Si Mo Tang - 四磨湯 - Four Milled-Herb Decoction

English:	Four Milled-Herb Decoction
Also Known As:

Herbs And Actions

Pharmaceutical Latin	Pin Yin	Dosage	Actions
Rx. Ginseng	Ren Shen	3-6g	Tonifies Heart Qi and calms the Spirit, Tonifies Lung Qi, Tonifies Spleen and Stomach Qi.
Sm. Arecae	Bing Lang	9g	Drains downward, Reduces accumulations, Regulates Qi, Unblocks the bowels.
Lignum Aquilariae Resinatum	Chen Xiang	3-6g	Promotes movement of Qi, alleviates pain, descends Qi, regulates the Middle, dispels Cold and warms the Spleen and Stomach. With Wu Yao, for lower abdominal pain, especially with lower abdominal cold and tension and a stifling sensation in the chest and diaphragm with wheezing, distention, and anorexia.
Rx. Linderae	Wu Yao	6-9g	Promotes movement of Qi and alleviates pain.

Formula Actions

• Promotes the movement of Qi
• Descends Rebellious Qi
• Expands the chest
• Disperses Stagnation

Syndromes

• Upper Jiao Qi Stagnation with clumping in the chest and Rebellious Qi
• Liver Qi stagnation caused by instability of the seven emotions (Secondary source)

Clinical Manifestations

An irritable, stifling sensation in the chest and diaphragm Labored breathing Wheezing Epigastric distention and fullness

Anorexia Hurried breathing T: Normal C: White P: Wiry

Treats

Bronchial asthma Emphysema Gastritis Anorexia Indigestion

Post-surgical adhesions Gynecomastia COPD Globus hystericus

Contraindications And Herb/Drug Interactions

Notes

Modifications

For strong patients with anger and distending pain in the abdomen and epigastrium:		For constipation, belching and abdominal pain and distention:
- Rx. Ginseng	Ren Shen	+ Fr. Aurantii Immaturus	Zhi Shi
+ Rx. Aucklandiae	Mu Xiang	+ Rx. et Rz. Rhei	Da Huang
+ Fr. Aurantii Immaturus	Zhi Shi