Zhang Jingyue's Liangyi Gao (Two-Aspect Paste): Simultaneously Tonifying Yin and Yang, Nourishing Yin and Generating Fluids

In Zhang Jingyue's Jingyue Quanshu (Complete Writings of [Zhang] Jingyue) there is a formula called Liangyi Gao (Two-Aspect Paste). Its composition is: Renshen (Ginseng Radix et Rhizoma) 120–250 g (converted into modern measure), and large Shudihuang (processed Rehmanniae Radix) 500 g (same conversion). Preparation: soak the two herbs in 3–4 sheng of good sweet water (i.e., mountain-spring water) or long-running water (clean stream water) for one night, then decoct over a slow-to-strong fire of mulberry twigs to obtain a concentrated decoction. If the flavor is not fully exhausted, add another 0.5–1 sheng of water, decoct the dregs, draw out the juice, and simmer it slightly thicker; then transfer to an earthen jar and simmer in a double boiler until it becomes a paste. Finally add honey 120–250 g and the paste is ready.

This formula has the action of nourishing yin and generating fluids. It is indicated for chronic deficiency and detriment, in which yin deficiency fails to transform qi, leading to dual deficiency of qi and blood: emaciation, lassitude of spirit, palpitations and fright, forgetfulness, tinnitus and dizziness, sallow complexion, and weakness of the limbs; it is also suitable for those with debility after illness.

Zhang Jingyue designated Renshen, Shudihuang, Shigao (Gypsum fibrosum), and Dahuang (Rhei Radix et Rhizoma) as the "four pillars of medicinals," holding that all four are life-saving drugs in critical moments. Shigao clears heat, Dahuang purges downward, and both Renshen and Shudihuang belong to the tonifying category.

Zhang Jingyue's pairing of Renshen and Shudihuang combines two of the four pillars he recognized. The name "Liangyi"—two aspects—refers to yin and yang in Chinese Daoist thought; thus Liangyi Gao is a paste that simultaneously supplements yin and yang. Renshen greatly supplements original qi and can tonify both yin and yang, while Shudihuang nourishes yin; used together, they supplement yin and yang at once. The herbs are few and the therapeutic aim clear, so this formula has the power to bring the dying back to life for diseases caused by deficiency and detriment.

One of Zhang Jingyue's most famous dicta is: "He who is skilled at supplementing yang must seek yang within yin, so that yang is aided by yin and its transformation is inexhaustible; he who is skilled at supplementing yin must seek yin within yang, so that yin is lifted by yang and its spring never runs dry." Liangyi Gao fully embodies this view of Zhang Jingyue's. Earlier writers spoke either of yang deficiency or of yin deficiency; Zhang Jingyue held that both yin and yang in the body are prone to deficiency. Lone yang cannot generate, lone yin cannot grow; only by supplementing yin and yang together can they reinforce each other and both grow.

Liangyi Gao has a strong effect in raising patients' physical strength and improving their blood counts. It is suitable for patients with aplastic anemia and for those with advanced cancer who suffer from dual depletion of qi and blood; it can improve their quality of life and prolong survival.