Si Ni Tang
四逆汤

 

 

Frigid Extremities Decoction

Disclaimer    For educational purposes only.  Do not use as medical advice

AboutHerbsCaution/Notes
Health Benefits
For: Acute myocardial infarction (heart attack) • Acute gastroenteritis • Chronic nephritis • Congestive heart failure • Cardiac insufficiency • Liver Cirrhosis • Diarrhea
Attributes: Immunity booster • Hypertensive • Anti-inflammatory • Analgesic • Antidiarrheal
Products (online examples)

Granules

Capsules

Capsules

Granules

Other Names: Aconite Ginger and Licorice Decoction • Cold limbs Decoction
Research (sample)
Categories (Click on ⌕ for other formulas in the category)
Category: Warm Interior Cold ⌕    Subcategory: Rescue Devastated Yang ⌕      Family: Fu Zi Lei Fang ⌕      Source: Shang Han Lun  ⌕       Related Formula: Si Ni Jia Ren Shen Tang • Shen Fu Tang • Tong Mai Si Ni Tang • Bai Tong Tang
Actions
Rescue devastated yang • Warm middle burner • Stop diarrhea
Indications and Contraindications
Appearance: Tongue -Pale with white slippery coating      Pulse -Submerged, thin, faint      Face/other 
Patterns:  
Indications: Vomiting • Diarrhea • Extremely cold limbs • Lethargic • Abdominal pain • Not thirsty • Feels cold
Contraindications: True heat with false cold (feels cold with cold limbs, but thirsty for cold drinks, has dark urine) • Stop using formula as soon as the limbs are warm
Properties
Data adapted from product found online.  Categories 4% or less not shown.

Herbs Cat/Dose Actions Properties
Sheng Fu Zi • Process Aconite Daughter Root • 附子 Warm Interior Expel Cold
6g-9g
Restore devastated yang • Warm channels • Warms interior cold • Relief pain • Strengthen Ming Men fire Anodyne • Analgesic • Anti-inflammatory • Antipyretic • Mild sedative
Gan Jiang • Ginger (Dried) • 干姜 Warm Interior Expel Cold
4.5g
Warm interior • Expel cold • Stop bleeding • Transform phlegm • Rescue devastated yang • Warm Middle Jiao • Warm lungs • Warm meridians Anticoagulant • Hypotensive • Antiplatelet • Stimulant • Analgesic • Anti-inflammatory • Antipyretic • Cholagogic • Antiemetic • Antimutagenic
Zhi Gan CaoLicorice Root • 甘草 Tonify Qi
6g
Tonify Spleen Qi • Tonify Heart qi • Clear heat • Resolve toxicity • Stop cough • Dispel phlegm • Lubricate lungs • Stop wheezing • Reduce spasm • Relieve pain • Harmonize other herb effects Hypoglycemic • Antiarrhythmic • Expectorant • Antidiarrheal • Antiulcer • Hepatoprotective • Antiulcer • Immunostimulant • Antitussive • Antiviral • Detox • Demulcent • Anti-inflammatory • Laxative • Emmenagogue • Antimicrobial • Spasmolytic
King/Chief    ♥ Minister/Deputy      Assistant     ♦ Envoy
Directions: 
  • Cook Fu Zi for 30-60 minutes before adding other ingredients.  Most physicians today use the prepared Fu Zi instead of raw to mitigate the toxicity of the herb.  20-30 grams of processed Fu Zi is used instead of the 6-9 grams of Sheng Fu Zi.22
Modifications For
+ Rou gui + Bai Zhu Chronic arthritis pain
+ Dang Shen + Ze Xie + Fu Ling Edema from spleen and kidney deficiencies

Caution
  • True heat with false cold (feels cold with cold limbs, but thirsty for cold drinks, has dark urine)
  • Stop using formula as soon as the limbs are warm

ALERT: Contraindications of each herb - use with caution under these conditions:
Si Ni Tang: True heat with false cold (feels cold with cold limbs, but thirsty for cold drinks, has dark urine) • Stop using formula as soon as the limbs are warm
Gan Jiang: Pregnancy • Blood heat • Pregnancy • Bloody mucous • Night sweats • Unexplained sweating • Heat induced pain • Heat induce vomiting
Gan Cao: High blood pressure • Low potassium • Pork • Seaweed • Chinese cabbage • Anti-diabetic drugs • Diuretic drugs

Notes

 

Bibliography: [3], [8], [9], [14]

Information in this post came from many sources, including class notes, practitioners, websites, webinars, books, magazines, and editor's personal experience.  While the original source often came from historical Chinese texts,  variations may result from the numerous English translations.   Always consult a doctor prior to using these drugs.  The information here is strictly for educational purposes. 

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