Why Si Wu Tang Is Included in Cold Quell

by
Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

Keywords: Chinese medicine, Chinese herbal medicine, Si Wu Tang, Cold Quell

Some practitioners of Chinese medicine may be puzzled why the ingredients of Si Wu Tang (Four Materials Decoction), the main blood-supplementing formula in Chinese medicine, are included in Cold Quell. These ingredients include Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Alba Paeoniae), Di Huang (Radix Rehmanniae), and Chuan Xiong (Rhizoma Chuanxiong). Cold Quell is Blue Poppy Herbs’ formula for a wind heat pattern of common cold and flu. Other commonly used Chinese formulas to treat the initial stage of colds and flu only contain exterior-resolving, wind-dispelling, and heat-clearing ingredients. Yet dozens of practitioners from all over the world have told us that Cold Quell outperforms all other Chinese formulas they have tried for the initial stage of common cold characterized primarily by sore throat, fever, and malaise. There are two explanations of why we have included the ingredients of Si Wu Tang in Cold Quell.

The first reason is demographics. Seventy percent of patients coming for treatment from acupuncturists and other practitioners of Chinese herbal medicine are women, and women frequently catch cold just before or at the onset of menstruation. This is because a large part of their blood has been sent down to accumulate in the uterus, thus leaving the upper part of the body relatively malnourished. The blood is the mother of the qi. That means that the blood is the root of the qi. It is the yin blood which keeps the yang defensive qi from floating up and away from the exterior of the body. Therefore, if the blood is relatively deficient in the upper half of the body, the defensive qi does not closely pack the interstices and secure the exterior. This leaves the defensive exterior more easily invaded by external wind evils. In fact, the combination of Xiao Chai Hu Tang (Minor Bupleurum Decoction), which is also included in Cold Quell, and Si Wu Tang is a well known formula in Chinese gynecology for treating common colds and flu in perimenstrual and pregnant women. Supplementing the blood provides a root for the defensive qi which then is able to protect the body more effectively from attack by external evils. Further, by supplementing the blood, we help to supplement the righteous qi which then fights any external evils that may have entered the body. This helps the body more effectively fight off the disease and recuperate more quickly.

The second reason has to do with the relationship between liver blood and the defensive qi in both men and women. This relationship is explained by Han Xiao-guang and Huang Qing-chun of the Chinese Medical Department of the People’s Liberation Army Hospital in Guangzhou in an article titled, “The Relationship between the Liver & the Disease Causes, Disease Mechanisms, and Treatment of Rheumatoid Arthritis.” This article appeared on pages 9-11 of issue #1, 2007 of the Zhong Yi Za Zhi (Journal of Chinese Medicine).  Although this article is specifically about the Chinese medical treatment of rheumatoid arthritis, Han and Huang’s explanation of the relationship between liver blood and the defensive qi hold good in general. The liver governs coursing and discharge, and it is this coursing and discharge which insures the free and uninhibited flow of the qi mechanism. If the qi mechanism is freely and uninhibitedly flowing, then the spleen qi can upbear clear yang, including the defensive qi, which is then spread throughout the exterior of the body. However, the liver’s function, i.e., coursing and discharge, is dependent on the liver’s obtaining sufficient blood to nourish it. Conversely, if liver blood is vacuous and insufficient, the liver is malnourished and it is not able to perform its function. In that case, the qi mechanism is inhibited and the spleen is prevented from upbearing clear yang. Hence the defensive qi does not permeate and secure the exterior. Instead, the exterior is left insecure, and external evils may take advantage of this vacuity to enter and lodge in the muscles and flesh, channels and network vessels there provoking disease. Han and Huang sum up this line of reasoning by saying:

If liver blood is vacuous, the liver qi does not course. Therefore, the qi mechanism becomes obstructed and stagnant and is not able to spread yang qi to warm the divisions of the flesh, to fatten [or plump] the interstices, or to command opening and sealing so as to protect against external evils.

In fact, the most commonly seen pattern in clinical practice in the West is a liver-spleen disharmony. This means that there is liver depression qi stagnation at the same time as there is spleen qi vacuity. If the spleen qi is vacuous and weak, the spleen will not properly engender the defensive qi nor will it properly upbear clear yang. In that case, there will be easy contraction of external evils and difficulty fighting those evils once they are inside the body. Therefore, there is little to prevent the disease from running it course.

At this point, some practitioners may object that the Nei Jing (Inner Classic) says not to supplement while evils are still present. However, what most Western practitioners and even many Chinese do not understand is that is only the first half of the sentence. The authors of the Nei Jing go on to say, “unless the righteous qi has been damaged, and then one must supplement and drain at the same time.” (Italics mine, added for emphasis.) Damage of the righteous qi means vacuity. So, in other words, if there is vacuity and repletion at the same time, then one must supplement and drain at the same time. The Chinese here does not say may or can. It clearly says one “must” supplement and drain at the same time. In addition, the Nei Jing says, “If the righteous qi exists internally, evils cannot strike,” and, “[If] evils are present, the qi must be vacuous.” According to this point of view, people are only invaded by external evils if their defensive qi is vacuous and insufficient. Therefore, ipso facto, if one has caught cold, there is a righteous qi vacuity and one must supplement vacuity and drain evils at the same time. This is exactly what Cold Quell does and is also why Cold Quell is so much more effective than other commonly used Chinese formulas for colds and flu.

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