Si Ni San Wan - Frigid Extremities Powder Pills

Herbal Formula Database

Si Ni San Wan Herbal Formula Classifications and Usages

The herbal formula "si ni san wan" , 四逆散, which in english is "frigid extremities powder pills", is categorized within the "harmonize" functional grouping and within the "regulate and harmonize the liver and spleen" sub-category.

You may also see this formula referenced by: Si Ni Wan, Frigid Extremities Formula, Frigid Extremities Decoction, Four Pillars Teapills.

Of many possible clinical applications, it may be considered to influence the following issues/symptoms:

  • Important formula for liver qi stagnation - manifesting as moodiness, depression, cold in the extremities (particularly hands and/or feet), possibly along with other stress signs - mild headaches, teeth grinding, facial twitching, etc.
  • A range of liver "attacking" the spleen digestive issues, hypochondriac, abdominal and/or epigastric pain.  Sensation of tension in the chest that worsens with stress.
  • All of the above symptoms that come along with menstruation.

Si Ni San Wan has some precautions to be considered (see our precautions list).

  • Not for cold extremities from yang or Blood deficiency.
  • Use with caution or avoid in very weak patients who cannot sustain the movement that this formula creates.

Our shop contains si ni san wan from the following manufacturer:

($9.99) Add To Cart View Si Ni San Wan - HBW

For many reasons such as availability, ecological choices, and/or price, each manufacturer or herbalist may well adjust the exact composition of a specific formula. Si Ni San Wan is generally comprised of the following herbs:

ViewBai Shao (White Peony Root)

Nourishes the blood and regulates menstrual problems due to blood deficiency (pale, lusterless complexion and nails) - menstrual dysfunction, vaginal discharge, uterine bleeding - very common herb fo…

ViewChai Hu (Thorowax Root, Bupleurum)

Clears shao yang disorders and reduces fever - alternating chills and fever, bitter taste in the mouth, irritability, vomiting, stifling sensation in the chest. Relieves liver qi stagnation (often u…

ViewZhi Gan Cao (Honey Fried Licorice Root)

This preparation increases the qi tonifying aspects of the heart and spleen along with its general harmonizing function within formulas.  See Gan Cao for complete information.

ViewZhi Shi (Immature Bitter Orange)

Breaks up Qi stagnation, reduces accumulations, transforms phlegm - epigastric or abdominal pain and distention or indigestion w/focal distention or gas. Directs qi downward and unblocks bowels - fr…

A single formula, alone, may not be sufficient to fully address a particular TCM diagnostic pattern. Formulas may be used alone, in combinations, and/or in stages. Si Ni San Wan is a candidate for consideration when needing to influence liver attacking the spleen, liver qi stagnation and/or stomach rebellious qi.

Si Ni San Wan may potentially be used, in coordination with a well tailored overall approach, to influence the following conditions: depression, hypochondriac pain, irritability and/or premenstrual syndrome (pms)

As noted above, si ni san wan is within the harmonize functional group. And it appears within the sub-category "regulate and harmonize the liver and spleen", which contains the following formulas:

ViewChai Hu Shu Gan Wan (Bupleurum Powder to Spread the Liver)

Liver qi stagnation signs - hypochondriac tension, abdominal pain, IBS symptoms Alternating chills and fever.

ViewDa Bu Gan Wan (Major Liver Nutrition Pills)

Brittle nails, yellowing of the skin (jaundice). Abdominal cramping, distension or pain in the hypochrondia due to liver qi stangation Fatty liver, hepatitis and other liver diseases. 

ViewJiang Ya Wan (Repress The Blood Pressure Pills)

Hypertension particularly with ascendent yang and heat signs - red face, red tongue, headaches, irritability, anxiety, insomnia, etc.

ViewJia Wei Gui Pi Wan (Augmented Restore The Spleen Decoction)

A combination of jia wei xiao yao wan and gui pi wan - similar effects but with more spleen qi and blood tonification. A range of stress related issues - essentially mixes of stagnation with underly…

ViewJia Wei Xiao Yao Wan (Free and Easy Wanderer Pills)

Derived from the base formula, xiao yao wan, an important formula for liver qi stagnation with herbs added to clear heat. Liver qi stagnation - menstrual issues, painful cycles, irregular cycles, br…

ViewPian Tou Tong Wan (Migraine Pills)

Headaches and/or migraines caused by liver yang or liver fire rising.

ViewPing Gan Liu Qi Yin Wan (Dang Gui And Pinellia Combination)

Liver qi stagnation with blood deficiency heat - signs of heat, red eyes, possibly anxiety and/or irritability, etc. along with digestive issues such as gastritis, cirrhosis, cholecystitis, hernia.…

ViewShao Yao Gan Cao Wan (Peony and Licorice Decoction)

Cramping and/or muscle spasms that are due to fluid deficiency. Frozen shoulder, trigger finger. General tightness or cramps especially along the tendons or ligaments. Restless leg syndrome for pa…

ViewShu Gan Wan (Liver Comfort Pills)

Abdominal and/or Hypochondriac pain, cramps or spasms resulting from liver qi stagnation. Alternating chills and fever. Nausea, bloating, acid reflux, alternating stools, or IBS like symptoms cause…

ViewTong Xie Yao Fang Wan (Important Pills for Painful Diarrhea / Calm Wind Pills)

Diarrhea, particularly with abdominal cramping. Diarrhea with alternating constipation.

ViewXiao Chai Hu Tang Wan (Minor Bupleurum Decoction)

Shao Yang Syndrome (or "lesser yang stage") - alternating fever and chills, hypochondriac pain, irritability, bitter taste in mouth, poor appetite, nausea.  Often used for illnesses (chronic or short…

ViewXiao Yao Wan (Free and Easy Wanderer)

Depression, anxiety, loss of motivation - resulting from liver qi stagnation. Fatigue, bloating, changes in appetite from the combination of spleen qi deficiency with liver qi stagnation. PMS, brea…

ViewYi Gan Wan (Restrain The Liver Powder)

Anxiety, palpitations, easily frightened, alternating fevers/chills; heat from deficiency in the liver.Originally designed for Children who had issues such as anger, fright, fevers, insomnia, digesti…

All formulas in the primary category of "harmonize" are listed below.

(truncated intro "...this group of formulas is for internal conditions involving the lesser yang stage of disease (alternating fever and chills). generally thes…)".

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