Bupleurum roots (Chai Hu) Dong quai (Dang Gui) White peony roots (Bai Shao) Poria-cocos mushrooms (Fu Ling)

Xiao Yao San

Chinese: 逍遥散

Pinyin: Xiāo Yáo Sàn

Other names: Rambling Powder, Bupleurum and Dang Gui Formula, Xiao Yao Wan

Number of ingredients: 6 herbs

Formula category: Formulas that harmonize Liver-Spleen

Conditions for which it may be prescribed: HepatitisCirrhosisCholecystitis and thirteen other conditions

  1. Harmonizes the function of Liver and Spleen
  2. Relieves Liver Qi stagnation
  3. Nourishes the Blood

Contraindications: Contraindicated for treating purely Deficient disorders.

Source date: 1107 AD

Source book: Formulary of the Pharmacy Service for Benefiting the People in the Taiping Era

Xiao Yao San is a 6-ingredient Chinese Medicine formula with Bupleurum Roots (Chai Hu) as a principal ingredient.

Invented in 1107 AD, it belongs to the category of formulas that harmonize Liver-Spleen. Its main actions are: 1) harmonizes the function of Liver and Spleen and 2) relieves Liver Qi stagnation.

In Chinese Medicine health conditions are thought to arise due to "disharmonies" in the body as a system. These disharmonies are called "patterns" and the very purpose of herbal formulas is to fight them in order to restore the body's harmony.

In this case Xiao Yao San is used by TCM practitioners to fight patterns like Liver Blood Stagnation, Liver Qi Stagnation or Qi Stagnation. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as low breast milk supply, irregular menstruation or abnormal vaginal discharge for instance.

On this page, after a detailed description of each of the six ingredients in Xiao Yao San, we review the patterns and conditions that Xiao Yao San helps treat.

The six ingredients in Xiao Yao San

Chai Hu is a king ingredient in Xiao Yao San. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Bupleurum Roots (Chai Hu)

Part used: Dried root and rhizome

Nature: Cool

Taste(s): Bitter

Meridian affinity: GallbladderLiver

Category: Cool/Acrid herbs that release the Exterior

Chai Hu To spreads the Liver Qi, relieves Stagnation and helps guide the other herbs into the Liver. Because of its cooling nature, it is also particularly dealing with Qi Stagnation that has started to generate Heat.

Learn more about Bupleurum Roots (Chai Hu)

Dang Gui is a deputy ingredient in Xiao Yao San. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

2. Dong Quai (Dang Gui)

Part used: Dried root

Nature: Warm

Taste(s): PungentSweet

Meridian affinity: SpleenHeartLiver

Category: Tonic herbs for Blood Deficiency

Dang Gui works together with White peony roots, the other deputy in this formula, to nourish Blood. This nourishing role also in turn helps strengthen the Liver since it stores Blood and is nourished by it.

Learn more about Dong Quai (Dang Gui)

Bai Shao is a deputy ingredient in Xiao Yao San. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

3. White Peony Roots (Bai Shao)

Part used: Dried root

Nature: Neutral

Taste(s): BitterSour

Meridian affinity: SpleenLiver

Category: Tonic herbs for Blood Deficiency

In general Bai Shao's main actions are as follows: "Tonifies the Blood and preserves the Yin. Nourishes the Liver and assists in the smooth flow of Qi. Regulates the meridians and eases the pain."

In the context of Xiao Yao San, it is used because it moves Qi and is specific for menstrual problems, especially from emotional stress.

Learn more about White Peony Roots (Bai Shao)

Fu Ling is an assistant ingredient in Xiao Yao San. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

4. Poria-Cocos Mushrooms (Fu Ling)

Part used: Dried sclerotium

Nature: Neutral

Taste(s): Sweet

Meridian affinity: SpleenHeartKidneyLung

Category: Herbs that drain Dampness

In general Fu Ling's main actions are as follows: "Encourages urination and drains Dampness. Tonic to the Spleen/Stomach. Assists the Heart and calms the Spirit."

In the context of Xiao Yao San, it is used because it strengthens the Spleen.

