A "shu-gan jie-yu, qing-re liang-xue" (spread the liver, resolve constraint, clear heat, cool blood) formula from the Ming-dynasty "Essentials of Internal Medicine", the "heat-clearing" expansion of the classic Xiao Yao San.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Compiled by Xue Ji (薛己) in his Ming-dynasty "Essentials of Internal Medicine" (《内科摘要》, 1529) as the "heat-clearing" expansion of Xiao Yao San, the same idea as the slightly earlier Jia Wei Xiao Yao Wan (加味逍遥散) tradition. In Japan, 丹梔逍遙散 (たんじしょうようさん / Tanji-shōyō-san) is sold by Tsumura (ツムラ) as the standard OTC formula for "liver-depression with heat" indications. In Korea, similar preparations appear in the Kyungdong (경동) hanbang line as 단지소요환 (Danji-soyo-hwan). The formula is, in short, the standard "liver-depression + heat" pattern formula in East Asia.
From the source text
This page is cultural documentation, not medical advice.
From the source text · 《内科摘要》卷上·郁症·加味逍遥散条
Classical text
据《内科摘要》郁症门载加味逍遥散：治肝郁血虚有热，遍身瘙痒，或口燥咽干，或发热盗汗，或月经不调，或小便淋涩等症。逍遥散加牡丹皮、栀子。
Modern Chinese rendering
本方用于"肝郁血虚有热"系列证候：肝郁日久化热，兼血虚失养所致的烦躁易怒、情志抑郁、口燥咽干、发热盗汗、皮肤瘙痒、月经不调、小便涩痛等。方以逍遥散（柴胡、当归、白芍、白术、茯苓、甘草、薄荷、生姜）疏肝养血健脾为底；加牡丹皮清肝中伏热、凉血散瘀；栀子清心除烦、导热下行。整体上，是薛己在逍遥散基础上"疏肝 + 清热 + 凉血"三位一体的加味化裁，也是"肝郁化火"证候最经典的处方之一。
Editorial translation
This formula is used for "liver-depression with blood-deficiency and heat" patterns: prolonged liver-qi stagnation that has transformed into heat, combined with failure of blood to nourish, presenting as irritability, emotional depression, dry mouth and throat, tidal fever, night sweating, skin itching, menstrual irregularity, and scanty dark urine. The formula takes the Xiāo Yáo Sǎn (Free Wanderer Powder: Chái Hú, Dāng Guī, Bái Sháo, Bái Zhú, Fú Líng, Gān Cǎo, Bò Hé, Shēng Jiāng) as its base to spread the liver, nourish blood, and fortify the spleen; it adds Mǔ Dān Pí to clear latent heat from the liver and cool the blood while dispersing stasis, and Zhī Zǐ to clear heart-fire, relieve irritability, and drain heat downward. It is, in short, Xue Ji's three-in-one "spread-liver + clear-heat + cool-blood" expansion of Xiāo Yáo Sǎn, and the most classical formula for the "liver-depression transforming into fire" register.
In tradition
In TCM framing, traditionally used in the context of "liver-qi stagnation transforming into fire", irritability, mood swings, premenstrual breast distension and irritability, hot flushes, occasional bitter taste in the mouth, dry mouth, slight red tongue edges, and a wiry and slightly rapid pulse. The formula adds Moutan (Mu Dan Pi) and Gardenia (Zhi Zi) to the more familiar Xiao Yao San base, intensifying the "clear heat" and "cool blood" aspects. It is the most common "liver-depression with heat" formula in TCM and is frequently used for premenstrual and perimenopausal mood-and-heat patterns. In Japan, 丹梔逍遙散 (Tanji-shōyō-san) is sold by Tsumura (ツムラ) as the standard OTC formula for "liver-depression with heat".
Formula composition
Monarch1
- Bupleurum root (Chái Hú / 柴胡)
Minister2
- White peony root (Bái Sháo / 白芍)
- Dang Gui (Dāng Guī / 当归)
Assistant5
- Atractylodes macrocephala (Bái Zhú / 白术)
- Poria (Fú Líng / 茯苓)
- Moutan tree bark (Mǔ Dān Pí / 牡丹皮)
- Gardenia fruit (Zhī Zǐ / 栀子)
- Peppermint (Bò Hé / 薄荷)
Envoy2
- Honey-fried licorice (Zhì Gān Cǎo / 炙甘草)
- Ginger (Shēng Jiāng / 生姜)
International availability
Japan (Kampo)
- KracieクラシエOTC丹梔逍遥散Tanchi-shōyaku-san
Korea (Hanbang)
- Kyungdong경동OTC단치소요산Danchi-soyo-san
Taiwan & Hong Kong
- 順天堂OTC丹梔逍遙散Dan Zhi Xiao Yao San
Cautions & context
- Contains cold-natured herbs (Moutan, Gardenia), long-term daily use is considered inappropriate in TCM framing; it is intended for short-to-medium courses of clearly "liver-depression with heat" presentations.
