You are on page 1of 17

The Evolution of Shn Q Wn (Kidney Q Pill)

by Lorraine Wilcox L.Ac.

Shn Q Wn (Kidney Q Pill) is known by many names: B Wi D Hung


Wn (Eight Ingredient Rehmannia Pill), B Wi Wn (Eight Ingredient Pill), and so
forth. It has a long history. Over the last 1,800 years, its uses have expanded, the theories
explaining its structure and functions have developed, and doctors have derived other important
formulas from it. This essay tracks the developments chronologically from the Hn dynasty
through the late Mng dynasty. All translations are my own, and all are enclosed in text boxes.

The first extant description of Shn Q Wn is found in Jn Gu Yo L (Essentials of the


Golden Cabinet) by Zhng Zhngjng (3rd century CE, Hn).1 Here is the original text and
recipe:


Diseases of Blood B-Obstruction and Deficiency Taxation with Pulses, Symptoms, and
Treatment, Chapter 6
Line 6.15:
B Wi Shn Q Wn (Eight Ingredient Kidney Q Pill) is indicated for someone with
deficiency taxation, lower back pain, hypertonicity of the lesser abdomen, and inhibited
urination.

The Formula for Shn Q Wn (Kidney Q Pill)


gn d hung eight ling
shn yo
shn zh y four ling of each
z xi

m dn p
three ling of each
f lng
gu zh
f z blast-fried one ling of each

Powder the above eight ingredients. Blend with processed honey and make pills the size
of w tng z (about 0.6-0.9 centimeters in diameter). Swallow fifteen pills with liquor,
increasing up to twenty-five pills. Take them twice a day.

Shn Q Wn is mentioned in three additional lines of Jn Gu Yo L, translated below:


Diseases of Phlegm-Rheum and Cough with Pulses, Symptoms, and Treatment, Chapter
12

Lorraine Wilcox L.Ac. Draft 1


Line 12.17:

Lng Gu Zh Gn Tng (Poria, Cinnamon Twig, White Atractylodes, and Licorice
Decoction) is indicated for shortness of breath with slight rheum; the rheum should be
removed through urination; for the formula, see above. Shn Q Wn (Kidney Q Pill) is
also indicated for this.

In Line 12.17, Lng Gu Zh Gn Tng is the primary formula, but Shn Q Wn can also be
used. We will ignore Lng Gu Zh Gn Tng in this essay. However, this line tells us that Shn
Q Wn can treat shortness of breath when there is a small accumulation of turbid fluids.


Diseases of Dispersion-Thirst and Dribbling Urination with Pulses, Symptoms, and
Treatment, Chapter 13
Line 13.3:
Shn Q Wn (Kidney Q Pill) is indicated for males with dispersion-thirst when
urination is repeated and copious; when he drinks one du, he urinates one du.


Miscellaneous Diseases in Women with Pulses, Symptoms, and Treatment, Chapter 22
Line 22:19:

Someone asked: What is it when a female patient whose eating and drinking are
unaffected has vexation heat, inability to sleep, and contrary incline breathing? The
Teacher said: This is named shifted bladder and she is unable to urinate. Rotation of the
bladder attachment is the reason for this disease. Just disinhibit urine and she will
recover. Shn Q Wn (Kidney Q Pill) is indicated for it.

The various indications and conditions from Jn Gu Yo L are summarized in the table below:

Line 6.15 Line 12.17 Line 13.3 Line 22:19


gender either either male female
rheun is
urination is unable to urinate, shifted
inhibited removed
urination repeated and bladder, rotation of the
urination through
copious bladder attachment
urination
shortness of
upper incline breathing, inability to
- breath, slight -
jio sleep, vexation heat
rheum
middle eating and drinking are
- - -
jio unaffected
lower back pain,
lower
hypertonicity of - - -
jio
lesser abdomen

Lorraine Wilcox L.Ac. Draft 2


deficiency dispersion-
systemic - -
taxation thirst

Many indications are listed in these four lines, including systemic conditions and symptoms of
the upper and lower jio. However, the unifying factor is that urination is involved in all. This
makes sense for a medicine called Kidney Q Pill. Note that reproductive or sexual disorders are
not mentioned, even though they also correspond to kidney problems.
***
In Zhu Hu Bi J Fng,2 the formula is called B Wi Shn Q Wn and the proportions of the
ingredients are different.3

gn d hung four ling


f lng
sh y
gu two ling of each
m dn
shn zh y
f z
one ling
z xi

Pound into honey pills the size of w tng z (about 0.6-0.9 centimeters in diameter).
Take seven pills, three times a day, increasing up to ten pills.


