Herbs that warm the interior and expel cold are pungent and hot. They warm the spleen and stomach, expel cold, and stop pain in interior cold syndromes. Interior cold syndromes can be caused either by invasion of exogenous pathogenic cold leading to deficiency of Yang Qi in the spleen and stomach, or by weakness of Yang Qi giving rise to excessive Yin and cold in the interior.
The manifestations of interior cold syndromes include cold pain in the epigastric and abdominal regions, vomiting, and diarrhea; or cold extremities, pale profuse clear urine, a pale tongue with a white coating, and a deep thready pulse. In serious cases, there is collapse of Yang with ice-cold extremities and a weak thready pulse.
Herbs that warm the interior are used in combination with herbs that release the exterior when an exterior syndrome accompanies the interior cold syndrome. Herbs that promote Qi circulation are used with herbs that warm the interior for interior cold and stagnation syndromes. Herbs that strengthen the spleen in the transformation of dampness are combined with herbs of this category for interior cold and dampness syndromes. Herbs that tonify the spleen and kidney are added to the combination for deficiency of the spleen and kidney. Herbs that tonify the source Qi are used with these herbs in emergency situations of collapsing Yang and Qi.
The prescriptions, which are chiefly composed of warm- or hot-natured herbs whose purpose is to warm Yang, dispel cold, and treat interior cold syndromes, are called “Interior-Warming Prescriptions” or “Cold-Dispelling Prescriptions.” Since interior syndromes may affect the viscera, meridians, or collaterals, and differ in degree of severity, prescriptions for warming the interior are accordingly subdivided into three categories:
(1)Prescriptions for warming the middle Jiao to dispel cold: They warm the spleen and stomach, and are applied in the syndromes caused by deficiency and coldness in the middle Jiao.
(2)Prescriptions for restoring Yang from collapse: They recuperate depleted Yang and rescue the patient from collapse. These prescriptions are used to treat syndromes caused by declined Yang with excessive Yin or sudden collapse of Yang.
(3)Prescriptions for warming meridians and dispelling cold: They warm meridians and are applied in the syndromes caused by the accumulation of coldness in the meridians and collaterals.
Interior-Warming Herbs
(i) Prepared aconite root (Fu Zi, 
)
Pharmaceutical Name: Radix Aconiti lateralis praeparata
Part Used: Root
Properties: Pungent, hot, and toxic
Channel Tropism: Heart, kidney, and spleen
| Functions: | (a) | To warm and strengthen kidney-Yang; |
| (b) | To expel cold and stop pain. |
Applications:
(a)Collapse of Yang syndrome, manifested as cold extremities, spontaneous cold sweating, and a fading pulse. Prepared aconite root (Fu Zi, 
) is used with Dried ginger (Gan Jiang, 
) and Licorice root (Gan Cao, 
).
(b)Collapse of Yang Qi syndrome, manifested as profuse sweating, shortness of breath, and asthma. Prepared aconite root (Fu Zi, 
) is used with Ginseng (Ren Shen, 
).
(c)Deficiency of kidney-Yang and declined kidney fire, manifested as chills, cold limbs, soreness and weakness of the lumbar region, impotence, and frequent urination. Prepared aconite root (Fu Zi, 
) is used with Cinnamon bark (Rou Gui, 
), Dogwood fruit (Shan Zhu Yu, 
), and Prepared Rehmannia root (Shu Di Huang, 
).
(d)Weakness of spleen-Yang, manifested as cold in the epigastric and abdominal regions, and diarrhea. Prepared aconite root (Fu Zi, 
) is used with Ginseng (Ren Shen, 
), White Atractylodes (Bai Zhu, 
), and Dried ginger (Gan Jiang, 
).
(e)Deficient Yang in the spleen and kidneys, manifested as dysuria and general edema. Prepared aconite root (Fu Zi, 
) is used with White Atractylodes (Bai Zhu, 
) and Poria (Fu Ling, 
).
