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(The formula *Danggui Sini Jia Wuzhuyu Tang* is detailed in the "General Examples of Yin Syndromes" chapter.)

*Siyu Tang* (Four-Substance Decoction) nourishes Ying and Wei (Defensive and Nutritive Qi), harmonizes Blood and Qi, and treats syndromes such as irregular menstruation and pain in the umbilical and abdominal regions. These syndromes are documented in the *Ju Fang* (Standard Formulary). Shudihuang (Prepared Rehmanniae Radix) [Shu Di Huang (Cooked Rehmannia Root): Nourishes Blood; e.g., for pain below the umbilicus, this herb is indispensable as it enters the Kidney Meridian]; Chuanxiong (Ligustici Chuanxiong Rhizoma) [Chuan Xiong (Szechwan Lovage Rhizome): Treats Wind by dispersing Liver Wood; e.g., for headache due to Blood deficiency, this herb is indispensable as it enters the Liver Meridian]; Shaoyao (Paeoniae Radix Alba/Rubra) [Bai Shao (White Peony Root): Harmonizes Blood and regulates the Spleen; e.g., for empty pain in the abdomen, this herb is indispensable as it enters the Spleen Meridian]; Danggui (Angelicae Sinensis Radix) [Dang Gui (Chinese Angelica Root): Harmonizes Blood; e.g., for stabbing blood pain, which feels like knife stabs, this herb is indispensable as it enters the Kidney Meridian]. The above herbs are coarsely powdered and decocted in water. Modifications are as follows:

If Gudupi (Cortex Lycii Radicis) and Mudanpi (Cortex Moutan Radicis) are added, it treats bone-steaming tidal fever in women;
If a pregnant woman experiences fetal restlessness and continuous bleeding, add ten leaves of Aijie (Folium Artemisiae Argyi) and one piece of Ejiao (Colla Corii Asini), plus Congbai (Scallion White) and Huangqi (Astragali Radix);
If uterine emptiness-cold causes metrorrhagia with excessive blood loss, also add Jiao'ai Tang (Gelatin and Mugwort Decoction);
If a woman frequently takes Spring-dose increased Chuanxiong, presenting with a wiry pulse and headache;
Summer-dose increased Shaoyao, presenting with a flooding pulse and undigested food diarrhea;
Autumn-dose increased Dihuang, presenting with a deep, choppy pulse and Blood deficiency;
Winter-dose increased Danggui, presenting with a deep, cold pulse and anorexia.

In Spring, use *Fengwang Siwu Tang* (Windproof Four-Substance Decoction: *Siyu Tang* plus *Fengwang*, with doubled *Chuanxiong*);
In Summer, use *Huangqin Siwu Tang* (Scutellaria Four-Substance Decoction: *Siyu Tang* plus *Huangqin*, with doubled *Shaoyao*);
In Autumn, use *Mendong Siwu Tang* (Asparagus Four-Substance Decoction: *Siyu Tang* plus *Tianmendong*, with doubled *Dihuang*);
In Winter, use *Guizhi Siwu Tang* (Cinnamon Twig Four-Substance Decoction: *Siyu Tang* plus *Guizhi*, with doubled *Danggui*).

If Blood deficiency causes abdominal pain with slight sweating and aversion to wind, use *Siyu Tang* plus Baizhu (Atractylodis Macrocephalae Rhizoma) and Guizhi (Cinnamomi Ramulus), named "Abdominal Pain Liuhe Tang" (Six-Harmony Decoction for Abdominal Pain);
If Wind-dizziness occurs, add Qinjiao (Gentianae Macrophyllae Radix) and Qianghuo (Notopterygii Rhizoma et Radix), named "Wind Liuhe";
If Qi is weak, causing fatigue upon rising and sudden fainting, add Houpo (Magnoliae Officinalis Cortex) and Chenpi (Citri Reticulatae Pericarpium), named "Qi Liuhe";
If fever, irritability, and insomnia occur, add Huanglian (Coptidis Rhizoma) and Zhizi (Gardeniae Fructus), named "Heat Liuhe";
If Empty-Cold presents with a minute pulse, spontaneous sweating, shortness of breath, but normal bowel and bladder functions, add Ganjiang (Zingiberis Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata), named "Cold Liuhe";
If dampness invades, causing heavy body, weakness, slight coolness, and sweating, add Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria), named "Dampness Liuhe".

