右归丸

3. Tongue and pulse

• Tongue: Pale, swollen tongue body with a white, slippery or white, greasy coating.
• Pulse: Deep and slow, faint and forceless.

4. Granule conversion and dose

Calculation of the total raw herb weight of the original formula:

Shu Di Huang (prepared rehmannia root) 24 g + Shan Yao (Chinese yam) 12 g + Shan Zhu Yu (cornus fruit) 9 g + Gou Qi Zi (goji berry) 9 g + Tu Si Zi (dodder seed) 12 g + Lu Jiao Jiao (deer antler glue) 6 g + Du Zhong (eucommia bark) 12 g + Rou Gui (cinnamon bark) 4 g + Fu Zi (prepared aconite root) 6 g + Dang Gui (Chinese angelica root) 9 g = 103 g.

Conversion to 5:1 granules:

103 g raw herbs ÷ 5 = 20.6 g granules.

Granule dose: Dissolve in warm water and take in 2 doses, morning and evening, about 10 g per dose. (The original formula was in pill form; the granule form is now better absorbed, and the dose may be adjusted as advised by a practitioner.)

5. Cautions and clinical notes

Contraindications:

1. This formula is acrid, hot, and strongly tonifying in nature; it is absolutely contraindicated in patterns of yin deficiency with effulgent fire or internal accumulation of damp-heat.
2. It should be avoided when exterior patterns from external contraction remain unresolved, or when there is internal excess heat.

Safety warnings:

1. Fu Zi in this formula is toxic and must be processed before use. In preparing ProCare Herbs granules, strictly processed prepared Fu Zi must be used to substantially reduce its toxicity and ensure safety of use.
2. This formula is a tonifying preparation with a rich, cloying nature; it should be used with caution in those with weak Spleen and Stomach function and poor transportation and transformation, or combined with herbs that strengthen the Spleen and regulate qi to prevent impairment of the Stomach.

Modern applications: Mainly used for chronic nephritis, nephrotic syndrome, hypothyroidism, adrenocortical hypofunction, aplastic anemia, senile osteoporosis, hypogonadism, and oligospermia, where the pattern is identified as Kidney yang insufficiency with decline of Mingmen fire.

Duration of use: This formula is a regulating preparation, mostly used for chronic deficiency-type disorders, and requires a certain period of continuous use before effects become apparent. It may be taken long-term as advised by a practitioner (e.g., 1-3 months), with modifications according to the pattern. Once yang qi gradually recovers and symptoms improve, the dose may be reduced for maintenance.