Si Miao Yong An Tang四妙勇安汤

Four-Valiant Decoction for Well-Being

Clearing Heat 清热剂Clear Heat and Resolve Toxicity 清热解毒

Ingredients4 herbs

HerbDosageWhat it does in this formula

金Jin Yin Hua金银花Lonicerae Japonicae Flos90gUsed in a very large dose to resolve entrenched heat toxicity 玄Xuan Shen玄参Scrophulariae Radix90gResolves toxicity while replenishing the yin the toxin has consumed 当Dang Gui当归Angelicae Sinensis Radix60gNourishes and moves blood into a limb that is starved and obstructed 甘Gan Cao甘草Glycyrrhizae Radix30gResolves toxicity, eases pain and harmonises the large doses

Indications

Clears heat and resolves toxicityNourishes yinInvigorates blood and relieves pain

Heat toxicity blazing with yin damaged and blood obstructed: the toxin is entrenched, the yin fluid is already consumed, and the vessels of the limb are blocked. All three are addressed by very large doses of few herbs rather than a broad prescription.

Clinical Manifestations

Gangrenous ulceration of the toes or fingers with heat toxicity
Dusky red, hot, painful limb with foul ulceration
Severe burning pain in an ischaemic limb
Chronic heat-toxic ulcers that will not close

TongueRed with a scanty coating

PulseRapid

Health Categories

Digestive HealthSkin HealthHeart & CirculationBlood Sugar Balance

Modern Applications

Thromboangiitis obliterans Peripheral arterial disease Diabetic foot ulcer Gangrene Chronic ulcer

Common adjustments

Severe pain — add Ru Xiang 乳香 and Mo Yao 没药
Marked blood stasis with a dark limb — add Dan Shen 丹参 and Chi Shao 赤芍
Yin badly depleted — add Shi Hu 石斛 and Mai Men Dong 麦门冬

Contraindications

For heat-toxic ulceration only. A pale, cold, non-inflamed limb is a cold pattern and needs warming, not this formula. Gangrene is a surgical emergency — herbal treatment belongs alongside conventional vascular care, never instead of it.

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

Pregnancy

Use in pregnancy only under practitioner supervision — Dang Gui moves the blood and the doses here are unusually large; the underlying condition also requires medical management.

Related Formulas

References

Source Yan Fang Xin Bian 《验方新编》 · Qing

Classical source (public domain) — composition per the standard textbook record.
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.