补者，补其所不足也；养者，栽培之、将护之，使得生遂条达，而不受戕贼之患也。人
之气禀，罕得其平，有偏于阳而阴不足者，有偏于阴而阳不足者，故必假药以滋助之。而又
须优
已病
铸兵
（钱氏仲阳因仲景八味丸减去桂附，以治小儿，以小儿纯阳，故减附桂，今用通治大小
证
治肝肾不足，真阴亏损，精血枯竭，憔悴羸弱，腰痛足酸，自汗盗汗，水泛为痰。（仲
景曰∶气虚有痰，宜肾气丸补而逐之。丹溪曰∶久病阴火上升，津液生痰不生血，宜补血以
制相火，其痰自除，）发热咳嗽（肾虚则移热于肺而咳嗽。按之至骨，其热烙手，骨困不任，
为肾热，）头晕目眩（《直指方》云∶淫欲过度，肾气不能归元，此气虚头晕也；吐衄崩漏，
脾不摄血，致血妄行，此血虚头晕也，）耳鸣耳聋，遗精便血，消渴淋沥，失血失音，舌燥
喉痛，虚火牙痛，足跟作痛，下部疮疡等（证诸证皆由肾水不足、虚火上炎所致。详注分见
各门）。
地黄（砂仁酒拌，九蒸九晒。八两） 山茱肉（酒润） 山药（四两） 茯苓（乳
拌） 丹皮
为君；精滑头
心虚火盛及有瘀血，丹皮为君
地黄只用臣分两。
此足少阴、厥阴药也。熟地滋阴补肾，生血生精；山茱温肝逐风，涩精秘气；牡丹泻君
相之
不知
蒸）；山药清虚热于肺脾，补脾固肾能涩精；茯苓渗脾中湿热，而通肾交心；泽泻泻膀胱水
邪，而聪耳明目（解见后注）。六经备治，而功专肾肝；寒燥不偏，而补兼气血。苟能常服，
其功未易殚述也（或谓肾气丸为补水之剂，以熟地大补精血故也，不知精血足则真阳自生，
况山药，茱萸，皆能涩精固气。气者，火也，水中之火，乃为真阳。此剂水火兼补，不寒不
燥，至平淡，至神奇也。或曰肾气丸实补肝药也，肾为肝母，子虚则补母之义，古云，肝肾
之病，同一治也。昂按∶“肾气丸”，熟地温而丹皮凉，山药涩而茯苓渗，山茱收而泽泻泻，
补肾而兼补脾，有补而必有泻，相和相济，以成平补之功，乃平淡之精奇，所以为古今不易
之良方也。即有加减，不过一二味，极三四味而止，今人多拣本草补药，任意加入，有补无
泻，且客倍于主，责成不专，而六味之功反退处于虚位，失制方之本旨矣，此后世庸师之误
也。李士材曰∶用此方者，有四失∶地黄非怀庆则力薄，蒸晒非九次则不熟，或疑地黄之滞
而减之，则君主弱，或恶泽泻之泻而减之，则使力薄，顾归咎于药之无功，毋乃愚乎。按∶
泽泻，《本经》云聪耳明目，为其能渗下焦之湿热也，湿热既除，则清气上行，故能养五脏、
起阴气、补虚损、止头旋，有聪耳明目之功，是以古方用之。今人多以昏目疑之，盖服之太
多。则肾
本方煎服，名六味地黄汤。治同（赵养葵作《医贯》，专用此汤大剂治病，且云∶即以
伤寒口渴言之，邪热入于胃府，消耗津液，故渴，恐胃汁干，急下之以存津液。其次者，但
云欲饮水者，不可不与，不可多与，别无治法，纵有治者，徒知以芩、连、栀、柏、麦冬、
五味、花粉，甚则石膏、知母，此皆有形之水，以沃无形之火，安能滋肾中之真阴乎。若以
六味地
亦赵
王冰所谓益火之源，以消阴翳也，尺脉弱者宜之（李士材曰∶肾有两枚，皆属于水，初无水
火之别。《仙经》曰∶两肾一般无二样，中间一点是阳精。两肾中间，穴名命门，相火所居
也。一阳生于二阴之间，所以成乎坎而位于北也。李时珍曰∶命门为藏精系胞之物，其体非
脂非肉，白膜裹之，在脊骨第七节两肾中央，系着于脊，下通二肾，上通心肺，贯脑，为生
命之原，相火之主，精气之府。人物皆有之，生人生物，皆由此出，《内经》所谓七节之旁
中有小心是也。以相火能代心君行事，故曰小心。昂按∶男女媾精，皆禀此命火以结胎，人
之穷通寿夭，皆根于此，乃先天无形之火，所以主云为而应万事，蒸糟粕而化精微者也。无
此真阳之火，则神机灭息，生气消亡矣。惟附子、肉桂，能入肾命之间而补之，故加入六味
丸中，为补火之剂。有肾虚火不归经，大热烦渴，目赤唇裂，舌上生刺，喉如烟火，足心如
烙，脉洪大无伦，按之微弱者，宜十全大补汤吞八味丸。或问燥热如此，复投附桂，不以火
济火乎。曰∶心包相火附于命门，男以藏精，女以系胞，因嗜欲竭之，火无所附，故厥而上
炎；且火从肾出，是水中之火也。火，可以水折；水中之火，不可以水折。桂附与火同气而
味辛，能开腠里、致津液、通气道，据其窟宅而招之，同气相求，火必下降矣，然则桂附者，
固治相火之正药欤。八味丸用泽泻，寇宗 谓其接引桂附，归就肾经，李时珍曰∶非接引也，
