Formulas · Warm the Interior 溫裏 · Jeongjeon (正傳)

Frigid Extremities Decoction

Sayeok-tang

한글 사역탕 · Pinyin Si Ni Tang

四逆湯

The stated amounts are for the whole, which is divided into two packets, so each dose is half. The aconite is counted by the root and specified raw 生, so grams are given as 0.

Composition 構成

Buja Fu Zi
附子 부자 · Prepared Aconite

—
Chief 君

one root, raw · toxic
Geongang Gan Jiang
乾薑 건강 · Dried Ginger

20 g
Deputy 臣

blast-fried
Gamcho Gan Cao
甘草 감초 · Licorice

24 g
Envoy 使

roasted

Total 44 g per packet (첩) · representative dosage — verify against source texts. Excludes 1 ingredient measured by count or used as a vehicle, shown as —.

Received this formula from your practitioner? Amounts shown here are classical reference values — granule and prepared products differ. Always follow your prescribed dosage and directions.

Actions 效能

Rescues the devastated yang
Warms the interior in the three yin patterns

Indications 主治

Pattern-based

Yin pattern of cold damage with a slow pulse and bodily pain
Reversal cold of the four limbs

Biomedical correlates

Circulatory collapse with cold extremities
Hypothermic shock

Source text 原文

Donguibogam 東醫寶鑑

治傷寒陰證要藥也. 凡三陰脉遲ㆍ身痛, 並用. 又治四肢逆冷. 甘草(灸) 六錢, 乾薑(炮) 五錢, 附子(生) 一枚. 右剉, 分二貼, 水煎服. 《正傳》

Translation

The essential medicine for the yin pattern of cold damage. Wherever in the three yin the pulse is slow and the body aches, it is used. It also treats reversal cold of the four limbs. Roasted licorice, 6 don; blast-fried dried ginger, 5 don; raw aconite, one root. Cut up, divide into two packets and decoct in water. — Jeongjeon 正傳 (Donguibogam · Han, upper)

Clinical commentary 臨床

The formula the whole category is named for. Roasted licorice takes the largest dose, which looks odd in a rescue formula until you see what it is for: it blunts the aconite's toxicity and slows its action, so the warming comes on over an hour rather than in minutes. Dried ginger holds the middle while the aconite works on the extremities. The Bogam specifies the aconite raw, which is the Shanghanlun's own reading and the most dangerous form of the drug — raw aconite is cardiotoxic at doses close to the therapeutic one and must not be used. Modern practice uses a properly blast-fried product at a controlled dose, with a trained prescriber. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.