HERB FORMULAS

SI NI TANG - 四逆湯 - FRIGID EXTREMITIES DECOCTION

English: Frigid Extremities Decoction
Also Known As: Decoction to Treat Cold Limbs
Aconite, Ginger and Licorice Combination
Aconite and G.L. Combination

HERBS AND ACTIONS

Pharmaceutical Latin
Pin Yin
Dosage
Actions
Rx. Aconiti Lateralis Preparata Zhi Fu Zi 9g Warms the Kidney and Heart Yang, stimulates exhausted Yang, warms the Ming Men Fire and the entire body by traveling through all twelve channels.
With Gan Jiang, strengthens the Kidney and Spleen Yang,warms the Spleen and Kidneys, disperses Cold and treats overabundance of Yin fluids due to Deficiency Cold, Devastated Yang and debilitated Spleen and Kidney Yang with incessant diarrhea.
With Gan Jiang and Zhi Gan Cao strengthens the actions of fortifying Qi and benefiting the Yang for Cold extremities and diarrhea with undigested food due to Collapse of the Spleen and Kidney Yang.
(Rx. Aconiti Lateralis) (Sheng Fu Zi) (1 piece) (Use only if condition is critical.)
Rz. Zingiberis Gan Jiang 4.5g Warms the Middle Jiao and Lungs, transforms thin mucus, expels Cold, rescues Yang, warms the channels (unblocks the pulse) and stops bleeding.
With Zhi Fu Zi, for Cold-Damp Bi.
With Zhi Gan Cao, for epigastric pain and vomiting due to Spleen and Stomach Deficiency Cold and detoxifies Zhi Fu Zi.
Rx. Glycyrrhizae Preparata Zhi Gan Cao 6g Tonifies Qi, strengthens the Spleen and moderates the drying properties of the formula.

FORMULA ACTIONS

  • Rescues Yang
  • Warms the Middle Jiao
  • Disperses Internal Cold
  • Stops diarrhea

SYNDROMES

  • Heart Yang Deficiency Exhaustion: Yang Xu Jue Ni
  • Kidney Yang Deficiency with Internal Cold
  • Shao Yin Cold
  • Yang Ming Han
  • Excess use of diaphoretics in Tai Yang Stage leading to loss of Yang

CLINICAL MANIFESTATIONS

  • Extremely cold extremities
  • Aversion to Cold
  • Sleeping with knees drawn up
  • Lethargy with a constant desire to sleep
  • Vomiting
  • Diarrhea with undigested food
  • Abdominal pain and Cold
  • Lack of thirst
  • Coma
  • Indigestion
  • Edema
  • Pale face
  • Superficial fever
  • Red face
  • Cyanosis of the lips and nails
  • T: Pale or Dark purple
  • C: White and slippery
  • P: Deep and thready or Deep and slow or Deep and faint

TREATS

CONTRAINDICATIONS AND HERB/DRUG INTERACTIONS

CONTRAINDICATIONS
  • Contraindicated for those with True Heat with False Cold (C.M.: cold extremities, thirst with a desire for cold drinks, dark urine, T: Red, C: Yellow).
  • Stop this formula immediately once the hands and feet have warmed up.
HERB/DRUG INTERACTIONS

NOTES

MODIFICATIONS

For edema or leukorrhea due Kidney and Spleen Yang Deficiency: For a red face with extreme irritability:
+ Rx. Codonopsis Dang Shen + Take formula Cold
+ Poria Fu Ling
For intractable arthritis due to Wind-Damp:
+ Rz. Alismatis Ze Xie + Cx. Cinnamomi Rou Gui
or
+ Rz. Atractylodes Macrocephalae Bai Zhu
+ 24g Rx. Astragali Huang Qi
+30g Poria Fu Ling
For chronic arthritis due to Cold:
For shortness of breath or accelerated respiration:
+ Ram. Cinnamomi Gui Zhi
+ Rx. Paeoniae Alba Bai Shao
+ Rx. Ginseng Ren Shen
For abdominal pain due to Cold:
For severe coma:
+ Ram. Cinnamomi Gui Zhi
+ Rx. Ginseng Ren Shen + Rx. Paeoniae Alba Bai Shao
For extreme coldness of the extremities:
For edema and palpitations:
+ Hb. cum Rx. Asari Xi Xin + Rx. Ginseng Ren Shen
+ Ram. Cinnamomi Gui Zhi + Poria Fu Ling
For abdominal pain due to Blood Deficiency:
For diarrhea with undigested food:
+ Four-Substance Decoction
Si Wu Tang
+ Regulate the Middle Decoction
Li Zhong Tang
For nausea, vomiting and a sore throat:
For aversion to Cold:
+ Rz. Zingiberis Recens Sheng Jiang + 9g Rz. Atractylodis Macrocephalae Bai Zhu
+ Rx. Platycodi Jie Geng
For sudden stopping of diarrhea:
For fever with insomnia and palpitations:
+ Rx. Ginseng Ren Shen + Sm. Zizyphi Spinosae Suan Zao Ren
For collapse of Qi and Yang:
+ Rx. Polygalae Yuan Zhi
+ Rx. Ren Shen Rubra Hong Shen
For diarrhea:
For gastroptosis with abdominal pain:
+ Rz. Coptidis Huang Lian
+ Cx. Cinnamomi Rou Gui
For gastroptosis with abdominal distention:
+ Camphora Zhang Nao + Fr. Gardeniae Zhi Zi
+ Fr. Evodiae Wu Zhu Yu + Rx. Aucklandiae Mu Xiang
For gastroptosis with nausea:
+ Cx. Magnoliae Officinalis Hou Po
+ Fr. Amomi Sha Ren
+ Rz. Pinelliae Preparatum Zhi Ban Xia
For gastroptosis with belching:
+ Fr. Crataegi Shan Zha
For low back pain due to Jue Yin Cold-Damp:
+ Fr. Hordei Germinatus Mai Ya
+ Rx. Bupleuri Chai Hu
For secondary dysmenorrhea:
+ Rx. Angelicae Pubescentis Du Huo
+ Flow-Warming Decoction
Wen Jing Tang
For secondary dysmenorrhea with cold limbs and a pale face:
+ Fol. Artemisiae Argyi Ai Ye
+ Fr. Foeniculi Xiao Hui Xiang
+ Flow-Warming Decoction
Wen Jing Tang
    
   
+ Fol. Artemisiae Argyi Ai Ye    
+ Fr. Foeniculi Xiao Hui Xiang    
+ Rx. Ophiopogonis Mai Men Dong    
+ Colla Corii Asini E Jiao