四物汤

Calculation of the total raw herb weight of the original formula:

Shu Di Huang (prepared rehmannia root) 12 g + Dang Gui (Chinese angelica root) 9 g + Bai Shao (white peony root) 9 g + Chuan Xiong (Sichuan lovage rhizome) 6 g = 36 g.

Converted to 5:1 granules:

36 g raw herb ÷ 5 = 7.2 g granules.

Granule dose: Dissolve in warm water and take twice daily, morning and evening, about 3.5 g per dose.

5. Cautions and clinical notes

• Contraindications:
  1. This formula tends toward richness and cloying quality, so it should be used with caution in those with Spleen-Stomach deficiency, poor appetite, and loose stools.
  2. It is contraindicated for excessive menstruation or metrorrhagia due to blood heat patterns or excess heat patterns.
• Clinical modifications: This is a foundational formula that is commonly modified according to the presentation in clinical practice. For example, if there is blood deficiency with heat, replace Shu Di Huang with Sheng Di Huang (fresh rehmannia root); if blood stasis is pronounced, increase the dose of Chuan Xiong and Dang Gui, or add Tao Ren (peach kernel) and Hong Hua (safflower) (this becomes Tao Hong Si Wu Tang, Peach-Safflower Four Substance Decoction).
• Modern applications: Widely used for women's menstrual irregularities, dysmenorrhea, disorders of pregnancy and childbirth, anemia, urticaria, and orthopedic disorders where the pattern is one of deficiency and stagnation of construction-blood.
• Duration of use: Blood deficiency does not form in a single day, so a certain duration of continuous use is required for the effect to appear; it may be taken according to the menstrual cycle or over the long term as advised by a practitioner.