Spring Is the Season for Kidney Essence: How to Use Shu Di Huang (Prepared Rehmannia) — Doctor Luo Dalun on Doctor Zhang Jingyue’s Six Pairing Directions
💬 Note from Doctor Luo: Dear friends, good morning, everyone. Today we continue our discussion of supporting the upright qi to expel the pathogen. During the pandemic, as a precaution, I drank raw huang qi (astragalus) with gou qi zi (wolfberries) in water every day, and in the evening I had a cup of Yu Ling Gao (Jade Spirit Paste, the paste made by slow-cooking longan flesh). I also drank a cup on my livestreams. When I felt the weather turning a bit cool, I would take two slices of ren shen (ginseng) along with the huang qi and gou qi zi; when it was hot and I was sweating a lot, I switched to a slice of American ginseng — all of these are ways of supporting the upright qi. When your upright qi is sufficient, the body can resist external pathogens. This approach feels very good.
Opening: Spring has arrived — time to bring out the Shu Di Huang
We have talked a great deal about supporting the upright qi, but there is one especially important herb I have not yet introduced — Shu Di Huang (prepared rehmannia).
💬 Note from Doctor Luo: If you can take prepared rehmannia regularly, it is wonderfully good for the body. Why? Because it supplements kidney essence. In the later stages of treating the pandemic, prepared rehmannia was used very widely — because so many people, especially many elderly people, suddenly ended up in the ICU or passed away. Severe deficiency of kidney essence — kidney essence simply not enough — is a very important reason. At that point the body needs to supplement kidney essence. That is why prepared rehmannia appeared so often in those formulas.
So why mention prepared rehmannia especially in spring?
💬 Note from Doctor Luo: In spring all things grow; trees sprout, and they need water underneath — at this time the body needs to nourish the kidney essence below. If the kidney essence is deficient, problems easily arise at this season. So today let’s talk about Shu Di Huang.
Why is prepared rehmannia the number-one herb for supplementing kidney essence?
Doctor Luo says that after weighing all the options, among all the herbs that supplement kidney essence in Chinese medicine, Shu Di Huang is the one that works especially powerfully — other herbs also tonify kidney essence a little, but none of them is as heavy and as strong as prepared rehmannia.
💬 Note from Doctor Luo: Why is kidney essence so important? It is the root of life. Laozi said, “The Dao gives birth to one, one gives birth to two, two gives birth to three, three gives birth to all things” — kidney essence is that “Dao”; it transforms into “one” (kidney qi), and kidney qi transforms into yin and yang — kidney yin and kidney yang. Kidney yang moves upward, warming the spleen-earth; kidney yin nourishes below… the yin and yang of the entire five organs are closely tied to the water and fire in the kidneys, to the yin and yang of the kidneys. So for the body’s upright qi to be sufficient, the most fundamental requirement is that kidney qi be sufficient; and what does kidney qi arise from? Kidney essence transforms into kidney qi — so the kidney essence must be sufficient, and must be replenished in time.
But modern people have an exceptional number of opportunities to damage kidney essence: all kinds of indulgence, overthinking, all kinds of consumption — staying up late, for instance. The opportunities to drain kidney essence are everywhere, so a bit of Shu Di Huang as nourishment is called for.
Who in history pushed prepared rehmannia to the very highest position? Doctor Zhang Jingyue.
💬 Note from Doctor Luo: In Zhang Zhongjing’s formulas, di huang was already used quite a lot — dried rehmannia, prepared rehmannia and so on: Jin Gui Shen Qi Wan is led by prepared rehmannia, and Liu Wei Di Huang Wan also leads with it. By the Ming dynasty, Doctor Zhang Jingyue raised prepared rehmannia to an extremely high position and valued it above almost everything.
Doctor Zhang Jingyue: Who says prepared rehmannia is cloying? It is a treasure that strengthens the spleen and stomach
The first thing Zhang Jingyue did with prepared rehmannia was to “overturn the verdict” against it.
💬 Note from Doctor Luo: People said prepared rehmannia is cloying (it obstructs the spleen and stomach). Zhang Jingyue answered: who says it’s cloying? Prepared rehmannia is precisely what strengthens your spleen and stomach — without prepared rehmannia, how could the spleen and stomach ever grow strong? Prepared rehmannia is grown in Wen County, Henan — this is the land of the Central Plains. Can you tell me that a medicinal from the Central Plains cannot supplement the spleen? I don’t believe it — it certainly supplements the spleen!
