Zuo Gui Wan: A Traditional Chinese Herbal Remedy for Kidney Yin Deficiency

Hongji Medical
Feb 2
6 min read

Zuo Gui Wan, a revered formula from the Jingyue Complete Works by Ming Dynasty physician Zhang Jiebin, is a cornerstone of traditional Chinese medicine for nourishing kidney yin and replenishing essence. As we age, many experience "kidney yin deficiency," a condition where the kidneys lack sufficient yin fluid, leading to symptoms like lower back pain, weak legs, dizziness, insomnia, and dry mouth.

Zuo Gui Wan offers a gentle yet effective solution to restore balance and vitality. This article explores its ingredients, benefits, modern uses, dietary support, and precautions in a clear and accessible way.

《The Complete Works of [Zhang] Jing-yue》Jing Yue Quan Shu《景嶽全書》

Ingredients of Zuo Gui Wan

Zuo Gui Wan combines eight herbs and natural ingredients, each carefully selected to nourish the body:

Shu Di Huang (Prepared Rehmannia, 24g): Nourishes kidney yin and boosts essence.
Shan Yao (Yam, 12g): Supports the spleen and strengthens kidney yin.
Gou Qi Zi (Goji Berry, 12g): Nourishes the kidneys and improves vision.
Shan Zhu Yu (Cornelian Cherry, 12g): Supports the liver and kidneys, securing essence.
Niu Xi (Achyranthes Root, 9g): Strengthens tendons and promotes blood flow.
Lu Jiao Jiao (Deer Antler Glue, 9g): Warms the kidneys and replenishes essence.
Gui Ban Jiao (Turtle Shell Glue, 9g): Nourishes yin and strengthens bones.
Tu Si Zi (Dodder Seed, 12g): Enhances kidney function and supports the liver.

Preparation: Traditionally, these ingredients are ground into a powder, mixed with honey to form pills, and taken with warm water. Modern methods may involve decoctions or pre-made pills, dosed as prescribed by a practitioner.

How the Herbs Work Together

Shu Di Huang (Prepared Rehmannia): The primary herb, it deeply nourishes kidney yin, supports essence production, and relieves symptoms like dizziness and back pain.
Shan Yao (Yam): Strengthens the spleen and kidneys, easing fatigue and weak legs.
Gou Qi Zi (Goji Berry): Nourishes the kidneys and liver, improving vision and vitality.
Shan Zhu Yu (Cornelian Cherry): Stabilizes kidney essence, reducing symptoms like spermatorrhea and tinnitus.
Niu Xi (Achyranthes Root): Supports the liver and kidneys, strengthening bones and easing soreness.
Lu Jiao Jiao (Deer Antler Glue): Warms the kidneys, boosts essence, and balances yin and yang.
Gui Ban Jiao (Turtle Shell Glue): Cools excess heat, nourishes yin, and strengthens bones.
Tu Si Zi (Dodder Seed): Enhances kidney and liver function, boosting overall resilience.

Together, these ingredients restore kidney yin, replenish essence, and promote overall health.

Effects and Indications

Main Effects:

Nourishes kidney yin to alleviate deficiency symptoms.
Replenishes essence and supports bone marrow production.
Enhances reproductive health and vitality.

Indications: Zuo Gui Wan is ideal for kidney yin deficiency, characterized by:

Dizziness or lightheadedness
Lower back pain and weak legs
Spermatorrhea or nocturnal emissions
Spontaneous sweating
Dry mouth and throat
Tinnitus or deafness
Insomnia
Red tongue with little coating
Thin, rapid pulse

These symptoms often appear in aging individuals or those with chronic stress, indicating a need to restore kidney yin and essence.

Zuo Gui Wan /左歸丸, 5:1 Concentrated Granules

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Benefits of Zuo Gui Wan

Nourishes Kidney Yin: Relieves symptoms like back pain, dizziness, and dry mouth caused by insufficient kidney yin.
Replenishes Essence and Marrow: Supports bone health and cognitive function, addressing issues like osteoporosis and memory decline.
Improves Reproductive Health: Enhances sperm quality in men and regulates menstruation in women, aiding fertility.
Boosts Vitality: Increases energy and resilience, especially for middle-aged and elderly individuals.

Modern Applications

Zuo Gui Wan is widely used in modern medicine for:

Neurological conditions: Improves memory and cognitive function in Alzheimer’s disease.
Menopausal symptoms: Eases hot flashes, insomnia, and mood swings.
Bone health: Increases bone density to prevent or treat osteoporosis.
Reproductive issues: Supports male and female fertility by improving sperm quality and menstrual regularity.
Chronic conditions: Manages symptoms of chronic bronchitis, nephritis, and hypertension.

Its yin-nourishing properties make it a versatile remedy for age-related and chronic ailments.

Dietary Support

Combining Zuo Gui Wan with dietary remedies can enhance its effects:

Goji and Dodder Seed Egg Tea: Boil 20g dodder seed, 15g prepared rehmannia, 15g lotus seed, and 1 egg with brown sugar. Simmer for 40 minutes. This nourishes yin and boosts energy.
Yam and Chestnut Soup: Cook 100g chestnuts, 30g yam, 15g goji berries, 2 carrots, and 200g lean meat for 1 hour. This strengthens the spleen and kidneys.
Apple and Tremella Soup: Simmer 2 apples, 1 tremella, 15g adenophora, 15g ophiopogon, and 200g lean meat for 1 hour. This hydrates and nourishes yin.

