地黄（砂仁酒拌，九蒸九晒，八两） 山茱萸（酒润） 山药（各四两） 茯苓 丹皮 泽泻（各三两） 蜜
丸，空心盐汤下。冬，酒下。熟地滋肾君药，然遇气药则运用于上，遇血药则流行
于经，不能制其一线入肾也，故以五者佐之。山药阴金也，（质重属阴，色白属金也。）能助
肺气之下降；山茱萸阴木也，（酸属木，润属阴。）能敛肝气之迅升，水火升降，必由金木
为道路，二者为左右降下之主，以制其旁轶。且补其母而水出高原，补其子（茱萸补肝
血也。）而不盗母气。又用丹皮泻南以补北，降火以滋阴，茯苓之淡泄，以降阴中之阳。
（肾中之邪，火也。水虚者，火必上炎。茯苓藏伏地中，为日最久，沉阴可知，故能降上炎之阴火，用茯苓正取其淡
泄。昧者反以乳制之，可笑。）泽泻之咸泄，以降阴中之阴。（膀胱中混浊之水液也。肾热则水液混浊，泻
其腑，正所以安其脏也。补肾水乃滋其润泽之气，无形之癸水也。若有形之壬水，须流行不蓄，否则泛溢为灾，即
不混浊，亦须导之。或疑泽泻泄肾，昧矣。）五者色色皆降，共挽地黄下趋，所谓治下制以急也。
（得力尤在苓、泻二味，常常下泄，则群药为其所导。味者嫌其渗泄而去之，加入补肾群品，久服气积，下泄无路，
势必上涌矣。故曰∶六味之苓、泻，补中之升、柴、流湿就燥，分道扬镳，皆必不可去者也。补中升也，清升则浊
降，故谓补中以升为降。六味降也，火降则水上升，故谓六味以降为升。水何以升，水足则上润也。）
地黄（用砂仁酒拌制，经过九次蒸制和九次晾晒，用量八两） 山茱萸（用酒润湿） 山药（各四两） 茯苓 丹皮 泽泻（各三两） 蜂蜜
制成丸药，空腹时用盐汤送服。冬季，用酒送服。熟地黄是滋补肾阴的主药，但如果遇到理气药，它就作用于上部；遇到活血药，它就流行于经脉中，不能引导其一线之气进入肾脏，所以用这五味药作为辅助。山药属阴金（质地沉重属阴，颜色白色属金），能协助肺气下降；山茱萸属阴木（酸味属木，滋润属阴），能收敛肝气过快的上升，水火之气的升降，必须经由金和木作为通道，这两味药是左右降下的主导，用来制约气机的旁逸斜出。并且通过补益母脏使水源充足（出自高原比喻），补益子脏（山茱萸补益肝血）而不盗取母脏之气。又使用丹皮泻南方心火以补北方肾水，降低虚火以滋养阴液；茯苓的淡渗利湿作用，以降泄阴中之阳。（肾中的邪气是火。肾水虚弱时，火必然上炎。茯苓深藏地下，受日照时间最长，可知其性质沉寒，所以能降泄上炎的阴火，使用茯苓正是取其淡渗利湿的特性。愚昧的人反而用乳汁炮制它，真是可笑。）泽泻的咸味泄浊作用，以降泄阴中之阴。（膀胱中浑浊的水液。肾热则水液浑浊，泻除腑中的邪气，正是为了安定脏器的功能。补肾水是滋养其润泽之气，这是无形的癸水。如果是有形的壬水，必须流通而不蓄积，否则泛滥成灾，即使不浑浊，也必须引导排出。有人怀疑泽泻会泄肾气，这是愚昧的看法。）这五味药都具有降泄的作用，共同牵引地黄向下运行，这就是所说的“治疗下部疾病要用急迫的方法”（指沉降药力）。（其中茯苓、泽泻两味药尤为得力，经常下行泄浊，其他药物被它们引导。愚昧的人嫌弃它们的渗泄作用而将其去掉，加入补肾的药物群，长期服用导致气机积聚，下行无路，势必向上冲涌。所以说：六味地黄丸中的茯苓、泽泻，就像补中益气汤中的升麻、柴胡，以及“流湿就燥”的理论，都是分道扬镳、各司其职，都不可去除的。补中益气汤主升，清阳上升则浊阴下降，所以说补中以升为降。六味地黄丸主降，相火下降则肾水上承，所以说六味地黄丸以降为升。水为什么能上升？因为肾水充足就能上润咽喉脏腑。）
Rehmanniae Radix Praeparata (mixed with wine of Amomi Fructus, steamed and sun-dried nine times each, eight liang) Corni Fructus (moistened with wine) Dioscoreae Rhizoma (each four liang) Poria (three liang) Moutan Cortex (three liang) Alismatis Rhizoma (three liang) Honey
Made into pills, taken on an empty stomach with salt water. In winter, taken with wine. Shu Di Huang (Prepared Rehmannia Root) is the principal herb for nourishing Kidney Yin. However, when combined with Qi-moving herbs, it acts upon the upper body; when combined with Blood-invigorating herbs, it circulates in the meridians, and cannot guide its essence directly into the Kidneys. Therefore, these five herbs are used as assistants. Shan Yao (Dioscorea Rhizome) belongs to Yin Metal (its heavy texture corresponds to Yin, and white color corresponds to Metal). It assists the descent of Lung Qi. Shan Zhu Yu (Cornus Fruit) belongs to Yin Wood (sour taste corresponds to Wood, moistening nature corresponds to Yin). It restrains the rapid ascent of Liver Qi. The ascent and descent of Water and Fire must pass through Metal and Wood as pathways. These two herbs act as the primary agents