茯苓、泽泻，皆取其泻膀胱之邪气也。古人用补药必兼泻邪，邪去则补药得力，一阖一辟，
此乃玄妙，后世不知此理，专一于补，必致偏胜之害矣。张仲景用此丸治汉武帝消渴，喻嘉
言曰∶下消之证，饮水一斗，小便亦一斗，故用此以折其水，使不顺趋。夫肾水下趋则消，
肾水不上腾则渴，舍此安从治哉。《金匮》又用此方治香港脚上入少腹不仁；又治妇人转胞小
便不通；更其名为肾气丸，盖取收摄肾气归元之义）。本方加黄柏、知母各二两，名知柏八
味丸∶治阴虚火动，骨痿髓枯，王冰所谓壮水之主，以制阳光也，尺脉旺者宜之（此以补天
一所生之水也。朱丹溪曰∶君火者，心火也，人火也，可以水灭，可以直折，黄连之属可以
制之；相火者，天火也，龙雷之火也，阴火也，不可以水湿折之，当从其类而伏之，惟黄柏
之属可以降之。按∶知柏八味丸与桂附八味丸寒热相反，而服之者皆能有功，缘人之气禀不
同，故补阴补阳，各有攸当，药者，原为补偏救弊而设也。《医贯》曰∶左尺脉虚细数者，
是肾之真阴不足，宜六味丸以补阴；右尺脉沉细数者，是命之相火不足，宜八味丸以补阳；
至于两尺微弱，是阴阳俱虚，宜十补丸，此皆滋先天化源。自世之补阴者，率用知柏反戕脾
胃，多致不起，不能无憾，故特表而出之。又曰∶王节斋云，凡酒色过度，损伤肺肾真阴者，
不可过服参 ，服多者死，盖恐阳旺而阴消也。自此说行而世之治阴虚咳嗽者，视参 如砒
鸩，以知柏为灵丹，使患此证者，百无一生，良可悲也。盖病起房劳，真阴亏损，阴虚火上
故咳，当先以六味丸之类补其真阴，使水升火降，随以参 救肺之品，补肾之母，使金水相
生，则病易愈矣。世之用寒凉者，固不足齿，间有知用参 者，不知先壮水以制火，而遽投
参以补阳，反使阳火旺而金益受伤，此不知后先之着者也）。本方加桂一两，名七味地黄
丸，引无根之火降而归元。本方加五味三两，名都气丸∶治劳嗽（益肺之源以生肾水。再加
桂，亦治消渴）。本方加五味二两、麦冬三两，名八仙长寿丸。再加紫河车一具，并治虚损
劳热（河车名混沌皮，本人之血气所生，故能大补气血）。本方加杜（仲姜炒）、牛膝（酒洗）
各二两，治肾虚腰膝酸痛。本方去泽泻，加益智仁三（两盐、酒炒），治小便频数（益智辛
热，涩精固气）。本方用熟地二两、山药、山茱、丹皮、归尾、五味、柴胡各五钱、茯神、
泽泻各二钱半，蜜丸，朱砂为衣，名益阴肾气丸（即明目地黄丸，东垣）∶治肾虚目昏（加
柴胡者，所以升阳于上也）。附桂八味丸加车前、牛膝，名肾气丸（《济生》）∶治蛊胀（别见
湿门）。
补，是指补充人体所不足的部分；养，是指培育和保护，使气血生机得以顺畅条达，而不受侵害。人的先天禀赋很难达到绝对平衡，有的偏于阳盛而阴液不足，有的偏于阴盛而阳气虚弱，因此必须借助药物来滋养辅助。
钱乙（字仲阳）因张仲景的八味丸（即金匮肾气丸）中含有桂枝、附子等大热之药，考虑到小儿体质“纯阳”，故减去这两味药，用于治疗小儿病症。如今此方通用于成人和儿童的各类证候。本方主治肝肾不足，真阴亏损，精血枯竭，形体憔悴瘦弱，腰痛足酸，自汗盗汗，水湿泛滥化为痰饮。（张仲景说：气虚生痰，宜用肾气丸温补并逐邪。朱丹溪说：久病导致阴火上升，津液凝聚成痰而非生成血液，宜补血以制约相火，痰自然消除。）发热咳嗽（肾虚则虚热移于肺而导致咳嗽。若按压至骨部感觉灼热烫手，骨骼困倦无力，这是肾热），头晕目眩（《直指方》说：房事过度，肾气不能归元，这是气虚导致的头晕；吐血、鼻衄、崩漏，脾不统血，导致血液妄行，这是血虚导致的头晕），耳鸣耳聋，遗精便血，消渴淋沥，失血失音，舌燥喉痛，虚火牙痛，足跟作痛，下部疮疡等（这些证候皆由肾水不足、虚火上炎所致。详细注解分见于各门类）。
地黄（用砂仁酒拌，九蒸九晒，用量八两）、山茱萸（酒润）、山药（四两）、茯苓（乳拌）、牡丹皮，作为君药；若见精滑、头昏、心虚火盛及有瘀血者，以牡丹皮为君药，地黄只用臣药的剂量。
