Back to the Cover Page



* Sexual function and performance

* Sexual desire and arousal in women and men

* Sexual disorders: low libido, impotence, erectile dysfunction, premature ejaculation, and spermatorrhea



* Increases the secretion of endogenous hormones 

* Increases the secretion of testosterone, corticosterone, and cortisol 



* Warms Kidney yang

* Replenishes Kidney jing (essence)

* Increases sexual desire



Take 3 to 4 capsules three times daily on an empty stomach with warm water. The last dosage after dinner or before bedtime can be served with grain-based liquor such as vodka to enhance the overall effect, as this formula was traditionally prepared as an herbal tincture.



Ba Ji Tian (Radix Morindae Officinalis)

Dang Gui (Radix Angelicae Sinensis)

Du Zhong (Cortex Eucommiae)

Fu Zi (Radix Aconiti Lateralis Praeparata)

Gou Qi Zi (Fructus Lycii)

Jiu Cai Zi (Semen Allii Tuberosi)

Ren Shen (Radix et Rhizoma Ginseng)

Rou Gui (Cortex Cinnamomi)

Shan Yao (Rhizoma Dioscoreae)

Shan Zhu Yu (Fructus Corni)

She Chuang Zi (Fructus Cnidii)

Shu Di Huang (Radix Rehmanniae Praeparata)

Suo Yang (Herba Cynomorii)

Tu Si Zi (Semen Cuscutae)

Yin Yang Huo (Herba Epimedii)



Sexual dysfunction is characterized by interference with interest or inability to engage in sexual intercourse. Common components of sexual dysfunction in men include decreased libido, lowered erectile dysfunction, inability to ejaculate and experience orgasm; and in women, female sexual dysfunction include lowered sexual desire, decreased sexual arousal, and absent or diminished orgasm. Possible causes of sexual dysfunction include stress, anxiety, depression, diabetes, endocrine disorders, circulatory disorders, and drugs (beta-blockers, diuretics, alcohol, antidepressants, hormones, and many others).



Vitality is a formula with primary emphasis to treat sexual dysfunction in men and women. It is an excellent formula to tonify Kidney yang and Kidney jing (essence). Clinically, deficiencies of Kidney yang and Kidney jing (essence) are characterized by impotence, erectile dysfunction, premature ejaculation, low sperm count, low libido, and general sexual disorders. In Western terminology, these herbs increase the production of sex hormones; and in TCM terminology, these herbs tonify Kidney yang and Kidney jing (essence). This formula works to enhance libido in women as it boosts the testosterone levels and Kidney yang.

        The direct translation of the chief herb Yin Yang Huo (Herba Epimedii) is “horny goat herb.” It was originally discovered by a herder who noticed the increase in proliferation in one of his herds of goats that were grazing on this herb. Yin Yang Huo (Herba Epimedii) increases sexual activity, increases sperm production, stimulates the sensory nerves and therefore increases sexual desire. Weakness of Kidney yang and depletion of Kidney jing (essence) contribute to symptoms of impotence, decreased libido, spermatorrhea, premature ejaculation and other sexual dysfunctions. The treatment protocol is to increase the Kidney yang and tonify the Kidney jing (essence). Fu Zi (Radix Aconiti Lateralis Praeparata), Rou Gui (Cortex Cinnamomi), Jiu Cai Zi (Semen Allii Tuberosi), Du Zhong (Cortex Eucommiae), Tu Si Zi (Semen Cuscutae), Ba Ji Tian (Radix Morindae Officinalis), Suo Yang (Herba Cynomorii), and She Chuang Zi (Fructus Cnidii) warm and tonify the Kidney yang. Shan Zhu Yu (Fructus Corni), Shu Di Huang (Radix Rehmanniae Praeparata), Gou Qi Zi (Fructus Lycii), and Shan Yao (Rhizoma Dioscoreae) tonify Kidney jing (essence). Dang Gui (Radix Angelicae Sinensis) tonifies and moves blood, and directs the effect to the lower abdomen. Ren Shen (Radix et Rhizoma Ginseng) is used to replenish the vital energy and prolong stamina.