If postpartum consumptive disease persists for a long time with a floating and rapid pulse, use *Chaihu Siwu Tang*. Composition: Chuanxiong, Shudihuang, Danggui, Shaoyao (each 1.5 liang), plus Chaihu (8 qian), Renshen (Ginseng Radix), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix), Banxia (Pinelliae Rhizoma), Shenqu (Massa Medicata Fermentata) (each 3 qian). Decoct in water and take orally.

If women suffer from pain in bones, sinews, limbs, and joints, along with headache, wiry pulse, and chills resembling malaria, use *Zhifeng Liuhe Tang* (Wind-Treating Six-Harmony Decoction). Composition: *Siyu Tang* (4 liang), Fengwang (Saposhnikoviae Radix), Qianghuo (each 1 liang).

If Qi and Blood rush upward to the heart and abdomen, causing fullness and oppression under the ribs, use *Zhiqi Liuhe Tang* (Qi-Treating Six-Harmony Decoction). Composition: *Siyu Tang* (4 liang), Cangzhu (Atractylodis Rhizoma), Binglang (Arecae Semen) (each 1 liang).

If emptiness-cold below the umbilicus causes abdominal pain and dull pain in the waist and spine, use *Xuanhu Liuhe Tang* (also for lower abdominal pain). Composition: *Siyu Tang* (4 liang), Xuanhusuo (Corydalis Rhizoma), Koushen (Toosendan Fructus) (each 1 liang, crushed and stir-fried until scorched).

If Qi fills the meridians causing frequent menstruation and much pain below the umbilicus, use *Shaoyao Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Shaoyao (1 liang).

If menstrual flow approaches with cramping pain in the umbilical and abdominal regions, and severe pain during menstruation indicating stagnant Blood, use *Bawu Tang* (Eight-Substance Decoction). Composition: *Siyu Tang* (4 liang), Xuanhusuo, Koushen (crushed and stir-fried until scorched), Binglang, Muxiang (Aucklandiae Radix) (each 1 liang).

If menstrual flow is excessive without other symptoms, use *Huangqin Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Huangqin, Baizhu (each 1 liang).

If menstrual flow is scanty and stagnant, add Kuihua Decoction (Sunflower Decoction) to *Siyu Tang* (can also add Honghua [Carthami Flos] and Xuejianchou [Leonurus Japonicus Herba]).

If consumptive disease causes weak Qi, cough, wheezing, and chest fullness, use *Noupo Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Noupo (Magnoliae Officinalis Cortex, ginger-processed, 1 liang), Zhishi (Immature Bitter Orange Fruit, bran-fried, half liang).

If menstrual blood flows violently, add Huangqin 1 liang; if abdominal pain, add Huanglian; in summer, do not remove Huangqin.

If menstrual blood resembles black bean juice, add Huangqin and Huanglian (each 1 liang).

If menstrual blood is scanty but normal in color, add Shudihuang and Danggui (each 1 liang) to *Siyu Tang*.

If menstruation starts and stops abruptly, or there are alternating chills and fever, first administer *Xiaochaihu Tang* (Minor Bupleurum Decoction) to resolve the chills and fever, then harmonize with *Siyu Tang*.

If a woman has Blood accumulation/stasis, add Ezhu (Curcumae Rhizoma), Jingsanleng (Sparganii Rhizoma), Guizhi, and Ganxi (Drynariae Rhizoma / Drynaria root? Note: Ganxi usually refers to Drynaria or similar, context implies blood-invigorating) (each 1 liang) to *Siyu Tang*.