This is the B Wi Shn Q Wn formula of Zhng Zhngjng. It treats deficiency
taxation and insufficiency with great injury, 4 drinking water [thirst], lower back pain,
tension of the lower abdomen, and inhibited urination. It is also said that if taken for a
long time, remove the f z and add in w wi z.5 It treats strong wind and cold.

Most of the symptoms listed here are also found in the four lines of Jn Gu Yo L. However, a
modification is listed if the formula is to be taken for a long time, as f z toxicity is a concern.

2
Zhu Hu Bi J Fng (Emergency Prescriptions to Keep Up Your Sleeve) is by G
Hng (published circa 341, Eastern Jn). This passage is found in Volume 4 in the section on formulas for
deficiency, emaciation, and inability to work ().
3
All the recipes in this essay call for pills the size of w tng z (about 0.6-0.9 centimeters in diameter), so each pill
should hold about the same weight of herbs. Therefore, the number of pills taken per day determines the daily
dosage. The formula in Zhu Hu Bi J Fng makes a smaller batch and so would make fewer pills because the
total weight of all the herbs is less than in the other recipes. The importance of the weight of each herb is in the
internal balance or proportions within the formula. The proportions in Zhu Hu Bi J Fng are different from
those in the other books. For a comparison of proportions and dosages, see the table in the discussion at the end of
this paper.
4
In Sn Smios version below, this phrase reads strong thirst with desire to drink water. injury
is probably a typo for thirst.
5
This variation is generally called Ji Jin B Wi Wn (Eight Ingredient Variant Pill). It is unclear
who originally said this. This variation is not found in the extant version of Jn Gu Yo L.

Lorraine Wilcox L.Ac. Draft 3


***
The next occurrence of Shn Q Wn that we will examine is in the section on formulas for the
kidneys in Volume 19 of Bi J Qin Jn Yo Fng (Essential Prescriptions for Emergencies
Worth a Thousand Pieces of Gold) by Sn Smio (652, Tng). 6 The ingredients are the same as
in Jn Gu Yo L but the dosage for gu xn and f z is doubled. The indications are almost a
direct quotation from Zhu Hu Bi J Fng. A couple of variations for the pill are mentioned.

B Wi Shn Q Wn (Eight Ingredient Kidney Q Pill)



The formula treats deficiency taxation and insufficiency, strong thirst with desire to
drink water, low back pain, hypertonicity of the lower abdomen, and inhibited
urination.
d hung eight ling
zh y
shn yo four ling of each
dn p

f lng
three ling of each
z xi
gu xn
f z two ling of each

Powder the above eight ingredients. Make honey pills the size of w tng z (about 0.6-
0.9 centimeters in diameter). Take fifteen pills with liquor, three times a day. Gradually
increase up to twenty-five pills.


Zhng Zhngjng said: Remove the f z if taken often, and add w wi z. 7
Yo Gng said: Add three ling of w wi z and four ling of cng rng.
Zhng Wnzhng8 added four ling each of w wi z and cng rng.
Zhu Hu Fng (Prescriptions to Keep Up Your Sleeve) uses four ling of d hung,
one ling each of z xi and f z, and two ling each of the rest of the ingredients.9

In Sns later book, Qin Jn Y Fng,10 there is another variation in the proportions of the herbs
and the number of pills to be taken per day. Fewer pills are prescribed per day but we are told
that the formula may be taken for a long time. (See the table at the end of this paper for details of
proportions and dosage.) No specific indications were given in Qin Jn Y Fng, but the formula
was listed under the heading of pills and powders to supplement deficiency.

6

7
This is the same modification given in Zhu Hu Bi J Fng. However, there it was not clearly attributed to Zhng
Zhngjng. It is not found in the extant version of Jn Gu Yo L.
8
Zhng Wnzhng was a Tng dynasty doctor and author. The identity of Yo Gng is currently unknown.
9
See above for the text of Zhu Hu Bi J Fng.
10
Qin Jn Y Fng (Supplement to Formulas Worth a Thousand Pieces of
Gold) by Sn Smio (682, Tng), in Volume 15 on Supplementing and Boosting.

