Si Ni San and Huang Qi Jian Zhong Tang May 16, 2005

Si Ni San and Huang Qi Jian Zhong Tang May 16, 2005

Si Ni San (Bupleurum, Citrus aurantium, White Peony, Licorice) is a formula from the “Shanghan Lun.” The “Shanghan Lun—Lesser Yin Disease Pulse and Symptom Chapter” states: “For Lesser Yin disease with cold extremities, the patient may cough, palpitate, have difficulty urinating, abdominal pain, or severe diarrhea. Si Ni San is the primary prescription.” This indicates that the main symptom of Si Ni San is cold extremities, but cold extremities can be caused by various factors, such as coughing, palpitations, difficulty urinating, abdominal pain, or severe diarrhea. Respiratory, circulatory, urinary, and digestive systems can all lead to cold extremities. In my clinical practice, I often use this formula to treat liver and gallbladder diseases as well as gastrointestinal disorders. Director Wu Zhen of the Nantong City Traditional Chinese Medicine Hospital in Jiangsu Province summarized six aspects of the clinical application of this formula, which I consider to be truly insightful.

1. Liver and gallbladder diseases: acute and chronic hepatitis, biliary tract diseases, pancreatitis, intercostal neuralgia.

2. Gastrointestinal diseases: chronic gastritis, peptic ulcer, gastrointestinal neurosis.

3. Neurosis: hysteria, neurasthenia.

4. Coronary heart disease, pleurisy.

5. Thyroid enlargement, thyroid tumor.

6. Breast lobular hyperplasia, dysmenorrhea, amenorrhea, menstrual irregularities.

Huang Qi Jian Zhong Tang appears in the “Jin Gui Yao Lue.” The “Jin Gui Yao Lue—Blood Stasis and Deficiency Syndrome Chapter” states: “For deficiency syndrome with urgent need and various deficiencies, Huang Qi Jian Zhong Tang is the primary prescription.” “For blood stasis, both yin and yang are weak, the pulse at the cun and guan positions is weak, and the pulse at the chi position is tight. The external manifestation is numbness of the body, resembling wind-stasis syndrome. Huang Qi Gui Zhi Wu Wu Tang is the primary prescription.” These two formulas differ only in licorice (Huang Qi Gui Zhi Wu Wu Tang does not contain licorice), fully demonstrating the role of Gui Zhi Tang in harmonizing exterior and interior, and stabilizing internal organs. I often use these two formulas for stomach pain, usually adding calcined oyster shell, fragrant fennel, and alum to enhance the effect.