此方是足少阴肾经、足厥阴肝经的药物。熟地黄滋阴补肾，生血生精；山茱萸温肝祛风，涩精固气；牡丹皮泻君火与相火；山药清肺脾之虚热，补脾固肾并能涩精；茯苓渗利脾中湿热，交通心肾；泽泻泻膀胱水邪，并能聪耳明目（解释见后注）。六经皆可治疗，但功效专于肾肝；寒燥不偏颇，补益兼及气血。若能常服，其功效难以尽述。（有人称肾气丸为补水之剂，是因为熟地大补精血之故，却不知道精血充足则真阳自然产生，况且山药、山茱萸都能涩精固气。气即是火，水中的火，才是真阳。此方水火兼补，不寒不燥，极其平淡，却又极其神奇。有人说肾气丸其实是补肝的药，因为肾为肝之母，子虚则补母的道理，古语云肝肾之病，治法相同。汪昂按：肾气丸中，熟地温而丹皮凉，山药涩而茯苓渗，山茱萸收而泽泻泻，补肾而兼补脾，有补必有泻，相互调和济助，成就平补之功，这是平淡中的精奇，所以成为古今不易的良方。即使有加减，也不过一两味或三四味为止。今人往往随意挑选本草中的补药加入，只补不泻，且客药倍数超过主药，责任不专一，反而使六味的主功退居次要地位，失去了制方的本意，这是后世庸医的错误。李士材说：使用此方有四失：地黄若非怀庆产则力薄，蒸晒若非九次则不熟；有人怀疑地黄滞腻而减少用量，则君主药力减弱；有人厌恶泽泻的泻利作用而减少用量，则使药力变弱，却反过来责怪药物无效，岂不是很愚昧吗？按：泽泻，《神农本草经》说能聪耳明目，因为它能渗利下焦湿热。湿热既除，清气上行，故能养五脏、起阴气、补虚损、止头晕，有聪耳明目之功，所以古方中使用它。今人多因眼睛昏花而怀疑它，大概是因为服用太多的缘故。如果肾……）
本方煎汤服用，名为六味地黄汤。主治相同。（赵献可著《医贯》，专用此汤大剂量治病，并且说：就以伤寒口渴为例，邪热进入胃腑，消耗津液，所以口渴，担心胃汁干枯，急下之以存津液。其次的人，只是说想喝水的，不可不给，不可多给，没有其他治法。纵有治者，只知道用黄芩、黄连、栀子、黄柏、麦冬、五味子、天花粉，甚至石膏、知母，这些都是有形之水，去浇灌无形之火，怎么能滋补肾中的真阴呢？如果用六味地黄……也是赵……王冰所谓“益火之源，以消阴翳”，尺脉弱者适宜使用（李士材说：肾有两个，都属于水，起初没有水火的区别。《仙经》说：两肾一般无二样，中间一点是阳精。两肾中间，穴位名叫命门，是相火居住的地方。一阳生于二阴之间，所以形成坎卦而位于北方。李时珍说：命门是藏精系胞之物，其体非脂非肉，白膜包裹，在脊骨第七节两肾中央，系着于脊骨，下通两肾，上通心肺，贯通脑部，是生命的本源，相火的主宰，精气的府库。人和动物都有它，生育人类和生物，都由此而出，《内经》所说的“七节之旁中有小心”就是这里。因为相火能代替心君行事，所以叫小心。汪昂按：男女交媾结胎，都禀受此命火，人的穷通寿夭，都根源于此，这是先天的无形之火，所以主宰言行而应对万事，蒸化糟粕而转化为精微。没有这真阳之火，则神机灭息，生气消亡了。只有附子、肉桂，能入肾命之间而补之，所以加入六味丸中，成为补火之剂。若有肾虚火不归经，出现大热烦渴，目赤唇裂，舌上生刺，喉如烟火，足心如烙，脉洪大无伦，按之微弱者，宜用十全大补汤吞服八味丸。有人问：燥热如此严重，又投附子、肉桂，不是以火救火吗？回答说：心包相火依附于命门，男用以藏精，女用以系胞，因嗜欲竭尽，火无所附，所以厥逆而上炎；而且火从肾出，是水中之火。火，可以用水扑灭；水中之火，不可以用水扑灭。桂附与火同气而味辛，能开腠理、致津液、通气道，占据其窟穴而招引它，同气相求，火必下降矣，那么桂附，确实是治疗相火的正药吧。八味丸用泽泻，寇宗奭认为它是接引桂附回归肾经，李时珍说：并非接引，茯苓、泽泻，都是取其泻膀胱之邪气。古人用补药必兼泻邪，邪去则补药得力，一阖一辟，这是玄妙之处，后世不知此理，专一于补，必致偏胜之害。张仲景用此丸治疗汉武帝的消渴症，喻嘉言说：下消之证，饮水一斗，小便亦一斗，所以用此方以折其水势，使其不顺趋下行。夫肾水下趋则消，肾水不上腾则渴，舍此方从哪里治疗呢？《金匮要略》又用此方治疗脚气上入少腹不仁；又治疗妇人转胞小便不通；更其名曰肾气丸，大概是取收摄肾气归元的意思）。