Lorraine Wilcox L.Ac. Draft 4


***
Tipng Hu Mn H J J Fng (Imperial Grace Formulary of the Ti Png Era)11 was compiled
by the Sng Imperial Medical Bureau. It fills out the clinical picture a lot, providing additional
symptoms, a name for the pattern, and a brief discussion of its functions. This passage contains
the first explicit mention of yng associated with the formula. It also says that this formula
benefit jng-essence, marrow, blood, and the zh-will. Note that for the first time, this recipe
specifies sh gn d hung, not simply gn d hung or d hung. Besides
the newer information, J Fng echoes the indications mentioned by Jn Gu Yo L, Zhu Hu
Bi J Fng, and Qin Jn Fng.

B Wi Wn (Eight Ingredient Pill)






Treats kidney q deficiency when the lower origin is cold and exhausted, with pain of
the umbilicus and abdomen, copious nighttime urination, slack weak legs and knees,
worn out body, dark facial complexion, and no thought of food or drink. It also treats
leg q surging upward with numbness of the lesser abdomen as well as deficiency
taxation and insufficiency, thirst with desire to drink water, heaviness and pain of the
lower back, hypertonicity of the lesser abdomen, and inhibited urination; or males with
dispersion-thirst when urination is repeated and copious; females with shifted bladder
and urinary stoppage. It is suitable to treat all of this.
m dn p

bi f lng
three ling of each
z xi
sh gn d hung eight ling
shn zh y
shn yo four ling of each
blast-fry; remove
f z
the skin and umbilicus
two ling of each
ru gu remove the coarse skin


Powder the above. Make into pills the size of w tng z (about 0.6-0.9 centimeters in
diameter) with processed honey. Each dose is fifteen pills up to twenty-five pills,
swallowed before eating with warm liquor on an empty stomach. Take it twice a day.

11
Tipng Hu Mn H J J Fng was updated several times so its dates
are 1078-1110 (Sng). Because the name of the book is so long, people often refer to it as the J Fng (Official
Formulary). The text here comes from Volume 5, Treating Various Deficiencies.

Lorraine Wilcox L.Ac. Draft 5



Taking it for a long time invigorates original yng, boosts jng-essence and marrow,
enlivens blood, preserves the facial complexion, strengthens the zh-will, and lightens
the body.
***
A big innovation appeared in Xio'r Yo Zhng Zh Ju (The Key to Therapeutics of Children's
Diseases) by Qin Y (1114, Sng).12 Qin removed the two hot ingredients (cinnamon and f z)
and renamed the formula D Hung Wn (Rehmannia Pill). Later, this variation became
more commonly known as Li Wi D Hung Wn (Six Ingredient Rehmannia
Pill). Note that here it is a pediatric formula.

D Hung Wn (Rehmannia Pill)



Treats kidney timidity with loss of voice, unclosed fontanels, insufficiency of shn-
spirit, a lot of the whites of the eyes [showing], pale white facial complexion, and so
forth.
sh d hung eight qin
shn y ru
gn shn yo four qin of each
z xi

m dn p
three qin of each
bi f lng remove the skin

Powder the above. Make into pills the size of w tng z (about 0.6-0.9 centimeters in
diameter) with processed honey. Take on an empty stomach by dissolving three pills in
warm water and swallowing it.

During the Mng dynasty, Zho Xink explained Qin Ys concept for this modification: 13


Master Qin removed gu and f and named it Li Wi D Hung Wn (Six Ingredient
Rehmannia Pill) in order to treat children. He took children as pure yng, so he removed
gu and f.

Today, this variant formula is commonly used for adults (especially older people), but it is
important to note that Qin was a pediatrician. It is generally agreed that children are relatively
yng and easily develop high fevers, so removing the two hot ingredients makes theoretical
sense. However, the symptoms listed by Qin are quite cold and deficient, a far cry from todays
common usage of Li Wi D Hung Wn for yn deficiency. Li Wi D Hung Wn itself has
given birth to many variant formulas, but they will not be discussed in this essay.

12

13
Y Gun (Thorough Knowledge of Medicine) by Zho Xink (1617,
Mng). For more discussion from this book, see below.

Lorraine Wilcox L.Ac. Draft 6


***
No specific indications were given for B Wi Wn in P J Bn Sh Fng (Formulas for
Universal Relief) by X Shwi (1132, Southern Sng),14 but the formula is found in Volume 6
under the title of Various Types of Cough, Deficiency Sweating, and Dispersion-Thirst. The
dosage of the two hot herbs is even higher. More specific directions are given for the processing
of each herb. Some food contraindications are listed.

