Also known as shen qi wan, cui shi ba wei wan, jin gui shen qi wan, gui fu di huang wan
Source Shang Han Za Bing Lun
sheng di huang 24 shan yao 12 shan zhu yu 12 fu ling 9 ze xie 9 mu dan pi 9 fu zi 3 gui zhi 3
It is important to understand shen qi wan because many modern formulas are based on the trio of sheng di huang, shan yao, and shan zhu yu.
Such as liu wei di huang wan, you gui wan, zou gui wan, zhi bai di huang wan, zan yu dan, da bu yuan jian. This formula first appeared in the Shang Han Za Bing Lun. We find it in the taxation chapter. Taxation refers to the loss of yang function and yin material and nutritive. If we look at the associated text we see what Zhang ji thought was important to know about the use of this formula
For deficiency taxation with lower back pain, urgent tightness in the lower abdomen, and difficult urination, ba wei shen qi wan governs.
Lower back pain is due to a deficiency of blood, nutritive, and material loss in the bones and muscles. Urgent tightness in the lower abdomen is due to a drying of blood. Difficult urination is due to a dryness of fluids.
We see that the Earth element is dry and not giving birth to Metal and Water. The body is so weakened and dry that it is becoming stiff and painful.
For consumptive thirst in men, but adversely with increased urination, for when one drinks one liter one urinates one liter, shen qi wan governs.
This line mentions increased urination. The body and especially the kidneys are so dry that it fails to hold water. Kind of like my plants after a vacation, dry and cracked earth prevents the water from being absorbed.
Shen qi wan treats a taxation pattern where due to excessive loss of yang function and yin nutritive water either drops out the bottom or is inhibited. It tonifies taxation, creates kidney qi, and restores water metabolism.
Arnaud Versluys writes, this formula not only addresses both excess and deficiency of the body’s innermost organs, but also functionally tonifies both the original yin and original yang of the physical body. Shen qi wan is the representative remedy to restore kidney qi which is produced by the constant interaction of the body’s true water and true fire.
Herbs in Shen qi wan
Sheng di nourishes the yin in blood and cools heat due to deficiency. It nourishes the body’s yin supply to nourish the jue yin liver blood storage. This restores the connection between the heart and kidneys through the jue yin. Imperial fire can then descend to the lower burner where it will warm the cold kidney water and promote the creation of physiological kidney qi for healthy water metabolism.
Shan yao is always used classically in taxation cases with weakened water controlling abilities of the spleen and kidneys. It restores normal opening and closing functions of the kidneys.
Shan zhu yu astringes kidney essence into the jue yin channels with its sour collecting nature.
Fu ling and ze xie combined promote urination and lead stagnant fluids into the tai yang bladder system to be expelled through urination. They also move water which promotes the movement of blood which has become stagnant and dry.
Mu dan pi is a blood moving herb that clears stagnation heat from the blood layer. The stagnation heat is caused by increased friction due to blood stasis. It is pungent moving, bitter draining and heat cooling herb.
Fu zi and gui zhi put the emperor back on his throne by warming the shao yin. They both warm the water to promote qi production. Some text books suggest the use of rou gui. Gui zhi is more of a tai yang herb and is a better choice for this shen qi wan pattern.
By removing the fu zi and gui zhi it becomes the modern formula liu wei di huang wan.
In TCM text books we see the following kidney pattern: Kidney yin vacuity with deficiency fire. Often the formula liu wei di huang is recommended to treat this pattern.
By calling this pattern by its yin organ it misleading. Using the climatic qi fire is also wrong. If we are talking about the kidneys we are talking about the shao yin and in shao yin the secondary climatic qi heat rules. Fire rules in shao yang. Yin is failing to hold the yang which becomes reckless and excessive. It is caused by a failure of yin to hold and contain the yang.
The kidneys belong to the shao yin level along with the heart and is coupled to the tai yang. If the yin kidneys are deficient then the yang organs of the bladder and small intestine are also deficient.
Chapter 3 Neijing suwen reads,
Yin is the essence of the organs and the fountain of the qi. Yang protects the exterior of the body against pathogens and makes the muscles function. When the yin fails to contain the yang, the flow in the channels will become rapid, causing the yang qi to become excessive and reckless. If the yang qi is deficient and unable to counterbalance the yin, communication between the internal organs will be disrupted, and the nine orifices will cease to function. When the yin and yang are balanced the true zhen qi becomes unshakable, and pathogens cannot invade.
Using liu wei di huang tang may cool the heat but it will also put out the imperial heat that the emperor needs to rule the kingdom. By removing the fu zi and gui zhi there will be no yang movement and warmth.
In the formula bai zhi di huang tang zhi mu and huang bai are added to cool the deficiency heat even more. Adding zhi mu will weaken the emperor even more. Zhi mu freezes yin fluids and that is why it is used in bai hu tang. Adding huang bai will also cool heat but it also drains dampness causing even more dryness.
Chapter 6 Neijing suwen reads,
Tai yin is the most superficial of the three yin channels, and its nature is expansive. The jue yin is the deepest of the yin. Its nature is that of storing and thus it is considered the house. The shao yin is in between, and acts to connect and is considered the hinge or door. The three yin must work in unison. Collectively they are considered one yin.
To nourish all three yin levels so they can work in unison we need to treat the tai yin, shao yin, and jue yin at the same time. Liu wei di huang just works on the shao yin and jue yin levels. There is no support for the tai yin. There is no tonification of yang qi so there is no movement of yin.
Removing fu zi and gu zhi is creating a very yin formula that will weaken the patient even further.