Si Wu Tang | Review of TCM Formulas

Hey this is Nicholas. In this video we're going over our basic blood tonifying formula, Siwu Tong, for substance decoction. Then we'll briefly mention some of the blood invigorating formulas that are based on it, like the Zhu Yutong formulas. And please remember that when I make these videos about herbal formulas, this is meant to be a review for students of traditional Chinese medicine who are currently studying at an accredited school. If you are not a student or practitioner, then this video is not for you. Please do not use this information to self-diagnose or self-treat. If you want to take herbs, please go see a licensed practitioner. Anyway, on with the video. So Siwu Tong is our basic formula for tonifying blood or treating blood deficiency. So what does blood deficiency look like? Well, if blood fails to nourish the skin, we might see dry itchy skin or a pale lusterless complexion. If blood fails to reach the head, we can see dizziness and vertigo. And then remember that's the liver that stores blood. So think about all the tissues that are associated with the liver. The liver opens to the eyes, so with blood deficiency, we might see blurred vision. The liver governs the sinews, and if blood fails to nourish the sinews, we can see muscle tension or muscle spasm. And the liver blooms in the nails, so we might see pale brittle nails. The other important blood organ is the heart. So if blood fails to nourish the heart, we might see things like insomnia or palpitations. And then of course there's menstruation. If there's just not enough blood to form the period, we might see things like delayed menses, scanty menses, or amenorrhea. It's actually kind of annoying that men don't have periods sometimes just because you miss out on all that good diagnostic information. But anyway, we could say that that menstruation stuff is related to the liver, or we could call Remember the chongmai is a sea of blood, and both the ren and the chong connect to the uterus. The tongue is going to be pale, and the pulse is going to be thin, deficient, and maybe even wiry or choppy. So that's what blood deficiency looks like, and one of our main formulas for generalized blood deficiency is siwutong, for substance decoction. Like the name suggests, this formula has four ingredients. Shudi, Baishao, and Dongwei are from the category herbs that tonify blood, and Chuanxiang is from the category herbs that invigorate blood. So the construction of this formula is interesting. We have two herbs that are mainly for tonifying blood, and two herbs that invigorate blood. And yes, Dongwei does both. It tonifies blood and invigorates blood. But part of the reason it's here is because of its invigorating function. So the idea here is blood is very yin. It's very thick and substantial. So if all we do is tonify blood, then the blood will just sit there and get stuck, potentially causing stagnation. So when we tonify blood, we have to add in some moving herbs in order to prevent this stagnation. Or another way of looking at it is there's a saying, if blood stasis is not transformed, new blood cannot be generated. So it's kind of like we have to move out the old blood in order to make room for the new blood. So we need blood invigorating herbs to do that. So maybe that's how you can remember the ingredients in this formula. We have two blood tonifying herbs, Shudi and Baishao. They both have sh's. And two blood invigorating herbs, Dongwei and Chuanxiang. And that's how we go about tonifying blood with Siwutong. But what's also interesting about this formula is that it's actually very versatile. That is, we can easily shift the focus of the formula from blood tonifying to blood invigorating just by making some small changes. For example, one way we could do this is just by adjusting the dosages of the ingredients. If we wanted this to be more of a blood tonifying formula, we could increase the dosages of the tonifying herbs and decrease the dosages of the invigorating herbs. Or, if we wanted to make it more of a blood invigorating formula, we could decrease the dosages of the tonifying herbs and increase the dosages of the invigorating herbs. Another option, if we wanted to emphasize the blood invigorating aspects of this formula, would be to change the form of the ingredients. That is, we could change Baishao to Chuanxiang and Dongwei to Dongweiwei. Remember, Baishao is white peony, it's in the tonify blood category, but Chuanxiang is red peony, and it's in the invigorate blood category. And then with Dongwei, remember that different parts of the root have different properties. Dongweiwei is the tail of the root, and it has a stronger action of invigorating blood. So by making these simple modifications, we've actually shifted the focus of the formula to be more about invigorating blood. And then another option would be to just add more ingredients. So if we wanted to make this more of a blood moving formula, we could add herbs like Taoxuan and Honghua, peach pit and safflower from the invigorate blood category. And now the formula becomes Taohong Siwutong. And this formula actually forms the basis for a lot of our blood invigorating formulas. So we actually have an entire group of formulas based on Taohong Siwutong. I like to call them the Wang Qingren formulas because that's the name of the guy who created them. But most people just call them the Juyutongs. Here, Juyu means to expel or to drive out stasis. And it's in the name of the most of the formulas. Xuefu Juyutong, Shaofu Juyutong, Gexia Juyutong, Shentong Juyutong, Tongqiao Huoshuitong, and Buyang Huanwutong. So these formulas all treat blood stagnation in various parts of the body due to various causes. Xuefu Juyutong means drive out stasis from the mansion of blood decoction. And here the mansion of blood is referring to the chest or the area above the diaphragm. So this formula is for blood stagnation in the chest. But take a look at the ingredients. The formula is basically a combination of Taohong Siwutong plus Sunisan, which is our basic formula for liver chi stagnation. So we could just think of this formula as treating blood stagnation in the chest. Or we could go a step further and say that this is a formula for blood stagnation plus liver chi stagnation. And then notice that Jiegeng is also here. So Jiegeng is not here to transform phlegm or stop cough. Rather, Jiegeng is here as a guiding