B Wi Shn Q Wn (Eight Ingredient Kidney Q Pill)



weigh a
gn d hung sprinkle with liquor, steam nine times and
half jn15
sun-dry nine times, stone-bake
shn yo four ling
f lng remove the skin
m dn p
three ling of
f z
blast-fried, remove the skin and umbilicus each
gu xn dont expose it to fire
z xi four ling
shn zh y including the kernel five ling

Make the above into fine powder. Make pills the size of w tng z (about 0.6-0.9
centimeters in diameter) with processed honey. Swallow twenty or thirty pills with
liquor. Avoid pork, cold water, w y (elm cakes), and h su (coriander).
***
Another variation that is still common today was developed in J Shng Fng (Formulas to Aid
Life) by Yn Yngh (1267, Sng).16 In the section on water swelling (in Volume 4), ch qin z
and chun ni x are added to the other eight herbs.

Ji Wi Shn Q Wn (Modified Kidney Q Pill)



Treats kidney deficiency with heaviness of the low back, swelling of the legs, and
inhibited urination.
f z blast-fried two ling
bi f lng remove the skin
z xi
shn zh y keep the flesh
one ling of
shn yo stir-fried
each
ch qin z steamed in liquor
m dn p remove the woody part

14

15
One jn equals sixteen ling so half a jn is the equivalent of eight ling.
16

Lorraine Wilcox L.Ac. Draft 7


gun gu dont expose it to fire
chun ni x remove the neck, soak in liquor a half ling of
sh d hung each

Make the above into coarse powder. Make into pills the size of w tng z (about 0.6-0.9
centimeters in diameter) with processed honey. Each dose is seventy pills, taken on an
empty stomach. Swallow with rice drink (m yn). 17

After this, people differentiated this variation from the original pill by naming them
J Shng Shn Q Wn (Kidney Q Pill from J Shng Fng) and Jn Gu Shn Q
Wn (Kidney Q Pill from Jn Gu Yo L). Bensky writes that J Shng Shn Q Wn has a
stronger effect on the waterways and is often prescribed for edema (page 278).
***
By the time we arrive at the Mng dynasty, Li Wi D Hung Wn had become popular for
adults. In fact, in Xu Js and Zhng Jibns works, B Wi Wn seems to be viewed as a
variation of Li Wi Wn. For example, in Ni K Zhi Yo (Summary of Internal Medicine) by
Xu J (1548, Mng),18 B Wi Wn is described as Li Wi Wn adding one ling each of ru
gu and f z. Many of the symptoms listed for Li Wi Wn correspond to yn deficiency with
heat.

Li Wi Wn (Six Ingredient Pill)



other names are D Hung Wn (D Hung Pill) and Shn Q Wn (Kidney Q Pill)



Treats insufficiency of the kidney channel with fever that leads to thirst, dribbling tight
urination, q obstruction with phlegmy cough, dizzy head and eyes, blurred vision,
deafness, dry throat, painful tongue, teeth not firm, weak atrophied low back and legs,
spontaneous sweating, night sweating, blood in the stool, various types of bleeding, loss
of voice, water flooding and becoming phlegm, blood deficiency fevers, and similar
symptoms. Its effects cannot be completely recounted [because there are too many].
sh d hung pestle into paste eight ling
shn zh y ru
gn shn yo four ling of each
m dn p

bi f lng
three ling of each
z xi

17
This may indicate rice soup.
18

Lorraine Wilcox L.Ac. Draft 8

Powder each of the above separately. Blend with the d hung and add honey to make
pills the size of w tng z (about 0.6-0.9 centimeters in diameter). Each dose is seventy
or eighty pills, taken on an empty stomach before eating. Swallow them with boiled
water.

B Wi Wn (Eight Ingredient Pill)




Treats debilitated mng mn fire with inability to engender earth. This results in
deficiency cold of the spleen and stomach, decreased thought of food and drink, stool
that is not solid, pain of the umbilicus and abdomen, copious nighttime urination, and
similar symptoms.

This means Li Wi Wn adding one ling each of ru gu and f z.

Here we can clearly see the dichotomy of Li Wi Wn for yn deficiency and B Wi Wn for
yng deficiency, as is common in modern use. Also note, this is the first mention of spleen,
stomach, and earth element as a region treated by B Wi Wn. There were no symptoms of the
middle jio listed in Jn Gu Yo L. Before this, only J Fng listed anything to do with the
spleen, and that was just the one symptom of no thought of food or drink.
***
Guiding fire back to its source () or guiding fire back to its origin () is a
concept associated with B Wi Wn. This phrase seems to have been first used by Zhng Jibn
in Jng Yu Qun Sh (Complete Writings of Zhng Jngyu) (1624, Mng).19 The phrase
remained popular with warm supplementation doctors who came after, such as Zho Xink. It
describes a function of certain hot herbs such as ru gu and f z (as well as formulas that
contain these herbs, such as B Wi Wn). Guiding fire back to its source is a therapeutic
principle for true cold and false heat with symptoms of yng or heat rising to the upper body.
The heat is due to unanchored yng floating up or weak displaced yng being forced upward -
yng deficiency can allow water to flood in, pushing the weakened yng upward.

