Dampness-Draining Formulas

甘薑苓朮湯 · Gān Jiāng Líng Zhú Tāng

Gan Jiang Ling Zhu Tang

A classical formula for cold-damp lumbar pain from Kidney-Spleen Yang deficiency (Shen Zhuo).

View formula profile →
Last reviewed August 2026
Formula CategoryDampness-Draining Formulas
Primary PatternCold Accumulation
Primary FunctionWarm the middle, drain damp, ease lumbar cold-pain
Primary Therapeutic PrincipleWarm Spleen and drain cold-damp from the lumbar region
Main HerbsLicorice Root · Dried Ginger · Poria / Hoelen · White Atractylodes Rhizome
Classical SourceShang Han Lun (Zhang Zhongjing, Eastern Han)

Why This Formula?

Traditionally selected for cold-damp lumbar pain from Spleen-Kidney deficiency (Shen Zhuo), rather than thin fluid retention, Yang-deficient edema, or chronic bi with essence deficiency.

Traditionally selected for cold-damp lumbar pain from Spleen-Kidney deficiency (Shen Zhuo), rather than thin fluid retention, Yang-deficient edema, or chronic bi with essence deficiency.

What Is Gan Jiang Ling Zhu Tang?

1. Classical Source

Gan Jiang Ling Zhu Tang (甘姜苓术汤), or Licorice, Dried Ginger, Poria, and Atractylodes Decoction, is a classical formula from Zhang Zhongjing’s Jin Gui Yao Lue (Essentials from the Golden Cabinet). It is also known as Shen Zhuo Tang (Kidney Fixity Decoction) and belongs to the category of formulas that warm the Spleen, disperse Cold, and leach Dampness.

This formula addresses Cold-Damp settling in the lower body—the pattern Zhang Zhongjing called “Kidney fixity”—in which Cold-Damp affixes to the lumbar region even though Kidney function itself may not be the primary failure. Typical signs include cold, heavy aching in the lower back as if sitting in water, heaviness of the body below the waist, normal appetite and urination, no thirst, a white greasy tongue coating, and a moderate or soggy pulse.

Combining a relatively large dose of Gan Jiang to warm Spleen Yang and scatter Cold, Fu Ling to leach Dampness and promote urination, Bai Zhu to strengthen the Spleen and dry Dampness, and Gan Cao to tonify the Middle and harmonize, Gan Jiang Ling Zhu Tang warms the earth element, overcomes Dampness, and relieves the characteristic cold-heavy lumbar pain of Shen Zhuo.

Gan Jiang Ling Zhu Tang

2. Cold-Damp Lower Back Pain

This is the number one condition Gan Jiang Ling Zhu Tang is used for.

  • Typical Symptoms: Patients experience a cold, heavy pain in the lower back that makes turning difficult. The pain doesn't go away with rest and gets noticeably worse in cold or rainy weather.
  • How it Works: By warming the kidneys, dispersing the cold, and clearing the dampness, this formula removes the energetic blockages in the lower back, providing highly effective pain relief.

3. Cold-Damp Bi Pain in the Lower Limb Joints

This formula can also be adapted for joint pain (Bi pain) caused by cold and dampness settling in the legs.

  • Typical Symptoms: Joints feel cold, heavy, and stiff (hard to bend or stretch). This is especially true for patients who also have poor digestion, such as cold stomach aches, bloating, and loose stools.
  • How it Works: By boosting the spleen's energy and transforming the cold-dampness, it helps clear the blockages causing the joint stiffness and digestive upset.
Gan Jiang Ling Zhu Tang

4. Cold-Damp Vaginal Discharge in Women

For women experiencing issues related to "cold-dampness pouring downward," this formula can be quite helpful.

  • Typical Symptoms: Profuse vaginal discharge that is white, thin, and watery/cold, often accompanied by a cold, aching lower back and a heavy, sinking feeling in the lower abdomen.
  • How it Works: The warming herbs in the formula target the lower part of the body (the lower burner), gently warming and drying the excessive cold-dampness to reduce the discharge and relieve the discomfort.

