New Understanding of Si Nisi San 1997.12.20

New Understanding of Si Nisi San 1997.12.20

“Shanghan Lun” Article 318 states: “For Shaoyin illness, with four extremities cold, the person may cough, palpitate, have difficulty urinating, abdominal pain, or severe diarrhea—Si Nisi San is the main prescription.” Chaihu, Zhishi, Bai Shao, and Gancao are taken in equal amounts, ground into powder, and taken at one square inch per dose, three times daily. For cough, add Wuweizi and Ganjiang; for palpitations, add Guizhi; for difficulty urinating, add Fuling; for abdominal pain, add Fupian; for severe diarrhea, add Ganjiang and Xiebai. “Shaoyin illness presents with a faint pulse but a strong desire to sleep,” indicating that the premise of the formula is as described—the four extremities cold are indeed a symptom. Patients with cold extremities, whether they cough, palpitate, have difficulty urinating, abdominal pain, or severe diarrhea, can all be treated with this formula. The implication is that diseases affecting the respiratory, circulatory, urinary, and digestive systems—all can present with cold extremities—and this formula can treat them. From a modern medical perspective, any systemic disease that results in shock can be treated with this formula. Based on my experience, Si Nisi San with added ingredients can treat pancreatitis, gallstones, and cholecystitis; Si Nisi San with Su Xing San can treat coughs and bronchitis; Si Nisi San combined with Ling Gui Shu Gan Tang can treat heart diseases; Si Nisi San combined with Longdan Xie Gan Tang can treat urinary tract diseases; Si Nisi San combined with Fupian Lizhong Tang can treat chronic gastritis and chronic diarrhea. In summary, according to the meaning of the classic text, Si Nisi San is the ultimate prescription for treating peripheral circulatory failure. According to recent domestic and international literature, Si Nisi San promotes gastric mucosal defense factors, thereby protecting the safety and stability of the gastric mucosa. Si Nisi San also inhibits gastric acid, but this effect is weaker than that of H2 receptor antagonists. In addition, Si Nisi San has anti-ulcer effects. Thus, the main focus of Si Nisi San’s action is on the stomach. I also have experience using this formula with Xixin and Mutong to treat acral cyanosis, with excellent clinical results, demonstrating the clinical significance of Si Nisi San in treating extremity cold.