Si Ni San
四逆散

 

 

Frigid Extremities Powder

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

AboutHerbsCaution/Notes
Health Benefits
For: Peptic Ulcer • Gastritis • Cholecystitis • Hepatitis • Mastitis • Fibrosystic breast tissue
Attributes:
Products (online examples)

Granules

Granules

Liquid

Tablets

Research (sample)
Categories (Click on ⌕ for other formulas in the category)
Category: Harmonize ⌕    Subcategory: Harmonize Liver and Spleen ⌕      Family: Chai Hu Lei Fang ⌕      Source: Shang Han Lun  ⌕       Related Formula:
Actions
Dispel pathogens • Release exterior • Harmonize liver qi • Harmonize spleen
Indications and Contraindications
Appearance: Tongue -      Pulse -      Face/other 
Patterns:  
Indications:
Contraindications: 
Properties
Data adapted from product found online.  Categories 4% or less not shown.

Herbs Cat/Dose Actions Properties
Chai Hu • Thorowax • 柴胡 Release Exterior Wind Heat
9g-12g
Harmonize interior and exterior • Reduce fevers • Reduce chills • Soothe liver Qi • Clear muscle layer heat • Tonify stomach Qi Antibiotic • Antipyretic • Anti-inflammatory • Antibaterial • Antiviral • Analgesic • Hepatoprotective • Immunemodulatory • Chemoprotective • Anti-tumor • Cholagogic • Sedative • Immunostimulate
Zhi Shi 
9g-12g
Bai Shao • White Root Peony • 白芍 Tonify Blood
12g-24g
Nourish blood • Regulate menses • Soothes liver • Relieve pain • Preserve yin • Reduce spasms • Harmonize Ying and Wei QiSheng - calm Liver, preserve yin • Chao - nourish blood, regulate menses analgesic • antibacterial • anti-inflammatory • hepatoprotective • immune system boost • sedative
Zhi Gan CaoLicorice Root • 甘草 Tonify Qi
6g-9g
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 effectsEnters all 12 channels, often serve as envoy in a formula. 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 60 minutes or more before adding other ingredients.  This breaks down aconite to aconine while maintaining its active ingredients.  Most physicians today use the prepared Fu Zi instead of raw to mitigate the toxicity of the herb.  This formula is purely adding Ginseng to the Frigid Extremities Decoction.  Adding Ginseng is the second stage of using the Fridgit Extremities formula, where the patient is weak from diarrhea and depletion of fluids.
Modifications For
+ Wu Mei + Ku Lian Gen Pi Round worms
+ Yin Chen Hao Tang Icteric hepatitis
+ Gua Lou Pi + Xie Bai + Yu Jin Neuralgia
+ Yin Chen Hao + Dan Shen + Yu Jin + Chi Shao + Jin Qian Cao Biliary tract disorder
+ Dang Gui + Wu Yao + Xiang Fu + Yan Hu Suo Menstrual cramps
+ Qing Pi Breast abscess
+ Shan Zha+ Mai Ya + Jin Nei Jin Food stagnation with abdominal pain
+ Wu Wei Zi _ Gan Jiang Cough
+ Gui Zhi Heart palpitations
+Fu Ling Difficulty urinating
+ Zuo Jin Wan Acid regurgitation
–Zhi Shi + Fu Ling + Bai Zhu + Dang Gui Irregular periods

Caution
ALERT: Contraindications of each herb - use with caution under these conditions:
Chai Hu: Do not use as intramuscular injections • Liver fire • Hyperactive liver yang • Cytochrome P450, 2C9, 2E1, 2D6, and 3A4 • Greater than 19g may lead to liver injury
Zhi Shi:
Bai Shao: Deficiency cold • Breast feeding • Pregnancy • Bleeding Disorder • Scheduled Surgery
Zhi 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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