- People with what TCM describes as "spleen yang deficiency" (loose stools, cold limbs, fatigue) are typically advised to avoid it, the formula is "cooling" in nature.
- Not appropriate during a common cold, fever, or active digestive upset in TCM framing.
- Persistent mood symptoms, hot flushes, or premenstrual distress should be evaluated by a clinician, TCM liver-soothing formulas are not a substitute for evaluation of underlying endocrine or psychiatric causes.
Related formulas
Browse by Pattern
Related concerns
Concern · stress
Stress & Mood
Everyday tension, low mood, irritability, the sense of being "wound up but tired". The cluster of complaints that brings many Chinese adults to the family 中成药 drawer before they ever see a doctor.
Editorial note
Compiled from "Essentials of Internal Medicine" (1529).
Last reviewed: July 18, 2026
Three layers of evidence
Classical source
≈ 500 years · "Essentials of Internal Medicine" (1529)
Pharmacopoeia indication
"Soothe the liver and resolve stagnation, clear heat and regulate menstruation. Used for liver stagnation transforming into fire: chest and hypochondriac distension and pain, vexation and restlessness, flushed cheeks with dry mouth, poor appetite, or tidal fever, and menstrual irregularity."
Modern research status
A 2023 systematic review with meta-analysis and trial sequential analysis (PMID 37905203) of randomized controlled trials found that Xiao Yao San (and its modified forms, including Dan Zhi Xiao Yao Wan / Jia Wei Xiao Yao Wan) showed better anxiety-related symptom improvement when used alone or combined with anxiolytics than anxiolytics alone; the authors noted that owing to the limited number and quality of the included studies, further high-quality research is essential to validate these results.
References
References reviewed on July 18, 2026 · PubMed search on 2026-07-18
- 01ClassicalXuē Jǐ (薛己), 《内科摘要》 (Nèi Kē Zhāi Yào / Essentials of Internal Medicine), late Ming dynasty, compiled ca. 1529, the "constrained-depression" (郁症) section, the entry for Jiā Wèi Xiāo Yáo Sǎn (加味逍遥散) on which the modern Dān Zhī Xiāo Yáo Wán is based, the representative "spread-liver + clear-heat + cool-blood" expansion of Xiāo Yáo Sǎn for the "liver-depression with blood-deficiency and heat" register; editorial adaptation, pending scholarly verification against the 1529 woodblock edition.
- 02TextbookDuān Fùjīn (段富津) et al. (eds.), 《方剂学》 (Fāngjìxué / Science of Formulas), 2nd edition, Shanghai Scientific and Technical Publishers, 2011, the standard modern university-level formula textbook in mainland China, with Dān Zhī Xiāo Yáo Wán analysed in the "harmonizing liver-spleen" (和解剂) chapter as the representative "liver-depression transforming into fire" formula, the canonical entry for the "liver-qi stagnation with heat" register.
- 03TextbookTsumura (ツムラ), 丹梔逍遙散 (たんじしょうようさん / Tanji-shōyō-san) product documentation, Japan's leading Kampo manufacturer, the standard Japanese Kampo "liver-depression with heat" formula derived from the late-Ming 《内科摘要》 / 加味逍遥散 line, sold in Japanese drugstores for premenstrual, perimenopausal, and irritability-with-heat presentations; mirrored in Korean hanbang "단지소요환" preparations in Kyungdong (경동).
- 04PharmacopoeiaPharmacopoeia Commission of the PRC, 《中华人民共和国药典》 2020 edition, vol. 1 (Zhōnghuá Rénmín Gònghéguó Yàodiǎn, Pharmacopoeia of the People's Republic of China, 2020 ed., vol. 1), China Medical Science Press, 2020, the official national monograph for Dān Zhī Xiāo Yáo Wán (丸 / 浓缩丸), "functional indication" reads "soothe the liver and resolve stagnation, clear heat and regulate menstruation, used for liver stagnation transforming into fire: chest and hypochondriac distension and pain, vexation and restlessness, flushed cheeks with dry mouth, poor appetite, or tidal fever, and menstrual irregularity".