cold herbs. This is not the error of contemporary physicians, but rather the result of the transmission by Liu [Hejian] and Zhu [Danxi]. The benevolent virtue of the Ancient Kings has been corrupted by this. If the words of Liu and Zhu do not cease, the grace of Xuanyuan and Qibo will not be manifest. This is truly a great demon of our Dao, and a misfortune for the people. Achieving virtue while covering flaws—is this not the way of a gentleman? What is my heart, daring to discuss predecessors? I fear that if I do not argue strongly, future generations will remain hesitant, trapped in a long dream, causing deeper harm. My thought is simply that I know only of Xuanyuan and Qibo, not of the various masters; I know only of loving life, not of avoiding taboos. These words cannot remain unspoken. However, if spoken unclearly, it is better not to speak at all. Let me explain in detail the image, organ, function, disease, and treatment of True Yin to fully elucidate its meaning.

The "image" of True Yin is like a house, like utensils, like a wife and her family. A house is valued for storing wealth; without a house, wealth will scatter. Utensils are valued for protecting items; without utensils, items will be destroyed. A wife and her family are valued for assisting the husband; without them, the husband will become dissolute. This illustrates that Yin takes Yang as its master, and Yang takes Yin as its root. The Classic says: "The five Zang organs are those that store Jing (Essence); they must not be injured. Injury leads to loss of control and Yin deficiency; Yin deficiency leads to lack of Qi; lack of Qi leads to death." Does this not regard Jing as True Yin? It also says: "If flesh and form are already emaciated, even if the nine pulses are harmonious, death will occur." Does this not regard Form as True Yin? Observing whether the physical constitution is intact or deteriorated reveals whether True Yin is injured or not. This image of True Yin must not be overlooked.

The "organ" of True Yin: All five Zang organs and five fluids have their respective rulers, indicating that all five Zang organs belong to Yin. However, the Classic states: "The Kidney governs Water and receives the Jing of the five Zang and six Fu organs to store it." Thus, the five fluids return to Jing, and the five Jings are unified by the Kidney. The Kidney has a chamber for Jing, called Mingmen (Gate of Life), which is the dwelling of Tianyi (One Heaven), i.e., the Fu organ of True Yin. Jing is stored here; Jing is the Water within Yin. Qi transformation occurs here; Qi is the Fire within Yin. Mingmen resides between the two kidneys, serving as the Taiji (Supreme Ultimate) of the human body. From Taiji arise Liangyi (Two Polarities), where Water and Fire are established, and their waxing and waning depend on it. Thus, it is the beginning of conception and the root of life and nature. To treat True Yin while abandoning Mingmen is incorrect treatment. This organ of True Yin must not be overlooked.

The "function" of True Yin: The functions of Water and Fire are indispensable. The Fire of Mingmen is called Yuan Qi (Original Qi); the Water of Mingmen is called Yuan Jing (Original Essence). When the five fluids are abundant, the physical body relies on them to be strong; when the five Qi are regulated, Ying (Defensive) and Wei (Nutritive) rely on them to be harmonious. These Waters and Fires of Mingmen are the source of transformation for the twelve Zang-Fu organs. Thus, the Heart relies on them for the Sovereign to be clear; the Lung relies on them for regulation to proceed; the Spleen and Stomach rely on them for the richness of granaries; the Liver and Gallbladder rely on them for the basis of strategy; the Bladder relies on them for Qi transformation of the Sanjiao (Triple Burner); the Large and Small Intestines rely on them for distinct conduction and transmission. Although these are said to be the skills of the Kidney, they are actually the functions of True Yin and must not be overlooked.

The "disease" of True Yin: Yin Qi never has excess; Yin diseases are all deficiencies. For example, Yin excess in the lower part is originally not Yin excess, but due to the decline of Mingmen Fire; Yang excess at the surface is originally not Yang excess, but due to the depletion of Mingmen Water. If the source of Water is depleted, Yin deficiency diseases emerge continuously; if the root of Fire declines, Yang deficiency syndromes appear repeatedly. For instance, Daiyang syndrome presents with a red face like cinnabar; Geyang syndrome presents with external heat like fire. There may be thirst and dry scorching throat, constantly drawing water to save oneself; or restlessness and mania, wanting to lie in mud. There may be heat in the five centers, wasting-thirst, and bone-steaming fever; or constipation of both bowels and bladder, with urine like juice. There may be hematemesis or epistaxis; or cough and spermatorrhea. There may be macules and jaundice without sweat, due to the exhaustion of body fluids; or stroke and convulsions, due to the ruin of Jing and Blood. All such cases belong to rootless flames or fire failing to return to its origin. These are all cases where Yin is insufficient to balance Yang, with the disease located in the Water of Yin.