Then Zhang Jingyue wrote a whole passage on prepared rehmannia’s function of nourishing blood — ren shen tonifies qi, Shu Di Huang nourishes blood; prepared rehmannia is the number-one blood tonic. He also said that prepared rehmannia supplements true yin.
💬 Note from Doctor Luo: What the ancients called true yin is, in today’s terms, kidney essence. The ancients used words loosely — sometimes they said kidney essence, sometimes true yin. In Zhang Jingyue’s school, true yin means kidney essence.
What problems appear when kidney essence is deficient?
💬 Note from Doctor Luo: With kidney essence deficiency, the fever, headache, thirst, sore throat, coughing phlegm and wheezing, vomiting and belching, nosebleeds and bleeding from the mouth, water spreading over the skin (edema), diarrhea, even the wild agitation of floating yang, the sudden “thump” collapse from yin deficiency with the spirit scattered, confused consciousness, and urinary tract infection — all of it relies on prepared rehmannia. If you don’t use prepared rehmannia, you cannot hold on to that true yin.
Pairing 1: Shu Di Huang with diaphoretics — without yin fluids, no sweat can be produced
Zhang Jingyue wrote about prepared rehmannia at great length and in great detail, and one point he especially stressed is this: prepared rehmannia combined with herbs that release the exterior and disperse cold can induce sweating.
💬 Note from Doctor Luo: Where does sweat come from? Sweat is a liquid — sweat is kin to blood; blood and sweat share the same source. If there is no yin substance (liquid matter) inside the body, sweat cannot be produced. Combine prepared rehmannia with sweating herbs, and you will get real sweat. During the pandemic we found that some people simply could not sweat and their fever would not break — they were yin-deficient, true-yin deficient, or blood-deficient. Boil Shu Di Huang and dang gui (angelica) in water and drink it — the sweat comes out and the fever falls. Many of those people were deficient.
Pairing 2: Shu Di Huang with qi tonics — Da Bu Yuan Jian, the first formula to “turn heaven around”
Zhang Jingyue’s core principle in using prepared rehmannia is: start from kidney essence, and whichever herbs you pair it with determines which direction it goes.
💬 Note from Doctor Luo: Putting prepared rehmannia into a qi-tonifying formula is one of his great usages — paired with ren shen, paired with shan yao (Chinese yam), and so on. Take Da Bu Yuan Jian (Great Tonify the Origin Decoction): prepared rehmannia with ren shen, shan yao and honey-fried licorice, specifically for that state where a man or woman’s qi and blood have collapsed, the spirit has lost its hold, and the body is in extreme danger. Zhang Jingyue called this the first formula to “turn heaven around,” to rescue the root and cultivate the origin — extraordinarily important.
Pairing 3: Shu Di Huang with yin-nourishing herbs — for elderly people with a bright red, coatless tongue, nourish yin first
Paired with herbs that supplement yin, prepared rehmannia moves in the direction of nourishing kidney yin.
💬 Note from Doctor Luo: Prepared rehmannia with gou qi zi (wolfberries), shan yu rou (cornus fruit), and yin-nourishing herbs moves toward the pattern of kidney yin deficiency and nourishing kidney yin — Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) follows exactly this logic. On top of Liu Wei Di Huang Wan you can also add sha shen (adenophora root), mai dong (ophiopogon), tian dong (asparagus root), and gou qi zi, pushing it further in the yin-nourishing direction. During the pandemic I met elderly people with a bright red tongue and almost no coat — I immediately nourished their yin. Because once they caught a severe infection it became dangerous: with lung yin deficiency, they were in danger right away. Shu Di Huang went in immediately, with tian dong, mai dong and the other yin-nourishing herbs, so that the inside never “dried out” (the yin fluids withered). The elderly did very well on this and the illness never advanced. People with a red tongue, dry mouth, or a racing heart should all nourish yin first — lung yin deficiency is itself one cause, one foundation, on which external pathogens invade.
Pairing 4: Shu Di Huang with yang-warming herbs — Jin Gui Shen Qi Wan, You Gui Yin, You Gui Wan
Kidney essence transforms into yin and yang — paired with yang-warming herbs, prepared rehmannia moves in the warming direction.