Herb Composition (Sovereign / Minister / Assistant / Envoy)

1. Chief Herb: Gan Jiang (Dry Ginger)

Gan Jiang is acrid and hot by nature, targeting the spleen, stomach, kidney, heart, and lung channels. In Gan Jiang Ling Zhu Tang, it takes the lead as the chief herb.

  • Key Action: Its intensely warm nature rapidly heats the middle of the body (the middle burner) to disperse stubborn cold and dampness.
  • Why it Matters: The spleen and stomach are the core of our digestive and energetic health. When cold-dampness bogs them down, everything slows down. Gan Jiang fires up the spleen and stomach's energy (Yang Qi), eliminating the cold and laying the groundwork for recovery.

2. Deputy Herb: Fu Ling (Poria)

Fu Ling is sweet, mild, and neutral. As the deputy herb, it plays a vital supporting role for the chief herb:

  • Drains Dampness: It promotes urination, giving the cold-dampness a clear exit route out of the body.
  • Strengthens the Spleen: It boosts digestive functions, working perfectly with Gan Jiang to regulate fluid metabolism and ensure the cold-dampness is fully cleared out.

3. Assistant Herb: Bai Zhu (Atractylodes Rhizome)

Bai Zhu is bitter, sweet, and warm. Acting as the assistant, it brings strong damp-drying properties to the mix:

  • Synergy: It significantly boosts the spleen-strengthening and dampness-resolving power of Fu Ling.
  • Balance: While Gan Jiang is very hot and spicy, Bai Zhu helps temper it, ensuring the extreme heat doesn't accidentally dry out the body's essential fluids (Yin).
Gan Jiang Ling Zhu Tang

4. Envoy Herb: Zhi Gan Cao (Honey-Fried Licorice)

Zhi Gan Cao is sweet and neutral. As the envoy or "guide" herb, it ties the whole formula together:

  • Boosts Energy (Qi): It tonifies the spleen, providing extra support for digestion.
  • Harmonizes: It smooths out the strong, fierce properties of the other three herbs. This ensures the formula works steadily, gently, and provides long-lasting relief without shocking the system.

Clinical Presentation in TCM

1. Pathomechanism

The core issue this formula addresses is cold-dampness getting trapped in the lower back.

  • The Cause: This usually happens from spending too much time in cold, wet environments, getting caught in the rain, or physical overstrain that weakens the body's natural defenses.
  • The Result: The cold-dampness settles into the muscles and energy channels of the lower back, causing pain and a heavy sensation. Because the kidneys energetically govern the lower back, this coldness can damage kidney Yang (the body's natural warming fire). Without this warmth, the dampness becomes even harder to clear, creating a vicious, painful cycle.

2. Actions

Gan Jiang Ling Zhu Tang is designed to break this cycle through a two-pronged approach:

  • Warming and Dispersing: Gan Jiang warms the kidneys and disperses the trapped cold.
  • Strengthening and Draining: Fu Ling and Bai Zhu strengthen the spleen to resolve dampness, cutting off the source of the problem. Together with Zhi Gan Cao, the formula effectively warms the body, restores healthy digestion, and kicks the dampness out.
Gan Jiang Ling Zhu Tang: Warming Yang, Dispersing Cold and Resolving Dampness for Chronic Lower Back Pain, Cold Lumbar Pain, and Cold-Damp Bi Pain | HJMEDICAL

3. Indications

This formula is the classic remedy for a condition known as "Kidney Lodged Disease" (Shen Zhuo). It is highly effective when a patient presents with the following:

  • A sensation of extreme heaviness in the body, particularly a feeling in the abdomen like "carrying five thousand coins."
  • Intense cold in the lower back, often described by patients as feeling like they are sitting in freezing water.
  • Normal upper body functions: Interestingly, patients usually have no unusual thirst, normal urination, and a completely normal appetite.

In modern contexts, these symptoms closely mirror chronic, heavy, aching lower back pain triggered or worsened by cold and damp weather.

