Si Wu Tang

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 cramps Late menstruation Prolonged periods and six other conditions

Main actions:

Restores and nourishes Blood
Stimulates Blood circulation

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.

The four ingredients in Si Wu Tang

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.

1. Prepared Rehmannia (Shu Di huang)

Part used: Prepared dried root tuber

Nature: Warm

Taste(s): Sweet

Meridian affinity: Kidney Liver

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.

Learn more about Prepared Rehmannia (Shu Di huang)

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.

2. White Peony Roots (Bai Shao)

Part used: Dried root

Nature: Neutral

Taste(s): Bitter Sour

Meridian affinity: Spleen Liver

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.

Learn more about White Peony Roots (Bai Shao)

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.

3. Dong Quai (Dang Gui)

Part used: Dried root

Nature: Warm

Taste(s): Pungent Sweet

Meridian affinity: Spleen Heart Liver

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.

Learn more about Dong Quai (Dang Gui)

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.

4. Szechuan Lovage Roots (Chuan Xiong)

Part used: Dried rhizome

Nature: Warm

Taste(s): Pungent

Meridian affinity: Gallbladder Liver Pericardium

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.

Learn more about Szechuan Lovage Roots (Chuan Xiong)

Conditions and patterns for which Si Wu 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 Si Wu Tang is used by TCM practitioners to treat nine 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 Absence of menstruation Prolonged periods 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 nine patterns commonly treated with Si Wu Tang.

Blood (Xue) is one of Chinese Medicine's vital subtances. Learn more about Blood in Chinese Medicine

Blood Deficiency

Pulse type(s): Choppy (Se), Fine (Xi)

Tongue color: Pale

Symptoms: Numbness Tingling Insomnia Dry skin Dizziness Pale face Pale lips Amenorrhea Depression Poor memory Late period Palpitations Scanty periods Blurred vision Pale complexion Tingling of limbs Pale menstrual blood Lower abdominal pain Feeling of bearing down

Si Wu Tang is sometimes prescribed by TCM practitioners to treat Blood Deficiency. This pattern leads to symptoms such as amenorrhea, scanty periods, dizziness and numbness. Patients with Blood Deficiency typically exhibit choppy (Se) or fine (Xi) pulses as well as a pale 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

Blood Stagnation

Pulse type(s): Choppy (Se), Wiry (Xian), Firm (Lao)

Tongue color: Reddish-Purple

Symptoms: Lumps Dark face Purple lips Purple nails Restlessness Stabbing pain Painful period Scanty periods Abdominal pain Abdominal masses Hesitant periods Premenstrual pain Dark colored blood 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 stabbing pain, abdominal masses, purple nails and painful period. Patients with Blood Stagnation typically exhibit choppy (Se), wiry (Xian) or firm (Lao) pulses as well as a reddish-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

Liver Blood Deficiency

Pulse type(s): Choppy (Se), Fine (Xi)

Tongue color: Pale

Symptoms: Cramps Insomnia Dry hair Dry skin Dizziness Pale lips Amenorrhea Depression Scanty periods Blurred vision Muscle weakness Floaters in eyes Tingling of limbs Dull-pale complexion Numbness in the limbs 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 scanty periods, blurred vision, dizziness and numbness in the limbs. Patients with Liver Blood Deficiency typically exhibit choppy (Se) or fine (Xi) pulses as well as a pale tongue.

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 tendons, the eyes, the nails and women's menstruation.

It arises from the same causes as general Blood Deficiency, such as a diet poor in... read more about Liver Blood Deficiency

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

Cold in the Uterus

Pulse type(s): Deep (Chen), Soggy (Ru)

Tongue coating: Thin white coating

Tongue color: Pale

Symptoms: Diarrhea Sore back No period Sore legs Pale face Tiredness Cold limbs Infertility Late period Scanty periods Painful period Abdominal pain Feeling of cold Frequent urination Dark colored blood Cold hands and feet Lower abdominal pain Irregular menstruation Pain relieved with heat Dark clots in menstrual blood

Si Wu Tang is sometimes prescribed by TCM practitioners to treat Cold in the Uterus. This pattern leads to symptoms such as infertility, scanty periods, painful period and late period. Patients with Cold in the Uterus typically exhibit deep (Chen) or soggy (Ru) pulses as well as a pale tongue with thin white coating.

'Cold in the Uterus' is one the most common TCM pattern for women. It can be responsible for many gynecological diseases such as menstrual cramps, irregular periods, infertility, etc. Coldness can also lead to other TCM patterns such as Blood and Qi Stagnation.

There are two types of Cold... read more about Cold in the Uterus

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

Heart Blood Deficiency

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 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 palpitations, insomnia, poor memory and dream disturbed sleep. Patients with Heart Blood Deficiency typically exhibit choppy (Se) or fine (Xi) pulses as well as a pale tongue.

