Si Shen Wan — Four Miracle Pill

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Conditions treated
5. Cautions

Overview

Si Shen Wan — Four Miracle Pill — is the classical Chinese herbal formula specifically for early morning diarrhoea — known in TCM as “cock-crow diarrhoea” (wu geng xie) because it characteristically occurs between 5am and 7am and is associated with Kidney Yang deficiency failing to warm and support Spleen Yang. The formula warms Kidney Yang, tonifies Spleen Yang and astringes the intestines to stop diarrhoea.

TCM pattern

Prescribed for Kidney and Spleen Yang deficiency with chronic diarrhoea, characterised by: diarrhoea in the early morning hours before or just after waking, undigested food in the stools, cold pain in the lower abdomen relieved by warmth, cold lower back and limbs, fatigue, a pale tongue with white coating, and a deep, slow and weak pulse.

Key herbs

1. Bu Gu Zhi (Psoralea corylifolia seed) — the principal herb; warms Kidney Yang and tonifies Ming Men Fire; astringes the intestines
2. Wu Zhu Yu (Evodia rutaecarpa fruit) — warms the Liver and Stomach, disperses Cold and stops diarrhoea
3. Rou Dou Kou (Myristica fragrans seed) — warms the Middle, astringes the intestines and stops chronic diarrhoea
4. Wu Wei Zi (Schisandra chinensis fruit) — astringes the intestines, consolidates Essence and generates fluids

Conditions treated

1. Early morning diarrhoea (cock-crow diarrhoea) — the formula’s specific classical indication
2. IBS with Spleen and Kidney Yang deficiency and cold diarrhoea
3. Crohn’s disease with Kidney Yang deficiency pattern in chronic remission-phase disease
4. Ulcerative colitis with constitutional Kidney and Spleen Yang deficiency in older or long-standing cases
5. Chronic bowel weakness with cold, unformed stools and fatigue

Strictly contraindicated in Damp-Heat diarrhoea patterns (with burning, urgency and mucus). For cold and deficient patterns only.

Cautions

Always consult a qualified Chinese herbalist registered with the Register of Chinese Herbal Medicine (RCHM). Online herbal consultations are available. See the prices page for costs.