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Si wu Decoction

(四物汤)

 

Siwu Decoction is a traditional medicinal recipe made from four main herbal ingredients: Danggui (当归, Angelica sinensis), Chuanxiong (川芎, Ligusticum chuanxiong), Baishao (白芍, Paeonia lactiflora), and Shudihuang (熟地黄, Rehmannia glutinosa). It is a classic Chinese medicine formula used for blood nourishment and regulation.

 

The earliest recorded formula of Siwu Decoction can be traced back to the Tang Dynasty in Xian Shou Li Shang Xu Duan Mi Fang (《仙授理伤续断秘方》) by Lin Daoren. However, the widely used version of the formula comes from Tai Ping Hui Min He Ji Ju Fang (《太平惠民合剂局方》). Generally, Siwu Decoction is known for its blood-nourishing and menstrual-regulating effects and is commonly used to alleviate menstrual pain in women.

Origin

Siwu Decoction is a commonly used blood-nourishing formula and a fundamental prescription for menstrual regulation. It was first documented in the late Tang Dynasty by Lin Daoren in Xian Shou Li Shang Xu Duan Mi Fang (《仙授理伤续断秘方》), originally used for treating trauma-induced blood stasis and pain. Later, it was recorded in China’s first national pharmacopoeia, the Song Dynasty’s Tai Ping Hui Min He Ji Ju Fang (《太平惠民和剂局方》), which first applied Siwu Decoction to gynecological diseases.

 

Subsequent medical books, such as the Song Dynasty’s Wei Sheng Jia Bao Chan Ke Bei Yao (《卫生家宝产科备要·产后方》), the Ming Dynasty’s Yi Fang Kao (《医方考·调经用四物汤》), and the Qing Dynasty’s Ji Yin Gang Mu (《济阴纲目·调经门》), all documented and analyzed the use of Siwu Decoction.

Siwu Decoction has been praised by later generations of physicians as:

·        "The number one gynecological prescription" (妇科第一方)

·        "The fundamental formula for blood disorders" (血证立法)

·        "A universal remedy for all blood disorders" (调理一切血证是其所长)

·        "A holy medicine for women" (妇女之圣药)

 

In Taiwan, a variation called Rose Siwu Decoction (玫瑰四物汤) is popular, made from Danggui (当归, Angelica sinensis), Chuanxiong (川芎, Ligusticum chuanxiong), Rougui (肉桂, Cinnamomum cassia), and either Shudihuang (熟地黄, Rehmannia glutinosa) or Shengdi (生地黄, Rehmannia glutinosa raw form).

·        Individuals with a heat-prone constitution should drink Shengdi-based Rose Siwu Decoction.

·        Individuals with a cold-prone constitution should drink Shudihuang-based Rose Siwu Decoction.

Composition

According to Tai Ping Hui Min He Ji Ju Fang (《太平惠民和剂局方》), Siwu Decoction is a formula for nourishing and activating blood circulation. The original prescription consists of:

·        Shudihuang (熟地黄, Rehmannia glutinosa, prepared) – 12g

·        Danggui (当归, Angelica sinensis) – 10g

·        Baishao (白芍, Paeonia lactiflora) – 12g

·        Chuanxiong (川芎, Ligusticum chuanxiong) – 8g

·        Usage: Decoction in water.

 

Siwu Decoction is known as “the number one gynecological prescription” (妇科第一方) and is regarded as the top blood-nourishing formula.

 

In Xian Shou Li Shang Xu Duan Mi Fang (《仙授理伤续断秘方》), the formula states:
"For severe trauma with blood stasis inside the intestines, use this formula: Baishao (白芍, Paeonia lactiflora), Danggui (当归, Angelica sinensis), Shudihuang (熟地黄, Rehmannia glutinosa), Chuanxiong (川芎, Ligusticum chuanxiong), in equal parts. Take three qian (approx. 9g) per dose, decocted in one and a half cups of water."

 

Zhang Shanlei (张山雷) commented:
"This formula actually originates from Jin Kui Yao Lue’s (《金匮要略》) Jiao Ai Decoction (胶艾汤). The original formula included Ejiao (阿胶, Donkey-hide gelatin), Aiye (艾叶, Mugwort), and Gancao (甘草, Licorice). Lin Daoren removed these three ingredients that warm the uterus, nourish blood, and stop bleeding. He replaced raw Dihuang with processed Shudihuang and used Baishao instead of Shaoyao, keeping Danggui and Chuanxiong. He then named it ‘Siwu Decoction’ (四物汤), transforming the formula from one that nourishes blood and stops bleeding to one that treats blood deficiency and blood stasis in traumatology.”

 

According to Tai Ping Hui Min He Ji Ju Fang (《太平惠民和剂局方·卷九》):
"Danggui (当归, Angelica sinensis, wine-soaked and stir-fried), Chuanxiong (川芎, Ligusticum chuanxiong), Baishao (白芍药, Paeonia lactiflora), and Shudihuang (熟干地黄, Rehmannia glutinosa, steamed with wine), all in equal parts."

 

Formula Characteristics

Siwu Decoction balances blood-nourishing and blood-activating properties:

·        Danggui and Chuanxiong are aromatic and invigorate blood circulation (moving function).

·        Baishao and Shudihuang nourish blood and yin (static function).

·        This combination ensures blood supplementation without stagnation and blood movement without injury.

