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
- Promotes the movement of Qi
- Directs rebellious Qi downward
- 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
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 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 or Qi Stagnation. 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: BladderKidneyLungSpleen
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.
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
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.
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
Meridian affinity: HeartLungSpleen
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.
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
Meridian affinity: Large intestineStomach
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
Conditions and patterns for which Si Mo 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 Mo 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:
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 patterns that are sometimes the root cause behind bronchial asthma.
Now let's look at the two patterns commonly treated 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
Pulse type(s): Weak (Ruo), Wiry (Xian)
Symptoms: Belching Hiccuping Weak Limbs Irritability Epigastric pain Frequent sighing Hypochondrial pain Sour regurgitation Nausea or vomiting Epigastric distension Hypochondrial distention A feeling of oppression in the epigastrium
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. It is one of the reason causing Rebellious Stomach Qi.
Rebellious Liver Qi also impairs... read more about Rebellious Liver Qi invading the Stomach
Qi is one of Chinese Medicine's vital subtances. Learn more about Qi in Chinese Medicine
Qi Stagnation
Pulse type(s): Tight (Jin), Wiry (Xian)
Tongue coating: Thin white coating
Tongue color: Red sides
Symptoms: Belching Vomiting Depression Mood swings Acid reflux Indigestion Late period Irritability Throat lumps Poor appetite Scanty periods Clots in blood Abdominal pain Frequent sighing Breast distention Soft palpable lumps Feeling of distension Moving distending pain Irregular menstruation Fixed pain in the hypochondria Premenstrual breast distension Mild coughing with copious sputum Premenstrual abdominal distension Feeling of oppression of the chest Stifling sensation in the chest and abdomen
Si Mo Tang is sometimes prescribed by TCM practitioners to treat Qi Stagnation. This pattern leads to symptoms such as feeling of distension, moving distending pain, depression and irritability. Patients with Qi Stagnation typically exhibit tight (Jin) or wiry (Xian) pulses as well as Normal or slightly dark on side with white or yellow coating.
If the flow of Qi is impeded in any way, it becomes stuck or stagnant. This can be likened to a traffic jam on the freeway. That's why, unlike in the cases of Qi Deficiency or Qi Sinking, tonification is contraindicated: it would be like adding more cars to the traffic jam. Instead, Qi moving or... read more about Qi Stagnation
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