Formula Composition

Huang Bo

Cang Zhu

Yi Yi Ren

Niu Xi (Huai)

View detailed herb information

King

Main ingredient

Deputy

Assists main

Assistant

Supports

Envoy

Directs formula

Formula Damp-Heat

Sì Miǎo Sàn

四秒散

Also known as:

Four Marvel Decoction

Available in our store

View in Store

From $58.00

Available in our store

View in Store

From $58.00

Formula Properties

Main Actions

Clear Damp-Heat from the Lower Burner
Strength the joints and musles of the lower extremities

Patterns Treated

Damp-Heat in the Lower Burner, Painful Obstruction due to Damp Heat in Channels

TCM Actions & Uses

Traditional Chinese Medicine properties and applications of Sì Miǎo Sàn

Main Actions

Clear Damp-Heat from the Lower Burner

Strength the joints and musles of the lower extremities

Key TCM Concepts

The formula is particularly effective for conditions presenting with red, hot, swollen, painful joints in the lower body with yellow greasy tongue coating — the hallmarks of Damp-Heat. It's a workhorse formula for gout, certain presentations of rheumatoid arthritis, UTIs, and lower extremity weakness/atrophy.

Er Miao → San Miao → Si Miao

Formula	Herbs	What It Adds
Er Miao San	Huang Bai + Cang Zhu	Basic Damp-Heat clearing
San Miao San	+ Niu Xi	Guides to lower body
Si Miao San	+ Yi Yi Ren	Drains via urination + supports Spleen

Simple rule:

Er Miao = Damp-Heat anywhere
San Miao = Damp-Heat in lower body
Si Miao = Damp-Heat in lower body + weakness/swelling

TCM Patterns Addressed

Common Applications

Rheumatoid arthritis Gouty arthritis Gout Osteoarthritis Fibromyalgia Sciatica Herniated lumbar disc Painful Knee Heel pain Low back pain Polymyositis Dermatomyositis Atrophy of lower extremities Weakness of lower extremities Foot pain Swollen foot Lower leg edema Swollen And Red Joints Sores on the lower extremities Numbness in lower limbs Leukorrhea Yellowish Thick Discharge From Vagina Urinary tract infection Eczema Polyneuritis Vaginitis Tinea pedis Cervicitis Beriberi Gonococcal arthritis Rheumatic fever Cervical polyps Purulent otitis media Progressive muscular dystrophy Acute myelitis Menorrhagia Poliomyelitis Sequelae Periodic paralysis Hysterical paralysis

Ingredients in Sì Miǎo Sàn

Detailed information about each herb in Sì Miǎo Sàn and their roles

Kings

Deputies

Assistants

Envoys

Huang Bo

Phellodendron bark

Temperature Cold

Taste Bitter

Organ Affinity Urinary Bladder, Kidneys, Large Intestine

Parts Used Dried bark

Role in Sì Miǎo Sàn

Huang Bo (Huang Bai) drains Damp-Heat, especially from the Lower Burner and drains Kidney Fire.

It has direct affinity for the Yin aspects of the body and enters the entire Lower Burner (pelvis, colon, bladder, uterus, genitals). It also directs Qi downward.

Its cold, bitter properties powerfully dry Dampness and clear Heat, making it effective against bacteria and fungi.

It can be used alone for many of this formula's indications — making it the undisputed chief.

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Cang Zhu

Black atractylodes rhizomes

Temperature Warm

Taste Bitter, Pungent

Organ Affinity Spleen, Stomach

Parts Used The dried rhizome

Role in Sì Miǎo Sàn

Cang Zhu strongly dries Dampness, tonifies the Spleen and clears Dampness from the Lower Burner.

While Huang Bai clears Heat, Cang Zhu addresses the Dampness component. Together with Huang Bai, treats pain, swelling, and weakness of lower extremities or skin lesions from Wind-Dampness. It also prevents the cold nature of Huang Bai from damaging the Spleen.

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Yi Yi Ren

Job's tears

Temperature Cool

Taste Sweet

Organ Affinity Lungs, Spleen, Stomach

Parts Used Dried ripe kernel

Role in Sì Miǎo Sàn

Yi Yi Ren promotes urination, leaches out Dampness, strengthens Spleen, expels Wind-Dampness and clears Damp-Heat.

It can clear Damp-Heat at any level, anywhere in the body. Specifically leaches Dampness from bone, sinew, and muscle — resolving "leg Qi" and Damp-Jeat arthritic conditions.

It also removes obstruction, relieves muscle spasm, increases mobility. Expels pus through its cold nature and affinity for the flesh (enters Lung, Spleen, Stomach channels).

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Niu Xi (Huai)

Role in Sì Miǎo Sàn

Niu Xi (Huai) guides the formula's actions downward to the lower body — legs, knees, low back. This directional guiding action ensures all the other herbs concentrate their effects where they're needed most.

It also invigorates Blood, expels Blood Stasis, clears Damp-Heat in Lower Burner and regulates water metabolism.

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Safety & Contraindications

Important safety information and precautions for Sì Miǎo Sàn

This information is for educational purposes only. Always consult with a qualified healthcare provider before using any TCM herbal formula.

Contraindications

Only use when there are clear Heat signs (yellow greasy tongue coat, rapid pulse, red/hot/swollen joints, yellow urine/discharge). Not for Cold, Deficiency, or pregnancy.

Herb-Drug Interactions

Like many TCM formulas, Sì Miǎo Sàn may interact with certain medications. If you are taking any prescription medications, we recommend consulting with a healthcare provider knowledgeable in herb-drug interactions.