💬 Note from Doctor Luo: Jin Gui Shen Qi Wan and Gui Fu Di Huang Wan both work this way (led by prepared rehmannia). Zhang Jingyue’s You Gui Yin (Restore the Right [Kidney] Drink): prepared rehmannia with shan yao, shan yu rou, gou qi zi, du zhong (eucommia bark), plus rou gui (cinnamon bark), fu zi (aconite) and so on. You Gui Wan (Restore the Right [Kidney] Pill): prepared rehmannia with shan yao, shan yu rou, gou qi zi, lu jiao jiao (deer antler glue), tu si zi (dodder seed), du zhong, dang gui, rou gui and processed fu zi — he simply threw out the draining herbs fu ling, ze xie and dan pi that Jin Gui Shen Qi Wan contains. If you’re tonifying, tonify; if you’re warming yang, warm yang. That is why You Gui Wan warms yang more strongly — it goes straight in the yang-warming direction.
Pairing 5: Shu Di Huang with blood-nourishing herbs — Si Wu Tang loses its power without it
How do you pair it for nourishing blood? Zhang Jingyue held that prepared rehmannia itself nourishes blood.
💬 Note from Doctor Luo: Pair it with ren shen and you tonify qi; pair it with dang gui, bai shao (white peony) and chuan xiong (ligusticum) and you nourish blood — that’s Si Wu Tang (Four Substances Decoction). Prepared rehmannia transforms into yin-blood. Zhang Jingyue considered prepared rehmannia the top card among blood-nourishing herbs — take it out of the formula and blood-nourishing simply doesn’t work as well. That is why he put prepared rehmannia first among all herbs.
Pairing 6: Shu Di Huang with phlegm-transforming herbs — Jin Shui Liu Jun Jian, “moistening” the phlegm away
Zhang Jingyue had another very interesting move — pairing prepared rehmannia with phlegm-transforming herbs.
💬 Note from Doctor Luo: The famous Jin Shui Liu Jun Jian (Metal-Water Six Gentlemen Decoction): prepared rehmannia and dang gui nourish blood, paired with chen pi (aged tangerine peel), ban xia (pinellia), fu ling (poria) and honey-fried licorice, for people with lung-kidney deficiency cold, water turning into phlegm, and copious phlegm. Zhang Jingyue asked: where does phlegm come from? It also comes from qi and blood — when transformation and transportation break down, these wastes turn into phlegm. If fluids are damaged and the body’s liquids are insufficient, blood and qi turn into phlegm even more easily. What to do? Harmonize the nutritive and defensive qi, replenish fluids, nourish blood; as the body gradually becomes moistened and qi and blood circulate, the phlegm can dissolve. Treating the replenishment of essence, blood and fluids as a way of transforming phlegm — this is an extremely subtle idea.
This move proved especially useful after the pandemic:
💬 Note from Doctor Luo: After the pandemic, why do so many people have nodules? Some people still cough, with a little “dry phlegm”? Blood vessels in the heart blocked, blocked down to the tiny endings — what is blocking the blood? Much of it is sticky fluid, tissue fluid — it is dry phlegm. What to do? At this point you moisturize: let the blood flow, let the fluids flow, and flush it out. When Zhang Jingyue met this situation in phlegm treatment, he generally used Er Chen Tang (Two Matured [Ingredients] Decoction) to transform phlegm, while at the same time using prepared rehmannia to nourish blood and replenish liquids, flushing open the tiny channels so they don’t clog. If a person keeps coughing, with a bit of sticky phlegm in the throat and not much wheezing in the airways, they may genuinely need moisturizing — pair prepared rehmannia with phlegm-transforming herbs; once the body is moistened, the phlegm comes out easily. Especially for people with blockage inside the heart: take some prepared rehmannia, nourish the essence, nourish the blood, slowly lubricate the inside — the heart recovers very well.
What kind of tongue can take Shu Di Huang? Red or dark red, with a thin coat
So who is suited to prepared rehmannia?
💬 Note from Doctor Luo: Everyone, remember this: if the tongue is red or dark red — not deathly pale all over, but somewhat dark red, a dusky red — and the tongue coat is very thin, that person is suited to prepared rehmannia. Zhang Jingyue also used prepared rehmannia frequently during exterior-release treatment: when treating a cold where sweat won’t come out, he used it too — because the upright qi is deficient and kidney essence is insufficient, and with some dispersing herbs it can bring the sweat out. That too is a very good approach.
A home staple: one small piece of Shu Di Huang, with one small slice of rou gui
To sum up, supporting the upright qi is nothing more than tonifying qi and blood — strengthening the spleen and supplementing the kidneys.
