A Commonly Used Summer TCM Formula: Liuyi San (Six-One Powder)
Recently quite a few patients have consulted me about seasonal summer urinary-tract infections, with the main symptom being difficult urination, and in some cases urinary difficulty. Some cancer patients worry greatly that it is a cancer complication; in fact this is a problem that ordinary people easily get in summer. TCM has a dedicated formula for this, called Liuyi San (Six-One Powder).
Besides urinary-tract infections in summer, patients with chronic prostatitis or cystitis are also prone to flares of prostatitis and cystitis, which can cause poor urination. In addition, summer heat can easily trigger acute pyelonephritis—typical symptoms are back pain and hematuria. Or heatstroke may cause gastrointestinal-type cold and gastroenteritis, with diarrhea, fever and fatigue. All of these can be treated with Liuyi San. Used externally, Liuyi San also treats eczema and prickly heat. Drinking Liuyi San granules in the intense heat can prevent heatstroke.
Liuyi San is a renowned formula created by the famous Jin-Yuan physician Liu Wansu, from his work Shanghan Zhige (Straight Guidance on Cold Damage). Liu Wansu was the founder of the TCM warm-disease school and was skilled at treating various fire-heat syndromes by clearing heat and resolving toxin.
The Liuyi San formula is very simple: two herbs, Huashi (talc) and Sheng Gancao (raw licorice), in a 6:1 ratio (its name comes from this). They are ground together into a fine powder; take 9 g each time, mixed with water. Its main action is to clear summerheat and drain dampness, used for contraction of summerheat combined with dampness and the syndrome of damp-heat pouring downward. Huashi combined with raw Gancao has a strong heat-clearing, diuretic effect, expelling summerheat through the urine and resolving the patient's damp-heat problem.
In Shanghan Zhige, Liuyi San also has several variant formulas. Adding Chensha (cinnabar) and Dengxincao (rush) to Liuyi San makes Yiyuan San, used for summer-damp syndrome accompanied by palpitations, anxiety, insomnia and dreaminess. Adding Qingdai (indigo naturalis) makes Biyu San, whose action is to dispel summerheat and clear the liver, used for summerheat accompanied by liver-gallbladder constrained heat. Adding Bohe (mint) makes Jisu San, whose action is to disperse wind and dispel summerheat, used for summer-damp syndrome accompanied by slight aversion to cold, headache and head fullness, and difficult coughing—a series of symptoms of the summer-heat-type cold that often appears in the hot season.
Summer is also a high-incidence season for urinary calculi; Liuyi San is an important medicine for the various urinary problems brought by urinary stones in summer.
Many TCM pharmacies stock Liuyi San already made into powder, and some pharmaceutical factories make it into a patent medicine. Patients with the above problems can buy some Liuyi San at the pharmacy and keep it at home as a standby summer remedy for emergencies. Clinically, TCM physicians may consider adding Liuyi San into decoctions during the hot season, where it provides good adjuvant treatment.
But all medicines have some side effects. Although Liuyi San's side effects are small, long-term use still has side effects; in particular, Huashi (talc), used over a long time, has carcinogenic effects. Liuyi San is generally not recommended for preventing heatstroke. Watermelon and mung-bean soup are excellent summerheat-relieving foods; when a problem can be solved with food, try not to use medicine.