Furthermore, if Fire is deficient below, Yang declines above. There may be mental dullness and fatigue, or drowsiness in movement. There may be dizziness and paralysis of the seven orifices; or choking in the throat, nausea, and shortness of breath. These are all Yang deficiency of the Upper Jiao. There may be indigestion, acid regurgitation, and reverse vomiting; or fullness, obstruction, and phlegm from water flooding. These are all Yang deficiency of the Middle Jiao. There may be indistinct clear and turbid, intestinal murmurs, and slippery diarrhea; or impotence, cold essence, and frequent abdominal pain. These are all Yang deficiency of the Lower Jiao. Or there may be aversion to cold and shivering, due to Yang deficiency of the Fire Organ (Heart) failing to resist cold; or muscle swelling, due to Yang deficiency of the Earth Organ (Spleen) failing to control water; or spasms and painful bi-syndrome, due to Yang deficiency of the Wood Organ (Liver) failing to nourish sinews; or cold cough and deficiency wheezing, cool body and spontaneous sweating, due to Yang deficiency of the Metal Organ (Lung) failing to protect the Lung; or seminal emission and blood loss, incontinence, waist and spine feeling broken, extreme bone pain, due to Yang deficiency of the Water Organ (Kidney) leading to internal exhaustion of essence and marrow. All such cases are either due to Yin strength counter-attacking Yang, or due to Yuan Qi being damaged. These are all cases where Yang is insufficient to overcome Yin, with the disease located in the Fire of Yin. Wang Taipu said: "When cold does not cure cold, blame the lack of Water; when heat does not cure heat, blame the lack of Fire." Lack of Fire and Water both reside in Mingmen. Generally termed Yin deficiency diseases, this must not be overlooked.

The "treatment" of True Yin: Since chaos has its origin and disease has its cause, treating disease requires seeking the root. The root of the five Zang organs lies in Mingmen; the root of Shen Qi (Spirit and Qi) lies in Yuan Jing. This is what is meant by True Yin. Wang Taipu said: "Strengthen the master of Water to control the sunlight; benefit the source of Fire to dissipate the shade." This is exactly what is meant. Xu Xueshi said: "Tonifying the Spleen is inferior to tonifying the Kidney." This is also what is meant. Recently, only Xue Lizhai of our Ming Dynasty has grasped this subtlety. He commonly uses Zhang Zhongjing's Bawei Wan (Eight-Ingredient Pill), which is a Fire-benefiting formula; and Qian Yi's Liuwei Wan (Six-Ingredient Pill), which is a Water-strengthening formula. Using them to help people often yields miraculous effects, which is indeed good. However, since True Yin is already deficient, it is unsuitable to further drain. Both formulas use Fuling (Poria) and Zexie (Alisma), which are too draining. Even Zhang Zhongjing's Jingui Yaolue was designed for draining water. Although adding these to major tonification seems harmless, it inevitably reduces tonifying power and makes efficacy difficult to achieve. If Yin Qi is weak but not severely damaged, or if Zang Qi is slightly stagnant with accompanying phlegm-dampness or water evil, then these are appropriate. But if Jing and Qi are severely damaged, age and strength are declining, True Yin is internally lacking, and symptoms include deficiency-phlegm and false-fire, even pure tonification may seem insufficient; adding draining agents would be like using a sieve. Therefore, one must observe the severity and urgency, and adjust medication according to the individual, which is perfect. I did not comprehend the principle of tonifying Yin until middle age. I then expanded upon its meaning, adopting the intent of Liuwei Wan but not its prescription. The results of saving lives were immediate and numerous, beyond full description. Pathological changes are not singular; why focus solely on Yin? Those who do not understand will surely laugh at this as absurd. Let me state it again briefly. When cold pathogenic factors invade humans, it is initially a Exterior Syndrome, but the transformation of sweat depends on Yin. Wind-stroke causes hemiplegia, and the ruin of sinews and vessels depends on Yin. Deficiency-consumption generates fire; how else can strengthening Water save it from raging flames? Diarrhea damages True Yin; how else can tonifying the Kidney secure the gates? Distension is due to water evil; the ruler of water must seek the Water Organ. Guan-Ge originates from Yin deficiency; to strengthen Yin, one cannot abandon Yin. These few points are the greatest guidelines among diseases. The enlightened can reflect on them repeatedly. Thus, treating water and fire both start from Kidney Qi. This emphasizes Mingmen, where Yang is based on Yin. Laozi said: "Know the male, keep to the female." The male moves and acts; the female is still and guards. Yet movement returns to stillness; the male returns to the female. This is why the male must be known, and the female guarded. Shao Zi said: "March spring light cannot be kept; spring returns, spring intent is hard to assign. Whatever speaks of returning must return home. Ask where is the home of spring?" Spring has feet, coming and going. Recognizing its return allows one to store and keep it, making eternal spring within oneself. These two sages' teachings are truly my great teachers. If one knows that the male contains the female, and spring has a home, one understands the meaning of True Yin. Therefore, I formulated the Ergui Pills, wishing to share them with those who understand the root.

