Si Ni TANG 四逆湯 – Frigid Extremities Decoction Formulas

Note that Si Ni TANG is very different than the formula SI NI SAN. This is because the symptom of cold hands and feet (frigid extremities) can have different causes, implying totally different treatments.  

One cause of cold hands is Devastated YANG causing internal cold, and is addressed by this formula, Si Ni TANG (frigid extremities DECOCTION).

Another common cause of these symptoms is a tightening of the Qi of the chest, which constrains the flow of Qi and Blood to the arms and hands.  This is called Liver Qi Stagnation.  It is addressed by the formula, SI NI SAN (frigid extremities POWDER).  

 Si Ni TANG – Frigid Extremities Decoction Ingredients

1. FU ZI
2. GAN JIANG
3. ZHI GAN CAO
4. HONG SHEN (in tablets only)

Si Ni TANG’S TCM Uses

• Rescues Devastated Yang
• Warms the Interior
• Curtails Diarrhea

Si Ni TANG Safety

Do not use for cold extremities cause by Liver Qi Stagnation.

Do not use with Yin deficiency or heat caused by Yin deficiency.

Pregnant or nursing women should consult their health care provider before taking any supplement.

Traditional Chinese Medicine is powerful and reliable, but it can be complex. As TCM is not based on symptoms alone, self-diagnosis and self-treatment aren’t recommended. Best to start a low cost online-herbal-consultation.

Si Ni TANG Dosage & Administration

Granules: 2-4 grams, taken 2-3 times a day, best on an empty stomach

Whole Herbs: The potent odors and flavors of Chinese herbs are legendary. Boiling the herbs and drinking the tea will provide the fullest experience of these medicines. 

In a ceramic, glass, or stainless steel pot (no aluminum, iron or copper), boil 1 packet of herbs in 1-2-quarts of water or until 2 cups of medicine remain. Strain herbs; save and refrigerate for a second boiling. Drink 1 cup in the AM. And 1 cup in the PM. If desired, repeat the following day, using the saved herbs from the refrigerator.

On Boiling Times for Chinese Herbal Decoctions

Commonly, Chinese herbs are boiled for 20 – 60 minutes. Boiling times are determined by the composition of the formula. Flower and leaf will yield medicine in 5 -20 minutes. Roots take 20 to 40 minutes; Shells and minerals must cook for at least one hour. A few herbs, like mint or tangerine peel, must be quick-boiled for only 1-5 minutes to retain their volatile oils. These herbs are added separately to the boiling mixture just before completion.  Some powdered herbs and tree saps, are not cooked but are added to the hot strained decoction.

* What’s the Difference Between, PIAN, WAN, TANG, SAN, SHUI and GAO?

• PIAN = Tablet (modern looking pill)
• WAN = Pill (old-style or handmade pill, or black teapill)
• TANG = Water Decoction (boiled whole herbs)
• SAN = Powder (milled or granulated)
• SHUI = Tincture (extract with alcohol or other solvent)
• GAO = Paste (topical unguent or plaster)

* These statements have not been evaluated by the US Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.