Liang Ge San
Classical TCM Formula Profile
Part of the HJMEDICAL TCM Discovery Center
凉膈散 · Liáng Gé Sàn
A classical formula for heat accumulating in the Upper and Middle Jiao (diaphragm region), with sore throat, oral sores, irritability, constipation and a rapid pulse.
Read the complete guide →Quick Facts
- Formula Category
- Heat-Clearing Formulas
- Primary Pattern
- Stomach Heat
- Primary Function
- Clear upper heat, drain downward, cool the diaphragm
- Primary Therapeutic Principle
- Clear heat from the Upper and Middle Jiao and guide it out through the bowels
- Classical Source
- Tai Ping Hui Min He Ji Ju Fang (Song dynasty)
- Available as Granules
- Yes
Formula Overview
A classical formula for heat accumulating in the Upper and Middle Jiao (diaphragm region), with sore throat, oral sores, irritability, constipation and a rapid pulse.
Therapeutic Principle
Traditionally selected when upper-body heat signs coexist with constipation — clearing above and draining below, rather than pure fire-draining or pure Yangming purge.
Composition: Sovereign, Minister, Assistant, Envoy
Every herb in the formula, grouped by the job it does in the classical hierarchy.
君SovereignTreats the main pattern
臣MinisterReinforces the sovereign
佐AssistantTreats accompanying patterns
大黃Da Huang9g
Rhubarb Root and Rhizome- drains fire
- promotes defecation
- and purges as a way of clearing heat
芒硝Mang Xiao9g
Mirabilite / Glauber's Salt- clears heat from the head and eyes
- and disinhibits the throat
薄荷Bo He6g
Mentha / Peppermint- clears heat from the head and eyes
- and disinhibits the throat
Classical Composition
- Rhei Radix et Rhizoma (Da Huang) 20 liang (600g)
- Natrii Sulfas (Po Xiao) 20 liang (600g)
- Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gan Cao) 20 liang (600g)
- Gardeniae Fructus (Zhi Zi) 10 liang (300g)
- Menthae Haplocalycis Herba (Bo He) 10 liang (300g)
- Scutellariae Radix (Huang Qin) 10 liang (300g)
- Forsythiae Fructus (Lian Qiao) 2.5 jin (1250g)
Dosages follow the classical source and are shown for study, not as a prescription.
Related Conditions
Related Health Topics
Actions
- Drains fire
- promotes defecation
- clears heat from the upper
- and discharges heat through the purgative method.
Indications
- This formula is indicated for the heat that has been generated from the constraint of pathogens in the upper jiao and middle jiao.
- The symptoms are vexing heat in the chest and diaphragm, red complexion, parched lips, vexation and agitation, thirst, mouth and tongue sores, restless sleep, delirium, pharyngeal pain, spitting of blood, nosebleed, constipation, dark urine, and incomplete defecation.
Tongue & pulseThe tongue is red with a yellow coating, and the pulse is slippery and rapid.
Traditional Pathogenesis
Cause & mechanism
- This is a pattern of zang-fu organ heat within the chest and diaphragm, which mainly manifests in the upper jiao and middle jiao.
- The heat burns in the chest and diaphragm to cause a vexing heat.
- The heat consumes fluids, which causes thirst, dry throat, and parched lips.
- The heat harasses the heart spirit, causing vexation and agitation, unquiet sleep, or delirium.
- Dryness-heat binds internally, causing constipation and dark urine.
- The characteristic feature of this pattern’s pathogenesis is the accumulation of zang-fu heat, which rests in the chest and diaphragm, damages the heart and stomach, transforms into fire, and then flames upward.
Clinical presentation
- Fire flames upward, according to nature, producing a red complexion, red eyes, mouth and tongue sores, pharyngeal pain, spitting of blood, and nosebleed.
- The red tongue with yellow coating, as well as the slippery and rapid pulse, reflects the intense interior heat.
Treatment strategy
- The treatment principle is to clear heat from the Upper and Middle Jiao and guide it out through the bowels.
How does this formula compare?
Clinical Perspective
Liang Ge San clears upper heat and drains downward. Huang Lian Jie Du Tang pure-drains fire without purge. Da Cheng Qi Tang is a pure Yangming purge. Pu Ji Xiao Du Yin focuses on head-face toxin.
Clinical Differentiation
- Liang Ge San is a commonly used formula applicable for the accumulated heat of zang-fu organs in the chest and diaphragm.
- This clinical pattern is marked by vexing heat in the chest and diaphragm, red complexion and parched lips, thirst, vexation, and agitation, red tongue with a yellow coating, and a rapid or slippery pulse.
Safety notes: Stop taking this formula once constipation is relieved. Otherwise, the spleen and stomach may be damaged. This formula should be taken with caution in pregnant or weak patients.
For educational reference only, based on traditional pattern differentiation — not a substitute for professional advice.
Frequently Asked Questions
What are the actions of Liang Ge San?
Liang Ge San has the actions of draining Fire, clearing Heat from the Upper and Middle Burners (especially the diaphragm area), unblocking the bowels, and resolving Toxicity. It clears Heat above while simultaneously draining it downward through the intestines — the classic strategy of “clearing the upper by draining the lower.”
Which modern diseases is Liang Ge San suited to?
Modern TCM clinical practice commonly applies it to individuals whose pattern differentiation falls within excess Heat in the Upper and Middle Burners, including acute pharyngitis, stomatitis or mouth sores, acute tonsillitis, certain biliary tract infections, and selected cases of acute jaundice-type hepatitis or other febrile conditions with constipation and Upper Burner Heat signs.
Is Liang Ge San suitable for improving facial redness, irritability, mouth sores, sore throat, and constipation?
For presentations of flushed face, dry or cracked lips, restlessness and heat sensation in the chest and diaphragm, thirst, mouth sores or tongue swelling, sore throat, constipation, dark urine, a red tongue with yellow coating, and a slippery rapid pulse — in those whose pattern differentiation confirms excess Heat accumulating in the Upper and Middle Burners — TCM commonly applies Liang Ge San as an adjunct. It cannot replace standard medical treatment.
Related Products
Nong's Liang Ge San (Cool the Diaphragm Powder) 5:1 Concentrated Granules
Han's Liang Ge San (Cooling the Diaphragm & Promoting Bowel Movement Formula) 5:1 Concentrated Granules
Related Articles
Liang Ge San: Classic TCM Formula for Heat in the Chest & Diaphragm, Irritability & Constipation
Huang Lian Jie Du Tang: Classic TCM Formula for Fire Toxin, High Fever & Damp-Heat
Da Cheng Qi Tang: Classic TCM Formula for Severe Constipation & Yangming Excess
Pu Ji Xiao Du Yin: Classic TCM Formula for Epidemic Heat Toxin, Swollen Face & Sore Throat
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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.