for descending from the left and right, thereby restraining aberrant movement. Furthermore, by tonifying the Mother organ, the source of Water becomes abundant (metaphorically "originating from the high plateau"), and by tonifying the Child organ (Shan Zhu Yu tonifies Liver Blood), it avoids stealing Qi from the Mother organ. Additionally, Mu Dan Pi (Moutan Bark) clears the South (Heart Fire) to tonify the North (Kidney Water), lowering fire to nourish Yin. Fu Ling (Poria) has a bland draining action to descend Yang within Yin. (The pathogen in the Kidney is Fire. When Kidney Water is deficient, Fire inevitably flares upward. Fu Ling hides deep in the earth and absorbs sunlight for the longest time, indicating its profound Yin/cold nature; thus, it can descend the flaming Yin-Fire. Using Fu Ling precisely exploits its bland-draining property. Ignorant practitioners instead process it with milk, which is laughable.) Ze Xie (Alisma Rhizome) has a salty draining action to descend Yin within Yin. (This refers to turbid fluids in the Bladder. When the Kidney is hot, body fluids become turbid. Draining the Fu organ is precisely to calm the Zang organ. Tonifying Kidney Water means nourishing its moistening Qi, which is the formless Gui Water. If there is formed Ren Water, it must circulate without stagnation; otherwise, it will overflow and cause disaster. Even if not turbid, it must be guided out. Some suspect that Ze Xie drains the Kidney, which is ignorant.) All five of these herbs have descending properties, collectively pulling down the tendency of Di Huang (Rehmannia) to sink excessively. This is what is meant by "treating lower disorders requires urgent/descending methods." (The efficacy relies particularly on Fu Ling and Ze Xie. Their constant downward drainage guides the other herbs. Ignorant people remove them due to their draining nature and add more tonifying herbs. Long-term use leads to Qi accumulation with no outlet for drainage, inevitably causing upward surging. Thus, it is said: Fu Ling and Ze Xie in Liu Wei Di Huang Wan are like Sheng Ma and Chai Hu in Bu Zhong Yi Qi Tang, or the principle of "draining dampness towards dryness"; they follow different paths and are indispensable. Bu Zhong Yi Qi Tang promotes ascending; clear Yang ascends, so turbid Yin descends; hence, tonification via ascending is considered descending. Liu Wei Di Huang Wan promotes descending; ministerial Fire descends, so Kidney Water rises; hence, Liu Wei Di Huang Wan uses descending to achieve rising. How does Water rise? Because sufficient Kidney Water moistens the upper Jiao.)