Improved Understanding of Shen Qi Wan Patterns through Abdominal Diagnosis

Shen qi wan (腎氣丸) or the Kidney Qi Pill, classically also known as cui shi ba wei wan (催氏八味丸, Dr. Cui’s Eight Ingredient Pill) or ba wei di huang wan (八味地黄丸, Eight Ingredient Rehmannia Pill), is a widely used formula from the Jin Gui Yao Lue (Essentials of the Golden Cabinet). Despite its popularity and the fact that it is prescribed often and successfully, it remains a difficult formula to deeply comprehend and accurately diagnose for. In modern traditional Chinese medicine (TCM) the diagnosis of a shen qi wan pattern is usually obtained through symptom analysis and only secondarily through tactile methods such as pulse diagnosis. This is mainly because the pulse pattern of shen qi wan is rather complex. Many scholar‑physicians, including the famous Japanese Shang Han Lun (Treatise on Cold Damage) scholar, Otsuka Keisetsu (1900‑1980 CE), say it is a formula that could have many different pulse patterns. In Japanese Kampo, however, the diagnosis of shen qi wan patterns is usually obtained through abdominal findings. The authors argue that the abdominal diagnostic pattern for shen qi wan is virtually constant whereas the pulse pattern can vary widely. They therefore recommend that TCM physicians allow their pulse and symptom analysis to be informed by findings from abdominal palpation.