Formula Pill (Wan)

Xiang Lian Wan

Aucklandia and Coptis Pill · 香连丸

A classical two-herb pill that clears Heat and Dampness from the intestines while moving Qi to relieve abdominal pain and tenesmus. It is most commonly used for acute diarrhea or dysentery with cramping, urgency, and a sensation of incomplete evacuation.

Origin Tai Ping Hui Min He Ji Ju Fang (太平惠民和剂局方) — Song dynasty, ~1107 CE
Category Heat-clearing and Dampness-drying formulas Formulas that clear Heat and expel dampness
Therapeutic focus Digestive health Diarrhea relief Gut inflammation Abdominal pain
Composition 2 herbs
Huang Lian
King
Huang Lian
Mu Xiang
Deputy
Mu Xiang
Explore composition

Educational content • Consult qualified TCM practitioners for diagnosis and treatment

Patterns Addressed

In TCM, symptoms don't appear randomly — they cluster into recognizable patterns of disharmony that reveal what's out of balance in the body. Xiang Lian Wan is designed to correct these specific patterns.

Why Xiang Lian Wan addresses this pattern

This formula is specifically designed for Damp-Heat lodged in the Large Intestine. The Heat component causes diarrhea, burning sensation, and possible blood in the stool, while the Dampness creates a sticky, turbid quality with mucus. The combination of both pathogens obstructs Qi flow, leading to the hallmark tenesmus and abdominal pain. Huang Lian clears the Heat and dries the Dampness at its source, and Mu Xiang unblocks the stagnant Qi, directly relieving the pain and urgency.

A practitioner would look for one or more of these signs

Toxic Dysentery

Diarrhea with mucus and blood

Abdominal Pain

Cramping abdominal pain relieved by defecation

Tenesmus

Sensation of incomplete evacuation

Diarrhea

Frequent, urgent, small-volume stools

Commonly Prescribed For

These conditions can arise from the patterns above. A practitioner would consider Xiang Lian Wan when these conditions are specifically caused by those patterns — not for all cases of these conditions.

Arises from: Damp-Heat in the Large Intestine

TCM Interpretation

In TCM, bacterial dysentery is seen as an invasion of external Damp-Heat pathogens that lodge in the Large Intestine. The body reacts with Heat signs (fever, burning sensation) and Dampness signs (mucus, sticky stools). The pathogens obstruct the normal downward flow of Qi, causing tenesmus and cramping. If Heat damages the blood vessels, bloody stools appear.

Why Xiang Lian Wan Helps

Huang Lian is a potent antimicrobial and anti-inflammatory herb that directly targets the pathogenic Heat in the gut. Mu Xiang relaxes intestinal spasms and regulates peristalsis, easing the painful straining. Together they clear the infection, dry the Dampness, and restore coordinated bowel movement, making it a classical choice for bacillary dysentery.

Also commonly used for

Gastroenteritis

Resolves acute Damp-Heat induced diarrhea and abdominal cramping

Ulcerative Colitis

Reduces inflammation and tenesmus in mild to moderate flares with Damp-Heat pattern

What This Formula Does

Every TCM formula has a specific set of actions — here's what Xiang Lian Wan does in the body, explained in both everyday and TCM terms

Therapeutic focus

In practical terms, Xiang Lian Wan is primarily used to support these areas of health:

Digestive health Diarrhea relief Gut inflammation Abdominal pain

TCM Actions

In TCM terminology, these are the specific therapeutic actions that Xiang Lian Wan performs to restore balance in the body:

Clears Heat Dries Dampness Moves Qi Stops dysentery Alleviates pain

How It Addresses the Root Cause

TCM doesn't just suppress symptoms — it aims to resolve the underlying imbalance. Here's how Xiang Lian Wan works at the root level.

Damp-Heat accumulates in the Large Intestine, disrupting its normal function. The Heat and Dampness combine to create turbidity, which obstructs the flow of Qi. This Qi stagnation causes gripping abdominal pain and a sensation of incomplete evacuation (tenesmus). The Damp-Heat damages the intestinal lining, leading to diarrhea or dysentery with mucus and possibly blood. The root is the Damp-Heat pathogen, and the branch is the Qi stagnation and pain.

Formula Properties

Every formula has an inherent temperature, taste, and affinity for specific organs — these properties determine how it interacts with the body

Overall Temperature

Cold

Taste Profile

Bitter and acrid — bitter to dry dampness and clear heat, acrid to move Qi and stop pain.

