Dang Gui Si Ni Tang: A Warming Herbal Remedy

Health Lab
Feb 3
7 min read

Updated: Apr 29

Dang Gui Si Ni Tang, also known as Angelica Warm Limbs Decoction, is a time-tested herbal formula from the ancient Chinese text Shang Han Lun. This warming remedy is designed to heat up the body, improve blood flow, and nourish the blood, making it especially helpful for those who feel cold or have poor circulation.

This article explains the ingredients, benefits, uses, and modern applications of this powerful herbal blend in a simple and clear way.

What’s in Dang Gui Si Ni Tang Formula?

Dang Gui Si Ni Tang is made from seven common herbs that work together to warm the body and support healthy blood flow:

Angelica root (12g): Nourishes and boosts blood health.
Cinnamon twig (9g): Warms the body and opens up blood vessels.
Peony root (9g): Supports blood nourishment and works with angelica to replenish the body.
Asarum (3g): Helps cinnamon twig warm the body and improve circulation.
Rice paper plant (6g): Clears blockages in blood vessels to promote smooth flow.
Licorice root, roasted (6g): Strengthens the spleen, supports energy, and balances the formula.
Jujube dates (8 pieces): Nourishes blood and softens the effects of stronger herbs to protect the body.

How to Prepare: Boil these herbs in 8 liters of water until reduced to 3 liters. Strain out the herbs, and drink 1 liter of the warm liquid three times a day. (Modern method: Boil in water as a decoction.)

What Does Dang Gui Si Ni Tang Do?

This herbal blend has two main effects:

Warms the Body and Fights Cold: It heats up the body’s energy pathways (meridians), relieving symptoms like cold hands, feet, or body aches caused by chilly conditions.
Nourishes Blood and Improves Circulation: It strengthens blood health and clears blockages, helping with issues like numbness or discomfort from poor blood flow.

When to Use It

Dang Gui Si Ni Tang is ideal for conditions caused by blood deficiency and cold, where the body lacks enough healthy blood and feels excessively cold. Common signs include:

Cold hands and feet
Weak or barely noticeable pulse
Pale tongue with a white coating

It’s also used in modern medicine to help with conditions like:

Diabetic nerve pain: Eases numbness and tingling in the hands and feet.
Painful periods (dysmenorrhea): Reduces cramps and discomfort during menstruation.
Frozen shoulder: Improves shoulder movement and reduces pain.
Frostbite: Warms the skin and improves blood flow to heal cold-damaged tissue.
Rheumatoid arthritis: Relieves joint pain and inflammation.
Raynaud’s disease: Warms fingers and toes that turn pale or blue in the cold.
Thromboangiitis obliterans: Supports blood flow in inflamed blood vessels.

How It Works in the Body

The formula targets two key issues:

Blood Deficiency and Cold Blockage: When the body lacks healthy blood, it can’t properly supply the arms and legs, and cold can worsen this by slowing blood flow. This leads to cold limbs and pain.
Weak Energy Flow: Cold and low blood levels prevent the body’s warming energy (Yang Qi) from reaching the hands and feet, making them feel icy.

The herbs work together to warm the body, nourish blood, and clear blockages, restoring comfort and circulation.

Dang Gui Si Ni Tang /當歸四逆湯, 5:1 Concentrated Granules

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Modern Research

Studies show that Dang Gui Si Ni Tang has multiple benefits, including:

Preventing blood clots
Improving blood flow throughout the body
Reducing inflammation and pain
Supporting nerve health
Easing digestive issues and menstrual cramps

Japanese research found that adding dogwood fruit and ginger to the formula can boost body warmth by increasing adrenaline and expanding blood vessels, further helping cold hands and feet.

How the Herbs Work Together

Each herb plays a unique role:

Angelica root: Boosts blood health and keeps it moving smoothly.
Cinnamon twig: Warms blood vessels to improve flow.
Peony root: Pairs with angelica to nourish blood.
Asarum: Enhances the warming effect of cinnamon twig.
Rice paper plant: Clears blockages for better circulation.
Licorice and jujube: Support energy, nourish blood, and balance the formula to prevent overly harsh effects.

This combination warms without being too harsh and nourishes without causing stagnation, making it gentle yet effective.

Dang Gui Si Ni Tang /當歸四逆湯, 5:1 Concentrated Granules

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Customizing the Formula

The formula can be adjusted for specific needs:

Leg or joint pain: Add achyranthes root, millettia vine, or papaya to boost blood flow.
Chronic cold with nausea: Add dogwood fruit and ginger to warm the stomach and stop vomiting.
Menstrual cramps or male hernia pain: Add lindera root, fennel, ginger, or cyperus to ease pain and warm the body.

A variation called Dang Gui Si Ni Tang Plus Dogwood and Ginger is especially good for severe cold, numbness, or pain, and is used for conditions like Raynaud’s disease, chronic hives, or frostbite.

Food to Support Treatment

Pairing the formula with warming foods can enhance its effects:

Ginger and jujube tea: Warms the body and supports blood health.
Angelica, ginger, and lamb soup: Warms the body and boosts blood flow.
Red date and longan soup: Nourishes blood and gently warms the body.

