Liang Ge San — Cool the Diaphragm Powder

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

Overview

Liang Ge San — the “Cool the Diaphragm Powder” — is from the Song-dynasty Tai Ping Hui Min He Ji Ju Fang. It addresses Heat accumulation in the upper and middle burners with the diaphragm and chest predominantly affected, especially when the underlying interior Heat has not yet caused full bowel impaction but is producing irritability, mouth ulcers, sore throat, chest oppression and constipation. The strategy combines lighter upper-burner Heat-clearers (Lian Qiao, Bo He, Zhu Ye, Huang Qin) with a small purgative core (Da Huang, Mang Xiao) to lead the Heat downward and out.

I prescribe Liang Ge San as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Liang Ge San is prescribed for Heat accumulation in the upper and middle burners:

• Sensation of Heat in the chest and diaphragm
• Mouth and tongue ulcers
• Red face, dry lips, mouth and throat
• Irritability, restlessness
• Sore throat
• Constipation with hard dry stool
• Dark scant urine
• Tongue — red, yellow dry coat
• Pulse — slippery, rapid

Key herbs

1. Lian Qiao — chief; clears upper-burner Heat and resolves toxin
2. Huang Qin, Zhi Zi — clear Heat from upper and middle burners
3. Bo He, Zhu Ye — clear Heat from the chest, head and throat; vent Heat outward
4. Da Huang, Mang Xiao — purge accumulated Heat downward through the bowels
5. Gan Cao, Bai Mi (honey) — protect the Stomach; harmonise

Formula actions

1. Clears Heat from the upper and middle burners
2. Purges Heat-accumulation downward through the bowels
3. Vents Heat through the throat and skin

Conditions treated

1. Acute tonsillitis or pharyngitis with high Heat, constipation and irritability
2. Severe mouth and tongue ulcers with chest Heat
3. Acute febrile illness with predominant chest Heat and constipation
4. Severe acute acne on chest and face with Heat and constipation
5. Acute conjunctivitis with high Heat and constipation
6. Childhood high fever with constipation and irritability

Cautions

Contains Da Huang and Mang Xiao — strictly contraindicated in pregnancy.

Not appropriate for cold-deficient, Yin-deficient or Spleen-Qi-deficient patterns — the cold draining and purging herbs damage Yang and depleted Yin.

For short-term acute use only; once Heat clears, switch to nourishing fluids.

Severe sore throat with difficulty breathing or swallowing, suspected epiglottitis or peritonsillar abscess require urgent medical care.

Always consult a qualified Chinese herbalist registered with the RCHM.

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