A "tonify spleen qi, leach dampness, stop diarrhea" formula from the Song dynasty, the gentlest of the major spleen-tonifying formulas, often chosen for chronic digestive weakness in thin, tired patients.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Finalized in the Song dynasty "Formulary of the Bureau of Medicine" (《太平惠民和剂局方》) as the "spleen-tonic with dampness-leaching" formula. In Japan, Jinrei-byakujutsu-san (参苓白朮散) is sold by every major manufacturer (Tsumura, Kracie, Kotaro) as the standard OTC for "weak digestion, loose stools, fatigue after eating". In Korea it appears as Samryeong-baekchul-san (삼령백출산) in the Hanpung hanbang line. The formula is the gentlest of the major spleen tonics, adding lotus seed, Chinese yam, and coix to the Four Gentlemen base.
From the source text
This page is cultural documentation, not medical advice.
From the source text · 《局方》卷三·治一切气·参苓白术散
Classical text
治脾胃虚弱，饮食不进，多困少力，中满痞噎，心忪气喘，呕吐泄泻，及伤寒咳噫。此药中和不热，久服养气育神，醒脾悦色，顺正辟邪。
Modern Chinese rendering
本方用于脾胃虚弱所致的饮食不进、多困少力、中满痞噎、心忪气喘、呕吐泄泻,及伤寒咳噫。这一段方论把参苓白术散定位为"益气健脾、渗湿止泻"思路下"脾虚湿盛"路径的代表方——以四君子汤(人参、白术、茯苓、炙甘草)补气健脾为基础,加山药、莲子、薏苡仁、砂仁等平补脾肾、渗湿止泻之品,佐以桔梗"载药上行"以益肺气。是"培土生金"(健脾以补肺)思路的经典条目,也是"局方"里"补中有行、补不碍滞"温和补益方的代表。
Editorial translation
This formula is used for "spleen-stomach weakness": poor food intake, much drowsiness and little strength, middle-burner fullness and diaphragm blockage, palpitations and panting, vomiting and diarrhea, and post-cold cough and retching. This preface positions Shēn Líng Bái Zhú Sǎn as the Formulary-derived "supplement qi and fortify the spleen, leach dampness and stop diarrhea" representative formula — the canonical entry for the "spleen-deficiency with damp-exuberance" register; it uses the Sì Jūn Zǐ Tāng base (Rén Shēn / Bái Zhú / Fú Líng / Zhì Gān Cǎo) to tonify qi and fortify the spleen, then adds Shān Yào (Chinese yam), Lián Zǐ (lotus seed), Yì Yǐ Rén (Coix) and Shā Rén (amomum) to gently fortify the spleen-kidney, leach dampness, and stop diarrhea, with Jié Gěng (platycodon) added as the "medicine-carrier upward" to benefit lung qi. The canonical entry for the "earth-generating-metal" (培土生金, fortifying the spleen to supplement the lung) approach, and the Formulary's representative "tonify yet move, supplement without stagnation" gentle tonic.
In tradition
In TCM tradition, associated with "spleen qi deficiency with dampness" patterns in patients who are thin or weak rather than heavy-set: poor appetite, fatigue, loose stools or chronic mild diarrhea, a sensation of heaviness in the limbs, and a tendency to feel "empty" after meals. It is the formula of choice when the digestive weakness is long-standing and the patient does not tolerate richer tonics. It is also one of the formulas most often discussed for chronic pediatric digestive issues.
Formula composition
Monarch4
- Ginseng (Rén Shēn / 人参)
- White atractylodes (Bái Zhú / 白术)
- Poria (Fú Líng / 茯苓)
- Licorice root, honey-fried (Zhì Gān Cǎo / 炙甘草)
Minister4
- Chinese yam (Shān Yào / 山药)
- Lotus seed (Lián Zǐ / 莲子)
- Coix seed (Yì Yǐ Rén / 薏苡仁)
- Amomum fruit (Shā Rén / 砂仁)
Assistant1
- Euryale seed (Qiàn Shí / 芡实)
Envoy1
- Platycodon root (Jié Gěng / 桔梗)
International availability
Japan (Kampo)
- Tsumura & Co.ツムラOTC参苓白朮散Shinrei Byakujutsu-san
Korea (Hanbang)
- Kyungdong경동OTC삼령백출산Samryeong-baekchul-san
Taiwan & Hong Kong
- 順天堂OTC參苓白朮散Shen Ling Bai Zhu San
Cautions & context
- A relatively safe daily-use formula in TCM framing, but not appropriate for active fever or acute infection.
- Considered inappropriate for what TCM describes as "yin deficiency with fire" patterns in some patients.
- Long-term daily use should be monitored by a practitioner, even gentle tonics can shift the body's balance over months.
- Persistent or worsening digestive symptoms, blood in the stool, or significant weight loss requires medical evaluation before any herbal remedy is considered.
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 · 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 "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
"Fortify the spleen-stomach and benefit lung qi. Used for spleen-stomach weakness: reduced food intake with loose stools, shortness of breath with cough, and fatigue of the limbs."
Modern research status
A 2022 systematic review (PMID 36156925) of Chinese herbal formula Shen-Ling-Bai-Zhu-San for chronic gastritis, published in World J Gastroenterol, synthesized clinical evidence and potential mechanisms; the review integrated clinical and pharmacological findings but noted that high-quality RCTs specific to this formula remain limited; no dedicated Cochrane-style review was identified. [5]
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. 3, the "treating all qi" (治一切气) section, the entry for Shēn Líng Bái Zhú Sǎn (参苓白术散), the gentle "spleen-tonic with dampness-leaching" formula, the canonical "earth-generating-metal" (培土生金) entry, characterised in the original preface as "neutral and not hot" (中和不热) and safe for long-term use.
- 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 Shēn Líng Bái Zhú Sǎn analysed as the representative "supplement qi and fortify the spleen, leach dampness and stop diarrhea" (益气健脾，渗湿止泻) formula, the canonical entry for the "spleen-deficiency with damp-exuberance" register, and the standard example of the "earth-generating-metal" approach in its "fortify the spleen to supplement the lung" form.
- 03TextbookTsumura & Co. (ツムラ), Jinrei-byakujutsu-san (参苓白朮散) product documentation, Japan's leading Kampo manufacturer, the standard Japanese Kampo formula for "weak digestion, loose stools, fatigue after eating", sold by every major manufacturer (Tsumura, Kracie, Kotaro), widely used in Japanese Kampo clinical practice for chronic pediatric digestive complaints and for adult spleen-deficiency patients who cannot tolerate richer qi tonics, listed in the Japanese Kampo formulary as a standard gentle spleen tonic.
- 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 Shēn Líng Bái Zhú Sǎn (丸 / 散 / 片 / 颗粒), "functional indication" reads "fortify the spleen-stomach and benefit lung qi, used for spleen-stomach weakness causing reduced food intake with loose stools, shortness of breath with cough, and limb fatigue".
- 05