• These herbs are generally contraindicated in cases of hyperactive Yin deficiency fire. Most are contraindicated when an excess, exterior, or heat condition exists. Compared to the category of herbs that warm the interior, Yang tonics are mostly sweet, many slightly nourish Yin, and most are slower acting than the interior-warming herbs to activate Yang. Herbs that warm the interior may be used for excess cold, can restore collapsed Yang, are mostly hot and acrid, and mainly activate but do not so much tonify Yang.
• Yang tonics are often combined with a small amount Yin nourishing herbs to give the Yang some substance to “cook” or “cling to.” (The formula Jin Gui Shen Qi Wan is a good example of this principle, though it utilizes Interior Warming herbs [Fu Zi, Rou Gui] instead of Yang tonics.)

Nature: acrid, sweet, slightly warm

Enters: Kidney, Liver

Actions: Tonifies kidney Yang (without blocking Qi); eliminates wind-damp (including in the bones); strengthens sinews and bones.

Indications:
• Kidney Yang deficiency: impotence, frequent urination, infertility (male or female), irregular menses, premature ejaculation, urinary incontinence, cold and pain in the lower abdomen, weak and sore lower back, muscular atrophy.
• Kidney Yang deficiency plus attack of wind-damp: weakness or pain in the lumbar region, knees, backs of the legs; bony Bi.
• Best used for cases of Yang deficiency with cold-damp.
Hong-Yen Hsu (Oriental Materia Medica): Antibacterial, hypotensive, has effects resembling those of cortical hormones.
Weng Weiliang, et. al.:
Aspermia:
Xing Yang Sheng Jing Dan (experiential formula): ba ji tian, ying yang huo, tu si zi, gou qi, yu biao jiao, testicles of goat, male silkworm moth, placenta, rou cong rong, jiu cai zi were made into pills, 10g, bid, three months as a course of treatment. 25 cases were treated, 20 were effective.
Impotence:
Xing Yang Chong Ji (experiential formula): chai gou shen, yin yang huo, ba ji tian, shan yu rou, chai hu, dang gui, bai shao, lu jiao jiao and gou qi were made into granules, 12g per bag, 1 bag, tid. 50 patients were treated and 43 were effective.

Dose: 6-15g

Nature: acrid, bitter, very warm

Enters: Kidney, Spleen

Actions: Tonifies kidney Yang; controls Jing and urine; tonifies and warms spleen Yang, stops diarrhea; helps the kidneys grasp the Lung Qi.

Indications:
• Kidney Yang deficiency: impotence, cold and pain in the lumbar region and knees, weak lower back and extremities, premature ejaculation; frequent urination, urinary incontinence, enuresis, nocturnal emissions without dreams.
• Spleen Yang deficiency (usually with kidney Yang deficiency): severe, chronic diarrhea, borborygmus, abdominal pain.
• Kidneys fail to grasp the Lung Qi: wheezing.
• This herb can be hard on the stomach, but is still sometimes used cautiously for cold deficiency of the stomach.
• Topical: alopecia, psoriasis, vitiligo (especially in combination with UV light), fungus. Caution with sun/UV exposure with this herb on the skin – increases risk of sunburn.
• May dilate coronary vessels.
• With Chi shi zhi, it can stop menorrhagia.
• Bu gu zhi’s kidney-tonifying properties are more pronounced than its spleen-warming qualities. The opposite is the case with Yi zhi ren.
• Topical vitiligo formula: in a base of coconut oil, extract on low heat: Bu gu zhi, barberry root bark (Western herb), and nigella (black cumin) seed (or just add cold pressed nigella seed oil to this formula).
• Crush before using.
Dr. Hong Jin (Oregon College of Oriental Medicine) Modern research shows hormonal (estrogen-like) effects.
• Uses in acne formula.
Dui Yao (Sionneau): Strengthens true Yang; warms the cinnabar field.
• With Hu tao ren to supplement metal and water, to effectively constrain the Lung Qi and promote the intake of Qi by the kidneys, stop cough, and calm asthma. For the following indications, salt-processed Bu gu zhi should be used:
– 1. Cough, dyspnea, and asthma due to kidney Yang deficiency.
– 2. Lumbago, impotence, seminal emission, constipation, frequent and abundant urination, and enuresis due to kidney Qi deficiency.
• With Rou dou kou to supplement spleen and kidney Yang, secure the intestines, and stop daybreak or “cock-crow” diarrhea. For indications such as:
– 1. Chronic diarrhea due to spleen-kidney Yang deficiency. (Si Shen Wan) Use salt mix-fried Bu gu zhi and roasted Rou dou kou.
– 2. Daybreak diarrhea with abdominal pain and rumbling noises due to spleen-kidney Yang deficiency. (Er Shen Wan)
• Bu gu zhi is incompatible with pork blood.
Hong-Yen Hsu (Oriental Materia Medica): Dilates coronary arteries, stimulates the heart, increases rate and function.
• Antibacterial (tuberculosis).
• External use promotes production of melanin – used to treat calluses and warts.
• May have anti-cancer effects – inhibits artificially-induced tumors.
• Therapeutic action against Tinea versicolor and psoriasis.

Dose: 3-9g

Nature: sweet, warm

Enters: Kidney, Lung

Actions: Tonifies Lung Yin and kidney Yang; stops bleeding; resolves phlegm.