        Together, the herbs in Vitality tonify Kidney yang and Kidney jing (essence) to effectively treat male and female sexual disorders.



* This formula is contraindicated in individuals with exterior or excess conditions, such as infections or inflammations.

* Because this formula is warm to hot in property, prolonged use may be associated with reactions such as thirst, dry mouth, warm sensations, constipation, flushed face, and nosebleeds. To avoid these reactions, decrease the dosage or temporarily discontinue the formula.

* Vitality should be used with caution in patients with pre-existing hypertension, since many herbs in this formula are warm or hot in nature and may raise the blood pressure.

* Patients who wear a pacemaker, or individuals who take antiarrhythmic drugs or cardiac glycosides such as Lanoxin (digoxin), should not take this formula. Fu Zi (Radix Aconiti Lateralis Praeparata) may interact with these drugs by affecting the rhythm and potentiating the contractile strength of the heart.[1]

* This herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.[2],[3]



* Vitality and Vital Essence are two formulas that are frequently combined together. Vitality tonifies Kidney yang to treat sexual dysfunction. Vital Essence replenishes Kidney yin and jing (essence) to treat reproductive disorders. Together, they complement and enhance the clinical success of each others.

* Vitality is an excellent male and female tonic to increase sexual prowess and strengthen sexual energy. It is important to keep in mind that Vitality nourishes the body from within to change the underlying constitution of the person. It does not provide an immediate boost of sexual power.

* The practitioner may be able to find in chiropractic or medical supply catalogs a small piece of furniture that fits around the toilet to provide a safe, stable platform to support the feet several inches off the floor, promoting a more natural 'squatting' posture for the individual seated on the toilet. This may assist in promoting the complete evacuation of the bladder and bowels, enhancing the effort to strengthen the normal function and position of the reproductive organs.


Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Deep and small pulse on the left chi.



* To boost energy and vitality, use with Vibrant or Imperial Tonic.

* To strengthen constitutional weakness and deficiency, use with Cordyceps 3.

* For adrenal deficiency, add Adrenal +.

* For poor memory and forgetfulness, add Enhance Memory.

* To treat male infertility, use Vital Essence.

* To treat female infertility, use Blossom (Phase 1-4).

* To tonify Kidney yin, add Kidney Tonic (Yin).

* To tonify Kidney yang, add Kidney Tonic (Yang).

* For vaginal dryness, add Balance Spring.



Traditional Points:

* Shenshu (BL 23), Mingmen (GV 4), Guanyuan (CV 4), Rangu (KI 2), Sanyinjiao (SP 6)


Classic Master Tung's Points:

* Infertility (male): Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14); Endocrine, Kidney and Testicle points on the ear. Moxa du (governing) channel on the back.

* Impotence: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Tongshen (T 88.09), Tongwei (T 88.10), Sanshen (T 44.27)*. Bleed tender points on the Kidney area of the back from L1-L5 with cupping. Bleed before needling for best result. Administer moxa for at least 30 minutes to the Kidney area on the back from L1-L5, Guanyuan (CV 4), Zhongji (CV 3).

* Spermatorrhea: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tongshen (T 88.09), Tongwei (T 88.10), Shuijin (T 1010.20), Shuitong (T 1010.19), Tianhuangfu [Shenguan] (T 77.18). Moxa Guanyuan (CV 4), Zhongji (CV 3), Zhongshu (GV 7).


Master Tung’s Points by Dr. Chuan-Min Wang:

* Decreased libido:

§ Female: Qimen (T 33.01), Qijiao (T 33.02), Qizheng (T 33.03)

§ Male: Tongshen (T 88.09), Tongwei (T 88.10), Tongbei (T 88.11)

* Erectile dysfunction, premature ejaculation: Tongshen (T 88.09), Tongwei (T 88.10), Tongbei (T 88.11)


Balance Method by Dr. Richard Tan:

* Left side: Xuehai (SP 10), Taixi (KI 3), Zhongfeng (LR 4), Yangxi (LI 5), Linggu (T 22.05)

* Right side: Lieque (LU 7), Daling (PC 7), Zusanli (ST 36), Shenmai (BL 62), Yanglingquan (GB 34)

* Left and right sides can be alternated from treatment to treatment.


