Four Gentlemen Decoction

Four Gentlemen Decoction

Ginseng Radix et Rhizoma (Ren Shen) 3 liang (9g), Atractylodis Macrocephalae Rhizoma (Bai Zhu) 3 liang (9g), Poria (Fu Ling) 3 liang (9g), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gan Cao) 2 liang (6g)

Grind all of the medicinals into a thin powder. Decoct fifteen grams together with one zhan of water until thirty percent of the water has vaporized. Take it orally whenever necessary. A little salt may be added to the powdered medicinals, but it is not necessary. (Modern use: prepare as a decoction.)

Boosts qi and fortifies the spleen.

Si Jun Zi Tang is indicated for patterns of spleen-stomach qi deficiency. Clinical manifestations include a pale, lusterless facial complexion, a faint, low voice, shortness of breath, and thin, unformed stool. The tongue is pale with a white coating. The pulse is deficient and weak.

This pattern is caused by spleen-stomach qi deficiency that hinders the transportation and transformation process. The spleen and stomach are the foundations of the postnatal constitution and the source of qi and blood production. When they become deficient there is not enough energy to support food digestion and absorption, which causes there to be less food intake. Internal damp-turbidity may follow spleen-stomach deficiency, which leads to thin, unformed stools. Since the spleen governs the muscles and limbs, and the nutrients transformed by a deficient spleen are far from enough, patients may lack strength. When this deficiency affects the qi and blood production, patients may develop a pale complexion because there is not enough blood going upward to nourish the face. The spleen is the mother to the lung, so lung qi may also become impaired and cause shortness of breath and a faint, low voice. The tongue and pulse signs all indicate qi deficiency. In this condition, the treatment is to supplement and boost the spleen-stomach qi in order to re-establish normal transportation and transformation.

1. Essential pattern differentiation Si Jun Zi Tang is a basic formula used to supplement qi, and is commonly used to treat patterns of spleen-stomach deficiency. Many formulas developed in later generations, that supplement the spleen and boost qi, are derived from it. This clinical pattern is marked by pale complexion, poor appetite, shortness of breath, lack of strength in the four limbs, pale tongue with white coating, deficient, weak pulse. 2. Modern applications This formula may be used to treat chronic gastritis, gastric ulcer, and duodenal ulcer when the patient shows signs of spleen qi deficiency.

1. Yi Gong San (Special Achievement Powder 異功散)

Ginseng ( Panax ginseng ) is listed in the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) Appendix II. Its trade is allowed but subject to licensing controls.