 

Formula Mnemonic

"Siwu (四物) contains Dihuang (地黄), Shaoyao (芍药), Danggui (当归), and Chuanxiong (川芎); it cures all blood disorders and regulates menstruation. Adjustments can be made based on individual needs."

Clinical Applications

Siwu Decoction has been widely used in Traditional Chinese Medicine (TCM) for over a thousand years and is known as the “Holy Formula for Gynecology” (妇科圣方).

 

Women are prone to three major issues:

1.     Blood deficiency (血虚)

2.     Blood stasis (血瘀)

3.     Irregular menstruation (月经不调)

 

These three conditions are often interrelated:

·        Blood deficiency can cause blood stasis.

·        Blood stasis can lead to blood deficiency.

·        Both blood deficiency and blood stasis contribute to menstrual irregularities.

 

Siwu Decoction specifically targets these three common gynecological concerns, making it an effective blood-nourishing, blood-activating, and menstrual-regulating formula.

 

Additionally, its formulation is highly balanced:

·        Shudihuang (熟地黄) and Baishao (白芍) are mild and nourishing, supplementing blood without causing excessive stagnation.

·        Danggui (当归) and Chuanxiong (川芎) are aromatic and invigorating, activating blood circulation without causing excessive blood loss.

·        Unlike Ejiao (阿胶, Donkey-hide gelatin), which can cause heat symptoms like nosebleeds or digestive discomfort, Siwu Decoction is warm but not drying, nourishing but not greasy, making it suitable for long-term use.

 

Thus, Siwu Decoction is one of the most commonly used TCM formulas for blood nourishment, blood circulation, and menstrual regulation, earning it the title “Holy Formula for Gynecology” (妇科圣方).

 

Secret Formula

Source:

Xian Shou Li Shang Xu Duan Mi Fang (《仙授理伤续断秘方》)

 

Alternate Names:

·        Di Sui Tang (地髓汤) from Sheng Ji Zong Lu (《圣济总录》), Volume 164

·        Da Chuan Xiong Tang (大川芎汤) from Ji Feng Pu Ji Fang (《鸡峰普济方》), Volume 16

 

Composition:

·        White Peony Root (Bai Shao Yao / 白芍药)

·        Angelica Sinensis (Dang Gui / 当归)

·        Rehmannia (Shu Di Huang / 熟地黄)

·        Szechuan Lovage (Chuan Xiong / 川芎)

 

Dosage:

·        9 grams of the formula, boiled with 220 milliliters of water until 150 milliliters remain. Take this in the morning on an empty stomach, hot.

 

Functions:

·        Nourish the blood and regulate menstruation

·        Dissolve blood stasis

 

Indications:

·        Deficiency of the Chong and Ren meridians

·        Irregular menstruation

·        Umbilical or abdominal pain due to blood deficiency or stasis

·        Postpartum issues such as failure of lochia to discharge, abdominal pain, and formation of blood masses

·        Threatened miscarriage, fetal movement abnormalities, abdominal pain with blood discharge

·        Trauma with internal blood stasis

 

Explanation of the Formula

This formula is commonly used to treat symptoms caused by insufficient blood and stagnation, improving the flow of blood and regulating the menstrual cycle.

·        Angelica Sinensis (Dang Gui) nourishes blood, strengthens the liver, and regulates menstruation as the primary herb.

·        Rehmannia (Shu Di Huang) nourishes and supplements the blood, acting as the secondary herb.

·        White Peony Root (Bai Shao Yao) softens the liver, nourishes blood, and harmonizes the body's vital energy as the assistant herb.

·        Szechuan Lovage (Chuan Xiong) activates blood flow and moves Qi, as the envoy herb.

 

The combination of these herbs is harmonious, providing nourishment to the blood while avoiding stagnation, and stimulating blood circulation without causing injury. The formula is ideal for the treatment of blood-related gynecological issues, particularly for women with blood deficiency and stasis.

 

He Ji Ju Fang (和剂局方)

This version of the formula consists of the four key herbs: Angelica Sinensis (Dang Gui), Szechuan Lovage (Chuan Xiong), White Peony Root (Bai Shao Yao), and Rehmannia (Shu Di Huang). It is used for symptoms like dizziness, tinnitus, pale lips, sparse nails, and irregular or insufficient menstruation.

The formula is regarded as a foundational prescription for nourishing and regulating blood, as outlined in the Jin Kui Yao Lue (《金匮要略》).

 

Additional Modified Versions

·        Composition: 15 grams of Rehmannia (Shu Di Huang), 15 grams of Angelica Sinensis (Dang Gui), 10 grams of White Peony Root (Bai Shao Yao), 8 grams of Szechuan Lovage (Chuan Xiong).

·        Functions: Nourishes blood and activates blood flow.

·        Indications: This modified version is applied to cases of blood deficiency with stagnation, such as palpitations, insomnia, dizziness, and irregular menstruation.

 

Modern Applications

In modern clinical use, this formula is commonly adjusted to treat:

·        Irregular menstruation

·        Pregnancy-related conditions

·        Allergies (like urticaria or purpura)

·        Trauma and bone injuries

·        Neurological conditions like migraines

 

Blood Deficiency Treatment

For those suffering from blood deficiency and dry symptoms, this formula can be combined with other herbs like Rùn Cháng Wán (润肠丸) to moisten the intestines.

