An "qing-gan he-wei, jiang-ni zhi-ou" (clear the liver and harmonize the stomach, descend counterflow and stop vomiting) formula, the augmented expansion of the classical Zuo Jin Wan with additional qi-regulating and pain-stopping herbs.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Compiled as an "augmented" version of the classical Zuo Jin Wan from Zhu Danxi's Yuan-dynasty "Danxi's Experiential Therapy" (《丹溪心法》, 1347), it adds qi-regulating and pain-stopping herbs to address the "liver-fire + stomach-pain" combination. The simpler Zuo Jin Wan (Coptis + Evodia, 6:1 ratio) is the most distilled version; the "augmented" version is the more commonly used commercial form. In Japan, 加味左金丸 (かみさきんがん / Kami-sakin-gan) is sold by Kracie (クラシエ) as the standard OTC formula for "liver-fire + stomach" presentations. In Korea, similar preparations appear as 가미좌금환 in the Kyungdong (경동) hanbang line.
From the source text
This page is cultural documentation, not medical advice.
From the source text · 《丹溪心法》卷三·火·左金丸加味
Classical text
左金丸：黄连六两，吴茱萸一两。为末，水丸或蒸饼丸，白汤下五十丸。加味：加木香、香附、荜茇、桂枝少许,治肝火犯胃,嘈杂吞酸,胁肋胀痛,呕吐泛酸。
Modern Chinese rendering
加味左金丸由经典左金丸(黄连、吴茱萸 6:1)加味演化而成。黄连为君,清肝火、泻胃热,量大至六两,直折上炎之火;吴茱萸为佐,一者开胃气、引热下行,二者制黄连之过寒,三者"左金"命名取"以金制木"之意(肝属木、金克木);再加木香理气止痛、香附疏肝解郁、荜茇温中散寒、桂枝少许调和诸药。全方"清肝火 + 理气 + 止痛"三法合用,治"肝火犯胃"所致嘈杂吞酸、胁肋胀痛、呕吐泛酸诸症,较单纯左金丸更兼顾气滞疼痛之候,成为"胃痛 + 反酸"兼有证候的常用中成药。
Editorial translation
Jiā Wèi Zuǒ Jīn Wán is the augmented evolution of the classical Zuǒ Jīn Wán (Coptis 6 : Evodia 1). Huáng Lián (Coptis) at 6 liǎng is the sovereign to clear liver-fire and drain stomach-heat, in a large dose to directly quell the flaring fire; Wú Zhū Yú (Evodia) is the assistant, with three roles: it opens the stomach-qi, guides fire downward, and moderates the extreme coldness of the Coptis, the name "Left-Metal" itself is a five-elements metaphor ("metal overcomes wood" / metal used to control the liver-wood fire). Mù Xiāng (Aucklandia) is added to regulate qi and stop pain, Xiāng Fù (Cyperus) to soothe the liver and resolve depression, Bì Bá (Sandew) to warm the middle and disperse cold, and a small amount of Guì Zhī (cinnamon twig) to harmonize the formula. The whole formula combines "clear liver-fire + regulate qi + stop pain" in one, addressing the "liver-fire invading the stomach" pattern with noisy discomfort, acid regurgitation, hypochondriac pain, and vomiting of sour fluid, and is more broadly useful than the simple Zuǒ Jīn Wán when "stomach-pain + acid-reflux" appear together, making it the most common commercial form for that combined presentation.
In tradition
In TCM framing, traditionally used in the context of "liver-fire invading the stomach", epigastric burning pain, acid reflux, bitter taste in the mouth, irritability, occasional nausea, distension in the chest and flanks, and a red tongue with a yellow coating. The formula is the "augmented" version of the simpler Zuo Jin Wan, adding herbs like Aucklandia, Cyperus, and Sandew to address the "stomach-pain + acid-reflux" pattern. It is one of the most prescribed classical OTC formulas for "stress-related" or "liver-depression-related" gastric complaints. In Japan, 加味左金丸 (Kami-sakin-gan) is sold by Kracie (クラシエ) as the standard OTC "liver-fire + stomach" formula.
