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Si Ni Tang (Frigid Extremities Decoction)

Previous Formula in CategoryNext Formula in Category Formula 8 of 10 in Formulas that Warm Interior Cold


  • Formulas that Warm the Channels and Disperse Cold


  • Kidney Yang deficiency with internal cold


  • Tonifies Kidney Yang and rescues devastated Yang
  • Warms the Middle Jiao and relieves abdominal pain and stops diarrhea.


  • Very cold extremities, intolerance of cold, a desire to lie down or sleep and curl in a fetal position, cold abdominal pain, diarrhea with undigested food, vomiting, no thirst, and somnolence
  • Devastated Yang symptoms may include profuse cold sweat, cold limbs, pale face, weak breath, and fainting.

Possible Tongue Appearance:

  • Pale or dusky with a white slippery coat

Possible Pulse Patterns:

  • Minute and deep pulse
  • Floating weak pulse

Western Uses:

  • Prostration
  • Acute Myocardial Infarction
  • Cardiac Insufficiency
  • Acute or Chronic Gastroenteritis with vomiting and diarrhea
  • Hypopituitarism
  • Hypothyroidism
  • Adrenal Insufficiency
  • Intractable Arthritis

Cautions, Contraindications, Herb Drug Interactions:

  • Do not use in cases of cold limbs due to true heat and false cold, Blood deficiency, or Qi stagnation
  • This formula contains one or more toxic substances (while some Chinese herbs are toxic, it must be noted that many come prepared, or are combined, to mitigate their toxicity).

Preparation Notes:

  • Decoction. Cook Fu Zi 30-60 minutes (depending on the dosage) before adding Gan Jiang and Gan Cao.

Originally Appeared In:

  • On Cold Damage (Shang Han Lun)

Combined Channels of all herbs in this formula:

  • Spleen, Heart, Kidneys, Lungs, Stomach

Substances in this Formula (3 Total):

Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli)
Fu Zi (Processed Aconite) 附子
Qty: 6-9 grams
Chan: HT, KI, SP
Prop: Spicy, Hot, Toxic
Latin: Radix Lateralis Praeparatus Aconiti Carmichaeli
Cat: Herbs that Warm the Interior and Expel Cold
Gan Jiang (dry Rhizoma Zingiberis)
Gan Jiang (Dried Ginger Rhizome) 干姜
Qty: 4.5 grams
Chan: HT, LU, SP, ST
Prop: Spicy, Hot
Latin: dry Rhizoma Zingiberis
Cat: Herbs that Warm the Interior and Expel Cold
Zhi Gan Cao (Radix Glycyrrhizae)
Zhi Gan Cao (Honey Fried Licorice Root) 炙甘草
Qty: 6 grams
Chan: All 12 Channels
Prop: Sweet, Warm
Latin: Radix Glycyrrhizae
Cat: Herbs that Tonify Qi
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