The Mechanism in Classical Theory

1. Combined Use of Warming Yang to Disperse Cold and Strengthening the Spleen

This formula tackles the problem from two angles, treating both the symptoms (the "branch") and the underlying cause (the "root"):

  • Addressing the Branch: Gan Jiang (Dry Ginger) is intensely hot and goes straight to the kidney channel. It acts as the lead herb to warm the body's Yang energy and drive out the chilling cold.
  • Stabilizing the Root: Fu Ling (Poria) and Bai Zhu (Atractylodes Rhizome) work to strengthen the spleen and resolve dampness. This gets the digestive system's transport and transformation functions back on track, allowing the body to naturally clear out excess water-dampness.

2. Synergistic Enhancement Through Herb Combination

The real magic of this formula lies in how the herbs work together as a team:

  • Gan Jiang + Fu Ling: Gan Jiang warms the body to push out cold, while Fu Ling promotes urination to drain out dampness. Together, they effectively flush the cold-damp pathogens out of the system.
  • Gan Jiang + Bai Zhu: Gan Jiang warms the spleen, and Bai Zhu dries dampness. This combination significantly boosts the formula's power to transform and eliminate cold-dampness.
  • Fu Ling & Bai Zhu + Zhi Gan Cao: While the first two strengthen the spleen and handle dampness, Zhi Gan Cao (Honey-Fried Licorice) gently boosts energy (Qi). Working synergistically, they restore the core digestive functions, allowing the entire formula to work smoothly and effectively.
Gan Jiang Ling Zhu Tang: Warming Yang, Dispersing Cold and Resolving Dampness for Chronic Lower Back Pain, Cold Lumbar Pain, and Cold-Damp Bi Pain | HJMEDICAL

3. Reflecting the Holistic View

Traditional Chinese Medicine looks at the big picture. This formula doesn't just treat the local pain in the lower back; it addresses the overall insufficiency of Spleen and Kidney Yang energy.

  • By warming the kidneys and strengthening the spleen, it regulates fluid metabolism throughout the entire body.
  • Once the internal environment is balanced and healthy, the trapped cold-dampness in the lower back is naturally dispelled. This perfectly embodies the TCM principle of treating the root cause to restore overall harmony.

Clinical Comparison Table

Compare Gan Jiang Ling Zhu TangLing Gui Zhu Gan TangZhen Wu TangDu Huo Ji Sheng Tang
Primary Function Warm the middle, drain damp, ease lumbar cold-painWarm Yang, transform phlegm-fluids, strengthen SpleenWarm Yang, promote urination, transform waterDispel wind-damp, stop bi pain, tonify Liver and Kidney, nourish Qi and blood
Formula Category Dampness-Draining FormulasDampness-Draining FormulasYang-Tonifying FormulasWind-Damp Dispelling Formulas
Typical TCM Pattern Cold AccumulationDampnessYang DeficiencyDampness
Main Conditions Low Back Pain, Cold Limbs, EdemaDizziness & Vertigo, Bloating, Excessive Mucus, PalpitationsEdema, Abdominal Pain, Cold Limbs, Diarrhea, PalpitationsLow Back Pain, Joint Discomfort, Numbness in Limbs
Main Herbs Licorice Root · Dried Ginger · Poria / Hoelen · White Atractylodes RhizomePoria / Hoelen · Cinnamon Twig · White Atractylodes Rhizome · Honey-fried LicoricePrepared Aconite Accessory Root · White Atractylodes Rhizome · Poria / Hoelen · White Peony Root · Fresh GingerPubescent Angelica Root · Taxillus / Mulberry Mistletoe · Eucommia Bark · Achyranthes Root · Asarum / Wild Ginger · Large-Leaf Gentian Root · Poria / Hoelen · Cinnamon Bark · Saposhnikovia Root · Chuanxiong Rhizome · Ginseng Root · Licorice Root · Chinese Angelica Root · White Peony Root · Prepared Rehmannia Root
Classical Source Shang Han Lun (Zhang Zhongjing, Eastern Han)Shang Han Lun / Jin Gui Yao Lue (Zhang Zhongjing)Shang Han Lun (Zhang Zhongjing, Eastern Han)Classical TCM formulary

How to tell them apart

Gan Jiang Ling Zhu Tang, Ling Gui Zhu Gan Tang, Zhen Wu Tang and Du Huo Ji Sheng Tang address cold-damp or lumbar issues. Ling Gui Zhu Gan Tang warms and transforms thin fluid; Zhen Wu Tang warms Kidney Yang for edema; Du Huo Ji Sheng Tang treats chronic bi with Liver-Kidney deficiency. Gan Jiang Ling Zhu Tang warms the middle and drains cold-damp for lumbar cold-pain (Shen Zhuo).

