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This formula is originally found in Gong Ding-xian’s Wan Bing Hui Chun (Restoring Spring to the Tens of Thousands of Diseases). Our version is a 12:1 extract.
 

Rx

Shu Di (cooked Radix Rehmanniae)
Sheng Di (uncooked Radix Rehmanniae)
Fu Ling (Poria)
Zhi Mu (Rhizoma Anemarrhenae)
Huang Bai (Cortex Phellodendri)
Dang Shen (Radix Codonopsitis)
Dang Gui (Radix Angelicae Sinensis)
Bai Shao (Radix Paeoniae Albae)
Niu Xi (Radix Achyranthis Bidentatae)
Bu Gu Zhi (Fructus Psoraleae)
Du Zhong (Cortex Eucommiae)
Xiao Hui Xiang (Fructus Foeniculi)
Chen Pi (Pericarpium Citri Reticulatae)
Gan Cao (Radix Glycyrrhizae)
 

Indications
This formula treats spleen qi and dual kidney yin and yang vacuity with vacuity heat complicated by liver depression and even possibly some blood stasis. Therefore, it is a good one for both perimenopausal syndrome and postmenopausal osteoporosis, in which case it can be taken preventively even by relatively asymptomatic women. This is because it is much more balanced and moderate than, say, Er Xian Tang (Two Immortals Decoction).

The signs and symptoms of spleen qi vacuity include:

• fatigue, especially after eating

• easy bruising

• abdominal bloating after eating

• a swollen tongue with teeth marks on its edges

• a tendency to loose stools but possibly constipation

• cold hands and feet

• a fine pulse which is often soggy or soft in the right bar position

• lack of strength in the four extremities

• dizziness when standing up

The signs and symptoms of kidney yin vacuity include:

• night sweats

• a pale red tongue or a pale tongue with red tip

• hot flashes

• scanty tongue fur

• heat in the five hearts or centers

• a fine, rapid or possibly floating, surging pulse

• tinnitus and dizziness

• thirst or a dry mouth but no desire to drink

The signs and symptoms of yang vacuity include:

• low back and/or knee pain

• cold feet

• frequent urination

• decreased sexual desire

• nocturia

The signs and symptoms of liver depression include:

• premenstrual or menstrual lower abdominal distention

• irritability

• lower abdominal cramping

• a bowstring pulse

• premenstrual breast distention and pain

The signs and symptoms of blood stasis include:

• fixed, sharp, and/or severe lower abdominal pain

• a sooty facial complexion

• blood clots in the menstruate

• a purplish tongue or static spots or macules on the tongue

• fixed lumps in the breast that are painful to pressure

• worsening of symptoms at night

• a possibly choppy and/or deep pulse

• visible engorged varicosities, including small hemangiomas, spider nevi, and hemorrhoids

Combinations
For visceral agitation, heart palpitations, vexation and agitation, and insomnia, this formula can be combined with Gan Mai Da Zao Wan (Licorice, Wheat & Red Dates Pills). For greater supplementation of the qi in order to treat more pronounced fatigue, one can combine this formula with Shen Qi Da Bu Wan (Ginseng & Astragalus Greatly Supplementing Pills). For greater supplementation of yin, it may be combined with Da Bu Yin Wan (Greatly Supplementing Yin Pills) or Zuo Gui Wan (Return the Left [Kidney] Pills). For greater supplementation of spleen qi and kidney yang, it may be combined with You Gui Wan (Return the Right [Kidney] Pills). For more marked qi stagnation and blood stasis with possible chest pain, one can combine this formula with Dan Shen Yin Wan (Salvia Drink Pills). For more marked qi and yin vacuity, it can be combined with Gu Ben Wan (Secure the Root Pills). If there is yang vacuity and fluid dryness constipation, this formula may be combined with Cong Rong Bu Shen Wan (Cistanches Supplement the Kidneys Pills). If constipation is primarily due to intestinal dryness, it can be combined with Tao Ren Wan (Persica Seed Pills). If there are generalized symptoms of fluid dryness, one can combine this formula with Sheng Mai San (Engender the Vessels [or Pulse] Powder, i.e., Pills). If there is concomitant headaches and/or dizziness due to yin vacuity and ascendant yang hyperactivity or stirring of internal wind, it may be combined with Tian Ma Gou Teng Wan (Gastrodia & Uncaria Pills), etc.

Formula explanation
Anemarrhena nourishes the kidneys and clears vacuity heat, while Phellodendron cleas heat and eliminates dampness. By leading yang back down to its lower source, Li Dong-yuan even says these two medicinals in combination supplement the essence, although this effect may only be indirect. Codonopsis fortifies the spleen and boosts the qi. Dang Gui, Peony, and cooked Rehmannia nourish the blood and enrich yin. Ligusticum Wallichium upbears yang and also quickens the blood, rectifying the qi within the blood. Achyranthes downbears the blood and also quickens the blood. Uncooked Rehmannia clears heat from the blood, also quickens the blood, and has some ability to enrich yin as well. Psoralea fortifies the spleen and supplements the kidneys. This means it supplements the spleen qi and kidney yang. It is assisted in supplementing kidney yang by Eucommia which nourishes the liver and invigorates the kidneys. When Achyranthes, Psoralea, and Eucommia are used together, they strengthen the low and knees. Poria assists Codonopsis in fortifying the spleen. However, it also seeps dampness and leads fire to move downward. In addition, it quiets the spirit. Citrus rectifies the qi, harmonizes the stomach, eliminates dampness, and transform phlegm. Fennel moves the qi specifically in the liver channel. It stops pain and also relieves abdominal distention (and flatulence). Licorice harmonizes all the other medicinals in the formula, while nourishing the heart and quieting the spirit.

Dosage
Three capsules two times per day equal not less than 36g of raw medicinals. However, because our extraction process is so much more efficient than stove-top decoction, we believe that this amount of our extract is actually more like the equivalent of 48-72g of bulk-dispensed herbs.
 

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