Kansui roots (Gan Sui) Genkwa flowers (Yan Hua) Peking spurge roots (Jing Da Ji) Jujube dates (Da Zao)

Shi Zao Tang

Chinese: 十枣汤

Pinyin: Shí Zǎo Tāng

Other names: Ten-Jujube Decoction

Number of ingredients: 4 herbs

Formula category: Formulas that drive out excess water

Conditions for which it may be prescribed: PneumoniaNephritisCirrhosis with ascites and one other condition

Main actions: Purges and drives out Phlegm-Fluids

Contraindications: This formula should be used with extreme caution in weak or pregnant patients.

Source date: 220 AD

Source book: Discussion of Cold Damage

Shi Zao Tang is a 4-ingredient Chinese Medicine formula with Kansui Roots (Gan Sui), Genkwa Flowers (Yan Hua) and Peking Spurge Roots (Jing Da Ji) as principal ingredients.

Invented in 220 AD, it belongs to the category of formulas that drive out excess water. Its main action is that it purges and drives out Phlegm-Fluids.

In Chinese Medicine health conditions are thought to arise due to "disharmonies" in the body as a system. These disharmonies are called "patterns" and the very purpose of herbal formulas is to fight them in order to restore the body's harmony.

In this case Shi Zao Tang is used by TCM practitioners to fight patterns like Phlegm-Fluids in the hypochondrium or Phlegm-Fluids in the chest and hypochondrium. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as pericardial and pleural effusions, pneumonia or cirrhosis with ascites for instance.

On this page, after a detailed description of each of the four ingredients in Shi Zao Tang, we review the patterns and conditions that Shi Zao Tang helps treat.

The four ingredients in Shi Zao Tang

Gan Sui is a king ingredient in Shi Zao Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Kansui Roots (Gan Sui)

Part used: The dried root

Nature: Cold

Taste(s): Bitter

Meridian affinity: SpleenKidneyLarge intestineLung

Category: Cathartic herbs that drain downward

In general Gan Sui's main actions are as follows: "Relieves water retention and congestion of Fluids. Cools swellings and reduces inflammation when applied topically. Strong purgative, driving water and Food Stagnation out though the stool."

In the context of Shi Zao Tang, it is used because it expels Fluids and Dampness from the Channels and collaterals.

Learn more about Kansui Roots (Gan Sui)

Yan Hua is a king ingredient in Shi Zao Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

2. Genkwa Flowers (Yan Hua)

Part used: Dried flower bud

Nature: Warm

Taste(s): BitterPungent

Meridian affinity: KidneyLarge intestineLung

Category: Cathartic herbs that drain downward

In general Yan Hua's main actions are as follows: "Relieves chronic congestion of Fluids in the chest and stops cough. Drains congested Fluids through the urine and the stool. Expels parasites."

In the context of Shi Zao Tang, it is used because it reduces and eliminates Phlegm-Fluids in the chest and hypochondria.

Learn more about Genkwa Flowers (Yan Hua)

Jing Da Ji is a king ingredient in Shi Zao Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

3. Peking Spurge Roots (Jing Da Ji)

Part used: Dried roots

Nature: Cold

Taste(s): Bitter

Meridian affinity: SpleenKidneyLung

Category: Laxative herbs that drain downward

In general Jing Da Ji's main actions are as follows: "Drains water downward and drives out Phlegm-Fluids. Reduces swellings and dispels lumps."

In the context of Shi Zao Tang, it is used because it drains Fluids and Dampness from the Organs.

Learn more about Peking Spurge Roots (Jing Da Ji)

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

4. 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 augment the Qi, protect the Stomach, and moderate the harshness and toxicity of the three other ingredients.

Learn more about Jujube Dates (Da Zao)

Conditions and patterns for which Shi Zao Tang may be prescribed

It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.

As such Shi Zao Tang is used by TCM practitioners to treat two different patterns which we describe below.

But before we delve into these patterns here is an overview of the Western conditions they're commonly associated with:

Pericardial and pleural effusions Pneumonia Cirrhosis with ascites Nephritis

Again it wouldn't be correct to say "Shi Zao Tang treats pericardial and pleural effusions" for instance. Rather, Shi Zao Tang is used to treat patterns that are sometimes the root cause behind pericardial and pleural effusions.

Now let's look at the two patterns commonly treated with Shi Zao Tang.

Body Fluids (Jin Ye) is one of Chinese Medicine's vital subtances. Learn more about Body Fluids in Chinese Medicine

Phlegm-Fluids in the hypochondrium

Pulse type(s): Deep (Chen), Wiry (Xian)

Tongue coating: Sticky coating

Tongue color: Pale

Tongue shape: Swollen

Symptoms: Coughing Palpitations Shortness of breath Dizziness or vertigo A feeling of distension of the hypochondrium Hypochondrial pain that is worse on coughing and breathing

Shi Zao Tang is sometimes prescribed by TCM practitioners to treat Phlegm-Fluids in the hypochondrium. This pattern leads to symptoms such as hypochondrial pain that is worse on coughing and breathing, a feeling of distension of the hypochondrium, shortness of breath and coughing. Patients with Phlegm-Fluids in the hypochondrium typically exhibit deep (Chen) or wiry (Xian) pulses as well as a pale tongue with sticky coating.

When Phlegm-Fluids (a type of Phlegm characterized by white, very watery and thin mucus) clogs up the chest and hypochondriac regions, the Qi rebels, producing cough and shortness of breath.

Obstruction of the flow of Qi also produces chest and hypochondriac pain that, in severe cases, may extend... read more about Phlegm-Fluids in the hypochondrium

Body Fluids (Jin Ye) is one of Chinese Medicine's vital subtances. Learn more about Body Fluids in Chinese Medicine

Phlegm-Fluids in the chest and hypochondrium

Pulse type(s): Deep (Chen), Wiry (Xian)

Tongue coating: Thin white coating

Symptoms: Vertigo Headaches Dry heaves Shortness of breath Hard focal distention in the epigastrium Cough with pain in the chest and hypochondria

Shi Zao Tang is sometimes prescribed by TCM practitioners to treat Phlegm-Fluids in the chest and hypochondrium. This pattern leads to symptoms such as cough with pain in the chest and hypochondria, hard focal distention in the epigastrium, dry heaves and shortness of breath. Patients with Phlegm-Fluids in the chest and hypochondrium typically exhibit deep (Chen) or wiry (Xian) pulses as well as a tongue with thin white coating.

Learn more about Phlegm-Fluids in the chest and hypochondrium

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