 

Additions for Modifications:

1.     For Dysmenorrhea: Add 12 grams of Xiang Fu (香附) and 10 grams of Yan Hu Suo (延胡索).

2.     For Qi Deficiency: Add 18 grams each of Dang Shen (党参) and Huang Qi (黄芪).

3.     For Cold Conditions: Add 4 grams of Rou Gui Fen (肉桂粉) and 4 slices of Pao Jiang (炮姜).

4.     For Uterine Bleeding: Add 8 grams of Qian Cao Gen (茜草根), 10 grams of Ai Ye (艾叶), and 10 grams of E Jiao (阿胶).

 

This formula works to balance the Yin and Yang, and harmonize the vital energies in the body, addressing the root causes of blood stagnation and deficiency.

 

(II) Composition

Each dose: 9 grams. Use 220 milliliters of water, and boil until 150 milliliters remain. Take on an empty stomach while warm.

 

Functions

Nourishes and invigorates the blood, regulates menstruation, and removes blood stasis.

 

Indications

Used for conditions such as deficiency of the Chong and Ren vessels, irregular menstruation, abdominal pain near the navel, excessive bleeding or spotting between periods, blood clots or lumps that are hard and painful, fetal restlessness during pregnancy, abdominal pain with bleeding, and postpartum issues like lingering lochia, clotted masses in the abdomen, pain in the lower abdomen, occasional chills and fever, and traumatic injury leading to blood stasis in the abdomen.

 

Herbal Formula Analysis

This formula is commonly used to treat deficiency of the nutritive blood (营血) and stagnation of blood flow.

·        Angelica Sinensis (当归, Dong Gui): Nourishes the blood and liver, harmonizes blood and regulates menstruation (chief herb).

·        Rehmannia Root (熟地黄, Shu Di Huang): Nourishes yin and replenishes blood (deputy herb).

·        White Peony Root (白芍药, Bai Shao): Nourishes blood, softens the liver, and harmonizes the ying (assistive herb).

·        Chuanxiong Rhizome (川芎, Chuan Xiong): Activates blood circulation, moves qi, and unblocks blood stasis (envoy herb).

 

The combination of these four herbs works synergistically to nourish and invigorate the blood without causing stagnation, to promote smooth circulation, and to regulate blood flow effectively.

 

Source:

Tai Ping Hui Min He Ji Ju Fang (太平惠民和剂局方)

 

Precautions

This formula is not suitable for conditions of yin deficiency with heat signs, as well as conditions of severe bleeding and qi collapse.

 

Effectiveness Notes

Zhang Lu notes that Si Wu Tang is a specialized formula for treating yin and blood-related disorders, but it should not be used as a general tonic for blood and yin deficiencies, as this can worsen heat signs or induce excessive bleeding. Some modern practices misuse the formula by indiscriminately adding other herbs for wind, food stagnation, or phlegm.

 

Treatment for excessive blood loss should not focus only on blood tonics but must first address the qi, which stabilizes and restores blood. Also, this formula is not meant to work as a standalone tonic for Qi and Blood—it should not be used in cases where other Qi-regulating herbs are required to balance the overall body condition.

 

Si Wu Tang

is a classic Chinese medicine formula for nourishing and regulating the blood, composed of the following herbs:

·        Angelica Sinensis (当归, Dong Gui): 10 grams

·        Chuanxiong Rhizome (川芎, Chuan Xiong): 8 grams

·        White Peony Root (白芍药, Bai Shao): 12 grams

·        Rehmannia Root (熟地黄, Shu Di Huang): 12 grams

 

Main Functions:

·        Nourish the blood and regulate menstruation

·        Treat conditions related to Chong and Ren vessel deficiencies

·        Manage irregular periods, abdominal pain, bleeding, and blood stagnation

 

Modern Usage:

The formula is used as a decoction, typically taken three times a day on an empty stomach. Adjustments should be made based on individual needs, especially considering potential heat or cold imbalances.

 

Precautions:

Consideration is required for those with heat signs or other serious imbalances.

 

Side Effects of Si Wu Tang:

1.     Heat Signs: As a warming formula, Si Wu Tang can lead to excessive heat, which may cause acne or other heat-related symptoms in individuals with a hot constitution.

2.     Gastrointestinal Issues: The herbs, especially Rehmannia and Angelica, may cause diarrhea in individuals with weaker digestive systems.

3.     Dry Mouth: Some users report dryness in the mouth and throat.

 

To mitigate side effects, adjustments can be made to the formula:

·        Reduce the amount of Chuanxiong Rhizome (川芎) in cases of blood heat.

·        Use Shu Di Huang (熟地) for cold constitutions, and Sheng Di Huang (生地) for hot constitutions.

·        If both nourishment and heat clearing are needed, combine Shu Di Huang and Sheng Di Huang in equal amounts.

·        For dry mouth, consider adding Scrophularia Root (玄参, Xuan Shen).

 

For those prone to heat signs or acne, a variation known as Qin Lian Si Wu Tang can be used, which includes herbs to clear heat while nourishing blood.

This formula is a key herbal remedy in Traditional Chinese Medicine for balancing blood flow and treating various gynecological conditions. Adjustments based on individual constitution and symptoms are important for maximizing benefits while minimizing side effects.