(f)Heart-Yang deficiency, manifested as palpitations, shortness of breath, and a stifling sensation and pain in the chest. Prepared aconite root (Fu Zi, 
) is used with Ginseng (Ren Shen, 
) and Cinnamon twigs (Gui Zhi, 
).
(g)Weakness of defensive Yang, manifested as spontaneous sweating. Prepared aconite root (Fu Zi, 
) is used with Astragalus root (Huang Qi, 
) and Cinnamon twigs (Gui Zhi, 
).
(h)Invasion of wind and cold in a person with deficient Yang. Prepared aconite root (Fu Zi, 
) is used with Ephedra (Ma Huang, 
) and Asarum herb (Xi Xin, 
).
(i)Cold-damp obstruction syndrome, manifested as general joint pain and chills. Prepared aconite root (Fu Zi, 
) is used with Cinnamon twigs (Gui Zhi, 
) and White Atractylodes (Bai Zhu, 
).
(j)Dosage: 3–15 g.
Cautions and Contraindications: This herb is contraindicated during pregnancy.
(ii) Dried ginger (Gan Jiang, 
)
Pharmaceutical Name: Rhizoma zingiberis
Part Used: Rhizome
Properties: Pungent and hot
Channel Tropism: Spleen, stomach, heart, and lung
| Functions: | (a) | To warm the spleen and stomach, and dispel cold; |
| (b) | To prevent Yang from collapsing; | |
| (c) | To warm the lungs and resolve phlegm-damp. |
Applications:
(a)Cold attacking the spleen and stomach, manifested as cold pain in the epigastric and abdominal regions, vomiting, and diarrhea. Dried ginger (Gan Jiang, 
) is used with Evodia fruit (Wu Zhu Yu, 
) and Pinellia tuber (Ban Xia, 
).
(b)Weakness and cold in the spleen and stomach, manifested as fullness and distension in the epigastric and abdominal regions, vomiting, nausea, loose stools, poor appetite, lassitude, and a deficient weak pulse. Dried ginger (Gan Jiang, 
) is used with White Atractylodes (Bai Zhu, 
) and Poria (Fu Ling, 
).
(c)Collapse of Yang, manifested as cold sweating, cold extremities, spontaneous sweating, listlessness, and a fading pulse. Dried ginger (Gan Jiang, 
) is used with prepared aconite root (Fu Zi, 
).
(d)Cold-phlegm in the lungs, manifested as chills, asthma, cough with clear profuse sputum, and a cold feeling in the upper back. Dried ginger (Gan Jiang, 
) is used with Ephedra (Ma Huang, 
), Asarum (Xi Xin, 
), and Pinellia tuber (Ban Xia, 
).
(e)Dosage: 3–9 g.
Cautions and contraindications: This herb should be used with caution during
pregnancy.
(iii) Cinnamon bark (Rou Gui 
)
Pharmaceutical Name: Cortex Cinnamomi
Part Used: Bark
Properties: Pungent, sweet, and hot
Channel Tropism: Kidney, spleen, heart, and liver
| Functions: | (a) | To tonify the kidneys; |
| (b) | To dispel cold and stop pain; | |
| (c) | To warm the channels and promote circulation. |
Applications:
(a)Kidney-Yang deficiency, manifested as cold limbs, soreness and weakness of the lumbar region and knees, impotence, spermatorrhea, and frequent urination. Cinnamon bark (Rou Gui 
) is used with Prepared aconite root (Fu Zi, 
), Prepared Rehmannia root (Shu Di Huang, 
), and Dogwood fruit (Shan Zhu Yu, 
).
(b)Deficient Yang of the spleen and kidneys manifested as cold pain in the abdominal region, poor appetite, and loose stools. Cinnamon bark (Rou Gui, 
) is used with Dried ginger (Gan Jiang, 
), White Atractylodes (Bai Zhu, 
), and Prepared aconite root (Fu Zi, 
).
