八珍汤

• Tongue: Pale, swollen tongue body with thin white coating.
• Pulse: Thin and weak, or vacuous and large without strength.

4. Common modifications

• Ba Zhen Yi Mu Tang (Ba Zhen Tang + Yi Mu Cao [motherwort herb]): Strengthens the action of invigorating blood and regulating menstruation, suitable for combined qi and blood deficiency with concurrent blood stasis presenting as irregular menstruation, or persistent lochia after childbirth.
• Shi Quan Da Bu Tang (Ba Zhen Tang + Huang Qi [astragalus root] and Rou Gui [cinnamon bark]): Enhances the function of warmly tonifying qi and blood, suitable for combined qi and blood deficiency inclining toward yang deficiency with cold, manifesting as aversion to cold, cold extremities, spontaneous sweating, etc.
• Ren Shen Yang Rong Tang (Shi Quan Da Bu Tang minus Chuan Xiong [chuanxiong rhizome], plus Yuan Zhi [polygala root], Wu Wei Zi [schisandra fruit], and Chen Pi [aged tangerine peel]): Focuses on tonifying qi and blood while nourishing the heart and calming the spirit, suitable for insufficiency of qi and blood with restlessness of heart-spirit, palpitations, and insomnia.
• If accompanied by insomnia with excessive dreaming, add Suan Zao Ren (spine date seed) and Yuan Zhi (polygala root) to nourish the heart and calm the spirit.
• If accompanied by very poor appetite with abdominal distension and fullness, add Chen Pi (aged tangerine peel) and Sha Ren (amomum fruit) to move qi and strengthen the Spleen.

5. Cautions and clinical notes

• Contraindications: Contraindicated in excess or heat patterns. Not suitable for those with fever from common cold, abdominal distension and constipation, red complexion and red eyes, or red tongue with yellow coating.
• This formula is by nature rich and cloying; it should be used with caution in those with Spleen-Stomach deficiency and internal obstruction by damp-turbidity, presenting with abdominal distension and fullness, vomiting and diarrhea, or thick, greasy tongue coating. In such cases, first regulate the Spleen and Stomach, or use together with herbs that strengthen the Spleen and promote digestion.
• During treatment, the diet should be light and nutritious; avoid raw, cold, greasy, and hard-to-digest foods.

6. Granule conversion and dose

• Calculation of the total raw herb weight in the original formula:
  • Ren Shen (ginseng root) 9 g + Bai Zhu (white atractylodes rhizome) 9 g + Fu Ling (poria) 9 g + Zhi Gan Cao (honey-fried licorice root) 6 g + Shu Di (prepared rehmannia root) 15 g + Dang Gui (Chinese angelica root) 12 g + Bai Shao (white peony root) 12 g + Chuan Xiong (chuanxiong rhizome) 6 g = 78 g.
  • (Note: This is the classical dosage. Clinicians often adjust it according to the case, such as substituting Dang Shen [codonopsis root] for Ren Shen, in which case the dose may be increased to 15 g, with the total raw herb weight changing accordingly.)
• Conversion to 5:1 granules:
  • 78 g raw herbs ÷ 5 = 15.6 g granules.
• Recommended dose:
  • One dose daily, taken in 2 divided doses (morning and evening), dissolved in warm water, about 8 g per dose.
  • Or as directed by a physician, who will modify the original formula according to the severity of the patient's qi and blood deficiency, in which case the dose must be recalculated based on the adjusted total raw herb weight.