Liang Ge San
Cool the Diaphragm Powder
- Category
- Formulas that Drain Downward
- Subcategory
- Formulas that Purge Heat Accumulation
- Ingredients
- 7 herbs
Actions
What does Liang Ge San do?
Liang Ge San (Cool the Diaphragm Powder) clears heat, drains fire, and unblocks the bowels to vent accumulated heat from the chest/diaphragm and Stomach/Intestines. Its strategy is distinctive: rather than only clearing heat from above, it opens a downward outlet through mild purgation so upper-body fire has somewhere to go — the classic teaching of “treating the upper body by draining the lower.” Sacred Lotus classifies it under Formulas that Drain Downward → Formulas that Purge Heat Accumulation, distinguishing it from purely heat-clearing formulas (e.g. Bai Hu Tang) and from purely purgative ones (the Cheng Qi Tang family).
The seven ingredients divide by role:
- Chief: Lian Qiao, at the largest dose in the formula, clears heat and resolves toxicity, especially from the upper body and chest, and disperses heat clumping.
- Deputies: Da Huang and Mang Xiao purge accumulated heat downward and unblock the bowels — draining excess fire out through the stool rather than letting it continue to scorch upward.
- Assistants: Huang Qin and Zhi Zi clear heat and drain fire from the upper and middle burners (Zhi Zi also promotes urination, a second outlet for heat); Bo He vents heat and benefits the head, eyes, mouth, and throat; bamboo leaf (Zhu Ye), added at preparation, assists in clearing heat from the chest/diaphragm.
- Envoy: Gan Cao, combined with honey in the classical preparation, harmonizes the formula and moderates the harshness of the purgatives so they do not injure Stomach qi.
Source: Sacred Lotus sources & references and category/subcategory + Bensky & Barolet, Formulas & Strategies (chief/deputy/assistant/envoy analysis). Traditional-use framing; not medical advice.
Indications
What is Liang Ge San used for?
Liang Ge San treats heat clumping (excess fire) in the chest/diaphragm and Stomach/Intestines — a pattern in which heat accumulated in the upper and middle burners has no outlet, so it scorches upward into the face, mouth, and throat while simultaneously binding the stool below.
Its classic clinical presentation:
- Upper-body heat signs: fever, thirst, irritability/restlessness, a flushed (red) face, red eyes, and sores or ulceration of the mouth and tongue.
- Throat involvement: sore, swollen throat, sometimes with mouth and gum sores — the pattern classical texts describe as fire scorching the chest and diaphragm.
- Lower involvement: dry stool or constipation, reflecting that the same excess heat has bound the Intestines.
Tongue and pulse: the tongue is red (or has red edges) with a dry, white or yellow coating; the pulse is rapid, and often slippery or forceful, reflecting excess.
Source: Sacred Lotus sources & references on pattern/tongue/pulse + Bensky & Barolet, Formulas & Strategies. Traditional-use framing; not medical advice.
Western Uses:
What is Liang Ge San used for in modern practice?
In modern practice Liang Ge San is referenced for febrile, inflammatory conditions of the head, mouth, and throat accompanied by constipation — contexts practitioners have traditionally matched to its chest/diaphragm heat pattern, such as pharyngitis, tonsillitis, mouth ulcers (stomatitis) and gum inflammation, and feverish agitation with bound stool. Laboratory research (see research) has additionally examined the formula’s constituents in models of acute lung inflammation.
These biomedical correlates are offered as a reference to the formula’s traditional use, not as a claim that it treats any disease. The available research is preclinical (cell and animal models); any use for a diagnosed condition belongs with a qualified practitioner and appropriate medical care.
Source: traditional-use correlates summarized from Bensky & Barolet, Formulas & Strategies, and background context in Liu et al., Oncotarget 2016 (PMID 27034013); reference only, not a treatment claim.
Ingredients
7 substances in Liang Ge San — each links to its full herb monograph.
Lian Qiao1,200 gClear Heat and Eliminate Toxins
Da Huang600 gPurgatives
Mang Xiao600 gPurgatives
Bo He300 gCool, Spicy Herbs that Release the Exterior
Huang Qin300 gClear Heat and Dry Dampness
Zhi Zi300 gDrain Fire
Gan Cao600 gTonify QiPreparation & dosage
How is Liang Ge San prepared?
Liang Ge San was originally prepared as a powder (san), taken in doses together with bamboo leaf (Zhu Ye) and honey, and is also commonly decocted as a draft (tang) in current practice. In the classical method the herbs are ground to a coarse powder; a dose is briefly simmered with a small amount of bamboo leaf and strained, and honey is stirred into the strained liquid before it is taken warm.
When decocted from whole herbs, Mang Xiao is dissolved into the strained decoction rather than boiled with the other herbs (it is heat-labile), and aromatic Bo He is added only in the final few minutes to preserve its volatile, heat-venting action — both standard handling for these herb types across TCM formulas. Traditionally the formula is discontinued once the bowels move and the acute heat signs resolve.
Source: Bensky & Barolet, Formulas & Strategies (classical san preparation with bamboo leaf and honey; standard handling of Mang Xiao and aromatic herbs).
Classically prepared as a powder (6-9 g per dose) simmered briefly with bamboo leaf, strained, with honey stirred in; also commonly decocted as a draft. Sacred Lotus sources & references preserves the classical Taiping Huimin Heji Jufang batch ratio: Lian Qiao at the largest share (chief), Da Huang, Mang Xiao, and Gan Cao at half that share, and Huang Qin, Zhi Zi, and Bo He at a quarter share. Mang Xiao is dissolved into the strained liquid rather than decocted; Bo He is added in the final few minutes. Reference only; modern clinical gram amounts should follow a current formulary and practitioner judgment.
