Dampness-Draining Formulas

苓桂术甘汤 · Líng Guì Zhú Gān Tāng

Ling Gui Zhu Gan Tang

A classical formula for Spleen Yang deficiency with phlegm-fluids, presenting with dizziness, palpitations, shortness of breath and a white slippery tongue coating.

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Last reviewed August 2026

Formula CategoryDampness-Draining Formulas

Primary PatternDampness

Primary FunctionWarm Yang, transform phlegm-fluids, strengthen Spleen

Primary Therapeutic PrincipleWarm the Middle, transform thin mucus and support Spleen transportation

Main HerbsPoria / Hoelen · Cinnamon Twig · White Atractylodes Rhizome · Honey-fried Licorice

Classical SourceShang Han Lun / Jin Gui Yao Lue (Zhang Zhongjing)

Why This Formula?

Traditionally selected for thin mucus with dizziness and palpitations from Middle Yang weakness — warming and transforming rather than pure diuresis or wind-extinguishing.

Overview

What Is Ling Gui Zhu Gan Tang?

1. The Origin and Background

Ling Gui Zhu Gan Tang (苓桂术甘汤), or Poria, Cinnamon Twig, Atractylodes and Licorice Decoction, is a classical formula from Zhang Zhongjing’s Shang Han Lun and Jin Gui Yao Lue. It belongs to the category of formulas that warm Yang, transform Phlegm-Fluids, and strengthen the Spleen.

This formula addresses Spleen Yang deficiency (or Middle Burner Yang insufficiency) leading to the retention of thin Phlegm-Fluids (Tan Yin). Typical signs include fullness or oppression in the chest and hypochondrium, dizziness or vertigo (especially upon standing), palpitations, shortness of breath, cough with thin watery sputum, possible mild edema, a pale tongue with white slippery coating, and a wiry or slippery pulse.

Combining Fu Ling as the chief herb to strengthen the Spleen, drain Dampness, and transform Phlegm-Fluids, Gui Zhi to warm Yang and promote the transformation of Qi, Bai Zhu to tonify the Spleen and dry Dampness, and Gan Cao to harmonize and support the Middle, Ling Gui Zhu Gan Tang effectively warms Yang, resolves retained fluids, and restores the Spleen’s ability to transform and transport.

This formula is highly versatile and is used to treat a variety of modern medical conditions, provided they stem from the root issue of a "cold core" (Yang deficiency) and trapped fluids.

Here is how it is applied across different systems in the body:

2. Cardiovascular System Diseases

It is commonly used to manage conditions like coronary heart disease and arrhythmias.

Target Symptoms: It is highly effective for patients experiencing palpitations, chest pressure, chest pain, and shortness of breath alongside signs of fluid retention (such as a white, greasy tongue coating).
Mechanism: By warming the internal energy and dissolving trapped fluids, it clears blockages and brings lasting relief to the heart and chest area.

3. Respiratory System Diseases

This formula is excellent for the recovery and maintenance phases of chronic bronchitis and bronchial asthma.

Target Symptoms: It is specifically suited for patients dealing with lingering coughs, excessive phlegm, shortness of breath, and chronic fatigue due to trapped cold fluids.
Mechanism: By warming the core and strengthening the Spleen to process out phlegm, it boosts the body's natural resistance and helps prevent future respiratory flare-ups.

4. Digestive System Diseases

It provides great relief for digestive issues caused by a "cold and deficient" digestive system that is bogged down by water retention.

Target Symptoms: It is ideal if you are experiencing stomach bloating, nausea, vomiting, loss of appetite, or loose stools.
Mechanism: The formula works by warming and strengthening the Spleen. It dries up excess dampness, settles the stomach, and effectively restores healthy digestive function.

5. Nervous System Diseases

In TCM, severe dizziness and vertigo are often caused by trapped fluids rising up and "clouding" the head. This formula is a classic, go-to treatment for these conditions.

Target Symptoms: It treats spinning sensations, severe dizziness, and associated nausea caused by this internal fluid imbalance.
Mechanism: The formula warms the core and clears out the cloudy fluids, allowing clear, healthy energy to rise to the head, which resolves the vertigo right at its source.

How It Works

Herb Composition (Sovereign / Minister / Assistant / Envoy)

Think of this herbal formula as a well-organized sports team. Each herb has a specific job to do to get your body back in balance.

