With light comes life, all vigor and virility in piercing green,
First-flush hailing the bouncing sprightliness of Spring.
Arms swinging in wide-arcs: the image of Free and Easy Wandering.
Zhuangzi (莊子), classical Chinese philosopher of the 4th century B.C., entitles the first chapter of his famous eponymous Daoist text Zhuangzi: Xiaoyao You (逍遙遊), variously translated as Rambling Carefree, Enjoyment in Untroubled Ease, Transcendent Bliss, Going Beyond.
逍 implies wandering, leisurely, carefree, while 遙 implies distant and remote. Together they express vast, effortless movement, like the wind within the sky.
The following is a brief excerpt from this famous chapter of Zhuangzi (莊子): Xiaoyao You (逍遙遊):
Now Liezi got around by charioting upon the wind itself and was so good at it that he could go on like that in his cool and breezy way for fifteen days at a time before heading back. He was someone who didn't get caught up in anxious calculations about bringing the blessings of good fortune upon himself. Nevertheless, although this allowed him to avoid the exertions of walking, there was still something he needed to depend on.
But suppose you were to chariot upon what is true both to Heaven and to earth, riding atop the back-and-forth of the six atmospheric breaths, so that your wandering could nowhere be brought to a halt. You would then be depending on--what? Thus I say, the Utmost Person has no definite identity, the Spiritlike Person has no particular merit, the Sage has no name.
As one of (if not the) most recommended of the traditional East Asian herbal formulae, Xiaoyao San (逍遙散) shares the above two characters and meaning.
At Kan, this formula family includes the base formulation Free and Easy Wanderer, alongside the heat-clearing modified (加味) version Relaxed Wanderer.
The principal formulary logic of Xiaoyao San involves accessing and harmonizing the shaoyang conformation (少陽), reordering the axis between Wood-Earth, venting heat transformed from qi stagnation and ministerial fire, and dredging Liver qi to allow for the unobstructed spreading of the Unyielding Organ: the Liver.
In the interest of Xiaoyao San utilization, and improving our connection to this incredibly useful formulation, let us review the functions of the Liver organ and network system through these traditional Chinese medical statements of fact.
Gān shǔ mù (肝屬木) The liver belongs to wood.
Gān zhǔ shū xiè (肝主疏泄) The liver governs free coursing.
Gān cáng xuè (肝藏血) The liver stores blood.
Gān zhǔ jīn (肝主筋) The liver governs the sinews.
Gān wèi gāng zàng (肝為剛臟) The liver is the unyielding viscus.
Holding these pearls in mind-and-heart, we may analyze the various functions and intent of Xiaoyao San and related formulae.
When Liver qi is bound (a consequence of stress, physiological stagnations, menstrual challenges, digestive dysfunction, or repressed expression of emotion), qi stagnates and begins to generate heat or even fire, which rebels, often laterally and vertically. This constraint impacts Stomach and Spleen zang-fu function, weakening the source of quality blood, while inflaming the Liver’s storage of blood. With less blood comes less yin to quell the rising heat, therefore dredging the Liver qi and organizing rebellious qi is essential. Indeed, one may argue that clearing heat is often not always necessary, as it is the qi which promotes the functional circulation of qi and blood, improving blood production and allowing a “hot” liver to relax its grip on its treasured vital substance. A relaxed liver is a moderate liver, and a moderate liver buffers the build-up of heat throughout the entire realm of body-mind.
This is expressed through the idiom: The liver is the unyielding organ, therefore it should be aided by softness (gān wèi gāng zàng, jì zhī yǐ róu. 肝為剛臟, 濟之以柔).