If a woman suffers from Cold Damage (Shanghan), and after sweating or purging treatments, diet decreases and Blood becomes deficient, use *Bawu Tang*. Composition: *Siyu Tang* (4 liang), Huangqi (Astragali Radix), Gancao, Fuling, Baizhu (each 1 liang).

If during pregnancy, Cold Damage or Wind Strike presents with exterior deficiency, spontaneous sweating, headache, neck stiffness, fever, aversion to cold, and a floating, weak pulse (Taiyang Meridian disease), use *Biaoxu Liuhe Tang* (Exterior-Deficiency Six-Harmony Decoction). Composition: *Siyu Tang* (4 liang), Guizhi, Gudupi (each 7 qian).

If during pregnancy, Cold Damage presents with headache, fever, no sweat, and a floating, tight pulse (Taiyang Meridian disease), use *Biaoshi Liuhe Tang* (Exterior-Excess Six-Harmony Decoction). Composition: *Siyu Tang* (4 liang), Mahuang (Ephedrae Herba), Xixin (Asari Radix et Rhizoma) (each half liang).

If during pregnancy, Cold Damage involves Wind-Dampness causing painful joints, floating and hot pulse, and headache (Taiyang Mark Disease), use *Fengshi Liuhe Tang* (Wind-Dampness Six-Harmony Decoction). Composition: *Siyu Tang* (4 liang), Fengwang, Cangzhu (processed, each 7 qian).

If during pregnancy, Cold Damage persists beyond the course after purging, and Warm-Toxin erupts like brocade patterns, use *Shengma Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Shengma (Cimicifugae Rhizoma), Lianqiao (Forsythiae Fructus) (each 7 qian).

If during pregnancy, Cold Damage presents with chest and hypochondriac fullness/pain and a wiry pulse (Shaoyang disease), use *Chaihu Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Chaihu, Huangqin (each 7 qian).

If during pregnancy, Cold Damage presents with hard stool, red urine, abdominal fullness, and a deep, rapid pulse (Yangming/Taiyang Root Disease), urgent purging is required. Use *Dahuang Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Dahuang (Rhei Radix et Rhizoma, half liang), Taoren (Persicae Semen, 10 seeds, skin and tip removed, flour-fried).

If during pregnancy, Cold Damage after sweating/purging results in persistent cough, use *Renshen Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Renshen, Wuweizi (Schisandrae Fructus) (each 5 qian).

If a pregnant woman with Cold Damage, after sweating/purbing, develops empty fullness and bloating (Yangming Root Deficiency), use *Noupo Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Noupo, Zhishi (bran-fried, each half liang).

If during pregnancy, Cold Damage after sweating/purbing causes insomnia, use *Zhizi Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Zhizi, Huangqin (each half liang).

If during pregnancy, Cold Damage presents with high fever, great thirst, steaming irritability, and a long, large pulse, use *Shigao Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma) (each half liang).

If during pregnancy, Cold Damage causes difficult urination (Taiyang Root Disease), use *Fuling Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Fuling, Zexie (Alismatis Rhizoma) (each half liang).

If during pregnancy, Taiyang Root Disease presents with red urine resembling blood, use *Hupo Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Hupo (Amber), Fuling (each half liang).

If during pregnancy, Cold Damage after sweating/purbing causes continuous blood leakage and damages fetal Qi, use *Jiaoai Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Ejiao, Aijie (each half liang). One formula adds Gancao; another adds Ganjiang, Gancao, and Huangqi.

If during pregnancy, Cold Damage causes limb contracture, cool body with slight sweat, abdominal pain, and a deep, slow pulse (Shaoyin disease), use *Fuzi Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Fuzi (prepared, skin and脐 removed), Rougui (Cinnamomi Cortex) (each half liang).

If white and yellow leukorrhea occurs, use *Xianggui Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Rougui, Xiangfu (Cyperi Rhizoma) (each half liang).

If pregnancy Cold Damage involves Blood accumulation, abortifacients should not be used. Instead, use *Siyu Dahuang Tang* to purge. Composition: *Siyu Tang*, Shengdihuang (Rehmanniae Radix), Jiujin Dahuang (Wine-soaked Rhubarb).

