二仙汤

4. Common modifications

• Marked Kidney yang deficiency with pronounced aversion to cold and cold limbs: Add Fu Zi (aconite root, prepared) and Rou Gui (cinnamon bark) to strengthen the yang-warming effect.
• Marked Kidney yin deficiency with dry mouth and dry tongue: Add Nu Zhen Zi (ligustrum fruit) and Han Lian Cao (eclipta) to nourish Kidney yin.
• Liver yang rising with pronounced dizziness: Add Tian Ma (gastrodia rhizome), Gou Teng (uncaria stem with hooks), and Shi Jue Ming (abalone shell) to calm the Liver and subdue yang.
• Insomnia with profuse dreaming: Add Suan Zao Ren (spiny jujube seed) and Ye Jiao Teng (polygonum stem) to nourish the Heart and calm the spirit.
• Modern applications: This formula is commonly used for menopausal syndrome, hypertension, chronic nephritis, aplastic anemia, and osteoporosis, in patients whose pattern is Kidney yin and yang dual deficiency with deficient fire disturbing above.

5. Cautions and clinical notes

• Contraindications:
  • Not suitable for excess patterns of pure yin deficiency with effulgent fire or Liver yang rising.
  • Use with caution in patients with Spleen deficiency and loose stools.
  • Xian Mao (curculigo rhizome) in this formula has a certain degree of toxicity and should not be taken in excess or for a prolonged period.

6. Granule conversion and dose

• Calculation of the total raw herb weight in the original formula:
  • Xian Mao (curculigo rhizome) 9 g + Yin Yang Huo (epimedium herb) 9 g + Ba Ji Tian (morinda root) 9 g + Dang Gui (Chinese angelica root) 9 g + Zhi Mu (anemarrhena rhizome) 6 g + Huang Bai (phellodendron bark) 6 g = 48 g.
• Conversion to 5:1 granules:
  • 48 g raw herb ÷ 5 = 9.6 g granules.
• Recommended dose:
  • One dose daily, taken in two portions morning and evening, dissolved in warm water, about 5 g per dose.
  • Or as directed by a practitioner, who will make fine modifications according to the patient's relative degree of Kidney yin and yang deficiency and the severity of fire effulgence; in that case, the total raw herb weight must be recalculated after adjustment.