Feeling Cold, Weak, and Full of “Fire” That Won’t Quit? Warming Yang Isn’t Just Piling On Aconite — Doctor Zhang Jingyue’s Hot Formation Explained by Doctor Luo Dalun (Si Wei Hui Yang Yin · Liu Wei Hui Yang Yin · Li Yin Jian · Wei Guan Jian · Zhen Yin Jian)

What people search for: always cold and weak / yang deficiency symptoms / false heat (jia re) explained / kidney essence deficiency signs / chronic diarrhea that never stops / sore throat and toothache that feel like fire / how to use aconite (fu zi) safely / how long to decoct aconite / warm yang formulas / Si Wei Hui Yang Yin / Liu Wei Hui Yang Yin / Li Yin Jian / Wei Guan Jian / Zhen Yin Jian / Nuan Gan Jian / Jing Yue Quan Shu / mung bean drink for heat / snow pear juice for deficiency heat / Zhang Jingyue warm-tonifying school

Medical terms for this condition: yang deficiency (yang xu) · yuan yang collapse (primordial yang about to disperse) · Si Ni Tang (Counterflow Cold Decoction) · Si Wei Hui Yang Yin (Four-Ingredient Restore Yang Drink) · Liu Wei Hui Yang Yin (Six-Ingredient Restore Yang Drink) · Li Yin Jian (Regulate Yin Decoction) · Wei Guan Jian (Stomach Gate Decoction) · Zhen Yin Jian (Settle Yin Decoction) · Nuan Gan Jian (Warm the Liver Decoction) · kidney essence (shen jing) · false heat (jia re) · ge yang yu shang (yin exuberance repelling yang upward) · long lei zhi huo (dragon-thunder fire) · qi and blood generating each other (qi xue hu sheng) · generating yang from yin (cong yin sheng yang) · the kidney as the gate of the stomach (shen wei wei zhi guan) · Ming Men (life gate) fire

Opening: the first formula of the Hot Formation — Si Wei Hui Yang Yin, rescuing primordial yang collapse at the moment of crisis

💬 Note from Doctor Luo: Dear friends, good morning everyone. Today we continue with the formulas of Doctor Zhang Jingyue. What are we talking about today? The Hot Formation (re zhen). Zhang Jingyue could be said to have especially loved warm tonics — he felt that very many people have insufficient yang qi and weak bodies, so his warm-tonifying formulas are especially refined. Every doctor has his own specialty; Zhang Jingyue was of course also skilled at clearing heat, but in the area of warm tonics he understood things very deeply, so this is something we all must study.

The first formula of the Hot Formation is called Si Wei Hui Yang Yin (Four-Ingredient Restore Yang Drink), and it treats yuan yang collapse, danger within a moment — yang qi is about to leave, about to scatter, and the person is nearly gone.

💬 Note from Doctor Luo: At that moment what do you use? Prepared aconite (zhi fu zi), blast-fried dried ginger (pao gan jiang), plus honey-fried licorice (zhi gan cao). What is this? It is what Chinese medicine calls Si Ni Tang (Counterflow Cold Decoction) — Zhang Zhongjing’s Si Ni Tang, the yang-warming formula. Aconite warms yang and rallies the yang of heart and kidney; but without the help of dried ginger, aconite’s strength may not be enough, so we generally pair aconite with dried ginger — this is Zhang Zhongjing’s secret combined together. Honey-fried licorice neutralizes aconite’s toxicity while protecting the spleen and stomach.

On this Si Ni Tang base, add one more ingredient — ginseng (ren shen) — and it becomes Si Wei Hui Yang Yin. Ginseng tonifies the primordial qi, and the dose is very large — Zhang Jingyue used one to two liang (30–60 g). This is the emergency application, because the upright qi is about to scatter, and you must pour it in quickly.

💬 Note from Doctor Luo: Prepared aconite plus honey-fried licorice plus blast-fried dried ginger — the Si Ni Tang base; add ginseng and it is called Si Wei Hui Yang Yin, warming yang and tonifying qi. If you add dang gui (Chinese angelica), that is warming yang and nourishing blood (the Dang Gui Si Ni Tang direction). Everyone must understand: on the foundation of warming yang, you can nourish blood, and you can tonify qi.

