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Si Jun Zi Tang
四君子汤

 

From:

Song Dynasty Taiping Huimin Heji Ju Fang

 

Prescription:

·        Ren Shen (人参, Ginseng) (remove the roots)

·        Gan Cao (甘草, Licorice) (processed)

·        Fu Ling (茯苓, Poria) (peel removed)

·        Bai Zhu (白术, Atractylodes)

 

Preparation:
Grind all ingredients into a fine powder.

 

Indications:
Treats deficiency of Qi, weakness of internal organs, fullness in the heart and abdomen, loss of appetite, bowel sounds, diarrhea, vomiting, and nausea. It is especially beneficial for people with weak spleen and stomach to promote digestion and prevent cold and dampness.

 

Dosage and Administration:
Take 6g per dose, simmer with 150ml of water until reduced to 100ml, and take orally. It can be taken at any time. A pinch of salt can be added, and it can also be consumed with clear soup.

 

Alternate Name:
Bai Zhu Tang (白术汤, Atractylodes Decoction) (from Sheng Ji Zong Lu, Volume 80)

 

Pharmacological Actions:

1.     Regulates Gastrointestinal Function:
Si Jun Zi Tang regulates the autonomic nervous system, counteracting acetylcholine and histamine to restore the disturbed functions of secretion, digestion, movement, and nutrition in the gastrointestinal system. It can reduce gastric acid secretion, lowering pH, and thus helps in the healing of gastric ulcers.
(Sources: New Chinese Medicine, 1978; New Medicine, 1979)

2.     Enhances Immune Function:
Studies show that Si Jun Zi Tang enhances macrophage phagocytosis in mice and boosts lymphocyte transformation. The formula without licorice shows an increase in serum IgG levels and a significant improvement in lymphocyte transformation rate.
(Sources: Journal of Integrative Medicine, 1984; New Medical Journal, 1979)

3.     Promotes Hematopoiesis:
Si Jun Zi Tang helps to increase reticulocyte count in animals with blood loss and promotes the transformation of reticulocytes into red blood cells.
(Source: Chinese Medicine Research Communications, 1963)

4.     Other Effects:
The formula increases liver glycogen content in mice and aids liver tissue repair. It also helps raise blood pressure and improve shock conditions by adjusting internal factors such as the nervous, cardiovascular, and endocrine systems.
(Sources: Teaching Dynamics, 1979; Chinese Medicine Research Communications, 1963)

 

Indications (Clinical Use):
Si Jun Zi Tang is used to treat conditions such as chronic gastritis, chronic gastric and duodenal ulcers, and chronic enteritis related to spleen and stomach deficiency. Typical symptoms include fatigue, pale complexion, lack of appetite, abdominal bloating, diarrhea, and a pale tongue with a thin white coating, weak and deficient pulse.

 

Usage and Dosage:
6g per dose, with 150ml of water, simmer until reduced to 100ml, and take orally. It can be taken at any time, and a pinch of salt can be added to the decoction.

 

Notes:
The formula includes:

·        Ren Shen (人参, Ginseng): A warm herb that tonifies Qi and benefits the middle.

·        Bai Zhu (白术, Atractylodes): Strengthens the spleen and dries dampness, working with ginseng to tonify the spleen and Qi.

·        Fu Ling (茯苓, Poria): Promotes urination and strengthens the spleen.

·        Gan Cao (甘草, Licorice): Harmonizes the other ingredients and moderates the formula’s actions.

 

These four herbs are all balanced in their properties, warm but not drying, tonifying but not excessive, earning the name Si Jun Zi Tang (Four Gentlemen Decoction).

 

Source:
Taiping Huimin Heji Ju Fang, Volume 3

 

 

Si Jun Zi Tang (Four Gentlemen Decoction)

Formula:

·        Bai Zhu (白术) - Atractylodes (Atractylodes macrocephala)

·        Ren Shen (人参) - Ginseng (Panax ginseng)

·        Huang Qi (黄耆) - Astragalus (Astragalus membranaceus)

·        Fu Ling (茯苓) - Poria (Poria cocos)

 

Preparation Method:

·        Grind all ingredients into a coarse powder.

 

Functions and Indications:

·        Tonify Qi and strengthen the lungs. It is used for lung damage and conditions where the skin and hair fall out.

 

Dosage:

·        Take 15–21 grams per dose. Boil in 150 ml of water until 100 ml remains, then strain. Take warm on an empty stomach.