1. Fu Ling (The King)

Role in the Formula: The "King" (The absolute MVP and leader of the team).
What it is: Poria mushroom.
What it does: It works like a sponge to soak up excess water and flush it out of your system through urination.
Why it’s important: Since the main problem we are treating is trapped water and dampness, Fu Ling takes the lead. It strengthens your digestive system and clears out the "water logging," making you feel lighter and less bloated.

2. Gui Zhi (The Minister)

Role in the Formula: The "Minister" (The King's trusted right-hand man).
What it is: Cinnamon Twig.
What it does: It acts like a little internal heater for your body. It warms up your core energy (Yang) to help vaporize and move stagnant fluids around.
Why it’s important: Water can't move well if your body is cold and sluggish. Gui Zhi brings the necessary warmth to "melt" away that cold water, teaming up perfectly with the King to get your metabolism flowing again.

3. Bai Zhu (The Assistant)

Role in the Formula: The "Assistant" (The hardworking support player).
What it is: White Atractylodes Rhizome.
What it does: It focuses heavily on your spleen and digestive system, acting like a powerful dehumidifier to dry up stubborn, lingering dampness.
Why it’s important: While the King and Minister are busy flushing water out, Bai Zhu works behind the scenes to reinforce your digestive strength. This ensures your body actually stops producing new, excess dampness in the first place.

4. Zhi Gan Cao (The Courier)

Role in the Formula: The "Courier" (The friendly peacemaker and guide).
What it is: Honey-fried Licorice Root.
What it does: It harmonizes all the different herbs so they play nicely together, ensuring the overall treatment isn't too harsh or shocking to your system.
Why it’s important: It gives your stomach a gentle energy boost and naturally sweetens the tea, making it much easier to drink. It ties the whole team together so your recovery is smooth and comfortable.

Symptoms Traditionally Associated

Clinical Presentation in TCM

1. The Root Cause (Pathogenesis)

The main issue this formula targets is a lack of "Middle Yang" (your core digestive warmth and energy), which leads to trapped phlegm and cold fluids inside the body.

The Body's Engine: In Chinese medicine, your spleen and stomach are the foundation of your health—they are the engine that creates energy and blood.
The Problem: If this engine gets too cold and weak (Yang deficiency), it stops processing fluids properly. Instead of moving through your system, water pools together and turns into stubborn dampness or phlegm.
How It Makes You Feel:
- If this trapped fluid blocks clear, fresh energy from reaching your head, you experience dizziness.
- If the fluid backs up and intimidates your heart, you feel palpitations.
- If the fluid rebels upward into your respiratory system, it causes fullness and pressure in the chest and ribs, coughing, and shortness of breath.

2. How It Works (Efficacy)

Because the root cause is a cold, sluggish digestive system trapping water, the formula works by doing two main things:

Warming the Core: It acts like a gentle internal heater, restoring your core Yang energy and waking up your digestive system.
Flushing the Fluids: By getting the spleen back online and working at full capacity, it helps your body naturally process, vaporize, and eliminate those lingering cold fluids.

3. What It Treats (Primary Indications)

This formula is the go-to remedy for anyone suffering from fluid retention caused by a weak, cold digestive system.

Key Symptoms: A feeling of pressure or fullness in the chest and ribs, dizziness, heart palpitations, and a cough accompanied by shortness of breath.
Signs a Practitioner Looks For: A tongue with a white, wet, or slippery coating, and a pulse that feels tight or "slippery" (indicating trapped fluid).
Modern Clinical Uses: As long as the root cause matches (cold fluid trapped by weak digestion), this formula is highly effective in treating modern medical conditions, including:
- Chronic bronchitis
- Bronchial asthma
- Cardiogenic edema (fluid retention or swelling related to heart issues)
- Chronic vertigo and dizziness syndromes

Formula Analysis

The Mechanism in Classical Theory

By looking at how these herbs interact, we can see the genius behind this formula's design. They work together through three main strategies:

1. Warming the Core to Resolve Fluids

The "Warm and Drain" Dynamic: Gui Zhi is a superstar at warming up your body's energy channels, while Fu Ling focuses on draining out dampness. Together, one warms and the other drains, perfectly melting away trapped cold fluids.
Building Core Heat: Bai Zhu steps in to dry out the dampness and rebuild your internal warmth.
Energy Boost: Zhi Gan Cao boosts your overall energy and digestion. When combined, this team ensures your body has enough "fire" to process and vaporize stubborn water weight.