本方加黄柏、知母各二两，名知柏八味丸：治疗阴虚火动，骨痿髓枯，王冰所谓“壮水之主，以制阳光”，尺脉旺者适宜使用（这是补天一所生之水。朱丹溪说：君火者，心火也，人火也，可以水灭，可以直折，黄连之类可以制约它；相火者，天火也，龙雷之火也，阴火也，不可以水湿折之，当从其类而伏之，惟黄柏之类可以降之。按：知柏八味丸与桂附八味丸寒热相反，但服用者皆能有功，缘于人的禀赋不同，所以补阴补阳，各有适当，药本来就是为了补偏救弊而设的。《医贯》说：左尺脉虚细数者，是肾之真阴不足，宜六味丸以补阴；右尺脉沉细数者，是命门之相火不足，宜八味丸以补阳；至于两尺微弱，是阴阳俱虚，宜十补丸，这都是滋补先天化源。自从世上那些补阴的人，都用知柏反而戕害脾胃，多导致不治，不能不感到遗憾，所以特意提出来说明。又说：王节斋说，凡是酒色过度，损伤肺肾真阴者，不可过服人参，服多者死，恐怕阳旺而阴消。从此说流行后，世上治疗阴虚咳嗽者，视人参如砒霜鸩毒，以知柏为灵丹，使患此证者，百无一生，实在可悲。盖病起房劳，真阴亏损，阴虚火旺故咳，应当先用六味丸之类补其真阴，使水升火降，随后用人参救肺之品，补肾之母，使金水相生，则病易愈。世之用寒凉者，固然不值一提，间或有知道用人参者，不知道先壮水以制火，而遽然投人参以补阳，反使阳火旺而金益受伤，这是不知先后步骤的错误）。
本方加桂枝一两，名七味地黄丸，引无根之火降而归元。本方加五味子三两，名都气丸：治疗劳嗽（益肺之源以生肾水。再加桂枝，也治疗消渴）。本方加五味子二两、麦冬三两，名八仙长寿丸。再加紫河车一具，并治虚损劳热（河车名叫混沌皮，是人之血气所生，故能大补气血）。本方加杜仲（姜炒）、牛膝（酒洗）各二两，治疗肾虚腰膝酸痛。本方去泽泻，加益智仁三两（盐、酒炒），治疗小便频数（益智仁辛热，涩精固气）。本方用熟地黄二两、山药、山茱萸、牡丹皮、当归尾、五味子、柴胡各五钱、茯神、泽泻各二钱半，蜜丸，朱砂为衣，名益阴肾气丸（即明目地黄丸，李东垣创制）：治疗肾虚目昏（加柴胡的原因，是为了升阳于上）。附桂八味丸加车前子、牛膝，名肾气丸（出自《济生方》）：治疗蛊胀（另见湿门）。
Tonification refers to supplementing what is deficient in the body; nurturing refers to cultivating and protecting, allowing the vital energy (Qi) and blood to flow smoothly and prosperously, without suffering damage. Human innate constitution rarely achieves absolute balance; some are prone to Yang excess with Yin deficiency, while others are prone to Yin excess with Yang deficiency. Therefore, it is necessary to rely on herbs to nourish and assist.
Qian Yi (courtesy name Zhongyang), because Zhang Zhongjing's Ba Wei Wan (Jin Gui Shen Qi Wan) contains Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root), which are large heat herbs, considering that children's constitutions are "pure Yang," he removed these two herbs to treat pediatric conditions. Today, this formula is used universally for both adults and children of various syndromes. This formula treats Liver and Kidney deficiency, depletion of True Yin, exhaustion of Essence and Blood, emaciation and weakness, lower back pain and soreness of the feet, spontaneous sweating and night sweats, and water