The lore of aconite (fu zi): excellent effect, real toxicity — always decoct it first for one hour

When he reached aconite, Doctor Luo stopped especially to explain the precautions for using aconite in careful detail — this is a matter of medication safety.

💬 Note from Doctor Luo: Aconite truly is a somewhat toxic herb — if you don’t take it properly, something can really go wrong. First, counterfeits are extremely common. Once you buy genuine aconite, you must boil it for about an hour to destroy the toxicity inside. My method: I decoct it alone for half an hour first, then add the other herbs and decoct together for another half hour — one hour total, and the toxicity is destroyed. After that, it warms the yang of heart and kidney, warms the yang qi. If you do not destroy the toxicity, after drinking it your heart will race wildly — pounding, pounding — and some people experience cardiac paralysis, numb lips, toxic symptoms: the world spinning, blackness before the eyes, and in some cases even death.

So with aconite, you must always decoct it first for an hour or more before drinking. Please never think, “Aconite is great — the Fire Spirit school says aconite is wonderful, warming yang is so good, once yang qi flourishes it pushes the evil qi right out, let’s all take it” — note that aconite has excellent effects, but its toxicity is also considerable, and there is real danger. Our usual dose is not large — two to three qian, that is 6 to 9 grams — and one hour of decocting is enough; if you use tens of grams, a large dose, you must decoct for two to three hours, truly keep boiling it the whole time.

Liu Wei Hui Yang Yin: when qi, blood, yin and yang are all depleted, this is the great approach to restoring balance

The second important formula of the Hot Formation is Liu Wei Hui Yang Yin (Six-Ingredient Restore Yang Drink). The formula books say it treats conditions like “yin and yang about to separate,” but Doctor Luo says what we learn is Zhang Jingyue’s way of thinking — you do not actually have to wait until yin and yang are on the verge of separation; anyone with insufficient upright qi, great depletion of qi and blood, and insufficient yang qi can use it.

💬 Note from Doctor Luo: What is this formula? Ginseng, aconite, blast-fried dried ginger, honey-fried licorice — those first four — plus prepared rehmannia (shu di huang) and dang gui. Ginseng tonifies the qi of heart and lung; prepared rehmannia tonifies the essence of liver and kidney — especially kidney essence; see how one works above and one below. Dang gui nourishes blood. Add aconite, dried ginger and honey-fried licorice to warm yang. So this takes care of qi, blood, yin and yang all at once. For people with depletion of all four, this is an excellent approach to restoring balance. I have been talking about this Liu Wei Hui Yang Yin all along — if you grasp the thinking, then when you nourish and regulate, you basically know what you are doing.

Dosage reference (the everyday nourishing amounts Doctor Luo gives from clinical practice): ginseng generally 3–6 g for nourishment (one to two liang is for emergencies); aconite 6–9 g; dried ginger two to three qian (6–9 g); prepared rehmannia five qian to one liang — about 30 g is right for nourishing; dang gui 9 g is enough for nourishing blood, no need for more.

💬 Note from Doctor Luo: Once you master this formula, you can actually develop it: for tonifying qi, can I add some huang qi (astragalus)? Pair it with some shan yao (Chinese yam) to tonify the spleen and qi together — of course. For nourishing blood, can I add gou qi zi (wolfberry) together with the prepared rehmannia — of course. Prepared aconite and blast-fried dried ginger — can I add a little rou gui (cinnamon bark)? Of course. Zhang Jingyue said: if the liver channel is stagnant, add two to three qian of cinnamon — it goes to the liver channel and can warm the liver too. So this is a direction: tonify on one side, warm you on the other.

Here we can see Zhang Jingyue’s nourishing philosophy: he thinks comprehensively. When a person truly reaches the point of insufficient upright qi, it is impossible for qi deficiency to exist alone, and impossible for blood deficiency to exist alone. Zhang Jingyue was deeply versed in the principles of the I Ching, valued the root, and understood that qi and blood generate each other — when tonifying qi, add something that nourishes blood; when nourishing blood, add something that tonifies qi.