Zuogui Wan (Left Return Pill): Treats insufficiency of True Yin and Kidney Water, unable to nourish Ying and Wei, gradually leading to emaciation; or alternating deficiency-heat, spontaneous sweating, and night sweats; or Spirit not residing in its house, Blood not returning to its origin; or injury from labor damaging Yin; or involuntary spermatorrhea and dribbling; or Qi deficiency causing dizziness; or blurred vision and deafness; or dry mouth and tongue; or soreness and weakness of waist and legs. For any condition involving internal exhaustion of essence and marrow, and withering of body fluids, one should quickly adopt the method of strengthening the master of Water to cultivate the Primordial Yin of the Left Kidney. This pill is indicated.
Prepared Rehmannia Root (8 liang), Yam (stir-fried, 4 liang), Cornus Fruit Flesh (4 liang), Tortoise Shell Glue (cut small and stir-fried into beads, 4 liang), Sichuan Achyranthes Root (wine-washed and steamed, 3 liang), Deer Antler Glue (broken and stir-fried into beads, 2 liang), Dodder Seed (processed and cooked, 3 liang), Goji Berry (3 liang).
First, pound the Prepared Rehmannia into a paste, mix with refined honey, and make pills the size of tung seeds. Take over 100 pills before meals, washed down with boiling white water.

If True Yin fails to hold and Deficient Fire flares upward, use pure Yin and extremely quiet herbs. Remove Goji Berry and Deer Antler Glue from the base formula, add Ligustrum Lucidum Fruit (3 liang) and Ophiopogon Tuber (3 liang). If Fire scorches Lung Metal causing dryness and frequent cough, add Lily Bulb (3 liang). If night fever and bone-steaming occur, add Ground Tree Bark (3 liang). If urination is difficult, add Poria (3 liang).
If stool is dry and obstructed, remove Dodder Seed and add Cistanche Stem (wine-washed, 3 liang).
If Blood deficiency with stasis exists, add Angelica Sinensis Root (4 liang) to the base formula.
All five fluids are governed by the Kidney; thus, all herbs belonging to the Yin aspect can enter the Kidney. Claims that guiding herbs are necessary show a lack of insight.

Yougui Wan (Right Return Pill): Treats insufficiency of Primordial Yang, congenital weakness, or excessive labor leading to decline of Mingmen Fire, inability to generate Earth, resulting in Spleen-Stomach deficiency-cold, poor appetite, nausea, bloating, reverse vomiting, obstruction, fear of cold, abdominal pain, loose stools, frequent diarrhea, urinary incontinence, deficiency dribbling, cold hernia, joint bi-pain from cold invading valleys, or edema from water evil in the Lower Jiao. In short, for True Yang insufficiency presenting with mental fatigue, Qi timidity, palpitations, limb flaccidity, visual hallucinations, or impotence and infertility, one should quickly adopt the method of benefiting the source of Fire to cultivate the Primordial Yang of the Right Kidney. This pill is indicated.
Huai Prepared Rehmannia Root (8 liang), Yam (stir-fried, 4 liang), Cornus Fruit (lightly stir-fried, 3 liang), Goji Berry (lightly stir-fried, 4 liang), Deer Antler Glue (stir-fried into beads, 4 liang), Dodder Seed (processed and cooked, 4 liang), Eucommia Bark (stir-fried in light ginger soup, 4 liang), Angelica Sinensis Root (3 liang, do not use if stools are loose), Large Aconite Root (start from 2 liang, gradually increase to 6 liang, depending on the person), Cinnamon Bark (start from 2 liang, gradually increase to 4 liang, depending on the person).
Prepare pills as before, or make them the size of quail eggs. Chew 2-3 pills each time, washed down with boiling white water for faster effect.
If Yang deficiency and Qi deficiency are severe, add Ginseng Root as the chief ingredient, 2-3 liang or 5-6 liang, adjusting according to deficiency or excess. Ginseng's function enters the Yang aspect when combined with Yang herbs, and the Yin aspect when combined with Yin herbs. Thus, to rapidly tonify Mingmen Yang, Ginseng is essential.
If Yang deficiency causes seminal emission, or cloudy leukorrhea and loose stools, add Psoralea Fruit (wine-fried, 3 liang). If飧泄 (undigested food diarrhea) or Kidney diarrhea persists, add Nutmeg (flour-fried and oil removed, 3 liang).
For nausea and acid regurgitation, add Dried Ginger (3 liang).
For unremitting abdominal pain, add Evodia Fruit (2 liang, soaked in hot water three times then stir-fried).