 

Clinical Applications

This formula, which primarily uses Shu Di Huang (熟地黄) for its nourishing properties, is designed to enrich the yin and replenish the blood. The addition of Dang Gui (当归) helps to nourish the blood and harmonize the liver, while Bai Shao (白芍) nourishes the blood and harmonizes the nutrients. Chuan Xiong (川芎) activates the blood and moves the qi to smooth the flow of energy and blood. This combination ensures the blood is nourished without becoming stagnant, and the blood is harmonized without being damaged. Thus, it is a commonly used formula for both blood deficiency and blood stasis conditions. It is effective for tonifying and nourishing the blood as well as promoting blood circulation and regulating menstruation.

1.     Menstrual Disorders

o   Adjust the formula as follows: Sheng Di (生地) and Chuan Xiong (川芎) 10g each, Bai Shao (白芍) 12g, Dang Gui (当归) and Xiang Fu (香附) 15g each, Fu Ling (茯苓) 18g, Gan Cao (甘草) 8g. Decoction, take one dose daily. Significant efficacy.

2.     Dysmenorrhea (Painful Menstruation)

o   Adjust the formula with Bai Zhi (白芷), Mu Xiang (木香), and Xiang Fu (香附) each 10g. Decoction, take one dose daily. Notable effectiveness.

3.     Luteal Phase Deficiency (Luteal Phase Dysfunction)

o   Modify the formula: Dang Gui (当归) 12g, Chuan Xiong (川芎) 9g, Chi Shao (赤芍) and Bai Shao (白芍) 15g each, Sheng Di Huang (生地黄) and Shu Di Huang (熟地黄) 15g each. Decoction, take one dose daily, twice daily during menstruation and after pregnancy cessation. Remarkable results.

4.     Functional Uterine Bleeding (Uterine Dysfunctional Bleeding)

o   Combine with Dang Gui Bu Xue Tang (当归补血汤) and adjust as necessary: Shu Di Huang (熟地黄) 15g, Hang Bai Shao (杭白芍), Dang Gui (当归), and San Qi (三七) 10g each, Huang Qi (黄芪) and Guan Zhong Tan (贯众炭) 30g each, Yi Mu Cao (益母草) 15g. Decoction, start on the third day of menstruation, take for 3-6 days depending on bleeding severity. Take one dose daily.

5.     Breech Presentation (Fetal Positioning Issue)

o   Remove Shu Di Huang (熟地黄), add Bai Zhu (白术) and Fu Ling (茯苓) each 15g. Decoction, take one dose every evening for 3 doses as one course. After completing the first course, recheck fetal position weekly for two weeks. If the fetal position corrects, continue for one more course to consolidate the effects. Significant in correcting fetal position.

6.     Neurogenic Headaches

o   Adjust the formula: Shu Di Huang (熟地黄) 50g, Bai Shao (白芍), Dang Gui (当归), Chuan Xiong (川芎), Gui Yuan Rou (桂圆肉) 15g each, Mu Dan Pi (牡丹皮), Tian Ma (天麻), Jiang Can (僵蚕), Quan Xie (全蝎), Gan Cao (甘草) 10g each, Chao Zao Ren (炒枣仁) and Shi Jue Ming (石决明) 50g each, and Wu Gong (蜈蚣) 2 pieces. Decoction, take one dose daily.

7.     Frozen Shoulder (Shoulder Periarthritis)

o   Adjust the formula with Gui Zhi (桂枝) 9g, Sheng Jiang (生姜) 3 slices, Gan Cao (甘草) 6g. Decoction, take one dose daily.

8.     Urticaria (Hives)

o   Adjust the formula: Dang Gui (当归) 9g, Bai Shao (白芍) 6g, Chuan Xiong (川芎) 3g, Sheng Di Huang (生地黄) 6g. Decoction, take one dose daily for 3-10 doses.

9.     Allergic Rhinitis

o   Adjust the formula: Sheng Di Huang (生地黄) 24g, Dang Gui (当归) 15g, Chi Shao (赤芍) 15g, Chuan Xiong (川芎) 6g, Cang Er Zi (苍耳子) 6g, Xin Yi (辛荑) 9g, Xu Chang Qing (徐长卿) 30g. Decoction, take one dose daily, for 1-2 months.

 

Additionally, this formula is often used to treat conditions such as sciatica, postpartum infections, uterine fibroids, excessive bleeding (postpartum or menstrual), skin itching, allergic skin diseases, flat warts, and macular hemorrhages.

 

Precautions:

·        Use cautiously during pregnancy.

·        Not suitable for individuals with yin deficiency and blood heat, excessive menstruation, or bleeding during pregnancy (spotting or miscarriage).

 

Pharmacological Actions

The primary pharmacological effects include correcting anemia, anti-radiation damage, anti-platelet aggregation, anti-thrombosis, anti-hypoxia, anti-free radical damage, inhibiting granulation tissue proliferation, inhibiting uterine activity, regulating immune function, and supplementing trace elements, phospholipids, vitamins, etc.

1.   Correcting Anemia: In experimental models, administration of methylcellulose (MC) intraperitoneally to rats or mice induces experimental anemia, leading to splenomegaly and kidney damage, with high mortality in the animals. The n-butanol extract of this formula can reduce the mortality rate of the model mice, and hematological observations show anti-anemia effects. However, there is no effect in rats. For phenylhydrazine-induced hemolytic anemia, the water extract of this formula shows slight inhibition. In the case of acute hemorrhagic anemia induced by bloodletting in mice, oral administration of this formula improves bone marrow hematopoiesis, enhances red blood cell and granulocyte count, and aids anemia recovery. Compared to the traditional Qi-tonic formula, Si Wu Tang (四物汤) shows stronger effects. For experimental rats with hemolytic anemia, this formula also provides a certain therapeutic effect, though weaker than the Si Jun Zi Tang (四君子汤). It increases red blood cells, hemoglobin, reticulocytes, and other blood components in acute hemorrhagic anemia in animals, with a significant increase in hemoglobin.

