Wu Ling San: A Simple Guide to Relieving Water Retention and Edema
Health Lab- Feb 1
- 6 min read
Updated: May 2
Wu Ling San, also known as Five Substances Powder, is a time-tested Chinese herbal formula from the Treatise on Febrile Diseases. Renowned for its ability to clear excess water and dampness from the body, it’s a go-to remedy for issues like bloating, edema, and difficulty urinating.
In this article, we’ll explore its ingredients, benefits, uses, and modern applications in a clear, approachable way, along with dietary tips to boost its effects.
What’s in Wu Ling San?
This formula combines five herbs to promote water balance and support digestion:
Poria mushroom (9g): Drains dampness and supports the spleen.
Alisma root (15g): Promotes urination and reduces swelling.
Atractylodes rhizome (9g): Strengthens digestion and dries dampness.
Polyporus mushroom (9g): Enhances water elimination.
Cinnamon twig (6g): Warms the body and boosts circulation.
How to use it: Take as a powder (6–10g) mixed with warm water or brew as a tea. Drink with plenty of hot water to encourage slight sweating. Follow a practitioner’s guidance for dosing.
How the Herbs Work Together
In Chinese medicine, herbs are grouped as “monarch, minister, assistant, and envoy”:
Monarch: Cinnamon twig leads by warming the body and activating the bladder to process and eliminate water.
Ministers: Atractylodes rhizome and poria mushroom support by strengthening digestion and draining dampness, ensuring water doesn’t build up.
Assistants: Alisma root and polyporus mushroom enhance urination to clear excess water and reduce swelling.
Envoy: Poria mushroom (also an assistant) ties the formula together, promoting smooth water metabolism and spleen health.
This blend gently warms and moves water while supporting digestion, making it effective yet balanced.
What Does It Treat?
Wu Ling San targets “water retention” caused by poor bladder function or excess dampness. Common symptoms include:
Difficulty urinating or reduced urine output.
Bloating, edema, or swelling in the body.
Headaches with mild fever.
Thirst, but vomiting after drinking water.
Palpitations below the navel or dizziness.
Shortness of breath, cough, or diarrhea.
A white tongue coating and a floating or rapid pulse.
These signs reflect water and dampness buildup, which disrupts the body’s ability to circulate fluids, leading to swelling, digestive issues, or respiratory discomfort.
How It Works
The formula promotes urination to clear excess water, warms the body to improve fluid metabolism, and strengthens the spleen to prevent dampness buildup. By addressing both the root cause (poor water processing) and symptoms (edema and bloating), it restores balance and eases discomfort.
Modern Uses
Wu Ling San is widely used today for conditions linked to water retention and dampness. Research highlights its diuretic, anti-inflammatory, and protective effects on the liver, kidneys, and gut. Common applications include:
Kidney and urinary issues: Treats acute or chronic nephritis, urinary retention, cystitis, kidney stones, or prostatic hyperplasia.
Edema: Relieves swelling from liver cirrhosis, heart failure, or hypothyroidism.
Digestive disorders: Helps with acute enteritis, diarrhea, or gastrointestinal inflammation.
Eye conditions: Effective for glaucoma, optic disc edema, or central serous retinitis.
Other conditions: Manages hypertension, herpes zoster, chronic heart failure, or hydrocephalus.
Its versatility makes it a valuable tool in both traditional and modern medicine.
Boosting the Formula with Diet
Pairing Wu Ling San with water-draining foods can enhance its effects. Try these recipes:
Red Bean and Job’s Tears PorridgeIngredients: 50g red beans, 50g Job’s tears (coix seeds), 100g rice, water.Preparation: Wash ingredients, simmer with water until thick, and serve warm.Benefits: Red beans and Job’s tears reduce swelling and drain dampness.
Winter Melon SoupIngredients: 500g winter melon (peeled, seeded), 200g lean pork, 3 ginger slices, water.Preparation: Cut winter melon into cubes, slice pork, and simmer with ginger until tender.Benefits: Winter melon clears heat and promotes urination to relieve edema.
Other dietary tips:
Eat light, warm foods like barley, mung beans, or pumpkin to support digestion.
Avoid heavy, greasy, or cold foods that worsen dampness, like dairy or fried dishes.
Stay hydrated but avoid overdrinking to prevent water buildup.
Things to Keep in Mind
Wu Ling San is a potent diuretic, so use it carefully:
Avoid overuse to prevent side effects like dizziness, loss of appetite, or dehydration.
Don’t take long-term without combining with spleen-supporting herbs if you have a weak constitution.
Take as a powder with plenty of hot water or as a tea, but avoid overcooking the decoction.
Consult a practitioner to ensure it’s right for your condition.
Conclusion
Wu Ling San is a gentle yet effective Chinese herbal formula that clears excess water and dampness, relieving bloating, edema, and urinary issues. Its five herbs work together to promote urination, warm the body, and support digestion, making it ideal for kidney, digestive, or eye conditions.