Indications:
• Kidney Yang deficiency: impotence, seminal emission, weak and sore lumbar region, knees, and lower extremities.
• Lung Yin deficiency: asthma and cough with bleeding, chronic bronchitis, pulmonary tuberculosis, consumptive cough with blood-streaked sputum.
• Because it tonifies both Yin and Yang and is a very safe substance, it can be taken over a long period of time.
• Often cooked with duck (or other meats) for a stronger tonic effect.
• Doctrine of signatures: for impotence – this mushroom (after invading the insect’s body with its mycelia) bursts forth from the caterpillar’s head.
• Different species of cordyceps fungi parasitize hundreds of different insects and also decaying wood. Dong chong xia cao is specifically the species that grows on the caterpillar or pupa Hepialus varians. The whole caterpillar-mushroom combination is very expensive. High quality, more affordable lab-grown fungus is now widely used.
Oriental Materia Medica (Hong-Yen Hsu): Bronchodilator, sedative, antibacterial, antifungal.
Eric Brand on wild vs cultivated cordyceps.
Weng Weiliang, et. al.:
Cardiovascular diseases:
• Shao Geng et al. carried out clinical research on the effects of treating hyperlipemia with cultured Cordyceps (Jin Shui Bao, a product made from cultured Cordyceps) with double-blind comparison method. 273 cases were equally divided into treated group and control group approximately. After 1~2 months’ treatment, in the treated group, the average of serum total cholesterol was lowered by 17.5% compared with that before the treatment (the control group lowered by 1.2%); triglyceride was lowered by 9.9% (the control group 6.7%); high-density lipoprotein cholesterol (HDL-C) was increased by 27.2% (the control group increased by 10.4%). Compared with the control group, the differences were statistically significant. Accordingly, it’s believed that this drug had reliable cholesterol-reducing as well as HDL-C increasing function.
• Arrhythmia was treated with Ning Xing Bao (a product made from Cordyceps) by Li Peizhang et al. and with Xing Gan Bao (a product made from different fermented Cordyceps) by affiliated hospital of Guangzhou medical college. 200 cases were reported by the former author, the total effective ate was 74.5%; while 188 cases were reported by the latter author, the total effective rate was 74.4%~79.6%.
• You Jingen used P.sinensis to treat 33 cases of coronary heart disease. The markedly effective rate of angina pectoris was 52.4%; and the effective rate of EKG was 42.4. Accordingly, it’s believed that the effect of P.sinensis came up to that of persantine.
Respiratory diseases:
• Six hospitals were organized by Jiangxi TCM factory to make the research on the effects of treating chronic bronchitis with Jin Shui Bao (a product made from Cordyceps). Results: after one month’s administration, among the 117 cases that took Jin Shui Bao, 58 cases were markedly effective (the markedly effective rate was 49.6%), 39 improved (33.3%), the total effective rate was 82.9%; among the 77 cases that took Mu Jing Oil, the markedly effective rate was 9%, and the total effective rate was 40.2%.
• Fu Fang Chong Cao (Cordyceps) Ge Jie (gecko) San was used to prevent asthma attack in 68 patients. There’re 42 males and 26 females, 35 of them had courses of diseases between 1~5 years, the other 33 cases were over 5 years. The ingredients: ge jie, one pair; Cordyceps, 5g; zi he che, huang qin, hou po, bai jie zi, 15g each; chen dan xing, 10g, huang qi, 30g. The drugs were ground into powder. For patients without symptoms, the dosage was 0.5~1g, tid; for those with symptoms of mild cough or asthma, the dosage was 1.5g tid. The patients took the treatment from later October to early April of next year, for two years. Results: within the two years, 36 cases didn’t have asthma attacks, and were markedly effective; the other cases were effective.
Sexual disorders:
• Yang Wenzhi et al. carried out clinical research on treating low sexual function with Jin Shui Bao (a product made from Cordyceps). They compared the effects of Jin Shui Bao, natural Cordyceps and placebo with method of single-blind comparison and sequential administration. Methods: dosage 1g every time, three times daily, 20 days as a course; take the medicine according to the order of Jin Sui Bao, placebo and natural Cordyceps. Results: 16 cases totally, 9 were markedly effective when given Jin Shui Bao (56.2%), only 1 markedly effective when given placebo, and 4 markedly effective when given natural Cordyceps (25%).
• Deng Xiaoan analysized 272 cases of low sexual function (11 were female), 152 cases were treated with Jin Shui Bao (a product made from Cordyceps). After 40 days’ administration, the effective rate was 66.1%. Among 23 cases treated with natural Cordyceps, the effective rate was 31.6%. In the 97 cases of control group, the effective rate was 23.7%.
Renal diseases:
• Chen Yiping et al. reported the effects of treating 30 cases of chronic renal failure with Jin Shui Bao (a product made from Cordyceps). After one month’s treatment, the patients’ renal function was improved significantly, which was manifested as obviously decreased creatinine and urea nitrogen in the blood compared with those before treatment, increased creatinine clearance and hemoglobin. Natural Cordyceps and other cultured Cordyceps preparation (Zhi Ling Capsule) had certain effects too. Shen Lingmei treated 18 cases of chronic nephritis with cultured Cordyceps, it was observed that the renal function was improved and urine protein decreased obviously.
Hepatic diseases:
• According the report of Zheng Furong, in Shanghai and some other areas, cultured Cordyceps preparation Xing Gan Bao was used to treat 256 cases of chronic viral hepatitis, the effective rate was over 80%, most patients symptoms, signs and liver function were improved to various degree, and the changes of serum albumin and sGPT were the most obvious. Zhou Liangmei used cultured Cordyceps to treat 33 cases of chronic hepatitis B, among the 32 cases with abnormal TTT, after 3 months’ administration, 10 cases returned to normal, 13 cases were improved significantly. Liu Cheng et al. used cultured Cordyceps to treat 22 cases of posthepatitic cirrhosis, after 3 months’ treatment, albumin increased; among 17 patients suffering from abdominal distension, 12 cases’ ascites disappeared, and 5 cases’ ascites decreased.
• Ma Xiong, et al did some research on Cordyceps polysaccharides (CP) in order to evaluate its therapeutic effects in chronic hepatitis C. Twenty-one patients with chronic hepatitis C were treated with CP (15ml, t.i.d, taken orally) for 3 months. Peripheral blood CD3, CD4, CD8, NK activity and serum HA etc. were tested before and after the treatment. The results showed that the serum levels of ALT and r-GT were lowered after the treatment (P<0.05). HA, PIIIP were lower (P Tumors:
• Cheng Jianhua reported the effects of treating 20 cases of lung cancer in late period with Jin Shui Bao (a product made from Cordyceps) as an auxiliary therapy. There’s also a control group with WBC-elevating drugs as the auxiliary therapy. Results: 95% of the cases in the Jin Shui Bao group completed the radiotherapy or chemotherapy, 85% of the cases had a normal blood picture, both were significantly higher than those of the control group (which were 64% and 59% respectively). Yan Rujie et al. treated 50 cases of lung cancer in late period (4 cases were complicated with radiotherapy or chemotherapy). Results: after 2~4 months’ treatment, most of patients’ subjective symptoms were obviously improved, focus of infection of 23 cases (46%) decreased by more than 25%. Zhang Jinchuan treated 30 cases of 30 cases of malignant tumors with the auxiliary therapy consisting of Zhi Ling Capsule, results: symptoms of 93% of the cases were improved, and the WBC was elevated obviously.
• Jinshuibao Capsule (JSBC), produced by Jiangxi Jinshuibao pharmaceutical Company Limited, possesses the similar active principles and pharmacological activity with those of Cordyceps sinensis. The effect of JSBC on the immunological function of 36 patients with advanced cancer showed that it could restore cellular immunological function, improve quality of life, but had no significant effect on humoral immunological function. The results suggested that JSBC could be used as adjuvant drug in advanced cancer.
• Others:
• Chen Daoming et al. reported that 30 cases of primary thrombocytopenic purpura were treated with cultured Cordyceps, after three months, patients’ subjective symptoms and bleeding condition were improved significantly, the total effective rate was 90%. Chai Weimin et al. reported that Xin Gan Bao (a product made from Cordyceps) was used to treat 20 cases of schistosomiasis of ascites type in late period, after 3 months, all symptoms were improved: abdomen circumference and the spleen decreased, the diameters of the portal vein and the splenic vein decreased too. Besides, Liu Weisheng et al. used Xin Gan Bao (a product made from Cordyceps) to treat patients with decreased hemoglobin, decreased platelet or aplastic anemia, Zhang Jinmei et al. used Cordyceps to treat allergic rhinitis and tinnitus, and better effects were obtained in these treatment.
Examine.com: In vitro, Cordycepin appears to induce apoptosis and reduce proliferation of breast cancer cells (MCF-7 and MDA-MB-231) with an approximate IC50 of 100uM.[31] Despite influencing both cell lines, the mechanisms appeared to differ.
In estrogen non-responsive cells (MDA-MB-231), Cordycepin appears to induce DNA fragmentation in a time and concentration dependent manner resulting in apoptosis. This appeared to be related to a release of cytochrome c from the mitochondria to the cytoplasm associated with caspase activation and PARP cleavage.[31] An aqueous extract of Coryceps per se shares these apoptotic effects associated with mitochondrial membrane depolarization, and aside from acting via Akt inhibition it is augmented with inhibition of PI3K/Akt in vitro.[32] Only one other study has noted anti-proliferative effects on this cell line, but was highly confounded with other Bioactive Mushrooms.[33]
In MCF-7 cells, the death of cells appeared to be autophagic.[31] Cordycepin failed to induce DNA fragmentation but 200uM clearly induced autophagic vacuoles and associated with conversion of LC3-I to LC3-II, commonly thought to be a biomarker for autophagy.[34] The exact mechanism was not elucidated but was independent of the estrogen receptors.[31] Beyond apoptotic, the ethanolic acetate fraction of Cordyceps (Mycelium) in general appears to have anti-proliferative effects on MCF-7 cells with an IC50 value of 44.7ug/mL (Petroleum 87.37+/-1.61ug/mL, ethanolic 79.57+/-2.68ug/mL, water ineffective).[10]
Another component, Cordymin (peptide) also appears to inhibit MCF-7 breast cancer proliferation in concentrations up to 5mg/mL but not surpassing 50% inhibition;[13] biological significance of this is unknown due to the large molecular weight (10,906Da) and being a long polypeptide possible not absorbed in vivo. Another peptide (12kDa) was able to induce cytotoxicity in MCF-7 cells and reduce their viability to 33.41+/-3.81% of control at 15uM with an IC50 of 9.3µM in vitro.[14]
Finally, in the highly invasive 4T1 cell line an injected water soluble extract of Cordyceps (10-50mg/kg) significantly inhibited metastasis as measured in the lung (when the tumors were injected into the breast of rodents) without significantly affecting tumor size whatsoever.[35] This study hypothesized that the immunostimulatory properties of Cordyceps on macrophages attenuated the rate of which 4T1 cells progressed from G0 /G1 to GM phase, which was demonstrated in vitro.[35]
Conclusion: A variety of compounds that could benefit breast cancer by reducing proliferation of cells or induce cancer cell death, but none of these mechanisms are currently established in living models or compared against active control drugs (to assess potency)

Dose: 4.5-12g

Jin Chan Hua: Cordyceps sobolifera – Cordyceps growing on Cicada.
• Tonifies Lungs, improves vision.
• Kamto Lee: Specific guiding herb for lung cancer.

Nature: sweet, warm

Enters: Liver, Kidney

Actions: Tonifies the kidneys and liver, strengthens tendons and bones; holds and calms the fetus; promotes smooth circulation of Qi and blood.

