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Four Spirits Pill

四神丸 〔四神丸〕sì shén wán

Source: Zhèng Zhì Zhǔn Shéng 证治准绳

Ingredients:

Action: Warms and supplements the spleen and kidney; astringes the intestines and checks diarrhea.

Indication: Spleen-kidney vacuity cold with fifth-watch diarrhea and no thought of food and drink, or enduring diarrhea with abdominal pain, aching lumbus and cold limbs, lassitude of spirit and lack of strength. Tongue: Pale with thin white fur. Pulse: Sunken, slow, and forceless.

Category: Astringing formulas / Intestine-astringing desertion-stemming formulas

Method: Grind to a fine powder, blend with a decoction of 80g ginger and 60g jujubes, and form into 300 mg pills.

Dosage: 10 pills on an empty stomach.

Rationale: Bǔ gǔ zhī is an acrid and bitter agent that is very warm. It supplements the life gate fire, which, according to the principle that fire engenders earth, promotes the spleen-stomach movement and transformation. Wú zhū yú is a hot acrid agent that warms the center and disperses cold, helping the Bǔ gǔ zhī to warm and the supplement the life gate. Ròu dòu kòu warms the center and checks diarrhea. Wǔ wèi zǐ is sour and astringent. Shēng jiāng and Dà zǎo are acrid and sweet agents that stimulate the spleen.

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