Lindera roots (Wu Yao) Agarwood (Chen Xiang) Ginseng (Ren Shen) Areca nuts (Bing Lang)

Si Mo Tang

Chinese: 四磨汤

Pinyin: Sì Mó Tāng

Other names: Four Milled-Herb Decoction

Number of ingredients: 4 herbs

Formula category: Formulas that promote Qi movement

Conditions for which it may be prescribed: EmphysemaGastritisBronchial asthma and one other condition

  1. Promotes the movement of Qi
  2. Directs rebellious Qi downward
  3. Expands the chest and dissipates clumping

Contraindications: This formula is for acute conditions and should not be taken long-term. It is... This formula is for acute conditions and should not be taken long-term. It is inappropriate for patients who have significant deficiency of True Qi, reflected in part by fatigue and a frail pulse. see more

Source date: 1253 AD

Source book: Formulas to Aid the Living

Si Mo Tang is a 4-ingredient Chinese Medicine formula with Lindera Roots (Wu Yao) as a principal ingredient.

Invented in 1253 AD, it belongs to the category of formulas that promote Qi movement. Its main actions are: 1) promotes the movement of Qi and 2) directs rebellious Qi downward.

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 Si Mo Tang is used by TCM practitioners to fight patterns like Rebellious Liver Qi invading the Stomach. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as bronchial asthma, emphysema or gastritis for instance.

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

The four ingredients in Si Mo Tang

Wu Yao is a king ingredient in Si Mo Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Lindera Roots (Wu Yao)

Part used: Dried root tuber

Nature: Warm

Taste(s): Pungent

Meridian affinity: BladderSpleenKidneyLung

Category: Herbs that regulate Qi

In general Wu Yao's main actions are as follows: "Warms and stimulates the flow of Qi and relieves pain. Disperses Cold and Warms the Kidneys."

In the context of Si Mo Tang, it is used because it enter all twelve Channels where it promotes both the ascent and descent of Qi.

Learn more about Lindera Roots (Wu Yao)

Chen Xiang is a deputy ingredient in Si Mo Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

2. Agarwood (Chen Xiang)

Part used: Wood shavings

Nature: Warm

Taste(s): BitterPungent

Meridian affinity: SpleenStomachKidneyLung

Category: Herbs that regulate Qi

Chen Xiang smoothes the flow of Qi, directing it downward from the Lungs to the Kidneys. Working synergistically with the key herb Wu Yao, this combination effectively disperses Stagnation.

Learn more about Agarwood (Chen Xiang)

Ren Shen is an assistant ingredient in Si Mo Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

3. Ginseng (Ren Shen)

Part used: Dried root

Nature: Warm

Taste(s): BitterSweet

Meridian affinity: SpleenHeartLung

Category: Tonic herbs for Qi Deficiency

In general Ren Shen's main actions are as follows: "Very strongly tonifies the Qi. Tonifies the Lungs and Spleen. Assists the body in the secretion of Fluids and stops thirst. Strengthens the Heart and calms the Shen (mind/spirit)."

In the context of Si Mo Tang, it is used because it augments original Qi but also enriches the Fluids.

Learn more about Ginseng (Ren Shen)

Bing Lang is an assistant ingredient in Si Mo Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

4. Areca Nuts (Bing Lang)

Part used: Dried ripe seed

Nature: Warm

Taste(s): BitterPungent

Meridian affinity: StomachLarge intestine

Category: Herbs that expel parasites

Bing Lang strongly promotes the downward movement of Qi, breaks up Stagnation and clumping and thereby eliminates the irritable, stifling, and full sensations

Learn more about Areca Nuts (Bing Lang)

Si Mo Tang is used to treat Rebellious Liver Qi invading the Stomach

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 Si Mo Tang is mostly used to treat the pattern "Rebellious Liver Qi invading the Stomach" which we describe below.

But before we delve into Rebellious Liver Qi invading the Stomach here is an overview of the Western conditions it is commonly associated with:

Bronchial asthma Emphysema Gastritis Postsurgical adhesions

Again it wouldn't be correct to say "Si Mo Tang treats bronchial asthma" for instance. Rather, Si Mo Tang is used to treat Rebellious Liver Qi invading the Stomach, which is sometimes the root cause behind bronchial asthma.

Now let's look at Rebellious Liver Qi invading the Stomach, a pattern that TCM practitioners commonly treat with Si Mo Tang.

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

Rebellious Liver Qi invading the Stomach

Si Mo Tang is sometimes prescribed by TCM practitioners to treat Rebellious Liver Qi invading the Stomach. This pattern leads to symptoms such as irritability, epigastric pain, epigastric distension and hypochondrial pain. Patients with Rebellious Liver Qi invading the Stomach typically exhibit weak (Ruo) or wiry (Xian) pulses.

Liver Qi is said to be rebellious when its horizontal movement is accentuated. This interferes with the descending of Stomach Qi, making it ascend instead. Hence the symptoms of belching, nausea and vomiting.

Rebellious Liver Qi also impairs the Stomach's function of rotting and ripening of food,... read more about Rebellious Liver Qi invading the Stomach

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