Si Ni San
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Si Ni San #2059

Pin Ying Name: Si Ni San

English Name: Frigid Extremities Decoction

Chinese Name: 四逆散

Herbs & Actions
Pharmaceutical Latin Pin Yin Dosage Actions
Rx. Bupleuri Chai Hu 5-12g

Resolves Shao Yang disorders, reduces fever, resolves Phlegm and congestion, disperses Wind-Heat, regulates Qi, relieves Stagnation and eliminates Heat.

Fr. Aurantii Immaturus Zhi Shi 2-12g

Breaks up Stagnant Qi, reduces accumulation, descends Qi, unblocks the bowels and removes stagnant food to relieve Stagnation in the Middle Jiao and help restore the Spleen's function of transformation and transportation.

With Zhi Shi for abdominal pain due to Qi and Blood Stagnation.

Rx. Paeoniae Alba Bai Shao 4-24g

Nourishes the Liver, nourishes the Blood, regulates menstruation, astringes and protects the Yin, calms Liver Yang, alleviates pain and adjusts the Ying and Wei.

With Zhi Gan Cao, moderates painful abdominal spasms. With Chai Hu for flank pain due to Liver Qi Stagnation.

Honey-fried Rx. Glycyrrhizae Zhi Gan Cao 1.5-9g

Tonifies the Spleen, augments Qi and moderates and harmonizes the properties of other herbs.

With Bai Shao, moderates painful abdominal spasms.

Formula Actions
  • Releases the Exterior
  • Regulates Liver and Spleen
  • Relieves Stagnation
  • Spreads Liver Qi
  • Eliminates Heat in the Interior
  • Relieves mental depression
Syndromes
  • Jue Yin Heat
  • Shao Yin Heat
  • Liver and Spleen Disharmony (Liver Attacking the Spleen) with costal or abdominal pain and menstrual complaints
  • Gu Syndrome
Clinical Manifestations
  • Cold fingers and toes with Heat in the Interior
  • Irregular fever
  • Hypochondriac fullness and distention
  • Distention, pain or a stuck feeling in the Stomach, lower abdomen or intercostal regions
  • Abdominal pain
  • Severe diarrhea
  • Dysentery
  • Costal pain
  • Menstrual complaints
  • Depression
  • Cough
  • A slight sensation of warmth in the body
  • Body hot and feverish due to lack of harmony of the Liver Qi
  • Thirst
  • Mild constipation
  • A sense of irritability and fullness in the chest and epigastrium
  • Mild obstruction and hardening beneath the Heart
  • A visible white line running from the navel to the tip of the breastbone
  • Mild abdominal distention
  • Abdominal spasms
  • Dry, swollen eyes
  • Tenesmus
  • Dysuria
  • Diarrhea
  • Dark yellow urine
  • T: Red or pale
  • C: Thin yellow or white or Greasy yellow or white
  • P: Wiry or Wiry and tight or Wiry and slippery
Treats
  • Gastritis
  • Gastric ptosis
  • Peptic ulcer
  • Cholecystitis
  • Cholelithiasis
  • Hepatitis
  • Intestinal obstruction (adhesive)
  • Mastitis
  • Fibrocystic breast disease
  • Syncope (due to Heat)
  • Gastric neuralgia
  • Intercostal neuralgia
  • Biliary ascariasis
  • Liver cirrhosis
  • Acute and chronic gastritis
  • Adnexitis
  • Impotence
  • Candidiasis
  • Obesity
  • Alternating diarrhea and constipation (hard pellet-like stools)
  • Premenstrual syndrome
  • Coronary artery disease
  • Enuresis
  • Blocked fallopian tubes
  • Trigeminal neuralgia
  • Epidemic hemorrhagic fever
  • Irritable bowel syndrome
  • Chronic tonsillitis
  • Pertussis
  • Gu syndrome
  • Otitis media
  • Meniere's disease
  • Neurasthenia
  • Abdominal pain
  • Abdominal spasms
  • Hiatus hernia
  • Indigestion
  • Neck tension
  • Chronic fatigue syndrome
  • Pancreatitis
  • Acute appendicitis
  • Gastric ulcer
  • Pleurisy
  • Rhinitis (one sided, with yellow mucus)
  • Sinusitis (one-sided, with yellow mucus)
  • Neurosis
  • Epilepsy
  • Tubercular peritonitis
  • Hernia
  • Acrocyanosis
  • Diarrhea (Smelly and painful)
  • Allergic colitis
  • Superficial gastritis
  • Ulcerative colitis
  • Infertility
  • Leaky gut syndrome
  • Giardiasis
  • Urinary calculi
  • Dysmenorrhea
  • Neurogenic headache
  • Stress incontinence
  • Perimenopausal syndrome
  • Encapsulated periappendicular abscess
  • Autonomic dystonia
  • Amenorrhea
  • Endometriosis
  • Chronic bronchitis
  • Fever
  • Nausea/Vomiting
  • Morning sickness
  • Depression
  • Abdominal fullness and distention
  • Impotence
  • Acid reflux
  • Gastroenteritis
  • Raynaud's disease
  • Shoulder tension
Contraindications
  • Contraindicated for those with cold extremities due to other causes.