Si Ni San (Frigid Extremities Powder)
- Regulate and Harmonize the Liver and Spleen
- Chai Hu
- Bai Shao
- Zhi Shi
- Zhi Gan Cao
- Chai Hu enters the Lv/GB channels, lifts and dominates Yang Qi, spreads Liver Qi to relieve constraint. Vents evil pathogen outward.
- Bai Shao astringes Yin, nourishes Blood, and softens the Lv. Combined with Chai Hu, it can harmonize Yin and Yang, and prevent Chai Hu from injuring the Yin and Blood by excessive raising and venting.
- Zhi Shi regulates the Qi, releases the constraint, drains heat, unblocks clumping. Combined with Chai Hu it can promote the action of Qi regulating, by one ascending the clear Qi, and the other descending the turbidity. Combined with Bai Shao, it can regulate and harmonize the Qi and Blood.
- Zhi Gan Cao harmonizes the actions of other ingredients, tonifies the spleen, and harmonizes the MJ. Combined with Bai Shao it can moderate spasms and stop pain.
Function: Vents the evil, releases constraint, spreads Lv Qi, and regulates the Spleen.
Indications:
- Frigid extremities due to Yang constraint.
- Disharmony of Liver and Spleen.
Symptoms:
- Cold hands and feet (although the body is warm), sometimes accompanied by slight body fever, coughing, palpitations, urinary difficulty, abdominal pain, or diarrhea.
- Distention and stifling sensation in hypochondria,. pain in epigastrium or abdomen.
Pulse: Wiry
Clinical Applications:
- In Shang Han Lun, this formula was originally used for frigid extremities due to constitutional Sp Qi deficiency with external evil entering, Shaoyin stage constraining Yang Qi, unable to reach the extremities. In later generations, this is a common formula used to spread the Lv Qi and regulate Spleen. Often used for treating frigid extremities due to LV/GB Qi stagnation, or pain in epigastrium and abdomen due to disharmony of Liver and Spleen.
- The key symptoms are cold hands and feet, pain in hypochondria, wiry pulse.
- For distention and pain of hypochondrium with alternating chills and fever du to Lv Qi and Blood stagnation, omit Zhi Shi, replace with Zhi Ke, Chen Pi, Chuan Xiong, and Xiang Fu (Chai Hu Shu Gan San).
- For coughing, add wu wei zi and Gan Jiang. For palpitations add Gui Zhi. For urinary difficulty, and Fu Ling. For abdominal pain, add Fu Zi. For diarrhea with tenesmus, add Xie Bai
- For severe Qi stagnation, add Xiang Fu and Yu Jin. For cases with fever, add Zhi Zi and Chuan Lian Zi.
- Currently used for chronic hepatitis, cholecystitis, gallstone, intercostal neuralgia, peptic ulcer, gastritis, adnexal inflammation, fallopian-tube obstruction, and acute mastitis etc. due to Lv/GB Qi stagnation, or disharmony of Lv and Sp, or disharmony of GB and St.