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Knowledge baseFormulas

Si Ni Tang四逆湯

Frigid Extremities Decoction

Also known asDecoction to Treat Cold Limbs · Aconite, Ginger and Licorice Combination · Aconite and G.L. Combination

Medicinals
4

Composition

  • Zhi Fu ZiRx. Aconiti Lateralis Preparata9 g

    Warms the Kidney and Heart Yang, stimulates exhausted Yang, warms the Ming Men Fire and the entire body by traveling through all twelve channels.

    • Gan Jiang
    strengthens the Kidney and Spleen Yang,warms the Spleen and Kidneys, disperses Cold and treats overabundance of Yin fluids due to Deficiency Cold, Devastated Yang and debilitated Spleen and Kidney Yang with incessant diarrhea.
    • Gan Jiang
    • Zhi Gan Cao
    • Qi
    • Yang
    strengthens the actions of fortifying Qi and benefiting the Yang for Cold extremities and diarrhea with undigested food due to Collapse of the Spleen and Kidney Yang.
  • (Sheng Fu Zi)(Rx. Aconiti Lateralis)(1 piece)

    (Use only if condition is critical.)

  • Gan JiangRz. Zingiberis4.5 g

    Warms the Middle Jiao and Lungs, transforms thin mucus, expels Cold, rescues Yang, warms the channels (unblocks the pulse) and stops bleeding.

    for Cold-Damp Bi.
    • Zhi Gan Cao
    for epigastric pain and vomiting due to Spleen and Stomach Deficiency Cold and detoxifies Zhi Fu Zi.
  • Zhi Gan CaoRx. Glycyrrhizae Preparata6 g

    Tonifies Qi, strengthens the Spleen and moderates the drying properties of the formula.

Actions

  • Revives Yang
  • Heats the Middle Jiao
  • Dispels Cold from the Interior
  • Halts diarrhea

Patterns treated

  • Exhaustion Arising from Heart Yang Deficiency: Yang Xu Jue Ni
  • Kidney Yang Deficiency accompanied by Internal Cold
  • Cold Affecting the Shao Yin
  • The Yang Ming Han Pattern
  • Yang Depleted by Overuse of Diaphoretic Therapy During the Tai Yang Stage

Manifestations

  • Severely cold limbs
  • Cold intolerance
  • Curling up with knees bent while asleep
  • Sluggishness and an unrelenting urge to sleep
  • Emesis
  • Loose stool containing unprocessed food particles
  • Cold sensation with pain in the abdomen
  • No sensation of thirst
  • Unconsciousness
  • Poor digestion
  • Fluid swelling
  • Pallid complexion
  • Fever at the body's surface
  • Flushed complexion
  • Bluish discoloration of the lips and nail beds
Tongue body
Pale, or alternatively Dark purple
Coating
White in color and slippery in texture
Pulse
Deep combined with thready, or deep combined with slow, or deep combined with faint

Indications

  • Acute heart attack
  • Heart failure
  • Pituitary gland insufficiency
  • Emesis and diarrhea from gastroenteritis, acute and chronic
  • Underactive thyroid
  • Insufficient blood flow to the brain
  • Sudden-onset gastroenteritis
  • Liver cirrhosis
  • Long-standing prostate inflammation
  • Poisoning
  • Joint inflammation
  • The flu
  • Difficulty passing stool
  • Pain in the abdomen
  • Irregular heartbeat sensations
  • Exhaustion
  • Long-term kidney inflammation
  • Congestive cardiac failure
  • Sweating of the limbs
  • Labored breathing
  • Obstructive painful condition
  • Underactive adrenal glands
  • Swelling from fluid retention
  • Stubborn, treatment-resistant arthritis
  • Cholera infection
  • Yellowing of the skin and eyes
  • Heat lodged in the Intestines
  • Circulatory shock
  • Long-standing colon inflammation
  • Non-organic uterine bleeding
  • Repeated canker sores
  • Prolapse of the stomach
  • Ordinary cold
  • Coughing
  • Queasiness and emesis
  • Loose stools
  • Loss of appetite
  • Physical debility
  • Long-term kidney failure
  • Sweating without exertion
  • Impaired digestion
  • Painful menstruation

Modifications

Cautions

  • This formula is contraindicated for patients presenting with True Heat with False Cold (C.M.: cold extremities, thirst with a desire for cold drinks, dark urine, T: Red, C: Yellow).
  • Discontinue use of this formula as soon as the hands and feet regain warmth.