Si Miao Wan四妙丸
Four-Marvel Pill
Ingredients4 herbs
Indications
Damp-heat pouring into the lower limbs with swelling as well as weakness. Damp is more visible here than in San Miao Wan, so an extra bland draining herb is added rather than more bitter cold.
Clinical Manifestations
- Swollen, heavy, weak legs
- Hot swollen ankles and feet
- Damp-heat leg qi
- Gouty pain of the big toe or ankle
- Weak legs with a greasy yellow coating
Health Categories
Modern Applications
Common adjustments
- Swelling is marked — add Fu Ling 茯苓 and Ze Xie 泽泻
- Joint pain with redness — add Fang Ji 防己 and Ren Dong Teng 忍冬藤
- Numbness and stiffness of the sinews — add Mu Gua 木瓜 and Luo Shi Teng 络石藤
- Long illness with Liver and Kidney deficiency — add Sang Ji Sheng 桑寄生 and Xu Duan 续断
Contraindications
Not for weak or swollen legs from Spleen or Kidney yang deficiency, where the skin is pale and cool and the tongue pale — that oedema needs warming, not draining. Swelling of both legs can also be cardiac, renal or venous in origin and must be assessed medically before it is treated as damp-heat.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Contraindicated in pregnancy — it contains Niu Xi, which moves blood downward, together with a large dose of Yi Yi Ren; both are avoided in pregnancy.
Related Formulas
References
Source Cheng Fang Bian Du 《成方便读》 · Qing
- Classical source of record (public domain).
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）— 附方 note and 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.