retention transforming into Phlegm. (Zhang Zhongjing stated: For Phlegm generated by Qi deficiency, one should use Shen Qi Wan to tonify and expel pathogens. Zhu Danxi stated: In chronic illness, Yin Fire rises, causing fluids to condense into Phlegm rather than generating Blood; one should tonify Blood to control Ministerial Fire, and the Phlegm will naturally resolve.) Fever and cough (Kidney deficiency allows empty heat to transfer to the Lung, causing cough. If pressing down to the bone feels scorching hot, and the bones feel exhausted and unable to bear weight, this is Kidney Heat). Dizziness and vertigo (*Zhizhi Fang* states: Excessive sexual activity prevents Kidney Qi from returning to its origin, causing Qi-deficiency dizziness; hematemesis, epistaxis, or metrorrhagia due to Spleen failing to control Blood, causing reckless bleeding, causes Blood-deficiency dizziness). Tinnitus and deafness, spermatorrhea and bloody stool, Xiao Ke (Wasting-Thirst syndrome) with dribbling, loss of voice due to hemorrhage, dry tongue and sore throat, false-fire toothache, heel pain, sores and ulcers in the lower body, etc. (All these syndromes are caused by insufficient Kidney Water and rising False Fire. Detailed annotations are found in respective sections).
Di Huang (Rehmanniae Radix Praeparata, mixed with Sha Ren (Amomi Fructus) wine, steamed and sun-dried nine times, 8 liang), Shan Zhu Yu (Corni Fructus, moistened with wine), Shan Yao (Dioscoreae Rhizoma, 4 liang), Fu Ling (Poria, mixed with milk), and Mu Dan Pi (Moutan Cortex) serve as the Sovereign herbs; if symptoms include seminal emission, dizziness, Heart deficiency with excessive fire, and blood stasis, Mu Dan Pi serves as the Sovereign, and Di Huang is used only at the minister dosage.
