Si Ni San SiNiSan Frigid Extremities Powder Pills 四逆散 Si Ni Wan, Frigid Extremities Formula, Frigid Extremities Decoction, Four Pillars Teapills si ni frigid extremities formula

Si Ni San Wan - Frigid Extremities Powder Pills

四逆散

Also known as: Si Ni Wan, Frigid Extremities Formula, Frigid Extremities Decoction, Four Pillars Teapills

Clinical Usage

  • 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.

Formula Combinations

  • Chai Hu Shu Gan Wan is another alternative for similar range of issues.

Cautions & Precautions

  • 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.
Relationships
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Formulas Related by Clinical Functions

Si Ni San Wan is in the "Regulate and Harmonize the Liver and Spleen" group within the "Harmonize" category.

Other Formulas in "Regulate and Harmonize the Liver and Spleen" (13)

Other Formulas in "Harmonize" (14)

Common Formula Ingredients

Si Ni San Wan is generally comprised of the following 4 ingredients:

Bai Shao
Bai 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 for gynecological disorders (Si Wu Tang).
  • Calms liver yang, alleviates pain from constrained liver qi or disharmony between the liver and the spleen due to liver yang rising - cramping and spasms (limbs and abdomen), abdominal pain from dysentery, headache and dizziness.
  • Preserves yin, adjusts ying and wei levels - vaginal discharge and spermatorrhea, exterior wind-cold from deficiency with continuous sweating, spontaneous sweating, night sweats.
Bai Shao is also included in 38 formulas
Chai Hu
Chai 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 used with Bai Shao) - vertigo, menstrual disorders, chest and flank pain, the most common herb to treat stress, irritability, depression, etc.; also for liver and spleen disharmony - bloating, nausea, indigestion, flank pain.
  • Raises yang qi in spleen and stomach deficiency patterns (often used with Sheng Ma) - prolapsed organ, diarrhea, hemorrhoids.
Chai Hu is also included in 23 formulas
Zhi 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.
Zhi Gan Cao is also included in 21 formulas
Zhi 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 - frequently used for abdominal pain and constipation by accumulation and stagnant Qi.
  • Transforms phlegm and expels focal.
  • Used with Qi tonifying herbs for the prolapse of organs.
  • Raises blood pressure.
Zhi Shi is also included in 8 formulas