Safety — read before use
What are the cautions for Liang Ge San?
Liang Ge San is a fast-acting formula for excess heat, built around two purgatives (Da Huang, Mang Xiao), so it is inappropriate for deficiency-cold patterns or where there is no true excess to drain. It is traditionally discontinued once the bowels move, and is not intended for sustained use.
- Pregnancy: contains Da Huang and Mang Xiao, purgative herbs that traditional sources caution against in pregnancy — avoid unless directed by a qualified practitioner.
- Weak digestion / Spleen deficiency: the purgative action can injure Stomach qi and cause loose stools or cramping in patients who are frail, elderly, or already have loose stools; use cautiously and reduce or remove the purgatives if so.
- Yin-deficiency heat without excess: heat from yin deficiency (e.g. low-grade afternoon fever, night sweats) is not the pattern this formula addresses and calls for yin-nourishing formulas instead.
- Not for prolonged use: traditionally stopped once stool passes and heat signs resolve, to avoid depleting Stomach qi and fluids.
Source: Bensky & Barolet, Formulas & Strategies (cautions for cold-purgation/heat-accumulation formulas). Traditional-use framing; not medical advice.
Originally Appeared In:
- Imperial Grace Formulary of the Tai Ping Era (Tai Ping Hui Min He Ji Ju Fang)
Notes:
How is Liang Ge San different from Huang Lian Jie Du Tang, Bai Hu Tang, and the Cheng Qi Tang formulas?
Liang Ge San combines heat-clearing with purgation, which sets it apart from formulas that do only one or the other. Choosing among these formulas depends on whether the stool is bound and where the heat is concentrated.
- vs Huang Lian Jie Du Tang: Huang Lian Jie Du Tang clears fire toxin from all three burners using only bitter, cold heat-clearing herbs, with no purgative outlet and no exterior-venting Bo He; reach for it when fire toxin is severe (high fever, delirium, sores) but the stool is not necessarily bound.
- vs Bai Hu Tang: Bai Hu Tang clears intense qi-level heat (high fever, profuse sweating, great thirst) without any purgative action; it is not built for accompanying constipation or localized chest/throat/mouth heat signs.
- vs the Cheng Qi Tang formulas (Da/Xiao/Tiao Wei Cheng Qi Tang): these purge Yangming bowel excess (abdominal fullness, pain, bound stool) but lack Liang Ge San’s upper-body heat-clearing herbs (Lian Qiao, Huang Qin, Zhi Zi, Bo He) for face/mouth/throat involvement.
- vs Pu Ji Xiao Du Yin: both address heat/toxin rising to the head and throat (da tou wen-type swelling), but Pu Ji Xiao Du Yin is built around dispersing and detoxifying without Liang Ge San’s purgative pair.
Common modifications: add Xuan Shen and Ban Lan Gen (or Ma Bo) for more severe throat/mouth sores; add cooling, blood-stanching herbs such as Bai Mao Gen for nosebleed accompanying the heat; increase Da Huang and Mang Xiao if the stool is more severely bound, or reduce/remove them once stool passes.
Source: Bensky & Barolet, Formulas & Strategies (comparative formula analysis and modifications).
Clinical Studies & Research:
Is there modern research on Liang Ge San?
Yes, but it is entirely preclinical — cell-culture, animal, and network-pharmacology studies of anti-inflammatory mechanisms, with no clinical trials identified. Several groups have studied Liang-Ge-San (LGS) as a candidate anti-inflammatory formula in models of lipopolysaccharide (LPS)- and virus-induced lung inflammation, work consistent with its traditional use for heat/fire patterns affecting the chest and upper body, though these studies test disease models, not the TCM pattern itself.
- Cholinergic anti-inflammatory pathway: LGS reduced IL-6 and TNF-alpha in LPS-stimulated macrophages and in vivo via activation of the alpha7 nicotinic acetylcholine receptor (PMID 27034013).
- Acute lung injury (miR-21/STAT3): LGS attenuated LPS-induced acute lung injury in mice by up-regulating microRNA-21, inhibiting STAT3 signaling and reducing IL-6, TNF-alpha, and IL-1beta (PMID 31803051).
- Sepsis-related inflammation (network pharmacology): bioinformatic and network-pharmacology analysis identified GSK-3beta as a target of LGS in acute inflammation, with follow-up cell and zebrafish experiments supporting an inhibitory effect on GSK-3beta activity (PMID 37456759).
- Virus-induced acute lung injury: LGS attenuated virus-induced acute lung injury and cytokine-storm formation via FXR-mediated downregulation of ACE2 in preclinical models (PMID 40056637).
Sources: PubMed 27034013; PubMed 31803051; PubMed 37456759; PubMed 40056637. Research context only, not a therapeutic claim; all identified studies are preclinical (cell/animal/computational), with no clinical trials found.
Sources & References
Compiled and edited by Thomas Dehli, Founder & Editor, Sacred Lotus Updated
The information here is referenced from numerous sources — teachers, practitioners, class notes from Five Branches University, the books below, and the published research literature, with citations given as resolvable PubMed identifiers. Where sources disagree, I have flagged the discrepancies directly. If facts couldn't be verified, I have left them out. How we source our content.
Reference information for students and practitioners — not medical advice. Consult a qualified practitioner. Terms of use.
Chinese Formulas Books & References
https://amzn.to/4fYI3f8
https://amzn.to/4j55NRA
https://amzn.to/4gMROyv
https://amzn.to/4h7msSK