Dong quai (Dang Gui) Cinnamon twigs (Gui Zhi) White peony roots (Bai Shao) Wild ginger (Xi Xin)

Dang Gui Si Ni Tang

Chinese: 当归四逆汤

Pinyin: Dāng Guī Sì Nì Tāng

Other names: Dong Quai Decoction for Frigid Extremities

Number of ingredients: 7 herbs

Formula category: Formulas that warm Interior Cold

  1. Warms the Channels
  2. Disperses Cold
  3. Nourishes the Blood
  4. Unblocks the Blood vessels

Contraindications: Contraindicated in patients with Fire or Heat Patterns or with Yin Deficiency... Contraindicated in patients with Fire or Heat Patterns or with Yin Deficiency pattern as it can injure Body Fluids further. It should also be used with caution during Hot season such as summer or in warm environment. see more

Source date: 220 AD

Source book: Discussion of Cold Damage

Dang Gui Si Ni Tang is a 7-ingredient Chinese Medicine formula with Dong Quai (Dang Gui) and Cinnamon Twigs (Gui Zhi) as principal ingredients.

Invented in 220 AD, it belongs to the category of formulas that warm Interior Cold. Its main actions are: 1) warms the Channels and 2) disperses Cold.

On this page, after a detailed description of each of the seven ingredients in Dang Gui Si Ni Tang, we review the patterns and conditions that Dang Gui Si Ni Tang helps treat.

The seven ingredients in Dang Gui Si Ni Tang

Dang Gui is a king ingredient in Dang Gui Si Ni Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Dong Quai (Dang Gui)

Part used: Dried root

Nature: Warm

Taste(s): PungentSweet

Meridian affinity: SpleenHeartLiver

Category: Tonic herbs for Blood Deficiency

In general Dang Gui's main actions are as follows: "Tonifies the Blood. Lubricates the Intestines. Relieve constipation. Promotes circulation and dispels Bi Pain. Reduce Dysmenorrhea and help with irregular menstruation."

In the context of Dang Gui Si Ni Tang, it is used because it is acrid, sweet, and warming. It tonifies and invigorates the Blood to disperse Cold.

Learn more about Dong Quai (Dang Gui)

Gui Zhi is a king ingredient in Dang Gui Si Ni Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

2. Cinnamon Twigs (Gui Zhi)

Part used: Dried young branches

Nature: Warm

Taste(s): PungentSweet

Meridian affinity: SpleenHeartLung

Category: Warm/Acrid herbs that release the Exterior

Gui Zhi warms the Channels and disperses Cold from the nutritive Qi. In addition, together with White peony root, they harmonize the protective and nutritive Qi so as to eliminate Cold from the more superficial levels of the body.

Learn more about Cinnamon Twigs (Gui Zhi)

Bai Shao is a deputy ingredient in Dang Gui Si Ni Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

3. White Peony Roots (Bai Shao)

Part used: Dried root

Nature: Neutral

Taste(s): BitterSour

Meridian affinity: SpleenLiver

Category: Tonic herbs for Blood Deficiency

Bai Shao strengthens the key ingredient Dong Quai's Blood tonifying effect. In addition, together with Cinnamon twigs, they harmonize the protective and nutritive Qi so as to eliminate Cold from the more superficial levels of the body.

Learn more about White Peony Roots (Bai Shao)

Xi Xin is a deputy ingredient in Dang Gui Si Ni Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

4. Wild Ginger (Xi Xin)

Part used: Dried root and rhizome

Nature: Warm

Taste(s): Pungent

Meridian affinity: HeartKidneyLung

Category: Warm/Acrid herbs that release the Exterior

In general Xi Xin's main actions are as follows: "Relieves the Exterior and warms the Yang. Expels Cold and relieves pain. Warms the Lungs and reduces Phlegm. Moves the Qi and disperses Phlegm to open the nasal passages."

In the context of Dang Gui Si Ni Tang, it is used because it , together with Cinnamon twigs, disperses both Internal and External Cold.

Learn more about Wild Ginger (Xi Xin)

Gan Cao is an assistant ingredient in Dang Gui Si Ni Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

5. Liquorice (Gan Cao)

Part used: Dried root and rhizome

Nature: Neutral

Taste(s): Sweet

Meridian affinity: SpleenStomachHeartLung

Category: Tonic herbs for Qi Deficiency

Gan Cao supports Qi and strengthens the Spleen. It assists Dong Quai and White peony root in tonifying the Blood. It also helps Cinnamon twigs and Wild ginger in facilitating Qi flow.

Learn more about Liquorice (Gan Cao)

Da Zao is an assistant ingredient in Dang Gui Si Ni Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

6. Jujube Dates (Da Zao)

Part used: Dried ripe fruit

Nature: Warm

Taste(s): Sweet

Meridian affinity: SpleenStomach

Category: Tonic herbs for Qi Deficiency

Da Zao supports Qi and strengthens the Spleen. It assists Dong Quai and White peony root in tonifying the Blood. It also helps Cinnamon twigs and Wild ginger in facilitating Qi flow.

Learn more about Jujube Dates (Da Zao)

Mu Tong is an envoy ingredient in Dang Gui Si Ni Tang. This means that it directs the formula towards certain area of the body and/or harmonizes the actions of other ingredients.

7. Akebia Stems (Mu Tong)

Part used: Dried stem

Nature: Cold

Taste(s): Bitter

Meridian affinity: HeartLungSmall intestine

Category: Herbs that drain Dampness

Mu Tong facilitates flows inside channels and vessels. It also balances the warming effect of other ingredients by removing any excessive Heat. This strengthens the actions of the other ingredients and focuses their effects on the channels and vessels.

Learn more about Akebia Stems (Mu Tong)

Dang Gui Si Ni Tang is used to treat Heart Vessel obstructed

The Heart is a so-called "Zang" Organ. Learn more about the Heart in Chinese Medicine

Heart Vessel obstructed

Dang Gui Si Ni Tang is sometimes prescribed by TCM practitioners to treat Heart Vessel obstructed. This pattern leads to symptoms such as palpitations, shortness of breath, depression and restlnessness. Patients with Heart Vessel obstructed typically exhibit choppy (Se), knotted (Jie), slippery (Hua) or wiry (Xian) pulses.

This is a complicated pattern as it is the combination of four other patterns and their features at the same time: Phlegm, Heart Blood Stagnation, Heart Qi Stagnation,  and Cold.  

If Phlegm is the dominant one out of the above four patterns, the pulse is rather Slippery instead of Wiry, Choppy or... read more about Heart Vessel obstructed

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