A "liver-spleen harmonizing" formula whose Chinese name literally means "carefree and at ease", and which is one of the most discussed remedies for low mood and irritability in Chinese households.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Compiled by the Song dynasty physician Wang Qi-ying in the "Formulary of the Bureau of Medicine" (《太平惠民和剂局方》) under the name Xiaoyao San, later widely produced as a pill or concentrated decoction. Its name, 逍遥, "to wander freely", is a deliberate allusion to the Zhuangzi, suggesting the kind of unconstrained ease the formula is intended to restore.
From the source text
This page is cultural documentation, not medical advice.
From the source text · 卷九·治妇人·逍遥散
Classical text
治血虚劳倦，五心烦热，肢体疼痛，头目昏重，心忪颊赤，口燥咽干，胸膈不利，减食嗜卧；及血热相搏，月水不调，脐腹胀痛，寒热如疟；又疗室女血弱阴虚，荣卫不和，痰嗽潮热，肌体羸瘦，渐成骨蒸。
Modern Chinese rendering
用于血虚劳倦：手足心烦热、肢体疼痛、头目昏沉、心中悸动、面颊潮红、口燥咽干、胸膈满闷、食欲减退、嗜睡；以及血热互结所致的月经不调、脐腹胀痛、寒热往来如疟；亦用于未婚女子血弱阴虚、营卫不和、痰中带咳、潮热不退、肌体消瘦、渐成骨蒸劳热。
Editorial translation
For blood deficiency with overwork of body and mind: heat in the palms and soles, aching limbs, heaviness and dizziness of the head and eyes, palpitations, reddening of the cheeks, dry mouth and throat, a sense of oppression across the chest, reduced appetite, and a desire to lie down. Also for blood and heat contending with one another, with menstrual irregularity, distending pain around the navel and lower abdomen, and alternating chills and fever as in malarial patterns; and for the young woman with depleted blood and yin deficiency, disharmony between the ying and wei aspects, phlegm-cough, tidal fever, emaciation of the body, and the gradual onset of "bone-steaming" taxation-fever.
In tradition
In TCM tradition, often associated with patterns described as "liver qi stagnation" affecting the spleen: low mood, irritability, a sensation of tightness across the chest or flanks, sighing, premenstrual mood shifts, breast tenderness, mild digestive looseness during stress, and a feeling of being "wound up but tired." It is one of the formulas most often reached for in China for everyday emotional and menstrual stress, though it is not a treatment for clinical depression.
Formula composition
Monarch1
- Bupleurum root (Chái Hú / 柴胡)
Minister2
- White peony root (Bái Sháo / 白芍)
- Dong quai (Dāng Guī / 当归)
Assistant3
- Poria (Fú Líng / 茯苓)
- White atractylodes (Bái Zhú / 白术)
- Peppermint (Bò He / 薄荷)
Envoy2
- Licorice root, honey-fried (Zhì Gān Cǎo / 炙甘草)
- Ginger (Shēng Jiāng / 生姜)
In modern life
In modern Chinese life, Xiāo Yáo Wán has become one of the most recognized names in the household "emotional stress" category, frequently mentioned in workplace wellness columns, women's health podcasts, and social-media discussions of premenstrual mood. It is produced by numerous manufacturers as small water pills (水丸) and concentrated pills (浓缩丸), and a "Dan Zhi" variant (with moutan bark and gardenia added) is typically stocked alongside it on pharmacy shelves. The name itself has migrated into popular culture as a shorthand for "the pill you reach for when you are wound up but tired", a usage that has spread the formula far beyond TCM-literate audiences, even as it sometimes blurs the line between cultural reference and self-care advice. We regard this popular visibility as a reason to write about it carefully, not as a reason to endorse casual use.
International availability
Common confusions
- Dan Zhi Xiao Yao San (丹栀逍遥丸, "Moutan & Gardenia Free Wanderer"): adds moutan bark (丹皮) and gardenia fruit (栀子) to the base formula. In TCM terms it is oriented toward "clearing liver heat," and is traditionally reached for when irritability is accompanied by a flushed face, a bitter taste, or low-grade feverishness, patterns considered "hotter" than those for plain Xiao Yao San.