Method for processing Aconite Root: Select large Aconite Roots weighing about 1 liang each; half a jin yields 6 liang of processed Aconite. First, decoct 4 liang of Licorice Root in thick soup, soak the Aconite for 2-3 days, peel off the thin skin, cut into four pieces, soak for another day until thoroughly penetrated. Remove, cool slightly, slice, and slowly stir-fry over low heat until 70% cooked. Do not overcook, lest it lose its properties entirely.

Zuogui Yin (Left Return Decoction): This is a Water-strengthening formula. For conditions where Mingmen Yin declines and Yang prevails, this decoction is suitable for modification.
Prepared Rehmannia Root (adjust from 2-3 qian to 1-2 liang based on severity), Yam (2 qian), Cornus Fruit (1-2 qian, use less if sour taste is disliked), Roasted Licorice Root (1 qian, the妙处 lies in this herb), Goji Berry (2 qian, remove if Minister Fire is excessive), Poria (1.5 qian).
Decoct in 2 zhong of water until 70-80% remains. Take warm after meals.
For Lung heat with irritability, add Ophiopogon Tuber (2 qian).
For Lung heat with frequent cough, add Lily Bulb (2 qian).
For Blood deficiency, add Angelica Sinensis Root (2 qian). For Blood stasis with heat, add Moutan Cortex (2 qian). For Yin deficiency with restlessness, add Ligustrum Lucidum Fruit (2 qian).
For reckless Blood heat, add Raw Rehmannia Root (2-3 qian).
For Spleen heat with easy hunger, or excessive sweating damaging Yin, add White Peony Root (2 qian).
For Heart heat with irritability, add Scrophularia Root (2 qian).
For Kidney heat with bone-steaming, add Ground Tree Bark (2 qian).
For fluid exhaustion with heat and thirst, add Trichosanthes Root (2 qian).
For upper excess and lower deficiency, add Achyranthes Root (2 qian) to guide downward.

Yougui Yin (Right Return Decoction): This is a Fire-benefiting formula. For conditions where Mingmen Yang declines and Yin prevails, this decoction is suitable for modification.
Huai Prepared Rehmannia Root (as above), Yam (stir-fried, 2 qian), Cornus Fruit Flesh (1.5 qian, use less if acid regurgitation or sour taste is disliked), Roasted Licorice Root (1 qian), Goji Berry (2 qian), Eucommia Bark (stir-fried in ginger soup, 2 qian), Cinnamon Bark (use from 1 qian to 2 qian), Processed Aconite Root (use as appropriate, up to 3 qian).
Decoct in 2 zhong of water until 70-80% remains. Take warm after meals.
For Qi deficiency and Blood collapse, syncope, coma, sweating, dizziness, virtual mania, or shortness of breath, add Ginseng Root, from 1-2 qian to 1-2 liang.
If Fire deficiency fails to generate Earth, causing nausea or acid regurgitation, add Stir-fried Ginger (1-3 qian).
If Yang deficiency with Middle Cold causes unremitting diarrhea and continuous abdominal pain, use Processed Aconite Root from 1 qian to 2-3 qian, combined with Ginseng Root, and possibly add Nutmeg (2 qian).
If lower abdominal pain persists despite adding Cinnamon and Aconite, add Evodia Fruit (approx. 1 qian) as an assistant.
For stranguria, seminal emission, leukorrhea, and abdominal pain, add Psoralea Fruit (1-2 qian, fried until cooked and crushed).
For Blood coagulation and deficiency, add Angelica Sinensis Root (2-3 qian).