Rehmannia Six (Liu Wei Di Huang Wan) addresses the classical presentation of Kidney and Liver Yin deficiency. Kidneys are the foundation for all Yin and store the Essence for the body, and when the Kidney Yin becomes depleted, the Yin of the Liver, Heart and Lungs are decreased as well. Especially significant is the mutually supportive relationship between the Kidney Essence, which is stored in the Kidney and nourishes the Liver Blood, and the Liver Blood, which nourishes and replenishes Kidney Essence. Kidney Yin deficiency may manifest in the low back or legs with occasional weakness due to the location of Kidney Qi. As the Kidneys open to the ears and the “sea of marrow”, occasional lightheadedness or dizziness may exist within this pattern. Kidney Yin deficiency may also present with occasional blurry vision or floaters. Persistent Kidney Yin deficiency will generate deficiency Heat which may contribute to the Yin being unable to retain substance, especially at the time of night associated with Yin, giving rise to occasional heat sensations in the palms and soles, or occasional night sweats. Balance between the Heart and Kidneys is reflective of the Yang and Yin, or Fire and Water relationship, which is mutually assisting. Kidney Yin deficiency often results in a lack of control over the Yang; Fire from deficiency blazes upward to the Heart channel, manifesting as occasional dry throat or mouth, thirst, lack of sleep and night sweats. When the Kidney and Liver Yin are deficient, Essence and Blood are not flourishing and are unable to nourish the upper part of the body. By tonifying the Kidneys, water is reinforced in order to control Fire. Both the Fire from deficiency and Phlegm can be present with a pattern of Kidney Yin and Spleen deficiency, justifying and explaining the inclusion of herbs that drain fluids and Liver Fire. With age, the Kidney energy and Essence slowly gets depleted, and Yin is more likely to become deficient. Rehmannia Six addresses Kidney and Liver Yin deficiency, replenishes and restores the foundational Yin to support a healthy aging process and helps to replenish Yin after monthly blood loss. The primary intention of this formula is one of tonification. The sedating and draining herbs balance the formula, and support the actions of the tonifying herbs. The formula is comprised of two groups of herbs, each consisting of three herbs. The first group contains the tonifying herbs. The chief herb, prepared Rehmannia root, strongly nourishes Kidney Yin and Jing or Essence, and in conjunction with Asiatic cornelian cherry and Chinese yam rhizome, astringe the Essence. Asiatic cornelian cherry nourishes the Liver and restrains the leakage of Essence by inhibiting the improper dispersion and drainage through the Liver, and helping the Essence to build up in the Kidneys. Chinese yam rhizome strengthens the Spleen, which is the source of postnatal Essence. The second group of herbs mainly sedate and drain. Asian water plantain rhizome drains Dampness accumulation, clears Kidney Yin deficiency Heat, and helps to move the cloying nature of the prepared Rehmannia root. Tree peony root bark sedates Fire due to a deficiency\ of Liver Yin. Poria drains Dampness, strengthens the Spleen and calms the Spirit. It is paired with Chinese yam rhizome to strengthen the transportative function of the Spleen. Asian water plantain rhizome in conjunction with Poria improve the metabolism of fluids and support healthy urination. To better address the prevalence of Spleen Qi deficiency in Western culture, and to mitigate the potentially cloying action of the formula, two herbs, both classical modifications are added. White atractylodes rhizome strengthens the Spleen, drains Dampness and supports healthy urination. Chinese amomum fruit promotes the movement of Qi, transforms Dampness and strengthens the Spleen. Formulas addressing Yin deficiency from the Kan Herbals line are Quiet Contemplative for a stronger focus on Essence Jing deficiency, and Temper Fire for deficient Kidney Fire, empty Fire, deficient Kidney Yin with Damp Heat in the Lower Burner. For concurrent Liver Qi stagnation, add Free and Easy Wanderer. For stronger signs of Spleen Qi deficiency, use Four Gentlemen. Origins and DevelopmentRehmannia Six acts as the foundation formula for almost all other formulas that address Yin deficiency. It was first presentedin 1119 B.C.
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