- Chai Hu Shu Gan San (柴胡疏肝散): a different formula built around Bupleurum but focused on moving liver qi and relieving pain, with more fragrant-moving herbs (citrus, cyperus, ligusticum). Traditionally used when chest and flank distension or pain is the dominant complaint, rather than the mixed mood-and-digestive pattern of Xiao Yao San.
- Yue Ju Wan (越鞠丸): Zhu Danxi's "five-stagnation" formula (Cang Zhu, Xiang Fu, Chuan Xiong, Shen Qu, Zhi Zi). It addresses a broader TCM concept of "six stagnations" (qi, blood, damp, phlegm, food, fire) and is not centered on the liver-spleen axis; it is typically reached for when stagnation presents as a knot of digestive and mood symptoms without the gynecological emphasis of Xiao Yao San.
- Hei Xiao Yao San (黑逍遥丸, "Black Free Wanderer"): adds prepared rehmannia (熟地黄) to the base, introducing a yin-nourishing element. It is traditionally considered when the liver-qi-stagnation pattern is complicated by subtle yin deficiency, in contrast to the plainer formula's more neutral tonic balance.
Cautions & context
- Considered unsuitable during a cold, fever, or active anger, TCM framing suggests that "liver qi" is already rising and the formula may not be appropriate.
- People with what TCM texts describe as pronounced "yin deficiency" (night sweats, dry mouth, heat in the palms) are typically advised to use the related formula "Dan Zhi Xiao Yao San" instead, under guidance.
- Long-term daily use is common in China but not well studied in Western pharmacology; periodic breaks are often recommended by Chinese practitioners.
- 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.
Concern · womens-health
Women's Health
The cluster of complaints that Chinese households often frame around the menstrual cycle: premenstrual mood shifts, breast tenderness, irregular cycles, and post-partum recovery.
Editorial note
We chose to include Xiāo Yáo Wán early in this encyclopedia because, more than almost any other formula, it sits at the intersection of serious TCM pharmacology and mass-market popular discourse in modern China. Writing the entry, we were struck by how often the same name is used to mean three different things: a Song-dynasty harmonizing formula, a modern over-the-counter pill, and a pop-cultural byword for "don't be so wound up." We have tried to keep those three layers distinct in the text above, and we recommend reading this entry alongside the related formulas listed below rather than in isolation.
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
"Soothe the liver and fortify the spleen, nourish blood and regulate menstruation. Used for liver stagnation with spleen deficiency: depressed mood and discomfort, chest and hypochondriac distension and pain, dizziness, reduced appetite, and menstrual irregularities."
Modern research status
A 2022 systematic review with trial sequential analysis (PMID 35126152) found Xiao Yao San alone or combined with conventional therapy showed better symptom improvement in functional gastrointestinal disorders than conventional therapy alone; the included trials were rated as low-to-moderate quality, and the authors called for rigorously designed confirmatory trials.
References
References reviewed on July 18, 2026 · PubMed search on 2026-07-18
- 01ClassicalSong dynasty, Imperial Bureau of Medicine. 《太平惠民和剂局方》 (Formulary of the Bureau of People's Welfare Pharmacies). First published 1078; entry "Xiaoyao San" in the 卷九 (juan 9) section.
- 02TextbookDuan Fujin, ed. 《方剂学》 (Chinese Formulaology), 2nd edition of the New Century series. China Press of Traditional Chinese Medicine, 2007. Xiaoyao San is discussed in the "harmonizing formulas" chapter.
- 03TextbookDeng Zhongjia, ed. 《方剂学》. China Press of Traditional Chinese Medicine, 2010.
- 04ClassicalZhang Jingyue. 《景岳全书》 (Complete Works of Jingyue). Ming dynasty. Discusses the clinical scope of Xiaoyao San in the "Gu Zhen" eight-category formula discussion.
- 05TranslationBensky, D., Clavey, S., Stöger, E., & Gamble, A. Chinese Herbal Medicine: Materia Medica, 3rd ed. Eastland Press, 2004. Entries on Chái Hú, Bái Sháo, Dāng Guī.
- 06TranslationScheid, V., Bensky, D., Ellis, A., & Barolet, R. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. Eastland Press, 2009. Xiaoyao San entry.