For educational reference only, based on traditional pattern differentiation — not a substitute for professional advice.

Clinical Modifications for Gan Jiang Ling Zhu Tang

1. Pronounced Cold-Damp with Severe Pain

If a patient's cold-dampness is particularly intense and causes severe pain, practitioners might add herbs to supercharge the formula's warming and pain-relieving effects:

  • Targeted Additions: Zhi Chuan Wu (Prepared Aconite Root), Zhi Cao Wu (Prepared Kusnezoff Monkshood Root), and Xi Xin (Chinese Wild Ginger).
  • How They Work: Both Zhi Chuan Wu and Zhi Cao Wu are very warm in nature and possess powerful abilities to drive out cold and stop pain. Xi Xin helps dispel wind, scatter cold, and open up the body's blocked channels. Together with the original formula, they provide highly effective relief for stubborn, cold-damp pain.

2. Spleen Deficiency with Pronounced Dampness, and Marked Abdominal Distension with Loose Stools

For patients who have a very weak digestive system (spleen deficiency) leading to heavy dampness, severe bloating, and loose stools, the formula needs a digestive boost:

  • Targeted Additions: Hou Po (Magnolia Bark), Chen Pi (Dried Tangerine Peel), and Sha Ren (Cardamom).
  • How They Work: Hou Po is excellent at drying dampness and pushing energy downward to relieve bloating. Chen Pi regulates digestion and resolves phlegm. Sha Ren transforms dampness, moves stagnant energy, and warms the stomach to stop diarrhea. These additions perfectly customize the formula for complex digestive complaints.
Gan Jiang Ling Zhu Tang

3. Concurrent Wind-Cold Exterior Pattern

Sometimes, a patient might have trapped cold-dampness while also suffering from an external "wind-cold" (similar to catching a common cold or flu):

  • Targeted Additions: Fang Feng (Siler Root), Qiang Huo (Notopterygium Rhizome), and Du Huo (Angelica Pubescens Root).
  • How They Work: These herbs are famous for releasing external wind and cold from the body's surface. When combined with Gan Jiang Ling Zhu Tang, the modified formula can fight off the external cold while simultaneously treating the internal cold-damp condition.

What the Science Suggests

Gan Jiang Ling Zhu Tang is a classical formula originating from the Han dynasty that strengthens the spleen and resolves dampness, harmonizes the middle jiao, and regulates water metabolism.

It is particularly effective for spleen yang deficiency or spleen qi deficiency with excess water, addressing diarrhea due to / diarrhea due to spleen deficiency, shortness of breath, chronic cough, heart palpitations, low back pain, dizziness and vertigo, and is also applied in modern practice for conditions such as Meniere's disease.

1. Pharmacological Research

Modern science has investigated the individual components of Gan Jiang Ling Zhu Tang and found solid evidence supporting its traditional uses:

  • Gan Jiang (Dry Ginger): Demonstrates strong anti-inflammatory, pain-relieving (analgesic), and anti-ulcer properties.
  • Fu Ling (Poria): Acts as a natural diuretic (promoting fluid release) and helps regulate the immune system.
  • Bai Zhu (Atractylodes Rhizome): Shown to effectively regulate gastrointestinal function and boost overall immunity.
  • Zhi Gan Cao (Honey-Fried Licorice): Possesses robust anti-inflammatory, anti-allergic, and immune-regulating actions. When combined, these pharmacological effects form the scientific foundation for why this formula works so well against cold-damp disorders.

2. Clinical Research

In recent years, numerous clinical studies have highlighted the practical effectiveness of Gan Jiang Ling Zhu Tang:

  • Efficacy: Research shows it effectively improves symptoms like lower back pain and heaviness, significantly enhancing patients' daily quality of life.
  • Combined Therapies: Many clinical observations note that using this formula alongside modern treatments—such as physical therapy—can lead to even better, faster treatment outcomes for cold-damp blockages (Bi obstruction).
Gan Jiang Ling Zhu Tang

3. Research on Dosage Form Improvement

To make taking herbal medicine easier, modern technology has upgraded how Gan Jiang Ling Zhu Tang is produced:

  • Beyond traditional decoctions (teas), researchers have successfully developed concentrated granules, capsules, and tablets.
  • These modern formats maintain the potent therapeutic effects of the original herbs while making the medicine much more stable and convenient for today's busy patients to take.

