When warmth stays shut inside

Cool hands and feet even though you do not feel the cold, tension that settles under the ribs or in the upper abdomen, frequent sighing, a mood that tightens with frustrations, digestion that knots up straight after… In TCM, these signs may be associated with Liver Qi Stagnation spilling over onto the Spleen: Qi blocked inside holds back the Yang, which can no longer reach the extremities. It is not that warmth is lacking, but that it does not circulate: tradition speaks of constrained Yang.

Si Ni San appeared 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). Its name evokes the “four limbs” that do not warm up. Tradition regards it as the ancestral formula of all those that free the Liver and regulate Qi: Xiao Yao San descends from it. Not to be confused with Si Ni Tang, whose name is almost identical, which addresses the opposite situation.

One rises, the other descends

Four plants, two pairs. Bupleurum frees Liver Qi and raises the clear Yang; immature bitter orange makes Qi descend and loosens what builds up in the centre. One rises, the other descends: together, they set the mechanics of Qi going again. White peony root holds the Liver from its other side: it nourishes the Blood, so that this movement does not wear down the Yin.

Helps promote the smooth flow of Liver Qi: Bupleurum, the emperor plant, opens what is blocked. The aim is neither to tonify nor to warm, but to open.

Harmonises the Liver and Spleen: According to tradition, a constrained Liver weighs on the Spleen and Stomach. By freeing the former, the formula gives the latter back their ease, and licorice protects the centre.

Helps the Yang reach the extremities: Once Qi is moving again, the warmth held inside finds its way back to the hands and feet.

Helps ease internal tension: White peony root and licorice form the pairing of Shao Yao Gan Cao Tang: sour and sweet together loosen what tightens.