A strong "drain fire from the liver and gallbladder" formula, bitter, cold, and one of the most frequently discussed prescriptions for pronounced "liver fire" patterns in the head, eyes, and lower body.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Compiled in the Song dynasty "Formulary of the Bureau of Medicine" (《太平惠民和剂局方》). In Japan, Ryutan-shakan-to (竜胆瀉肝湯) is sold by every major kampo manufacturer (Tsumura, Kracie, Kotaro) as the standard OTC remedy for pronounced "liver-gallbladder damp-heat" patterns. In Korea it is sold as Yongdam-sagan-hwan (용담사간환) by Kyungdong. A 2003 Chinese-language report (largely retracted and re-evaluated since) raised concerns about long-term use of certain Aristolochia-family "Mu Tong" species causing renal toxicity, modern pharmacy preparations use non-aristolochic substitutes.
From the source text
This page is cultural documentation, not medical advice.
From the source text · 《局方》卷六·治积热·龙胆泻肝汤（注：今本《局方》原方无方论，本文以《医方集解》引《局方》方论为参）
Classical text
治肝胆经实火湿热，胁痛耳聋，胆溢口苦，筋痿阴汗，阴肿阴痛，白浊溲血。
Modern Chinese rendering
本方用于肝胆经实火湿热所致的胁痛耳聋、胆溢口苦、筋痿阴汗、阴肿阴痛、白浊溲血。这一段方论把龙胆泻肝汤定位为"清肝胆实火、利下焦湿热"的代表方——大苦大寒、上下同治,既清肝胆实火以治上,又利下焦湿热以治下,也是"苦寒直折、泻火解毒"思路下"清上泻下"路径的经典条目。
Editorial translation
This formula is used for "liver-gallbladder channel excess fire and damp-heat": hypochondriac pain and deafness, gallbladder overflow with bitter taste, sinew flaccidity and yin-sweating, yin swelling and yin pain, white turbidity and bloody urine. This preface positions Lóng Dǎn Xiè Gān Tāng as the Formulary-derived "clear liver-gallbladder excess fire, disinhibit lower-burner damp-heat" representative formula — strongly bitter and cold, addressing above and below together — clearing the liver-gallbladder excess fire to address the upper body while disinhibiting the lower-burner damp-heat to address the lower body — the canonical entry for the "bitter-cold direct attack, drain fire and resolve toxin" approach in its "clear above and drain below" register.
In tradition
In TCM tradition, associated with pronounced "liver-gallbladder damp-heat" patterns: red, painful, swollen eyes; bitter taste in the mouth; ear pain or tinnitus with a hot sensation; hypochondriac pain; headache at the temples; irritability; and, in the lower body, dark-yellow urine, vulvar itching, or, in men, scrotal dampness. It is a "bitter-cold" formula and is one of the strongest OTC options sold in Chinese pharmacies for the more dramatic "liver fire" presentations.
Formula composition
Monarch1
- Gentian root (Lóng Dǎn Cǎo / 龙胆草)
Minister3
- Scutellaria root (Huáng Qín / 黄芩)
- Gardenia fruit (Zhī Zǐ / 栀子)
- Coptis root (Huáng Lián / 黄连)
Assistant5
- Bupleurum root (Chái Hú / 柴胡)
- Alisma rhizome (Zé Xiè / 泽泻)
- Akebia stem (Mù Tōng / 木通)
- Plantago seed (Chē Qián Zǐ / 车前子)
- Dong quai (Dāng Guī / 当归)
Envoy1
- Licorice root (Gān Cǎo / 甘草)
International availability
Japan (Kampo)
- Tsumura & Co.ツムラOTC竜胆瀉肝湯Ryūtan-shakan-tō
Korea (Hanbang)
- Kyungdong경동OTC용담사간탕Yongdam-sagan-tang
Taiwan & Hong Kong
- 順天堂OTC龍膽瀉肝丸Long Dan Xie Gan Wan
Cautions & context
- A "bitter-cold" formula, long-term daily use is considered inappropriate in TCM framing; it is intended for short courses of clearly "hot" symptoms.
- People with what TCM describes as "spleen yang deficiency" (loose stools, cold limbs, fatigue) are typically advised to avoid it or use it only briefly under guidance.
- Sudden, severe, or rapidly progressing symptoms (severe headache, visual loss, high fever, severe abdominal pain) require immediate medical evaluation, they are not within the scope of self-treatment.
- Pregnant or breastfeeding people should consult a qualified practitioner before use.
Related formulas
Other formulas from this text· "Formulary of the Bureau of Medicine"
Other formulas by this contributor· Imperial Medical Bureau (Song)
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 "Formulary of the Bureau of Medicine" (1078).
Last reviewed: July 18, 2026
Three layers of evidence
Classical source
≈ 900 years · "Formulary of the Bureau of Medicine" (1078)
Pharmacopoeia indication
"Clear the liver and gallbladder, drain damp-heat. Used for liver-gallbladder damp-heat: dizziness with red eyes, tinnitus and hearing loss, swelling and pain of the ear, hypochondriac pain with bitter taste, and damp-heat vaginal discharge."
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
- 01ClassicalChen Shiwen (陈师文) et al. (eds.), 《太平惠民和剂局方》 (Tài Píng Huì Mín Hé Jì Jú Fāng / Formulary of the Bureau of Medicine), Song dynasty, compiled 1078, vol. 6, the "addressing accumulated heat" (治积热) section, the entry for Lóng Dǎn Xiè Gān Tāng (龙胆泻肝汤), the canonical "drain fire from the liver and gallbladder" representative formula; note that the present text of the Formulary carries the formula composition but not a fang-lun, and the fang-lun quoted under this name in modern references is taken from Wāng Áng's (汪昂) 《医方集解》 (Qīng dynasty) which explicitly attributes it back to the Formulary.
- 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 Lóng Dǎn Xiè Gān Tāng analysed as the representative "clear liver-gallbladder excess fire, disinhibit lower-burner damp-heat" (清肝胆实火，利下焦湿热) formula, the canonical entry for the "bitter-cold direct attack, drain fire and resolve toxin" (苦寒直折，泻火解毒) approach in its "clear above and drain below" (清上泻下) register.
- 03TextbookTsumura & Co. (ツムラ), Ryutan-shakan-to (竜胆瀉肝湯) product documentation, Japan's leading Kampo manufacturer, the standard Japanese Kampo remedy for "liver-gallbladder damp-heat" patterns, sold by every major manufacturer (Tsumura, Kracie, Kotaro), widely used in Japanese clinical Kampo practice for pronounced liver-fire presentations in the head, eyes, and lower body, listed in the Japanese Kampo formulary as a standard OTC for upper-and-lower damp-heat patterns.
- 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 Lóng Dǎn Xiè Gān Wán, "functional indication" reads "clear the liver and gallbladder, drain damp-heat, used for liver-gallbladder damp-heat causing dizziness with red eyes, tinnitus and hearing loss, swelling and pain of the ear, hypochondriac pain with bitter taste, dark-painful urine, and damp-heat vaginal discharge".