Indications:
• Kidney and liver deficiency: weak, sore lumbar region and knees, Wei syndrome, fatigue, frequent urination.
• Kidney and liver deficiency: threatened or habitual miscarriage, restless fetus; cold deficient kidney patterns with bleeding during pregnancy.
• Liver/kidney Yang deficiency cold: impotence, frequent urination.
• Lowers blood pressure: for hypertension, dizziness, lightheadedness from liver Yang rising.
• Compared to Xu duan, Du zhong is more effective when the problem is due primarily to deficiency, while Xu duan is used more to treat lower back pain with significant aspects of both wind-damp and kidney deficiency.
• Fry in salt water to increase kidney-tonification properties.
Hong-Yen Hsu (Oriental Materia Medica): Hypotensive – the fried herb is more potent, and the decoction is better than the tincture.
• Analgesic.
• Can decrease absorption of cholesterol.
Dui Yao (Sionneau & Flaws): Secures the Chong Mai.
• The major herb to treat lumbar pain. Can be used for all types – excess or deficiency, hot or cold – when combined appropriately with other herbs.
• With Xu duan for mutual reinforcement, to supplement the liver and kidneys, strengthen the sinews and bones, stop metrorraghia during pregnancy, and quiet the fetus. For indication such as:
– 1. Aches and pains, stiffness, lumbar pain, and weakness of the lower limbs due to kidney-liver deficiency. (Du Zhong Wan) Salt mix-fry both herbs.
– 2. Knee and lumbar pain due to wind-dampness.
– 3. Metrorrhagia during pregnancy and threatened miscarriage accompanied by lumbar pains due to kidney deficiency. (Salt mix-fry both herbs.)
– 4. Traumatic lumbar pain. (Qian Jin Bao Yun Dan) Use salt mix-fried Du zhong and wine mix-fried Xu duan.
• Du zhong is more powerful than Xu duan at supplementing the liver and kidneys, strengthening the sinews, bones, and lumbar area. But Xu duan promotes circulation within the vessels, dispels blood stasis, and knits together fractured bones and torn ligaments.

Dose: 6-15g

Nature: sweet, warm

Enters: Lung

Actions: Strengthens Yang; transforms phlegm; descends Qi; benefits Qi; promotes lactation.

Indications:
• Yang deficiency with phlegm: cough and wheezing, emphysema.
• Insufficient lactation.
• Doctrine of signatures: its ability to direct Qi downward is indicated by its consistent downward growth.
• Crush or powder before use.
• Excessive or prolonged use can stagnate stomach Qi.
• Bensky/Gamble: In most cases this herb is fossilized Balanophylla species (coral).
• Contraindicated in cases of wheezing with blood.
• Cook 30 minutes longer than other herbs.

Dose: 9-30g

Nature: salty, neutral

Enters: Kidney, Lung

Actions: Tonifies Lung Qi and kidney Yang; nourishes Jing and blood.

Indications:
• Lung Qi deficiency: cough.
• Kidney Yang deficiency (fails to grasp the Lung Qi): asthma.
• Also for a combination of the two above syndromes, and consumptive cough, blood streaked sputum.
• Kidney Yang deficiency: impotence, daybreak diarrhea, frequent urination.
• Often made into a tonic wine – commonly using one male and one female gecko.
• The tail is considered the most effective part.
• The head and feet are usually not used in decoctions.
Joe Coletto: May counteract the destructive effect of steroids on the adrenals.
Dose: 3-7g directly as powder or 9-15g in decoction

Nature: bitter, sweet, warm

Enters: Kidney, Liver

Actions: Tonifies the liver and kidneys; strengthens bones and sinews, the lumbar region and knees; eliminates wind-damp; consolidates Jing, stabilizes the kidneys.

Indications:
• Liver and kidney deficiency: stiffness, soreness, weakness of the knees, feet, lower back, spine, and lower extremities. Inability to lie flat without pain.
• Wind-cold-damp obstruction: pain, soreness, stiffness, numbness – in people with a weak constitution; also swelling of the legs.
• Primarily used for pain due to weakness (with or without concomitant wind-damp invasion). Mild for sexual dysfunction.
• Kidney deficiency (kidney yang unable to control Jing): urinary incontinence, profuse clear vaginal discharge, spermatorrhea, hypermenorrhea.
• Similar to Du zhong, but milder to tonify the kidneys and liver.
• Compared to Ba ji tian, this herb is drier.
• According to Chen & Chen in Chinese Medical Herbology & Pharmacology this herb is a mild Kidney yang tonic and must be combined with other yang tonics.
• Chen & Chen: Dry-frying it helps in removal of hair-like protrusions. This hair-like material can be used externally to stop bleeding.
Dose: 4.5-15g

Nature: bitter, warm

Enters: Kidney, Liver

Actions: Promotes bone and sinew regeneration; promotes blood circulation; tonifies the kidneys; stop bleeding; stimulates hair growth.

Indications:
• Kidney deficiency: lumbar pain, weak feet, lumbar region, knees, tinnitus, poor hearing, toothache, bleeding gums, chronic diarrhea.
• Traumatic injury: falls, fractures, contusions, sprains. Especially good for ligamentous injuries and simple fractures (use internally and externally). Also used to help regain strength during the convalescent phase following injuries.
• Topical (tincture): for hair loss/alopecia, corns, warts (soak 100g herb in 1 L white rice wine for at least a week).
• Stronger than Xu duan at promoting blood circulation, but weaker at tonifying the liver and kidneys.
• Treats adverse effects of streptomycin in patients with a sensitivity to it: headache, dizziness, numbness of the tongue, tinnitus, hearing loss.

Dose: 6-18g

Nature: bitter, warm

Enters: Kidney, Liver

Actions: Warms the kidneys; disperses damp and cold, alleviates pain; increases lactation.

Indications:
• Kidney Yang deficiency with cold accumulation or stagnation Qi: abdominal or flank distention and pain or hernial disorders.
• Cold-damp leg qi: soreness, numbness, weakness, edema.
• Prevents and treats mountain sickness (in studies, was effective in about 1/3 of the subjects).
• May be useful in some forms of insomnia.
• Lowers blood sugar.
K&R: Hypoglycemiant, adrenal cortex stimulant, digestive tonic, lymphatic detergent, improves digestive absorption, eliminates intestinal mucus.
• Earth deficiency, metal deficiency.
• Earth: digestive aid, hypoglycemiant, good for emaciation.
• Metal: neuromuscular stimulant, good for emaciation (including diabetic), malnutrition, anemia, frigidity, impotence.
• Water: impotence, frigidity, lumbar pain, dysmenorrhea.
• Opera singers used for centuries to clear excess phlegm from the throat.
• Claimed equal to quinine in preventing fever.
• Topical: for cellulitis.
• Chronic prostatitis, impotence.
BII: May lower blood lipids (LDL, VLDL and trigylcerides): atherosclerosis.
• Diabetes: may improve glucose tolerance.
Yoga: Methi: bitter, pungent, sweet/heating/pungent; V, K-; P+
• Stimulant, tonic, expectorant, rejuvenative, aphrodisiac, diuretic.
• Hypo-function of the liver, seminal debility, dysentery, dyspepsia, chronic cough, allergies, bronchitis, flu, convalescence, dropsy, toothache, neurasthenia, sciatica, arthritis.
• Take gruel to improve lactation milk flow and hair growth.
• Use paste for boils, ulcers, non-healing sores.
• Caution in pregnancy.
PCBDP: Trigonelline significantly inhibits liver carcinoma in mice, is used in China for cervical cancer.

Dose: 3-9g

Nature: sweet, warm

Enters: Kidney, Large Intestine, Lung

Actions: Tonifies kidney Qi, strengthens the back and knees; warms the Lungs, tonifies Lung Qi; helps the kidneys grasp the Lung Qi; moistens the large intestine, unblocks the bowels.

Indications:
• Kidney Yang deficiency: weak, cold, painful lumbar region, feet, knees, frequent urination.
• Lung cold and Qi deficiency: cough, asthma.
• Lung and kidney deficiency: wheezing.
• Large intestine dryness: constipation, especially in the elderly or that from injured fluids following a febrile disease.
• Also used to dissolve/expel urinary stones.
• Use as a paste for contact, seborrheic, and atopic dermatitis.
• Its function to tonify Yang is very mild.
• The skin of the nutmeat is astringent. Eat this in order to help the kidneys grasp the Lung Qi. To promote bowel movement, remove this skin.
Jin: Eat in pregnancy for constipation. Also helps the baby’s brain develop.
DY: Invigorates Yang; calms or levels asthma; warms and supplements the life gate.
• With Bu gu zhi to supplement metal and water, to effectively constrain the Lung Qi and promote the intake of Qi by the kidneys, stop cough, and calm asthma. For the following indications, salt-processed Bu gu zhi should be used:
– 1. Cough, dyspnea, and asthma due to kidney Yang deficiency.
– 2. Lumbago, impotence, seminal emission, constipation, frequent and abundant urination, and enuresis due to kidney Qi deficiency.