💬 Note from Doctor Luo: In fact, very many people get results from this approach. Why? Because people are usually deficient in upright qi, then external cold arrives and makes the yang qi even more insufficient; qi and blood are depleted, so the cold evil comes again. Normally you might resist, but because the upright qi is insufficient, qi and blood are both depleted, function is low, the cold evil causes trouble, and yang qi is insufficient. So many people’s bodies fall into disorder, growing weaker and weaker, until they enter this state. This Liu Wei Hui Yang Yin of Zhang Jingyue — my personal feeling is that this way of thinking is extremely important and effective in the process of regulating the body. You adjust the amounts back and forth, but the thinking is the key, because when we discuss the case records, the Liu Wei Hui Yang Yin thinking appears many times.

Li Yin Jian: it looks like heat, but it is really kidney essence deficiency — the false-heat condition

The third formula to discuss is Li Yin Jian (Regulate Yin Decoction). Zhang Jingyue himself said that Li Zhong Tang (Center-Regulating Decoction) is a variation — in fact, Li Yin Jian is far more profound than Li Zhong Tang.

💬 Note from Doctor Luo: What does this formula treat? Zhang Jingyue himself said it treats true yin weakness (zhen yin xu ruo) — true yin is actually kidney essence. When kidney essence is weak, qi becomes deficient and yang qi insufficient; water stays in the body, causing bloating; qi movement cannot circulate, it rushes upward, causing nausea and spitting up a great deal of phlegm and fluids, because you cannot transform that water. There is also vomiting blood and abdominal pain, and in women, irregular menstruation.

Why does one get this illness? Those who are frequently weary from overwork (shu duo lao juan zhi bei) — people who consume a great deal in daily life and deplete kidney essence severely — suddenly catch cold evil that cannot be dispersed: fever, head and body pain, red face and dry scorched tongue, thirst but unable to drink much cold liquid, back and limbs fearing cold, pulse large but without force — these are all false-heat presentations. It looks like heat, but actually the upright qi is insufficient, especially yang qi. When kidney essence is depleted and cold evil arrives, it makes your yang qi insufficient and your upright qi unable to push it out, so you use this formula: tonify on one side, and drag and push the evil qi outward on the other.

Li Yin Jian’s thinking is also comprehensive: prepared rehmannia paired with dang gui (nourishing blood), honey-fried licorice (guarding the center), blast-fried ginger and cinnamon (warming yang) — you can also add aconite, and it becomes Fu Zi Li Yin Jian, for when the warming strength is not enough.

💬 Note from Doctor Luo: The core of this formula is prepared rehmannia, used at one to two liang — a fairly large dose. If you add ginseng to Li Yin Jian, and add aconite, it becomes the Liu Wei Hui Yang Yin we discussed earlier — but the point of action differs: Li Yin Jian focuses on kidney essence, tonifying kidney essence, with the prepared rehmannia dose clearly increased, up to two liang; the main ingredient of Liu Wei Hui Yang Yin is ginseng, one to two liang. In Li Yin Jian the main ingredient is prepared rehmannia, matched with the warming-yang thinking of cinnamon and aconite, then moving in the blood-nourishing direction by adding dang gui to nourish blood, then pushing the evil qi outward. You must master this way of thinking. In Zhang Jingyue’s case records we keep coming back to this Li Yin Jian — for some people, the heat is false; the upright qi is insufficient, especially kidney essence. You can see such a person always shows signs of insufficient upright qi: even though it is an external contraction, the upright qi deficiency is obvious. At that time, if you do not replenish the kidney essence and warm up the yang qi, the cold qi will never disperse. Replenish the kidney essence, gather the deficiency fire, scatter the evil qi — and the illness is cured.

