Wind Scatters, Rain Moistens
On Xiāo Yáo Sǎn
As the spring rolls on, I thought I might revisit another warhorse formula. I suspect Xiāo Yáo Sǎn (Free Wanderer Powder) needs no introduction to most of the folks reading this. It comes from the Tài Píng Huì Mín Hé Jì Jú Fāng《太平惠民和劑局方》 (Imperial Grace Formulary of the Tài Píng Era, 1078). There are extensive discussions in the various formularies available in English. For my small part, I thought to highlight a text I have already been working with and make some brief comments and an infographic from that. So to that end, this is my working version of an excerpt from Wáng Xùgāo’s Yī Fāng Zhèng Zhì Huì Biān Gē Jué (Compilation of Medical Formulas, Patterns and Treatments), 1897:
逍遙散（《太平惠民和劑局方》）用當歸（酒拌）芍，（白芍酒炒）柴（胡）苓（茯苓）術（白朮土炒各一兩）草（炙草五錢）煨姜薄。（加煨薑、薄荷煎。）
Xiāo Yáo Sǎn (“Tài Píng Huì Mín Hé Jì Jú Fāng”) uses Dāng Guī [Rx Angelicae Sinensis] (soaked in wine), Sháo (Bái Sháo [Rx Paeoniae Alba] wine-fried), Chái (Hú) [Rx Bupleuri], Líng (Fú Líng [Poria]), Zhú (Bái Zhú [Rz Atractylodis Macrocephalae] stir-fried with earth, each 1 liǎng), Cǎo (Zhì Cǎo [Rx Glycyrrhizae Praeparata] 5 qián), Wēi Jiāng [Rz Zingiberis Tostum], Bò [Bò Hé / Hb Menthae] (add Wēi Jiāng and Bò Hé while decocting.)
散郁除蒸功最奇，調經八味丹（皮）梔（山梔）著。（本方治肝家血虛火旺，頭痛目眩，頰赤口苦，倦怠煩渴，抑鬱不樂，寒熱往來，及骨蒸潮熱。薛立齋加丹皮瀉血分鬱熱，山梔清氣分鬱火，名八味逍遙散，治婦人經水不調，脈弦大而虛，其理頗通。）
It has the most marvelous effect to scatter depression and eliminate steaming; to regulate menstruation there is eight-flavor [Xiāo Yáo Sǎn] with Dān (Pí) [Cx Moutan] and Zhī (Shān Zhī) [Fr Gardeniae]. (The original formula treats liver-type blood vacuity with exuberant fire, headache, dizziness, flushed cheeks, bitter [taste in the] mouth, fatigue, vexation-thirst, emotional depression and unhappiness, alternating sensations of cold and heat, as well as steaming bone tidal fever. Xuē Lìzhāi added Dān Pí to drain blood aspect depressed heat, and Shān Zhī to clear qì aspect depressed fire. [The formula] is named Bā Wèi Xiāo Yáo Sǎn [Eight-Flavor Free Wanderer Powder], it treats women’s unregulated menstrual flow with a pulse that is wiry, large and empty; his reasoning is quite logical.)
Mulch comments: Xuē Lìzhāi was also known as Xuē Jǐ (1488-1558), a Ming-era physician from the Sūzhōu area. I’ve never been super-convinced of Xiāo Yáo Sǎn’s heat-clearing abilities and much prefer Bā Wèi Xiāo Yáo Sǎn (or, as it is better known, Jiā Wèi Xiāo Yáo Sǎn), which I use quite liberally in my practice.
郁雖有六思慮多，（六郁：氣、血、痰、火、濕、食也。夫郁為情志之病，丹溪雖論六郁，然思慮怒致郁者多。）
Depression, even though there are 6 [types], is frequently due to thought and preoccupation (6 depressions: they are qì, blood, phlegm, fire, dampness, and food. Depression becomes an illness of the affect-mind. Although Dānxī discussed the six depressions, in reality thought, preoccupation, and anger are frequent causes of depression cases.)