Dose: 9-30g (eaten)

Nature: acrid, sweet, warm

Enters: Kidney, Liver

Actions: Tonifies kidney Yang; controls Jing; warms the stomach, stops vomiting.

Indications:
• Kidney Yang deficiency: impotence, weakness, cold and pain in lumbar and knee, urinary incontinence.
• Kidney Qi deficiency: seminal emission, frequent urination, copious leukorrhea.
• Stomach cold: vomiting.
• Must crush before use.

Dose: 3-9g (decoctions, pills, and powders)

Nature: sweet, salty, slightly warm

Enters: Kidney, Liver

Actions: Tonifies kidney Yang; slightly nourishes kidney Yin; nourishes Jing and blood, supports the brain; strengthens tendons and bones; tonifies the Du Mai (governing vessel); regulates the Chong Mai (penetrating vessel) and Ren Mai (conception vessel), and stabilizes the Dai Mai (girdle vessel).

Indications:
• Kidney Yang deficiency: intolerance to cold, cold extremities, impotence, seminal emission, infertility, frequent, clear urination, dizziness, sore and weak lumbar region and knees, fatigue, lightheadedness, tinnitus.
• Jing and blood deficiency: mental and physical retardation or deformity, weak tendons and bones, failure to thrive, learning disabilities, insufficient growth, Down’s syndrome, rickets – especially in children.
• Kidney Yang deficiency with cold in the Chong, Ren, and Dai Mai: copious leukorrhea, uterine bleeding, infertility with a cold womb.
• Qi and blood deficiency: chronic ulcerations or Yin-type boils (those that are concave, ooze a clear fluid, and do not heal).
• Diuretic.
• Doctrine of signatures: the antler is an extension of the deer’s Du Mai.
• It is important to start with a low dose and slowly increase it. If too much is taken at the beginning, the Yang can rise, leading to internal wind with dizziness and red eyes, or it can injure the Yin, leading to deficiency fire and even hemorrhage. In my experience, the most common side effect is an “edgy” feeling – irritable, or slightly physically overwhelmed, similar to having too much caffeine.
• Antler products are generally too valuable to cook. Take as powder or in wine.
• All antler products are contraindicated in cases of Yin deficiency heat.
• Contains pantocrinum: can regulate arrhythmias, improve poor circulation, increase work capacity, improve sleep and appetite, decrease rate of muscle fatigue.
Matthew Wood (Lecture notes): Lyme disease is caused by the same spirochete which lives on deer and stimulates their antlers to grow.
Hong-Yen Hsu (Oriental Materia Medica): Raises RBC count and hemoglobin, promotes growth and development, cardiotonic, increases uterine tonicity.
Weng Weiliang, et al: This TCM herb is indicated in the treatment of backache, impotence, emission, enuresis, sterility, aplastic anemia, senile osteoporosis, senile diarrhea, Raynaud’s disease, senile intractable cough and asthma, thromboangitis obliterans, lobular hyperplasia of mammary glands, etc.
• Lobular hyperplasia of mammary glands: Lu Jia San (experiential formula): lu jiao pian, chuan shan jia, 60g each; wang bu liu xing, sang leng, e zhu, 100g each; all the drugs were ground into fine powder. 9g, tid. 40 cases of lobular hyperplasia of mammary glands were treated with this method, after three months, 36 were effective.
• Hypothyroidism: Shen Lu tablet (experiential formula): lu jiao pian 4.5g, yin yang huo 30g, dang shen 12g, suo yang 12g, gou qi 9g. Each tablet contained 6g crude drugs, 5 tablets every time, three times daily, 3 months as a course of treatment. All the treated 32 cases were effective.
• Senile intractable cough and asthma: ma huang, 20g; bei xi xin, 10g, bai jie zi, gan di long, 15g each; lu jiao pian, wu wei zi, kuan dong hua, gan jiang, 10g each; dang shen, 24g, yin yang huo, 12g; shu di, 30g; rou gui, 5g. Modify the formula according to TCM differentiation, water decoction. 50 cases were treated and 48 were effective.
• Female low sexual function: Yi Shen Zhu Yang Tang (experimental formula): lu jiao shuang, 30g; shu di, shan yao, shan yu rou, gou qi, nu zhen zi, tu si zi, she chuang zi, yin yang huo, 15g; huang jing, gui ban jiao, 12g each; rou gui, 8g. With qi stagnation, add he huan pi 12g, xiang fu and chai hu 8g each; with Blood stasis, add dang gui, chuan xiong, and yi mu cao, 10g each. 1 dose every day, water decoction, 1 month as a course of treatment. 35 cases were treated, 33 were effective.
Subhuti Dharmananda: Deer antler is a common ingredient in Chinese tonic preparations. It may be surprising, especially to the practitioner of Chinese medicine, to learn that New Zealand is the world’s largest producer of deer antler, followed closely by Australia and Canada (both increasing rapidly), and that Korea is probably the world’s largest user of antlers, with an apparently insatiable appetite for antlers of all species. China is also a major producer and consumer of deer antler products and appears to have the longest history of medicinal use of deer antler as well as production via deer farming.
The story of deer antler can be traced back to the first Chinese Materia Medica, Shennong Bencao Jing (ca. 100 A.D.), where it is described briefly (1). There is also reference to earlier use of deer antler in an archeological find (a set of silk scrolls named Wushier Bingfang, from a tomb dated 168 B.C.). However, use of antler appears to have been infrequent until the animals were raised on “deer farms” starting in the mid-16th Century in China (Ming Dynasty period). This is a time when several other cultivation and animal husbandry projects were established in support of medicine. Soon after, Wu Kun included a formula in his book Yi Fang Kao (Study of Prescriptions, 1584) that has inspired much work with the combination of deer antler and tortoise shell, two bone-like materials rich in gelatins. His formula is Gui Lu Erxian Jiao (gui = tortoise, lu = deer, erxian = two immortals; jiao = gelatin). The formula is made as a firm gelatin, using the following recipe (proportioned to the amount being made):
Deer antler (lujiao) 5,000 g
Tortoise plastron (guiban) 2,000 g
Lycium fruit (goujizi) 1,500 g
Ginseng (renshen) 500 g
This formula is said to replenish yin and essence, tonify qi, and strengthen yang. It is used for deficiency of kidney yin and yang, deficiency of blood and essence in the penetrating and conception vessels, with symptoms of weakness of the lower back and legs, impotence, blurred vision, etc. (2). The penetrating vessel, (chongmai), one of the extra meridians, is referred to as the “sea of blood.” The conception vessel (renmai), while sometimes associated with reproduction, is related to generation more broadly, including generation of blood. Tortoise shell and deer antler are said to nourish the marrow.
More importantly for the future of Chinese herb prescribing with deer antler, Zhang Jingyue described two important tonic formulas in pill form (presented in the book Jingyue Quanshu, 1624), one to emphasize tonification of kidney yang (said to nourish the right kidney), called Yougui Wan, and one to emphasize nourishing kidney yin (said to nourish the left kidney), called Zuogui Wan. Though prepared originally as pills (= wan), they were later commonly used as decoctions for replenishing the kidney (you = right; zuo = left; gui = replenish).
Both formulas contain deer antler gelatin derived from boiling the antler (described further below). Chinese doctors regard the whole antler as primarily a revitalizing yang tonic with some yin nourishing qualities, while the gelatin is considered to be a milder yang tonic, with greater emphasis on nourishing yin, in a manner similar to tortoise shell (which lacks yang tonic properties). Both of Zhang Jingyue’s formulas nourish the kidney yin and essence, and both nourish yang, but Yougui Wan also warms the kidney and invigorates yang. To further emphasize yang tonification, deer antler may be used in place of the gelatin in Yougui Wan.
Because of the rather late introduction of antler in standard traditional Chinese medicine formulations, this ingredient rarely appears in Japanese preparations. The last major influence on Kampo from China was Gong Tingxian (1522-1619) with his book Wanbing Huichun (1587). He did not emphasize kidney tonification strategies. As a result, the Kampo literature doesn’t reveal antler-based formulas.
During the Qing Dynasty (1644-1910), the use of ginseng and deer antler became quite popular as a method of therapy, sometimes referred to as warm tonification. The Qing Dynasty medical commentator Xu Dachun (1693-1773) complained about over-reliance on these remedies (3):
Those physicians who prefer to be fashionable use only rapidly supplementing acrid and hot substances, namely ginseng, aconite, dry ginger, red atractylodes, deer antler, and cooked rehmannia. And no matter whether a patient was harmed by cold, heat, or dampness, these physicians go back and forth between these few herbs to compose their prescriptions. Often enough, these herbs are contraindicated in the case of the illness to be treated, and every trial is bound to kill someone. Still, there is not the slightest self-reproach.
Well, this has its origin in the physicians of today who prefer to make lofty speeches to deceive the people. Also, people are pleased if one uses warm and supplementing herbs, and this applies, in particular, to the rich and noble. Those physicians who do not follow these preferences of their patients will not be able to continue their profession for long! Hence, people strive to achieve the best effects, but they cause only unending calamity.
The acrid herbs were dry ginger, aconite, and red atractylodes (which was used at that time as we now use white atractylodes), and all the herbs mentioned were warming, some of them considered hot (though today, all are classified as warm except dry ginger and raw aconite, but not processed aconite). These invigorating tonics were expected to cause people to feel an immediate response to the therapy-a stimulation of their basic energy-compared to the usual tonification approach which might require weeks of regular use of the herbs and a nearly imperceptible daily improvement. Some of these herbs, like ginseng and deer antler, were rare and costly, so the rich sought them out, figuring that they had unique access to important remedies. It is much the same today: many people seek quick fixes and may be drawn to the unusual costly herbs if they can afford them.
Xu argued that reliance on a few popular and quick acting agents tends to be contrary to the most widely accepted methodology, which is to perform differential diagnosis and then prescribe according to need, regardless of the ordinary nature of some herbs or their lack of contemporary popularity. Hence, these warm tonifying agents might be contraindicated in cases of heat syndrome, damp-heat, blood heat, stomach fire, phlegm-heat in the lungs, and yin deficiency leading to excess yang. There was much concern during his time about killing patients with wrong prescriptions. Working in the absence of modern medicine, the remedies were used for people with fatal diseases who would die if not cured, and who might be worsened by some of the therapies (for example, raw aconite could be quite toxic if not cooked properly in making a tea). These specific concerns aside, all of the herbs mentioned were recognized as valuable, so long as they were given according to need.
The use of deer antler continued through the Qing Dynasty at a modest level until the 20th century, when it became the subject of modern research methods. Both the Russians (who had been farming deer antler since the 1840s) and the Chinese started subjecting deer antler to analysis by scientific methods, though those methods were relatively crude. About the same time, patent medicine factories sprung up in China and helped fill the growing demand for tonics made with rare ingredients such as deer antler and ginseng. Chinese patent medicine factories now use more than 1,000 kg of deer antler each year. This increased interest and distribution, in turn, led to rapid build-up in the number and size of deer farms.
SPECIES OF DEER
Initially, antler was collected from several species of wild deer (animals of the Cervidae family). There are 45 species of deer in the world, divided into 17 genera; not all of them have antlers. Two species of deer have been the common source of domestic deer antler for Chinese medicine: Cervus nippon, the sika deer, and Cervus elaphus, the red deer.
The sika deer is an East Asian species, ranging from Vietnam to Taiwan in the south and from China to Korea and Japan in the north; there are about 13 different subspecies of this deer. The sika deer mainly lives in open woodlands and is typically a chestnut red to yellowish brown with white spots on the sides and a dark stripe extending from neck to tail. Sika deer have been introduced to New Zealand for deer farming to produce antlers, and have also been introduced into Europe.
