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Anhui Provincial Hospital of Traditional Chinese Medicine
Zuogui Wan and Yougui Wan: Which Direction Does “Gui” Go?
Source: Published on: 2020-01-03
We often find two kinds of traditional Chinese patent medicines in pharmacies — Zuogui Wan and Yougui Wan — with very similar names. And just by their names, it’s easy to get confused: one is “left”, the other “right”. Does this mean their effects are like the song lyrics that say — “go left, go right”?
To understand these two traditional Chinese medicines, we first need to look at the anatomical concepts of the kidneys in traditional Chinese medicine (TCM). Ancient doctors believed that humans have two kidneys; the left kidney stores the “original Yin,” while the right kidney stores the “original Yang.” The classical TCM text Nan Jing (The Classic of Difficult Issues) states: “There are two kidneys; not both are the same kidney. The left one is the kidney, and the right one is the Mingmen (Life Gate).” It also says: “Mingmen is the place where all spirits and essences reside and where the primordial Qi is connected.” Zhang Jingyue, in his work Zhi Yi Lu (Record of Inquiries), clearly put forward: “The left kidney governs true Yin, the right kidney governs true Yang.” The main effect of Zuogui Wan is to nourish the Yin of the left kidney; Yougui Wan warms and tonifies the Yang of the right kidney. Thus, the names indeed carry a meaning like “go left” and “go right.”
Both Zuogui Wan and Yougui Wan originate from the famous Ming Dynasty TCM doctor Zhang Jingyue’s Jingyue Quanshu (Complete Works of Jingyue). Their effects, as mentioned earlier, are to nourish kidney Yin and warm kidney Yang, respectively. So what are the specific differences between the two? Let’s examine them from the following aspects.
First, the composition of medicinal ingredients differs. Although both come from Jingyue Quanshu, their base formulas are different:
Zuogui Wan: Based on the Six-Ingredient Rehmannia Pill (Liuwei Dihuang Wan), which tonifies both Yin and Yang, it retains the “three tonics” — Chinese yam (Shan Yao), Cornus (Shan Yudou), and prepared Rehmannia (Shu Dihuang); while removing the “three draining” herbs — Moutan cortex (Dan Pi), Alisma (Ze Xie), and Poria (Fu Ling). It adds tortoise shell glue (Gui Jia Jiao) to nourish Yin and marrow, and also combines herbs that gently warm and tonify kidney Yang — goji berry (Gou Qi), Cuscuta (Tu Si Zi), Cyathula root (Chuan Niu Xi), and deer antler glue (Lu Jiao Jiao). This modifies the formula to specifically nourish kidney Yin, replenishing true Yin with a mildly sweet and strengthening water-natured formula.
Yougui Wan: Based on the Kidney Qi Pill (Shen Qi Wan), it also removes the same “three draining” herbs, while using Chinese yam, Cornus, and prepared Rehmannia supplemented by warming and Yang-supporting herbs cinnamon (Rou Gui) and processed aconite (Zhi Fu Zi). It further combines deer antler glue, Cuscuta, Eucommia (Du Zhong), goji berry, and angelica (Dang Gui) to warm the kidney and enrich essence. Thus, it has a powerful effect in tonifying kidney Yang and replenishing essence, a strong formula for filling essence and warming Yang.
From the composition of ingredients, it is clear that both formulas consist purely of tonic herbs without any purgatives. However, Zuogui Wan focuses on nourishing kidney Yin, combined with warming Yang herbs to achieve the effect of “seeking Yin within Yang”; while Yougui Wan focuses on tonifying Yang combined with Yin-supporting herbs to achieve “seeking Yang within Yin.” This fully reflects the TCM concept of “Yin and Yang generating each other.”
Secondly, as mentioned above, the therapeutic effects differ, and so do the indications or applicable symptoms for each:
Zuogui Wan nourishes Yin and tonifies the kidney, replenishes essence and marrow, and is used for true Yin deficiency syndrome. Symptoms include: soreness and weakness of the waist and knees, dizziness and vertigo, tinnitus, insomnia, seminal emission and frequent urination, spontaneous and night sweating, dry mouth and tongue, red tongue with little coating, and thin pulse.
Yougui Wan warms and tonifies kidney Yang, replenishes essence and marrow, and is used to treat kidney Yang deficiency and decline of the Mingmen fire. Symptoms include: fatigue from aging or chronic illness, lack of strength, fear of cold and cold limbs, weakness of the waist and knees, impotence and seminal emission, reduced appetite, loose stools, or involuntary urination. The tongue is pale with white coating, and the pulse is deep and slow.
From the above, it is clear that both Zuogui Wan and Yougui Wan are kidney tonics, but they tend to nourish Yin and Yang differently. Patients should carefully “match the medicine to the symptoms” in daily healthcare. If unable to discern symptoms or if questions arise during use, consult a clinical TCM physician or pharmacist promptly. One should never self-medicate blindly, as this may worsen the condition.