Dang Gui Si Ni Tang

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当归四逆汤 (Tangkuei Decoction for Frigid Extremities)

Source: Shang Han Lun — Zhang Zhongjing (Han, 220)

Last updated July 22, 2026

Cold extremities from Blood deficiency and channel obstructionRaynaud's phenomenonChilblainsCold hands and feetLower abdominal cold painMenstrual irregularity with cold sensation

Description

Dang Gui Si Ni Tang (Tangkuei Decoction for Frigid Extremities) warms the channels and unblocks them, nourishes Blood and disperses Cold. It treats the combination of Blood deficiency and Cold obstructing the channels, causing cold extremities despite no significant interior Cold. The formula is particularly important for cold hands and feet from Blood deficiency-Cold, chilblains, and Raynaud's phenomenon.

Composition

Herb Amount % Role Function
Dang Gui 9g 17.65% Jun (Chief) Nourishes and invigorates the blood, warms the channels
Gui Zhi 9g 17.65% Chen (Deputy) Warms the channels and disperses cold to unblock the vessels
Bai Shao 9g 17.65% Chen (Deputy) Nourishes blood and preserves yin, aids Dang Gui
Xi Xin
Low dose; observe the classical ≤3g decoction cap for Xi Xin.
3g 5.88% Zuo (Assistant) Scatters cold and unblocks the channels to reach the extremities
Tong Cao 6g 11.76% Zuo (Assistant) Unblocks the vessels and promotes movement
Gan Cao 6g 11.76% Shi (Envoy) Tonifies the middle and harmonizes the formula
Da Zao 9g 17.65% Shi (Envoy) Nourishes blood and harmonizes (classically 25 pieces)

Total weight: 66g

Preparation

Decoct all herbs in water 25–30 minutes. Take warm in 2 doses/day.

Dosage

Decoction: 1 dose/day. Take warm. Can be used long-term for chronic conditions.

Conditions Addressed

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Traditional formula information is for educational purposes only. Herbal formulas should be prescribed by a qualified practitioner — dosages and combinations are individualized and can interact with medications.

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