Siwu Decoction (Four Substances Decoction) is first seen in

Xian Shou Li Shang Xu Duan Mi Fang

(Secret Formulas for Healing Wounds and Fractures Bestowed by a God) of the Tang Dynasty.

Tai Ping Hui Min He Ji Ju Fang

(Beneficial Formulas from the Taiping Imperial Pharmacy) placed Siwu Decoction in the category of gynecological diseases

which is known as the "No. 1 formula of gynecology" .

Fu Qing Zhu Nv Ke

(Fu Qingzhu’s Gynecology) was written by Fu Qingzhu in the late Ming Dynasty and the early Qing Dynasty. According to the physiological characteristics of women in different periods

Fu made modifications to the decoction flexibly for the treatment of their gynecological diseases

which exhibited desirable clinical efficacy. It was found that

among the 151 prescriptions contained in book

seven used the original recipe of Siwu Decoction

and 29 adopted three out the four herbs in the classic formula. These modifications are characterized by: ① tonifying qi and blood to replenish the uterus

② nourishing the blood and emolliating the liver to reverse the counterflow of liver qi and thus resolve the constraint of the other organs: soothing the liver to resolve the kidney restraint

nourishing the kidney water to moisten the liver wood; regulating the qi movement

so that water and fire are both balanced; soothing the liver and strengthening the spleen

clearing collaterals promoting lactation; emolliating the liver to relieve constraint

cultivating the spleen soil to calm the heart

diffusing the kidney qi to regulate the meridians

③ tonifying the blood to treat tension with relaxation and loosen the

dai mai

promote qi around the waist and belly.