Skip to content
Cura x Cura

Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang当归四逆加吴茱萸生姜汤

Tangkuei Decoction for Frigid Extremities plus Evodia and Fresh Ginger

Warming the Interior 温里剂Warm the Channels and Disperse Cold 温经散寒

Ingredients9 herbs

当Dang Gui当归12gNourishes the blood and moves it, so the warmed channels have blood to carry
芍Bai Shao芍药9gNourishes blood and construction with Dang Gui and relaxes cramping
甘Zhi Gan Cao甘草炙6gAugments qi and harmonizes the whole通Tong Cao通草6gUnblocks the blood vessels and the collaterals so the warmth travels桂Gui Zhi桂枝去皮9gWarms the channels and unblocks the vessels so yang reaches the extremities细Xi Xin细辛3gPenetrates to disperse cold lodged deep in the channels; used in small dose and decocted, never as powder生Sheng Jiang生姜切12gUsed generously to warm the Stomach and stop the vomiting吴Wu Zhu Yu吴茱萸9gWarms the Liver and Stomach, disperses the old cold within, and settles rebellious qi大Da Zao大枣擘8枚Tonifies the Spleen and nourishes blood, tempering the acrid herbs

Indications

Warms the channels and disperses coldNourishes blood and unblocks the vesselsWarms the Liver and Stomach, directs rebellious qi downward

Blood deficiency with cold congealing in the channels, complicated by long-standing cold in the interior. The classical phrase is that the person 'has old cold within' — cold lodged in the Liver and Stomach that a channel-warming formula alone will not move.

Clinical Manifestations

  • Cold hands and feet in a blood-deficient patient who also vomits
  • Long-standing cold in the Stomach with retching of thin fluid
  • Vertex headache of cold in the Liver channel
  • Cold lower abdominal or hernial pain
  • Cold, painful periods with cold extremities
TonguePale with a white coating
PulseThin and on the verge of expiring

Health Categories

Women's HealthDigestive HealthSkin HealthHeart & Circulation

Modern Applications

Raynaud phenomenonChilblainsMigraineDysmenorrheaChronic gastritisPeripheral vascular disease

Common adjustments

Contraindications

Not for cold limbs arising from yang collapse — that pattern reaches above the elbows and knees and needs Si Ni Tang, not this. Not for heat patterns, yin-deficient heat, or vomiting from Stomach heat; Wu Zhu Yu is acrid, hot and drying and is easily overdone.

For licensed practitioners’ reference only — not a self-treatment guide.

Pregnancy

Use with caution in pregnancy, and only on a practitioner's decision. Wu Zhu Yu is a mildly toxic, strongly hot herb that is traditionally restricted in pregnancy; Dang Gui and Gui Zhi move the blood; and the classical preparation includes wine. Not appropriate for self-medication at any time.

Related Formulas

References

Source Shang Han Lun 《伤寒论》 · Eastern Han

「若其人内有久寒者，宜当归四逆加吴茱萸生姜汤。」
— 《伤寒论》(classical source, public domain)
  1. Classical source (public domain), cited in the source-quote section.
    2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
    3. 《方剂学》（全国中医药行业高等教育规划教材）— pattern analysis cross-checked.

Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.