Chinese Angelica Frigid Extremities Decoction

Chinese Angelica Frigid Extremities Decoction

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)

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.)

Warms the channels to expel cold, nourishes the blood and unblocks the channels.

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.

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.

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.

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)