思慮傷脾肝作惡。（思慮則氣鬱結而傷脾，脾傷則肝木乘勝而為病。）此方疏達肝與脾，（此疏達肝脾之方）無傷正氣逍遙卻。（「逍遙」，《說文》與「消搖」通。此方消散其氣鬱，搖動其血鬱，卻無傷正氣，故名「逍遙」。）
Thought and preccupation damage the spleen and liver, making one gloomy. (Thought and preoccupation result in qì depression binding as well as damage to the spleen, damage to the spleen results in its exploitation by liver wood and the formation of disease.) This formula courses and outthrusts the liver together with the spleen, (this is a coursing and outthrusting liver and spleen formula) however Xiāo Yáo does not damage the correct qì. (“xiāo yáo / freely wandering” in the “Shuō Wén” carries a similar meaning to “xiāo yáo / dispersing and shaking.” This formula disperses and scatters the depressed qì and shakes and moves the depressed blood, however it won’t damage the correct qì, therefore it is called “Free Wanderer”.)
Mulch comments: “Shuō Wén” likely refers to Shuō Wén Jiě Zì 說文解字, a famous Hàn dynasty dictionary. “Dānxī” refers to Zhū Dānxī, the last of the Four Great Masters of the Sòng-Jīn-Yuán period.
丹溪用治乾咳嗽，（朱丹溪曰：「乾咳嗽極為難治，此係火鬱之證，惟用逍遙散以發之，繼服補陰清肺可愈。」）養葵用治傷寒瘧。（趙養葵治傷寒、瘧疾、溫疫，咸以此湯出入加減，無不獲效。）外感多從郁證看，木鬱解而諸郁削。
Dānxī used it to treat dry cough, (Zhū Dānxī said: “Dry cough is exceedingly difficult to treat, this is connected to a pattern of fire depression, only use Xiāo Yáo Sǎn to effuse it, and continue by taking yīn-supplementing lung-clearing to recover”). Yǎngkuí used it to treat cold damage malaria. (Zhào Yǎngkuí treated cold damage, malarial diseases, warm epidemics, all using this decoction, taking some out and putting some in, adding and subtracting, it never failed to obtain good results.) Exterior contraction is often seen following depression patterns; wood depression resolves and all other depressions are reduced.
Mulch comments: Zhào Yǎngkuí was otherwise known as Zhào Xiànkě 趙獻可, author of Yī Guàn (Key Link of Medicine). We made reference to him in an earlier post, mentioning his use of Xiāo Yáo Sǎn.
（趙養葵《醫貫》曰：「凡外感證，皆宜作郁治，古方如小柴胡湯、四逆散，俱是此意，然總不若逍遙影響也。」又曰：「方中柴胡、薄荷二味最妙，蓋木喜風搖，寒即摧萎，溫即發生，木鬱則火鬱，火鬱則土鬱，土鬱則金鬱，金鬱則水鬱，五行相因，自然之理也。予以一方治木鬱，而諸郁皆解，逍遙散是也。」）
(Zhào Yǎngkuí said in “Yī Guàn”: ‘It is appropriate to treat every exterior contraction pattern for depression; ancient prescriptions like Xiǎo Chái Hú Tāng [Minor Bupleurum Decoction] and Sì Nì Sàn [Four Counterflows Powder], are all intended to be like this, though generally their effects are not as good as Xiāo Yáo Sǎn.’ He also said: ‘In the formula are Chái Hú and Bò Hé, two flavors most subtle; because of wood’s fondness for wind and shaking, the cold promptly breaks and withers, warmth promptly effuses and grows, wood depression results in fire depression, fire depression results in earth depression, earth depression results in metal depression, metal depression results in water depression, the five phases mutually cause [one another], this is a principle of nature. Give one formula to treat wood depression, and the various depressions will all resolve, this is Xiāo Yáo Sǎn.’)