Safety Considerations

1. Dietary Precautions

While taking Gan Jiang Ling Zhu Tang, avoid raw, cold, greasy, spicy, and irritating foods. These may impair spleen–stomach function, worsen cold-dampness, or interfere with treatment.

2. Contraindications and Special Circumstances

Use cautiously in people with yin deficiency and excessive internal heat, as the formula’s warming nature may worsen dry mouth or throat, tidal fever, and night sweats. Pregnant women should use it only under a physician’s guidance.

Questions About Gan Jiang Ling Zhu Tang

Q1: What are the actions of Gan Jiang Ling Zhu Tang?
Gan Jiang Ling Zhu Tang (also called Shen Zhuo Tang) has the actions of warming the Middle, dispelling Cold, strengthening the Spleen, and leaching Dampness. It “ovens the Earth to overcome Water”: the Spleen is warmed so Cold-Damp lodged in the low back can be transformed.
Q2: Which modern conditions is Gan Jiang Ling Zhu Tang suited to?
Modern TCM clinical practice commonly applies it to individuals whose pattern differentiation falls within Cold-Damp in the lumbar region, including cold heavy low-back pain that worsens in damp weather, some cold-damp sciatica, clear thin leukorrhea of Cold-Damp type, and heaviness of the lower body with a pale tongue and white greasy coating.
Q3: Is Gan Jiang Ling Zhu Tang suitable for a low back that feels cold and heavy, as if sitting in water?
For presentations of cold, heavy lumbar pain or a sensation of sitting in water, body heaviness, no thirst, normal appetite and uninhibited urination, a pale tongue with white coating, and a deep slow or soggy pulse — in those whose pattern differentiation confirms Shen Zhuo (Cold-Damp fixation of the low back) — TCM commonly applies this formula as an adjunct. It cannot replace evaluation of disc herniation, fracture, or other structural spine disease.
Q4: Who should not take Gan Jiang Ling Zhu Tang?
Those with Damp-Heat low-back pain (burning, yellow urine, yellow greasy coating), Yin-deficiency empty Fire, or acute traumatic or neurological red-flag back pain are generally not suitable. The formula is warm and drying. Use should be assessed by a qualified TCM physician after serious spinal causes have been excluded.
Q5: Why is this formula named “Kidney fixation” if it does not tonify the Kidney?
In Jin Gui Yao Lue, “Shen Zhuo” describes Cold-Damp that has settled in the region of the Kidney (the low back), not Kidney organ deficiency itself. Appetite is normal and urination is free, so the root is Spleen failing to transform Damp rather than exhausted Kidney Yang. Gan Jiang warms the Middle; Bai Zhu and Fu Ling strengthen the Spleen and leach Dampness; Gan Cao harmonizes. Warming Earth resolves the water that has soaked the lumbar area.
Q6: How does Gan Jiang Ling Zhu Tang differ from Zhen Wu Tang or Du Huo Ji Sheng Tang?
Zhen Wu Tang warms Kidney Yang and transforms overflow of water with more edema, palpitations, and deep weak pulse. Du Huo Ji Sheng Tang treats chronic Wind-Cold-Damp Bi with Liver-Kidney deficiency and more limb-joint involvement. Gan Jiang Ling Zhu Tang is the simpler choice when the hallmark is a cold, water-soaked low back with intact appetite and urine, and the strategy is to warm the Spleen rather than tonify the Kidney.
Q7: What are the main ingredients of Gan Jiang Ling Zhu Tang?
The classical four-ingredient formula consists of Gan Jiang to warm the Middle and dispel Cold; Fu Ling to leach Dampness; Bai Zhu to strengthen the Spleen and dry Dampness; and Gan Cao to tonify the Middle, ease pain, and harmonize.
Q8: Is Gan Jiang Ling Zhu Tang suitable for long-term use?
It may be used for a course of treatment in chronic Cold-Damp lumbar heaviness under professional supervision. Because Gan Jiang is drying and warming, Heat signs or Yin injury mean the formula should be stopped. Once the soaked-cold sensation lifts, keeping the Spleen warm with diet often matters more than staying on the decoction indefinitely.
Q9: Can this formula help both the cold heavy low back and a heavy, damp-feeling body?
Yes. Cold-Damp generated by a weak Spleen first encumbers the flesh (body heaviness) and then settles in the lumbar region (cold as if sitting in water). Warming the Middle and leaching Dampness addresses both the systemic heaviness and the local “Kidney fixation” when they share this pattern.
Q10: What lifestyle advice supports the use of Gan Jiang Ling Zhu Tang?
Keeping the low back dry and warm, avoiding sitting on cold or damp surfaces, eating warm cooked food rather than raw-cold meals, and seeking medical review for numbness, saddle anesthesia, or progressive weakness all support correct use. This formula treats a Cold-Damp pattern; it is not a generic painkiller for every backache.