The red deer originally ranged from Europe to Asia, and it has been introduced into New Zealand, Australia, Chile, and Argentina for the purpose of deer farming to produce antler. It has a glossy reddish brown color in summer (but in winter turns drab grey-brown). Red deer prefer open, grassy glades in the forest, but frequently use woody cover.
DEER FARMING
Deer farming has become a huge enterprise outside the Orient. The animal meat is used as food, and the antlers are usually exported to the Orient, though there is a new industry in making antler-based health products for domestic consumption in Canada and other countries. The table on the next page indicates the extent of deer farming (adapted from ref. 4).
In Korea, the biggest consumer nation for deer antler, data from the end of 1992 indicated that 143,000 deer were held in pens (about 20 deer each), producing about 100 tons of fresh antler, which yields about 30 tons of dried product (6). That same year, about three times as much was imported, mainly from New Zealand, Russia, and China. China later became an antler importer rather than exporter, except for finished medicinal preparations and small supplies sent to oversea Chinese pharmacies.
The primary material collected at the deer farms is called velvet. The term originally arose from the fine hairs on the antler, but is now used specifically to indicate the antler’s stage of growth: before it calcifies (ossifies). In nature, antlers will fall off after they have ossified; thus, collecting fallen antler doesn’t provide the desired “velvet.” The older material is still valued: it is boiled to yield deer antler gelatin (described below) and used for certain applications, such as dispersing swellings.
Deer velvet is removed while the deer is under local anesthetic (which is a new practice in China and is a mandated practice in other countries that developed deer antler farming more recently). The antlers then grow back. Alternatively, if the deer is killed for use as food, the antlers are removed afterward. The cut antlers are bathed in boiling water and air dried, and then further dried in the shade or by low temperature baking. The fine hairs may be removed before additional processing. A typical dried antler from the sika deer weighs about 150 grams.
ANTLER PREPARATIONS
Traditionally, deer antler is sliced very thinly or ground to powder. It is not commonly boiled in decoctions with herbs because the gelatins easily stick to the herb dregs or cooking pot, and so the loss of valuable material is considered too great. Therefore, the herb powder is usually taken separately.
To make gelatin, ossified antlers (which are less expensive than velvet) are boiled for several hours to release the gelatin (protein components) from the hard matrix. Then, the antler gelatin can be added to an herbal decoction after all the boiling is done and the dregs have been strained. Or, it too can be ground to powder, and consumed directly. After removing the gelatin from the antler, the residual hard antler material is dried and ground up to make lujiaoshuang (degelatinized deer antler), which is mostly used for topical applications (treating boils, eczema, and skin ulcers, serving as an astringent and aid to faster healing). It is also considered of some limited value as a kidney yang tonic if taken at high enough dosage.
Antler pills are a common patent medicine product; the antler is not used alone, but in various formulations. These include liquids in glass vials (ginseng-deer antler, similar to the ginseng-royal jelly product; there is a combination with ginseng, antler, and royal jelly); pills used as sexual tonics (antler combined with epimedium, cynomorium, ginseng, and lycium fruit); and general tonics (complex formulas with herbs for tonifying qi and yang, and nourishing yin and blood).
The thin slices are made by removing the outer, hairy portion of the antler, soaking the antler in hot alcohol to soften it, and then carefully slicing it to produce round wafers. The slices are best suited for soaking in wine to make a “tincture” of antler, sometimes referred to as pantocrin (or pantocrine), based on the Russian designation for the alcohol extract. Very thin slices (virtually clear) can be eaten directly.
ANTLER CONSTITUENTS
Antler is a simple extension of bone, so it has a calcium-phosphate matrix of hydroxyapatite, Ca10(PO4)6(OH)2, integrated with smaller amounts of calcium carbonate (CaCO3); its composition is similar to that of human bones. Thus, one of the therapeutic roles of taking deer antler is as a source of calcium to help prevent or treat osteoporosis, which is consistent with the traditional bone strengthening action of deer antler. An analysis of the ossified antler showed that 73% is hydroxyapatite and related mineral compounds, while 27% is organic materials (7). If consumed as a powder (rather than a decoction), a person taking 3 grams of deer antler (see dosage section, below) will get about 800 mg of calcium. Hydroxyapatite is considered one of the most efficiently absorbed forms of calcium available. In velvet, the hydroxyapatite is about 50% (8), so the calcium in 3 grams is about 600 mg.
Deer antler also has a substantial amount of gelatinous components, ones that have become widely publicized in recent years, though from other source materials: glucosamine sulfate, chondroitin sulfate (which is a polymer of glucosamine), and collagen. These compounds have been shown to benefit the joints in cases of osteoarthritis by providing substrate materials useful for regenerating the body’s connective tissues (collagens) found in joints and sinews. In addition, they may have some anti-inflammatory action, useful for arthritis and tendonitis. These actions of the gelatin portion support the traditional concept that antler benefits joints and ligaments. In a 3-gram dose of ossified deer antler powder, one will obtain about 750 mg of these substances, which is low compared to therapeutic amounts taken as supplements for osteoarthritis (about 1,500 mg/day); 3 grams of velvet antler will provide the desired 1,500 mg. If deer antler gelatin is consumed, there is an even higher proportion of these ingredients, though some of the components may be transformed during the prolonged boiling into less active forms, so the dosage of gelatin to use is higher than for antler velvet.
Recently, the traditional use of antler to nourish the bone marrow and blood has been validated by studies in which the active components responsible were identified: monoacetyldiglycerides (9, 10). These are small molecules that stimulate the marrow stem cells that produce blood cells (see illustration, next page; 11). Inhibition of hematopoiesis (blood cell production) occurs with several cancer drugs and with radiation therapy; some disease processes, such as myelodysplastic syndrome (MDS), involve progressive decline in stem cell activity with undetermined causes. If further research confirms the therapeutic importance of the monoacetyldiglycerides, they can be synthesized in large quantity. In the meantime, deer antler is the main therapeutic source for them (the amount present in antler has not been quantified).
Deer antler also has essential fatty acids, making up about 2.5% of the velvet antler (not enough to be clinically active) and insulin-dependent growth factor (for which it is not known whether there is any clinical effect). Other organic compounds have been detected, but in miniscule amounts.
DOSAGE
The velvet antler in powdered form is typically used in dosages of 1-3 grams/day. Less than 3 grams may be a low dosage for promoting bone marrow function; the dosage levels traditionally indicated may reflect the rarity and expense of the antler (which is now partly alleviated by the increase in deer farming, but velvet is still relatively costly). The 3-gram dosage is probably essential for hematopoietic effect and for benefiting joints and tendons. Antler gelatin, because it is obtained from older antler material, is relatively inexpensive, is milder, and is used in larger quantities, 6-9 grams. Degelatinized antler is consumed in dosages of 6-9 grams, or more.
TRADITIONAL MEDICINE COMMENTARIES
The book Ten Lectures on the Use of Medicinals from the Personal Experience of Jiao Shude (12) provides these insights:
Lurong (velvet deer antler): Warm in nature and sweet and salty in flavor, lurong supplements kidney yang, strengthens sinew and bone, boosts sinew and marrow, and nourishes the blood. It is used for patterns of vacuity detriment, such a kidney deficiency and cold limbs, soreness of the limbs, dizzy head and blurred vision, seminal emission, and impotence.
Lujiao (ossified deer antler): Salty in flavor and warm in nature, lujiao supplements kidney yang and boosts essence and blood. It is similar in action to, and can substitute for, lurong, but it is less effective.
Lujiaojiao (deer antler gelatin): Sweet in flavor and warm in nature, lujiaojiao warms and supplements the kidney, supplements yang within yin, frees the blood of the thoroughfare vessel (chongmai), engenders essence and blood, and stanches flooding (excessive uterine bleeding)….It is mostly used for flooding and spotting, vaginal discharge, deficiency bleeding, and yin type flat-abscess (lumps that are not red, swollen, hot, or painful).
Comparisons: Lurong is commonly used as a drastic liver-kidney supplementing medicinal. It has greater supplementing power than lujiao. Lujiao, by contrast, has a moderate liver-kidney supplementing effect, but it quickens the blood, dissipates stasis, and disperses swelling and toxin with greater strength than lurong…. Used processed or as a glue (lujiaojiao), it tends to warm and supplement the liver and kidney, enrich and nourish essence-blood. Lujiaojiao is similar in action to lurong, but being slower to supplement, it must be taken over a long period of time to be effective. Lujiaoshuang, which is the dregs left after making lujiaojiao, is less warming and supplementing than either lujiao or lujiaojiao. Lujiaoshuang is used for spleen-stomach deficiency cold, low food intake, and sloppy stool, and it is also used as a substitute for lujiao and lujiaojiao, in which case the dosage must be increased.
The problem of “flooding” and spotting was described by Liu Yiren in his book Heart Transmission of Medicine (ca. 1850; 13):
The disease of flooding and leaking is due to detriment of the chong (penetrating) and ren (conception) vessels. The chongmai is the sea of blood of the twelve channels, and the renmai is the original qi of engenderment and nourishment. If these two vessels suffer detriment, the blood will consequently move frenetically. At its onset, this disease is categorized as repletion heat, requiring clearing heat. Later on, it is characterized as deficiency heat, requiring nourishing the blood and clearing heat. If it endures for many days, it is categorized as deficiency cold, requiring warming the channels and supplementing the blood.
Although antler wasn’t commonly used during Liu Yiren’s time, it would today be a primary choice for treating the deficiency cold syndrome that he described. Since bleeding is part of the syndrome, antler gelatin would be utilized, probably with tortoise shell.
The Advanced Textbook of Traditional Chinese Medicine and Pharmacology (14) notes the main uses for deer antler (lurong):
a) Chronic diseases marked by general lassitude and spiritlessness, lumbago, and cold limbs, polyuria with clear urine, impotence, spermatorrhea, and leukorrhagia with clear discharge, for which it is often used with cooked rehmannia, eucommia, and cistanche.
b) Infantile maldevelopment marked by weakness of the muscles and bones, incomplete closure of the fontanel, and retarded speech and movement, for which it is often combined with cooked rehmannia and cornus [it is sometimes added to Rehmannia Six Formula, which has these ingredients, and which was designed for promoting healthy growth of children who displayed slow development].
c) Chronic diseases with blood deficiency and liver and kidney deficiency, for which it is often used with ginseng, astragalus, cooked rehmannia, and tang-kuei.
d) Deficiency of the extra meridians (e.g., chongmai) with incessant uterine bleeding, for which it is often prescribed with gelatin, sepia bone, tang-kuei, and tortoise shell.
The effects of lujiao, lujiaojiao, and lujiaoshuang derived from the antlers are basically the same: warming and nourishing kidney yang. But, lujiao also activates blood circulation and relieves swelling, lujiaojiao is more effective for nourishing blood and checking bleeding, and lujiaoshuang possesses an astringent effect [e.g., for incontinence of urine, uterine bleeding, and leukorrhea].

