A "warm and tonify the kidney yang" formula from the Han dynasty, best understood as the six-ingredient Liuwei Dihuang Wan (Six Flavor Rehmanni) with cinnamon and aconite added back in to address the "yang" rather than the "yin" aspect.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Recorded by Zhang Zhongjing in the "Essential Prescriptions of the Golden Cabinet" (《金匮要略》) as the foundational "warm the kidney yang" formula. In Japan it is marketed as Hachimijiogan (八味地黄丸) by every major kampo manufacturer (Tsumura, Kracie, Kotaro) and is widely used for cold extremities, nighttime urination, and mild lower-back pain in older adults. In Korea it is sold by Kyungdong and Hanpung as Palmi-jihwang-hwan (팔미지황환). The "Hachimi" and "Bawei" names are simply the Sino-Japanese and Sino-Korean readings of "Eight Flavor".
From the source text
This page is cultural documentation, not medical advice.
From the source text · 卷上·血痹虚劳病脉证并治·第 15 条
Classical text
虚劳腰痛，少腹拘急，小便不利者，八味肾气丸主之。
Modern Chinese rendering
虚劳病见腰痛、少腹拘急、小便不利的，用八味肾气丸主治。这是"温补肾阳"思路下"补阴中求阳"的代表性条文：方子以六味地黄丸滋补肾阴为基础，加入桂枝、附子温阳化气，使"阴中求阳"，是后世肾气丸系列方与"阴中求阳"治法的源头。
Editorial translation
In a consumptive-deficiency pattern (xu lao) with lumbar pain, lower-abdominal cramping, and difficulty in urination, Eight-Ingredient Kidney Qi Pills is the formula of choice. This is the canonical clause for the "seek yang within yin" line of reasoning under "warm and tonify the kidney yang": the formula is based on Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pills) to nourish kidney yin, with cinnamon twig and aconite added to warm yang and transform qi, so that "yang is sought within yin". It is the historical source of the later Kidney Qi Pill family of formulas and the "seek yang within yin" treatment principle.
In tradition
In TCM tradition, associated with patterns described as "kidney yang deficiency": cold limbs, a deep and slow pulse, soreness or cold sensation in the lower back and knees, frequent nighttime urination, mild edema of the lower legs, and a generalized sense of "cold from the inside." It is, in short, the "yang-tonic" counterpart to the better-known Liuwei Dihuang Wan. In Japan it is sold under the name Hachimijiogan (八味地黄丸) as one of the most commonly used over-the-counter kidney formulas.
Formula composition
Monarch1
- Rehmannia root, cooked (Shú Dì Huáng / 熟地黄) - principal, nourishes kidney yin
Other ingredients7
- Cornus fruit (Shān Zhū Yú / 山茱萸)
- Chinese yam (Shān Yào / 山药)
- Moutan tree bark (Mǔ Dān Pí / 牡丹皮)
- Poria (Fú Líng / 茯苓)
- Alisma rhizome (Zé Xiè / 泽泻)
- Cinnamon twig (Guì Zhī / 桂枝)
- Aconite root, processed (Fù Zǐ / 附子)
International availability
Japan (Kampo)
- Tsumura & Co.ツムラOTC八味地黄丸Hachimijiōgan
Korea (Hanbang)
- Kyungdong경동OTC팔미지황환Palmi-jihwang-hwan
Taiwan & Hong Kong
- 順天堂OTC金匱腎氣丸Jin Kui Shen Qi Wan
Cautions & context
- Aconite (Fù Zǐ / 附子) is a "toxic" herb in Chinese pharmacopoeia, the processed form used in pharmacy is safe at standard doses, but overdose can cause cardiac arrhythmia. Never use unprocessed aconite.
- Considered inappropriate during a common cold, fever, or active digestive upset in TCM framing, the formula is "warming and tonifying" and may "trap" external pathogens.
- People with what TCM describes as "yin deficiency with fire" (night sweats, dry mouth, heat in the palms) are typically steered toward Liuwei Dihuang Wan instead.
- Pregnant or breastfeeding people should consult a qualified practitioner before use.
Related formulas
Other formulas from this text· "Essential Prescriptions of the Golden Cabinet"
Other formulas by this contributor· Zhang Zhongjing
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Related concerns
Concern · stress
Stress & Mood
Everyday tension, low mood, irritability, the sense of being "wound up but tired". The cluster of complaints that brings many Chinese adults to the family 中成药 drawer before they ever see a doctor.
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Immune Support
The everyday language of "wanting to stay well", a sense of being run down, the change of seasons, occasional mouth ulcers, the slow recovery after a cold.
Editorial note
Compiled from "Essential Prescriptions of the Golden Cabinet" (200).
Last reviewed: July 18, 2026
Three layers of evidence
Classical source
≈ 1800 years · "Essential Prescriptions of the Golden Cabinet" (200)
Pharmacopoeia indication
"Warm and tonify kidney yang, transform qi and move water. Used for kidney-deficiency edema, soreness and weakness of the lower back and knees, difficult urination, and aversion to cold with cold limbs."
Modern research status
As of 2026-07-18, a PubMed search using the formula name and the Latin / Korean / Japanese transliterations together with "systematic review" and "meta-analysis" did not identify a dedicated systematic review for this formula. Any clinical evidence that does exist is fragmented across small individual trials or covered in broad herbal-medicine umbrella reviews, which do not allow a per-formula evidence assessment; the absence of a dedicated SR is itself the relevant editorial fact here.
References
References reviewed on July 18, 2026 · PubMed search on 2026-07-18
- 01ClassicalZhang Zhongjing, 《金匮要略》 (Jǐn Guì Yào Lüè / Essential Prescriptions of the Golden Cabinet), Eastern Han dynasty, c. 200 CE, with the base formula appearing in clause 15 of the "blood impediment and consumptive disorder" section, the canonical text for the "seek yang within yin" approach in kidney yang tonification.
- 02TextbookDuan Fuqin (段富津) et al. (eds.), 《方剂学》 (Fāngjìxué / Textbook of Formulas), Shanghai Scientific and Technical Publishers, 1995, the standard modern university-level formula textbook in mainland China, with Jin Gui Shen Qi Wan analysed as the representative "warm and tonify the kidney yang" formula, the historical precursor of the modern Hachimijiogan / Palmi-jihwang-hwan.
- 03PharmacopoeiaChinese Pharmacopoeia Commission, 《中华人民共和国药典》 2020 年版一部 (Zhōnghuá Rénmín Gònghéguó Yàodiǎn, Pharmacopoeia of the People's Republic of China, 2020 Edition, Vol. I), China Medical Science Press, 2020, the official monograph for Jin Gui Shen Qi Wan / Shen Qi Pian dosage forms.