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Si Shen Wan: An ancient remedy that warms the spleen and kidneys, strengthens the intestines and stops diarrhea

Writer's picture: Hongji MedicalHongji Medical

Si Shen Wan, also known as "Four Spirits Pill", was first mentioned in the book "Internal Medicine Abstract". It is a kind of astringent, mainly used to treat diarrhea caused by spleen and kidney yang deficiency. Si Shen Wan is a traditional Chinese medicine prescription, famous for its effect of warming the spleen and kidney, strengthening the intestines and stopping diarrhea.


With the development of modern medicine, the application scope of Si Shen Wan has been continuously expanded, showing its potential in the treatment of various chronic diseases. In this article, we will take a deep look at the ingredients, mechanism of action and application of Si Shen Wan in modern medicine to help you better understand the charm of this traditional Chinese medicine.


Introduction to the Si Shen Wan Recipe


Shishenwan
四神丸

Psoralea corylifolia: As the main drug, it plays a core role. It has the effects of warming and nourishing the kidney yang, replenishing fire and replenishing earth, and providing a continuous supply of heat to the body.


Nutmeg: As a minister drug, it assists the monarch drug to enhance the therapeutic effect. It has the effects of warming the middle and dispelling cold, astringing the intestines and stopping diarrhea, and can warm the spleen and stomach.


Schisandra chinensis: It has all five flavors and is slightly sour, which can retain the replenishing Yang Qi.


Cornus officinalis, red dates, and ginger: these three herbs work together to assist nutmeg in stabilizing the stomach and dispersing cold.


The method of making Si Shen Wan is as follows:

  1. Crush nutmeg, psoralea corylifolia, schisandra chinensis, and cornus officinalis into fine powder, sieve, and mix well.

  2. Take 120g of ginger, mash it, add appropriate amount of water and squeeze out the juice.

  3. Mix ginger juice with the above powder, roll into pills and dry.


Take 9g each time, 1-2 times a day, with light salt soup or warm water before going to bed. It can also be made into a soup, add ginger and jujube water, and drink it warm before going to bed. The dosage can be reduced according to the original prescription.


Shishenwan
四神丸

Functions and indications of Si Shen Wan


The main function of Si Shen Wan is to warm the spleen and kidney, consolidate the intestines and stop diarrhea. It is mainly used to treat diarrhea caused by spleen and kidney yang deficiency. Symptoms include:

  • Five o'clock diarrhea

  • Loss of appetite

  • Indigestion

  • Prolonged diarrhea

  • Abdominal pain, back pain

  • Cold limbs

  • Fatigue

  • Pale tongue with thin white fur

  • Weak pulse


Shishenwan
四神丸

Pathogenesis of Sishen Pills


Si Shen Wan is mainly used to treat a disease called "five-o'clock diarrhea", which is caused by weak kidney yang, resulting in insufficient yang in the body, unable to warm the spleen and stomach, causing spleen and stomach dysfunction and food cannot be digested normally, resulting in diarrhea before dawn in the morning.


In this case, people will feel stomach discomfort, backache, cold hands and feet, and fatigue. The treatment for this disease is mainly to warm and replenish the yang energy of the spleen and kidneys, while stopping diarrhea. Si Shen Wan is such a prescription.


It is mentioned in the "Medical Prescriptions Collection" that this medicine is best taken with light salt water or boiled water before going to bed , so that the effect will be better. This is because if it is taken in the morning, the effect of the medicine will disappear in the evening, and it will not be able to resist the cold at night, and it is easy to have diarrhea again. Therefore, it is recommended that patients take the medicine before going to bed, so that the effect of the medicine can be better exerted and diarrhea can be prevented at night.


Shishenwan
四神丸

Modern Application of Sishen Pills


Si Shen Wan is a traditional Chinese medicine prescription, mainly used to treat diarrhea caused by spleen and kidney yang deficiency. With the development of modern medicine, the application scope of Si Shen Wan has been continuously expanded, showing good therapeutic effects. The following are several main applications of Si Shen Wan in modern medicine:


1. Treatment of chronic diarrhea: Chronic diarrhea is a common clinical disease, mostly caused by organ dysfunction. Sishen Pills with added ingredients are effective in treating chronic diarrhea of spleen and kidney yang deficiency type (deficiency and cold syndrome).




Common symptoms of patients include diarrhea, bloody stools, mucus in stools, loose stools, accompanied by loss of appetite, abdominal distension, tinnitus, chills, fear of cold, fatigue, weakness in waist and knees, etc. Sishen Pills can effectively improve these symptoms by warming the spleen and kidneys, strengthening the intestines and stopping diarrhea.


2. Treatment of non-specific colitis: Si Shen Wan plus or minus treatment has a satisfactory effect in the treatment of non-specific colitis. According to the severity of the disease, it is divided into three types: severe, mild, and slow for treatment. In an observation of 100 cases, except for 4 cases where treatment was interrupted, the total effective rate reached 96.7%, and the recent cure rate was 36.4%. This shows that Si Shen Wan has a significant therapeutic effect in the treatment of non-specific colitis.