Dose: 1-3g (take directly, divided into two or three doses over the course of the day)

Nature: salty, warm

Enters: Liver, Kidney

• Weaker than Lu rong to tonify, but also promotes blood circulation, reduces swelling.
• Good for kidney Yang deficiency with blood stagnation.
• Non-healing fractures.
• Toxic sores and swellings.
• Breast abscesses.
• Pain from blood stasis and deep pain in the lower back.

Dose: 5-10g

Nature: sweet, salty, slightly warm

Enters: Kidney, Liver

Actions: Tonifies liver blood and kidney Jing; stops bleeding.

Indications:
• Kidney Yang deficiency: intolerance to cold, cold extremities, impotence, seminal emission, infertility, frequent urination, dizziness, weak lumbar region and knees, fatigue.
• Kidney Yang deficiency cold: hematemesis, epistaxis, hematuria, uterine bleeding.
• Non-healing Yin-type carbuncles.
• Do not cook – melt into a warm decoction or yellow wine.
• Can be combined with Chen pi to counteract its greasiness.
Dr. Wei Li: Strong blood tonic, great for chemotherapy patients.

Dose: 6-12g

Nature: sweet, slightly warm.
• Much weaker than Lu rong to tonify Jing and blood, but has a stronger retaining effect.
• Mainly for cold deficient uterine bleeding and vaginal discharge.
• Topical: to stop bleeding.

Nature: sweet, salty, warm

Enters: Kidney, Large Intestine

Actions: Tonifies kidney Yang; moistens the large intestine, promotes bowel movement; warms the womb.

Indications:
• Kidney Yang deficiency: impotence, infertility, weakness and cold pains in the lumbar region and knees, urinary incontinence, posturinary dripping, spermatorrhea.
• Large intestine dryness: constipation .
• Deficiency cold womb: infertility, excessive uterine bleeding, vaginal discharge.
• Stronger than Ba ji tian to tonify Jing and blood and to moisten the large intestine.
• Sticky, but not greasy – a large dose will not hurt the spleen.
• Tonifies the Yang yet is not drying; its effects are moderate.
• Treated with salt for frequent urination or spermatorrhea.
• Increases secretion of saliva.
• Currently in protected status. Becoming increasingly difficult to find in U.S.
Jin: Tonifies both the kidneys and spleen. Not drying like some other Yang tonics.
Hsu: Laxative, hypotensive.

Dose: 9-21g

Nature: sweet, warm

Enters: Liver, Kidney

Actions: Tonifies kidney Yang; controls Jing; nourishes liver Yin to improve vision.

• Kidney Yang deficiency: lumbar pain, impotence, seminal emission, frequent urination, urinary incontinence, copious leukorrhea, premature ejaculation.
• Liver Yin (and kidney) deficiency: poor or blurry vision.
• Compared to Tu si zi, Sha yuan ji li focuses more on improving the vision, whereas Tu si zi focuses more on tonification.
Hsu: Antidiuretic, stimulates uterine contraction.
DY: Astringing (secures the essence); harmoniously supplements Yin and Yang.
• With Bai ji li to regulate upbearing and downbearing and the liver and kidneys. Together, they course the liver and rectify Qi, resolve depression and calm the liver. They harmoniously supplement the liver and kidneys – they enrich the kidneys and secure the essence, nourish the liver and brighten the eyes. For such indications as:
– 1. Vertigo, unclear vision due to liver and kidney deficiency. (Use salt mix-fried Bai ji li.)
– 2. Lumbar pain, seminal emission, premature ejaculation, frequent urination due to kidney deficiency. (Use salt mix-fried or stir-fried Sha yuan zi.)
– 3. Abnormal vaginal discharge due to kidney deficiency.