(c)Cold stagnation in the meridians, manifested as epigastric and abdominal cold pain, lower back pain, general pain, irregular menstruation, and dysmenorrhea. Cinnamon bark (Rou Gui, 
) is used with Dried ginger (Gan Jiang, 
), Evodia fruit (Wu Zhu Yu, 
), Chinese Angelica root (Dang Gui, 
), and Chuan Xiong rhizome (Chuan Xiong, 
).
(d)Yin type of boils (chronic boils) Cinnamon bark (Rou Gui, 
) is used with Astragalus root (Huang Qi, 
) and Chinese Angelica root (Dang Gui, 
).
(e)Dosage: 2–5 g.
Caution and Contraindications: This herb is contraindicated during pregnancy.
(iv) Evodia fruit (Wu Zhu Yu, 
)
Pharmaceutical Name: Fructus Evodiae
Part Used: Fruit
Properties: Pungent, bitter, hot, and slightly toxic Channel Tropism: Liver, spleen, and stomach
| Functions: | (a) | To dispel cold and stop pain; |
| (b) | To pacify the liver and direct rebellious Qi downward; | |
| (c) | To stop vomiting. |
Applications:
(a)Cold attacking the spleen and stomach, manifested as epigastric and abdominal cold pain. Evodia fruit (Wu Zhu Yu, 
) is used with Dried ginger (Gan Jiang, 
).
(b)Cold stagnation in the Liver Meridian, manifested as hernia. Evodia fruit (Wu Zhu Yu, 
) is used with Fennel fruit (Xiao Hui Xiang, 
) and Lindera root (Wu Yao, 
).
(c)Weakness of spleen and stomach, and liver-Qi rising upward manifested as headache and vomiting. Evodia fruit (Wu Zhu Yu, 
) is used with Ginseng (Ren Shen, 
) and Fresh ginger (Sheng Jiang, 
).
(d)Deficiency and cold of the spleen and kidneys, manifested as chronic diarrhea. Evodia fruit (Wu Zhu Yu, 
) is used with Schisandra fruit (Wu Wei Zi, 
) and Nutmeg (Rou Dou Kou, 
).
(e)Beriberi. Evodia fruit (Wu Zhu Yu, 
) is used with Chaenomeles fruit (Mu Gua, 
) for external application.
(f)Vomiting and acid regurgitation: (1) cold in the stomach — Evodia fruit (Wu Zhu Yu, 
) is used with Fresh ginger (Sheng Jiang, 
) and Pinellia tuber (Ban Xia, 
); (2) fire transformed from prolonged liver-Qi stagnation — Evodia fruit (Wu Zhu Yu, 
) is used with Coptis root (Huang Lian, 
).
(g)Dosage: 2–5 g.
(v) Asarum herb (Xi Xin, 
)
Pharmaceutical Name: Herba asari cum Radice
Part Used: The entire plant
Properties: Pungent and warm
Channel Tropism: Lung and kidney
| Functions: | (a) | To dispel cold and stop pain; |
| (b) | To warm the lungs and resolve phlegm-damp; | |
| (c) | To relieve nasal congestion. |
Applications:
(a)Headache, toothache, and obstruction pain: (1) wind-cold headache — Asarum herb (Xi Xin, 
) is used with Chuan Xiong rhizome (Chuan Xiong, 
); (2) wind-cold toothache — Asarum herb (Xi Xin, 
) is used with Dahurian angelica root (Bai Zhi, 
); (3) toothache due to excessive heat in the stomach — Asarum herb (Xi Xin, 
) is used with Gypsum (Shi Gao, 
) and Scutellaria root (Huang Qin, 
); (4) wind-cold-damp obstruction syndrome — Asarum herb (Xi Xin, 
) is used with Notopterygium root (Qiang Huo, 
), Ledebouriella root (Fang Feng, 
), and Cinnamon twigs (Gui Zhi, 
).
(b)Wind-cold exterior syndromes, manifested as chills, fever, headache, and general pain. Asarum herb (Xi Xin, 
) is used with Notopterygium root (Qiang Huo, 
) and Ledebouriella root (Fang Feng, 
).