So the deficiency heat caused by kidney essence deficiency has several situations in total: dragon-thunder fire rushing upward (long lei zhi huo shang ben), yin exuberance repelling yang (yin sheng ge yang), and the various false-heat illusions that appear when kidney essence is deficient and external evil is contracted — Li Yin Jian targets exactly this, sometimes when external evil is also present.

Wei Guan Jian: the formula Zhang Jingyue worked out from his own eleven years of diarrhea

Another formula in the Hot Formation is called Wei Guan Jian (Stomach Gate Decoction), treating spleen-kidney deficiency cold with diarrhea (pi shen xu han zuo xie) — always having diarrhea, unrelenting abdominal pain, cold dysentery and the like, all caused by insufficient yang qi. Zhang Jingyue himself used this formula.

💬 Note from Doctor Luo: Zhang Jingyue said he had diarrhea for a very long time — eleven years. He mulled it over again and again, used many formulas of the sages before him, no effect, so he worked it out himself, and with this formula it took a year to get well. This formula also uses prepared rehmannia as the lead. Why use prepared rehmannia for diarrhea? Let me tell you an important symptom: after kidney essence is consumed, one of the symptoms that will eventually appear is chronic diarrhea. So people often say, “My head is fine, it’s just that my stool is loose” — loose stool is sometimes indeed a spleen-stomach weakness problem, but some people have what? Kidney essence deficiency from long-term consumption — and this root goes deeper. Look at Zhang Jingyue’s formula here: prepared rehmannia. If chronic diarrhea has gone on for many years, eventually it will damage yin, and damaging yin further damages kidney essence, so kidney essence becomes insufficient. His use of prepared rehmannia in treating diarrhea shows he was working at a very high level.

💬 Note from Doctor Luo: People usually say, “I just casually eat some rehmannia and after eating it I get diarrhea” — this is one response to prepared rehmannia: people with weak spleen-stomach will get diarrhea from it. So decoct it longer, boil it hard, more time; use a smaller amount; take it every few days — that’s fine. But some people genuinely have diarrhea, have been purging for years; prolonged diarrhea inevitably damages yin, and damaged yin eventually leads to kidney essence deficiency — at that point you truly need prepared rehmannia to build it back up. This only comes from real experience.

The complete Wei Guan Jian: prepared rehmannia, shan yao (Chinese yam), bai bian dou (white hyacinth bean), bai zhu (atractylodes), blast-fried ginger, and wu zhu yu (evodia fruit).

💬 Note from Doctor Luo: Shan yao, bai bian dou and bai zhu all tonify the spleen — shan yao tonifies spleen and kidney, nourishing all three organs of lung, spleen and kidney; Doctor Zhang Xichun treated diarrhea with shan yao to tonify spleen and kidney, and shan yao also has an astringent action. Bai bian dou is astringent and treats diarrhea from spleen deficiency. Dried ginger and wu zhu yu warm the spleen and kidney, and can even warm the liver. If liver yang is insufficient and the liver evil insults the spleen, Zhang Jingyue says afterward you can add one qian of cinnamon.

Behind this lies an old saying from the Inner Canon (Nei Jing): “the kidney is the gate of the stomach (shen wei wei zhi guan).”

💬 Note from Doctor Luo: This really is so — when your kidney qi is insufficient and kidney essence is depleted, it will ultimately lead to diarrhea, and it can last a very long time and go quite deep. Ordinary treatment and regulation won’t work; you truly have to tonify the kidney, and especially to think of tonifying kidney essence — I think that is a very high-level approach. Zhang Jingyue cured his own diarrhea with Wei Guan Jian. Nowadays many of us are slowly consumed — staying up late, overthinking, excessive sex and so on — leading to kidney essence deficiency. Remember the thinking of this formula: tonify the spleen on one side, warm the kidney on one side, fill the essence on one side.

Afterward there are also Zuo Guan Jian, Yi Fu Jian, Si Wei San and other warming formulas — Zhang Jingyue discussed many, all in the same line of thinking.

Zhen Yin Jian: fire everywhere above, kidney essence empty below — yang repelled to the top

Another very important formula in the Hot Formation — Zhen Yin Jian (Settle Yin Decoction) — was used often by Zhang Jingyue.

