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Four Ingredients Decoction (Si Wu Tang) is one of the most common tonifying blood formulas in Traditional Chinese medicine (TCM). "Four Ingredients" means that the prescription only uses four herbs—too many or too few would not be called Four Ingredients Decoction. Some people go to a Chinese medicinals shop to get Four Ingredients Decoction and find over ten herbs, which is not the authentic formula.

In Four Ingredients Decoction, Chinese Angelica and Sichuan Lovage Rhizome are also known as "blood-aspect qi-medicinal." "Blood-aspect" indicates that they act on the "blood" part, while "qi-medicinal" means they carry "energy." For example, if a wave pool in an amusement park runs out of water, you not only need to add water but also make the water flow. The act of adding water is "tonifying blood," while making the water flow is adding kinetic energy, or "tonifying qi." "Blood-aspect qi-medicinal" mean that besides nourishing blood, they also promote blood circulation. Sichuan Lovage Rhizome can further disperse blood stasis, similar to the concept of anticoagulation.

Peony Root and Rehmannia belong to tonifying blood and yin tonics, with properties similar to iron supplements in modern medicine. However, in TCM, "blood" and "yin" are broad terms that include but are not limited to iron in the blood; they encompass all nutrients that nourish the body. Additionally, these two herbs are cool in nature and can balance the warm properties of Chinese Angelica and Sichuan Lovage Rhizome. Rehmannia is purely a tonifying blood and yin tonic, while Peony Root also has some ability to transform static blood.

In practical application, the composition of Four Ingredients Decoction is not fixed. If a patient has deficient fire, the processed and slightly warm Prepared Rehmannia Root can be replaced with the cool Unprocessed Rehmannia Root. Similarly, fried Peony Root can be replaced with raw Peony Root, and Sichuan Lovage Rhizome, which is warm in nature, can be reduced or omitted. If the patient has blood circulation stasis, Peony Root can be replaced with Red Peony Root, and Chinese Angelica can be replaced with Chinese Angelica tail. Sichuan Lovage Rhizome may be increased to strengthen harmonizing collaterals and promote blood circulation. If the patient has poor gastrointestinal function, Rehmannia can be reduced or omitted, or herbs that aid digestion can be added. In other words, a flexible Four Ingredients Decoction is a living formula, while rigid application makes it a dead formula.

Thus, a simple dose of Four Ingredients Decoction embodies the art of TCM in tonifying blood by fully utilizing the dynamic and static properties, as well as the cold, hot, warm, and cool natures of different herbs, complementing and balancing each other. Four Ingredients Decoction may seem simple, but it is not. A famous saying in TCM states: "Qi is the commander of blood, and blood is the mother of qi." In plain terms, this means: "The flow of blood requires the propulsion, guidance, and warmth of qi (energy), while qi must rely on blood to exist and function." This reflects the concept of yin within yang and yang within yin, mutually supporting and complementing each other, which is also a characteristic of the Tai Chi system.

Modern medical research has found that the single herb Chinese Angelica cannot significantly promote the recovery of red blood cells and hemoglobin in animals with hemorrhagic anemia, thus concluding that Chinese Angelica has no tonifying blood effect. This is because modern medicine lacks the concepts of "blood-aspect qi-medicinal" and "blood kinetic energy." TCM emphasizes the synergistic effects of herbs, with Chinese Angelica responsible for blood kinetic energy and Rehmannia responsible for blood-building materials, whereas modern medicine only focuses on blood-building materials. Just one dose of Four Ingredients Decoction completely outperforms the iron supplements used in modern medicine to treat anemia.