In my last few articles about mental health and TCM, I mentioned a number of formulas to help with certain conditions.  I would like to take some time and talk about one of the most common formulas given to patients, Xiao Yao San.

Xiao Yao San is translated as "Free and Distant Powder".  It's an allusion to being carefree and having easy travel.  The idea behind the formula was to allow the qi, if stuck for whatever reason, to freely flow again.  It the qi is stuck, or stagnated, there will be pain and discomfort for the duration.  If you've ever been stuck on an airplane for 12 or more hours nonstop, you know stagnation, pain, and discomfort ...

As mentioned in my previous articles, Xiao Yao San helps move the Liver qi again after emotional distress.  Over recent years, it has also been linked to help with menstrual issues (PMS, irregular menstruation, infertility, etc.). However, some of the root causes for those issues were based by emotion. When dealing with menstrual issues, Xiao Yao San (or it's modifications) would be prescribed at a certain time of the cycle along with other formulas.

The formula was developed to help strengthen the Liver and Spleen.  Chai Hu, Dang Gui, Bai (Shao) Yao, and Bo He all help the Liver and keep qi and blood moving, while Bai Zhu, Fu Ling, Sheng Jiang, and Gan Cao all help strengthen the Spleen to help prevent more stagnation.  One of the schools of thought in TCM 5 Element theory says the root of all diseases start from the Liver (And by root, it means stress) and then moves to the Spleen.  If you strengthen the Spleen, you can help prevent transmission to the rest of the body.

There are two modifications of the formula for Xiao Yao San, Jia Wei Xiao Yao San and Hei Xiao Yao San.  Jia Wei refers to an enhancement.  It adds two more herbs, Zhi Zi and Mu Dan Pi, into the formula to help clear heat from stagnation.  When qi stagnation sits for too long, it creates heat and starts to irritate the body (as mentioned in the depression article).  Hei Xiao Yao San is "Black" Xiao Yao San based on the black herbs being used.  Sheng Di Huang replaces Bai Zhu and helps with menstrual and Liver blood deficiency conditions.

These are not formulas you can take all the time.  It should only be used when there's Liver qi stagnation.  Once that's gone, it should be stopped.  Once that's done, you can move onto another dedicated formula to help strengthen the Spleen, like Liu Jun Zi Tang (Six Gentleman Decoction). Using Xiao Yao San too much will cause the Qi to wander too much in the body, which may cause feelings of being aloof.

If you're interested in trying Xiao Yao Wan to help prevent stagnation symptoms, take it just before/after a stressful situation.  Obviously, it depends on the level of stress itself, but for daily work related stress, it should be good for you.

Xiao Yao San

Chai Hu : 柴胡
Fu Ling : 茯苓
Bai Zhu : 白术
Dang Gui : 當歸
Zhi Gan Cao : 炙甘草 
Shao Yao : 芍藥  (Bai Shao : 白芍 / Chi Shao :  赤芍)
Sheng Jiang : 生薑
Bo He : 薄荷

Jia Wei (Dan Zhi) Xiao Yao San

Xiao Yao San +
Zhi Zi : 梔子
Mu Dan Pi : 牡丹皮

Hei Xiao Yao San

Xiao Yao Wan +
Sheng Di Huang : 生地黃 replacing Bai Zhu
(Sheng Jiang and Bo He are sometimes removed)