Long Dan Xie Gan Tang: A Simple Guide to a Liver-Clearing, Heat-Soothing Herbal Formula

Health Lab
Dec 23, 2024
6 min read

Updated: May 5

Long Dan Xie Gan Tang, or "Gentian Liver-Draining Decoction," is a classic Chinese herbal formula perfect for tackling the heat and humidity of summer.

Renowned for clearing liver and gallbladder fire and draining damp-heat, it soothes symptoms like red eyes, headaches, and irritability caused by excess liver heat and internal dampness. This potent blend restores balance with a cooling, detoxifying effect.

What’s in Long Dan Xie Gan Tang?

Long Dan Xie Gan Tang combines ten herbs to cool and clear the liver:

Gentian (Long Dan Cao): Bitter and cold, it powerfully clears liver fire and reduces heat.
Skullcap (Huang Qin): Bitter and cold, it detoxifies and dries dampness to cool inflammation.
Gardenia (Zhi Zi): Clears heat and reduces dampness, aiding liver and gallbladder function.
Alisma (Ze Xie): Promotes urination to drain damp-heat from the body.
Akebia Vine (Mu Tong): Clears heat and enhances urine flow to expel dampness.
Plantain Seed (Che Qian Zi): Guides damp-heat out through urination.
Angelica Root (Dang Gui): Nourishes blood and yin to protect against drying effects.
Rehmannia (Sheng Di Huang): Cools blood and supports yin to balance bitter herbs.
Bupleurum (Chai Hu): Soothes liver qi and directs herbs to the liver meridian.
Licorice (Gan Cao): Harmonizes the formula and protects the stomach.

Long Dan Xie Gan Tang /龍膽瀉肝湯, 5:1 Concentrated Granules

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How Long Dan Xie Gan Tang Works

Long Dan Xie Gan Tang targets excess liver fire and damp-heat, which cause:

Headaches, red or painful eyes, or migraines
Irritability, tinnitus, or bitter taste in the mouth
Itchy genitals, yellow urine, or painful urination
Bright red tongue, yellow coating, rapid or stringy pulse

Its actions include:

Clearing Liver Fire: Gentian, skullcap, and gardenia cool liver and gallbladder heat, easing red eyes and anger.
Draining Damp-Heat: Alisma, akebia, and plantain expel dampness via urine, relieving itching or urinary issues.
Nourishing Yin and Blood: Angelica and rehmannia prevent damage from cold herbs.
Soothing Liver Qi: Bupleurum ensures smooth qi flow for better liver function.

Modern Uses

Long Dan Xie Gan Tang is used for:

Urogenital Issues: Treats urethritis, prostatitis, or gonorrhea.
Digestive Disorders: Helps with acute cholecystitis or hepatitis.
Eye, Ear, and Throat: Eases conjunctivitis, otitis media, or sore throat.
Skin Conditions: Soothes herpes zoster or eczema.
Other Conditions: Manages hypertension, migraines, or glaucoma.

Research shows it boosts immunity, reduces inflammation, promotes urination, and fights bacteria.

Long Dan Xie Gan Tang /龍膽瀉肝湯, 5:1 Concentrated Granules

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Dietary and Lifestyle Support

To enhance Long Dan Xie Gan Tang’s effects:

Mung Bean Soup: Clears heat and promotes detoxification.
Barley Porridge: Strengthens the spleen and drains dampness.
Bitter Melon Stir-Fry: Cools the liver and reduces heat.
Chrysanthemum Tea: Soothes the liver and clears internal heat.
Stay Cool: Avoid spicy or greasy foods to prevent heat buildup.

Things to Keep in Mind

Short-Term Use: As an “attacking” formula, avoid long-term use to prevent spleen damage.
Weak Spleen/Stomach: Not for those with cold digestion or yin deficiency with yang excess.
Professional Guidance: Consult a TCM practitioner for safe dosing and use.

Why Long Dan Xie Gan Tang Matters

Long Dan Xie Gan Tang is a TCM powerhouse, blending gentian, skullcap, and bupleurum to cool liver fire and clear damp-heat. Perfect for summer flare-ups, it soothes everything from migraines to urinary issues. With cooling foods and expert guidance, this formula restores balance and calm, proving the enduring wisdom of Chinese herbal medicine.