These foods help the body absorb the herbs’ benefits for better results.

Key Signs for Use

Use this formula if you have:

Cold hands and feet
Pale tongue with white coating
Weak or faint pulse

Angelica Sini Decoction — Sings to use Dang Gui Si Ni Tang

Conclusion

Dang Gui Si Ni Tang is a versatile and effective herbal remedy for warming the body, nourishing blood, and improving circulation. It’s perfect for people with cold limbs, poor blood flow, or related health issues like nerve pain, menstrual cramps, or frostbite.

Modern research backs its wide-ranging benefits, from reducing inflammation to supporting nerve and digestive health. By combining this formula with warming foods, you can enhance its effects and feel warmer, healthier, and more comfortable.

Chinese Name	當歸四逆湯
Phonetic	Dang Gui Si Ni Tang
English Name	Chinese Angelica Frigid Extremities Decoction
Classification	Warming interior formulas
Source	《Treatise on Cold Damage》Shang Han Lun《傷寒論》
Combination	Angelicae Sinensis Radix (Dang Gui) 3 liang (12g), Cinnamomi Ramulus (Gui Zhi) 3 liang (9g), Paeoniae Radix Alba (Shao Yao) 3 liang (9g), Asari Radix et Rhizoma (Xi Xin) 3 liang (3g), Glycyrrhizae Radix et Rhizoma (Gan Cao) 2 liang (6g), Tetrapanacis Medulla (Zhi Tong Cao liquid-fried) 2 liang (6g), Jujubae Fructus (Da Zao) 25 pcs (8 pieces)
Method	Decoct all seven medicinals with eight sheng of water, boil them until three sheng of water is left, and remove the dregs. Take the decoction warm three times a day. (Modern use: prepare as a decoction.)
Action	Warms the channels to expel cold, nourishes the blood and unblocks the channels.
Indication	Counterflow cold of the limbs due to blood deficiency is characterized by counterflow cold of hands and feet, pain in the waist, thighs, lower legs, feet, shoulders, and back, no thirst, a pale tongue body with a white coating, and a deep, thin pulse or thin, impalpable pulse.
Pathogenesis	This pattern is caused by the combination of blood deficiency and cold accumulation in the channels, which result in poor blood circulation. The blood is chronically deficient and the channels have been invaded by pathogenic cold; therefore, there is poor blood circulation due to deficient blood obstructed by the pathogenic cold accumulated within the vessels. In this event, the hands and feet become very cold and the pulse is thin and impalpable because blood fails to supply the vessels and yang fails to reach the four extremities. Dang Gui Si Ni Tang treats counterflow cold of the hands and feet. Specifically, it treats cold below the wrist and ankle, which differs from counterflow cold of the four limbs. The proper treatment is to warm the channels, expel cold, nourish the blood, and unblock the channels.
Application	1. Essential pattern differentiation Dang Gui Si Ni Tang is commonly used to nourish blood and warm the channels in order to expel cold. This clinical pattern is marked by counterflow cold of the four limbs, pale tongue body with a white coating, and a thin, impalpable pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of blood deficiency and cold accumulation: thromboangitis obliterans, Takayasu's arteritis (pulseless disease), Raynaud’s phenomenon, polio, chilblain, dysmenorrhea, periarthritis of shoulder, and rheumatoid arthritis.
Additonal formulae	1. Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang (Chinese Angelica Frigid Extremities Decoction Plus Evodia and Fresh Ginger 當歸四逆加吳茱萸生薑湯) [Source]《Treatise on Cold Damage》Shang Han Lun《傷寒論》 [Ingredients] Dang gui 3 liang (12g), shao yao 3 liang (9g), zhi gan cao 2 liang (6g), tong cao 2 liang (6g), gui zhi 3 liang (9g), wu zhu yu 2 sheng (9g), da zao 25 pieces (8 pieces), xi xin 3 liang (9g), sheng jiang 0.5 jin (12g) [Preparation and Administration] Decoct the nine medicinals with 6 sheng of water and 6 sheng of wine until 5 sheng left, remove the remainder and take the warm decoction five times a day. [Actions] Warms yang and dispels cold, nourishes blood and unblocks blood vessels, harmonizes the center and arrests vomiting. [Applicable Patterns] Blood deficiency and cold accumulation, counterflow cold of hands and feet, accompanied with vomiting and painful abdomen due to stomach cold. 2. Huang Qi Gui Zhi Wu Wu Tang (Astragalus and Cinnamon Twig Five Substances Decoction 黃芪桂枝五物湯) [Source]《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 [Ingredients] Huang qi 3 liang (9g), shao yao 3 liang (9g), gui zhi 3 liang (9g), sheng jiang 6 liang (18g), da zao 12 pieces (4 pieces) [Preparation and Administration] Decoct the five medicinals with 6 sheng of water until 2 sheng left, remove the remainder and take the warm decoction three times a day. [Actions] Boosts qi and warms the channels, harmonizes the blood, and relieves bi. [Applicable Patterns] Blood bi. Symptoms include: numbness of the skin, and a choppy, tight, and unsmooth pulse.

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