For Empty-Heat diseases, combine *Siyu Tang* and *Renshen Su Yin* (Ginseng and Perilla Drink) equally, named *Buxin Tang* (Heart-Nourishing Decoction).

For swollen and painful limbs unable to move, use *Siyu Cangzhu Geban Tang* (Equal-Half Four-Substance and Atractylodes Decoction).

To treat dryness constipation, combine *Siyu Tang* and *Tiaowei Chengqi Tang* equally, named *Yuzhu San* (Jade Candle Powder).

To moisten dryness, use *Siyu Lizhong Geban Tang* (Equal-Half Four-Substance and Regulate Middle Decoction).

To preserve fetal Qi and aid conception, combine *Siyu Tang* and *Suisha Sizjunzi Tang* (Amomum and Four-Gentlemen Decoction) equally, named *Bazhen Tang* (Eight-Treasure Decoction).

If Heat and Blood struggle, causing dry mouth/tongue and thirst despite drinking, add Gualou (Trichosanthis Fructus) and Maidong (Ophiopogonis Radix).

If stabbing abdominal pain and failure to expel lochia, add Danggui and Shaoyao.

For Metrorrhagia, add Shengdihuang, Puhuang (Pollen Typhae), and Huangqin.

For dizziness and neck stiffness, add Chaihu and Huangqin.

For Wind generated by Heat, add Chuanxiong, Chaihu, and Fengwang.

For organ constipation, add Dahuang and Taoren.

For slippery/stagnant irregularity, add Guanzi (Cinnamon Bark) and Fuzi.

For vomiting, add Baizhu, Renshen, and Shengjiang (Fresh Ginger).

For extreme thirst, add Zhimu and Shigao.

For chills and fever, add Ganjiang, Danpi (Moutan Cortex), Shaoyao, and Chaihu.

For Water retention under the Heart causing mild nausea/vomiting, add Zhuling (Polyporus), Fuling, and Fangji (Stephaniae Tetrandrae Radix).

For Empty-Cold resembling Cold Damage, add Renshen, Chaihu, and Fengwang.

For various postpartum syndromes, differentiate according to the Six Meridians, combining *Siyu Tang* with Zhang Zhongjing's formulas in equal halves; the effect is miraculous.

If women suffer from alcohol injury, blood loss from childbirth, or consumptive disease with five-palm heat, use *Siyu Erlian Tang*. Composition: *Siyu Tang* (using Shengdihuang), Huanglian, Hu Huanglian (True Picrorhizae Rhizoma), taken with warm essence fluid.

*Siyu Tang* can be combined in equal halves with Guizhi Tang, Mahuang Tang, Baizhu Tang, Chaihu Tang, Lizhong Tang, Sini Tang, Wuzhuyu Tang, Chengqi Tang, Liangge San, etc. This is the general principle of Yilao's medication.

For empty irritability and insomnia, add Zhuye (Bambusae Folium) and Renshen.

If a woman with Blood deficiency suffers unbearable heart/abdominal pain, remove Dihuang and add Ganjiang, named *Sishen Tang* (Four-Spirit Decoction).

For various pains with Dampness, combine *Siyu Tang* and Baizhu in equal halves, add Tianma (Gastrodiae Rhizoma), Fuling, and Chuanshanjia (Manis Squama), decoct in wine.

For sudden red eyes forming cloud-like opacity and unbearable pain, use *Siyu Longdan Tang*. Composition: *Siyu Tang* (each half liang), Qianghuo, Fengwang (each 3 qian), Longdancao (Gentianae Radix), Fangji (each 2 qian). Decoct in water.

Haizang said: For pregnant women with Blood accumulation, or if a pregnant woman has Blood accumulation, do not rashily use Didang Tang or Taoren Chengqi Tang. To ensure mother and child remain unharmed, take Dahuang and *Siyu Tang* together.