💬 Note from Doctor Luo: What does this formula treat? It treats “yang repelled to the top (ge yang yu shang)”: yin deficient below, kidney essence deficient below, yang repelled to the top, true yang losing its post. Kidney essence deficiency leads to insufficient yang qi; yin qi becomes extremely heavy and pushes the yang qi up to the top — this is called yang repelled to the top. We have talked about this all along in Zhang Jingyue’s case records. In this situation, above you see heat symptoms: bleeding, vomiting blood, or throat bi (sore, swollen throat) and so on. What is it actually? Kidney essence depleted, kidney qi insufficient, developing in the direction of kidney yang deficiency, and this little bit of deficiency fire has run up to the top. Because the whole lower body is cold, the cold pushes the yang up to the top — so above it looks like fire, but actually it is kidney essence deficiency and yang deficiency.

The formula’s composition: a large dose of prepared rehmannia (one to two liang) paired with cinnamon (one to two qian), a little aconite (with the cinnamon), plus niu xi (achyranthes root) (guiding the medicinal strength downward), ze xie (alisma) (draining the dampness of the kidney channel), and honey-fried licorice.

💬 Note from Doctor Luo: These formulas are very simple, but the core is a large amount of prepared rehmannia matched with a little cinnamon — you can match the cinnamon with aconite, and niu xi helps guide downward, a guiding-downward approach. Many of the later Chen Shiduo’s formulas follow this same thinking — the Yin Huo Tang (Guide Fire Down Decoction) we often use, and so on, all follow this approach. This is a contribution of the Ming-dynasty physicians like Zhang Jingyue: they explained extremely clearly this upper-jiao deficiency fire — caused by kidney essence deficiency, ending with upper-jiao deficiency fire from yin deficiency and yang deficiency, with kidney essence deficiency and yang insufficiency below. Now, an enormous number of people have upper-body fire caused by kidney essence deficiency. A flood of fans leave messages: “My toothache — this formula cured it”; “My headache, my ear problem — one use of this formula (Yin Huo Tang, Zhen Yin Jian) and it was cured” — all the same way of thinking. So this is an essence of Zhang Jingyue’s thought that everyone should grasp.

Nuan Gan Jian: cold liver and kidney — not warming directly, but generating yang from yin

There is also a Nuan Gan Jian (Warm the Liver Decoction), treating liver-kidney cold (gan shen yin han) — insufficient yang qi and cold in liver and kidney, lower abdominal pain, hernia problems and the like.

💬 Note from Doctor Luo: Do you see? It does not warm directly. First it adds dang gui — nourishing blood; adds gou qi zi (wolfberry) — warm in nature, nourishing the essence of liver and kidney; adds fu ling (poria) to drain dampness; xiao hui xiang (fennel seed) and rou gui (cinnamon) — these are the yang-warming ones; adds wu yao (linderae root) to move qi and regulate qi, and adds chen xiang (agarwood) — all of these move and regulate qi. Look at how his formula comes out — it is always qi, blood, yin and yang generating each other — not simply, “Don’t I just need to warm the liver? Then I’ll give you wu zhu yu, xiao hui xiang and rou gui, a whole plate of warming herbs.” No. The thinking is very interesting: starting from dang gui and gou qi zi to nourish liver blood, generating yang from yin. I think this is a very high-level approach.

Zhang Jingyue’s general warming approach: tonify and warm together, yin and yang generating each other

Look through all the formulas of the Hot Formation and you can see the common rule in Zhang Jingyue’s warming of yang.

💬 Note from Doctor Luo: When studying Zhang Jingyue’s yang-warming approach, you must learn this: I am warming yang, but usually when he warms yang, he adds prepared rehmannia, adds dang gui, pairs them in. For yang-deficient people, we just need to warm them up — tonify on one side, warm on the other. Zhang Jingyue’s yang-warming formulas are rarely pure warming from the start — aconite, bai zhu and ginseng alone are rarely paired. He usually does what? When warming yang, he makes yin and yang generate each other, adding something that tonifies essence, something that nourishes blood, or something that nourishes yin. This is his especially clever point. Why are his formulas so effective? Because his theoretical foundation is thick — he understands the law that yin and yang generate each other. For a person who is truly extremely cold, of course you warm yang; but he often tonifies essence, nourishes blood and warms yang all together — this is the truly high-level practice, and the key point we should study.

