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Neijing
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Knowledge baseFormulas

Si Mo Tang四磨湯

Four Milled-Herb Decoction

Medicinals
4

Composition

  • Ren ShenRx. Ginseng3–6 g

    Tonifies Spleen and Stomach Qi, tonifies Lung Qi, tonifies Heart Qi and calms the Spirit.

  • Bing LangSm. Arecae9 g

    Regulates Qi, reduces accumulations, drains downward and unblocks the bowels.

  • Chen XiangLignum Aquilariae Resinatum3–6 g

    Promotes movement of Qi, alleviates pain, descends Qi, regulates the Middle, dispels Cold and warms the Spleen and Stomach.

    for lower abdominal pain, especially with lower abdominal cold and tension and a stifling sensation in the chest and diaphragm with wheezing, distention, and anorexia.
  • Wu YaoRx. Linderae6–9 g

    Promotes movement of Qi and alleviates pain.

Actions

  • Facilitates the flow of Qi
  • Directs Rebellious Qi downward
  • Opens up the chest
  • Relieves Stagnation

Patterns treated

Stagnation of Qi in the Upper Jiao, presenting with chest clumping and Rebellious Qi

Manifestations

  • A feeling of irritability and oppression in the chest and diaphragm
  • Difficulty breathing
  • A wheezing sound on breathing
  • Fullness and distention in the epigastrium
  • Loss of appetite
  • Rapid, hurried respiration
Tongue body
Unremarkable in appearance
Coating
White in color
Pulse
Wiry in quality

Indications

  • Asthma of bronchial origin
  • Cases of emphysema
  • Inflammation of the stomach lining
  • Diminished appetite
  • Poor digestion
  • Adhesions following surgery
  • Enlargement of breast tissue in males
  • Chronic obstructive pulmonary disease
  • The sensation of a lump in the throat (globus hystericus)

Modifications

  • For robust patients experiencing anger along with distending pain in the abdomen and epigastrium

  • For constipation with belching, abdominal pain, and distention

Cautions

  • This formula should not be used over an extended period.
  • Should not be given to patients with marked Qi Deficiency presenting fatigue and a frail pulse.