These recipes support kidney health and complement the formula’s effects.

Zuo Gui Wan /左歸丸, 5:1 Concentrated Granules

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Precautions

Zuo Gui Wan is generally safe but requires caution:

Contraindications: Avoid in cases of spleen deficiency with diarrhea, as its rich, moistening herbs may worsen digestive issues. Not suitable for pregnant women or children.
Side effects: Long-term use may strain the spleen and stomach, causing bloating or loose stools.
Dietary restrictions: Avoid raw, cold, or greasy foods during treatment.
Professional guidance: Consult a Chinese medicine practitioner to ensure proper use and avoid interactions with other medications.
Storage: Keep in a cool, dry, light-proof place.

If discomfort occurs, stop use and consult a doctor.

Conclusion

Zuo Gui Wan is a time-honored Chinese herbal formula that excels at nourishing kidney yin, replenishing essence, and restoring vitality. Its carefully balanced ingredients address symptoms like back pain, dizziness, and fatigue, making it especially valuable for middle-aged and elderly individuals.

Modern applications extend its use to conditions like Alzheimer’s, osteoporosis, and infertility, showcasing its versatility. With proper use, dietary support, and professional guidance, Zuo Gui Wan can significantly improve quality of life and promote lasting wellness.

Chinese Name	左歸丸
Phonetic	Zuo Gui Wan
English Name	Left-Restoring Pill
Classification	Tonic formulas
Source	《The Complete Works of [Zhang] Jing-yue》Jing Yue Quan Shu《景嶽全書》
Combination	Rehmanniae Radix Praeparata (Shu Di Huang) 8 liang (240g), Dioscoreae Rhizoma (Shan Yao dry-fried) 4 liang (120g), Lycii Fructus (Gou Qi Zi) 4 liang (120g), Corni Fructus (Shan Zhu Yu) 4 liang (120g), Cyathulae Radix (Chuan Niu Xi wash with wine and steamed) 3 liang (90g), Cervi Cornus Colla (Lu Jiao Jiao broke into pieces and fried) 4 liang (120g), Testudinis Plastri Colla (Gui Ban Jiao broke into pieces and fried) 4 liang (120g), Cuscutae Semen (Tu Si Zi prepared) 4 liang (120g)
Method	Di huang is steamed, made into paste and prepared into pills the size of a phoenix tree seed using honey. A little more than a hundred pills, which equals to about nine grams, are swallowed before meals with boiled water or slightly salted water. It can also be prepared as a decoction by adjusting the medicinal quantities based on the original medicinal ratios.
Action	Enriches kidney yin, supplements essence, and boosts marrow.
Indication	Zuo Gui Wan is used to treat patterns of true yin deficiency marked by dizziness, blurred vision, soreness of the waist and knees, seminal emission, efflux diarrhea, spontaneous sweating, night sweat, a dry mouth and tongue, a red tongue with a scanty coating, and a thready pulse.
Pathogenesis	This pattern is caused by deficiency of the true yin, essence, and marrow. The kidney stores the essence, is in charge of the bones, and generates marrow. Deficiency of kidney yin, essence, and marrow causes less essence to be stored causing symptoms such as dizziness, blurred vision, soreness of the waist and knees, seminal emission, and efflux diarrhea. Yin deficiency with yang hyperactivity, forcing body liquids to leak out, causes symptoms of spontaneous sweating and night sweat. Yin deficiency, which fails to moisten the upper part of the body, causes a dry mouth and tongue and a red tongue with little coating. The thready pulse is a sign of true yin deficiency. The treatment is to supplement the water and cultivate true yin.
Application	1. Essential pattern differentiation Zuo Gui Wan serves as the most common formula applied for true yin deficiency. The medicinals in this formula are mainly used to supplement yin. Therefore, long-term administration may cause stagnation of the spleen and stomach. This formula is to be used cautiously for patients suffering from diarrhea due to spleen deficiency. This clinical pattern is marked by dizziness, blurred vision, soreness of the waist and knees, scanty coating, thready pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of deficiency of kidney yin, essences, and marrow: senile dementia, menopausal syndrome, senile osteoporosis, amenorrhea, and oligohypomenorrhea. 3. Cautions and contraindications Ingredients in the formula are mainly of yin nature and are nourishing and moistening. Long-term administration may cause impairment of the spleen and stomach. Therefore, it should be used with caution in patients with diarrhea due to spleen deficiency.
Additonal formulae	Zuo Gui Yin (Left-Restoring Beverage 左歸飲) [Source] 《The Complete Works of [Zhang] Jing-yue》Jing Yue Quan Shu《景嶽全書》 [Ingredients] Shu di huang 2-3 qian or 1-2 liang (9-30g), shan yao 2 qian (6g), gou qi zi 2 qian (6g), zhi gan cao 1 qian (3g), fu ling 1.5 qian (4.5g), shan zhu yu 1-2 qian (3-6g) [Preparation and Administration] Prepare it as a decoction. [Actions] Supplements kidney yin. [Applicable Patterns] True yin deficiency. Symptoms marked by: soreness of the waist, seminal emission, night sweat, a dry mouth and throat, thirst with a desire to drink, a red tongue tip, and a thready, rapid pulse.