FOUR-SUBSTANCE DECOCTION
(si wu tang)

AVAILABLE IN TINCTURE FORM: code # 04090
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Composition: Rehmanniae; Paeoniae; Angelica sinensis and Ligustici chuanxiong.

Action: Invigorates and tonifies the blood, regulates menstruation.

Indication: Stagnation of nourishing blood due to deficiency, palpitation and insomnia, dizziness and vertigo, pale complexion, irregular menstruation with scanty flow, lower abdominal and periumbilical pain, pale tongue and thin pulses.

Analysis of formula:

1. Angelica sinensis (dang gui), invigorates the blood and nourish the liver. Tonifies blood and nourishes the heart, it also moistens the intestine (to treat constipation). The minister herb.
2. Paeoniae, tonifies the blood and pacifies the liver, harmonizes internal (organs). Assistant herb.
3. Rehmanniae glutinosa, nourish the yin of the blood, king herb. Use together with dang gui reinforces the blood tonifying action.
4. Ligustici chuanxiong, acts to invigorate the blood and promote the movement of qi. It thereby alleviates areas of constraint and stops the pain.
5. The formulation is aim at deficiency and insufficient circulation of blood. The liver is the storage organ of blood, deficiency leads to undernourishment of the liver, insufficient blood reaching the head causing dizziness and vertigo.
6. The heart controls blood circulation and resides the mind, deficient blood fail to nourish the heart and leads to anxiety, palpitation and insomnia.
7. Deficient blood also causes pale complexion, nails and lips, scanty flow and irregular menstruation.
8. Blood deficiency often causes blood stagnation.

Notes: This is a very effective formula for tonifying the blood and regulating menstruation. It is also the most important foundation formula for blood deficiency, combining four synergistically acting herbs. It can be used alone or to reinforce other products. It is a popular postmenstrual and postpartum tonic for women. When combined with Si Jun Zi Tang (Four-Gentlemen's Decoction), it becomes Ba Zhen Tang (Eight-Treasure Decoction), a popular tonic for deficiency of both qi and blood. With appropriate presentation, this formula may be used in treating disorders such as primary dysmenorrhea, irregular menstruation, anemia, postpartum weakness, eczema, dermatitis, urticaria, allergic purpura and neurogenic headache.

Cautions and contraindications: This formula is appropriate for chronic conditions which are not too severe. It should not be used in treating acute, severe blood loss or other problems of blood deficiency which include severe weakness and labored breathing. Patients with constitutional deficiency of Spleen Yang with poor appetite and loose stool, should take this formula with herbs that strength the digestive system (i.e., Four-Gentlemen's Decoction, Si Jun Zi Tang, see next formula). Stop taking this formula during menstruation and pregnancy.

Research: In 44 cases of headache with dizziness or insomnia treated with a short course of Si Wu Tang, 23 cases showed no reoccurrence for six month, and 13 showed significant improvement.

Analysis of synergistic action:

1. All the qi tonic formulations starts with Four-Gentlement's Decoction.
2. All the blood tonic formulations starts with Four-Substance Decoction.
3. To tonify qi one should seek after "Spleen (digestive system) and Lung".
4. To tonify blood one should seek after "Liver and Kidney".
5. Rehmanniae enters Kidney meridian, strengthening water (kidney's function) and tonify the yin.
6. Paeoniae enters liver meridian, controlling yin and benefit's the blood. The above two herbs are "the blood tonifier".
7. Because blood deficiency often causes blood stagnation, blood may not flows smoothly within the meridian channel passages. This is why Angelica sinensis and Ligustici chuanxiong are added. These two herbs are acrid, fragrance, warm and moist, can nourish and move the blood and promote circulation.
8. In short, this is the formula that regulates all blood related symptoms.

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