Sì Shén Wán

Question 1

Indications

Answer 1

Diarrhea that occurs daily just before sunrise, lack of interest in food and inability to digest what is eaten, soreness of the lower back with cold limbs, fatigue and lethargy, a pale tongue with a thin, white coating, and a submerged, slow, and forceless pulse. There may also be abdominal pain.

Question 2

Actions

Answer 2

Warms and tonifies the Spleen and Kidneys, binds up the Intestines, and stops diarrhea

Question 3

Herbs

Answer 3

bŭ gŭ zhī
chăo wú zhū yú
ròu dòu kòu
wŭ wèi zĭ

Question 4

Chief

Answer 4

bŭ gŭ zhī: acrid, bitter, warm; directly tonifies gate of vitality and benefits earth (Spleen) by fortifying this aspect of fire
astringent: acts on Kidneys to secure primal yang, on the Spleen to stop diarrhea
generates yang from within yin (for daybreak diarrhea from yang deficiency)

Question 5

Deputy

Answer 5

ròu dòu kòu: warms the Spleen and Kidneys and binds up the Intestines; works synergistically with chief by focusing its attention on Intestines; often used to treat lack of appetite due to cold from deficiency

Question 6

Assistants

Answer 6

chăo wú zhū yú: warm, acrid, drying, strongly dispersing; disperses cold in the middle burner (Spleen and Stomach) - complements chief; dredges Liver constraint, promoting movement of qi and stopping pain
wŭ wèi zĭ: strong, warm, sour, sweet, astringent; strengthens deputy’s ability to bind up the Intestines; works synergistically with wú zhū yú

Question 7

Envoys

Answer 7

shēng jiāng: disperses cold, activates metabolism of water
dà zăo: nourishes Spleen and Stomach

Question 8

Cautions and Contraindications

Answer 8

Should not be used if there is accumulation or stagnation in the Stomach or Intestines. Avoid raw or cooling foods.

Question 9

Diagnostic Pattern

Answer 9

Daybreak diarrhea, also called “cock-crow diarrhea.”