Si Jun Zi Tang (Four Gentlemen Decoction)
From the Song Dynasty "Tai Ping Hui Min He Ji Ju Fang" (Taiping Huimin Heji Ju Fang)

 

Formula Composition:

·        Ren Shen (人参) - Ginseng (Panax ginseng), remove the root (9 grams)

·        Bai Zhu (白术) - Atractylodes (Atractylodes macrocephala), remove the skin (9 grams)

·        Fu Ling (茯苓) - Poria (Poria cocos), remove the skin (9 grams)

·        Zhi Gan Cao (炙甘草) - Honey-fried Licorice (Glycyrrhiza uralensis) (6 grams)

 

Preparation Method:

·        Grind all ingredients into a fine powder.

·        Take 15 grams of the powder with one cup of water, boil until 70% of the liquid remains. It can be taken at any time of the day, with a small amount of salt or plain water if desired. In modern use, boil the decoction.

 

Functions and Indications:

·        Tonify Qi and strengthen the spleen.

 

Indications:

·        Spleen and stomach Qi deficiency, manifested by symptoms such as pale complexion, low voice, shortness of breath, fatigue, poor appetite, loose stools, pale tongue with white coating, and weak pulse.

 

Analysis of the Formula:

·        The condition treated by Si Jun Zi Tang is caused by a deficiency in spleen and stomach Qi, leading to impaired digestion and transformation of food. The spleen is the foundation of postnatal Qi and blood, and when its function is weak, symptoms like reduced appetite, loose stools, pale complexion, and weakness occur. The treatment aims to tonify the spleen and stomach Qi to restore their function.

·        Ren Shen (人参), which strongly tonifies the original Qi and strengthens the spleen, is the chief ingredient. Bai Zhu (白术), which is warm and dries dampness, helps strengthen the spleen and promotes Qi transformation, and is the deputy herb. Fu Ling (茯苓), which drains dampness and strengthens the spleen, is the assistant herb. Zhi Gan Cao (炙甘草) harmonizes and moderates the effects of the other herbs, and is used as a guide in the formula.

·        The combination of these four herbs enhances Qi and strengthens the spleen.

 

Clinical Applications:

1.     Si Jun Zi Tang is a fundamental formula for treating spleen and stomach Qi deficiency. Many other formulas for tonifying Qi and strengthening the spleen are derived from this formula. Key diagnostic features include pale complexion, shortness of breath, weakness of the limbs, pale tongue with white coating, and weak pulse.

2.     This formula is commonly used in modern times to treat chronic gastritis, gastric and duodenal ulcers, and other conditions of spleen and stomach Qi deficiency. It is also used for conditions such as hepatitis B, coronary heart disease, pregnancy complications, and post-infection spleen deficiency in children.

3.     A clinical study showed Si Jun Zi Tang with modifications was more effective than domperidone in treating functional dyspepsia, with a total effectiveness rate of 88.9%.

4.     In the treatment of chronic superficial gastritis with a formula of 30 grams of Ren Shen, 10 grams of Bai Zhu, 10 grams of Fu Ling, and 6 grams of Zhi Gan Cao, the total effective rate was 91.4%.

5.     Si Jun Zi Tang with modifications showed high efficacy in treating chronic lower limb ulcers, with a total effective rate of 98.3%.

6.     The formula, combined with other treatments for diabetes, showed a total effectiveness rate of 94.2% in clinical trials.

 

Comparison with Li Zhong Wan:

·        Both Si Jun Zi Tang and Li Zhong Wan use Ren Shen, Bai Zhu, and Zhi Gan Cao to tonify and benefit Qi, but their functions differ. Si Jun Zi Tang, with Fu Ling, focuses on tonifying Qi and strengthening the spleen, while Li Zhong Wan, with Gan Jiang (干姜), emphasizes warming the middle and expelling cold, suitable for treating middle-Jiao cold and deficient Qi.

 

Formula Song (Memorization Verse):

·        Si Jun Bu Qi Ji Chu Fang,
Shi Shao Wu Li Da Bian Tang,
Ren Shen Bai Zhu Fu Ling Cao,
Yi Qi Jian Pi Gong Xiao Qiang.

 

(Translation: The Four Gentlemen Decoction, a foundational formula to tonify Qi, treats symptoms like poor appetite, weakness, and loose stools. Ginseng, Atractylodes, Poria, and Licorice work together to strengthen the Qi and the spleen.)