"Zhike Siwu Tang": A Four-Substance Decoction That Nourishes Blood and Stops Thirst
Zhike Siwu Tang comes from "Ye's Gynecology" (Ye Shi Nüke). It treats great postpartum diabetes-like thirst, incessant drinking, with extreme fluid depletion and fire restlessness. Its composition is: Shudihuang (prepared Rehmannia) two qian, Danggui (Angelica sinensis) two qian, Baishao (White Peony) one qian, Chuanxiong (Ligusticum) one qian, Zhimu (Anemarrhena) one qian, Huangbai (Phellodendron) one qian, Fuling (Poria) one qian, Huangqi (Astragalus) one qian. Taken as a water decoction. From a modern medical perspective, this is a prescription for thirst caused by excessive postpartum blood loss. Besides the above symptoms, the patient may also have spontaneous sweating and palpitations.
These symptoms also appear in terminal-stage cancer patients: when tumor progression or side effects of radiotherapy and chemotherapy cause anemia and hypoglycemia, the patient too experiences incessant great thirst, poor appetite, no desire for food, and a craving only for water—having just drunk, they want more. Such patients are also suitable for Zhike Siwu Tang.
Zhike Siwu Tang is based on Siwu Tang, reducing the amount of the warm-drying Chuanxiong and adding Zhimu, Huangbai, Fuling, and Huangqi. Siwu Tang invigorates and nourishes blood; Zhimu nourishes yin and moistens dryness; Huangbai clears heat and downbears fire; Fuling and Huangqi strengthen the spleen and drain water, with Huangqi also supplementing qi and blood. Used together, the formula treats both root and branch: it nourishes blood and yin, moistens dryness and downbears fire, and frees the water passages—hence it achieves the effect of nourishing blood and stopping thirst.
The composition and action of Zhike Siwu Tang are somewhat similar to Zhibai Dihuang Wan (composed of prepared Rehmannia, Dioscorea, Cornus, Poria, Alisma, Moutan, Anemarrhena, and Phellodendron; sold as a patent medicine by several manufacturers). Zhibai Dihuang Wan is Liuwei Dihuang Wan plus Anemarrhena and Phellodendron, and is the representative TCM formula for yin deficiency with effulgent fire—afternoon fever, night sweats, dry throat and mouth, tinnitus and seminal emission, and scanty dark urine. Comparing these two formulas deepens memory and improves understanding of TCM formulation technique.
Using modern sliced herbs, Zhike Siwu Tang may be dosed as follows (adult dose; reduce for children): Shudihuang (prepared Rehmannia) 12 g, Danggui (Angelica) 12 g, Baishao (White Peony) 6 g, Chuanxiong (Ligusticum) 6 g, Zhimu (Anemarrhena) 6 g, Huangbai (Phellodendron) 6 g, Fuling (Poria) 6 g, Sheng Huangqi (raw Astragalus) 6 g. Decoct in water; take twice daily, once after breakfast and once after dinner.
If the patient has poor appetite, add stir-fried Maiya (germinated barley) 15 g and charred Shanzha (hawthorn) 6 g. If chemotherapy causes nausea and vomiting, add Zhuru (bamboo shavings) 6 g, Jupi (tangerine peel) 6 g, Daizheshi (hematite) 6 g, and Xuanfuhua (inula flower) 6 g. If the patient has exuberant heat with steaming bone night sweats, add Digupi (Lycium bark) 6 g and Mudanpi (Moutan) 6 g. If bleeding occurs, add Xianhecao (agrimony) 30-50 g, Baiji (Bletilla) 6-30 g, Qiancao (madder) 10 g, Xueyutan (hair charcoal) 6 g, and Diyu (Sanguisorba) 10 g. If white blood cells are low, increase Sheng Huangqi to 15-30 g.