A "pure tonification, no draining" (纯补无泻) kidney-yin formula from Zhang Jingyue's Ming-dynasty "Complete Works of Jingyue", the more potent, "no-draining" counterpart of the classic Liuwei Dihuang Wan.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Compiled by Zhang Jingyue (张景岳) in his Ming-dynasty "Complete Works of Jingyue" (《景岳全书》, 1624) as the "pure tonification" counterpart of Liuwei Dihuang Wan, the source text explicitly argues that "for true-yin deficiency, only pure tonification will do". In Japan, 左帰丸 (さきがん / Saki-gan) is sold by Kracie (クラシエ) as the standard OTC "true-yin" formula. In Korea, it appears as 좌귀환 (Jwagwi-hwan) in the Kyungdong (경동) hanbang line. The formula is, in short, the philosophical alternative to "tonify + drain" theory, a strong, almost aggressive kidney-yin tonic.
From the source text
This page is cultural documentation, not medical advice.
From the source text · 《景岳全书》卷五十一·补阵·左归丸
Classical text
左归丸，治真阴肾水不足，不能滋养营卫，渐至衰弱，或虚热往来，自汗盗汗，或神不守舍，血不归原，或虚损伤阴，或遗淋不禁，或气虚昏运，或眼花耳聋，或口燥舌干，或腰酸腿软。凡精髓内亏，津液枯涸等证，俱速宜壮水之主，以培左肾之元阴而精血自充矣。宜此方主之。
Modern Chinese rendering
本方用于"真阴肾水不足"所致诸症,涵盖虚热、自汗盗汗、神不守舍、血不归原、虚损伤阴、遗淋不禁、气虚昏晕、眼花耳聋、口燥舌干、腰酸腿软等。张景岳主张"精髓内亏,津液枯涸,俱速宜壮水之主",即"培左肾之元阴",以填补真阴,精血自然充盈。方名"左归"意为"归于左肾",对应"左肾属水、藏真阴"的中医生理观念,与"右归丸"归于右肾之命门之火形成阴阳对偶。方子配伍"纯补无泻"——去六味地黄丸的丹皮、茯苓、泽泻三味"泻"药,加鹿角胶、龟板胶、枸杞、菟丝子、牛膝等"补"品,集中滋补肾中真阴,体现张景岳"补阴不宜泻"的学术主张。
Editorial translation
Zuǒ Guī Wán is used for the "true-yin kidney-water insufficiency" pattern, covering the full symptom-cluster of deficiency-heat, spontaneous and night sweats, spirit unrest, blood failing to return to its source, yin damage from depletion, uncontrolled seminal emission, qi-deficiency dizziness, blurred vision and tinnitus, dry mouth and tongue, and soreness of the lower back and knees. Zhang Jingyue argues that whenever the essence-marrow is internally depleted and the fluids are desiccated, one must swiftly "strengthen the master of water", that is, cultivate the original yin of the left kidney so that essence and blood naturally fill up. The name "Zuǒ Guī" — "return to the left" — points to the TCM anatomical-correlative idea that "the left kidney stores water, the true-yin", and is paired with the Yòu Guī Wán which "returns to the right" kidney fire of the gate of life. The formula embodies the deliberate "pure tonification, no draining" principle, removing the three "draining" herbs of Liùwèi Dìhuáng Wán (Moutan, Poria, Alisma) and adding substantive tonics (deer-horn glue, tortoise-plastron glue, wolfberry, dodder seed, achyranthes), realizing Zhang Jingyue's "yin-supplementation should not be diluted by draining" thesis.
In tradition
In TCM framing, traditionally used in the context of "true-yin deficiency", marked fatigue, dizziness, tinnitus, low-back and knee soreness, night sweats, occasional seminal emission, dry mouth and throat, a thin pulse, and a red tongue with little coating. The formula's distinction from Liuwei Dihuang Wan is the deliberate removal of the three "draining" herbs (Moutan, Poria, Alisma) and the addition of more substantive "tonic" herbs (deer-horn glue, tortoise-plastron glue, wolfberry, dodder seed), the result is described in the source text as "pure tonification". In Japan, 左帰丸 (Saki-gan) is sold by Kracie (クラシエ) as the standard OTC "true-yin tonification" formula; in Korea it is sold as 좌귀환 (Jwagwi-hwan) by Kyungdong (경동).