Auricular Medicine by Dr. Li-Chun Huang:

* Impotence: Internal Genital, External Genital, Gonadotropin Point, Kidney, Liver, Libido, Exciting Point, Endocrine, Pituitary

* Emission: Shenmen, Kidney, Liver, Heart, Neurasthenia Point (front and back), Neurasthenia Area (front and back), Nervous, Subcortex, Dream-Disturbed Sleep Area



* Eliminate alcohol from the diet as it decreases the body’s ability to produce testosterone.

* Intake of vitamin E should be increased. Foods high in vitamin E include wheat germ oil, almonds, sunflower seeds or oil, peanuts, soybeans, whole wheat products, and asparagus. Kiwis and fresh oysters can also be taken together as an aphrodisiac.

* Shellfish, oysters, shrimp, cashews, beef, and mushrooms are all foods that either contain high protein or zinc that may increase libido. However, these foods often are high in cholesterol and should not be over-consumed as they will otherwise cause blockage and lead to the opposite effect.

* Impotence is sometimes caused by circulatory problems. In such cases, increase the consumption of foods rich in niacin (eggs, peanut butter, avocado, and fish) and vitamin E (raw wheat germ and vegetable oil).

* Zinc is also beneficial in preventing impotence and reduced sperm count. Zinc is found in such foods as pumpkin seeds, sunflower seeds, oysters, soy, and eggs. Avoid eating foods that deplete the body of zinc, such as alcohol and coffee.


The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Impotence

§ Recommendations: scallions, scallion seeds, lamb, sea cucumber, shrimp, rooster, bitter melon seeds, ginseng, black beans, kidney beans, yams, and lycium fruit. Maintaining a calm composure.

§ Make lamb stew with daikon radish and Chinese black dates. Drink the broth and eat the lamb.

§ Steam rooster with ginger.

§ Make tea from walnuts, lotus seeds, pearl barley, Chinese black dates and goji berries. Drink three times daily.

§ Cook together scallions, shrimp, and egg. Eat with a shot of white liquor.

§ Avoid pornography, masturbation, overwork, and excessive sexual activities.

§ Reduce the intake of dairy products and sweets.



* Avoid cigarette smoking or exposure to secondhand smoke.

* Vigorous exercise, hot tubs, saunas, and tight underwear lead to increased temperature in the testicles and reduced sperm count.

* Refrain from sexual activity when exhausted or under stress. Do not overindulge in sexual activity when any weakness in function or performance is present.

* Exercises for men with impotence and premature ejaculation: Tip-toe and clench one’s teeth while urinating. This simple posture will tighten and strengthen the muscles surrounding the groin to help condition the Kidney qi. This is also a good exercise to help with terminal dripping in elderly patients. Women can practice this exercise by squatting and tip-toeing over the toilet while urinating. This exercise for women will strengthen and tighten the muscles and ligaments surrounding the reproductive organs to help treat prolapse of the bladder and uterus or frequent urinary urges due to Kidney yang deficiency. It also tightens the muscles surrounding the vagina and can be recommended to the partners of those taking Vitality or those who have low libido to enhance pleasure. Results can be expected in a few months if practiced daily and consistently.

* Exercises for women with low libido: Walk on the balls of the feet with the navel pulled towards the spine and the heels off the ground, taking care to breathe deeply. Engage in the Kegel exercise (attempting to use vaginal muscles to stop and start the flow of urine rapidly and frequently at each time of urinating) while also clenching the teeth and breathing through the nose. These exercises will be helpful if they are practiced regularly.

* There are five conditions when sexual activity should be avoided: when one is hungry, full, drunk, emotionally unstable (angry, sad, fearful, hateful or worried) or recovering from chronic illness.



* A 65-year-old male presented with generalized male sexual dysfunction, possibly due to old age and/or use of high blood pressure medications. The diagnosis was Kidney yang and qi deficiencies. The patient was instructed to take Vitality with good results noted within one week. Submitted by R.C., M.D., Ph.D., New York, New York.