2. Strengthening the Spleen to Flush Out Water

The Tag Team: Fu Ling and Bai Zhu are the ultimate duo for fixing your digestive system (the Spleen) and managing water retention.
Flushing Downward: Fu Ling drives the action downward, pushing excess water out of your system through urination.
Drying and Preventing: At the same time, Bai Zhu acts like a dehumidifier, drying up existing dampness and strengthening your digestion so water doesn't start pooling up again.
Metabolism Boost: With the added warming power of Gui Zhi to speed up your water metabolism, this combination thoroughly eliminates trapped fluids from the root.

3. Harmonizing the Team

The Peacemaker: Zhi Gan Cao acts as the great balancer of the entire formula.
Softening the Edges: It gently smooths out the strong, active effects of Gui Zhi, Fu Ling, and Bai Zhu. This ensures the treatment is gentle on your system and doesn't overwhelm or exhaust your body's natural defenses.
Maximizing Results: By coordinating how all the ingredients interact, it makes sure the herbs work together flawlessly as a unified team for the safest and most effective healing process.

How This Formula Compares

Clinical Comparison Table

Compare	Ling Gui Zhu Gan Tang	Wu Ling San	Zhen Wu Tang	Ban Xia Bai Zhu Tian Ma Tang
Primary Function	Warm Yang, transform phlegm-fluids, strengthen Spleen	Promote urination, drain Dampness, warm Yang	Warm Yang, promote urination, transform water	Dry damp, resolve phlegm, calm Liver, extinguish wind
Formula Category	Dampness-Draining Formulas	Dampness-Draining Formulas	Yang-Tonifying Formulas	Phlegm-Resolving Formulas
Typical TCM Pattern	Dampness	Dampness	Yang Deficiency	Phlegm-Dampness
Main Conditions	Dizziness & Vertigo, Bloating, Excessive Mucus, Palpitations	Edema, Frequent Urination, Damp Constitution	Edema, Abdominal Pain, Cold Limbs, Diarrhea, Palpitations	Dizziness & Vertigo, Headache, Nausea
Main Herbs	Poria / Hoelen · Cinnamon Twig · White Atractylodes Rhizome · Honey-fried Licorice	Alisma Rhizome · Poria / Hoelen · Polyporus · White Atractylodes Rhizome · Cinnamon Twig	Prepared Aconite Accessory Root · White Atractylodes Rhizome · Poria / Hoelen · White Peony Root · Fresh Ginger	Pinellia Rhizome · Gastrodia Rhizome · Poria / Hoelen · Red Tangerine Peel · White Atractylodes Rhizome · Licorice Root
Classical Source	Shang Han Lun / Jin Gui Yao Lue (Zhang Zhongjing)	Shang Han Lun (Zhang Zhongjing, Eastern Han)	Shang Han Lun (Zhang Zhongjing, Eastern Han)	Li Dongyuan school / classical

How to tell them apart

Ling Gui Zhu Gan Tang warms and transforms phlegm-fluids. Wu Ling San promotes urination more strongly. Zhen Wu Tang warms Kidney Yang for oedema. Ban Xia Bai Zhu Tian Ma Tang transforms phlegm and extinguishes wind for dizziness.

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

Clinical Modifications

Clinical Modifications for Ling Gui Zhu Gan Tang

1. When Accompanied by "Exterior" Symptoms (Cold or Flu-like Signs)

The Scenario: Sometimes, a patient will experience surface-level sickness alongside their internal fluid issues, showing symptoms like chills, fever, headaches, or body aches.
The Solution: We can add herbs designed to push out external pathogens, such as Ma Huang and Gui Zhi, to the base formula of Ling Gui Zhu Gan Tang. This gives the formula an extra push to clear the surface-level sickness.
Dosage Adjustments: The amount used depends on the patient's constitution and how severe the sickness is:
- For mild symptoms, we use a smaller dose of Ma Huang and Gui Zhi.
- For severe symptoms, we increase the dose and may suggest taking the formula for a longer period.

2. When Dealing with a Severe Cough

The Scenario: If a persistent or heavy cough is the most obvious and bothersome symptom.
The Solution: We can add specific herbs known for stopping coughs and breaking down phlegm:
- Xing Ren: Helps direct lung energy downward to calm coughing and ease wheezing.
- Jie Geng: Opens up the lungs, soothes the throat, and helps expel stubborn phlegm.
- Zi Wan: Moistens the lungs, directs energy downward, and actively stops coughing.
The Result: When paired with Ling Gui Zhu Gan Tang, these additions provide a powerful boost to relieve coughing and clear out mucus effectively.

