Verscienta

Tong Mai Si Ni Jia Zhu Dan Zhi Tang

Star

通脉四逆加猪胆汤 (Vessel-Freeing Counterflow Cold Decoction Plus Pig's Bile)

Source: Shang Han Lun — Zhang Zhong-Jing (Eastern Han, c. 220)

Last updated October 20, 2026

Not yet clinically reviewed

Explain this formula AI · professionals
Verified professionals

An AI tool for verified professionals

Our AI tools are available only to verified practitioners, who can weigh what a language model drafts against their own training and a patient in front of them.

Already verified? Sign in to use it. Practitioners can register a professional account; we review your credentials before the AI tools unlock.

Sign in Register as a professional

Description

Tong Mai Si Ni Jia Zhu Dan Zhi Tang (Vessel-Freeing Counterflow Cold Decoction Plus Pig's Bile) is the formula given in Line 390 of the Shang Han Lun for sudden turmoil in which the vomiting and diarrhea have stopped but sweating, reversal, unresolved hypertonicity of the limbs and a faint pulse verging on expiry remain (yáng collapse with yīn exhaustion).

Source: Mitchell C, Feng Y, Wiseman N. Shang Han Lun: On Cold Damage, Translation & Commentaries. Paradigm Publications, 1999, pp. 591–592.

Composition

Liquorice — estimated at the Chinese Pharmacopoeia's minimum content: about 313 mg of glycyrrhizic acid a day (zhi Gan Cao 31.25 g × 1.0 %). The EU Scientific Committee on Food considers 100 mg/day an upper limit for regular intake that protects most people. The estimate assumes all of it passes into what is taken, uses the pharmacopoeia's dry-weight minimum, and takes the amounts as one day's dose.

Sources

Sources: Chinese Pharmacopoeia 2020, 甘草 and 炙甘草, assay (glycyrrhizic acid not less than 1.8 % in the dispensed slices and 1.0 % in honey-fried liquorice, by dry weight). EU Scientific Committee on Food, Opinion on glycyrrhizinic acid and its ammonium salt, SCF/CS/ADD/EDUL/225 Final, 2003. The Committee notes this limit may not protect people with high blood pressure, electrolyte or fluid-balance disorders, slow gut transit, or reduced 11β-HSD2 activity.

Herb Amount % Role Function
Gan Cao
as printed: 甘草二两（炙） (2 liang, mix-fried); 31.25 g at 1 liang = 15.625 g (p. 64)
31.25g 40% —
Gan Jiang
as printed: 干姜三两（强人可四两） (3 liang; strong people can [be given] 4 liang); 46.875 g at 1 liang = 15.625 g (p. 64)
46.88g 60% —
Zhi Fu Zi
as printed: 附子大者一枚（生，去皮，破八片） (1 large piece, raw, remove skin, break into eight pieces); aconite used raw (生), linked to the Zhi Fu Zi record with processing sheng
1pieces 100% —
Zhu Dan
as printed: 猪胆汁半合 (half ge of pig's bile; a volume, no gram weight given); goat's gallbladder may be substituted
g — —
➕ Modify this formula — AI additions for what it isn't resolving

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 warm (+1.20)

From 100% of the weighed grams.

neutral hot

Grams by band: neutral 40%, hot 60%.

Taste

pungent sweet
  • pungent 60%
  • sweet 40%

From 100% of the weighed grams.

Channels reached

  • Lung 100%
  • Stomach 100%
  • Spleen 100%
  • Heart 100%

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

2 herbs without a dose in grams, so left out of every figure above: Zhi Fu Zi, Zhu Dan.

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 Si Ni Tang →

Preparation

[For] the four ingredients above, use three shēng of water. Boil [the first three ingredients] to get one shēng two gě and remove the dregs. Add pig's bile (zhū dǎn zhī). Divide [into two parts], and take warm twice a day. The pulse will then return. [If there is] no pig's gallbladder (zhū dǎn), goat's gallbladder (yáng dǎn) [can be] substituted. (Mitchell, Feng & Wiseman 1999, p. 592, Line 390)

Relationships

Explain its connection to another record → Full-screen graph →

Click a node for details · double-click to expand it · Ctrl/⌘ + scroll or two fingers to zoom and pan.

Loading graph…

Formula family

Each entry reads as the larger formula written out: “+” adds its other catalogue cores, then the herbs none of them hold. 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.