Volume 7 of Jng Yu Qun Sh, Zhng recommends D B Yun Jin, Yu


Gu Yn, and/or Cu Sh B Wi Wn (another name for Jn Gu B Wi Wn) to
guide fire back to its origin. Zhng gives the recipe for Cu Sh B Wi Wn in Volume 53 of
Jng Yu Qun Sh:


Cu Sh B Wi D Hung Wn (Master Cus20 Eight Ingredient Rehmannia Pill)

19

20
It is currently unclear who Master Cu was. A Master Cu Zht () contributed many formulas to
Wi Ti M Yo. B Wi Wn is found in Volume 18 of Wi Ti M Yo, but there, it is attributed to Zhng
Zhngjng, so it is probably not this Master Cu.

Lorraine Wilcox L.Ac. Draft 9





Treats debilitated mng mn fire with inability to engender earth. This results in
deficiency cold of the spleen and stomach, decreased thought of food and drink, stool that
is not solid; or coldness and exhaustion of the lower origin with pain of the umbilicus and
abdomen, and similar symptoms.21

Wng Tip22 said: Boost the source of fire to disperse yn screens, meaning this.

This indicates the above formula, Li Wi D Hung Wn, adding one ling each of ru
gu and processed f z.

Cu Sh B Wi D Hung Wn is simply another name for B Wi Wn. It was included using


this name in the Sng dynasty revision of Jn Gu Yo L under formulas appended to the
chapter on wind-stroke and joint running (). There, it says it treats
Hong Kong leg ascending to enter the lesser abdomen with numbness (
).

Zhng Jibns description of B Wi D Hung Wn is quite similar to Xu Js. They both were
instrumental in developing the school of warm supplementation () as was the next doctor,
Zho Xink.
***
A major discussion of B Wi Wn is found in Y Gun (Thorough Knowledge of Medicine) by
Zho Xink (1617, Mng).23

In his explanation for vomiting blood (Volume 3 of Y Gun), Zho wrote:



There is another kind [of vomiting blood], which is true yn failing in its duty so mng
mn fire becomes debilitated and fire does not return to its origin. Water flourishes and
compels the fire to float upward. The upper jio has cough, shortness of breath, aversion
to heat, and red face, with vomiting of phlegm and blood. This is connected to a pattern
of false yng. One must use B Wi D Hung Wn to guide fire back to its origin.

This describes the mechanism by which minister fire can flare upward and cause heat symptoms
in the upper jio. Many today would read these symptoms as a pattern of yn deficiency fire and
be horrified at the idea of prescribing B Wi Wn. However, it is easy to see that if this disease
mechanism exists in a patient, herbs to supplement kidney yn would only increase the water

21
Up to this point, this is almost an exact quotation from Xu J.
22
Wng Tip is another name for Wng Bng (Tng).
23

Lorraine Wilcox L.Ac. Draft 10


flourishing and compelling the fire to float upward. Careful diagnosis is needed and a simplified
understanding of the formulas could result in harm to a patient.

One could also use this idea to understand Line 22:19 of Jn Gu Yo L in which the patient
has vexation heat, inability to sleep, and respiratory distress, symptoms of heat in the upper jio.

Zho provides the recipe and further discussion in Volume 4.

B Wi Wn (Eight Ingredient Pill)




Treats debilitated mng mn fire with inability to engender earth. This results in
deficiency cold of the spleen and stomach, decreased thought of food and drink, stool
that is not solid.24 Or the lower origin is debilitated and exhausted with pain of the
umbilicus and abdomen, copious nighttime urination, and similar symptoms.