* R.R., a 61-year-old female, presented with multiple symptoms including low libido, low back pain, low energy, and brittle hair beginning to fall out. The practitioner diagnosed this condition as Kidney yang deficiency with jing (essence) deficiency. For treatment, Vitality was prescribed at three capsules three times a day. After taking the herbs for two months, she reported an increase in her sex drive. Her low back pain and energy improved as well. She had been receiving acupuncture treatments two to three times a week as well. No change was reported in the health of her hair. Submitted by S.L., Yuma, Arizona.

* T.S. is a female who presented with pain (especially of the joints of the limbs), coldness of the fingers and difficulty falling asleep. Objective findings revealed that her fingers were icy and cyanotic. Her leg muscles appeared to be abnormally tight. Her blood pressure was 110/80 mmHg and her heart rate was 78 beats per minute. She also received monthly rheumatoid arthritis shots. Western diagnosis for this patient was fibromyalgia. The TCM diagnosis was yang deficiency. Vitality was prescribed and the patient reported she felt the formula worked well in improving her condition and relieving the pain. Submitted by M.W., San Diego, California.



Sexual dysfunction is characterized by interference with interest or inability to engage in sexual intercourse. Possible causes of sexual dysfunction include stress, anxiety, depression, diabetes, endocrine disorders, circulatory disorders, and drugs (beta-blockers, diuretics, alcohol, antidepressants, hormones, and many others). Optimal treatment requires use of herbs to balance the hormones, regulate the endocrine system, and promote blood circulation.

        Vitality contains many herbs to treat both sexual and reproductive disorders. Pharmacologically, Yin Yang Huo (Herba Epimedii) has been shown to stimulate the sensory nerves, increase sexual desire and activity, and boost sperm production.[4] The mechanism of these actions is associated with the increased production and release of testosterone.[5] Furthermore, the extract of Yin Yang Huo (Herba Epimedii) shows a marked effect for the treatment of erectile dysfunction. The mechanism of this function is attributed to the relaxation of the corpus cavernosum smooth muscle through multi-targets in nitric oxide/cyclic guanosine monophosphate signaling pathway.[6] Jiu Cai Zi (Semen Allii Tuberosi) has positive aphrodisiac properties that affect sexual behavior in male subjects, such as an increase in penile erection, mating performance, mount frequency, mount latency, and ejaculation frequency.[7] Shan Zhu Yu (Fructus Corni) and Suo Yang (Herba Cynomorii) both have significant effects on the quality and quantity of sperm. Shan Zhu Yu (Fructus Corni) has a substantial stimulatory effect on sperm motility from 25.8 +/- 7.7% to 42.8 +/- 10.3%.[8] Administration of Suo Yang (Herba Cynomorii) is associated with a significant increase in spermatogenesis. It significantly increases the epididymal sperm count, absolute testes weights, and the expression of GDNF (glial cell-derived neurotrophic factor) at both the mRNA and protein levels in rat testes.[9]

Clinically, many herbs in this formula have been used to successfully treat sexual and reproductive disorders. According to one double-blind, placebo-controlled study, 143 male patients experiencing erectile dysfunction who were treated with Ren Shen (Radix et Rhizoma Ginseng) for eight weeks showed significantly higher erectile function and overall satisfaction scores in comparison with the placebo group.[10] According to another study, use of Ren Shen (Radix et Rhizoma Ginseng) effectively treated 24 of 27 patients with impotence.[11] Furthermore, use of fresh Gou Qi Zi (Fructus Lycii) in a formula effectively increased sperm count and improved sperm motility. Of 42 patients, 33 successfully conceived children.[12] Lastly, 78 men with impotence were treated with a 98% rate of effectiveness using an herbal formula that contained Rou Gui (Cortex Cinnamomi), Jiu Cai Zi (Semen Allii Tuberosi), Yin Yang Huo (Herba Epimedii), and others.[13]