(c)Cold-phlegm fluid attacking the lungs, manifested as asthma and cough with profuse clear sputum. Asarum herb (Xi Xin, 
) is used with Ephedra (Ma Huang, 
) and Dried ginger (Gan Jiang, 
).
(d)Rhinorrhea, manifested as copiously running nose, nasal congestion, and headache. Asarum herb (Xi Xin, 
) is used with Angelica root (Bai Zh, 
), Magnolia flower (Xin Yi 
), and Mentha (Bo He, 
).
(e)Dosage: 2–5 g.
Cautions and Contraindications: This herb is contraindicated in headache due to deficient Yin and hyperactive Yang, or cough caused by heat in the lungs.
Interior-Warming Prescriptions
(1) Lizhong Wan 
(Middle-Regulating Pill)
| Composition: | Ginseng (Ren Shen, ) |
6 g |
Baked licorice (Zhi Gan Cao,  ) |
6 g | |
Dried ginger (Gan Jiang,  ) |
5 g | |
White Atractylodes (Bai Zhu,  ) |
9 g |
Administration: The herbs are ground into powder, and then mixed with honey to make pills. Each time 6 g of the pills is taken with warm water.
| Functions: | (a) | To warm the middle Jiao (spleen and stomach) and dispel cold; |
| (b) | To tonify Qi and strengthen the spleen. |
Indications:
(a)Asthenic cold of the spleen and stomach, marked by vomiting, diarrhea, abdominal pain relieved by warming and pressing, anorexia, aversion to cold, cold limbs, a pale tongue with a white tongue coating, and a deep thready pulse.
(b)Yang deficiency with bleeding, marked by hemoptysis, nosebleed, hemafecia, metrorrhagia, a dull blood color, and cold limbs.
(c)Obstruction of chest Qi, marked by infantile chronic convulsions, or a predilection for spitting, and saliva after recovery from diseases due to asthenic cold of the spleen and stomach.
Formula Analysis: The syndrome results from Yang deficiency of the middle Jiao, and deficiency-cold of the spleen and stomach, leading to dysfunctional digestion and transformation. All the disorders should be treated by warming the middle Jiao to dispel cold, and replenishing Qi to invigorate the spleen. Acting as the chief herb, Gan Jiang 
with acrid and hot properties warms Yang of the spleen and stomach and dispels interior cold. It is the important herb for support in suppressing Yin. Ren Shen 
with sweet and warm properties, the assistant herb, supplements Qi and strengthens the spleen to promote its transportation and transformation functions. The chief and assistant herbs restore Yang in the middle Jiao and benefit the spleen Qi. Bai Zhu, 
serves as the adjuvant herb and, together with Gan Jiang 
and Ren Shen 
, replenishes Qi, strengthens the spleen, and eliminates dampness. Zhi Gan Cao 
, sweet and mild in its properties, helps the other herbs reinforce the spleen and stomach, mediates their properties, and plays the part of the guiding herb.
Applications in Bio-medicine: Indigestion, chronic diarrhea, functional uterine bleeding, bloody stools due to gastroduodenal ulcers, angina pectoris, etc., characterized by vomiting, diarrhea, cold and pain, and pertaining to deficiency-cold in the spleen.
Modifications:
(a)For severe vomiting, replace Bai Zhu 
with Fresh ginger (Sheng Jiang, 
) and Clove flower bud (Ding Xiang, 
).
(b)For severe abdominal pain and distension, add prepared aconite root (Fu Zi, 
)
(c)For severe diarrhea, add Dioscorea (Shan Yao, 
), Hyacinth bean (Bian Dou, 
), and Poria (Fu Ling, 
).
(d)For loss of blood due to Yang deficiency, add Donkey hide gelatin (E Jiao, 
), Mugwort leaf (Ai Ye, 
), and Deer antler gelatin (Lu Jiao Jiao, 
).