Wash the genuine unprocessed product
in liquor from Huiqng and soak
sh d hung overnight. Put in a willow wood steamer eight ling
and steam it for a half day in a clay pot.
Dry in the sun. Steam again and sun-dry
again for [a total of] nine times as the
goal. Near the time of use, pound it into
a paste.
shn yo four ling
shn zh y ru four ling
dn p three ling
bi f lng three ling
z xi three ling
ru gu one ling
f z one ling




Method for preparing f z: Weigh out thirteen or fourteen qin of f z. Ones that have
lotus petal (lin hu bn) shape with a round head and flat base are good. Have five or
six cups of childs urine (tng bin) ready. Soak the f z for five or six days. Wait for
the moisture to penetrate. Take off the skin and cut [each one] into four pieces. Soak for
three or four more days. Wrap it in several layers of coarse paper. Soak to moisten it and

24
These sentences are taken directly from Xu J or Zhng Jibn.

Lorraine Wilcox L.Ac. Draft 11


roast it in the ashes of a fire. Take it out and slice it. Check for those that have white
stars. Further broil them on a new tile until there are no white stars as the goal. If you
want to use them quickly, cut big slices and boil them in childs urine for three or four
boilings. Blast-fry them on a hot tile until they are cooked and they are ready for use.25

Zho went on to discuss the formula and a number of its modifications. He felt that many people
who modified it had no idea of the original intention of the formula ().

Later in Y Gun, Zho explained his understanding of B Wi Wn.


B Wi Wn (Eight Ingredient Pill) Theory



The superior person observes the images26 within kn and realizes that the kidneys
possess the do of water and fire within them. Whatever way you look at it, one yng
[line] residing within two yn [lines] is kn. This is human life resembling heaven and
earth.27 When people today enter the bedroom enthusiastically, their yng thing [the
penis] is easily aroused, and yn deficiency fire stirs. If the yng thing becomes wilted
[impotence], mng mn fire is debilitated. When true water is exhausted, midwinter is not
cold; when true fire ceases, midsummer is not hot.

In the Mng dynasty and after, the two yn lines of kn were viewed as the two physical kidneys
or kidney yn. The one yng line was seen as mng mn fire or kidney yng. When true water is
exhausted, midwinter is not cold refers to yn deficiency fire and people with excessive sex
drive. When true fire ceases, midsummer is not hot refers to debility of mng mn fire and
impotence. In other words, the seasons of the human body are totally out of balance.

25
Y Gun does not give directions for making the pills or the daily dosage.
26
xing image is an important concept in the theories of Y Jng (Change Classic). Ancient doctors,
including Zho, frequently used Change Theory to explain medicine.
27
There is a resemblance [of humans] with heaven and earth so there are no exceptions.
X C Zhun, Volume 1

Lorraine Wilcox L.Ac. Draft 12


In this formula, sh d, shn y, dn p, z xi, shn yo, and f lng are all moist items;
because of this, they govern the ability to strengthen water. Ru gu and f z are acrid
moist items; they can supplement the fire that is within water; because of this they boost
the source of fire. When water and fire receive their nourishment, kidney q recovers its
inherent nature. Boosting the source of fire disperses yn screens. That is what this
formula is about. It undoubtedly boosts the spleen-stomach and banks up the mother of
the ten-thousand things [earth]; the benefits are vast.

Surprisingly, Zho states that ru gu and f z are acrid moist items. One might easily consider
them drying, but they must be less so than herbs like gn jing. Being somewhat moist,
they may have more of an affinity for the kidneys, the water zng.

Lorraine Wilcox L.Ac. Draft 13


Discussion
Some classical () practitioners believe these later developments are unnecessary and detract
from the original formula, while others feel that they improve the understanding and usage. This
essay does not engage in that debate. It simply tracks the developments chronologically from the
Hn dynasty through the late Mng dynasty without judgment.

The table below outlines the variant names given for each ingredient, the proportion of each
herb, and the daily dosage of pills in different books. Variant formulas are not included.

Proportions and Alternate Names of Ingredients, Daily Dosage of B Wi Wn


shn z m f daily
Book d hung shn yo zh y xi dn p f lng gu z dose
gn d gu 15-25,
Jn Gu shn yo 4 3 3 3 1
hung zh 1 2x
Zhu gn d m
sh y 4 2 4 4 2 7-10, 3x
Hu28 hung dn 4
Qin zh y dn p gu 15-25,
d hung shn yo 3 3 2
Jn 4 3 xn 2 3x
Qin gn d gu
sh y 4 2 3 3 2 7-10, 3x
Jn Y hung xn 2
sh gn bi f ru 15-25,
J Fng shn yo 4 3 3 2
d hung lng 3 gu 2 2x
gn d gu 20-
Bn Sh shn yo 529 4 3 3 3
hung xn 3 30, ?x
sh d gn shn shn zh bi f ru
Ni K 3 3 1 70-80
hung yo y ru 4 lng 3 gu 1
Jng sh d dn p bi f ru
shn yo 4 3 1 70-80
Yu hung 3 lng 3 gu 1
Y sh d shn zh dn p bi f ru
shn yo 3 1 ?
Gun hung y ru 4 3 lng 3 gu 1
21-80
Range 8 4 4-5 2-4 3-4 3-4 1-4 1-3
per day
The numbers in this table originally referred to units of ling. However, the equivalence of ling
to grams is not important as the recipes make large batches. One should read the numbers as
proportions. Whatever measurement is used (qin, ling, grams, kilograms, etc.), there are eight
parts d hung to 4 parts shn yo to 1 part f z, etc. The differing proportions affect the internal
balance of the formula but not the daily dosage.

