Classic formula · Tonify blood
Si Wu Tang
四物汤 Four-Substance Decoction
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.
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.
Also sold as: Si Wu Wan · Four Substances Teapills · Dang Gui Four Combination
Who Si Wu Tang is for
This formula is chosen for 3 patterns. Match your own picture before you match the name.
Signs it is classically given for
- 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
- Tongue
- Pale.
- Pulse
- Thin and wiry, or thin and weak.
What is in Si Wu Tang
Amounts are the classic decoction range in grams. Patent pills use the same herbs in the same proportion, so read the box for these names.
| Herb | Amount | Role | Job in the formula |
|---|---|---|---|
| Shu Di Huang Prepared Rehmannia Root Use caution | 12 g | Chief | Prepared rehmannia, the heaviest blood tonic, fills the Liver and Kidney. |
| Bai Shao White Peony Root | 9 g | Deputy | White peony nourishes blood and yin and softens the Liver. |
| Dang Gui Root of Chinese Angelica Use caution | 9 g | Deputy | Angelica builds blood and moves it. |
| Chuan Xiong Chuanxiong Rhizome, Szechuan Lovage Root Use caution | 6 g | Assistant | Ligusticum moves blood and qi so the tonic circulates. |
How Si Wu Tang 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.
Actions in classic terms
- Tonifies and invigorates the blood
- Regulates the menstrual cycle
Common changes to Si Wu Tang
A practitioner rarely gives the bare formula. These are the classic additions for a specific picture.
- Blood stasis with clots and stabbing cramps add Tao Ren, Hong Hua This becomes Tao Hong Si Wu Tang.
- Tiredness with the pallor add Dang Shen, Bai Zhu, Fu Ling, Zhi Gan Cao This becomes Ba Zhen Tang.
- Poor sleep add Suan Zao Ren, Bai Zi Ren Calming seeds for the Heart.
- A cold uterus with cramps add Ai Ye, Rou Gui Mugwort and cinnamon warm the womb.
Cautions with Si Wu Tang
- 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 and typical dose
Sold as teapills, concentrated tablets, granules, decoction.
- 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.
Follow the label of the brand you buy. Pill sizes differ between makers.
Buying Si Wu Tang
The box reads Si Wu Tang or Si Wu Wan with the characters 四物. Four ingredients: prepared Rehmannia, White peony, Angelica, and Ligusticum.
Brand comparisons for formulas live on Supplements Apothecary, the buying side of this library.
Formulas often confused with Si Wu Tang
- Ba Zhen Tang 八珍汤 Si Wu Tang plus the four qi herbs, for someone who is tired as well as pale.
- Tao Hong Si Wu Tang 桃红四物汤 Si Wu Tang plus peach kernel and safflower, for blood deficiency with stasis: clots, fixed pain, a purple tongue.
- Dang Gui Bu Xue Tang 当归补血汤 Two herbs, astragalus and angelica, to build blood fast from qi after blood loss.
Conditions where Si Wu Tang comes up
Sources
- Bensky, Scheid, Ellis and Barolet, Chinese Herbal Medicine: Formulas and Strategies, 2nd edition Composition, actions, indications, cautions, and modifications.
Important Note
Formula pages describe classic use so you can read a label, ask a better question, and find the right monographs. They are education, not a prescription. A formula that fits the wrong pattern can make things worse, so match the picture first.