2.   Anti-Radiation Damage: In normal mice exposed to lethal radiation, the intraperitoneal injection of 200 mg/kg of Si Wu Tang methanol extract provides good protective effects if administered prior to radiation exposure. However, when administered after radiation exposure, no protective effect is observed. This protective effect is dependent on Chuanxiong (川芎), with Danggui (当归) and Bai Shao (白芍) providing auxiliary effects.

3.   Anti-Platelet Aggregation, Anti-Thrombosis: The formula shows a significant inhibitory effect on ADP-induced platelet aggregation in rabbits. This action is achieved by increasing AMP concentration and ferulic acid content in platelets. In external thrombosis experiments, no thrombosis was observed in the Si Wu Tang group, while the control group showed blood clot length (mm), wet weight (mg), and dry weight (mg) measurements.

4.   Anti-Hypoxia: In various hypoxia models, including whole-body hypoxia, myocardial hypoxia induced by isoproterenol, cerebral hypoxia induced by carotid artery ligation, and cell hypoxia induced by sodium nitrite, the survival time of the Si Wu Tang group is significantly increased compared to the control group, demonstrating its anti-hypoxia effect.

5.   Anti-Free Radical Damage: In juvenile mice subjected to O3 stimulation, which causes similar symptoms to aging, such as decreased physical strength, cold resistance, and hypoxia tolerance, Si Wu Tang shows significant improvement in these indicators. Biochemical changes such as increased MAO-B activity in the brain and changes in SOD activity, lipid peroxidation, and MAO-B activity in various tissues show that the formula improves the aging-like symptoms caused by oxidative damage.

6.   Inhibition of Granulation Tissue Proliferation: In a model where granulation tissue was induced on the back of ddy mice, intraperitoneal administration of Si Wu Tang (50-200 mg/kg) showed dose-dependent inhibition of granulation tissue wet weight and new blood vessel formation, with a maximum inhibition rate of 40%. The primary effect was attributed to Chuanxiong (川芎) and Danggui (当归), which inhibit vascular smooth muscle cell proliferation.

7.   Inhibition of Uterine Activity: The formula has been shown to inhibit spontaneous uterine contractions in rats and rabbits. The administration of a 1×10^-2 (g/ml) concentration reduced the frequency of contractions and muscle tension slightly. The formula also weakened the uterine contraction response induced by prostaglandin F2α, showing dose-dependent effects.

8.   Regulation of Immune Function: In lymphocyte transformation tests and other immunological assays, this formula has shown significant immune-enhancing effects. It increases the proliferation of lymphocytes, counters the immunosuppressive effects of Hydrocortisone (HC), and enhances delayed-type hypersensitivity (DTH) reactions in mice.

9.   Supplementation of Trace Elements: Flame atomic absorption tests have revealed that Si Wu Tang contains trace elements such as Cu, Zn, Mn, and Fe. Graphite furnace atomic absorption tests also detected Ni, Cd, Po, and Cr, which are generally associated with blood production.

10. Supplementation of Phospholipids and Vitamins: Si Wu Tang contains 0.025 mg/g of total phospholipids (measured by molybdenum blue colorimetry) and significant levels of Vitamin C (61.20 mg/g) and Folic acid (0.212 mg/g), as measured by high-performance liquid chromatography (HPLC).

 

These pharmacological actions suggest that Si Wu Tang has a broad spectrum of therapeutic effects, particularly in hematological, cardiovascular, immune system regulation, and oxidative stress-related conditions.

 

Promotional Application

One major feature of the Si Wu Tang (四物汤, Four Substance Decoction) is that with different proportions of the four herbs, it can serve a wide range of functions. For example, by heavily using Rehmannia (熟地, Shú Dì) and Angelica (当归, Dāng Guī) while using a small amount of Chuanxiong (川芎, Chuān Xiōng), it becomes a great blood tonifying formula. When Angelica and Chuanxiong are lightly used or omitted, it can help pregnant women maintain pregnancy. By heavily using Angelica and Chuanxiong while lightly using White Peony (白芍, Bái Sháo), it can treat scanty menstruation and blood stasis-type amenorrhea, among other conditions. Additionally, many derivative formulas of Si Wu Tang have contributed greatly to the treatment of gynecological disorders. Famous examples include Tao Hong Si Wu Tang (桃红四物汤), a modification of Si Wu Tang by adding peach kernel (桃仁, Táo Rén) and safflower (红花, Hóng Huā), which is specifically used for blood deficiency and blood stasis leading to scanty menstruation, as well as preventing miscarriage; Ai Jiao Si Wu Tang (阿艾四物汤), created by adding Mugwort (艾叶, Ài Yè), Donkey-hide gelatin (阿胶, Ā Jiāo), and Licorice (甘草, Gān Cǎo) to treat excessive menstruation, providing a vital formula to calm the fetus and nourish the blood; Ba Zhen Tang (八珍汤), derived from Si Wu Tang combined with Si Jun Zi Tang (四君子汤, Four Gentlemen Decoction), is used to tonify both Qi and Blood; and Shi Quan Da Bu Tang (十全大补汤), which is Si Wu Tang plus Astragalus (黄芪, Huáng Qī) and Cinnamon (肉桂, Ròu Guì), is a very popular tonic.