Target Organs

Large Intestine Stomach Spleen

Channels Entered

Large Intestine Stomach Spleen

Ingredients

2 herbs

The herbs that make up Xiang Lian Wan, organized by their role in the prescription

King — Main ingredient driving the formula
Deputy — Assists and enhances the King
King — Main ingredient driving the formula
Huang Lian

Huang Lian

Coptis rhizome

Dosage 6 - 9g
Temperature Cold
Taste Bitter (苦 kǔ)
Organ Affinity Heart, Liver, Stomach, Large Intestine, Gallbladder, Spleen

Role in Xiang Lian Wan

Clears Heat and dries Dampness in the Large Intestine, targeting the root cause of dysentery and diarrhea.
View herb details
Deputy — Assists and enhances the King
Mu Xiang

Mu Xiang

Costus root

Dosage 3 - 6g
Temperature Warm
Taste Acrid / Pungent (辛 xīn), Bitter (苦 kǔ)
Organ Affinity Spleen, Stomach, Large Intestine, San Jiao (Triple Burner), Gallbladder

Role in Xiang Lian Wan

Moves Qi in the Intestines, alleviates abdominal pain and tenesmus, and prevents the cloying nature of Huang Lian.
View herb details

Why This Combination Works

How the herbs in Xiang Lian Wan complement each other

Overall strategy

This formula directly confronts Damp-Heat lodged in the Large Intestine while simultaneously unblocking the stagnant Qi that causes the most distressing symptoms.

King herb

Huang Lian (Coptis) is the sovereign herb. It is intensely bitter and cold, powerfully clearing Heat and drying Dampness from the Intestines. It addresses the root pathogenic factor.

Deputy herb

Mu Xiang (Aucklandia) serves as the deputy. It is warm, acrid, and bitter, specializing in moving Qi in the Intestines. It directly relieves the abdominal pain and tenesmus caused by Qi stagnation. Its warmth also tempers the extreme cold of Huang Lian, preventing damage to the Spleen Yang.

Notable synergies

The pairing of Huang Lian and Mu Xiang creates a balanced dynamic: one clears the pathogen, the other restores the flow of Qi. Without Mu Xiang, the cold nature of Huang Lian might congeal the Qi and worsen the stagnation. Without Huang Lian, the root Damp-Heat would remain untouched. Together they resolve both the cause and the symptoms.

How to Prepare

Traditional preparation instructions for Xiang Lian Wan

Grind the herbs into a fine powder. Form into small pills with water or a starch binder. Take 6–9 g per dose, 2–3 times daily, with warm water. The formula is classically prepared as a pill for gradual, sustained release in the intestines.

Common Modifications

How practitioners adapt Xiang Lian Wan for specific situations

Added
Bai Shao

9-12g, to relax spasms and alleviate pain

Gan Cao

6g, to harmonize and moderate acute pain

Bai Shao and Gan Cao form the classical Shao Yao Gan Cao Tang pair, which strongly relaxes smooth muscle and relieves cramping pain in the abdomen.

Related Formulas

Formulas often compared to or combined with Xiang Lian Wan, with a side-by-side look at how their compositions differ

Similar indication
Cold 9 herbs Decoction (Tang)

A classical formula used to clear Heat and Dampness from the intestines while soothing abdominal pain and regulating Qi and Blood circulation. It is primarily used for inflammatory bowel conditions with symptoms such as abdominal cramping, bloody or mucus-containing stools, and a constant urge to go to the bathroom that brings little relief.

Therapeutic focus
Digestive Health Gut Inflammation Gut Health

How it compares

Shao Yao Tang is stronger for dysentery with more pronounced Blood-Heat and pus. It contains Huang Lian and Mu Xiang plus additional herbs to cool Blood and regulate Qi. Use Xiang Lian Wan for milder cases focused on Damp-Heat and Qi stagnation; use Shao Yao Tang when there is significant pus and blood with severe tenesmus.

Composition comparison

Shared (2)
Huang Lian Mu Xiang
Only in Xiang Lian Wan (0)
—
Only in Shao Yao Tang (7)
Bai Shao Huang Qin Da Huang Dang Gui Bing Lang Rou Gui Gan Cao
Contrasting approach
Cold 4 herbs Decoction (Tang)

A powerful classical formula that clears intense heat and toxins from all levels of the body. It is used for conditions involving high fever, restlessness, infections, skin eruptions, and bleeding caused by excessive internal heat. Because it is strongly cooling, it is intended only for acute, excess-heat conditions and not for long-term use.

Therapeutic focus
Fever Management Skin Health Inflammation Support Detoxification

How it compares

Huang Lian Jie Du Tang is a broader Heat-clearing formula for toxic Heat affecting multiple organs. It lacks the Qi-moving component of Xiang Lian Wan. Use Xiang Lian Wan when intestinal Qi stagnation and tenesmus are prominent; use Huang Lian Jie Du Tang when toxic Heat is systemic with high fever, inflammation, and less digestive-specific Qi stagnation.

Composition comparison

Shared (1)
Huang Lian
Only in Xiang Lian Wan (1)
Mu Xiang
Only in Huang Lian Jie Du Tang (3)
Huang Qin Huang Bo Zhi Zi
Similar indication
Cold 4 herbs Decoction (Tang)

A classical four-herb formula used for acute diarrhea accompanied by fever, thirst, and a burning sensation in the gut. It works by clearing Heat and Dampness from the intestines while helping to release any lingering surface-level illness. In modern practice, it is also widely used for inflammatory bowel conditions and, increasingly, for type 2 diabetes when a Damp-Heat pattern is present.

