Zuo Ci Wan: A TCM Formula for Tinnitus and Dizziness from Liver-Kidney Yin Deficiency
- Hongji Medical
- Jun 2
- 4 min read
Zuo Ci Wan, or Rehmannia Pill, is a renowned Traditional Chinese Medicine (TCM) formula celebrated for its ability to nourish yin, subdue liver yang, and improve hearing and vision.
It primarily treats conditions caused by liver and kidney yin deficiency with rising virtual fire, leading to symptoms like tinnitus, deafness, dizziness, and blurred vision. While its exact origin is debated, it is commonly attributed to two ancient texts: Revised Extensive Discourse on Warm-Heat Diseases (Volume 2) or Sihe Ting Ji Fang. Further research is needed to confirm its precise source.
Based on the classic Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), Zuo Ci Wan adds herbs like Magnetite, Acorus, and Schisandra to enhance its calming and ear-opening effects, making it ideal for liver-kidney yin deficiency with virtual fire.
Formula Composition and Roles
Zuo Ci Wan is composed of herbs organized according to the TCM principle of “monarch, minister, assistant, and envoy”:
Monarch
Prepared Rehmannia (Shu Di Huang)Sweet and slightly warm, it enters the liver and kidney meridians, nourishing yin, enriching blood, and replenishing essence and marrow. It is the primary herb for treating liver-kidney yin deficiency.
Ministers
Cornelian Cherry (Shan Zhu Yu)Sour, astringent, and slightly warm, it enters the liver and kidney meridians, nourishing the liver and kidneys while securing essence.
Chinese Yam (Shan Yao)Sweet and neutral, it enters the spleen, lung, and kidney meridians, strengthening the spleen, boosting qi, and securing kidney essence.Together, these herbs enhance Rehmannia’s nourishing effects and stabilize essence and qi.
Assistants
Moutan Bark (Mu Dan Pi)Bitter, pungent, and slightly cold, it enters the heart, liver, and kidney meridians, clearing heat, cooling blood, and promoting circulation.
Alisma (Ze Xie)Sweet, bland, and cold, it enters the kidney and bladder meridians, promoting diuresis and draining heat.
Poria (Fu Ling)Sweet, bland, and neutral, it enters the heart, spleen, and kidney meridians, draining dampness and calming the mind.These herbs clear virtual fire and balance the rich, nourishing nature of the tonic herbs to prevent excessive supplementation.
Assistants and Envoys
Calcined Magnetite (Duan Ci Shi)Pungent, salty, and cold, it enters the liver and kidney meridians, subduing liver yang and calming the mind to relieve tinnitus and deafness.
Acorus (Shi Chang Pu)Pungent, bitter, and warm, it enters the heart and stomach meridians, opening orifices and calming the mind to improve hearing.
Schisandra (Wu Wei Zi)Sour, sweet, and warm, it enters the lung, heart, and kidney meridians, securing essence, boosting qi, and calming the mind.These herbs subdue yang, open ear orifices, and stabilize the spirit, addressing tinnitus and dizziness.
Pathophysiology of Zuo Ci Wan
Zuo Ci Wan targets the following pathological mechanisms:
Liver-Kidney Yin DeficiencyChronic illness, overexertion, or excessive sexual activity depletes liver and kidney yin, weakening the body’s nourishing essence.
Rising Virtual FireYin deficiency allows yang to become relatively excessive, causing virtual fire to rise and disturb the head’s orifices, leading to tinnitus, deafness, dizziness, and blurred vision.
Insufficient Essence and MarrowDeficient liver and kidney yin fail to nourish essence and marrow, which cannot properly support the ears, resulting in hearing issues.
Symptoms include tinnitus (intermittent or persistent), dizziness, blurred vision, weak and sore lower back and knees, dry mouth and throat, heat in the palms and soles, insomnia, excessive dreaming, a red tongue with scant coating, and a thin, rapid pulse.
Indications and Benefits
Benefits
Nourishes yin and subdues liver yang
Improves hearing and vision
Indications
Tinnitus (intermittent or constant)
Deafness
Dizziness and blurred vision
Weak and sore lower back and knees
Dry mouth and throat
Heat in the palms and soles
Insomnia and excessive dreaming
Red tongue with scant coating
Thin, rapid pulse
Comparison with Similar Formulas
Zuo Ci Wan stands out among other TCM formulas for tinnitus and deafness:
Liuwei Dihuang Wan: Focuses on nourishing liver and kidney yin but lacks the calming and ear-opening herbs, making it less effective for virtual fire.
Er Ming Zuo Ci Wan: Adds Bupleurum (Chai Hu) to relieve liver stagnation, enhancing its effect on tinnitus.
Qiju Dihuang Wan: Emphasizes vision improvement for symptoms like dry eyes and blurred vision, less focused on hearing.
Ci Zhu Wan: Targets heart shen disturbance and insomnia, prioritizing calming over ear-specific effects.Zuo Ci Wan excels in treating tinnitus and deafness caused by liver-kidney yin deficiency with virtual fire.
Modern Applications and Research
Modern studies highlight Zuo Ci Wan’s benefits:
Improved Inner Ear Circulation: Expands blood vessels to enhance ear blood flow, relieving tinnitus and deafness.
Neuroprotection: Protects auditory nerves, reducing noise-induced hearing damage.
Anti-Aging Effects: Contains antioxidants that combat free radicals, slowing aging.
Clinically, it is used for:
Neurogenic tinnitus and deafness
Age-related hearing loss
Vertigo
Precautions for Use
Pattern Differentiation: Zuo Ci Wan is specific to liver-kidney yin deficiency with virtual fire. It is not suitable for tinnitus or deafness caused by excess fire or phlegm-stasis.
Adverse Reactions: Stop use and consult a doctor if discomfort occurs during treatment.
Diet and Lifestyle: Follow TCM dietary and lifestyle advice, avoiding spicy or greasy foods that may exacerbate symptoms.
Conclusion
Zuo Ci Wan is a powerful TCM formula for treating tinnitus, deafness, and dizziness caused by liver-kidney yin deficiency with rising virtual fire. Building on Liuwei Dihuang Wan, its unique blend of herbs nourishes yin, subdues yang, and opens ear orifices, offering relief for hearing and vision issues. Its modern applications in neurogenic and age-related conditions highlight its enduring value. Always consult a qualified TCM practitioner to ensure proper diagnosis and safe use, tailored to individual needs.