(e)If accompanied by pain in the chest, add Red sage root (Dan Shen, 
), Trichosanthes fruit (Gua Lou, 
), Curcuma root (Yu Jin, 
), and Bitter orange (Zhi Qiao, 
).
(f)In the case of infantile convulsions, add Uncaria stem (Gou Teng, 
), White stiff silkworm (Jiang Can, 
) and Gastrodia tuber (Tian Ma, 
).
(g)For leukorrhagia due to the downward flow of dampness produced by weakness and coldness of the spleen, add Dodder seed (Tu Si Zi, 
), Degelatinized deer antler (Lu Jiao Shuang, 
), Dioscorea (Shan Yao, 
), Poria (Fu Ling, 
), Fried Coix seed (Chao Yi Ren, 
), and Oyster shell (Mu Li, 
).
(ii) Wu Zhu Yu Tang 
(Evodia Decoction)
| Composition: | Evodia fruit (Wu Zhu Yu,  ) |
3 g |
Jujube (Da Zao,  ) |
4 pcs | |
Ginseng (Ren Shen,  ) |
6 g | |
Fresh ginger (Sheng Jiang,  ) |
18 g |
Administration: The herbs are cooked by decoction.
| Functions: | (a) | To warm and tonify the spleen and stomach; |
| (b) | To descend the adverse Qi and arrest vomiting. |
Indications: Asthenic cold of the liver and stomach with adversely rising turbidity and Yin, marked by a desire for vomiting after the meal, or vomiting of sour fluid, or vomiting of clean cold saliva, or parietal headache, restlessness, chest fullness, abdominal pain, aversion to cold, cool limbs, diarrhea, even cold hands and feet, a pale tongue with a thin whitish coating, and a deep thready pulse or a taut slow pulse.
Formula Analysis: This is the commonly used formula for treating asthenic cold of the liver and stomach with adversely rising turbid Yin. All the disorders should be treated by warming the middle Jiao to restore Qi, dispersing pathogenic cold, and sending down the incorrectly ascending Qi to arrest vomiting. Wu Zhu Yu 
with acrid and hot properties, the chief herb, warms the stomach cold, liver, and kidney, and lowers adverse Qi to arrest vomiting. Ren Shen 
acts as the assistant herb, supplementing and restoring Qi, and nourishing the spleen and stomach. Sheng Jiang 
warms the stomach to arrest vomiting, and Da Zao 
invigorates Qi and reinforces the spleen. They act together as the adjuvant herbs. When used jointly, Ren Shen 
and Da Zao 
warm the spleen and benefit Qi to make the spleen Qi vigorous, pure Yang rise, and turbid Yin go down. Da Zao 
has the additional function of guiding herb, mediating the properties of other herbs.
Applications in Bio-medicine: Acute and chronic gastritis, neurotic headache, Meniere’s syndrome, migraine, and other illnesses which have as their chief symptoms vomiting and pain in the epigastrium and which pertain to the reversed flow of Qi due to stomach cold.
Modifications:
(a)In cases with severe headache, add Chuan Xiong rhizome (Chuan Xiong, 
) and Sichuan chinaberry (Chuan Lian Zi, 
).
(b)For severe vomiting, add Pinellia tuber (Ban Xia, 
), Amomum fruit (Sha Ren, 
), and Citrus peel (Ju Pi, 
).
Cautions: This decoction should be cooled and taken in small, frequent doses so as to avoid further vomiting. Additionally, it is contraindicated for patients with epigastralgia and acid regurgitation, which are attributable to accumulated heat in the stomach.