This formula acts on the Foot-Shaoyin Kidney Meridian and Foot-Jueyin Liver Meridian. Shu Di Huang (Prepared Rehmannia Root) nourishes Yin and tonifies the Kidney, generating Blood and Essence; Shan Zhu Yu warms the Liver and dispels Wind, astringing Essence and securing Qi; Mu Dan Pi clears Ministerial Fire; Shan Yao clears empty heat in the Lung and Spleen, tonifies the Spleen and secures the Kidney, and can astringe Essence; Fu Ling leaches out damp-heat in the Spleen and facilitates communication between the Heart and Kidney; Ze Xie (Alismatis Rhizoma) drains water-pathogens from the Bladder and benefits hearing and vision (explanation see later notes). It treats all six meridians but focuses specifically on the Kidney and Liver; it is neither cold nor drying, and tonification extends to both Qi and Blood. If taken regularly, its merits are hard to fully describe. (Some say Shen Qi Wan is a formula for replenishing Water because Shu Di Huang greatly tonifies Essence and Blood; they do not know that when Essence and Blood are sufficient, True Yang arises naturally. Moreover, Shan Yao and Shan Zhu Yu can astringe Essence and secure Qi. Qi is Fire; the Fire within Water is True Yang. This formula tonifies both Water and Fire, neither cold nor drying, extremely plain yet miraculous. Some say Shen Qi Wan actually tonifies the Liver, because the Kidney is the Mother of the Liver; according to the principle of tonifying the Mother when the Child is deficient, ancient texts state that diseases of the Liver and Kidney share the same treatment. Wang Ang notes: In Shen Qi Wan, Shu Di Huang is warm and Mu Dan Pi is cool, Shan Yao is astringent and Fu Ling is draining, Shan Zhu Yu is collecting and Ze Xie is purging; it tonifies the Kidney while also tonifying the Spleen. There is tonification and there is purging, harmonizing and assisting each other to achieve balanced tonification. This is the subtlety within plainness, making it an excellent formula unchanging since ancient times. Even with modifications, it usually involves only one or two herbs, up to three or four at most. Modern practitioners often arbitrarily add herbal tonics, tonifying without purging, and letting the guest herbs exceed the sovereign herbs in dosage, losing focus, thereby diminishing the efficacy of the Six Ingredients and deviating from the original intent of the prescription. This is the error of mediocre physicians of later generations. Li Shicai said: There are four mistakes in using this formula: If Di Huang is not from Huaqing, its potency is weak; if not steamed and dried nine times, it is not sufficiently processed; some doubt Di Huang's cloying nature and reduce its dose, weakening the sovereign herb; some dislike Ze Xie's draining action and reduce its dose, weakening the envoy's power, yet blame the drug for ineffectiveness—is this not foolish? Note: Ze Xie, according to *Shennong Bencao Jing*, benefits hearing and vision because it leaches damp-heat from the Lower Jiao. Once damp-heat is removed, clear Qi ascends, thus nourishing the Five Viscera, raising Yin Qi, tonifying deficiencies, and stopping dizziness, hence its benefit to hearing and vision, which is why ancients used it. Modern people suspect it due to blurred vision, likely because of excessive consumption. If the Kidney...
