Chinese: 四物汤
Pinyin: Sì Wù Tāng
Other names: Four Substances Decoction, Dang Gui Four Combination
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: LiverSpleen
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: HeartLiverSpleen
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 twelve 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 Low breast milk supply Absence of menstruation 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 twelve 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), Firm (Lao), Wiry (Xian)
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), firm (Lao) or wiry (Xian) 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 Uterus is a so-called "Extraordinary" Organ. Learn more about the Uterus in Chinese Medicine
Pulse type(s): Deep (Chen), Soggy (Ru)
Tongue coating: Thin white coating
Tongue color: Pale
Symptoms: Fatigue Diarrhea Lassitude Sore back No period Sore legs Pale face Tiredness Amenorrhea Cold limbs Infertility Late period Loose stools Poor appetite Scanty periods Painful period Abdominal pain Feeling of cold Low sexual desire Frequent urination Dark colored blood Cold hands and feet Lower abdominal pain Irregular menstruation Pain relieved with heat Dark clots in menstrual blood Thin and watery vaginal discharge
Si Wu Tang is sometimes prescribed by TCM practitioners to treat Cold in the Uterus. This pattern leads to symptoms such as loose stools, poor appetite, fatigue and lassitude. Patients with Cold in the Uterus typically exhibit deep (Chen) or soggy (Ru) pulses as well as Pale tongue with white coating.
O'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, late period, scanty period, amenorrhea, infertility, etc.
The Cold here mainly refers to Wind-Cold or Damp-Cold which can invade the... read more about Cold in the Uterus
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
The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine
Pulse type(s): Weak (Ruo)
Symptoms: Fatigue Timidity Dizziness Indecision Depression Nervousness Irritability Easily scared Poor appetite Blurred vision Lack of courage Restless dreams Floaters in eyes Frequent sighing Abdomen distension Irregular menstruation Hypochondrial distention
Si Wu Tang is sometimes prescribed by TCM practitioners to treat Liver Qi Deficiency. This pattern leads to symptoms such as dizziness, blurred vision, floaters in eyes and nervousness. Patients with Liver Qi Deficiency typically exhibit weak (Ruo) pulses.
It is more common to see Liver Qi Deficiency accompanying other patterns.
The most obvious one is Liver Qi Stagnation. One of Liver's main functions is to ensures the smooth flow of Qi throughout the body, in all Organs and in all directions. This function is impaired when the Qi in Liver is... read more about Liver Qi Deficiency
Qi is one of Chinese Medicine's vital subtances. Learn more about Qi in Chinese Medicine
Pulse type(s): Choppy (Se), Deep (Chen), Fine (Xi)
Symptoms: Insomnia Dark face Moodiness Dizziness Chest pain Depression Amenorrhea Purple lips Mood swings Breast pain Hot flushes Purple nails Irritability Blotchy skin Restlessness Breast lumps Restlnessness Chest fullness Painful period Scanty periods Clots in blood Abdominal pain Abdominal masses Lochia retention Breast distention Dark colored blood Abdominal fullness Intense period pain High blood pressure Swelling of the feet Lower abdominal pain Dark menstrual blood Flooding and leaking Abdominal distension Pre-menstrual tension Black and tarry stools Irregular menstruation Boring fixed stabbing pain 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 chest fullness, chest pain, boring fixed stabbing pain and dark face. Patients with Qi And Blood Stagnation typically exhibit choppy (Se), deep (Chen) or fine (Xi) pulses.
The typical symptoms of Qi stagnation are distension, oppression and swelling. There are also emotional issues like mood swing, depression or irritability. However, the Blood Stagnation is more on pains and purple color manifestation on skin, face, lips and nails.
Qi Stagnation can cause the... read more about Qi And Blood Stagnation
The Interior in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Interior in Chinese Medicine
Pulse type(s): Fine (Xi), Rapid (Shu), Wiry (Xian)
Symptoms: Coma Tics Fever Anger Tremor Insomnia Dry eyes Red eyes Red face Deafness Dizziness Paralysis Headaches Back pain Dry throat Convulsions Poor memory Irritability Constipation Eye deviation Blurred vision Scanty periods Tremor of limbs Mouth deviation Numbness in the limbs Dream disturbed sleep
Si Wu Tang is sometimes prescribed by TCM practitioners to treat Interior Wind. This pattern leads to symptoms such as convulsions, tremor of limbs, dizziness and paralysis. Patients with Interior Wind typically exhibit fine (Xi), rapid (Shu) or wiry (Xian) pulses.
Interior Wind is mostly referred to be the Liver Wind. There are 4 types of Interior Liver Wind due to the original causes:
1. Liver Wind agitating Internally due to Liver Fire
2. Liver Wind agitating Internally due to extreme Heat
Qi is one of Chinese Medicine's vital subtances. Learn more about Qi in Chinese Medicine
Pulse type(s): Slowed-down (Huan), Weak (Ruo), Fine (Xi)
Tongue coating: Partial absence of coating
Tongue color: Pale
Symptoms: Edema Fatigue Vertigo Anxiety Insomnia Dry hair Dry skin Dry lips Tingling Numbness Dry eyes Pale face Dizziness Pale lips Hair loss Tiredness Sore back Weak voice Sore knees Depression Low energy Poor memory Pale tongue Watery milk Palpitations Listlessness Loose stools Poor appetite Scanty periods Blurred vision Low milk supply Pale complexion General weakness Aversion to speak Pale color periods Shortness of breath Numbness in the skin Spontaneous sweating Lower abdominal pain Pale menstrual blood Numbness in the limbs Dream disturbed sleep Dull menstrual cramps Feeling of bearing down Thin and watery periods Withered and brittle nails Thin body lacking strength 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 Qi and Blood Deficiency. This pattern leads to symptoms such as general weakness, fatigue, weak voice and pale face. Patients with Qi and Blood Deficiency typically exhibit slowed-down (Huan), weak (Ruo) or fine (Xi) pulses as well as Pale tongue with thin white coating .
The Qi and Blood are from the some origin and these two elements are transformable between each other. The Qi creates the Blood, and vice versa the Blood supplies Qi. Therefore it is quite common both patterns appear at the same time.
When general Qi is Deficient, the patients lack the energy to... read more about Qi and Blood Deficiency
The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine
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 Excessive tear Lower back pain Lightheadedness Afraid of light 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 Normal-coloured without coating or with rootless 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
Blood (Xue) is one of Chinese Medicine's vital subtances. Learn more about Blood in Chinese Medicine
Pulse type(s): Choppy (Se), Fine (Xi), Wiry (Xian)
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), fine (Xi) or wiry (Xian) pulses as well as a pale tongue.
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