herb to the chest. Jiegeng is balloon flower root and it can float upward and guide the actions of the formula to the upper jowl. Shaofu Juyutong means drive out stasis from the lesser abdomen decoction. So with this one we're treating blood stasis in the lower abdomen. Usually this means painful menses. But again, take a look at the ingredients. We can see our Siwutong formula here, but we also have a bunch of herbs from the category herbs that warm the interior, like Ganjiang, Xiaohuixiang, and Ruogui. So this tells us that this formula is for blood stagnation due to cold. Then we also see the herbs for Shixiaosan, sudden smile powder, which is a formula for painful menses. And then Yanhusuo is here because it has a very famous action of stopping pain. Gexia Juyutong means drive out stasis below the diaphragm decoction. So this formula is for blood stagnation below the diaphragm. But here we're specifically referring to fixed pain, hardness, or palpable abdominal masses due to blood stasis. So the way I remember this one is from a story my Chinese teacher told me. In his generation, when he was practicing in China, hepatitis was a very common problem. So it was very common for them to palpate for liver cirrhosis during their intake. So normally when you palpate this area, you shouldn't be able to feel the liver because it's underneath the ribs. But if a person has liver cirrhosis, you'll be able to feel areas of hardness below the diaphragm. So this is a formula that may have been used because it treats palpable abdominal masses below the diaphragm. Now again, I'm not recommending that anybody with this condition should necessarily take these herbs. This is just a story that I use to help remember the actions of this formula. If you want to take herbs, go see a licensed practitioner. Shentong Juyutong is drive out stasis from the painful body decoction. Remember the word tong, fourth tone, means pain, like in Tongziwutong. And this formula is treating pain in the entire body. So again, we see Taohuangziwutong plus some other blood invigorators. Then we'll see Dilong, which is earthworm. So just like worms dig tunnels through the earth, Dilong tunnels through your body unblocking the channels to treat pain. And then we see a couple of herbs that treat bee syndrome. So that tells us that this formula is treating painful joints or chronic aches and pains like bee syndrome. So Shentong Juyutong is for unblocking the channels to treat pain anywhere in the body. Then we have Tongchaohuoshuitong. Open the orifices and invigorate blood decoction. Here, tong, first tone, means free flow or to unblock, like Tongziwutong. So this is for blood stagnation in the head and face. So we start with Taohuangziwutong to invigorate blood. Then we add in a very aromatic substance, Shixiang, which opens up the orifices of the face. We also add in a small amount of alcohol. Remember, alcohol has an upward direction that guides herbs to the head and face. That's why your face gets red when you drink alcohol. And that's how we can tell that this formula is for blood stagnation in the head and face. And finally, we have Buyanghuangwutong. Tonify yang to restore the five-tenths decoction. So when you say five-tenths, that means one half. So this formula is for sequela of wind stroke when one half of the body is paralyzed. We call that hemiplegia. So this is for hemiplegia, paralysis, atrophy of the limbs, facial paralysis, deviation of the mouth, and all these things that can happen after a stroke. So again, we have Taohuangziwutong to invigorate blood. Dilong is there to unblock the channels and extinguish wind. And then we have a very large dosage of huangqi. So unlike other physicians, Huang Qingren didn't necessarily believe that this condition was caused by wind. He thought it was caused by qi deficiency. That's why we have this large dosage of huangqi to tonify qi. And this also goes back to our idea that qi is the commander of blood. So by tonifying qi, that gives the blood the energy or the motive force to start moving again. So I should probably clarify here that when Huang Qingren named this formula restore the five-tenths decoction, he wasn't actually referring to the fact that half your body is paralyzed. What he actually meant was after a stroke, he believed that you lost five-tenths of your yangqi. So that's why he named the formula this way. Tonify yang to restore five-tenths. And that's why we have such a large dosage of huangqi. So those are the Huang Qingren formulas. Our formulas for blood stasis that are based off of Taohuangziwutong. Xuefujiwutong treats blood stagnation in the chest or we could say blood stagnation with liver g-stagnation. Shaofujiwutong treats blood stagnation in the lower abdomen, specifically blood stagnation due to cold. Geshajiwutong treats blood stagnation below the diaphragm, specifically palpable abdominal masses. Shentongjiwutong treats pain of the entire body or we could say bee syndrome. Tongqiaohuoshuitong treats blood stagnation in the head and face. And Buyanghuangwutong invigorates blood and unblocks channels but also tonifies qi to treat hemiplegia. So that's kind of the versatility of sutong. We can think of it more as a formula that tonifies blood and that shows up by itself or inside of other formulas like bajentong and Taishanpanshiwang that we can think of it as a blood invigorating formula especially in the context of the Wangqingren formulas. But if you want to learn more about the individual herbs that make up this formula I do have a video about the single herb category herbs that tonify blood. I'll link it up here or in the description below. This is actually an excerpt from a course that reviews all of the single herbs so if you're interested in purchasing that course you might want to check out that video first and make sure it's what you're looking for. It is just a quick review so I talk kind of fast and go through things kind of quickly so if you're interested in that you might want to check that out before you purchase the course. So that's it for this video about sutong. Special thank you to the Patreon members for supporting this channel and making videos like this possible. If you'd like to join them in supporting this channel there's a link in the description below. And special thank you to you for watching this video and making it this far. I appreciate you. But that's all for today. Thanks and see you next time.