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Treats all types of blood deficiency (Xuè Xū, Blood Deficiency) and women's menstrual disorders (Jīng Bìng, Menstrual Diseases). [Note: Early menstruation is due to Heat; late menstruation is due to Cold, Deficiency, Stagnation, or Phlegm. Zhu Danxi said: Menstrual blood is Yin Blood. Yin must follow Yang, hence its red color, corresponding to the moon above, with regular flow, thus named "Jing" (Menses). It is the companion of Qi, moving with Qi. Clots indicate Qi stagnation; pain before flow indicates Qi obstruction; pain after flow indicates both Qi and Blood deficiency; pale color also indicates deficiency. Irregular bleeding indicates Qi chaos; purple color indicates Qi Heat; black color indicates extreme Heat. Nowadays, people seeing purple-black clots with pain generally attribute it to Wind-Cold invasion and use warm-hot formulas, which brings disaster immediately. The Classic says: Excess causes harm, restraint brings balance. Extreme Heat combines with Water transformation, so Heat makes it purple, extreme makes it black.] Therefore, know that: Dang Gui (Radix Angelicae Sinensis, washed with wine), Sheng Di Huang (Rhizoma Rehmanniae Recens, 3 qian), Bai Shao (Radix Paeoniae Alba, 2 qian), Chuan Xiong (Rhizoma Chuanxiong, 1.5 qian). All blood syndromes are suitable for Si Wu Tang (Four Substances Decoction).

If cooling blood is needed, add Gu Pi (Cortex Lycii Radicis, enters San Jiao/Triple Burner); Qing Pi (Pericarpium Citri Reticulatae Viride, enters Xin Bao Luo/Pericardium); Bai Shao (enters Spleen); Gan Jiang (Rhizoma Zingiberis Recens, enters Stomach). For dryness of blood, add Ren Ru (Human Milk). For blood stasis, add Chao Pu Huang (Pollen Typhae, stir-fried) and Jing Mo (Ink Stick). For chronic cases not resolving, add Gui Fu (Cortex Cinnamomi and Radix Aconiti Lateralis Preparata). For obese individuals with phlegm, add Cang Zhu (Rhizoma Atractylodis Lanceae) and Shen Qu (Massa Medicata Fermentata). For blood stasis... [Text implies further modifications]. This formula consists of herbs entering the Hand-Shaoyin Heart Meridian, Foot-Taiyin Spleen Meridian, and Foot-Jueyin Liver Meridian (Heart generates blood, Spleen controls blood, Liver stores blood). Dang Gui is pungent, bitter, sweet, and warm, entering Heart and Spleen to generate blood, serving as the Sovereign (Jun) herb; Sheng Di Huang is sweet and cold, entering Heart and Kidney to nourish blood, serving as the Minister (Chen) herb; Bai Shao is sour and cold, entering Liver and Spleen to astringe Yin, serving as the Assistant (Zuo) herb; Chuan Xiong is pungent and warm, circulating up and down to move Qi within Blood, serving as the Envoy (Shi) herb. (Chuan Xiong enters the Jueyin Pericardium and Liver meridians, ascending to the head and eyes, descending to the Sea of Blood. *Yu Ji Wei Yi* states: Chuan Xiong is the Qi herb within Blood, entering the Liver meridian, with pungent and dispersing nature, capable of moving Qi stagnation in Blood; Di Huang is the Blood herb within Blood, entering the Kidney meridian, with sweet and cold nature, capable of generating true Yin deficiency; Dang Gui is the main herb within Blood, entering the Liver meridian, with pungent and warm nature, dividing into three treatments, fully using blood-activating properties, each returning to its meridian; Bai Shao is a Yin-substance herb, entering the Spleen meridian, with sour and cold nature, capable of harmonizing blood, treating blood-deficiency abdominal pain. These are merely herbs belonging to the blood category for blood diseases. If Qi deficiency and blood weakness exist, one should follow Changsha [Zhang Zhongjing]'s method of supplementing Qi with Ren Shen [Radix Ginseng] when blood is deficient; abundant Yang can generate Yin Blood. Auxiliary herbs include Tao Ren (Semen Persicae), Hong Hua (Flos Carthami Tinctorii), Su Mu (Lignum Sappan), Dan Pi (Cortex Moutan), Xue Jie (Resina Draconis) for blood stasis; Pu Huang, E Jiao (Colla Corii Asini), Di Yu (Radix Sanguisorbae), Bai Cao Shuang (Carbonized Herba Artemisiae Argyi), Zong Lu Hui (Ash of Palm Frond) for metrorrhagia; Cong Rong (Herba Cynomorii), Suo Yang (Herba Cynomorii), Niu Xi (Radix Achyranthis Bidentatae), Gou Qi Zi (Fructus Lycii), Gui Ban (Carapax et Plastrum Testudinis), Xia Ku Cao (Spica Prunellae), Yi Mu Cao (Herba Leonuri) for blood deficiency; Ru Xiang (Resina Olibani), Mo Yao (Resina Myrrhae), Wu Ling Zhi (Faeces Trogopterori), Ling Xiao Hua (Flos Campsis) for blood pain; dairy products for blood dryness; Ginger and Cinnamon for blood cold; Ku Shen (Radix Sophorae Flavescentis) and Sheng Di Huang juice for blood heat. By analogy, one can respond to infinite variations.

Danxi treated Yin-deficiency fever by distinguishing Yin and Yang within the blood herbs of Si Wu Tang: The moving aspect of blood is Yang, governed by Chuan Xiong and Dang Gui; the still aspect is Yin, governed by Di Huang and Bai Shao. If Yin-blood is insufficient, although Chuan Xiong and Dang Gui are pungent-warm, they are not used; if Yang-blood is insufficient, although Ginger and Cinnamon are pungent-hot, they are used. This aligns with the direct and indirect methods of clearing fire. Wu Hegao said: The way of Heaven and Earth is that Yang is often in excess and Yin is often deficient; the human body is the same. Thus, blood is hard to form and easy to lose. Plants have no consciousness, how can they generate blood? Because Di Huang and Bai Shao can nourish the Yin of the five Zang organs, and Chuan Xiong and Dang Gui can regulate the Qi of Ying (Nutrient), harmony of Yin and Yang leads to natural blood generation. If blood loss is excessive and breath is faint, do not administer this, for Si Wu Tang is of the Yin category, not suitable for generating life/Qi. One should heavily use Ren Shen and Huang Qi to consolidate the dying Qi. Hence, it is said that in hemorrhage, first benefit the Qi; otherwise, the aromatic penetration of Chuan Xiong will consume Qi, leading to death from dual exhaustion of Qi and Blood. Therefore, those with deficiency damage, weak stomach, or weak Qi should not take it frequently. Someone asked: Is Si Wu Tang exclusively for gynecology? Does it contain Spleen/Stomach herbs? Yi Yang Zi said: Si Wu Tang implicitly contains Spleen/Stomach treatment methods, long misunderstood by people. The Spleen meridian has little blood and much Qi; Dang Gui and Di Huang generate blood to irrigate the Spleen meridian. Earth fears thief pathogens, Wood overacts on Earth; Bai Shao can drain Wood and tonify Spleen. Liver desires dispersion, using the pungency of Chuan Xiong to disperse it. Is this not a method of restraining Wood and tonifying Earth/Spleen? Some ask: Is Bai Shao contraindicated postpartum? Answer: After new birth, Qi and Blood are unsettled, fearing Bai Shao's astringent nature may cause pain. However, Bai Shao specifically treats Qi-pain from blood deficiency. Postpartum is precisely a time of Qi-Blood deficiency pain. Using it lightly stir-fried with mellow wine, what harm is there? Regarding blood clots causing trouble, do not stick to the idea of massive tonification postpartum. Boldly using purgatives like Yu Zhu San (Jade Candle Powder) is acceptable; eliminating old to generate new is also a tonification method. Many died from retained blood due to the dogma of "massive tonification postpartum." Appendix: Hezi's Yu Zhu San: Dang Gui Wei (Tail of Radix Angelicae Sinensis), Sheng Di Huang, Chuan Xiong, Chi Shao (Radix Paeoniae Rubra), Da Huang (Radix et Rhizoma Rhei), Mang Xiao (Natrii Sulfas), Gan Cao (Radix Glycyrrhizae Uralensis). Treats amenorrhea with abdominal pain.

