Herb Formulas Notebook

Tong Mai Si Ni Tang

Unblock the Pulse Decoction for Frigid Extremities

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Source: Discussion of Cold Damage (c. 220)
Author: Zhang Ji / Zhong-Jing

Category: Formulas that Warm Interior Cold

Pattern: Shaoyin disorder with true Cold in the Interior and false Heat in the Exterior, or severe Heat Yang deficiency

Key Symptoms: Diarrhoea with undigested food in the stool, cold extremities, no aversion to cold
Secondary Symptoms: Flushed face, dry retching, pain in the throat

Pulse: Faint, hidden or almost imperceptible.

Zhi Gan Cao 6g
Sheng Fu Zi 12-24g
Gan Jiang 9-12g

In modern practice Sheng Fu Zi is always replaced with the less toxic Zhi Fu Zi. In the UK both have to be replaced although no useful substitute can be made in this context making the inclusion of this formula for reference only. For a less severe presentation using the maximum amount of Gan Jiang to warm the middle and adding Gui Zhi to warm the extremities may be possible but this would not be a Shaoyin Cold Inversion pattern.

Preparation: Decoction.

Actions: Restores the Yang and unblocks the pulse

Research Links:
Science Direct
Google Scholar
Journal of Chinese Medicine
American Dragon

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.