Si Ni San – vents pathogenic factors, release Liver Qi, regulate Spleen, (cold extremities/warm interior)

Si Ni San – Shang Han Lun

Chai Hu (radix bupleuri)…9-12g

Zhi Shi (fructus immaturus citri aurantii)…9-12g

Bai Shao (radix paeoniae lactiflorae)…12-24g

Zhi Gan Cao (honey fried radix glycyrrhizae uralensis)…6-9g

Indications: this formula is used for a Yang-hot type collapse, this means that only the fingers and toes are cold (in a Yin-cold type collapse where the Yang is exhausted, the area below the elbows and knees or maybe the whole limb is cold), Heat has entered the interior which is stopping the spreading of the Yang Qi to the extremities (hence the body is warm, and the fingers and toes are cold). chest and abdominal fullness show the constraint in the interior, T- red with yellow coat, P- wiry. 

This formula is also used for Liver Qi stagnation overacting on the Stomach.  Some say that this formula is designed for the patient with a weak Spleen that has been invaded by a pathogenic influence.  This causes a disruption in the Spleens ability to control the limbs, causing coldness.

This condition seems to relate very closely to Raynaud’s syndrome.

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Reference:

Benskey & Gamble 1993, Chinese Herbal Medicine Formulas and Strategies, Seattle Washington, Eastland Press Inc.

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