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 August 30, 2026

Not yet clinically reviewed

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

Energetics dose-weighted

The formula's overall nature, taste balance and channel reach, weighted by each herb's dose. Classical formulas often pair warm and cool herbs on purpose, so a net figure summarises the mix — it doesn't describe every herb in it.

Nature

Cold Cool Neutral Warm Hot

Net slightly warm (+0.29)

From 100% of the weighed grams.

cool neutral warm

Grams by band: cool 29%, neutral 12%, warm 59%.

Pairs warm and cool. 59% of the weighed grams are warm or hot and 29% cool or cold — the net is their average, not the whole story.

Taste

pungent sweet sour bitter bland
  • pungent 24%
  • sweet 53%
  • sour 9%
  • bitter 9%
  • bland 6%

From 100% of the weighed grams.

Channels reached

  • Spleen 65%
  • Heart 53%
  • Lung 47%
  • Stomach 41%
  • Liver 35%
  • Kidney 6%

Share of the grams entering each channel, from 100% of the weighed grams.

Dose-weighted from each herb's recorded nature, taste and channels (missing values are left out, never counted as neutral). It describes the composition — it is not a recommendation.

Compare side by side with Gui Zhi Tang →

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

Related Formulas

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Formula family

A catalogue formula counts as a core only when at least 80% of its herbs are present, no more than 1 is absent, and the absent herb is not its chief.

Formula Network

Formulas that share herbs with this one — the closer to the centre, the stronger the match. Click a node to explore.

Similar Formulas by composition

Match score combines dosage-weighted composition (cosine, 70%) with shared-herb overlap (Jaccard, 30%).

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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