Formula composition
Monarch1
- Rehmannia root, cooked (Shú Dì Huáng / 熟地黄) - principal, nourishes true-yin
Other ingredients7
- Cornus fruit (Shān Zhū Yú / 山茱萸) - astringes essence, tonifies liver and kidney
- Chinese yam (Shān Yào / 山药) - tonifies spleen and kidney, stabilizes essence
- Wolfberry fruit (Gǒu Qǐ Zǐ / 枸杞子) - nourishes liver and kidney yin
- Dodder seed (Tù Sī Zǐ / 菟丝子) - tonifies kidney, stabilizes essence
- Deer-horn glue (Lù Jiǎo Jiāo / 鹿角胶) - warms yang, tonifies essence and marrow
- Tortoise-plastron glue (Guī Bǎn Jiāo / 龟板胶) - nourishes yin, subdues yang
- Achyranthes root (Niú Xī / 牛膝) - strengthens lower back and knees
International availability
Japan (Kampo)
- Tsumura & Co.ツムラOTC左帰丸Saki-gan
Korea (Hanbang)
- Kyungdong경동OTC좌귀환Jwagwi-hwan
Taiwan & Hong Kong
- 順天堂OTC左歸丸Zuo Gui Wan
Cautions & context
- A "pure-tonification" formula with warming and cloying herbs (deer-horn glue, cooked Rehmannia), long-term daily use is considered inappropriate in TCM framing without supervision.
- People with what TCM describes as "spleen yang deficiency" (loose stools, poor appetite, fatigue) or "dampness" (heavy limbs, sticky tongue coating) are typically advised to avoid it, the formula is rich, cloying, and warming.
- Not appropriate during a common cold, fever, or active digestive upset in TCM framing, the formula is purely tonifying and may "trap" external pathogens.
- Persistent fatigue, dizziness, tinnitus, or low-back soreness should be evaluated by a clinician, TCM tonics are not a substitute for evaluation of underlying anemia, thyroid, or cardiac conditions.
Related formulas
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.
Concern · immune
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 "Complete Works of Jingyue" (1624).
Last reviewed: July 18, 2026
Three layers of evidence
Classical source
≈ 400 years · "Complete Works of Jingyue" (1624)
Pharmacopoeia indication
"Nourish the kidney and tonify yin. Used for true yin insufficiency: soreness of the lower back and knees, night sweats, listlessness, and dry mouth."
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
- 01ClassicalZhāng Jièbīn (张介宾, styled Jǐngyuè 景岳, self-styled Tōngyīzǐ 通一子, 1563–1640), 《景岳全书》 (Jǐngyuè Quánshū / Complete Works of Jingyue), 64 volumes, completed 1624, vol. 51 (卷五十一), the "supplementation formation" (补阵) chapter of the "newly organized eight formations" (新方八阵) section, the entry for Zuǒ Guī Wán (左归丸), the canonical "pure-tonification, no-draining" kidney-yin formula of the late-Ming "warming-tonification" school, with the "return-to-the-left" (左归) naming capturing the TCM anatomical-correlative idea that the left kidney stores water and the true-yin; the present-day 中成药 form is the modern industrial production of the classical Ming-dynasty pill formula attributed to Zhang Jingyue's "true-yin-not-insufficient" thesis.
- 02TextbookDuan Fuqin (段富津) et al. (eds.), 《方剂学》 (Fāngjìxué / Science of Formulas), 2nd edition, Shanghai Scientific and Technical Publishers, 2011, the standard modern university-level formula textbook in mainland China, with Zuǒ Guī Wán analysed in the "tonifying formulas" (补益剂) chapter as the representative "tonify kidney-yin" formula, the canonical entry for "true-yin insufficiency" (真阴不足), and historically paired with Yòu Guī Wán as the canonical yin-yang complementary pair of the late-Ming "warming-tonification" school.
- 03PharmacopoeiaPharmacopoeia Commission of the PRC, 《中华人民共和国药典》 2020 edition, vol. 1 (Zhōnghuá Rénmín Gònghéguó Yàodiǎn, Pharmacopoeia of the People's Republic of China, 2020 ed., vol. 1), China Medical Science Press, 2020, the official national monograph for Zuǒ Guī Wán (丸 / 颗粒 / 片), "functional indication" reads "nourish the kidney and tonify yin, used for true-yin insufficiency with soreness of the lower back and knees, night sweats, listlessness, and dry mouth".