Dose: 6-15g

Nature: sweet, warm

Enters: Liver, Kidney, Large Intestine

Actions: Tonifies kidney Yang; moistens the large intestine, promotes bowel movement; nourishes blood and Jing; strengthens the sinews.

Indications:
• Kidney Yang and Jing deficiency: infertility, impotence, spermatorrhea, weakness of the lumbar region and knees, weakness of the tendons and bones, frequent urination.
• Large intestine dryness (Qi and blood deficiency): constipation.
• Jing and blood deficiency: weakness of the sinews, motor impairment, paralysis, muscular atrophy.
• Doctrine of signatures: for impotence – see morphology of the stem.
• Stronger than Rou cong rong at tonifying kidney Yang, but weaker at moistening the large intestine and promoting bowel movement.
Subhuti Dharmananda: Cynomorium is known in Chinese as suoyang, which is based on the herb’s medicinal effects, “locking the yang.” It is obtained mainly from the East Asian species, Cynomorium songaricum, though the similar C. coccineum is sometimes utilized as a substitute (and is used in other countries, from Europe to Central Asia, where it is the native species). The plant harvested for Chinese medicine grows at high altitude, mainly in Inner Mongolia, Qinghai, Gansu, and Tibet. It is used to tonify the yang (treat impotence and backache), strengthen the tendons, and nourish the blood to alleviate the blood-deficiency type of constipation (typically occurring with old age).
The value of cynomorium was depicted similarly in many cultures. In 16th century Europe, it was known as the Maltese mushroom, though it is not a true fungus. The plant was so highly regarded that the Knights of Malta often sent samples of it to European monarchs as presents. To protect the so-called Fungus Rock, where cynomorium was abundant, the grandmaster posted guards around the area and ordered the sides of the outcropping to be rendered smooth to eliminate any footholds and prevent access from the sea. The rock, rising to a sheer height of 60 meters (200 feet) from the rough sea, became virtually inaccessible. As an explanation of its uses by the doctrine of signatures, since the plant appears reddish-brown, and becomes darker upon drying, herbalists thought it would be useful to treat ailments of the blood. On top of that, the phallic shape indicated the plant could also be used to treat sexual problems. The dried spikes were used by the Crusader Knights after their battles to recover strength. In Saudi Arabia, the plant is called tarthuth, and is recognized to have the same properties mentioned above, as well as many others, including treatment of digestive disorders and ulcers (see Appendix for story).
Cynomorium is parasitic on the roots of salt-tolerant plants, mainly species of Atriplex, the “saltbushes” (for C. coccineum) and on Nitraria sibirica (for C. songaricum). The plant has no chlorophyll; the fleshy red stems or spikes have tiny scarlet flowers. Its active constituents have not been fully analyzed, but cynomorium is known to contain anthocyanic glycosides, triterpene saponins, and lignans. Pharmacology experiments are in the early stage, with attempts to demonstrate a hormonal effect that would explain its use in impotence (its current main application in commercial products), as well as findings that the herb extracts inhibits HIV, lower blood pressure, and improve blood flow in laboratory experiments.
Cynomorium, which has a pleasant, sweet taste when raw, has long been known as a “famine food,” that is, something not frequently eaten, but nourishing enough to help people survive when the standard foods are insufficient. In fact, a city in China is named for cynomorium because of this benefit. The city is near Anxi (in today’s Gansu Province), which lies at the center of the ancient Silk Road, and was long considered as the key to the West. During the Tang Dynasty, Anxi was established as a military base to gain control over Middle Asia. About 40 miles away was an old Han Dynasty town called Kugucheng, also of strategic military importance. Numerous walls and gates were set up to form a line of defense. During the Tang dynasty, the famous general Xue Rengui and his army were besieged in the Anxi area while on the way to conquer the West. The soldiers had used up all their supplies and they had no hope of assistance. Yet, they were able to survive by eating suoyang, and after that the city was renamed as Suoyang.
Cynomorium didn’t enter into the Materia Medica until Zhu Danxi of the Yuan Dynasty period mentioned it in his Bencao Yanyi Buyi (Supplement and Expansion of Materia Medica, 1347). The Yuan Dynasty, which was the time of Mongolian rule, introduced several plants from the Mongolian area, including this one. Zhu Danxi also offered a formula with cynomorium that became quite famous, Huqian Wan (Hidden Tiger Pills), used for impotence and/or for weakness and atrophy of the legs. The formula is named for the tiger in crouched position, ready to spring. In order to attain that position (which is also replicated in Gong Fu with the “crouching tiger” technique), one must have great strength in the tendons, ligaments, and muscles of the legs. This strengthening is sometimes referred to as “hardening” of yin (substance of the body); but that doesn’t necessarily indicate lack of flexibility. The weak leg disorders were first described in the Neijing Suwen (ca. 100 A.D.), in the chapter on wei syndrome, which is translated as atrophy or wilting syndrome. There were five types of atrophy listed, associated with each of the five organs. The disorder was thought to derive from heat or damp-heat damaging the yin.
Huqian Wan is comprised of anemarrhena, phellodendron, cooked rehmannia, tortoise shell, tiger’s bone (no longer used), peony, citrus, and dry ginger; sometimes cistanche (another parasitic desert plant) is added. The formula was recently described by Kong Lingqi (Resolutely Upholding the Concept of Hardening the Kidneys Method, by Kong Lingqi, Sichuan Chinese Medicine, 1998 (6): 8-9, translated by Bob Flaws, and edited here):
The Suwen chapter titled Treatise on Wilting says, ‘The ancestral sinews rule the binding of the bones and the disinhibition of the joints.’ If damp heat invades and assails the muscles and flesh and sinews and bones, the qi and blood will not move. The sinews will become slack and not pulled together and, hence, will be useless. If severe, the liver and kidneys will become debilitated and consumed and the ancestral sinews will cease their duty. Master Ye Tianshi, in his Guide to Clinical Conditions & Case Histories chapter titled Vacuity Taxation highly praised Zhu Danxi’s Huqian Wan for their effect of subduing yang and hardening yin. These pills use phellodendron and anemarrhena’s bitterness to harden yin. This causes the source to be cleared and flow to be cleaned. Atractylodes (cangzhu) and coix (yiyiren) dispel dampness. Cistanche (roucongrong), cynomorium (suoyang), achyranthes (niuxi), and tiger bone (hugu) strengthen the sinews and bones. Peony (baishao) and chaenomeles (mugua) emolliate the sinews and relax tension. Cooked rehmannia (shudi) and tortoise shell (guiban) enrich yin and boost the marrow. Thus damp heat is discharged and transformed, yin essence is subdued and astringed, the ancestral sinews are hardened and strengthened, and the feet are able to walk.
Because of these uses, the formula has been suggested by Chinese clinicians as a possible therapy for paralytic disorders, such as multiple sclerosis and ALS.

Dose: 4.5-15g

Nature: sweet, acrid, neutral

Enters: Liver, Kidney

Actions: Tonifies kidney Yang; mildly nourishes kidney Yin; controls Jing and urine; improves vision; tonifies spleen Qi to stop diarrhea; calms the fetus.

Indications:
• Kidney Yang deficiency: impotence, frequent urination, tinnitus, copious leukorrhea, weak and sore lumbar region and knees, nocturnal emission without dreams.
• Liver and kidney Yin deficiency: blurry vision, seeing spots, dizziness, tinnitus.
• Habitual or threatened miscarriage.
• Spleen Qi deficiency (with concurrent kidney deficiency): diarrhea or loose stools, poor appetite.
• Do not count on this herb for tonification of spleen Qi – use it when there is also kidney Yang/Qi deficiency.
• Compared to Sha yuan ji li, Tu si zi focuses more on tonification, whereas Sha yuan ji li focuses more on improving the vision.
• Because this herb is a parasite of some agricultural crops, it must usually be sterilized before entry into the United States.
MLT: A tonic specific for low sperm count and inactivity of sperm.
Hsu: Cardiotonic, hypotensive, stimulates the uterus, decreases the size of the spleen, inhibits intestinal activity.

Dose: 9-15g

Nature: acrid, slightly toxic, hot

Enters: Liver, Kidney

Actions: Tonifies kidney Yang – can reach and tonify the Ming Men; eliminates cold and damp.