Adding Huang Bo (Cortex Phellodendri) and Zhi Mu (Rhizoma Anemarrhenae) to this formula creates Zhi Bai Si Wu Tang (Anemarrhena and Phellodendron Four Substances Decoction); adding Xuan Shen (Radix Scrophulariae) creates Zi Yin Jiang Huo Tang (Nourish Yin Descend Fire Decoction): Treats Yin deficiency with fire. Honey-pill form is called Kan Li Wan (Kan-Li Pill): Treats Yin-deficiency coughing blood. (Danxi argued Lao Zhai [Consumption] is primarily Yin deficiency. From Zi to Wu hours belongs to Yang, from Wu to Hai hours belongs to Yin. Yin deficiency causes heat, occurring after noon before midnight. Awakening is Yang, sleeping is Yin. Yin deficiency causes night sweats during sleep. Ascending is Yang, descending is Yin. Yin deficiency causes Qi descent, phlegm-saliva counterflow, continuous spitting. Pulse floating is Yang, sinking is Yin. Yin deficiency makes pulse large and forceful on floating, empty on sinking. Use Si Wu Tang with Zhu Li (Bambusae Succus) plus stir-fried Bai Hu and Gui Ban to nourish Yin and descend fire. Also avoid desires, light diet, calm mind to assist. *Zhun Sheng* says: Danxi's theory on consumption focuses on Yin deficiency, using Si Wu Tang plus Zhi Bai. Physicians followed this with little success. Why? Yin deficiency fire flares upward. Chuan Xiong and Dang Gui are pungent-warm, not suitable for nourishing deficiency and descending fire. Chuan Xiong ascends, unsuitable for deficiency flare-ups with shortness of breath. Di Huang clogs the chest, unsuitable for weak stomach with much phlegm and poor appetite. Zhi Bai are bitter-cold and large-cold. Though said to nourish Yin, they actually dry blood; though said to descend fire, long-term use increases Qi and aids fire, damaging the stomach. Better to use Yi Yi Ren (Semen Coicis), Bai He (Bulbus Lilii), Tian Dong (Radix Asparagi), Mai Dong (Radix Ophiopogonis), Sang Bai Pi (Cortex Mori), Di Gu Pi (Cortex Lycii), Dan Pi, Suan Zao Ren (Semen Ziziphi Spinosae), Wu Wei Zi (Fructus Schisandrae), Pi Pa Ye (Folium Loquae), etc., assisted by Sheng Di Huang juice, Ou Jian (Rhizoma Nelumbinis Juice), Ren Ru, Tong Bian (Infant Urine). For cough, use more Sang Bai Pi and Pi Pa Ye; add Bei Mu (Bulbus Fritillariae Cirrhosae) for phlegm; add Yi Yi Ren, Bai He, E Jiao for blood; add Di Gu Pi for severe heat; add Yi Yi Ren up to 7-8 qian for poor appetite, with Mai Dong as chief to protect Lung Metal and nourish source of transformation, achieving immediate effect. Also: Chronic deficiency diseases involve emptiness of all vessels, requiring sticky substances to fill; dried essence and blood require moistening substances to lubricate. Use Ren Shen, Huang Qi, Di Huang, Er Dong (Tian Dong, Mai Dong), Gou Qi, Wu Wei Zi, decocted into pastes. Separate Qing Hao (Herba Artemisiae Annuae) paste made with infant urine, mix with previous juices, plus Lu Jiao Jiao (Colla Cornus Cervi) and Xia Tian Gao (Paste of Beef/Moose Meat). Generally, Yi Yi Ren and Bai He treat Lung deficiency; Ren Shen, Huang Qi, Di Huang pastes treat Kidney deficiency. Heart and Liver belong to Yang, Lung and Kidney belong to Yin. Thus, tonifying Lung and Kidney is tonifying Yin, not using Zhi Bai type herbs.