Chinese Name	龍膽瀉肝湯
Phonetic	Long Dan Xie Gan Tang
English Name	Gentian Liver-Draining Decoction
Classification	Heat-clearing formulas
Source	《Medical Formulas Collected and Analyzed》Yi Fang Ji Jie《醫方集解》
Combination	Gentianae Radix et Rhizoma (Long Dan Cao wine-fried) 6g, Scutellariae Radix (Huang Qin dry-fried) 9g, Gardeniae Fructus (Zhi Zi wine-fried) 9g, Alismatis Rhizoma (Ze Xie) 12g, Akebiae Caulis (Mu Tong) 6g, Plantaginis Semen (Che Qian Zi) 9g, Angelicae Sinensis Radix (Dang Gui wine-washed) 6g, Rehmanniae Radix (Sheng Di wine-fried) 12g, Bupleuri Radix (Chai Hu) 12g, Glycyrrhizae Radix et Rhizoma (Gan Cao) 6g
Method	Use water to decoct the medicinals. The formula could also be prepared as pills as well. Take one dose (6~9g) with warm water per day at two times.
Action	Clears and drains excessive fire of the liver and gallbladder, and clears damp-heat in the liver channel.
Indication	1. Flaming up of excessive fire of the liver and gallbladder, which manifests as headache and red eyes, pain in the rib-side, bitter taste in the mouth, deafness, swelling of the ears, a red tongue with a yellow coating, and a forceful wiry, rapid pulse. 2. Pouring downward of damp-heat in the liver channel, which manifests as vaginal swelling and itching, dampness or sweating at the exterior genitalia, painful urination with turbid urine, impotence, smelly yellow leukorrhea, a red tongue with a yellow greasy coating, and a slippery, wiry, rapid pulse.
Pathogenesis	This pattern includes the flaming up of excessive liver and gallbladder fire and the pouring downward of damp-heat in the liver channel. The foot jueyin liver channel goes around exterior genitalia, goes along the rib-side, connects with the eyes, and enters the top of the head. The foot shaoyang gallbladder channel starts at the inner canthus, goes around the ears, and enters the ears. From there, one branch enters the femoribus internus and goes around the exterior genitalia, and the other branch runs along the rib-side. The fire of the liver and gallbladder flames upward along the two channels which causes pain in the head, eyes, and ears; or deafness. Liver and gallbladder fire attacks the rib-side, which causes pain in rib-side and bitter taste in the mouth. Damp-heat in the liver channel pours downward along the channel, which causes vaginal swelling, itching, damp or sweat at the exterior genitalia, painful urination with turbid urine, impotence, and smelly yellow leukorrhea. A red tongue with a greasy yellow coating and a slippery, wiry rapid pulse are signs of intense fire and damp-heat. The characteristic features of this pattern pathogenesis are flaming up of excessive fire of the liver and gallbladder, pouring downward of damp-heat in the liver channel, and a disturbance of the qi movement. Therefore, the therapeutic method is to clear and drain excessive fire of the liver and gallbladder, clear damp-heat in the liver channel, and free the qi movement.
Clarification	If Long Dan Xie Gan Tang is indicated for the flaming up of excessive fire of the liver and gallbladder, why are nourishing and moistening medicinals like dang gui and sheng di included? There are two reasons for using dang gui and sheng di: There are many bitter-dry medicinals in the formula that can damage liver yin. Since the liver is yin in form but yang in function, yin and blood are essential for the liver. Dang gui and sheng di are included to nourish yin and blood to supplement the liver’s form, and prevent damage to liver yin by the bitter-dry medicinals.
Application	1. Essential pattern differentiation Long Dan Xie Gan Tang is a commonly used formula for treating the flaming up of excessive fire of the liver and gallbladder, or the pouring downward of damp-heat in the liver channel. This clinical pattern is marked by bitter taste in the mouth, dark urine, red tongue with yellow coating, or red tongue with greasy, yellow coating, and a wiry, rapid or slippery pulse 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of flaming up of excessive fire of the liver and gallbladder: resistant brow ache, eczema in the head, hypertension, acute conjunctivitis, iridocyclitis, external auditory boils, and rhinitis; when the patient shows signs of damp-heat in the liver and gallbladder: acute icteric hepatitis, acute cholecystitis, acute posteriorganglionitis, acute mastitis, impotence; or when the patient shows signs of pouring downward of damp-heat in the liver channel: urinary tract inflammation, reproductive system inflammation, acute pyelonephritis, acute cystitis, urethritis, aidoiitis, orchitis, inguinal lymphadenitis, acute pelvic inflammatory disease, and Behcet's disease. 3. Cautions and contraindications Do not use the formula in patients with deficiency-cold of the spleen and stomach, as well as those with yin deficiency and yang hyperactivity, because there are many bitter-cold medicinals that can damage the spleen and stomach.
Additonal formulae	1. Xie Qing Wan (Green-Draining Pill, 瀉青丸) [Source]《Key to Diagnosis and Treatment of Children’s Diseases》Xiao er Yao Zheng Zhi Jue《小兒藥證直訣》 [Ingredients] Dang gui 3g, long dan cao 3g, chuan xiong 3g, zhi zi 3g, da huang 3g, qiang huo 3g, fang feng 3g [Preparation and Administration] Grind these medicinals in to powder and form into pills the size of a qian shi (1.5g) using honey. Take 0.5-1 pills once with the decoction of zhu ye and sugar. [Actions] Clears the liver fire and drains fire. [Applicable Patterns] Fire constraint in the liver channel. Symptoms include: red swelling and painful eyes, vexation and irascibility, sleeplessness, dark urine and constipation, a surging excess pulse, acute infantile convulsion in children and convulsion caused by intense heat. 2. Dang Gui Long Hui Wan (Chinese Angelica, Chinese Gentian and Aloe Pill, 當歸龍薈丸) [Source]《Formulas from the Discussion Illuminating the Yellow Emperor's Basic Questions》Huang Di Su Wen Xuan Ming Lun Fang《黃帝素問宣明論方》 [Ingredients] Dang gui 1 liang (30g), long dan cao 1 liang (30g), zhi zi 1 liang (30g), huang lian 1 liang (30g), huang bai 1 liang (30g), huang qin 1 liang (30g), lu hui 5 qian (15g), qing dai 5 qian (15g), da huang 5 qian (15g) [Preparation and Administration] Grind these medicinals in to powder and form into pills the size of a bean using honey. Take 20 pills once with the decoction of sheng jiang. [Actions] Clears excessive fire from the liver and gallbladder. [Applicable Patterns] Excessive fire in the liver and gallbladder. Symptoms include: dizziness, restlessness, delirious speech and mania, constipation, and difficult urination with dark urine.