Learn more about Poria-Cocos Mushrooms (Fu Ling)

Bai Zhu is an assistant ingredient in Xiao Yao San. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

5. Atractylodes Rhizomes (Bai Zhu)

Part used: Dried rhizome

Nature: Warm

Taste(s): BitterSweet

Meridian affinity: SpleenStomach

Category: Tonic herbs for Qi Deficiency

Bai Zhu works together with Poria mushrooms to strengthen the Spleen. Indeed, as described in the famous TCM treaty Essentials from the Golden Cabinet: "When one sees a Liver disorder, one knows that the Liver will transmit it to the Spleen. Therefore, one should first treat the Spleen." Strengthening the Spleen, since it 'rules transformation and transportation', has a direct positive impact on Blood Deficiency.

Learn more about Atractylodes Rhizomes (Bai Zhu)

Gan Cao is an assistant ingredient in Xiao Yao San. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

6. Liquorice (Gan Cao)

Part used: Dried root and rhizome

Nature: Neutral

Taste(s): Sweet

Meridian affinity: SpleenStomachHeartLung

Category: Tonic herbs for Qi Deficiency

Gan Cao tonifies the Spleen and, when combined with White peony roots (as is the case here), helps reduce the spasms that are often a symptoms for patients that use this formula.

Learn more about Liquorice (Gan Cao)

Conditions and patterns for which Xiao Yao San may be prescribed

It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.

As such Xiao Yao San is used by TCM practitioners to treat six different patterns which we describe below.

But before we delve into these patterns here is an overview of the Western conditions they're commonly associated with:

Low breast milk supply Irregular menstruation Abnormal vaginal discharge Late menstruation Menstrual cramps Hepatitis Cholecystitis Peptic ulcers Gastric neurosis Chronic gastritis Cirrhosis Premenstrual syndrome Fibrocystic breasts Perimenopausal syndrome Pelvic inflammatory disease Uterine fibroids

Again it wouldn't be correct to say "Xiao Yao San treats low breast milk supply" for instance. Rather, Xiao Yao San is used to treat patterns that are sometimes the root cause behind low breast milk supply.

Now let's look at the six patterns commonly treated with Xiao Yao San.

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Blood Stagnation

Xiao Yao San is sometimes prescribed by TCM practitioners to treat Liver Blood Stagnation. This pattern leads to symptoms such as dark clots in menstrual blood, dark colored blood, irregular menstruation and painful period. Patients with Liver Blood Stagnation typically exhibit wiry (Xian) pulses as well as a bluish-purple sides tongue.

Liver Blood Stagnation usually develops from other patterns, Liver Qi Stagnation, Cold and Heat being the most common ones. Sometimes Qi Deficiency, Blood Deficiency and Phlegm can also be the precursors. 

Liver Qi Stagnation is the most common cause. If left unchecked for a while without being... read more about Liver Blood Stagnation

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Qi Stagnation

Xiao Yao San is sometimes prescribed by TCM practitioners to treat Liver Qi Stagnation. This pattern leads to symptoms such as depression, irregular menstruation, menstrual cramps and irritability. Patients with Liver Qi Stagnation typically exhibit wiry (Xian) pulses as well as a normal (light red) tongue.

When Liver Qi does not flow smoothly or regularly, it becomes Stagnant and in Excess. This leads to Heat accumulating in the Liver. This affects not only the Liver, but other connected Organs too as well as the Seven Emotions.

Liver Qi Stagnation is not only the most seen Liver disharmony, but... read more about Liver Qi Stagnation

Qi is one of Chinese Medicine's vital subtances. Learn more about Qi in Chinese Medicine

Qi Stagnation

Xiao Yao San is sometimes prescribed by TCM practitioners to treat Qi Stagnation. This pattern leads to symptoms such as moving pain, depression, irritability and mood swings. Patients with Qi Stagnation typically exhibit tight (Jin) or wiry (Xian) pulses as well as a red sides tongue with thin white coating.

If the flow of Qi is impeded in any way, it becomes stuck or stagnant. This can be likened to a traffic jam on the freeway. That's why, unlike in the cases of Qi Deficiency or Qi Sinking, tonification is contraindicated: it would be like adding more cars to the traffic jam. Instead, Qi moving or... read more about Qi Stagnation

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Blood Deficiency with disharmony of Liver and Spleen

Xiao Yao San is sometimes prescribed by TCM practitioners to treat Blood Deficiency with disharmony of Liver and Spleen. This pattern leads to symptoms such as chest fullness, chest pain, anemia and dizziness. Patients with Blood Deficiency with disharmony of Liver and Spleen typically exhibit empty (Xu) or wiry (Xian) pulses as well as a pale tongue.

Learn more about Blood Deficiency with disharmony of Liver and Spleen

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