A "water metabolism" formula from the Han dynasty, best understood as a gentle regulator of how the body handles water, used for short-term patterns of thirst, reduced urine, and mild edema.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Compiled by Zhang Zhongjing in the "Treatise on Cold Damage" (《伤寒论》) as the formula for "water stagnation in the bladder". In Japan, Goreisan (五苓散) is one of the most universally stocked kampo formulas, used by every major manufacturer (Tsumura, Kracie, Kotaro) for "water metabolism" complaints, including hangover, summer heat, motion sickness, and mild edema. In Korea it is sold as Oryeong-san (오령산) by Kyungdong.
From the source text
This page is cultural documentation, not medical advice.
From the source text · 卷三·辨太阳病脉证并治中·第 71 条
Classical text
太阳病，发汗后，大汗出，胃中干，烦躁不得眠，欲得饮水者，少少与饮之，令胃气和则愈。若脉浮，小便不利，微热消渴者，五苓散主之。
Modern Chinese rendering
太阳病发汗后大汗出，致胃中干燥而烦躁不得眠、想要饮水的，应当少量频饮以和胃气则愈；若见脉浮、小便不利、轻微发热而口渴不止的，用五苓散主治。这是"膀胱气化不利"导致"水停下焦"的口渴与消渴的代表性条文。
Editorial translation
After sweating therapy for a taiyang disorder has produced great sweating, the stomach becomes dry, the patient is agitated and cannot sleep, and wants to drink water: give a small amount frequently so that the stomach qi is harmonized and recovery follows. If, however, the pulse is floating, urination is difficult, there is slight fever, and the thirst is unquenchable, then Five-Ingredient Powder with Poria is the formula of choice. This clause is the canonical text for "bladder qi transformation failure" leading to "water stagnating in the lower jiao" with polydipsia and wasting thirst.
In tradition
In TCM tradition, associated with patterns of "water-dampness accumulation" combined with "qi transformation failure" of the bladder: thirst but with reduced urine output; mild edema; a sense of heaviness in the body; a "watery" sound in the stomach; and, in some texts, diarrhea with undigested food and accompanying thirst. It is one of the most commonly discussed formulas in Japan for "water metabolism" (水分の代謝) problems, hangover, mild morning edema, summer fatigue.
Formula composition
Monarch1
- Poria (Fú Líng / 茯苓) — strengthens the spleen and drains water
Minister2
- Alisma rhizome (Zé Xiè / 泽泻)
- Polyporus (Zhū Líng / 猪苓)
Assistant2
- White atractylodes (Bái Zhú / 白术)
- Cinnamon twig (Guì Zhī / 桂枝)
International availability
Cautions & context
- Considered inappropriate for "yin deficiency with fire" patterns in TCM framing, the formula is "warm and diuretic" and may worsen dryness.
- People on diuretic medications should be cautious, the formula adds further water loss and may affect electrolyte balance.
- If edema is accompanied by chest pain, shortness of breath, or sudden weight gain, medical evaluation is required before continuing use.
- Pregnant or breastfeeding people should consult a qualified practitioner before use.
Related formulas
Other formulas from this text· "Treatise on Cold Damage"
Other formulas by this contributor· Zhang Zhongjing
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 "Treatise on Cold Damage" (200).
Last reviewed: July 18, 2026
Three layers of evidence
Classical source
≈ 1800 years · "Treatise on Cold Damage" (200)
Pharmacopoeia indication
"Warm yang and transform qi, drain dampness and move water. Used for failure of yang to transform qi with internal accumulation of water-damp: difficult urination, edema, diarrhea, and phlegm-rheum."
Modern research status
A 2022 systematic review and meta-analysis (PMID 36212947) of 24 RCTs found that adding Wuling San (Wuling Powder) to conventional symptomatic treatment for diabetic nephropathy was associated with improved renal function markers, fasting blood glucose, lipid profiles, and overall of note rate; the authors noted the conclusions are encouraging but must be further validated in higher-quality clinical studies, and no high-quality Cochrane-style review was identified.
References
References reviewed on July 18, 2026 · PubMed search on 2026-07-18
- 01ClassicalZhang Zhongjing, 《伤寒论》 (Shānghán Lùn / Treatise on Cold Damage), Eastern Han dynasty, c. 200 CE, with the base formula appearing in clause 71 of the "taiyang" section, the canonical text for "water stagnation in the lower jiao" from bladder qi transformation failure.
- 02TextbookDuan Fuqin (段富津) et al. (eds.), 《方剂学》 (Fāngjìxué / Textbook of Formulas), Shanghai Scientific and Technical Publishers, 1995, the standard modern university-level formula textbook in mainland China, with Wu Ling San analysed as the representative "transform qi and drain water" formula.
- 03PharmacopoeiaChinese Pharmacopoeia Commission, 《中华人民共和国药典》 2020 年版一部 (Zhōnghuá Rénmín Gònghéguó Yàodiǎn, Pharmacopoeia of the People's Republic of China, 2020 Edition, Vol. I), China Medical Science Press, 2020, the official monograph for Wu Ling San dosage forms.