 

Rose Si Wu Decoction (玫瑰四物饮)

Ingredients:

·        Angelica (当归, Dāng Guī) – 3 liang

·        White Peony (白芍, Bái Sháo) – 5 liang

·        Rehmannia (熟地, Shú Dì) – 2 liang

·        Chuanxiong (川芎, Chuān Xiōng) – 1 liang

·        Red dates (红枣, Hóng Zǎo) – 2 liang

·        Rose (玫瑰花, Méi Guī Huā) – appropriate amount

 

Preparation:

1.     Soak the herbs in a large pot of water for 30 minutes. Do not add rose petals at the beginning, as they will be added later.

2.     After soaking, bring to a boil over high heat, then reduce to a simmer with the lid on.

3.     Simmer for 2-3 hours, then bring to a boil again and add the rose petals. Stir and simmer on low heat.

4.     After 5 minutes, turn off the heat and let it sit for another 10 minutes. Once cooled, strain the decoction into a bottle and store it in the refrigerator.

 

Usage:

Drink one small bowl of the decoction heated twice a day (morning and evening), starting after menstruation ends. You can drink once a day for up to 14 days.

 

Purpose:
The formula of Si Wu Tang, consisting of Angelica, White Peony, Rehmannia, and Chuanxiong, serves to tonify blood and invigorate circulation, replenishing the Yin blood lost during menstruation. Rose petals have a mild effect of promoting blood circulation and resolving blood stasis, while being rich in vitamin C. Red dates are known for their nutritional value and are considered a natural source of vitamins, helping to tonify the spleen and enhance Qi.

Breast Enhancement Decoction (丰胸汤)

In Traditional Chinese Medicine (TCM), Qi is considered the general of blood, and when Qi flows smoothly, blood follows. Conversely, when blood is smooth, Qi flows. If a woman suffers from Qi and blood deficiency, she is prone to menstrual pain, pale complexion, dry hair and skin, and even spots on her face, which can impact breast development. Many women with small breasts may experience insufficient development due to Qi and blood deficiency.

 

Ingredients for Breast Enhancement Decoction:

·        Astragalus (黄芪, Huáng Qī) – 10g

·        Codonopsis (党参, Dǎng Shēn) – 10g

·        Chuanxiong (川芎, Chuān Xiōng) – 10g

·        Angelica (当归, Dāng Guī) – 10g

·        Goji berries (枸杞, Gǒu Qǐ) – 10g

·        Donkey-hide gelatin powder (阿胶, Ā Jiāo) – take with warm water (can substitute with pig's trotters)

 

Usage:

·        First month: Take morning and evening.

·        Second month: Take every other day.

·        Third month onwards: Once a week is sufficient. For long-term use, once or twice a week is ideal.

 

Effectiveness:
This formula helps with improving complexion, easing menstrual cramps, enhancing breast size, and potentially slimming the waistline if paired with a light diet.

In a famous story, Huang Wanqiu, the actress from the classic Liu Sanjie film, maintained a youthful appearance and radiant complexion even after 30 years of marriage. Her husband, from a family of traditional Chinese medicine practitioners, prescribed her a decoction very similar to this breast enhancement formula, which contributed to her ageless beauty.

 

Alternative Version (similar to above): Ingredients:

·        Astragalus, Angelica, Chuanxiong, Codonopsis, and 1/3 block of donkey-hide gelatin

·        Boil the herbs with a whole egg (with skin) for 10 minutes. After removing the egg and peeling it, add the gelatin and cook for another 10 minutes. Consume the egg and the decoction in the morning on an empty stomach and before bedtime for best results.

 

Suitable For:
Women with cold constitutions, those suffering from menstrual pain due to Qi and blood deficiency, and those with poor breast development and pale complexions.

 

Not Suitable For:
Individuals with a damp-heat constitution or those prone to excessive internal heat.

 

Precautions:

1.     Consultation with a Doctor: Before using this recipe, make sure to consult with a doctor to determine your body constitution. Since individuals have different constitutions, it is best to get a prescription from a traditional Chinese medicine (TCM) doctor.

2.     Pregnancy and Breastfeeding: Pregnant or breastfeeding women should avoid taking this herbal remedy unless they have received professional advice and are aware of all precautions to avoid adverse effects.

3.     Warm Consumption: Drink the herbal medicine when it is warm. You can either prepare it yourself or ask a TCM pharmacy to prepare it for you. Each time, take it out of the fridge and heat it slightly before drinking. Always consume it warm for better absorption.

4.     Avoid Certain Foods: Avoid spicy foods, milk, mung beans, and radishes while taking the medicine. Milk may interact with the herbal ingredients, while mung beans and radishes may counteract the medicinal properties of the herbs.

 

User Feedback:

I was in a state of sub-health and had poor physical constitution due to long hours of work and lack of sleep. After drinking this herbal remedy for about fifteen days, I noticed an improvement in my energy, and my menstrual cramps became more manageable. Interestingly, my husband noticed that my breasts had become fuller. While I did not measure my bust size, I felt that my chest had a more lifted and fuller appearance, with noticeable firmness. Importantly, I did not gain weight and even felt that my skin was firmer. These herbs are beneficial for toning the blood and qi, not hormones, so they are safer than other products. I will not use any breast enhancement products or oils since their ingredients are often unclear.