Adding Lian Lian (Radix Coptidis) and Hu Lian Lian (Rhizoma Hydrastis) to this formula creates Er Lian Si Wu Tang (Two Coptises Four Substances Decoction) (*Yuan Rong*: Treats chronic deficiency blood deficiency, five-center heat, heat entering Blood Chamber, night fever. Blood Chamber refers to Chong Mai/Thoroughfare Vessel, the Sea of Blood. Quiet by day, hot by night, Yang trapped in Yin, named Heat Entering Blood Sea). Adding Huang Bo, Huang Qin (Radix Scutellariae), Gan Cao creates San Huang Si Wu Tang (Three Yellows Four Substances Decoction): Treats Yin deficiency tidal fever. Using Sheng and Shu Di Huang (Two Dishes), adding Huang Qi (Radix Astragali), Dan Pi, Sheng Ma (Rhizoma Cimicifugae), Chai Hu (Radix Bupleuri) creates San Huang Bu Xue Tang (Three Yellows Tonify Blood Decoction): Treats blood loss and blood deficiency, six pulses large but empty on pressure. (Two Dishes nourish blood, Dan Pi cools blood, Huang Qi tonifies Qi, Sheng/Chai raise Yang. Abundant Qi generates blood; Yang generation leads to Yin growth). Adding Tao Ren, Hong Hua creates Yuan Rong Si Wu Tang (Yuan Rong Four Substances Decoction): Treats organ knotting with constipation, traumatic blood stasis. Adding Qiang Huo (Rhizoma Notopterygii), Fang Feng (Radix Saposhnikoviae) (one uses Qin Jiao [Radix Gentianae Macrophyllae]) creates Zhi Feng Liu He Tang (Wind-Regulating Six-Harmony Decoction): Treats wind-deficiency dizziness, wind-constipation. Honey pills create Bu Gan Wan (Tonify Liver Pill) (Liver benefits from dispersion). Adding Mu Xiang (Radix Aucklandiae), Bing Lang (Areca Seed) creates Zhi Qi Liu He Tang (Qi-Regulating Six-Harmony Decoction): Treats blood deficiency with Qi stagnation, or Qi-Blood rushing upward. Adding Qiang Huo, Tian Ma (Rhizoma Gastrodiae), honey pills create Shen Ying Yang Zhen Dan (Divine Response Nourish True Pill): Treats Foot-Jueyin meridian affected by Wind-Cold-Damp-Heat, paralysis; slurred speech, and blood-deficiency gout. Adding Tao Ren, Hong Hua, Zhu Li, Jiang Zhi (Ginger Juice) treats hemiplegia; left-sided belongs to blood stasis (If stasis is not removed, new blood cannot be generated; thus Tao Ren and Hong Hua activate blood and remove stasis; adding Zhu Li and Jiang Zhi because phlegm knows no left/right distinction). Removing Bai Shao, adding Fang Feng creates Fang Feng Dang Gui San (Saposhnikovia and Angelica Powder): Treats spasms from excessive sweating, suitable for dispelling wind and nourishing blood. Removing Di Huang, adding Gan Jiang creates Si Shen Tang (Four Spirits Decoction): Treats women's blood deficiency with heart/abdominal colic (Jiu/Jiao sound, acute pain). Adding E Jiao, Ai Ye (Folium Artemisiae Argyi), Gan Cao creates Jiao Ai Tang (Donkey-hide Glue and Mugwort Decoction): Treats Chong/Ren vessel deficiency damage, dripping menstruation, and blood-deficiency dysentery (See Obstetrics/Gynecology section). Adding Ai Ye, Si Zhi Xiang Fu (Cyperi Rhizoma processed with infant urine, salt water, wine, vinegar, soaked 3 days each), vinegar pills create Ai Fu Nuan Gong Wan (Mugwort and Cyperi Womb-Warming Pill): Treats uterine deficiency-cold. Adding E