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Si Ni Tang 四逆湯
Frigid Extremities Decoction
Frigid Extremities Decoction
Tradition:
TCM
Source / Author:
Discussion of Cold-induced Disorders (Shang Han Lun)
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Herb Name
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Preparation:
Prepare a standard decoction, cooking the Aconite for 45 minutes before adding the other herbs.
Originally, raw Aconite was ordered, but due to its high toxicity, prepared Aconitum Fu Zi is usually used. When raw Aconite is used, it requires prolonged cooking.
Function:
Rescues Yang, Warms the Stomach, Stops Diarrhea
Use:
Very cold extremities, always tired, cold abdominal pain, diarrhea, vomiting, pale tongue with a white coating, deep, thin and weak pulse.
1. Vomiting and Diarrhea from chronic Gastroenteritis
2. Edema
3. Chronic Nephritis
4. Chronic Renal Failure
5. Hypopituitarism
6. Hypothyroidism
7. Adrenal insufficiency
8. Chronic, severe Arthritis
9. Chronic Prostatitis
10. Cardiac Insufficiency
Dose:
The above decoction is divided into 3 equal doses to be taken over the course of a day.
Cautions:
1. Avoid overdose. If using full doses of Aconite, begin with lesser doses.
2. Not used in Heat conditions
3. Not used in Cold extremities caused by "True Heat and False Cold", marked by cold extremities with a red tongue and yellow coating, and a fast pulse.
Modifications:
1. For marked Qi deficiency, add Ginseng. This is called Ren Shen Si Ni Tang.
2. Chronic Arthritis, add Paeonia Bai Shai, Atractylodes Bai Zhu, Cinnamon twig (Gui Zhi)
3. Chronic, Severe Arthritis, add Cinnamon (Rou Gui), Atractylodes Bai Zhu
4. Chronic Edema, add Poria Fu Ling, Alisma Ze Xie
5. Severely cold extremities, add Asarum Xi Xin, Cinnamon twig (Gui Zih)
6. Shortness of Breath, add Ginseng (Ren Shen)
7. Edema with Palpitations, add Poria Fu Ling, Ginseng (Ren Shen)
8. Diarrhea with undigested food from Stomach Cold, take with Li Zhong Wan.
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