Formula composition
Monarch2
- Ginger-fried Coptis root (Jiāng Huáng Lián / 姜黄连) - sovereign, clears liver-fire, drains stomach-heat
- Evodia fruit, prepared (Zhì Wú Zhū Yú / 制吴茱萸) - sovereign, opens the stomach, guides the formula downward
Other ingredients12
- Scutellaria root (Huáng Qín / 黄芩) - minister, clears heat and dries dampness
- Bupleurum root (Chái Hú / 柴胡) - minister, soothes the liver and raises yang
- Aucklandia root (Mù Xiāng / 木香) - assistant, moves qi and stops pain
- Cyperus rhizome, vinegar-processed (Cù Xiāng Fù / 醋香附) - assistant, soothes the liver and regulates qi
- Curcuma rhizome (Yù Jīn / 郁金) - assistant, invigorates blood and moves qi
- White peony root (Bái Sháo / 白芍) - assistant, nourishes blood and softens the liver
- Green tangerine peel, vinegar-processed (Cù Qīng Pí / 醋青皮) - assistant, soothes the liver and breaks qi
- Bitter orange, bran-fried (Fū Chǎo Zhǐ Ké / 麸炒枳壳) - assistant, regulates qi and widens the middle
- Tangerine peel (Chén Pí / 陈皮) - assistant, regulates qi and transforms dampness
- Corydalis rhizome, vinegar-processed (Cù Yán Hú Suǒ / 醋延胡索) - assistant, invigorates blood and stops pain
- Dong quai (Dāng Guī / 当归) - assistant, nourishes blood and invigorates blood
- Licorice root (Gān Cǎo / 甘草) - envoy, harmonizes the formula
International availability
Taiwan & Hong Kong
- 順天堂OTC加味左金丸Jia Wei Zuo Jin Wan
Cautions & context
- Contains Coptis (Huáng Lián) and Evodia (Wú Zhū Yú), the Coptis is "bitter-cold" and the Evodia is "warming". Long-term daily use is considered inappropriate in TCM framing without supervision.
- Not appropriate for "spleen yang deficiency with cold" presentations (cold limbs, loose stools, severe fatigue), the formula is mixed hot-cold in nature.
- Persistent epigastric pain, acid reflux, or weight loss should be evaluated by a clinician, these can be symptoms of peptic ulcer, GERD, or other conditions requiring evaluation.
- Pregnant or breastfeeding people should consult a qualified practitioner before use.
Related formulas
Other formulas from this text· "Danxi's Mastery of Medicine"
Other formulas by this contributor· Zhu Danxi
Related concerns
Concern · digestion
Digestion
Upper-abdominal heaviness, bloating, sour reflux, loose stools, traveler's stomach, and the aftermath of a meal that was richer, spicier, or larger than usual.
Editorial note
Compiled from "Danxi's Mastery of Medicine" (1347).
Last reviewed: July 18, 2026
Three layers of evidence
Classical source
≈ 700 years · "Danxi's Mastery of Medicine" (1347)
Pharmacopoeia indication
"Level the liver and downbear counterflow, soothe the liver and drain fire. Used for liver fire invading the stomach: noisy discomfort with acid regurgitation, hypochondriac pain, and vomiting of sour fluid."
Modern research status
As of 2026-07-18, a PubMed search using the formula name and the Latin / Korean / Japanese transliterations together with "systematic review" and "meta-analysis" did not identify a dedicated systematic review for this formula. Any clinical evidence that does exist is fragmented across small individual trials or covered in broad herbal-medicine umbrella reviews, which do not allow a per-formula evidence assessment; the absence of a dedicated SR is itself the relevant editorial fact here.
References
References reviewed on July 18, 2026 · PubMed search on 2026-07-18
- 01ClassicalZhū Zhènhēng (朱震亨, styled Yànxiū 彦修, self-styled Dān Xī 丹溪, 1281–1358), 《丹溪心法》 (Dān Xī Xīn Fǎ / Danxi's Mastery of Medicine), compiled by his disciples around 1347, vol. 3 (卷三), the "fire" (火) section, where the original Zuǒ Jīn Wán is recorded and from which Jiā Wèi Zuǒ Jīn Wán is derived by adding Mù Xiāng (Aucklandia), Xiāng Fù (Cyperus), Bì Bá (Sandew) and a small amount of Guì Zhī (cinnamon twig); the augmented formula is the most clinically encountered commercial form for the "stomach-pain + acid-reflux" combination arising from "liver-fire invading the stomach" (肝火犯胃).
- 02TextbookDuan Fuqin (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 Jiā Wèi Zuǒ Jīn Wán analysed in the "harmonizing formulas" (和解剂) chapter as the augmented version of the canonical Zuǒ Jīn Wán, the principal reference for "liver-fire invading the stomach" (肝火犯胃) with both qi-stagnation and pain components.
- 03PharmacopoeiaPharmacopoeia 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 Jiā Wèi Zuǒ Jīn Wán (丸 / 颗粒 / 片), "functional indication" reads "level the liver and downbear counterflow, soothe the liver and drain fire, used for liver-fire invading the stomach with noisy discomfort and acid regurgitation, hypochondriac pain, and vomiting of sour fluid".