Three treasures of the Cold Formation: mung bean drink, jade spring powder, snow pear juice

Zhang Jingyue did not only warm yang — after the Hot Formation he also has a Cold Formation (han zhen) — with many formulas for clearing heat, and three especially simple and convenient ones that Doctor Luo teaches everyone along the way.

💬 Note from Doctor Luo: Mung bean drink (Lu Dou Yin) — what do mung beans do? When you are extremely hot — heat toxin, labor heat, all sorts of blazing fire that will not retreat — mung beans are the best: take mung beans, boil them in a broad pot, put in a great deal of water and cook until soft, add a little salt or honey, and after it cools drink the liquid freely, three or four times a day without restriction. Its nature is not so bitter-cold, it does not injure spleen qi, but it is the best at detoxifying, clearing vexation, reducing fever, quenching thirst, and promoting urination and defecation — extremely simple and convenient. Of course this does not mean he used mung beans for every illness; it is for when there is heat toxin.

Jade spring powder (Yu Quan San) — take raw gypsum (sheng shi gao), six liang ground to powder (dry-fry one liang), grind to a fine powder, and take it mixed with freshly drawn well water or warm soup.

💬 Note from Doctor Luo: Who learned this formula in later generations? Zhang Xichun learned it! He saw that raw gypsum could be eaten as powder, and Zhang Xichun came and studied it — calling it Yu Quan San.

Snow pear juice (Xue Li Jiang) — if you are truly vexed and hot, with deficiency fire, yin deficiency with heat, there is a method: take a big white pear, peel it, put cool water aside, cut the pear into thin slices and soak them in the water, then drink that water.

💬 Note from Doctor Luo: This can reduce fire — its fire-reducing effect is especially good for yin deficiency with heat; it quenches thirst and reduces fire. So Zhang Jingyue did not only warm yang — when nourishing yin and clearing heat he also had a Cold Formation, many heat-clearing formulas. That is Zhang Jingyue’s academic thought.

Epilogue: Zhang Jingyue treated tens of thousands of patients, yet recorded few cases — Jing Yue Quan Shu is worth opening

💬 Note from Doctor Luo: I think Zhang Jingyue is a very famous Chinese medicine doctor in Chinese history. Because I teach through case records, I am also limited by that — doctors like Zhang Jingyue saw an enormous number of patients, tens of thousands, but he himself recorded not many. He wrote his book very completely, but there are not many more case records, so this is all the case material we have, and we tell you about it. If you encounter related problems, I suggest you open Zhang Jingyue’s Jing Yue Quan Shu (Complete Works of Jing Yue) — Jing Yue Quan Shu basically explains with great clarity how to treat every category of disease, how the Inner Canon discussed it, how the former sages discussed it, and how he himself saw it. I think it is especially valuable for reference — especially for clinicians, if you read it, your thinking will be more comprehensive. What must be particularly mentioned: Zhang Jingyue’s discussion of the various changes caused by kidney essence deficiency (which he called “true yin”) is detailed and he was especially skilled at treating it.

The next physician is also a famous Ming-dynasty doctor from the late Ming — Miao Xiyong. Doctor Luo has written about him in his stories: this man had many warm-disease (wen bing) ideas budding in him, went among the people collecting all kinds of formulas, and treated illness with “thunder and lightning” — especially decisive and satisfying. Starting tomorrow, we will introduce all sorts of Miao Xiyong’s treatment approaches.

💬 Compiled from Doctor Luo Dalun’s explanations of Doctor Zhang Jingyue’s academic thought. The formulas come from Jing Yue Quan Shu · Xin Fang Ba Zhen (Eight Formations of New Formulas), published in 1624.