Decocting this formula yields Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Decoction). The indications are the same. (Zhao Yangkui wrote *Yi Guan*, using this decoction in large doses to treat diseases, stating: Taking thirst in Shang Han (Cold Damage) as an example, pathogenic heat enters the Stomach Fu, consuming fluids, causing thirst. Fearing the Stomach juices are dry, one must purge urgently to preserve fluids. Those of secondary understanding say that if the patient desires water, give it, but not too much, with no other treatment method. Even those who treat it only know to use Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), Zhi Zi (Gardenia Fruit), Huang Bai (Phellodendron Bark), Mai Dong (Ophiopogon Tuber), Wu Wei Zi (Schisandra Berry), Tian Hua Fen (Trichosanthes Root), and even Shi Gao (Gypsum) and Zhi Mu (Anemarrhenae Rhizoma). These are all tangible waters trying to extinguish intangible fire; how can they nourish the True Yin in the Kidney? If using Liu Wei Di Huang... also Zhao... Wang Bing said "Tonify the source of Fire to eliminate Yin shadows"; suitable for those with weak Chi pulse. (Li Shicai said: The Kidneys are two, both belonging to Water, initially having no distinction between Water and Fire. *Xian Jing* says: The two kidneys are identical, with a point of Yang Essence in the middle. Between the two kidneys lies the Mingmen (Gate of Life) acupoint, where Ministerial Fire resides. One Yang arises between two Yins, forming the Kan trigram located in the North. Li Shizhen said: Mingmen is the organ storing Essence and connecting to the uterus. Its substance is neither fat nor flesh, wrapped in white membrane, located centrally between the two kidneys at the seventh thoracic vertebra, attached to the spine, connecting downward to the two kidneys, upward to the Heart and Lungs, and penetrating the brain. It is the origin of life, master of Ministerial Fire, and residence of Essence and Qi. Humans and animals possess it; human reproduction and biological growth all originate from here. This corresponds to the *Nei Jing* statement "beside the seventh vertebra lies the 'Small Heart'." Because Ministerial Fire acts on behalf of the Heart Monarch, it is called "Small Heart." Wang Ang notes: Conception relies on this Mingming Fire; a person's fortune, longevity, and lifespan all root here. It is the innate intangible Fire, governing actions and responding to all matters, steaming dregs into essence. Without this True Yang Fire, spiritual mechanisms cease, and vital energy perishes. Only Fu Zi (Aconite Root) and Rou Gui (Cinnamon Bark) can enter the Kidney-Mingmen area to tonify it; thus added to Liu Wei Wan, it becomes a Fire-tonifying formula. For Kidney deficiency with Fire not returning to its origin, presenting with severe heat, irritability, thirst, red eyes, cracked lips, thorns on the tongue, throat feeling like fire/smoke, soles of feet burning, and a flooding pulse that is forceless upon deep pressure, one should use Shi Quan Da Bu Tang (Ten Great Tonifying Decoction) to swallow Ba Wei Wan. Someone asked: With such dryness and heat, adding Fu Zi and Gui Zhi is not adding fire to fire? I reply: Pericardium Ministerial Fire attaches to Mingmen; men store Essence, women connect to the Uterus. Due to excessive desire exhausting them, Fire has no attachment, thus rebellious and rising upward; moreover, Fire originates from the Kidney, it is Fire within Water. Fire can be extinguished by Water; Fire within Water cannot be extinguished by Water. Gui Zhi and Fu Zi share the same Qi as Fire and are pungent/warm; they can open the interstices, generate fluids, and unblock pathways, occupying the lair to attract Fire. Like attracts like, so Fire must descend. Thus, Gui Zhi and Fu Zi are indeed the correct medicines for treating Ministerial Fire. Ba Wei Wan uses Ze Xie; Kou Zongshi claimed it guides Gui Zhi and Fu Zi back to the Kidney Meridian. Li Shizhen said: It is not guiding; Fu Ling and Ze Xie are used to drain pathogenic Qi from the Bladder. Ancients always combined draining herbs with tonics; once pathogens are gone, tonics work effectively. Closing and opening—this is the mystery. Later generations did not understand this, focusing solely on tonification, leading to imbalance. Zhang Zhongjing used this pill to treat Emperor Wu of Han's Xiao Ke. Yu Jiayan said: In Lower Xiao Ke, drinking one dou results in urinating one dou; thus this formula is used to curb the water, preventing it from flowing downward recklessly. When Kidney Water flows downward, wasting occurs; when it does not ascend, thirst arises. From where else can we treat this? *Jin Gui Yao Lue* also uses this formula for Jiao Qi (Foot Weakness) ascending to the lower abdomen causing insensitivity; and for women with Zhuan Bao (displacement of the bladder) causing urinary retention; renaming it Shen Qi Wan, implying the meaning of gathering and returning Kidney Qi to its origin.