3. Treatment of irritable bowel syndrome: Irritable bowel syndrome (IBS) is a common functional intestinal disease and one of the main causes of chronic diarrhea. Sishen Pills with added ingredients are effective in treating IBS. The specific prescription includes 20g each of white peony root, nutmeg, and radix psoraleae, 15g each of schisandra chinensis, bupleurum, atractylodes, saposhnikovia divaricata, and tangerine peel. Decoction is concentrated to obtain 200ml of juice, which is taken warm on an empty stomach twice a day, morning and evening. One course of treatment is 7 days, and the drug is discontinued for 3 days after each course of treatment. This treatment method can effectively relieve the symptoms of IBS and improve the quality of life of patients.


Shishenwan
四神丸

4. Treatment of diabetes combined with stubborn diarrhea: Si Shen Wan combined with Shen Ling Bai Zhu San with modifications is effective in treating diabetes of spleen and kidney yang deficiency type combined with generalized edema and diarrhea.


The specific prescription includes 9g each of dogwood, nutmeg, and dried orange peel, 12g each of psoralea corylifolia, lotus seed pulp, and stir-fried white atractylodes, 24g of Chinese yam, 15g each of lentils and Taiwan ginseng, 30g of coix seed, 30g each of Poria cocos and Poria cocos peel, 6g each of licorice and ginger. Decoction, 1 dose per day. This treatment method can effectively improve the diarrhea symptoms of diabetic patients and reduce body swelling.


5. Treating asthenia and cold constipation: Sishen Pills with added ingredients are effective in treating asthenia and cold constipation. The specific prescription includes 180g each of Bupuzhi (fried with wine), ginger, 80g of Cornus officinalis, 120g each of fried Schisandra chinensis and nutmeg (wrapped in flour and stewed), 30g of Sichuan pepper (slightly roasted), 18g of refined sulfur, and 80 jujubes. First boil the ginger and jujubes, remove the ginger and jujube kernels, grind the remaining medicine into fine powder, and mix with jujube pulp to make pills. Each pill weighs 10g, take 1 pill each time, 3 times a day, and drink rice soup after taking.


6. Treatment of diarrhea at dawn: Sishen Pills in the form of soup is effective in treating diarrhea at dawn. The specific prescription includes 20g of Bupleurum, 10g each of stewed nutmeg and Schisandra chinensis, 5g of Cornus officinalis, 10 red dates, 40g of ginger, 5 doses, decocted in water, 1 dose every other day. This treatment method can effectively improve the symptoms of diarrhea at dawn and improve the quality of life of patients.


Modern research on Si Shen Wan shows that it has potential in the treatment of a variety of chronic diseases. Studies have shown that Si Shen Wan has significant effects in the treatment of chronic colitis, intestinal tuberculosis, irritable bowel syndrome, diabetes combined with intractable diarrhea, cold constipation, early morning diarrhea, enuresis and spermatorrhea.


Looking ahead, with the deepening of research on traditional Chinese medicine, the application scope and efficacy of Si Shen Wan will be further expanded and verified. Future research directions include conducting large-scale clinical research, in-depth exploration of the mechanism of action of Si Shen Wan, developing new dosage forms, studying its combination with other drugs, and establishing an adverse reaction monitoring system to ensure drug safety. These studies will provide more theoretical basis and practical guidance for the clinical application of Si Shen Wan.


Notes


Although Sishen Pills are effective in treating night diarrhea, they are not suitable for everyone. The following people should use it with caution:

  • Patients with chronic diseases, such as hypertension, heart disease, diabetes, etc.

  • People with allergies

  • Fever

  • Pregnant women and the elderly

These people should use it under the guidance of a doctor and it is best not to take it without authorization to avoid adverse effects.


Any medicine has certain side effects, so Si Shen Wan is not recommended for long-term use as a health product. After the disease is cured and the symptoms are eliminated, the patient should stop taking the medicine as appropriate. Chinese medicine pays attention to symptomatic treatment. Si Shen Wan is used for diarrhea caused by spleen and kidney yang deficiency, but diarrhea is not limited to this situation. Intestinal and stomach dampness and heat, intestinal and stomach stagnation, etc. can also cause diarrhea, but Si Shen Wan is contraindicated in these two situations. At this time, you should go to the hospital for diagnosis and let the doctor diagnose, and do not take it casually.


Conclusion


As an ancient Chinese medicine prescription, Si Shen Wan has the effects of warming the spleen and kidney, strengthening the intestines and stopping diarrhea. It is mainly used to treat diarrhea at dawn caused by spleen and kidney yang deficiency. With the development of modern medicine, the application scope of Si Shen Wan has been continuously expanded, showing good therapeutic effects. However, Si Shen Wan is not suitable for everyone, especially patients with chronic diseases, allergic constitutions, those with fever, pregnant women and the elderly should use it under the guidance of a doctor. In addition, Si Shen Wan is not recommended for long-term use, and should be discontinued as appropriate after the disease is cured and the symptoms are eliminated. Future research should further verify the efficacy and safety of Si Shen Wan, develop new dosage forms, study its mechanism of action, and provide more theoretical basis for clinical application.

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