*Haizang Danggui Wan* (Haizang Angelica Pill): Treats syndromes of Heart, Umbilical, and Lower Abdominal pain, Qi, and Wind caused by pathogenic invasion of the Three Yin Meridians. Composition: *Siyu Tang* (each half liang), Fengwang, Duhuo (Angelicae Pubescentis Radix), Quanxie (Scorpio), Huixiang (Foeniculi Fructus, fried), Xuduan (Dipsaci Radix) (each half liang), Koushen, Xuanhusuo (each 7 qian), Muxiang, Dingxiang (Caryophylli Flos) (each 2.5 qian). Powder finely, make pills with wine paste, size of paulownia seeds. Take 30-50 pills with warm wine on an empty stomach for great effect.

*Koushen Wan* (Toosendan Pill): Miraculous for Ben Tun (Rushing Pig) syndrome and lower abdominal pain. Composition: Chuan Koushen, Huixiang, Fuzi (1 liang, prepared, skin and脐 removed). Boil these three ingredients in 2 sheng of wine until the wine is exhausted, dry, and powder finely. For every 1 liang of powder, add 0.5 liang Xuanhusuo, 18 Quanxie (fried), and 18 Dingxiang, all separately powdered and mixed evenly. Make pills with wine paste, size of paulownia seeds. Take 50 pills with warm wine on an empty stomach. If pain is severe, take with Danggui decocted in wine.

Formula for treating Throat Closure (Hou Bi) requiring swift rescue: Zaojiao (Gleditsiae Sinensis Spina, skin and seeds removed, raw, 0.5 liang, powdered finely). Dip the tip of a chopstick into the powder and apply to the painful area. Also, mix the powder with vinegar paste and apply thickly to the neck. Pus and blood will break out shortly, leading to immediate recovery.

*Jiji Huangu Dan* (Ultimate Salvation Bone-Changing Pill): Not suitable for those with spontaneous sweating (per Haiyun). Verse: "Sophora bark, Chuanxiong, Atractylodes, Angelica; Immortal, Windproof, Polygonum, Vitex; Ten flavors balanced equally; Bitter and fragrant halved; Dragon and Musk in small amounts; Cinnabar coating wraps them; Ephedra paste boils pills; Size like a finger bullet." The above treats hemiplegia, facial paralysis, numbness of hands/feet, slurred speech, pain penetrating to the bone marrow, bi-syndrome affecting the skin, acute wind-phlegm causing muteness, mental confusion, difficulty walking, tendon/muscle contracture, left hemiplegia/right paralysis, and all wind diseases. Composition: Huaiguazi (Sophorae Fructus, raw), Renshen, Sangbaipi (Mori Cortex), Cangzhu, Chuanxiong, Heshouwu (Polygoni Multiflori Radix), Manjingzi (Viticis Fructus), Weilingxian (Salviae Miltiorrhizae Radix? Note: Weilingxian is Saposhnikoviae Radix here, distinct from Danshen), Fengwang (each 2 liang), Wuweizi, Xiangfu, Kushen (Sophorae Flavescentis Radix) (each 1 liang), Xiangbaizhi (Angelicae Dahuricae Radix, 2 liang), Shexiang (Moschus, 2 qian, separately powdered). These 14 ingredients are powdered finely, mixed with fragrance. Then, take 10 jin of Mahuang (remove nodes and roots), boil in 3 dan 3 dou of river water until reduced to 6 dou, filter residue, boil again until reduced to 2.5 sheng, put in silver/copper vessel, boil into paste. Add the herbal powder, mix well, pound 3000-5000 times. Each 1 liang of powder makes 10 pills, coated with Cinnabar. Take 1 pill, crush first, soak in 1 cup of wine from morning to evening. Stir well and take after meal before bed. Clarity of mind and lack of sleepiness indicate efficacy. Take again after 5 days. Suitable for Wind-Stroke without sweat; if deficient with spontaneous sweat, taking it further depletes fluids. People with excess Wind should lie in a warm room to induce sweat.