The total daily dosage a patient receives is based on the number of pills times the frequency
taken in a day. Since all the recipes call for pills the size of w tng z (about 0.6-0.9 centimeters
in diameter), one pill from any recipe contains approximately the same weight of herbs as one
pill from another recipe, although the internal proportions of herbs vary from recipe to recipe.
28
The recipe in Zhu Hu Bi J Fng is about half of the size as the batches in other sources. To make comparison
easier, the number of ling for each ingredient are all doubled in this table, but the proportions remain the same.
29
P J Bn Sh Fng specifies to include the kernel of shn zh y, which would explain the higher weight. As can
be seen in this table, many other books specified the flesh (ru) which would not include the kernel.

Lorraine Wilcox L.Ac. Draft 14


While it is not clearly stated, the dose of 70-80 pills mentioned in Ni K Zhi Yo and Jng Yu
Qun Sh is probably the daily dose, which may be broken into two or three smaller doses per
day.

Jn Gu Yo L, Ni K Zhi Yo, Jng Yu Qun Sh, and Y Gun all have the same
proportions for the herbs. However, the daily dosage varies between them.

Qin Jn Fng and Tipng Hu Mn H J J Fng share the same proportions for the herbs.
However, the daily dose is higher in Qin Jn Fng than in J Fng.

The books used different names for some of the herbs, but the variant names make no difference
in some cases (for example, bi f lng versus f lng). In other cases, the difference is significant
(gn d hung versus sh d hung). Sh d hung (cooked d hung) and gn d hung (dried d
hung) are processed differently and have different functions, so which to use is an important
question. Later books tend to designate sh d hung.

The various names for gu-cinnamon are also an issue. There is controversy over the meaning of
gu zh in Zhng Zhngjngs writings. Some think his gu zh is todays ru gu. Within the bark
of the plant, there are different layers that may be selected, and different species of cinnamon
exist.

While there are no variant names for f z, different methods of processing are described in the
texts above, and some recipes do not mention processing at all. The processing may lead to
minor differences in function, but more importantly, some methods may be better to detoxify f
z than others. Zhu Hu Bi J Fng stated that when this formula is used for a long period of
time, it is better to substitute w wi z for f z. It seems since early times, they knew f z was
powerful but could be dangerous.

In this paper, we have traced B Wi Wn through the centuries. It began as a formula that
primarily involved urinary problems with a few symptoms of the upper jio. Expanded uses
began to include spleen functions. The original name of the pill emphasized kidney q deficiency,
while later the focus was on kidney yng deficiency. Eventually, instead of seeing the patient as
purely cold and deficient, B Wi Wn could be used to guide fire back to its source where there
were heat symptoms above. Variations of this pill were developed, the most famous being Li
Wi D Hung Wn. While originally developed for pediatric use, Li Wi D Hung Wn was
commonly used later to treat yn deficiency.

Many practitioners today simply think of B Wi Wn for yng deficiency and Li Wi Wn for
yn deficiency. One can see that there are more nuanced ways to understand these two formulas.

Lorraine Wilcox L.Ac. Draft 15


Appendix
An Incomplete Timeline of B Wi Wn (Eight Ingredient Pill)
Source Name for B Wi Wn Related Formula
B Wi Shn Q
Wn (Eight Ingredient Kidney Q
Note: The books below may
Pill), Shn Q Wn
Jn Gu Yo L (Essentials of the contain other related formulas, but
(Kidney Q Pill) [later called
Golden Cabinet) by Zhng Zhngjng only the ones discussed above are
(3rd century CE, Hn) Jn Gu Shn Q Wn listed in this column.
(Kidney Q Pill from Jn Gu Yo
L)]

B Wi Shn Q
Zhu Hu Bi J Fng (Emergency
Wn (Eight Ingredient Kidney Q
Prescriptions to Keep Up Your Sleeve)
Pill)
by G Hng (circa 341, Eastern Jn)