💬 Note from Doctor Luo: For the spleen we use shan yao (Chinese yam), bai zhu (atractylodes) and the like — everyone can eat a little shan yao powder now and then to strengthen the spleen. For the kidneys, use Shu Di Huang. You don’t need it every day — two or three times a week is plenty. When you think of it, throw it into a soup: take one piece of prepared rehmannia, with one small slice of rou gui. The rou gui must be bought from a pharmacy — don’t buy the cassia bark from the supermarket. Cassia bark and rou gui are not the same thing; the flavor is very similar, but they are not the same plant. If the supermarket label actually says “cinnamon,” you can buy it; if it says “cassia bark,” don’t. Pharmacy rou gui, about the size of your thumbnail, with the prepared rehmannia. When you stew pork soup or any soup at home, put it in and drink — it supplements kidney essence.
💬 Note from Doctor Luo: Its effect is similar to eating two slices of ren shen — ren shen tonifies qi, Shu Di Huang tonifies kidney essence, a dual tonification of qi and yin: ren shen tonifies the lungs, Shu Di Huang tonifies the kidneys; the two together strengthen your stamina. This is my standard home combination — I keep two jars of it in my fridge. Boil it in water every few days; you don’t need it daily — if you take it daily while the spleen and stomach are weak, some people get diarrhea. Especially in spring, when all things sprout and need yin essence nourishment, eating a little is beneficial; actually you can start after the winter solstice — the nourishing effect is excellent. This is my recommendation to everyone.
Closing: Doctor Zhang Jingyue’s “four dimensions of medicine”
Finally, Zhang Jingyue had a famous saying that lays out the direction of prescribing completely.
💬 Note from Doctor Luo: Zhang Jingyue spoke of the “four dimensions of medicine” — nothing more than ren shen, di huang, fu zi and da huang. Get these four herbs right and you’re most of the way there: ren shen tonifies qi, di huang (prepared rehmannia) tonifies yin (supplements kidney essence), fu zi warms yang, and da huang (rhubarb) drains outward. There is tonifying and there is draining — grasp these four directions and prescribing is no longer hard. In daily life, tonics are not that numerous either; you don’t need many. Pick a few and nourish yourself on a regular schedule, supplement the upright qi — that’s a good thing. It is the foundation for resisting external pathogens. Everything we do is so that we can live better and more comfortably.
What to take away
- Spring is kidney-essence season. When trees sprout they need water below; the human body in spring most needs kidney essence — the root that transforms into kidney qi, and from kidney qi into yin and yang. Shu Di Huang is the strongest single herb for supplementing kidney essence.
- Kidney essence deficiency is a long list. Fever, headache, thirst, sore throat, cough with phlegm and wheezing, vomiting, nosebleeds and mouth bleeding, edema, diarrhea, floating yang with agitation, sudden collapse with scattered spirit, confused consciousness, urinary tract infection — Zhang Jingyue anchored all of them with prepared rehmannia, because without it the true yin cannot be held.
- One herb, six directions. Pair Shu Di Huang with diaphoretics to produce sweat (blood and sweat share one source); with ren shen and shan yao to build Da Bu Yuan Jian, the first rescue formula for collapsed qi and blood; with yin-nourishing herbs toward Liu Wei Di Huang Wan territory (elderly people with a bright red, coatless tongue should nourish yin first); with yang-warming herbs toward Jin Gui Shen Qi Wan, You Gui Yin and You Gui Wan; with dang gui, bai shao and chuan xiong to form Si Wu Tang, where it is the star blood tonic; and with chen pi, ban xia and fu ling to form Jin Shui Liu Jun Jian, which dissolves phlegm by replenishing fluids — especially relevant for post-pandemic nodules and blocked vessels from “dry phlegm.”
- Check the tongue first. Red or dark red tongue with a thin coat — prepared rehmannia suits you. A pale, swollen, wet tongue is a different picture.
- Home staple. One small piece of Shu Di Huang with one thumbnail-sized slice of pharmacy rou gui in soup, two or three times a week — a gentle qi-yin dual tonification, best in spring and after the winter solstice. And remember: supermarket cassia bark is a different plant from medicinal cinnamon.
- The four dimensions of medicine. Ren shen tonifies qi, di huang tonifies yin, fu zi warms yang, da huang drains — with these four directions clear, using herbs is no longer hard.
Compiled from Doctor Luo Dalun’s health lecture.