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Si Ni San (Frigid Extremities Powder)

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  • Formulas that Harmonize Lesser Yang-stage Disorders


  • Liver (Qi Stagnation) attacking the Spleen and Stomach


  • Spreads Liver Qi and regulates the Spleen
  • Eliminates internal heat and reduces stagnation.


  • Cool or cold extremities (fingers and toes)
  • Possible irritability with distension and fullness in the epigastria and chest.
  • Bitter taste in the mouth and dry throat.
  • Possible abdominal pain with diarrhea.
  • Dysmenorrhea and distending breast pain.

Possible Tongue Appearance:

  • Red or dusky tongue with a yellow coat

Possible Pulse Patterns:

  • Wiry pulse, possibly rapid

Western Uses:

  • Gastritis
  • Peptic Ulcer
  • Cholecystitis
  • Cholelithiasis
  • Hepatitis
  • Intestinal Obstruction
  • Mastitis
  • Breast Fibroids
  • Hernia
  • Pancreatitis

Cautions, Contraindications, Herb Drug Interactions:

  • Do not use in cases where cold extremities are due to Blood deficiency from true heat and false cold
  • Use with caution in cases of excess Yin with full cold or Yang deficiency with empty cold.

Preparation Notes:

  • Decoction.

Originally Appeared In:

  • On Cold Damage (Shang Han Lun)

Combined Channels of all herbs in this formula:

  • Pericardium, Gall Bladder, Liver, Large Intestine, Stomach, Spleen

Substances in this Formula (4 Total):

Chai Hu (Radix Bupleuri)
Chai Hu (Thorowax Root , Bupleurum) 柴胡
Qty: 9-12 grams
Chan: GB, LIV, PER, TB
Prop: Bitter, Spicy, Cool
Latin: Radix Bupleuri
Cat: Cool, Spicy Herbs that Release the Exterior
Zhi Shi (Fructus Immaturus Citri Aurantii)
Zhi Shi (Immature Fruit of the Bitter Orange) 枳实
Qty: 9-12 grams
Chan: LI, SP, ST
Prop: Bitter, Spicy, Slightly Cold
Latin: Fructus Immaturus Citri Aurantii
Cat: Herbs that Regulate the Qi
Bai Shao (Radix Albus Paeoniae Lactiflorae)
Bai Shao (White Peony Root) 白芍
Qty: 12-24 grams
Chan: LIV, SP
Prop: Bitter, Sour, Cool
Latin: Radix Albus Paeoniae Lactiflorae
Cat: Herbs that Tonify Blood
Zhi Gan Cao (Radix Glycyrrhizae)
Zhi Gan Cao (Honey Fried Licorice Root) 炙甘草
Qty: 6-9 grams
Chan: All 12 Channels
Prop: Sweet, Warm
Latin: Radix Glycyrrhizae
Cat: Herbs that Tonify Qi
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