Bi J Qin Jn Yo Fng (Essential B Wi Shn Q
Prescriptions for Emergencies Worth Wn (Eight Ingredient Kidney Q
a Thousand Pieces of Gold) by Sn Pill)
Smio (652, Tng)

B Wi Shn Q
Qin Jn Y Fng (Supplement to
Wn (Eight Ingredient Kidney Q
Formulas Worth a Thousand Pieces of
Pill)
Gold) by Sn Smio (682, Tng)

Tipng Hu Mn H J J Fng B Wi Wn (Eight
(Imperial Grace Formulary of the Ti Ingredient Pill)
Png Era), (1078-1110, Sng)
D Hung Wn (Rehmannia
Xio'r Yo Zhng Zh Ju (The Key Pill) [same as Li Wi
to Therapeutics of Children's D Hung Wn (Six Ingredient
Diseases) by Qin Y (1114, Sng) Rehmannia Pill)]

B Wi Shn Q
P J Bn Sh Fng (Formulas for
Wn (Eight Ingredient Kidney Q
Universal Relief) by X Shwi
Pill)
(1132, Southern Sng)
Ji Wi Shn Q Wn
(Modified Kidney Q Pill) [also
J Shng Fng (Formulas to Aid Life) called J Shng Shn
by Yn Yngh (1267, Sng) Q Wn (Kidney Q Pill from J
Shng Fng)]
Li Wi Wn (Six

Ingredient Pill) [also called
Ni K Zhi Yo (Summary of B Wi Wn (Eight
D Hung Wn (D Hung Pill) and
Internal Medicine) by Xu J (1548, Ingredient Pill)
Shn Q Wn (Kidney Q
Mng)
Pill)]
Cu Sh B
Jng Yu Qun Sh (Complete Wi D Hung Wn (Master
Writings of Zhng Jngyu) by Zhng Cus Eight Ingredient
Jibn, (1624, Mng) Rehmannia Pill)

Y Gun (Thorough Knowledge of B Wi Wn (Eight
Medicine) by Zho Xink (1617, Ingredient Pill)
Mng)

Lorraine Wilcox L.Ac. Draft 16


References
Bensky D and Barolet R (1990); Chinese Herbal Medicine: Formulas and Strategies; Eastland
Press: Seattle.

G H (1996); Zhu Hu Bi J Fng (Emergency Prescriptions to Keep


Up Your Sleeve); (rnmn wishng chbn sh) People 's Health
Publishing House: Bijng.

Qin Y (2005); Xio'r Yo Zhng Zh Ju (The Key to Therapeutics


of Children's Diseases); (tinjn kxu jsh chbn sh) Tianjin
Science and Technology Press: Tinjn.

Sng Imperial Medical Bureau, L ZL, et al. (editors), (1997);


Tipng Hu Mn H J J Fng (Imperial Grace Formulary of the Ti Png Era);
(lionng kxu jsh chbn sh) Lionng Science and Technology
Press: Shnyng.

Sn SM (author), Li GS, et al. (editors) (1994); Qin Jn Fng


(Prescriptions Worth a Thousand Pieces of Gold); (huxi chbn sh)
Huaxia Publishing House: Bijng.

X SW (author), Li JC and Li JS (editors) (2005);


X Shwi yxu qunsh (The Complete Medical Works of X Shwi);
(zhnggu zhng yyo chbn sh) China Traditional Chinese Medicine
Publishing House: Bijng.

Xu J (author), Sheng WZ et al. (editor) (1999); Xu Lzhi


Y Xu Qun Sh (The Complete Medical Works of Xu Lzhi);
(zhnggu zhng yyo chbn sh) China Traditional Chinese Medicine Publishing
House: Bijng.

Yn YH; J Shng Fng (Formulas to Aid Life), viewed at


http://ctext.org/wiki.pl?if=en&res=380914 on July 31, 2017.

Zhng JB, Zho LX (editor) (1991); Jng Yu Qun Sh


(Complete Writings of Zhng Jngyu); (rnmn wishng chbn sh)
People 's Health Publishing House: Bijng.

Zhng ZJ (author); Wiseman N and Wilms S (translators) (2013); Jn Gu Yo L: Essential


Prescriptions of the Golden Cabinet; Paradigm Publications: Taos NM.

Zho Xink, Gu JS (editor) (2005); Y Gun (Thorough


Knowledge of Medicine); (rnmn wishng chbn sh) People 's
Health Publishing House: Bijng.

Lorraine Wilcox L.Ac. Draft 17