(iii) Xiao Jianzhong Tang 
(Minor Center-Tonifying Decoction)
| Composition: | White peony root (Bai Shao,  ) |
18 g |
Cinnamon twigs (Gui Zhi,  ) |
9 g | |
Baked licorice (Zhi Gan Cao,  ) |
6 g | |
Fresh ginger (Sheng Jiang,  ) |
10 g | |
Jujube (Da Zao,  ) |
12 pcs | |
Maltose (Yi Tang,  ) |
30 g |
Administration: The five herbs are first cooked by decoction, and then Yi Tang 
is added.
| Functions: | (a) | To warm and tonify the middle Jiao to restore Qi; |
| (b) | To relieve spasm and pain; | |
| (c) | To coordinate Yin and Yang. |
Indications: Asthenic cold of the middle Jiao with disharmony of the liver and spleen, marked by abdominal pain and spasm relieved by warming and pressing, dispiritedness, fatigue, or palpitations, asthenic restlessness, or aching pain of limbs, a feverish sensation of the hands and feet with dysphoria, dryness of the mouth and throat, a pale tongue with a white tongue coating, and a thready taut pulse.
Formula Analysis: This is the commonly used formula for treating the syndrome resulting from pathogenic factors in the liver subjugating the spleen due to deficiency-cold in the middle Jiao and disharmony between Yin and Yang. All the disorders should be treated by warming and tonifying the middle Jiao to restore Qi, concurrently regulating the liver and spleen, relieving spasms and pain, and regulating Yin and Yang. Yi Tang 
is used as the chief herb. It not only warms the middle Jiao and restores Qi but also relieves spasms and pain. Gui Zhi 
with sweet and acrid properties warms Yang and dispels cold, and Bai Shao 
with sour and sweet properties nourishes Yin and the liver. Both of the herbs act as assistant herbs, helping the chief herb carry out its functions, and regulating Ying Qi and Wei Qi as well as Yin and Yang. Zhi Gan Cao 
, with its sweet and warm nature and its ability to replenish Qi, warms the middle Jiao — especially in combination with the pungent and sweet properties of Yi Tang 
and Gui Zhi |
Additionally, Zhi Gan Cao’s 
qualities coordinate with the sour and sweet nature of Bai Shao 
to relieve spasms and pain. ShengJiang 
and Da Zao 
have the functions of warming the stomach and reinforcing the spleen. They serve as the adjuvant herbs. Zhi Gan Cao 
, the guiding herb, also mediates the effects of the other herbs. The formula contains mild herbs with the simultaneous application of generating Yang with acrid and sweet herbs and producing Yin with sour and sweet herbs.
Applications in Bio-medicine: Chronic gastritis, gastric and duodenal ulcers, nervous exhaustion, functional fever, and other conditions with the above symptoms that are attributable to deficiency-cold syndrome of the spleen and stomach.
Modifications:
(a)For severe blood deficiency, add Chinese Angelica root (Dang Gui, 
). The formula is then called Dang Gui Jianzhong Tang.
(b)In the case of severe Qi deficiency, add Astragalus root (Huang Qi, 
), creating the formula Huang Qi Jianzhong Tang.
(iv) Sini Tang 
(Cold-Extremities Decoction)
| Composition: | Prepared aconite root (Fu Zi,  ) |
5–10 g |
Dried ginger (Gan Jiang,  ) |
6–9 g | |
Baked licorice (Zhi Gan Cao,  ) |
6 g |
Administration: Fu Zi 
is first individually decocted for an hour, and then the other two herbs are added to decoct together.
Function: To recuperate depleted yang, rescuing the patient from collapse.
Indications: Cold syncope due to Yang decline of the heart and kidney, marked by cold limbs, aversion to cold, lying huddled up, vomiting, absence of thirst, abdominal pain, diarrhea, mental fatigue and sleepiness, a whitish slippery tongue coating, and a feeble thready pulse.