 

How to Identify a Cold Constitution:

Common signs of a cold constitution include infrequent thirst, feeling weak and fatigued, pale complexion, cold hands and feet, a preference for hot drinks and food, frequent diarrhea, frequent urination with pale urine, delayed menstruation with clots, and a pale tongue.

 

If you're unsure about your body constitution, it's recommended to consult with a TCM doctor for an accurate diagnosis and treatment plan. A good adjustment to your qi and blood can make your body more balanced and even improve your bust.

Peach-Red Four Herbs Soup (桃红四物汤)

This recipe, also known as "Modified Four Herbs Soup," is recorded in the Yujimiyi and is effective for improving blood circulation and alleviating menstrual discomfort.

 

Indications:

·        For Qi stagnation and blood stasis, with symptoms like dark menstruation or blood clots, dysmenorrhea (painful periods), and a dull complexion.

·        Helpful for small uterine fibroids or ovarian cysts, but it does not guarantee the removal of these conditions.

 

Warning for Breast Hyperplasia:

Be cautious with this recipe if you have breast hyperplasia, as it might cause discomfort in some cases, although it is rare. If you experience discomfort, stop using it, but if it works well without any discomfort, it can be continued.

 

Formula:

One dose (equivalent to one day's supply):

·        Shu Di Huang (熟地黄) – 15g

·        Dang Gui (当归) – 15g

·        Bai Shao (白芍) – 10g

·        Chuan Xiong (川芎) – 8g

·        Tao Ren (桃仁) – 9g

·        Hong Hua (红花) – 6g

 

Note: If prone to "heat" (internal excess), substitute Shu Di Huang (熟地黄) with Sheng Di Huang (生地黄).

 

Contraindications:

·        Pregnant women should avoid this formula.

·        Do not use if there is no blood stasis condition, and avoid prolonged use if not necessary.

 

Treatment Cycle:

1.     For mild conditions, use for about 10 days each month as a maintenance regimen.

2.     For more serious conditions, such as heavy menstrual clots or dysmenorrhea, a 30-day course is recommended. Use one dose per day, taken in three doses (morning, afternoon, and evening).

 

Preparation Method (Boiling):

1.     Rinse the herbs to remove dust.

2.     Place herbs in a medicinal pot, add 3 bowls of water, and soak for 20 minutes.

3.     Bring to a boil over high heat, then switch to low heat and simmer for 25 minutes. Strain the liquid.

4.     Add 2 more bowls of water, boil again, and simmer for 20 minutes, then strain the liquid.

5.     Repeat the process one more time, adding 2 bowls of water. After the third boiling, combine all the liquids. You should have about 650 ml of liquid.

 

Store in the refrigerator, and drink 200 ml three times a day, preferably before meals if your digestion is good, or 1 hour after meals if your digestion is weaker.

 

This method results in a rich, concentrated herbal tea, which is both nourishing and effective for balancing the body's energy and improving blood circulation.

 

Common Questions

Given that there is a lot of scattered information online, and this website has many articles about Siwu Decoction, I will summarize the common questions for quick reference.

Q: What ingredients are in Siwu Decoction?
A: The standard Siwu Decoction formula consists of four Chinese herbs:

·        Dang Gui (当归) - 9g

·        Shu Di Huang (熟地黄) - 12g

·        Chuan Xiong (川芎) - 6g

·        Bai Shao (白芍) - 9g
Depending on individual needs or body constitution, other herbs may be added, such as:

·        For Qi deficiency: Add Ren Shen (人参) or Huang Qi (黄芪)

·        For Blood stasis: Add Tao Ren (桃仁) or Hong Hua (红花)

Q: What are the effects of Siwu Decoction?
A: Generally, Siwu Decoction has the effects of:

·        Nourishing and enriching the blood

·        Beautifying the skin, especially for women

·        If combined with Tao Ren (桃仁) and Hong Hua (红花), it can promote blood circulation and eliminate blood stasis

Q: How do I make Siwu Decoction?

1.     Using a thermos: Place washed herbs in a thermos and add boiling water. Let it steep for about 10 minutes before drinking.

2.     Traditional method: Wash the herbs, put them in a pot (preferably a clay pot), and simmer for 20-30 minutes. Collect the juice, and repeat once or twice. Combine all juices together.

3.     Stewing with other food: Wash the herbs and stew them with other foods (like chicken or pork) in a pot, adjusting the time based on the other ingredients.

Q: Are there any side effects from Siwu Decoction?
A:

1.     The herbs in Siwu Decoction are generally warming, so it can cause heat for people with significant internal heat.

2.     Shu Di Huang (熟地黄) may cause diarrhea for people with weak stomachs.

3.     It is not suitable for children or pregnant women without consulting a local TCM practitioner.

Q: Which version of Siwu Decoction should I use?
A: The standard formula is usually fine, but for better results, it's recommended to consult a local Traditional Chinese Medicine (TCM) practitioner to tailor the formula to your individual constitution (e.g., heat or Qi deficiency).

Q: When should I drink Siwu Decoction?
A:

·        It’s best for women to drink after menstruation ends.

·        Do not drink during menstruation as it could have adverse effects.

·        Drinking half an hour before meals is optimal.

·        Avoid drinking during fever or colds.

Q: Can men drink Siwu Decoction?
A: Yes, according to well-known practitioner Zhuang Yahui, men who suffer from poor complexion, fatigue, or are in a sub-healthy state can also use Siwu Decoction for body adjustment.

