Si Ni Jia Ren Shen Tang四逆加人参汤
Frigid Extremities Decoction plus Ginseng
Ingredients4 herbs
Indications
Devastated yang with simultaneous exhaustion of qi and fluids. Cold reversal remains, but the vessels are also empty of substance, so warming alone cannot refill them.
Clinical Manifestations
- Yang collapse after prolonged or violent diarrhoea
- Cold limbs with a faint pulse and profuse cold sweating
- Diarrhoea that has stopped through sheer depletion
- Severe fluid loss with dry mouth in a cold, collapsing patient
- Exhaustion following excessive sweating or vomiting
Health Categories
Modern Applications
Common adjustments
- Sweating profuse and unstoppable — add Long Gu 龙骨 and Mu Li 牡蛎 to secure what is leaking away
- Fluids severely depleted — add Mai Men Dong 麦门冬 and Wu Wei Zi 五味子
- Cold repelling yang outward — increase Fu Zi and Gan Jiang 干姜
Contraindications
Not for heat-type diarrhoea or dehydration accompanied by real heat signs. Severe fluid loss with collapse requires urgent rehydration and medical care; this formula is an adjunct to that, never a substitute.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Contraindicated in pregnancy outside a physician-assessed emergency. Prepared Fu Zi is a toxic aconite root: processed material only, mandatory prolonged pre-decoction, and no self-administration. Under-boiled or overdosed Fu Zi causes numbness, arrhythmia and can be fatal.
Related Formulas
References
Source Shang Han Lun 《伤寒论》 · Eastern Han
「恶寒脉微而复利，利止亡血也，四逆加人参汤主之。」
- 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.