Chinese: 四物汤
Pinyin: Sì Wù Tāng
Other names: Four Substances Decoction, Dang Gui Four Combination
Number of ingredients: 4 herbs
Formula category: Formulas that tonify Blood
Conditions for which it may be prescribed: Menstrual crampsLate menstruationProlonged periods and six other conditions
Contraindications: Contraindicated for treating acute, severe Blood loss or other issues of blood... Contraindicated for treating acute, severe Blood loss or other issues of blood Deficiency characterized by severe weakness and labored breathing. see more
Source date: 846 AD
Source book: Secret Formulas to Manage Trauma and Reconnect Fractures Received from an Immortal
The information provided here is not a replacement for a doctor. You shouldn't use it for the purpose of self-diagnosing or self-medicating but rather so you can have a more informed discussion with a professional TCM practitioner.
Si Wu Tang is a 4-ingredient Chinese Medicine formula with Prepared Rehmannia (Shu Di huang) and White Peony Roots (Bai Shao) as principal ingredients.
Invented in 846 AD, it belongs to the category of formulas that tonify Blood. Its main actions are: 1) restores and nourishes Blood and 2) stimulates Blood circulation.
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 Wu Tang is used by TCM practitioners to fight patterns like Blood Deficiency, Blood Stagnation or Liver Blood Deficiency. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as late menstruation, scanty menstruation or heavy menstruation for instance.
On this page, after a detailed description of each of the four ingredients in Si Wu Tang, we review the patterns and conditions that Si Wu Tang helps treat.
Shu Di huang is a king ingredient in Si Wu Tang. Like the name indicates, it means it has more power than other ingredients in the formula.
Part used: Prepared dried root tuber
Nature: Warm
Taste(s): Sweet
Meridian affinity: KidneyLiver
Category: Tonic herbs for Blood Deficiency
Shu Di huang has a very strong tonifying effect on the Liver and Kidneys and is said to nourish the Yin of the Blood.
Bai Shao is a king ingredient in Si Wu Tang. Like the name indicates, it means it has more power than other ingredients in the formula.
Part used: Dried root
Nature: Neutral
Meridian affinity: SpleenLiver
Category: Tonic herbs for Blood Deficiency
Bai Shao helps reduce the muscle spasms caused by Blood-Deficiency and it is particularly well-suited to treat abdominal pain. Together with Prepared rehmannia (Shu Di huang), it has a strong tonifying effect on the Blood.
Dang Gui is a deputy ingredient in Si Wu Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
Part used: Dried root
Nature: Warm
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 Si Wu Tang, it is used because it enters the Liver and Heart to tonify and invigorate the Blood.
Chuan Xiong is a deputy ingredient in Si Wu Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
Part used: Dried rhizome
Nature: Warm
Taste(s): Pungent
Meridian affinity: GallbladderLiverPericardium
Category: Herbs that invigorate the Blood
Chuan Xiong facilitates the flow of Blood through the vessels, alleviates symptoms such as headache, dizziness, blurred vision and pain.
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 Wu Tang is used by TCM practitioners to treat eleven 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:
Late menstruation Scanty menstruation Heavy menstruation Prolonged periods Absence of menstruation Low breast milk supply Menstrual cramps Irregular menstruation Postpartum weakness
Again it wouldn't be correct to say "Si Wu Tang treats late menstruation" for instance. Rather, Si Wu Tang is used to treat patterns that are sometimes the root cause behind late menstruation.
Now let's look at the eleven patterns commonly treated with Si Wu Tang.
Blood (Xue) is one of Chinese Medicine's vital subtances. Learn more about Blood in Chinese Medicine
Pulse type(s): Choppy (Se), Fine (Xi)
Tongue color: Pale
Symptoms: Insomnia Tingling Dry skin Dry hair Dry lips Dizziness Pale lips Thin body Pale face Amenorrhea Depression Poor memory Late period Palpitations Scanty periods Blurred vision Pale complexion Slightly anxiety Tingling of limbs Pale menstrual blood Lower abdominal pain Numbness in the limbs Dull white shallow face Feeling of bearing down Withered and brittle nails
Si Wu Tang is sometimes prescribed by TCM practitioners to treat Blood Deficiency. This pattern leads to symptoms such as dizziness, scanty periods, amenorrhea and dull white shallow face. Patients with Blood Deficiency typically exhibit choppy (Se) or fine (Xi) pulses as well as Pale, thin and slightly tongue .
A Deficiency of Blood occurs when their entire body, a part of body or a particular Organ is insufficiently nourished by Blood. This can be caused by a loss of blood, insufficient Spleen Qi to produce Blood or congealed Blood which prevents new Blood from forming.