The Jin Gui Yao Lue portion of the Shanghan Zabing Lun includes a brilliant expose on the multidimensional approach to internal medicine synthesized, refined, and perfected millenia-ago by Zhang Zhongjing. The following quotation serves to emphasize the nuance, subtlety, and depth of therapeutic flavors and their effects upon the zang-fu:
Question: ‘The superior practitioner treats disease before it arises. What does this mean?’ The Master says: ‘Treating disease before it arises means for example that if you see disease of the liver, you know that it will pass from the liver to the spleen, [thus you] must first replenish the spleen. Supplementation is unnecessary [only if] the spleen is effulgent [throughout] the four seasons. The practitioner of medium proficiency does not know about the passage of the disease. Thus when he sees liver disease, he does not understand the need to replenish the spleen, and treats only the liver.
In liver disease, supplement with sourness, assist with charred and bitter [flavors], and boost with medicinals of sweet flavor to harmonize. Sourness enters the liver, charred and bitter [flavors] enter the heart, and sweetness enters the spleen. The spleen can damage the kidney. When kidney qi is weak, water fails to move; when water fails to move, heart fire becomes exuberant, it damages the lung; when the lung is damaged, metal qi fails to move; when metal qi fails to move, liver qi becomes exuberant. Therefore when you replenish the spleen, the liver recovers on its own. This is the main subtlety of treating the liver by supplementing the spleen. Use this method to treat liver vacuity, but not to treat repletion.’
Xiaoyao San employs the chief herb chai hu to vent heat and course Liver qi, while dang gui and bai shao enrich and soften Liver blood. Bai zhu, fu ling, and gan cao protect and supplement the Spleen-earth, safeguarding this vulnerable area from the onslaught of constraint while improving the generation of blood, a factor which bolsters the ability of the Liver qi to glide freely in all directions and throughout the whole body.
All twelve primary channels connect to the inside and outside of the body via internal-external-yin-yang channel relationships. This is a common consideration in the clinic, as disparate regions and organ-systems become intertwined through meaningful, sometimes anatomically hidden relationships.
Another configuration of processes and bodily regions involves pairing yin with yin and yang with yang, connecting the upper and lower aspects of the body, hand-to-foot. This constitutes the six conformations, the primary theoretical framework which organizes the application of herbs stemming from the time of Zhang Zhongjing and his 1800-year old medical text Shanghan Lun. Through the lens of this system, the syndrome landscape indicated for the application of Xiaoyao San is shaoyang (少陽). Shaoyang includes the Gallbladder and San Jiao fu-organs.
A Chinese medical idiom relates the connection of the Liver to this shaoyang level: The liver and gallbladder connect interior to exterior (Gān yǔ dǎn xiāng biǎo lǐ. 肝與膽相表裡).
By recognizing Xiaoyao San as a shaoyang-stage formula, its indications broaden, as it is a formulation specifically designed to harmonize and vent heat by circulating qi and nourishing the Earth phase, therefore it may be used long-term and for weaker individuals. This consideration can be particularly useful when applied in the context of a chronically deficient patient who is often ‘fighting something’, such as an apparent infection or common cold. In this case, an addition of sheng jiang and bo he to the base formula, at increased dosages, is appropriate.
A critical reflection on the use of Xiaoyao San is in the realm of gynecology. Indeed, the Chinese medical adages, “In women, the liver is the former heaven (nǚzǐ yǐ gān wèi xiān tiān. 女子以肝为先天)” and “The blood chamber (uterus) is the liver (xuè shì zhě gān yě. 血室者肝也)”, expresses the profound intimacy of Liver zàng function and female reproductive and overall health. The explicit connection within the juéyīn (绝阴) paradigm (liver-pericardium) of the six conformations expounds upon this relationship. The free-flowing and unimpeded circulation of Liver function means graceful cycles and transitions, including the small cycle of monthly menstruation and larger movements such as peri-menopause, menopause, and post-menopause. A freely circulating pericardium-liver system entails emotional ease and mental clarity, clear complexion, and positive outlook.
As all our Livers awaken, befriending our Free and Easy Wanderer spirit resonates deeply with the great harmony of the seasons. Let’s ramble like Zhuangzi.
As warmth exudes from clear skies, fresh aromatics of honeysuckle and Monterey pine wash the ambient air: an image of Spring in full-flight.
肝主春
The liver rules Spring.