        Circulatory impairment is a major cause of erectile dysfunction and other sexual and reproductive disorders. Therefore, many herbs are used in Vitality to promote blood circulation. Dang Gui (Radix Angelicae Sinensis) has a direct and significant effect to stimulate angiogenesis, a physiological process that promotes blood vessel formation in various parts of the body.[14] It also improves overall blood circulation by decreasing the whole blood specific viscosity, or improving the hemorrheological changes associated with blood stagnation.[15] Du Zhong (Cortex Eucommiae) and She Chuang Zi (Fructus Cnidii) have vasorelaxant effects as they decrease resistance to blood flow.[16] Specifically, the ethanolic extract of She Chuang Zi (Fructus Cnidii) exhibits a vasorelaxant effect on the corpus cavernosum to improve blood circulation to the penis.[17]

        Lastly, Vitality contains many herbs that treat sexual dysfunction due to the mind and the body. Ba Ji Tian (Radix Morindae Officinalis) is an excellent herb to treat chronic stress causing decreased plasma testosterone and increased plasma corticosterone.[18] It also contains constituents with marked antidepressant activities to treat depression.[19],[20] In addition, Ba Ji Tian (Radix Morindae Officinalis) is shown in one study to have antifatigue activity as the polysaccharides (galacturonic acid, arabinose and galactose) of the herb improved the endurance of weight-loaded swimming subjects.[21]

        In summary, Vitality is an excellent formula to treat various sexual and reproductive disorders, including, but not are limited to, decreased sexual desire and arousal, impotence, erectile dysfunction, and absence of or diminished orgasm.



One striking difference between Western and traditional Chinese medicine is that Western medicine focuses and excels in crisis management, while traditional Chinese medicine emphasizes and shines in holistic and preventative treatments. Therefore, in emergencies, such as gunshot wounds or surgery, Western medicine is generally the treatment of choice. However, for treatment of chronic idiopathic illness of unknown origins, where all lab tests are normal and a clear diagnosis cannot be made, traditional Chinese medicine is distinctly superior.

        Sexual disorders, such as erectile disorders, are treated with drugs such as Viagra (sildenafil) and Cialis (tadalafil). These drugs generally have a quick onset of effect, and they work primarily by increasing blood flow to the penis. However, these drugs may cause side effects such as headache, upset stomach, diarrhea, dizziness or lightheadedness, flushing, nasal congestion, blindness, breast enlargement, rash, painful erection, prolonged erection, fainting, chest pain, and itching or burning during urination. Furthermore, these drugs are only effective for men, and not for women.

        One main function of Kidney yang is the regulation of sexual and reproductive functions. Vitality is a Kidney yang tonic formula that emphasizes the maintenance of sexual functions and the treatment of sexual disorders, such as decreased libido in men and women, impotence, premature ejaculation, and spermatorrhea. Though this formula is very effective, it does not have an instantaneous effect, but rather requires continuous use for two to three months for maximum effect.

        Both drugs and herbs are effective for treating sexual disorders. Drugs have a quick onset of action, but they only have one specific indication, are effective only for men, and have numerous significant side effects. Herbs have a gradual onset of action, but may be used in both men and women to treat a wide variety of sexual disorders. Furthermore, herbs are safe and natural, and have few or no side effects. Finally, it is important to remember that neither drugs nor herbs prevent pregnancy, nor do they protect either partner from sexually transmitted diseases and HIV.


[1] Forensic Science International, 1994 June 28; 55-8.

[2] Chan K, Lo AC, Yeung JH, Woo KS. Journal of Pharmacy and Pharmacology 1995 May;47(5):402-6.

[3] Pharmacotherapy 1999 July;19(7):870-876; European Journal of Drug Metabolism and Pharmacokinetics 1995; 20(1):55-60.

[4] Zhong Yao Da Ci Dian (Dictionary of Chinese Herbs), 1977:2251.

[5] Zhong Xi Yi Jie He Za Zhi (Journal of Integrated Chinese and Western Medicine), 1989; 9(12):737-8,710.

[6] Chiu JH, Chen KK, Chien TM, Chiou WF, Chen CC, Wang JY, Lui WY, Wu CW. Epimedium brevicornum Maxim extract relaxes rabbit corpus cavernosum through multitargets on nitric oxide/cyclic guanosine monophosphate signaling pathway. Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Peitou, Taipei, Taiwan, ROC. Int J Impot Res. 2006 Jul-Aug;18(4):335-42.