Jiao creates Fu Bao Dan (Women's Treasure Pill): Treats deficiency-cold irregular menstruation. Adding Dan Pi, Di Gu Pi treats women's bone-steaming fever. Removing Bai Shao and Di Huang creates Xiong Gui Tang (Chuanxiong and Angelica Decoction); powdered, Fo Shou San (Buddha's Hand Powder); also named Yi Qi San (One Marvel Powder), Jun Chen San (Sovereign-Minister Powder): Treats postpartum blood-deficiency headache; fetal movement with bleeding, taking this ensures safety; dead fetus in womb, taking this expels it; miraculous for labor induction. Combining with Si Jun Zi Tang (Four Gentlemen Decoction) creates Ba Zhen Tang (Eight Treasures Decoction): Treats Heart/Lung deficiency damage, dual Qi-Blood deficiency (Si Jun Zi tonifies Qi, Si Wu nourishes Blood). Adding Huang Qi, Rou Gui (Cortex Cinnamomi) creates Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction): Assists Yang and consolidates Wei (Defensive) Qi. (Wang Haicang said: Gui Zhi and Gan Cao form Xiao Jian Zhong Tang; adding Huang Qi forms Huang Qi Jian Zhong Tang; Ren Shen, Bai Zhu, Fu Ling, Gan Cao form Si Jun Zi Tang; Chuan Xiong, Dang Gui, Bai Shao, Di Huang form Si Wu Tang. Since Qi and Blood are both declining, Yin and Yang both weak, following the completion numbers of Heaven and Earth, it is called Shi Quan San). Shi Quan Tang removing Bai Shao, adding Shan Zhu Yu (Fructus Corni), Wu Wei Zi, Fang Feng, Cong Rong, decocted with Ginger and Jujube, creates Da Bu Huang Qi Tang (*Bao Jian*): Treats dual Qi-Blood deficiency with incessant spontaneous sweating (Huang Qi fears Fang Feng, combined best stops sweat; and Yang deficiency syncope). Si Wu + Si Jun Zi + Xiao Chai Hu Tang creates San He San (Three-Harmony Powder) (He Jian): Treats chronic deficiency consumption postpartum. Si Wu each 7 qian, add Fang Feng 1 liang, Zhi Zi (Fructus Gardeniae), Huang Qin, Huang Lian (Radix Coptidis) each 3 qian, take 5 qian per dose. If pulse is solid, add Da Huang, creates Sheng Di Huang Lian Tang (Rehmannia and Coptis Decoction) (Hai Zang): Treats women's Wind-Blood syndrome, excessive blood loss leading to dryness, grasping at clothes, picking at air, closing eyes, waving hands, throwing feet, confused speech, loss of spirit, pulse string-like, floating, and empty. (Men with excessive blood loss also have this syndrome. Tao Jie'an said: Da Cheng Qi Tang is a Qi herb, used for pathogen moving from exterior to interior; Sheng Di Huang Lian Tang is a Blood herb, used for pathogen moving from interior to exterior. In Qi-Blood combined disease, grasping at clothes, similar to Qi transforming to Blood, Blood transforming back to Qi, Da Cheng Qi Tang purges; from Blood transforming to Qi, Qi transforming back to Blood, Sheng Di Huang Lian Tang governs. Both have constipation; this is the counterpart to Cheng Qi Tang, related to San Huang Shi Gao Tang, all diseases of deficient fire in San Jiao and Pericardium. Since the disease is critical, only this can descend hidden fire in blood. *Ben Cao Gang Mu* says: Si Wu Tang combined with Gui Zhi, Ma Huang, Bai Hu, Chai Hu, Li Zhong, Si Ni, Zhu Yu, Cheng Qi, Liang Ge, etc., can serve as various...)