This is a classical formula that was originally recorded in the 'Synopsis of Prescriptions of the Golden Cabinet' (jin gui yao lue fang lun) by Zhang Zhong-jing (circa 150 ‐ 219 CE). Like so many of Zhang Zhong-jing's formulas, this one was so ingeniously designed that its clinical uses have been expanded over the centuries to include many more disorders than originally intended.
Its actions cover four broad areas, all of which are related to Kidney deficiency. The first is Kidney Qi deficiency: because the formula warm-tonifies the Kidney Yang and nourishes the Kidney Yin, it facilitates the production of Kidney Qi. Signs of Kidney Qi deficiency include low back pain, reduced libido, and severe fatigue. Secondly, this formula addresses deficiency of the Kidney Yang with insufficiency of its warming and activating functions. This may manifest clinically with cold intolerance, cold extremities and cold sensations in the lower back and abdomen. The third covers disturbances of fluid metabolism: deficiency of the Kidney Yang leads to insufficiency of the original Qi (yuan qi), which normally drives the metabolism of fluids. Clinical features include polyuria and nocturia with pale urine, or alternatively oliguria with edema.
Finally, this formula is effective in conditions due to disturbance of the minister Fire, which is an aspect of the Kidney Yang. This syndrome is often referred to as 'false Heat with true Cold'. Clinical manifestations include menopausal hot flushes, wheezing, severe sweating, etc. with signs of Cold in the lower body.
Due to Australian Health department regulatory requirements, the formula does not contain Aconite, as does the original. However, Zingiber rhizome, dried (gan jiang) and Foeniculum fruit (xiao hui xiang) are included, as both have a warming action on the Kidney.
TCM ACTIONS
Warm-tonifies the Kidney Yang.
TCM SYNDROMES
Kidney Yang deficiency
INDICATIONS
Chronic nephritis, diabetes mellitus, hyperaldosteronism, diabetes insipidus, menopausal syndrome, erectile dysfunction, spermatorrhea, geriatric cataract, chronic bronchitis, chronic asthma.
SIGNS & SYMPTOMS
(Key clinical features in bold)
- Low back pain (usually with a cold sensation)
- Intolerance of cold
- Cold hands, feet and lower abdomen
- Polyuria, nocturia
- Low libido
- Pale complexion
- Fatigue
- Infertility
- Erectile dysfunction
- Pale, swollen and moist tongue
- Deep pulse that is also weak and thready