Modern research confirms its wide-ranging benefits, from reducing swelling to managing hypertension. Pair it with foods like red bean porridge or winter melon soup for better results, and always use under professional guidance for safe, effective care.
Chinese Name | 五苓散 |
Phonetic | Wu Ling San |
English Name | Five Substances Powder with Poria |
Classification | Dampclearing formulas |
Source | 《Treatise on Cold Damage》Shang Han Lun《傷寒論》 |
Combination | Polyporus (Zhu Ling) 18 zhu (9g), Alismatis Rhizoma (Ze Xie) 1 liang and 6 zhu (15g), Atractylodis Macrocephalae Rhizoma (Bai Zhu) 18 zhu (9g), Poria (Fu Ling) 18 zhu (9g), Cinnamomi Ramulus (Gui Zhi) 0.5 liang (6g) |
Method | Grind the ingredients into powder and take 6-10g. It can also be prepared as a decoction. After ingestion, drink hot water to induce a light sweat. |
Action | Promotes urination and percolates dampness, warms yang and promotes qi transformation. |
Indication | Wu Ling San is indicated for water amassment syndrome due to dysfunction of bladder qi transformation. The symptoms are dysuria, headache with mild fever, thirst and desire to drink, vomiting as soon as drinking, throbbing below the navel, spitting, dizziness, shortness of breath, cough, edema, and diarrhea. The tongue coating is white and the pulse is either floating or floating and rapid. |
Pathogenesis | While the indications are various this pattern has the same pathogenesis of excessive internal water-dampness and dysfunction of bladder qi transformation. In the《Treatise on Cold Damage》, this formula is used for water amassment syndrome. It is caused by external pathogens in the taiyang entering the corresponding fu-organ along the channels that leads to a disease involving both the taiyang channel and its fu-organ. External pathogenic contraction in the taiyang gives rise to headache and mild fever. The failure of bladder qi transformation leads to dysuria. Retention of water blocks yang qi and results in qi failing to diffuse fluids. This in turn leads to the failure of fluid ascending into the mouth causing thirst with a desire to drink. Water stagnation in the lower jiao hinders the ability for fluids that are drunk to distribute. This causes water counterflow marked by vomiting as soon as drinking. It is also called water-up rushing pattern. Excessive water-dampness spills over the skin manifesting edema. When water-dampness descends into the large intestine, diarrhea is the result. When water-dampness accumulates in the stomach and intestine, a disharmony between the ascension and descending will result. In this case, a conflict between the clear and turbid will manifest vomiting and diarrhea. When water accumulates in the lower jiao, water and zheng qi conflict with each other and cause throbbing below the navel. When water up rushes and invades the upper jiao, lung qi is blocked. This causes shortness of breath and coughing. The therapeutic methods are to promote urination and percolate dampness; however, methods to warm yang and promote qi transformation are also used. |
Application | 1. Essential pattern differentiation Wu Ling San is a common formula used to promote urination and qi transformation. This clinical pattern is marked by dysuria, white tongue coating, floating or slow pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of retention of water and dampness: edema in acute or chronic nephritis, ascites in liver cirrhosis, cardiac edema, acute enteritis, urinary retention, and hydrocephalus. |
Additonal formulae | 1. Si Ling San (Four Substances Powder with Poria 四苓散) [Source]《Teachings of [Zhu] Dan-xi》Dan Xi Xin Fa《丹溪心法》 [Ingredients] Wu Ling San minus gui zhi [Preparation and Administration] Grind the medicinals into a fine powder. One dose is 4 qian (12g). Prepare it as a decoction. [Actions] Fortifies the spleen and percolates dampness. [Applicable Patterns] Retention of water-dampness due to deficiency of the spleen and stomach. Symptoms include: scanty dark urine and loose stool. 2. Wei Ling Tang (Stomach-Calming Poria Decoction 胃苓湯) [Source]《Effective Formulas from Generations of Physicians》Shi Yi De Xiao Fang《世醫得效方》 [Ingredients] Wu Ling San plus Ping Wei San [Preparation and Administration] Mix these medicinals and decoct them with su zi and wu mei. [Actions] Dispels dampness and harmonizes the stomach, moves qi, and promotes urination. [Applicable Patterns] Cold damage of the spleen and stomach in-between summer and autumn leading to the failure to separate the clear and turbid. Symptoms include: watery diarrhea, edema, abdominal distension, and dysuria. 3. Yin Chen Wu Ling San (Five Substances Powder with Poria Plus Virgate Wormwood 茵陳五苓散) [Source]《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 [Ingredients] Wu Ling San plus double yin chen [Preparation and Administration] Prepare it as a decoction. [Actions] Drains dampness and relieves jaundice. [Applicable Patterns] Damp-heat jaundice with dysuria with more dampness than heat . |
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