Si Mo Tang四磨汤

Four-Ground Decoction

Regulating Qi 理气剂Promote the Movement of Qi 行气

Ingredients4 herbs

HerbDosageWhat it does in this formula

人Ren Shen人参Ginseng Radix et Rhizoma6gHolds up the upright qi so the three qi-breaking herbs do not deplete the patient 槟Bing Lang槟榔Arecae Semen9gDrives qi downward and breaks up what has knotted 沉Chen Xiang沉香Aquilariae Lignum Resinatum6gDirects rebellious qi downward and warms the middle without drying

天Wu Yao天台乌药Linderae Radix6gOpens Liver constraint and moves qi through chest and abdomen

Indications

Moves qi and directs counterflow downwardLoosens the chest and disperses knotted qiSupports the upright qi while breaking stagnation

Liver qi constraint with qi counterflow. Emotional strain binds the qi, which then rises instead of descending; because such patients are often already depleted, the formula moves qi without abandoning the upright qi.

Clinical Manifestations

Oppressive fullness of the chest and diaphragm after emotional upset
Shortness of breath with a sense of qi rising
Fullness and blockage below the heart
Loss of appetite from constraint rather than weakness
Belching and sighing with abdominal distention

TongueWhite coating

PulseWiry

Health Categories

Digestive HealthStress & Emotional Balance

Modern Applications

Functional dyspepsia Globus sensation Hyperventilation Abdominal distention Post-operative ileus

Common adjustments

Patient robust with no deficiency — remove Ren Shen 人参 and add Zhi Shi 枳实 and Mu Xiang 木香, which gives Wu Mo Yin Zi
Constipation with abdominal distention — add Da Huang 大黄 to the five-herb version, which gives Liu Mo Tang
Phlegm present with sputum — add Zhi Ban Xia 制半夏 and Chen Pi 陈皮
Constraint has generated heat — add Zhi Zi 栀子 and Chuan Lian Zi 川楝子

Contraindications

Not for wheezing from Lung or Kidney deficiency, where the breath is weak rather than driven, and not for severe qi collapse. Bing Lang breaks qi downward and is unsuitable for a frail patient in more than a small dose. Sudden severe breathlessness or chest pain is a medical emergency and requires urgent assessment, not a qi-moving decoction.

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

Pregnancy

Avoid in pregnancy unless a practitioner judges otherwise. Bing Lang breaks qi downward and Chen Xiang is strongly descending — the direction of the formula is the opposite of what is wanted in pregnancy.

Related Formulas

References

Source Ji Sheng Fang 《济生方》 · Southern Song

「治七情伤感，上气喘息，妨闷不食。」
— 《济生方》(classical source, public domain)

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 and preparation method 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.