【Chinese Name】 |
當歸四逆湯
|
【Phonetic】 |
Dang Gui Si Ni Tang
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【English Name】 |
Chinese Angelica Frigid Extremities Decoction |
【Classification】 |
Warming interior formulas |
【Source】 |
《Treatise on Cold Damage》Shang Han Lun《傷寒論》 |
【Combination】 |
Angelicae Sinensis Radix (Dang Gui) 3 liang (12g), Cinnamomi Ramulus (Gui Zhi) 3 liang (9g), Paeoniae Radix Alba (Shao Yao) 3 liang (9g), Asari Radix et Rhizoma (Xi Xin) 3 liang (3g), Glycyrrhizae Radix et Rhizoma (Gan Cao) 2 liang (6g), Tetrapanacis Medulla (Zhi Tong Cao liquid-fried) 2 liang (6g), Jujubae Fructus (Da Zao) 25 pcs (8 pieces) |
【Method】 |
Decoct all seven medicinals with eight sheng of water, boil them until three sheng of water is left, and remove the dregs. Take the decoction warm three times a day. (Modern use: prepare as a decoction.) |
【Action】 |
Warms the channels to expel cold, nourishes the blood and unblocks the channels. |
【Indication】 |
Counterflow cold of the limbs due to blood deficiency is characterized by counterflow cold of hands and feet, pain in the waist, thighs, lower legs, feet, shoulders, and back, no thirst, a pale tongue body with a white coating, and a deep, thin pulse or thin, impalpable pulse. |
【Pathogenesis】 |
This pattern is caused by the combination of blood deficiency and cold accumulation in the channels, which result in poor blood circulation. The blood is chronically deficient and the channels have been invaded by pathogenic cold; therefore, there is poor blood circulation due to deficient blood obstructed by the pathogenic cold accumulated within the vessels. In this event, the hands and feet become very cold and the pulse is thin and impalpable because blood fails to supply the vessels and yang fails to reach the four extremities. Dang Gui Si Ni Tang treats counterflow cold of the hands and feet. Specifically, it treats cold below the wrist and ankle, which differs from counterflow cold of the four limbs. The proper treatment is to warm the channels, expel cold, nourish the blood, and unblock the channels. |
【Application】 |
1. Essential pattern differentiation Dang Gui Si Ni Tang is commonly used to nourish blood and warm the channels in order to expel cold. This clinical pattern is marked by counterflow cold of the four limbs, pale tongue body with a white coating, and a thin, impalpable pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of blood deficiency and cold accumulation: thromboangitis obliterans, Takayasu's arteritis (pulseless disease), Raynaud’s phenomenon, polio, chilblain, dysmenorrhea, periarthritis of shoulder, and rheumatoid arthritis. |
【Additonal formulae】 |
1. Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang (Chinese Angelica Frigid Extremities Decoction Plus Evodia and Fresh Ginger 當歸四逆加吳茱萸生薑湯) [Source]《Treatise on Cold Damage》Shang Han Lun《傷寒論》 [Ingredients] Dang gui 3 liang (12g), shao yao 3 liang (9g), zhi gan cao 2 liang (6g), tong cao 2 liang (6g), gui zhi 3 liang (9g), wu zhu yu 2 sheng (9g), da zao 25 pieces (8 pieces), xi xin 3 liang (9g), sheng jiang 0.5 jin (12g) [Preparation and Administration] Decoct the nine medicinals with 6 sheng of water and 6 sheng of wine until 5 sheng left, remove the remainder and take the warm decoction five times a day. [Actions] Warms yang and dispels cold, nourishes blood and unblocks blood vessels, harmonizes the center and arrests vomiting. [Applicable Patterns] Blood deficiency and cold accumulation, counterflow cold of hands and feet, accompanied with vomiting and painful abdomen due to stomach cold. 2. Huang Qi Gui Zhi Wu Wu Tang (Astragalus and Cinnamon Twig Five Substances Decoction 黃芪桂枝五物湯) [Source]《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 [Ingredients] Huang qi 3 liang (9g), shao yao 3 liang (9g), gui zhi 3 liang (9g), sheng jiang 6 liang (18g), da zao 12 pieces (4 pieces) [Preparation and Administration] Decoct the five medicinals with 6 sheng of water until 2 sheng left, remove the remainder and take the warm decoction three times a day. [Actions] Boosts qi and warms the channels, harmonizes the blood, and relieves bi. [Applicable Patterns] Blood bi. Symptoms include: numbness of the skin, and a choppy, tight, and unsmooth pulse. |
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