Heart Blood Deficiency hurts the Mind (神 Shen) which resides in the Heart. Therefore, it causes symptoms such as insomnia, dream-disturbed sleep, anxiety, poor memory and tendency to be scared. Another typical symptom is palpitation due to Heart Qi Deficiency which is a result of Heart Blood... read more about Heart Blood Deficiency

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

Kidney and Liver Yin Deficiency

Pulse type(s): Empty (Xu), Floating (Fu)

Tongue coating: Partial absence of coating

Tongue color: Red

Symptoms: Tics Vertigo Fatigue Tinnitus Insomnia Dry eyes Dry hair Dry skin Dizziness Dry mouth Sore back Headaches Dry throat Dry vagina Dry stools Amenorrhea Joint pain Infertility Hot flushes Night sweats Blurred vision Scanty periods Delayed period Lower back pain Lightheadedness Tingling of limbs Diminished hearing Vertical headaches Occipital headaches Nocturnal emissions Chronic sore throat Hot palms and soles Numbness in the limbs Withered and brittle nails Heat in vaginal and vulvar Feeling of heat in the afternoon Spontaneous and nocturnal emissions Soreness and weakness in the lower back

Si Wu Tang is sometimes prescribed by TCM practitioners to treat Kidney and Liver Yin Deficiency. This pattern leads to symptoms such as dizziness, tinnitus, diminished hearing and lower back pain. Patients with Kidney and Liver Yin Deficiency typically exhibit empty (Xu) or floating (Fu) pulses as well as a red tongue with partial absence of coating.

The Liver stores Blood while the Kidneys store Essence.

Liver Blood depends on Essence for nourishment, while Essence depends on Blood for replenishment. Both have a common source: Grain Qi derived from the Spleen. In terms of Five Elements, the Kidneys nourish the Liver.

A long term Liver Blood... read more about Kidney and Liver Yin Deficiency

Qi is one of Chinese Medicine's vital subtances. Learn more about Qi in Chinese Medicine

Qi and Blood Stagnation

Pulse type(s): Choppy (Se), Wiry (Xian)

Tongue color: Normal (light red), Red, Red sides

Symptoms: Insomnia Moodiness Dark face Dizziness Depression Chest pain Breast pain Hot flushes Restlessness Irritability Breast lumps Restlnessness Scanty periods Clots in blood Abdominal pain Chest fullness Breast distention Abdominal fullness Dark colored blood Intense period pain High blood pressure Lower abdominal pain Dark menstrual blood Flooding and leaking Abdominal distension Pre-menstrual tension Irregular menstruation Pre-menstrual irritability Dark clots in menstrual blood Menstruation decreases gratually Feeling of fullness in the chest Abdominal distention and fullness Pain relief after clots discharge

Si Wu Tang is sometimes prescribed by TCM practitioners to treat Qi and Blood Stagnation. This pattern leads to symptoms such as lower abdominal pain, breast distention, abdominal distention and fullness and pre-menstrual tension. Patients with Qi and Blood Stagnation typically exhibit choppy (Se) or wiry (Xian) pulses as well as a normal (light red), red, red sides tongue.

Learn more about Qi and Blood Stagnation

Blood (Xue) is one of Chinese Medicine's vital subtances. Learn more about Blood in Chinese Medicine

Blood Deficiency and Stagnation

Pulse type(s): Choppy (Se), Wiry (Xian), Fine (Xi)

Tongue color: Pale

Symptoms: Insomnia Dizziness Amenorrhea Palpitations Blurred vision Muscle tension Lower abdominal pain Irregular menstruation Thin body lacking strength Generalized muscle tension Lusterless complexion and nails

Si Wu Tang is sometimes prescribed by TCM practitioners to treat Blood Deficiency and Stagnation. This pattern leads to symptoms such as dizziness, blurred vision, lusterless complexion and nails and muscle tension. Patients with Blood Deficiency and Stagnation typically exhibit choppy (Se), wiry (Xian) or fine (Xi) pulses as well as a pale tongue.

Learn more about Blood Deficiency and Stagnation

Qi is one of Chinese Medicine's vital subtances. Learn more about Qi in Chinese Medicine

Blood and Qi Deficiency

Pulse type(s): Weak (Ruo), Fine (Xi)

Tongue coating: Partial absence of coating

Tongue color: Pale

Symptoms: Edema Vertigo Fatigue Anxiety Dry skin Tingling Numbness Insomnia Dry hair Dry eyes Pale face Pale lips Hair loss Tiredness Dizziness Sore back Sore knees Depression Low energy Pale tongue Watery milk Poor memory Palpitations Loose stools Poor appetite Scanty periods Blurred vision Pale complexion Pale color periods Shortness of breath Lower abdominal pain Pale menstrual blood Dull menstrual cramps Feeling of bearing down Thin and watery periods Pain relieved with massage Lethargic and withdrawn state Spontaneous flow of breast milk Menstruation decreases gratually No feeling of distension of the breasts Insufficient or absent lactation after childbirth

Si Wu Tang is sometimes prescribed by TCM practitioners to treat Blood and Qi Deficiency. This pattern leads to symptoms such as lower abdominal pain, pale complexion, lethargic and withdrawn state and palpitations. Patients with Blood and Qi Deficiency typically exhibit weak (Ruo) or fine (Xi) pulses as well as a pale tongue with partial absence of coating.

Learn more about Blood and Qi Deficiency