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Treats all conditions of blood deficiency, blood heat, and blood dryness.
Danggui (Radix Angelicae Sinensis), Shudi (Prepared Radix Rehmanniae) each 3 qian; Chuanxiong (Rhizoma Chuanxiong) 1.5 qian; Baishao (Radix Paeoniae Alba, wine-fried) 2 qian. The above four herbs are decocted in water and taken orally.

[Collected Annotations] Zhang Lu said: Siwu Tang (Four Substance Decoction) is a specialized formula for treating diseases of Yin-blood, but it is not the precise formula for tonifying True Yin. Medical texts generally claim that Siwu Tang tonifies Yin, leading to its use in treating conditions such as Yin-deficiency fever and hemorrhage due to flaming fire, which has been misleading and harmful to this day. Furthermore, practitioners specializing in gynecology often arbitrarily add wind-dispelling, food-resolving, phlegm-resolving, and Qi-regulating herbs to this decoction according to symptoms, resulting in chaotic prescriptions; what is most detestable is that they fail to distinguish between excess and deficiency of heat, yet rashly add Zhi Mu (Rhizoma Anemarrhenae) and Huang Bo (Cortex Phellodendri), causing patients to take them for long periods. Quacks, attracted by their ability to forcibly suppress disease, readily employ them. Little do they know that for massive hemorrhage from above or below, all blood-tonifying herbs should be set aside, and only Dushen Tang (Single Ginseng Decoction) combined with Tongbian (Child's Urine) should be advocated to secure the collapse, because formed blood cannot be generated quickly, whereas formless Qi must be urgently secured. As the ancients said, when encountering bleeding, do not merely treat the blood; first, regulate the Qi. It is also said: Without Qi-tonifying herbs, Siwu Tang cannot achieve the merit of "Yang generating Yin." Indeed, these are true words! However, after the resolution of pathogenic fire in Shanghan (Cold Damage), residual heat may remain in the blood level, causing slight fever at night that does not subside. In such cases, combining it with Chaihu (Radix Bupleuri) or adding Guizhi (Ramulus Cinnamomi) yields immediate results. Its efficacy should not be overlooked.

Ke Qin said: The Classic states: "The Heart generates blood, and the Liver stores blood." Therefore, for the generation of blood, one should investigate the Heart; for the regulation of blood, one should seek the Liver. This formula is a specialized agent for regulating blood in the Liver meridian, not the primary formula for generating blood in the Heart meridian. Danggui is sweet and warm to harmonize blood; Chuanxiong is acrid and warm to invigorate blood; Shaoyao is sour and cold to astringe blood; Dihuang is sweet and neutral to tonify blood. These four substances possess the functions of growth, flourishing, harvesting, and storing, thus enabling Ying-Qi (Nutritive Qi) to flow smoothly through the meridians. If there is blood deficiency, add Renshen (Radix Ginseng) and Huangqi (Radix Astragali); if there is blood stasis, add Taoren (Semen Persicae) and Honghua (Flos Carthami); if there is blood obstruction, add Dahuang (Radix et Rhizoma Rhei) and Mangxiao (Natrii Sulfas); if there is blood cold, add Guizhi (Ramulus Cinnamomi) and Fuzi (Lateralis Radix Aconiti Preparata); if there is blood heat, add Huangqin (Radix Scutellariae) and Lianqiao (Fructus Forsythiae). To promote blood circulation, remove Shaoyao; to stop bleeding, remove Chuanxiong. Act according to what is beneficial, and one need not be rigidly confined to these four herbs. For women who frequently lose blood, this formula is used to regulate menstruation and facilitate conception. However, in cases of metrorrhagia (uterine bleeding) or syncope due to blood loss, Siwu Tang cannot rapidly replenish blood and may instead exacerbate slipping and collapsing; in such instances, one should follow the principle of tonifying Qi to generate blood and assisting Yang to grow Yin. Generally, this formula can tonify formed blood during normal times but cannot generate formless blood in emergencies; it can regulate blood within Yin but cannot cultivate the root of True Yin. It establishes laws for the blood level and is not merely a stereotyped prescription exclusively for gynecology. Wang Haogu treated women's diseases, regardless of internal injury, external contraction, antenatal, or postnatal conditions, by adding two herbs to Siwu Tang, naming it Liuhe Tang (Six Harmonies Decoction), which was somewhat arbitrary and forced.