75% 50% Closer to the centre = stronger match · thicker line = more shared herbs — hover a formula for details 83% Si Ni Tang 3 shared Si Ni Tang 83% match · 3 of 3 herbs shared Shares: Gan Cao, Gan Jiang, Zhi Fu Zi 83% Tong Mai Si Ni Tang 3 shared Tong Mai Si Ni Tang 83% match · 3 of 3 herbs shared Shares: Gan Cao, Gan Jiang, Zhi Fu Zi 78% Si Ni Jia Ren Shen Ta… 3 shared Si Ni Jia Ren Shen Tang 78% match · 3 of 4 herbs shared Shares: Gan Cao, Gan Jiang, Zhi Fu Zi 70% Bai Tong Jia Zhu Dan … 3 shared Bai Tong Jia Zhu Dan Zhi Tang 70% match · 3 of 4 herbs shared Shares: Gan Jiang, Zhi Fu Zi, Zhu Dan 70% Si Wei Hui Yang Yin 3 shared Si Wei Hui Yang Yin 70% match · 3 of 4 herbs shared Shares: Gan Cao, Gan Jiang, Zhi Fu Zi 64% Gan Jiang Fu Zi Tang 2 shared Gan Jiang Fu Zi Tang 64% match · 2 of 2 herbs shared Shares: Gan Jiang, Zhi Fu Zi 62% Fu Zi Li Zhong Wan 3 shared Fu Zi Li Zhong Wan 62% match · 3 of 5 herbs shared Shares: Gan Cao, Gan Jiang, Zhi Fu Zi 59% Fu Ling Si Ni Tang 3 shared Fu Ling Si Ni Tang 59% match · 3 of 5 herbs shared Shares: Gan Cao, Gan Jiang, Zhi Fu Zi Tong Mai Si Ni Jia Zhu Dan Zhi Tang

Similar Formulas by composition

Si Ni Tang
四逆汤 · Si Ni Tang
Shang Han Lun
83% match
3 shared herbs of 3— Gan Cao, Gan Jiang, Zhi Fu Zi
how are these connected? (Si Ni Tang)
Tong Mai Si Ni Tang
通脉四逆汤 · Tong Mai Si Ni Tang
Shang Han Lun
83% match
3 shared herbs of 3— Gan Cao, Gan Jiang, Zhi Fu Zi
how are these connected? (Tong Mai Si Ni Tang)
Si Ni Jia Ren Shen Tang
四逆加人参汤 · Si Ni Jia Ren Shen Tang
Shang Han Lun
78% match
3 shared herbs of 4— Gan Cao, Gan Jiang, Zhi Fu Zi
how are these connected? (Si Ni Jia Ren Shen Tang)
Bai Tong Jia Zhu Dan Zhi Tang
白通加猪胆汁汤 · Bai Tong Jia Zhu Dan Zhi Tang
Shang Han Lun
70% match
3 shared herbs of 4— Gan Jiang, Zhi Fu Zi, Zhu Dan
how are these connected? (Bai Tong Jia Zhu Dan Zhi Tang)
Si Wei Hui Yang Yin
Si Wei Hui Yang Yin
Jing Yue Quan Shu
70% match
3 shared herbs of 4— Gan Cao, Gan Jiang, Zhi Fu Zi
how are these connected? (Si Wei Hui Yang Yin)
Gan Jiang Fu Zi Tang
干姜附子汤 · Gan Jiang Fu Zi Tang
Shang Han Lun
64% match
2 shared herbs of 2— Gan Jiang, Zhi Fu Zi
how are these connected? (Gan Jiang Fu Zi Tang)
Fu Zi Li Zhong Wan
附子理中丸 · Fu Zi Li Zhong Wan
Tai Ping Hui Min He Ji Ju Fang
62% match
3 shared herbs of 5— Gan Cao, Gan Jiang, Zhi Fu Zi
how are these connected? (Fu Zi Li Zhong Wan)
Fu Ling Si Ni Tang
Fu Ling Si Ni Tang
Shang Han Lun
59% match
3 shared herbs of 5— Gan Cao, Gan Jiang, Zhi Fu Zi
how are these connected? (Fu Ling Si Ni Tang)

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.

📝 Notes

Public notes from the community and your own private notes on Tong Mai Si Ni Jia Zhu Dan Zhi Tang.

No notes yet.

Log in or register to add your own notes.

Back to Formula Library