Adding Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma), each 2 liang, to this formula creates Zhi Bai Ba Wei Wan (Anemarrhena and Phellodendron Eight-Ingredient Pill): Treating Yin deficiency with moving Fire, bone atrophy, and marrow exhaustion. Wang Bing described this as "Strengthening the Master of Water to control the Sunlight"; suitable for those with vigorous Chi pulse. (This tonifies the Water born from Heaven One. Zhu Danxi said: Jun Fire is Heart Fire, human fire; it can be extinguished by water or directly折 (broken); herbs like Huang Lian can control it. Xiang Fire is Heavenly Fire, Dragon-Lei Fire, Yin Fire; it cannot be broken by wet/cold water, but should be subdued by following its nature; only herbs like Huang Bo can descend it. Note: Zhi Bai Ba Wei Wan and Gui Fu Ba Wei Wan have opposite cold/heat properties, yet both are effective because human constitutions differ; thus tonifying Yin and Yang have their appropriate uses. Herbs are originally set to correct imbalances and save from defects. *Yi Guan* says: A void, fine, and rapid pulse at the Left Chi indicates insufficiency of True Yin in the Kidney; use Liu Wei Wan to tonify Yin. A deep, fine, and rapid pulse at the Right Chi indicates insufficiency of Ministerial Fire in Mingmen; use Ba Wei Wan to tonify Yang. If both Chi pulses are weak, it indicates dual deficiency of Yin and Yang; use Shi Bu Wan (Ten-Tonifying Pill). All these nourish the congenital source of transformation. Since worldly practitioners of Yin-tonification mostly use Zhi Bai, damaging the Spleen and Stomach, often leading to death, regret is inevitable, so I specifically highlight this. Also: Wang Jiezhai said, for those whose Lung-Kidney True Yin is damaged by excessive alcohol and sex, Ginseng should not be overused; excessive use leads to death, fearing Yang prosperity consumes Yin. Since this theory spread, those treating Yin-deficiency cough view Ginseng as arsenic, regarding Zhi Bai as a miracle pill, leaving patients with zero chance of survival, which is truly sad. Illness arising from sexual fatigue causes True Yin depletion; empty-Yin Fire flares causing cough. One must first use Liu Wei Wan to tonify True Yin, allowing Water to rise and Fire to descend, then use Ginseng to rescue the Lung, tonifying the Mother of Metal, so Metal and Water generate each other, making recovery easier. Practitioners using cold/cool herbs are unworthy of mention. Those who occasionally know to use Ginseng, failing to first strengthen Water to control Fire, and abruptly administering Ginseng to tonify Yang, instead make Yang Fire prosperous and injure Metal further; this is a mistake in knowing sequence.
Adding Gui Zhi (Cinnamon Twig) 1 liang to this formula creates Qi Wei Di Huang Wan (Seven-Ingredient Rehmannia Pill), guiding rootless Fire to descend and return to its origin. Adding Wu Wei Zi (Schisandra Berry) 3 liang creates Du Qi Wan (Duqi Pill): Treating Lao Sou (consumptive cough) (Benefiting Lung source to generate Kidney Water. Adding Gui Zhi also treats Xiao Ke). Adding Wu Wei Zi 2 liang and Mai Dong 3 liang creates Ba Xian Chang Shou Wan (Eight Immortals Longevity Pill). Adding one Placenta (Zi He Che) also treats deficiency damage and labor fever (Placenta, named Hun Dun Pi, is generated from human Qi and Blood, thus greatly tonifying Qi and Blood). Adding Du Zhong (Eucommia Bark, stir-fried with ginger) and Niu Xi (Achyranthes Root, washed with wine), each 2 liang, treats Kidney deficiency with soreness and pain in waist and knees. Removing Ze Xie and adding Yi Zhi Ren (Alpinia Oxyphylla Fruit) 3 liang (salted and wine-fried) treats frequent urination (Yi Zhi Ren is pungent-warm, astringing Essence and securing Qi). Using Shu Di Huang 2 liang, Shan Yao, Shan Zhu Yu, Mu Dan Pi, Dang Gui Wei (Angelica Sinensis Root Tail), Wu Wei Zi, Chai Hu (Bupleuri Radix) each 5 qian, Fu Shen (Poria with Hostwood), and Ze Xie each 2.5 qian, honey-pilled, coated with Cinnabar, creates Yi Yin Shen Qi Wan (Nourishing Yin Shen Qi Pill) (also known as Ming Mu Di Huang Wan (Bright-Eye Rehmannia Pill), created by Li Dongyuan): Treating blurry vision due to Kidney deficiency (Chai Hu is added to raise Yang upward). Adding Che Qian Zi (Plantago Seed) and Niu Ai to Gui Fu Ba Wei Wan creates Shen Qi Wan (*Ji Sheng Fang* version): Treating Gu Zhang (abdominal distension with fluid accumulation) (see Wetness section separately).