The Organs most likely to be... read more about Blood Deficiency
Blood (Xue) is one of Chinese Medicine's vital subtances. Learn more about Blood in Chinese Medicine
Pulse type(s): Choppy (Se), Wiry (Xian), Firm (Lao)
Tongue color: Reddish-Purple
Symptoms: Lumps Tremor Numbness Dark face Dizziness Purple lips Purple nails Blotchy skin Restlessness Itching scalp Painful period Abdominal mass Scanty periods Abdominal pain Abdominal masses Skin capillaries Hesitant periods Tendency to bleed Premenstrual pain Dark colored blood Traumatic swelling Shoulder stiffness Absence of menstruation Boring fixed stabbing pain Frequent bleeding episodes Dark clots in menstrual blood Abdominal distention and fullness
Si Wu Tang is sometimes prescribed by TCM practitioners to treat Blood Stagnation. This pattern leads to symptoms such as dark face, purple lips, boring fixed stabbing pain and abdominal masses. Patients with Blood Stagnation typically exhibit choppy (Se), wiry (Xian) or firm (Lao) pulses as well as Purple tongue .
Blood Stagnation - also often referred to as "Blood Stasis" - is where the Blood flow is heavily restricted in all or parts of the body. It is one of the most important diagnostic conditions in Chinese Medicine because it is frequently the cause of intractable pain syndromes anywhere in the... read more about Blood Stagnation
The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine
Pulse type(s): Choppy (Se), Fine (Xi)
Tongue color: Pale
Symptoms: Insomnia Dry hair Dry skin Pale lips Dizziness Amenorrhea Depression Joint pain Blurred vision Scanty periods Muscle weakness Floaters in eyes Tingling of limbs Dull-pale complexion Numbness in the limbs Dream disturbed sleep Feeling of aimlessness Diminished night vision Withered and brittle nails
Si Wu Tang is sometimes prescribed by TCM practitioners to treat Liver Blood Deficiency. This pattern leads to symptoms such as blurred vision, dull-pale complexion, scanty periods and numbness in the limbs. Patients with Liver Blood Deficiency typically exhibit choppy (Se) or fine (Xi) pulses as well as Pale tongue, especially on the sides with thin, dry and white coating.
This pattern has all the general manifestation of the Blood Deficiency, such as dizziness, pale lips, dull pale face. The Liver stores Blood, that is the reason any Blood Deficiency often involves the Liver.
This pattern has an impact on areas the Liver relates to, such as the eyes, the sinews,... read more about Liver Blood Deficiency
The Heart is a so-called "Zang" Organ. Learn more about the Heart in Chinese Medicine
Pulse type(s): Choppy (Se), Fine (Xi)
Tongue color: Pale
Tongue shape: Thin
Symptoms: Anxiety Fatigue Insomnia Dizziness Pale face Pale lips Poor memory Tearfulness Palpitations Restlessness Easily scared Loss of libido Excessive dreams Feeling of guilt Dream disturbed sleep
Si Wu Tang is sometimes prescribed by TCM practitioners to treat Heart Blood Deficiency. This pattern leads to symptoms such as easily scared, excessive dreams, palpitations and insomnia. Patients with Heart Blood Deficiency typically exhibit choppy (Se) or fine (Xi) pulses as well as Pale thin and slightly dry tongue .
This pattern is manifested by a pale face, pale lips and a pale tongue due to lack of Blood supply. Heart Blood Deficiency may eventually cause Heart Yin Deficiency because Blood is a Yin element. Dizziness is also a symptom because not sufficient Blood is able to nourish the Brain.
The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine
Pulse type(s): Wiry (Xian), Fine (Xi)
Tongue color: Pale
Symptoms: Insomnia Dizziness Headaches No period Facial tic Dry throat Fine tremor Poor memory Hypertension Blurred vision Scanty periods Tingling of limbs Numbness in the limbs
Si Wu Tang is sometimes prescribed by TCM practitioners to treat Liver Wind agitating Internally due to Liver Blood Deficiency. This pattern leads to symptoms such as fine tremor, facial tic, dizziness and blurred vision. Patients with Liver Wind agitating Internally due to Liver Blood Deficiency typically exhibit wiry (Xian) or fine (Xi) pulses as well as Pale and thin tongue.
If there is Liver Blood Deficiency, especially if the condition lasts a long time without being treated, the Blood vessels become 'empty' and the space is taken over by Internal Wind. Like an empty building will often get a lot of wind in its corridors, the concept here is the same.
This kind of... read more about Liver Wind agitating Internally due to Liver Blood Deficiency
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