Formula Database


Si Ni Tang

(Frigid Extremities Decoction)

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

Category: Formulas that Warm Interior Cold

Pattern: Cold inversion Shaoyin disorder (Kidney Yang deficiency with internal Cold)

Key Symptoms: Extremely cold extremities, aversion to cold, lethargy with a constant desire to sleep
Secondary Symptoms: Lying down in foetal position, vomiting, diarrhoea with undigested food particles, painful and cold abdomen, increased urination, absence of thirst

Tongue: Pale, little or thin white coating
Pulse: Thin, submerged, faint
Abdomen: Weak muscle tone, skin folds can be easily lifted up, splashing sounds


Ingredients
Fu Zi 5-15g
Gan Jiang 5-9g
Zhi Gan Cao 6g

Subsitutions:
In the UK Fu Zi has 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: Rescues devastated Yang, warms the middle Jiao, stops diarrhoea

Contraindications: True heat and false cold (Si ni san presentations)


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.