Indications:
• Kidney Yang deficiency: impotence, nocturnal emission, urinary incontinence, cold in the chest and abdomen, infertility from cold Jing or cold womb.
• Cold-damp Bi: cold and pain in the lumbar region, knees, abdomen, a sense of weakness in the bones and sinews.
• Especially useful for cold abdominal or lower back pain.
• Often taken soaked in wine by itself.
• Compared to Ba ji tian and Yin yang huo, Xian mao is stronger and harsher. It should not be taken long term.
• Toxic reactions, such as swelling of the tongue, can occur. This can be alleviated with a decoction of Da huang, Huang lian, and Huang qin.
MLT: For menopausal symptoms from deficiency of both Yin and Yang.
• Use as an alternative to Fu zi and Rou gui when they would be too heating and stimulating.

Dose: 3-10g (10g for impotence)

Nature: bitter, sweet, acrid, slightly warm

Enters: Liver, Kidney

Actions: Promotes tendon and bone regeneration, generates flesh; tonifies the liver and kidneys; promotes blood circulation, alleviates pain; stops uterine bleeding; calms the fetus.

Indications:
• Liver and kidney deficiency: weak lumbar region, knees and legs, stiff joints, seminal emission, uterine bleeding, threatened miscarriage with bleeding, restless fetus.
• Topical or internal: for trauma, sores, pain, swelling, Bi syndrome (especially of the lumbar region and limbs).
• Given its ability to control excessive menstrual bleeding, its Yang nature, and its ability to support a fetus, Kou believe this herb has a progesterone-supporting effect and in high doses (30-60g), he says it effectively treats estrogen dominance.
• Tonifies without causing stagnation.
• Much milder than Du zhong at tonifying the liver and kidneys.
• Compared to Du zhong, Xu duan is used more to treat lower back pain with significant aspects of both wind-damp and kidney deficiency, while Du zhong is more effective when the problem is due primarily to deficiency.
• Fry in vinegar to enhance its ability to promote blood circulation and alleviate pain.
• Roasting with salt facilitates its entry into the kidney channel.
• Dry-fry or char for excessive uterine bleeding.
• Powder for topical application.
Hsu: Induces eruption of pus, stops bleeding, promotes tissue regeneration, analgesic effect on patients with carbuncle dermatosis.
Dui Yao (Sionneau & Flaws): Stops metrorrhagia during pregnancy.
• With Du zhong for mutual reinforcement, to supplement the liver and kidneys, strengthen the sinews and bones, stop metrorrhagia during pregnancy, and quiet the fetus. For specific indications and notes, See Du zhong in this category.
Matt Wood: For torn, stretched or wrenched joints, especially in large people who throw joints out with force. Chronic muscle inflammation, limitation of movement, great pain. Widespread arthritis, stiffness, incapacitation.
• Nerve irritation, sciatica.
• Intermittent fever.
• Regarding its literal translation, “restore what is broken,” it can be used for anything “broken” in one’s life, so that a part of one’s path cannot become manifest. “For people who had a use but lost it.” Helplessness, loss of purpose.
• Powerful remedy for Lyme disease (“deer syphilis”) and Lyme-like diseases. Deer appreciate this plant for relieving a disease they carry the vector for.
• MW dosing: 1-3 drops tincture 1-3 times daily. If this produces an aggravation, the dose may be lessened. Caution: may cause a healing crisis first (perhaps syphilis-like, genital rash, etc.).
• Doctrine of signatures: The thorny stalks are a signature for tension and nerve irritation. The tall, hard stalks which remain strong through the winter seem to indicate an affinity for the bones. At intervals along the stem the opposite leaves merge to form a cup which holds water after a rain – a remedy for joints and the kidney essence.

Dose: 6-30g

Nature: salty, slightly warm

Enters: Kidney

Actions: Tonifies kidney Yang; warms the womb.

Indications:
• Kidney Yang deficiency: impotence, infertility, spermatorrhea, premature ejaculation, cold, soreness, weakness and pain in the lumbar region and knees.
• Cold womb: infertility, uterine bleeding.
• Increases female libido.
• Not for long term use.
• Contains oxides of iron, calcium, and magnesium, plus about 50% silica.
• Usually calcined.

Dose: 3-9g

Nature: acrid, warm

Enters: Spleen, Kidney

Actions: Warms the spleen, stops diarrhea, promotes food intake for the stomach; controls saliva (spleen and kidney Qi); warms the kidneys to control urine and Jing.

Indications:
• Spleen and kidney cold and Yang deficiency: vomiting, diarrhea, abdominal pain.
• Middle Jiao Qi deficiency: poor appetite, copious saliva (not for excess salivation due to heat forcing out fluid).
• Kidney Yang deficiency: seminal emission, frequent and copious urination, urinary incontinence, dribbling.
• Cold entering the spleen and kidneys: abdominal pain, vomiting, diarrhea.
• Excessive saliva and thick, unpleasant taste in the mouth: Yi zhi ren is better for cold conditions while Pei lan is better for hot conditions.
• Yi zhi ren’s spleen-warming properties are more pronounced than its kidney-tonifying qualities. The opposite is the case with Bu gu zhi.
• Crush before use.
Hsu: Stomachic, antidiuretic, inhibits salivation.
DY: With Fu ling to fortify the spleen, secure the kidneys, reduce urination, and stop diarrhea. For indications such as:
– 1. Strangury with chyluria, milky, turbid urine, and dysuria due to deficiency cold in the kidneys or kidney Qi not securing with imbalance in the function of transformation of the bladder. (Use salt mix-fried Yi zhi ren)
– 2. Diarrhea due to deficiency cold of the spleen and kidneys. Particularly watery diarrhea. Use Yi zhi ren which has been stir-fried until scorched.

Dose: 3-9g

Nature: acrid, sweet, warm

Enters: Liver, Kidney, (Hong Jin: Spleen)

Actions: Tonifies kidney Yang; eliminates wind-damp; tonifies Yin and Yang to harness rising liver Yang.

Indications:
• Kidney Yang deficiency: impotence, seminal emission, frequent urination, forgetfulness, withdrawal, weak, painful, cold lumbar region and knees.
• Wind-cold-damp: pain or numbness in the limbs, spasms or cramps in the hands and feet, joint pain.
• Liver/kidney deficiency with subsequent liver Yang rising: low back pain, dizziness, menstrual irregularity.
• Sexual effects: increases sexual activity, sperm production, desire; androgen-like effects on testes, prostate and levator ani.
• May possess expectorant and antitussive qualities.
• Watch out for arisal of heat symptoms from use of this herb – contraindicated with Yin deficiency heat. Very drying.
• Particularly useful for Bi syndrome in patients with waning Ming Men fire.
• Often steeped in wine for kidney Yang deficiency or painful obstruction.
Jin: Also warms spleen Yang.
Hsu: Aphrodisiac (stimulates secretion of semen, indirectly promoting sexual desire).
• Hypotensive – dilates peripheral blood vessels, inhibits vasomotor center in the brain.
• Antitussive, expectorant, anti-asthmatic effects.
• Small doses are diuretic, large doses are antidiuretic.

Dose: 6-15g

Nature: sweet, salty, warm

Enters: Lung, Liver, Kidney

Actions: Nourishes blood; tonifies Qi; tonifies the kidneys and liver, nourishes Jing; promotes lactation.

Indications:
• Kidney Qi and Jing deficiency: infertility, impotence, seminal emission, soreness in the lumber region, dizziness, tinnitus, lightheadedness.
• Qi and blood deficiency (especially postpartum): thin muscles, pallor, scanty lactation.
• Lung and kidney Qi deficiency: asthma/wheezing (especially useful between acute attacks); consumption with night sweats, emaciation, debility, chronic wheezing and cough.
• Unremitting seizure disorders.
• Cancer with severe anemia: use fresh placenta with Huang qi and Dang gui.
• May enhance immune function: HIV, TB.
• Used for bleeding from factor XIII deficiency.
• Enhances wound healing.
• May be of benefit in COPD.
• Cooler and weaker at nourishing Jing than Lu rong, but stronger at nourishing blood.
• Placenta from China is usually from animals. Also is usually bleached. Dried placenta is normally dark red, since it’s full of blood. If collected from women, should be sure any potential blood-borne pathogens are killed.
Hsu: Anti-infectious: increases the body’s immune resistance, anti-allergic actions, contains a substance which acts as an antibody against measles, influenza.
• Inhibits precipitation of fat in the liver.
• Stimulates the testes, stimulates production of chorionic hormones, stimulates production of female sex hormones, including for pregnancy.

Dose: 1.5-4.5g