風以散之雨潤之，郁平繼以滋陰藥。（逍遙散，風以散之也。六味地黃湯，雨以潤之也。昔趙養葵、高鼓峰輩，往往用逍遙散後，繼以六味丸收功。）
Wind scatters and rain moistens, after depression is calmed follow up by using medicinals to enrich yīn. (Xiāo Yáo Sǎn is like the wind that scatters, Liù Wèi Dì Huáng Tāng [Six-Flavor Rehmannia Decoction] is the rain that moistens. In the past, Zhào Yǎngkuí and Gāo Gǔfēng’s generation would often, after using Xiāo Yáo Sǎn, follow up with Liù Wèi Wán to consolidate the effects.)
Mulch comments: These last passages are largely taken from the depression chapter in Yī Guàn. Zhào was an interesting figure, and his views on the Gate of Life were quite influential. You can read more about them in De Vries (2012). Zhào apparently relied on a few formulas: Liù Wèi Wán, Bā Wèi Wán (Eight-Flavor Rehmannia Pill, a.k.a. Jīn Guì Shèn Qì Wán or Golden Cabinet Kidney Qì Pill), Bǔ Zhōng Yì Qì Tāng (Center-Supplementing Qì-Boosting Decoction), and Xiāo Yáo Sǎn. Most notably he used the first two, in line with his reputation as a representative of the Warm Supplementation (wēn bǔ) movement. When I read De Vries’ paper, it prompted some reflection on a lot of the earlier practitioners who were around when I was coming up; it seemed like the only formulas a lot of them would prescribe were “Rehmannia Six” and “Rehmannia Eight” (and maybe “Free and Easy” if there was liver stagnation). For years I thought that was due to a lack of knowledge or laziness, but De Vries’ paper made me reconsider whether they were somehow just imitating their teachers who were influenced in some way by Zhào.
The “Primary Pathological Triad”
Students often ask about getting started with herb formulas, especially formula composition. I usually advocate for picking a few standard formulas and getting to know them well. If you focus on common pathomechanisms like liver depression qì stagnation, especially as it pertains to liver-spleen disharmony, you can apply a formula like Xiāo Yáo Sǎn to a wide range of conditions. Maclean et al (2018) posited a “primary pathological triad” composed of the three vertices of “liver qi constraint”, “spleen qi deficiency”, and “constrained heat or damp-heat”. Maclean places various formulas inside his triangle with Xiǎo Chái Hú Tāng at the very center, indicating it as the formula best able to pivot in whatever direction the pathogenesis might lead. However, as I pointed out last spring, I consider especially Bái Sháo to be crucial to re-establishing the liver’s orderly reaching (條達 tiáo dá), and thus I am more inclined to use Xiāo Yáo Sǎn. The other concern I typically have is the development of secondary pathogens like blood stasis, which is addressed by Dāng Guī, and in Bā Wèi Xiāo Yáo Sǎn by Dān Pí. While it is true that Xiǎo Chái Hú Tāng is stronger for treating phlegm (another secondary pathogen), Xiāo Yáo Sǎn can be modified to that end; Zhào, for example, adds Bèi Mǔ [Blb Fritillariae] to the prescription to treat malarial illness.
Okay, that’s it for now. Thanks for reading.
Note: this publication is for information purposes only and is not intended as medical advice. Please seek the opinion of a health care professional for any specific medical issues you may have.
References
De Vries, L. (2012). The gate of life: Before heaven and curative medicine in Zhao Xianke’s Yiguan. [Doctoral dissertation, Ghent University]. https://biblio.ugent.be/publication/4337151
Maclean, W., Lyttleton, J., Bayley, M., & Taylor, K. (2018). Clinical handbook of internal medicine: The treatment of disease with traditional Chinese medicine. Eastland Press.
Wáng, X. (1897). Yī fāng zhèng zhì huì biān gē jué. https://jicheng.tw/tcm/book/%E9%86%AB%E6%96%B9%E8%AD%89%E6%B2%BB%E5%BD%99%E7%B7%A8%E6%AD%8C%E8%A8%A3/index.html
Zhào, X. (1687). Yī guàn. https://jicheng.tw/tcm/book/%E9%86%AB%E8%B2%AB/index.html