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Si ni tang(Cold Limbs Decoction )---四逆汤

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【组成】  附子(15g) 干姜(9g)  炙甘草(6g)
 
【功用】  回阳救逆。
 
【主治】  少阴病。四肢厥冷,恶寒踡卧,呕吐不渴,腹痛下利,神衰欲寐,舌苔白滑,脉微;或太阳病误汗亡阳
 
【歌诀】  四逆汤中附草姜,四肢厥冷急煎尝,腹痛吐泻脉微细,急投此方可回阳。
 

   

Cold Limbs Decoction (Si ni tang)

[SOURCE]: Treatise on Cold-Attack

[INGREDIENTS]: Prepared aconite lateral root 5lOg,  Dry ginger 69g ,  Roasted licorice 6g

[DIRECTIONS]: Decoct the above herbs in water for oral administration.

[EFFECT]: Restoring yang to rescue collapse.

[INDICATIONS]:

(1)      Shaoying diseases with symptoms of cold limbs, chill, lying crookedly, vomiting without thirst, abdominal pain and diarrhea, mental fatigue and drowsi­ness, white and greasy coating, feeble and thread pulse.

(2)      Depletion of yang due to erroneous use of purgative to Taiyang diseases.

ANALYSIS OF FORMULA This is a representative formula for restoring

yang to rescue collapse. Being extremely pungent flavor and hot nature,prepared aconite lateral root as the main herb warms and restores the kidney-yang to rescue collapse. As the assistant herb, dry ginger warms up the spleen-yang and helps prepared aconite lateral root strengthen the kidney-yang. As the adjuvant and dis­patcher herb, licorice promotes transformation of yang by combination with prepared aconite lateral root and dry ginger and buffers the extremely hot nature of prepared aconite lateral root and dry ginger to prevent injury or yin.

[ASSOCIATED FORMULAE]:

(1)      Ginseng plus Cold Limbs Decoction (si ni jia ren shen tang)---四逆加人参汤(Treatise on Cold-Attack):

Add 3 gram of ginseng on the basis of Cold Limbs Decoction. The directions are the same as that of Cold Limbs Decoction.

Effects:Restoring yang and reinforcing qi to rescue collapse and consolidate prostration.

Indications: Cold limbs, chill, lying crookedly, feeble pulse and diarrhea. The above symptoms aften exist diarrhea is stopped.

(2)      Poria Cold Limbs Decoction(fu ling si ni tang)---茯苓四逆汤(Treatise on Cold-At­tack)

Add 18 gram of poria and 3 gram of ginseng on the basis of Cold Limbs De­coction. The directions are the same as that of Cold Limbs Decoction.

Indications: Cold attack after diaphoresis remaining of illness and restless­ness.

(3)      Spring Onion Decoction(Bai tong tang)---白通汤(Treatise on Cold-Attack):

Chinese onion stalk 9g, dry ginger 3 5g,prepared aconite lateral root 5 10g.

Decoct the above herbs in. water for oral use.

[Effects]: activating yang to break yin.

Indications Shaoyin diseases with diarrhea and feeble pulse.

(4)      Pig,s Bile plus Spring Onion Decoction(Bai tong jia zhu dan zhi tang)---白通加猪胆汁液汤. (Treatise on Cold-Attack):

Add 20 ml of pig's bile and 50 ml of human urine to Spring Onion Decoction. The above three herbs should be decocted in water for oral use after mixing with pig,s bile and human urine.

Effects Breaking yin to restore yang for connecting the superiority and infe­riority.

Indications: Shaoyin diseases with symptoms of unceasing diarrhea even after application of Spring Onion Decoction with cold limbs, retching, vexation and fee­ble pulse.

NOTES: All the above four formulae are modified from Cold Limbs Decoc­tion. Ginseng plus Cold Limbs Decoction is indicated to the syndromes as indicaed by Cold Limbs Decoction but complicated by exhaustion of yin-fluid. In this case ginseng is added to restore yin, yang and qi in order to promote generation of body fluid. Poria cold Limbs Decoction is indicated to injury of both yin and yang marked by restlessness after diaphoresis and purgation. In this case poria and gin­seng are combined to nourish yin on the basis of restoring yang by Cold Limbs Decoction. Chinese Onion Decoction is applied to syndromes due to yin-cold in the lower part with exhaustion of yang-qi, so licorice is removed from Cold Limbs Decoction and Chinese onion stalk is added to activate yang for dispelling cold-evil. If the exuberant yin expelling yang exteriorly manifested by hectic cheek, retching ind vexation, Pig,s Bile plus Chinese Onion Decoction could be applied. Herbs with bitter flavors and cold nature are used in yang-warming formulae as the counter adjuvant to prevent cold-evil rejecting the hot-natured herbs.


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