[7] Guohua H, Yanhua L, Rengang M, Dongzhi W, Zhengzhi M, Hua Z. Aphrodisiac properties of Allium tuberosum seeds extract. College of Life and Environment Science, Shanghai Normal University, Shanghai, PR China. J Ethnopharmacol. 2009 Apr 21;122(3):579-82.

[8] Jeng H, Wu CM, Su SJ, Chang WC. A substance isolated from Cornus officinalis enhances the motility of human sperm. Department of Anatomy, Taipei Medical College, Taiwan. Am J Chin Med. 1997;25(3-4):301-6.

[9] Yang WM, Kim HY, Park SY, Kim HM, Chang MS, Park SK. Cynomorium songaricum induces spermatogenesis with glial cell-derived neurotrophic factor (GDNF) enhancement in rat testes. Department of Prescriptionology, College of Oriental Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Republic of Korea. J Ethnopharmacol. 2010 Apr 21;128(3):693-6.

[10] Kim TH, Jeon SH, Hahn EJ, Paek KY, Park JK, Youn NY, Lee HL. Effects of tissue-cultured mountain ginseng (Panax ginseng CA Meyer) extract on male patients with erectile dysfunction. Department of Urology, School of Medicine, Kyung Hee University, Seoul 134-727, Korea. Asian J Androl. 2009 May;11(3):356-61.

[11] Ji Lin Yi Xue (Jilin Medicine), 1983; 5:54.

[12] Xin Zhong Yi (New Chinese Medicine), 1988; 2:20.

[13] Zhong Yi Yao Yan Jiu (Research of Chinese Medicine and Herbology), 1997; (5):37.

[14] Lam HW, Lin HC, Lao SC, Gao JL, Hong SJ, Leong CW, Yue PY, Kwan YW, Leung AY, Wang YT, Lee SM. The angiogenic effects of Angelica sinensis extract on HUVEC in vitro and zebrafish in vivo. J Cell Biochem. 2008 Jan 1;103(1):195-211.

[15] Xue, JX. et al. Effects of the combination of astragalus membranaceus (Fisch.) Bge. (AM), angelica sinensis (Oliv.) Diels (TAS), cyperus rotundus L. (CR), ligusticum chuanxiong Hort (LC) and paeonia veitchii lynch (PV) on the hemorrheological changes in "blood stagnating" rats. Chung Kuo Chung Yao Tsa Chih; 19(2):108-10, 128. Feb 1994.

[16] Kwan C.Y., Chen C.X., Deyama T. & Nishibe S. Endothelium-dependent vasorelaxant effects of the aqueous extracts of the Eucommia ulmoides Oliv. leaf and bark: implications on their antihypertensive action. Vascul Pharmacol. 2003, 40(5): 229-235.

[17] Chiou WF, Huang YL, Chen CF, Chen CC. Vasorelaxing effect of coumarins from Cnidium monnieri on rabbit corpus cavernosum. Planta Med. 2001 Apr;67(3):282-4.

[18] Li YF, Yuan L, Xu YK, Yang M, Zhao YM, Luo ZP. Antistress effect of oligosaccharides extracted from Morinda officinalis in mice and rats. Acta Pharmacol Sin. 2001 Dec;22(12):1084-8.

[19] Cui C, Yang M, Yao Z, Cao B, Luo Z, Xu Y, Chen Y. Antidepressant active constituents in the roots of Morinda officinalis How. Zhongguo Zhong Yao Za Zhi. 1995 Jan;20(1):36-9, 62-3.

[20] Zhang Z.Q., Yuan L., Yang M., Luo Z.P. & Zhao Y.M. The effect of Morinda officinalis How, a Chinese traditional medicinal plant, on the DRL 72-s schedule in rats and the forced swimming test in mice. Pharmacol Biochem Behav. 2002, 72(1-2): 39-43.

[21] Zhang HL, Li J, Li G, Wang DM, Zhu LP, Yang DP. Structural characterization and anti-fatigue activity of polysaccharides from the roots of Morinda officinalis. Int J Biol Macromol. 2009 Apr 1;44(3):257-61.