When warmth no longer reaches your fingertips
Cold hands and feet, even indoors, fingers that struggle to warm up in winter, sensitivity to cold, a pale complexion, a feeling that warmth stops before reaching the extremities… In TCM, these signs may be associated with Blood deficiency in which Cold has lodged. Blood warms and nourishes; when it is lacking, the vessels are no longer filled and warmth no longer reaches the ends of the limbs. If Cold then settles in the meridians, it slows the Blood even more. According to tradition, here the Cold is in the meridians, not in the organs: the aim is to fill and warm the vessels.
Dang Gui Si Ni Tang appears around the year 200, at the end of the Eastern Han, in the Shang Han Lun (《伤寒论》) by Zhang Zhongjing (张仲景), in the chapter on Jue Yin, the meridian of the Liver, which stores the Blood. Si Ni (四逆) refers to the cold that spreads to the four limbs. Three formulas bear this name, and the physician Zhou Yangjun (周扬俊) told them apart in a single sentence: one brings back the Yang, another harmonises, and Dang Gui Si Ni Tang nourishes the Blood and reopens the vessels. In Japan, it remains one of the most widely used kampo formulas, under the name Tōki-shigyaku-tō.
Filling the vessels to warm
The physician Ke Yunbo (柯韵伯) drew the principle from it: to increase the Blood, you must warm the meridians. The formula starts from Gui Zhi Tang: it removes fresh ginger, doubles the jujube and adds, among others, angelica, which becomes one of its two pillars together with cinnamon twig. Tradition sums up the resulting balance: warming without drying, nourishing without clogging (温而不燥，补而不滞).
Warms the meridians: Pungent and warm, cinnamon twig warms the meridians, disperses Cold and reopens the path of the vessels.
Gently nourishes the Blood: Angelica, the most generously dosed herb, nourishes the Blood; white peony supports it by nourishing Yin, and jujube supports the Spleen, from which the Blood arises.
Supports Blood circulation: Angelica nourishes the Blood while setting it in motion: it is the root of the formula, while cinnamon is its branch.
Brings warmth to the hands and feet: Better-filled, warmed vessels let warmth and Blood travel all the way to the ends of the limbs. Jujube and licorice temper the pungency of cinnamon, for a gentle warmth.