Recipes

Recipe 1:

Basic Ingredients:

·        Konjac (蒟蒻)

·        Black dates (黑枣)

·        Sweet potato (地瓜) - 1 medium

·        Corn (玉米) - 2 cobs (cut into chunks)

·        Tofu skin (豆包) - 2 pieces

·        Shiitake mushrooms (香菇) - several pieces

·        Black sesame oil (黑麻油)

 

Steps:

1.     Put the Siwu Decoction herbs into a pot with 5 bowls of water and simmer to extract the juice. Set aside the liquid.

2.     Reuse the herbs and add 3 more bowls of water, repeat the simmering process.

3.     In a separate pan, heat black sesame oil and sauté the shiitake mushrooms, then add tofu skin.

4.     Pour in the previously collected broth, and add sweet potato, konjac, black dates, and corn. Steam in an electric cooker until cooked.

 

Optional: Add other ingredients like yam (山药), lily (百合), lotus seeds (莲子), ginkgo nuts (白果), and red dates (红枣) for extra benefits.

Recipe 2:

Sun Yat-sen's version of Siwu Decoction:

·        Daylily (黄花菜), also known as Golden Needle (金针), contains vitamin A, fiber, and iron. It is known for its ability to clear heat and promote blood circulation, useful for conditions like edema, blood in urine, or gastrointestinal issues.

·        Wood ear (木耳) is a well-known ingredient in Chinese medicine for nourishing blood and promoting circulation. It is often used for conditions like blood dysentery, hemorrhoids, and post-natal weakness.

·        Tofu and bean sprouts (豆芽) are common ingredients in Chinese cuisine, offering a great source of plant-based protein, fat, and vitamins.

 

This recipe is known for being a healthy vegetarian option, promoting longevity.

Recipe 3:

Black-bone Chicken Siwu Decoction:

1.     Prepare the black-bone chicken by scalding it in hot water to remove impurities, then clean it.

2.     Wash the herbs for Siwu Decoction and place them into a tea filter or coffee filter.

3.     Boil black-bone chicken, goji berries (枸杞), dried mushrooms (香菇), and ginger (姜) in a clay pot. Add rice wine (米酒) and simmer on low heat for 2-3 hours.

4.     The broth may be dark due to the herbs and black chicken, and its strong herbal taste may take some getting used to.

 

This is a nourishing formula that’s great for women due to its blood-building and replenishing properties.

These recipes showcase various ways to use Siwu Decoction with different ingredients, depending on your preferences and dietary needs.

 

Recipe Four
Ingredients:

·        Dong Gui (当归): 9g

·        Chuan Xiong (川芎): 8g

·        Shu Di (熟地): 12g

·        Chao Bai Shao (炒白芍): 10g

·        Hong Zao (红枣): 5 pieces

·        Hong Tang (红糖): A small amount

 

Instructions:

1.     Add water to the ingredients and bring to a boil.

2.     Continue boiling for another 15 minutes.

3.     Drink two times a day, with approximately 100ml per serving.

Celebrity Endorsements

1.     Taiwanese women commonly use Four-Substance Soup (四物汤) to maintain good health. The beauty-conscious actress Big S is known to use it, especially after her menstrual cycle ends. She drinks it twice daily for a week to help her body recover.

2.     Wu Pei Ci, whose grandfather was a Chinese medicine practitioner, swears by traditional Chinese medicine beauty treatments, believing they have no side effects. She has been drinking medicinal soups like Four-Substance Soup, Ten Comprehensive Tonics Soup (十全大补汤), and Red Date Soup since childhood. She claims it helps with skin and body health.

3.     Lai Ya Yan, daughter of a Chinese medicine shop owner, has been drinking Four-Substance Soup since she was young, especially when she first got her period. She enjoys preparing her own medicinal soups and has shared her experiences and insights about Four-Substance Soup in her book.

Culinary Anecdote
Sun Yat-sen and Four-Substance Soup

Sun Yat-sen's version of Four-Substance Soup does not contain four medicinal herbs but instead uses four essential plant-based foods: Yellow Flower Vegetable (黄花菜), Wood Ear (木耳), Tofu (豆腐), and Bean Sprouts (豆芽).

Sun Yat-sen, who was skilled in Western medicine, also studied Chinese medicine and nutrition. His version of

Four-Substance Soup reflects his research in diet and nutrition.

·        Yellow Flower Vegetable (黄花菜), also known as Golden Needle (金针), is rich in Vitamin A, fiber, and iron. It has diuretic, cooling, and blood-cleansing properties. It is commonly used for treating water retention, urinary tract infections, nosebleeds, and digestive issues, as well as strengthening the stomach and spleen.

·        Wood Ear (木耳), listed as a middle-grade herb in the Shennong Ben Cao Jing (神农本草经), nourishes the blood, invigorates circulation, and has astringent properties. It is beneficial for conditions like hemorrhoids, postpartum weakness, excessive bleeding, and vaginal discharge. Wood ear is rich in protein, vitamins, and minerals such as calcium, phosphorus, and iron.

·        Tofu (豆腐) and Bean Sprouts (豆芽) are both derived from soybeans, preserving their proteins, fats, vitamins, and other nutrients, which are easily absorbed by the body.

 

This vegetarian version of Four-Substance Soup is an excellent example of healthy, plant-based nourishment and is considered one of the best vegetarian dishes for health.