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Frigid Extremities Powder

Frigid Extremities PowderFormula Image

Frigid Extremities Powder
ChiefChai Hu
    • soothes the liver and resolves constraint
    • vents pathogens through the exterior
This combination is commonly used to regulate the liver.
DeputyBai Shao
    • nourishes the blood and softens the liver
This combination is commonly used to regulate the liver.
AssistantZhi Shi
    • rectifies qi and resolves constraint
    • combined with chai hu, simultaneously ascends and descends the qi, which may strengthen the power to soothe and free the movement of qi
    • combined with shao yao, it moves qi and harmonizes blood, which may regulate and harmonize qi and blood
EnvoyGan Cao
    • harmonizes the all of the medicinals in the formula

Frigid Extremities PowderPrescription Information

Name
Frigid Extremities Powder
Chinese Name

四逆散

Classification

Harmonizing formulas

Combination
Bupleuri Radix (Chai Hu) 10 fen (6g), Paeoniae Radix Alba (Shao Yao) 10 fen (6g), Aurantii Fructus Immaturus (Zhi Shi) 10 fen (6g), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gan Cao) 10 fen (6g)
Method
Grind all of the medicinals into powder and mix them together. Take the powder with rice gruel three times a day. (Modern: Prepare it as a decoction.)
Action
Moves qi, resolves the constraint, soothes the liver, and rectifies the spleen.
Indication
1. Pattern of yang constraint and reversal counterflow cold of the limbs, marked by a lack of warmth in the extremities, abdominal pain, diarrhea, dysentery tenesmus, and a wiry pulse.
Pathogenesis
Originally Si Ni San is used to treat “counterflow cold of the four limbs in a shaoyin pattern”. Counterflow cold of the four limbs here actually refers to a lack of warmth in the extremities. When the exterior pathogen invades the internal body via the channels, constraint and stagnation of the qi movement occurs. Disordered qi flow causes yang qi constraint, which results in a lack of warmth in the extremities. Later doctors broadened its scope by using it for distention and fullness in the rib-side, and pain in the stomach cavity and abdomen due to liver and spleen constraint and stagnation. The treatment is to move qi, resolve constraint, soothe the liver, and rectify the spleen.
Application
1. Essential pattern differentiation Si Ni San treats the patterns of yang constraint and reversal counterflow cold of the limbs, which is its original indication. However, later doctors use it as a basic formula to soothe the liver and rectify the spleen. This clinical pattern is marked by lack of warmth in the extremities, pain in the rib-side, stomach cavity, and abdomen, and a wiry pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of qi constraint of liver and gallbladder, liver-spleen disharmony, or liver-stomach disharmony: chronic hepatitis, cholecystitis, cholelithiasis, biliary ascariasis, intercostal neuralgia, ulcers, gastritis, gastrointestinal neurosis, annex inflammation, tubal obstruction, and acute mastitis.
Additonal formulae
1. Chai Hu Shu Gan San (Bupleurum Liver-Soothing Powder, 柴胡疏肝散)
Source
《Treatise on Cold Damage》Shang Han Lun《傷寒論》

Frigid Extremities PowderFormulation composition herbal medicine

Immature Bitter Orange

Immature Bitter Orange

Aurantii Fructus Immaturus
Functions：Breaks qi, resolves accumulation, transforms phlegm, disperses focal distention. Apply to inner stagnation, fullness and distention and swelling pain, constipation, diarrhea and tenesmus, chest stasis, ptosis of the stomach; uterine prolapse; prolapse of the anus.
Liquorice Root

Liquorice Root

Glycyrrhizae Radix et Rhizoma
Functions：Supplements the spleen, boosts qi, clears heat, resolves toxin, dispels phlegm, relieves cough, relaxes tension, relieves pain, harmonizes the nature of other medicinals.
Chinese Thorawax Root

Chinese Thorawax Root

Bupleuri Radix
Functions：Harmonizes the interior and exterior, courses the liver, resolves depression, outthrust the exterior, discharge heat, upbears yang, and raises the sunken. Apply to cold and pyrexia, spell of fever and chills, malaria, stagnation f liver and qi, gastric and costal swelling pain, anal prolapsed, uterine prolapse, irregular menses.
White Peony Root

White Peony Root

Paeoniae Radix Alba
Functions：Nourishes the blood, regulates menstruation, calms the liver, relieve pain, astringes yin, stops sweating. Apply to thoracic, abdominal and costal pains, abdominal pain due to dysentery, spontaneous perspiration and night sweat, fever with yin deficiency, irregular menstrual periods, metrorrhagia and metrostaxis, leukorrhea.
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