{ "slug": "si-wu-tang", "names": { "pinyin": "Si Wu Tang", "chinese": "四物汤", "english": "Four-Substance Decoction", "alternate": [ "Si Wu Wan", "Four Substances Teapills", "Dang Gui Four Combination" ] }, "category": "tonify-blood", "source": { "text": "Tai Ping Hui Min He Ji Ju Fang (Imperial Grace Formulary of the Tai Ping Era)", "author": "Imperial Medical Bureau", "dynasty": "Song", "year": "1078" }, "summary": "The base blood formula of Chinese medicine. Four herbs for blood deficiency: a pale dull face, pale nails and lips, dizziness, blurry vision, palpitations, light sleep, and a scanty, late, or painful cycle. Two herbs build blood and two keep it moving.", "picture": "Blood that is only built sits still, and blood that is only moved runs thin. Si Wu Tang does both: rehmannia and peony fill the river, angelica and ligusticum keep it flowing.", "patterns": [ { "slug": "blood-deficiency", "role": "primary", "_links": { "self": "https://www.naturalherblibrary.com/api/v1/pattern/blood-deficiency", "html": "https://www.naturalherblibrary.com/pattern/blood-deficiency" } }, { "slug": "liver-blood-deficiency", "role": "primary", "_links": { "self": "https://www.naturalherblibrary.com/api/v1/pattern/liver-blood-deficiency", "html": "https://www.naturalherblibrary.com/pattern/liver-blood-deficiency" } }, { "slug": "heart-blood-deficiency", "role": "base", "_links": { "self": "https://www.naturalherblibrary.com/api/v1/pattern/heart-blood-deficiency", "html": "https://www.naturalherblibrary.com/pattern/heart-blood-deficiency" } } ], "indications": [ "Pale, dull face, pale lips and nails", "Dizziness, blurry vision, floaters", "Palpitations and light sleep", "Numb hands and feet", "Dry skin and hair", "Scanty, late, or painful periods", "Amenorrhea from deficiency", "Pain around the navel after a period" ], "signs": { "tongue": "Pale.", "pulse": "Thin and wiry, or thin and weak." }, "ingredients": [ { "pinyin": "Shu Di Huang", "grams": "12", "role": "chief", "job": "Prepared rehmannia, the heaviest blood tonic, fills the Liver and Kidney.", "herb_slug": "prepared-rehmannia-root", "english": "Prepared Rehmannia Root", "chinese": "熟地黄", "latin": "Radix Rehmanniae Praeparata", "_links": { "herb": "https://www.naturalherblibrary.com/api/v1/herb/prepared-rehmannia-root", "html": "https://www.naturalherblibrary.com/herb/prepared-rehmannia-root" } }, { "pinyin": "Bai Shao", "grams": "9", "role": "deputy", "job": "White peony nourishes blood and yin and softens the Liver.", "herb_slug": "white-peony-root", "english": "White Peony Root", "chinese": "白芍", "latin": "Radix Paeoniae Alba", "_links": { "herb": "https://www.naturalherblibrary.com/api/v1/herb/white-peony-root", "html": "https://www.naturalherblibrary.com/herb/white-peony-root" } }, { "pinyin": "Dang Gui", "grams": "9", "role": "deputy", "job": "Angelica builds blood and moves it.", "herb_slug": "root-of-chinese-angelica", "english": "Root of Chinese Angelica", "chinese": "当归", "latin": "Radix Angelicae Sinensis", "_links": { "herb": "https://www.naturalherblibrary.com/api/v1/herb/root-of-chinese-angelica", "html": "https://www.naturalherblibrary.com/herb/root-of-chinese-angelica" } }, { "pinyin": "Chuan Xiong", "grams": "6", "role": "assistant", "job": "Ligusticum moves blood and qi so the tonic circulates.", "herb_slug": "chuanxiong-rhizome-szechuan-lovage-root", "english": "Chuanxiong Rhizome, Szechuan Lovage Root", "chinese": "川芎", "latin": "Rhizoma Chuanxiong", "_links": { "herb": "https://www.naturalherblibrary.com/api/v1/herb/chuanxiong-rhizome-szechuan-lovage-root", "html": "https://www.naturalherblibrary.com/herb/chuanxiong-rhizome-szechuan-lovage-root" } } ], "actions": [ "Tonifies and invigorates the blood", "Regulates the menstrual cycle" ], "how_it_works": "Two still, moist herbs and two moving, warm herbs. The balance is the whole lesson: a blood tonic needs motion or it clogs, and blood movers need material or they run the body dry. Almost every gynecology formula in the tradition is built on these four.", "modifications": [ { "for": "Blood stasis with clots and stabbing cramps", "add": [ "Tao Ren", "Hong Hua" ], "note": "This becomes Tao Hong Si Wu Tang." }, { "for": "Tiredness with the pallor", "add": [ "Dang Shen", "Bai Zhu", "Fu Ling", "Zhi Gan Cao" ], "note": "This becomes Ba Zhen Tang." }, { "for": "Poor sleep", "add": [ "Suan Zao Ren", "Bai Zi Ren" ], "note": "Calming seeds for the Heart." }, { "for": "A cold uterus with cramps", "add": [ "Ai Ye", "Rou Gui" ], "note": "Mugwort and cinnamon warm the womb." } ], "cautions": [ "Rich. Not for a weak Spleen with loose stools and poor appetite until the Spleen is supported.", "Not during heavy acute bleeding; angelica and ligusticum move blood.", "Not for a damp or hot picture with a thick coat.", "Pregnancy: a practitioner's call. It is used in pregnancy, but only when prescribed." ], "forms": [ "teapills", "concentrated tablets", "granules", "decoction" ], "typical_dose": { "teapills": "8 pills, three times a day with warm water, the usual label dose", "decoction": "One bag a day in two doses, with the amounts above", "course": "One to three months, or the second half of each cycle for menstrual use." }, "cousins": [ { "slug": "ba-zhen-tang", "difference": "Si Wu Tang plus the four qi herbs, for someone who is tired as well as pale." }, { "slug": "tao-hong-si-wu-tang", "difference": "Si Wu Tang plus peach kernel and safflower, for blood deficiency with stasis: clots, fixed pain, a purple tongue." }, { "slug": "dang-gui-bu-xue-tang", "difference": "Two herbs, astragalus and angelica, to build blood fast from qi after blood loss." } ], "commerce": { "store": "supplementsapothecary.com", "store_name": "Supplements Apothecary", "store_slug": "si-wu-tang", "store_url": "https://www.supplementsapothecary.com/supplement/si-wu-tang", "status": "planned", "label_check": "The box reads Si Wu Tang or Si Wu Wan with the characters 四物. Four ingredients: prepared Rehmannia, White peony, Angelica, and Ligusticum." }, "conditions": [ "blood-deficiency", "anemia", "dizziness", "amenorrhea", "dysmenorrhea", "menstrual-irregularities", "palpitations", "blurred-vision" ], "sources": [ { "title": "Bensky, Scheid, Ellis and Barolet, Chinese Herbal Medicine: Formulas and Strategies, 2nd edition", "note": "Composition, actions, indications, cautions, and modifications." } ], "meta": { "status": "published", "last_updated": "2026-10-12", "reviewed_by": null }, "_links": { "html": "https://www.naturalherblibrary.com/formula/si-wu-tang", "self": "https://www.naturalherblibrary.com/api/v1/formula/si-wu-tang", "index": "https://www.naturalherblibrary.com/api/v1/formulas" } }