Si Shen Wan四神丸
Four-Miracle Pill
Ingredients4 herbs
Indications
Spleen and Kidney yang deficiency diarrhoea: without the Kidney's warmth the Spleen cannot transform food and the lower gate cannot stay shut, so stool passes in the early hours when yang is weakest.
Clinical Manifestations
- Diarrhoea before dawn
- Chronic loose stools with undigested food
- Poor appetite with no interest in eating
- Cold abdomen and cold limbs
- Long-standing morning urgency in a tired patient
Health Categories
Modern Applications
Common adjustments
- Cold and pain in the abdomen marked — add Fu Zi Fu Zi (Zhi) and Rou Gui 肉桂 under supervision
- Loss so uncontrolled that the bowel will not hold — combine with Zhen Ren Yang Zang Tang 真人养脏汤, or add He Zi 诃子 and Chi Shi Zhi 赤石脂
- Spleen qi deficiency prominent — add Dang Shen 党参 and Bai Zhu 白术
Contraindications
Not for diarrhoea from damp-heat or food stagnation — burning stool, foul odour, urgency and a yellow greasy tongue coating all call for clearing, not warming and binding. Early-morning stool that is otherwise normal is not this pattern.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Used with caution in pregnancy and only on practitioner advice — Wu Zhu Yu is warm and dispersing and is generally avoided during pregnancy.
References
Source Nei Ke Zhai Yao 《内科摘要》 · Ming
- Classical source as cited above (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）— 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.