3. When Swelling (Edema) is Prominent

The Scenario: If the patient is experiencing significant water retention or visible swelling in the body.
The Solution: We introduce strong water-draining herbs to help the body flush out the excess fluid quickly:
- Ze Xie: Excellent for draining dampness and promoting fluid metabolism.
- Zhu Ling: Offers a very strong, direct water-draining effect.
- Che Qian Zi: Helps clear out heat while promoting healthy, easy urination.
The Result: These herbs team up with the Fu Ling and Bai Zhu already present in the base formula. This creates a highly effective synergy that greatly enhances the formula's ability to reduce swelling and eliminate excess water.

Modern Research

What the Science Suggests

1. Pharmacological Research

Modern pharmacological studies reveal that Ling Gui Zhu Gan Tang has profound effects on several key body systems:

Cardiovascular System: It helps regulate heart function by widening coronary arteries and increasing blood flow. This improves the oxygen supply to the heart muscle, helps regulate irregular heartbeats (arrhythmias), and lowers the heart's overall oxygen demand.
Digestive System: It actively promotes healthy bowel movements, boosts overall digestion, and improves blood circulation in the stomach lining, making it easier for the body to process and absorb nutrients.
Immune System & Inflammation: The formula also offers anti-inflammatory and anti-allergic benefits. It helps regulate the immune system, boosting the body's natural resistance and reducing inflammatory responses.

2. Clinical Efficacy

Extensive clinical research confirms the formula's effectiveness in treating a wide range of conditions:

Cardiovascular Diseases: It reliably improves patient symptoms, strengthens overall heart function, and helps lower the risk of severe cardiovascular events.
Respiratory Diseases: It significantly reduces the frequency of flare-ups for conditions like chronic bronchitis and asthma, providing lasting symptom relief and a better quality of life.
Digestive Diseases: It is highly effective at resolving stomach bloating, nausea, and vomiting, actively helping the gastrointestinal system return to normal, healthy function.
Neurological Diseases: For conditions like severe vertigo, the formula has shown excellent results in stopping spinning sensations and dizziness, greatly improving daily living for patients.

3. Advancements in Dosage Forms

With the rapid development of modern technology, how we take Ling Gui Zhu Gan Tang continues to evolve and improve:

New Convenient Forms: Moving beyond traditional boiled teas (decoctions) and modern concentrated granules, this formula is now widely available in pills, capsules, and tablets. These new formats are highly convenient to take and easy to store, meeting the fast-paced needs of modern patients.
Enhanced Quality: Modern manufacturing has also optimized the extraction process and quality control. This ensures that the final product is more stable and consistently effective, paving the way for its wider use in modern clinics worldwide.

As a classic Traditional Chinese Medicine formula, Ling Gui Zhu Gan Tang has been passed down for over a thousand years and remains a powerful, reliable tool in modern clinical practice. By exploring its history, ingredients, core mechanisms, and modern applications, we hope more people can understand and benefit from this incredible formula, helping to preserve and share the profound wisdom of TCM with the world.

Safety

Safety Considerations

1. Dietary Restrictions

Avoid raw, cold, greasy, and spicy foods, which harm spleen yang and worsen fluid retention. Stick to a light, easily digestible diet like porridge and vegetables to aid recovery.

2. Constitution Contraindications

Unsuitable for yin-deficiency patterns with dry mouth and a red, uncoated tongue, as this warm formula worsens dryness. Pregnant women must consult a doctor before use.

3. Medication Notes

Take as directed and track your symptoms. Stop the medication and consult a physician immediately if any discomfort occurs, such as nausea, vomiting, abdominal pain, or diarrhea.

Available Products

Where to Get It

Nong's Ling Gui Zhu Gan Cao Tang Extract Granules

HJMEDICAL Nong's Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes & Licorice Decoction) 5:1 Concentrated Granules $46.97

HJMEDICAL Hoi Tin Wu Ling San (Five-Ingredient Powder with Poria) 5:1 Concentrated Granules $22.15

HJMEDICAL Nong's Wu Ling San (Poria Five Powder) 5:1 Concentrated Granules $51.25

HJMEDICAL Hoi Tin Zhen Wu Tang (True Warrior Decoction) 5:1 Concentrated Granules $26.32

HJMEDICAL Nong's Zhen Wu Tang (True Warrior Decoction) 5:1 Concentrated Granules $51.25

FAQ

Questions About Ling Gui Zhu Gan Tang

Q1: What are the actions of Ling Gui Zhu Gan Tang?

