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Treats the condition of *Wulao* (Five Labors, referring to five types of chronic deficiency syndromes) leading to extreme emaciation and weakness. Abdominal fullness and inability to eat. Caused by injury from diet, sorrow/worry, drinking/alcohol, sexual activity, hunger, labor/exhaustion, and Qi injury. There is dry blood (old stasis) inside the body, the skin is rough like scales (*jicuo*), and both eyes are dark. For those requiring the method of "soothing the middle and tonifying deficiency," this pill is the primary treatment.

Da Huang (Polygoni Multiflori Radix Prepared / Rhizoma Polygoni Cuspidati), Huang Qin (Scutellariae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Tao Ren (Persicae Semen), Xing Ren (Armeniacae Semen Amarum), Shao Yao (Paeoniae Radix Alba), E Chong (Asiatic Ground Beetle), Shui Zhi (Hirudo), Meng Chong (Tabanidae), Gan Qi (Resina Taxilli), Di Huang (Rehmanniae Radix), Lu Ru (Rhizoma Alpinii Offinarum).

The above twelve ingredients are powdered, mixed with refined honey, and formed into pills the size of small beans. Take five pills per dose, administered with wine, three times daily.

The song states: Dry blood causes labor; trace the source and details. Soothing the middle and tonifying deficiency is the main principle. One hundred E Chong, half a sheng; Tao Ren, Xing Ren, and Meng Chong each one sheng. One liang of Gan Qi, a large amount of raw Di Huang can be relied upon.

You Zaijing said: If wind-qi is not expelled, it will sufficiently damage righteous Qi, causing growth and flourishing to be unprosperous. Therefore, Shuyu Wan is an essential formula. If dry blood is not expelled, it will suffice to hinder the generation of new blood, injuring the Qi of Ying and Wei in their collaterals. Carefully analyzing the original text: abdominal fullness and inability to eat, skin rough like scales, dark face and eyes, clearly indicate the inability to process grain to circulate Ying and Wei Qi. Thus, Ying and Wei Qi stagnate and accumulate, and the stasis becomes firm and unbreakable. Even if new blood is generated, it cannot flourish and flow freely. Only gradually becoming emaciated, resulting in internal injury dry blood labor. Few would survive. Zhang Zhongjing then, with Buddha's heart and immortal hands, treats it with Dahuang Zhechong Wan. Da Huang serves as the sovereign herb, dispersing stasis and moistening dryness from the stomach collaterals. Huang Qin assists by clearing Lung Wei, Xing Ren moistens Heart Ying, Tao Ren tonifies Liver deficiency, Di Huang nourishes Kidney dryness. Gan Qi has an urgent and penetrating nature, breaking stasis in the spleen, stomach, and joints. Meng Chong has an ascending nature, entering the Yang aspect to break blood. Shui Zhi has a descending nature, entering the Yin aspect to expel stasis. E Chong removes hard stasis under the two flanks. [Note: The text mentions 'Cao Si' or similar insect in the song, but You's commentary refers to properties of specific insects]. It breaks hardness, unblocks collaterals, and promotes Yang movement, possessing divine efficacy. Hence the formula name is highlighted. Shao Yao and Gan Cao support the Spleen and Stomach and resolve drug toxicity. "Soothing the middle and tonifying deficiency" means soothing and relaxing. Graceful and soft. It refers to the herbs in the formula that broaden and moisten the blood. Therefore, Yu Jiayan said: Qiongyu Gao can be used for tonification. Do not use Bai Zhu and Cang Zhu to tonify the middle, lest you lose the meaning of broadening and soothing the Stomach Qi.