General Questions

How do I choose the right formula?
TCM formulas are traditionally selected according to individual pattern differentiation rather than by symptom alone. If you're not sure which formula fits your presentation, take our AI Assessment below for a personalized starting point, then confirm with a qualified TCM practitioner.
What are concentrated herbal granules?
Concentrated herbal granules are made by decocting raw herbs, then extracting and concentrating the resulting liquid into a fine granule or powder form. This preserves the same active compounds as a traditional decoction while making the herbs far easier to store, measure, and prepare.
How should I take these products?
Dissolve the recommended amount of granules in hot water, stir until fully dissolved, and drink while warm — following the dosage and frequency advised by your TCM practitioner or as stated on the product packaging.
Are concentrated herbal granules equivalent to traditional decoctions?
Concentrated granules are produced from the same herbs and processed to retain their active compounds, so they are traditionally regarded as a convenient alternative to decoctions rather than a different remedy. Some practitioners note subtle differences in strength or absorption between the two forms, so your TCM practitioner may adjust dosage accordingly.
Are your products authentic?
Yes. HJMEDICAL sources its concentrated granules exclusively from established, reputable manufacturers such as Nong's and Hoi Tin, both long-standing names in the TCM granules industry, with GMP compliance stated directly on their packaging.
Are HJMEDICAL products manufactured under GMP standards?
HJMEDICAL sources its concentrated granules from established, reputable manufacturers such as Nong's and Hoi Tin, both long-standing names in the TCM granules industry. GMP compliance for these products is stated directly on their packaging.
Do you ship internationally?
Yes — we ship worldwide! Every order goes out via Hong Kong Post, and your exact shipping cost and estimated delivery time for your address are calculated and shown right at checkout, so there are never any surprises. We also offer free shipping once your order reaches our free-shipping threshold, so it's easy to stock up on your favorite formulas and save.
Can I take more than one formula at the same time?
Some formulas are traditionally combined, while others overlap or counteract each other. We recommend checking with a qualified TCM practitioner before combining formulas, especially if you are already taking other medication.
Are these products suitable during pregnancy or breastfeeding?
Some TCM formulas are not suitable during pregnancy or breastfeeding. Please consult a qualified TCM practitioner or your doctor before use if you are pregnant, trying to conceive, or nursing.
Do these products replace medical treatment?
No. These products are traditional herbal supplements intended to support wellbeing according to TCM principles — they are not a replacement for professional medical diagnosis or treatment. Please consult a qualified TCM practitioner or licensed healthcare provider before starting, stopping, or combining any treatment, especially if you have a chronic condition.
Medical Disclaimer

For general TCM education only — not medical advice. Consult a qualified TCM practitioner or licensed healthcare provider before use, especially if pregnant, nursing, on medication, or managing a chronic condition.

Not sure which formula is right for you?

Take the AI Assessment

最新文章

Login

Forgot your password?

Don't have an account yet?
Create account

Gan Jiang Ling Zhu Tang: Classic TCM Formula for Cold-Damp in the Middle, Heavy Body & Lower Back Pain