Ling Gui Zhu Gan Tang has the actions of warming Yang, transforming Phlegm-Fluids (Tan Yin), strengthening the Spleen, and draining Dampness. It is the classic formula for cold thin mucus or fluid retention arising from Middle Yang (Spleen Yang) deficiency.

Q2: Which modern diseases is Ling Gui Zhu Gan Tang suited to?

Modern TCM clinical practice commonly applies it to individuals whose pattern differentiation falls within Spleen Yang deficiency with Phlegm-Fluid retention, including Meniere’s disease or peripheral vertigo of fluid type, chronic bronchitis with thin watery sputum, certain presentations of cardiac edema or palpitations related to fluid retention, functional dyspepsia with epigastric splashing sounds, and selected cases of dizziness or fullness due to internal fluids.

Q3: Is Ling Gui Zhu Gan Tang suitable for improving dizziness, chest fullness, and palpitations with thin watery sputum?

For presentations of fullness or distention in the chest and hypochondrium (or epigastrium), dizziness or vertigo, palpitations, shortness of breath, cough with thin clear or watery sputum, a white slippery tongue coating, and a wiry or slippery pulse — in those whose pattern differentiation confirms Phlegm-Fluids due to Middle Yang deficiency — TCM commonly applies Ling Gui Zhu Gan Tang as an adjunct. It cannot replace standard medical treatment.

Q4: Who should not take Ling Gui Zhu Gan Tang?

Those with Yin deficiency and Heat (dry mouth, red tongue with little coating, rapid pulse), Phlegm-Heat patterns (yellow sticky sputum, thirst), or Damp-Heat are generally not suitable. The formula is warming and drying; it can worsen Heat or further deplete Yin. Caution is advised in pregnancy. Use should be assessed by a qualified TCM physician.

Q5: Why is Fu Ling the chief herb in this formula?

Fu Ling strengthens the Spleen, drains Dampness, and promotes the transformation of fluids. In the pattern of Middle Yang deficiency, the Spleen fails to move water, which accumulates as Phlegm-Fluids. Fu Ling directly addresses this by supporting the Spleen’s transport function and leaching out the retained fluids, making it the foundational herb of the prescription.

Q6: Can Ling Gui Zhu Gan Tang help both the dizziness from fluids and the underlying Spleen weakness?

Yes. Gui Zhi warms Yang and promotes Qi transformation so fluids can move; Bai Zhu and Fu Ling strengthen the Spleen and drain Dampness; Gan Cao harmonizes and supports the Middle. By warming the Yang that drives fluid metabolism and simultaneously tonifying the Spleen, the formula treats both the branch (retained fluids causing dizziness and fullness) and the root (Spleen Yang deficiency).

Q7: What are the main ingredients of Ling Gui Zhu Gan Tang?

The classical four-herb formula consists of Fu Ling (Poria) as the chief to strengthen the Spleen and drain Dampness; Gui Zhi (Cinnamon Twig) to warm Yang and transform Qi so fluids can move; Bai Zhu (Atractylodes) to fortify the Spleen and dry Dampness; and Zhi Gan Cao (honey-fried Licorice) to tonify the Middle and harmonize the formula.

Q8: Is Ling Gui Zhu Gan Tang suitable for long-term use?

It is generally used until the fluid retention and related symptoms (dizziness, fullness, thin sputum) resolve. Once the Phlegm-Fluids are transformed and the Middle Yang is more stable, the formula is typically stopped or modified. Continued long-term use of its warming and draining action without reassessment can potentially deplete fluids or over-dry the system.

Q9: How does Ling Gui Zhu Gan Tang differ from stronger diuretic or pure Spleen-tonifying formulas?

Strong pure diuretics drain water without addressing the Yang deficiency that allows fluids to accumulate. Simple Spleen tonics may strengthen transport but lack the warming and fluid-transforming power of Gui Zhi. Ling Gui Zhu Gan Tang uniquely combines gentle Yang warming with Spleen strengthening and fluid draining, specifically for cold thin mucus due to Middle Yang deficiency.

Q10: What lifestyle advice supports the use of Ling Gui Zhu Gan Tang?

Avoiding cold and raw foods, keeping the abdomen warm, eating regular easily digestible meals, moderating fluids if retention is marked, and gentle movement to support Spleen transport help the formula transform fluids and restore Middle Yang. Professional evaluation remains important for vertigo, edema, or chronic respiratory or cardiac symptoms.

FAQ

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.

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