Therapeutic focus
Digestive Health Diarrhea Relief Blood Sugar Support Gut Inflammation

How it compares

This formula also treats Damp-Heat diarrhea but includes Ge Gen to release the exterior, making it suitable when there is an accompanying exterior syndrome (chills, fever, body aches). Xiang Lian Wan is purely internal, without exterior-releasing herbs. Choose based on the presence or absence of external symptoms.

Composition comparison

Shared (1)
Huang Lian
Only in Xiang Lian Wan (1)
Mu Xiang
Only in Ge Gen Huang Qin Huang Lian Tang (3)
Ge Gen Huang Qin Gan Cao

Educational content — always consult a qualified healthcare provider or TCM practitioner before using any herbal formula.

Contraindications

Situations where Xiang Lian Wan should not be used or requires extra caution

Avoid

Contraindicated in cold-damp diarrhea or diarrhea due to Spleen yang deficiency with cold signs (e.g. watery, clear diarrhea without burning sensation, cold limbs, pale tongue with white coat).

Caution

Use with caution in pregnancy. Huanglian (Coptis) is bitter and cold, traditionally considered potentially harmful to the fetus.

Caution

Use with caution in patients with Spleen and Stomach deficiency cold (chronic loose stools, poor appetite, cold sensation in abdomen). Long-term use may damage Spleen yang.

Avoid

Not suitable for chronic diarrhea due to Spleen and Kidney yang deficiency without damp-heat signs.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

Use with caution during pregnancy. Huanglian (Coptis) is considered potentially harmful due to its bitter cold nature and may stimulate uterine contractions. Only use under strict guidance of a qualified TCM practitioner.

Breastfeeding

No specific data on breast milk transfer exists for the herbs in this formula. Huanglian (Coptis) may pass into breast milk and could potentially affect the infant. Caution is advised. Use only under the guidance of a healthcare provider.

Children

Use with caution in children. Dosage should be reduced according to age and weight. The bitter taste may be difficult for children to tolerate. Always consult a qualified pediatric TCM practitioner before use.

Drug Interactions

If you are taking pharmaceutical medications, be aware of these potential interactions with Xiang Lian Wan

Huanglian (Coptis) contains berberine, which can interact with several classes of drugs:

  • Anticholinergics (e.g., atropine): concomitant use may increase toxicity.
  • Drugs metabolized by CYP3A4 and CYP2D6 (e.g., statins, calcium channel blockers, cyclosporine, certain antipsychotics, warfarin): berberine may inhibit these enzymes and raise blood levels of these drugs, increasing risk of adverse effects.
  • Anticoagulants and antiplatelet drugs (e.g., warfarin, aspirin): berberine has mild antiplatelet activity; combined use may increase bleeding risk.
  • Hypoglycemic agents (e.g., insulin, sulfonylureas): additive hypoglycemic effect possible.
  • Sedatives (e.g., benzodiazepines): may enhance central nervous system depression.
  • Antidiarrheal agents (e.g., smectite): may antagonize the Qi-moving and dampness-clearing effects of the formula.

Take this formula at least 2 hours apart from other medications. Consult a healthcare provider before concurrent use.

Usage Guidance

Practical advice for getting the most out of Xiang Lian Wan

Best time to take

Take after meals to minimize stomach irritation. Usually taken 2–3 times daily.

Typical duration

For acute damp-heat diarrhea, typically 3–7 days. Discontinue if no improvement after 3 days. For chronic conditions, treatment may be extended but formula may be modified to avoid damaging Spleen yang.

Dietary advice

Avoid spicy, greasy, and fried foods. Avoid raw, cold, and sweet foods that can generate dampness. Eat light, easily digestible foods such as congee. Alcohol and caffeine should be avoided.

Xiang Lian Wan originates from Tai Ping Hui Min He Ji Ju Fang (太平惠民和剂局方) — Song dynasty, ~1107 CE

Classical Texts

Key passages from the classical Chinese medical texts that first described Xiang Lian Wan and its clinical use

《太平惠民和剂局方》卷六：“治冷热不调，下痢赤白，脓血相杂，里急后重，腹痛肠鸣，不思饮食。”
Treats irregular cold and heat, dysentery with red and white, pus and blood mixed, tenesmus, abdominal pain, borborygmus, and loss of appetite.

Historical Context

How Xiang Lian Wan evolved over the centuries — its origins, lineage, and place in the broader tradition of Chinese medicine

Xiang Lian Wan first appeared in the Song dynasty text Tai Ping Hui Min He Ji Ju Fang (太平惠民和剂局方), compiled around 1107 CE. The formula originally consisted of Huanglian (Coptis) processed with Wu Zhu Yu (Evodia) to moderate its coldness and enhance its astringent effect, combined with Mu Xiang (Costus root) to move Qi and stop pain. This processing technique reflects the sophisticated approach of Song dynasty pharmacy, where the harshness of bitter cold herbs was tempered while preserving their therapeutic actions. The formula became a standard for damp-heat dysentery and has been used continuously for nearly a millennium, with modern variants often adding other herbs for specific presentations.