Si Sheng Wan (Four Fresh Pill)

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Indications

Western Uses:

• What is Si Sheng Wan used for in modern practice?

  In modern practice Si Sheng Wan's blood-heat pattern has traditionally been correlated with conditions involving acute, bright-red upper-body bleeding. Practitioner sources describe traditional application to pulmonary tuberculosis and bronchiectasis with hemoptysis, peptic ulcer or acute gastritis with hematemesis, gingivitis and periodontitis with bleeding gums, and epistaxis, with some sources also noting functional uterine bleeding as a modified application.

  These are offered as a reference to the formula's traditional use, not as a claim that it treats any diagnosed disease. Direct clinical research on the combined formula is essentially absent (see research); any bleeding disorder warrants prompt evaluation by a qualified clinician.

  Source: traditional-use correlates summarized from multiple online sources (Sisheng Wan; Bensky & Barolet-tradition summary); reference only, not a treatment claim.

Originally Appeared In:

• Fine Formulas for Women (Fu Ren Liang Fang)

Notes:

• How does Si Sheng Wan compare to other formulas that clear heat and stop bleeding?

  Within its own category (Formulas that Clear Heat and Stop Bleeding), Si Sheng Wan is distinguished by its location — the upper jiao — and its simple, four-fresh-herb, cooling-and-astringing approach.

  • vs Huai Hua San: Huai Hua San targets wind-heat/damp-heat bleeding in the large intestine (intestinal bleeding, bleeding hemorrhoids) — a lower-jiao pattern, versus Si Sheng Wan's upper-jiao heat in the blood.
  • vs Xiao Ji Yin Zi: Xiao Ji Yin Zi addresses heat in the blood in the lower burner (blood lin/hematuria) and combines blood-cooling herbs with damp-draining, urinary herbs — a different location and a more complex strategy than Si Sheng Wan's four plain hemostatics.
  • vs Shi Hui San: Shi Hui San (Ten Partially Charred Substances Powder) treats a broader, more severe presentation of reckless upper-body hemorrhage due to heat/fire, using ten charred (tan-processed) herbs for stronger astringent hemostasis; Si Sheng Wan is comparatively simple and milder.

  Reported modifications (per Bensky & Barolet-tradition sources): combined with elements of Huang Tu Tang (Yellow Earth Decoction) for bleeding peptic ulcer; combined with Jiao Ai Tang for functional uterine bleeding; additional blood-cooling herbs added for severe hemoptysis.

  Source: this site’s own category record + multiple online sources (Bensky & Barolet-tradition summaries).

Clinical Studies & Research:

• Is there modern research on Si Sheng Wan?

  No clinical trials of the combined four-herb formula were found in PubMed/PMC searches; available evidence sits at the level of its individual ingredients' hemostatic pharmacology. Two of the formula's herbs have documented, mechanistic hemostatic research.

  • Ce Bai Ye (Platycladus orientalis leaves): heat-processing of the flavonoid extract generates a novel benzofuran compound named cecarbon, which dose-dependently shortened clotting times (APTT, PT) and promoted collagen-induced platelet aggregation in laboratory assays, offering a mechanistic basis for the herb's classical blood-cooling, hemostatic use (PMID 26393545 / PMC 6332512). A broader phytochemistry and pharmacology review situates this within the plant's known diterpene and flavonoid constituents (PMID 24871649).
  • Ai Ye (carbonized Artemisia argyi, "Folium Artemisiae Argyi Carbonisatum"): chemical analysis identified rutin, quercetin, and octacosanol as key constituents; zebrafish assays showed an enhanced hemostatic effect at moderate and high concentrations, alongside dose-related developmental and cardiac toxicity at higher concentrations (PMID 35693441).

  Sources: PubMed 26393545 (PMC 6332512); PubMed 24871649; PubMed 35693441. Herb-level mechanistic research; not a formula-level clinical claim, and not medical advice.