The unique design of Qianyang Dan appeared relatively recently in the 19th century scholar-physician Zheng Qin’an’s book, True Transmission of the Fundamental Principles of Medicine (Yili zhenchuan). Due to the recent popularity of the Sichuan Fire Spirit School of Chinese Herbal Medicine (Huoshen Pai), however, the formula has become the standard bearer of the lineage’s “Aconite Method” (sini fa). In contrast to the more moving and dispersing “Cinnamon Method” (guizhi fa) adapted from the classical Guizhi Tang (Cinnamon Decoction), the Aconite Method not only vitalizes Spleen and Kidney yang, but enhances the down-drawing capacity of the cardinal herb Fuzi by pairing it with Xi Sharen, a rare type of wild cardamon that is now mostly found in Myanmar, Laos and Vietnam. In the original Qianyang Dan recipe, a small amount of turtle plastron is added for the highly specific purpose of opening the Conception Vessel (renmai), the pathway where the Kidney’s downward drawing function manifests itself. A relatively high amount of licorice, moreover, fortifies the center and neutralizes the potential intensity of aconite.

All schools of Chinese medicine agree on the concept that the Kidney network functions as a type of “storage battery” for prenatal energy. Contemporary approaches to Kidney deficiency disorders, however, have strongly favored the tonification of Kidney yin by prescribing rehmannia based remedies such as Liuwei Dihuang Wan (Six Ingredient Pill with Rehmannia). The design of Qianyang Dan emphasizes the fact that failure of the Kidney system to act as an “oceanic receptacle” for the body’s descending qi processes (naqi)—typically leading to the flaring of false heat (as in insomnia or menopausal hot flashes)—can be just as often the result of (Kidney) yang deficiency as of (Kidney) yin deficiency. This formula thus fills an important clinical void for chronic Kidney problems caused by yang deficiency and dampness, a situation for which the prescription of the sticky yin herb rehmannia is contraindicated. Qianyang Dan can thus be regarded as a constitutional base formula for chronic cold-damp disorders characterized by the principal etiology of Kidney yang deficiency accompanied by false heat and/or phlegm symptoms in the upper part of the body. In order distinguish the suitability of the Qianyang Dan approach from flare-up symptoms that are due to yin deficiency or true fire, however, it is important to confirm the patient’s yang deficient constitution via the tongue and pulse.