Four Counterflow Combination by Far East Summit Chinese Classics, also known as Si Ni San, vents pathogenic influences, releases constraint, spreads Liver Qi, and regulates the Spleen.

This formula is used for yang- or hot-type collapse (yang jue), which is most commonly due to heat entering the interior where it constrains the yang qi. This inhibits the spreading of yang qi to the extremities, causing cold fingers and toes (in contrast to devastated yang, where the entire limb is cold), and a warm body.

Potency: 5:1

Actions: Out-thrusts depression, soothes the liver, and regulates the spleen.

Chinese Symptomology: Signs & symptoms of liver depression qi stagnation include: Irritability. Cold hands as a stress response. Chest and ductal distention and fullness. Rib-side distention and pain. Abdominal pain. A bowstring pulse. Signs & symptoms of depressive heat include (but may not be present): A bitter taste in the mouth. Constipation with dark stools. A red tongue. Signs & symptoms of spleen qi vacuity include: Vomiting; Diarrhea; Lack of appetite.

Western Symptomology: Liver-spleen disharmony resulting in 1) disorders characterized by spasmodic pain, such as cholecystitis/cholelithiasis, gastritis, gastric prolapse, peptic ulcers, allergic colitis, appendicitis, adhesive intestinal obstruction, pancreatitis, urolithiasis, and dysmenorrhea; 2) disorders related to psycho-emotional stress, such as neurogenic headache, premenstrual syndrome, impotence, coronary artery disease, stress incontinence, enuresis, and peri- and menopausal syndromes; and 3) disorders characterized by inpatent excretions or secretions, such as rhinitis, acute mastitis, fallopian tube blockage, and encapsulated periappendical abscesses. Other possible indications include intercostal neuralgia, trigeminal neuralgia, epilepsy, autonomic dystonia, hepatitis, and epidemic hemorrhagic fever.

Pattern: Liver-spleen disharmony

Ingredients: Buplerum root, Immature Bitter Orange fruit, White Peony root, Chinese Licorice root.