Shi Xiao Si Wu Tang - 时效四物汤 - Effective Four Substances Decoction

English:	Effective Four Substances decoction
Also Known As:

Herbs And Actions

Pharmaceutical Latin	Pin Yin	Dosage	Actions
Rx. Rehmanniae	Shu Di Huang	4-21g	Strengthens the Liver and Kidneys and nourishes the Yin of the Blood. With Bai Shao, strongly nourishes Liver Blood.
Rx. Paeoniae Alba	Bai Shao	4-15g	Calms Liver Yang and alleviates pain, Nourishes Blood, Preserves Yin. With Dang Gui, nourishes Yin and Blood. With Dang Gui and Shu Di Huang, for dizziness, blurred vision and dysmenorrhea due to Blood Deficiency or Blood Stasis.
Rx. Angelicae Sinensis	Dang Gui	4-12g	Nourishes and activates Blood, regulates Liver and Kidneys, regulates menses and alleviates pain. With Shu Di Huang, Bai Shao and Chuan Xiong, for menstrual irregularity, amenorrhea and dysmenorrhea due to Blood Deficiency or Stasis.
Rx. Ligustici	Chuan Xiong	3-9g	Invigorates Blood, moves Qi, releases Stagnation and alleviates pain. With Dang Gui, for Blood Deficiency causing menstrual problems including dysmenorrhea, scanty menses and amenorrhea.
Excr. Trogopterori	Wu Ling Zhi	3-15g	Alleviates pain, Clears the blood vessels, Disperses stagnant Blood, Stops bleeding. With Pu Huang, for abdominal pain, lochioschesis, menstrual irregularity and stabbing epigastric, joint pain and chest pain due to Blood Stasis.
Pollen Typhae	Pu Huang	3-15g	Raw: Strongly promotes Blood circulation. Honey-fried: Stops bleeding. Use in equal parts for hemorrhage due to Blood Stasis.

Formula Actions

• Nourishes the Blood
• Regulates the Liver
• Regulates menstruation
• Invigorates Blood
• Dispels Blood Stasis
• Disperses accumulation
• Alleviates pain

Syndromes

• Liver Blood Stagnation due to Blood Deficiency

Clinical Manifestations

Sharp pain in the chest or abdomen Irregular menstruation Dysmenorrhea Retention of lochia Postpartum abdominal pain Acute, colicky lower abdominal pain Severe pain in the middle abdomen Dizziness Blurred vision Pale, lusterless complexion Pale nails Pale lips Generalized muscle tension Irregular menstruation with little flow Amenorrhea Periumbilical pain Lower abdominal pain Vertigo Tinnitus Blurred vision Insomnia Spotting of pale Blood Postpartum uterine bleeding

Epigastric pain Postpartum bleeding Pain beneath the heart Swelling and pain of external injuries Maybe five sole heat Delayed menstruation Palpitations Dizziness Dry skin Maybe leukorrhea Maybe fever Firm, painful abdomen Sporadic fever and chills Menorrhagia Hard abdominal masses with recurrent pain Unstable fetus with bleeding Chills and fever T: Pale or Purple with purple spots C: Normal P: Thready and wiry or Thready and choppy or Wiry, choppy and tight

Treats

Metrorrhagia Postpartum uterine bleeding

Amenorrhea Postpartum abdominal pain

Contraindications And Herb/Drug Interactions

Notes

Modifications

For a heavy flow:		For spotting:
- Rx. Angelicae Sinensis	Dang Gui	+ Rx. Notoginseng	San Qi
- Rz. Chuanxiong	Chuan Xiong	+ Sm. Persicae	Tao Ren
+ Hb. Leonuri	Yi Mu Cao	For Qi Stagnation leading to Blood Stagnation:
+ Crinis Carbonisatus	Xue Yu Tan	+ Rx. Bupleuri	Chai Hu
For long term bleeding leading to Qi and Blood deficiencies:		+ Rx. Curcumae	Yu Jin
+ Rx. Codonopsis	Dang Shen	+ Fr. Toosendan	Chuan Lian Zi
+ Rx. Astragali	Huang Qi
+ Rz. Atractylodis	Bai Zhu