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Chinese Angelica Counterflow Cold Decoction
当归四逆汤 〔當歸四逆湯〕dāng guī sì nì tāng
Source: Shāng Hán Lùn 伤寒论
Ingredients:
- Dāng guī (当归 Angelicae Sinensis Radix, Chinese angelica) 6–9g
- Guì zhī (桂枝 Cinnamomi Ramulus, cinnamon twig) 3–9g
- Sháo yào (芍药 Paeoniae Radix, peony [root]) 6–9g
- Xì xīn (细辛 Asari Rhizoma et Radix, asarum) 3–6g
- Gān cǎo (甘草 Glycyrrhizae Radix, licorice [root]) (mix–fried) 3–6g
- Mù tōng (木通 Akebiae Trifoliatae Caulis, trifoliate akebia) 3–6g
- Dà zǎo (大枣 Jujubae Fructus, jujube) 5–12 pieces
Action: Warms the channels and disperses cold; nourishes the blood and frees the vessels.
Indication: (a) Contraction of cold in blood vacuity patients, characterized by counterflow cold of the limbs, and a fine pulse on the verge of expiration; (b) wind-damp impediment (fēng shī bì) patterns; (c) delayed menstruation and cold-type menstrual pain.
Category: Interior-warming formulas / Channel-warming cold-dispersing formulas
Method: Decoct with water.
Rationale: Dāng guī not only supplements liver blood but also warms the channels and disperses cold. Treating both the root and tip, it is the sovereign agent. Guì zhī works with the Dāng guī to move the blood and free the vessels, and to warm the channels and disperse cold. Bái sháo works with Dāng guī to nourish the blood and free the vessels. Xì xīn is a warm acrid agent that disperses the cold evil and frees the channels. Mù tōng is cold, but with Guì zhī and Xì xīn, its nature is inhibited without detriment to its function of freeing the vessels. Zhì gān cǎo works with cinnamon to warm and invigorate heart yáng thereby helping to free the vessels. Dà zǎo acts with the Dāng guī to warm and supplement provisioning.
Variations:
- The formula is more effective if the Mù tōng (木通 Akebiae Trifoliatae Caulis, trifoliate akebia) is replaced with Jī xuè téng (鸡血藤 Spatholobi Caulis, spatholobus [stem]).
Vacuity cold : Add Fù zǐ (附子 Aconiti Radix Lateralis Praeparata, aconite [accessory root]), Gān jiāng (干姜 Zingiberis Rhizoma, dried ginger), and Huáng qí (黄芪 Astragali Radix, astragalus [root]).Blood stasis : Add Chuān xiōng (川芎 Chuanxiong Rhizoma, chuanxiong [rhizome]), Hóng huā (红花 Carthami Flos, carthamus [flower]), and Táo rén (桃仁 Persicae Semen, peach kernel).- Pain: Add Wēi líng xiān (威灵仙 Clematidis Radix, clematis [root]), Rǔ xiāng (乳香 Olibanum , frankincense), and Mò yào (没药 Myrrha , myrrh).