Formula Analysis: The syndrome results from depletion of Yang Qi and excessive Yin-cold in the interior, and should be treated by recuperating yang. Fu Zi 
, with extremely pungent and hot properties, acts as the chief herb to warm and strengthen the kidney Yang, and dispels Yin and cold to assist the deficient Yang Qi of the heart and kidney. Gan Jiang 
with acrid and hot properties, in conjunction with Fu Zi 
, warms the kidney to assist the spleen and stomach, and warms the spleen and stomach to nourish the kidney. The two herbs accentuate each other. For this reason, there is a historical medical saying, “Without Gan Jiang 
, the hot property of Fu Zi 
cannot be brought into play.” Zhi Gan Cao 
replenishes Qi and restores Yang of the middle Jiao. It serves as the adjuvant herb, increasing the efficacy of the first two herbs and reducing the toxicity of Fu Zi 
. Thus, it mediates the efficacy of the chief and assistant herbs and reduces their potential side effects.
Applications in Bio-medicine: Myocardial infarction, acute cardiac failure, excessive vomiting and diarrhea from acute or chronic gastroenteritis, or shock caused by profuse perspiration, all of which pertain to Yin excess due to Yang exhaustion, or collapse from Yang depletion.
Modifications:
(a)In the case of predominate Yin rejecting Yang manifesting as a flushed face and cold syndrome with pseudoheat symptoms, increase the dosage of the first two herbs to enhance the effect of recuperating depleted Yang and promoting blood circulation, namely Tongmai Sini Tang.
(b)For severe coma, add Ginseng (Ren Shen, 
).
(v) Dang Gui Sini Tang 
(Angelica Cold-Extremities Decoction)
| Composition: | Chinese Angelica root (Dang Gui,  ) |
12 g |
Cinnamon twigs (Gui Zhi,  ) |
9 g | |
White peony root (Bai Shao,  ) |
9 g | |
Asarum (Xi Xin,  ) |
1.5 g | |
Licorice (Gan Cao,  ) |
5 g | |
Rice paper pith (Tong Cao,  ) |
3 g | |
Jujube (Da Zao,  ) |
8 pcs |
Administration: The herbs are cooked with water by decoction.
| Functions: | (a) | To warm meridians and dispel cold; |
| (b) | To nourish the blood and promote blood circulation. |
Indications: Cold syncope with blood deficiency, manifested as cold limbs, or local black-and-blue marks, or pain and numbness of the waist, thighs, legs and feet, aversion to cold with a preference for warmth, a pale tongue with a whitish coating, and a deep thready pulse.
Formula Analysis: The syndrome is due to constitutional deficiency of blood and Yang, causing the meridians to be affected by cold as well as obstructed blood flow. The method of treatment is to warm the meridians to dispel cold, and to nourish the blood to remove obstruction in the meridians. Acting as the chief herbs, Dang Gui 
with sweet and warm properties nourishes and regulates blood, and Gui Zhi 
with acrid and warm properties warms meridians to dispel cold, and promotes blood circulation. As the assistant herbs, Bai Shao 
helps Dang Gui 
invigorate Yin and blood, and Xi Xin 
helps Gui Zhi 
dispel cold and relieve pain. Tong Cao 
, the adjuvant herb, dredges meridians, promotes blood circulation, and enhances the effects of the chief and assistant herbs. Gan Cao 
and Da Zao 
, the guiding herbs, replenish Qi to invigorate the spleen, and enforce the effects of nourishing blood and activating Yang. The whole formula with the warming, tonifying, and dredging actions warms Yang Qi, tonifies blood, dispels pathogenic cold, and promotes blood circulation.
Applications in Bio-medicine: Thromboangiitis, athetosis, frostbite, dysmenorrheal, and chronic rheumatoid arthritis.
Modifications:
(a)For dysmenorrhea, add Lindera root (Wu Yao, 
) and Fennel fruit (Xiao Hui Xiang, 
).
(b)In cases of severe pain in the limbs, add Cyathula root (Niu Xi, 
), Spatholobus stem (Ji Xue Teng, 
), and Quince fruit (Mu Gua, 
).
(c)If there is abdominal pain and vomiting, add Evodia fruit (Wu Zhu Yu, 
) and Fresh ginger (Sheng Jiang, 
). The formula then becomes Dang Gui 
Sini Jia Wu Zhu Yu Sheng Jiang Tang.