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This is one of the most commonly used Chinese herbs, referred to as the “King of All Herbs” by Tao Hongjing, and Li Shizhen believed it to “treat all evils universally.” Moreover, it is sweet and neutral in nature, capable of both tonifying and alleviating, and can nourish the five organs, all at a very low cost. So, which herb is this? It is the most commonly used yet extraordinary Gan Cao (Licorice).
Gan Cao (Licorice) is one of the most commonly used Chinese herbs and has many aliases, such as Mei Cao (Sweet Grass), Mi Gan (Honey Licorice), Fen Cao (Powdered Grass), Tian Cao (Sweet Grass), etc., all related to its sweet flavor. Additionally, it has an interesting nickname—Guo Lao (National Elder), because of its sweet, neutral, and tonifying properties, capable of both alleviating and tonifying. In herbal formulas, it can monitor, control, restrain, and promote the effects of other herbs with strong or weak properties; in different formulas, it can serve as the monarch, minister, assistant, or envoy, harmonizing various herbs to enhance their efficacy. Therefore, in the kingdom of herbs, Gan Cao (Licorice) is the elder of the nation.
Modern medical research has found that Gan Cao (Licorice) contains hundreds of chemical components, exhibiting antiviral, anti-inflammatory, and liver-protective effects, and can be used to treat conditions such as spleen deficiency, cough, asthma, sore throat, and carbuncles.
1.Nourishing the Heart
The “Treatise on the Effects of Medicinal Cooking” first proposed that Gan Cao (Licorice) enters the “Heart and Spleen Meridians”. In the Yuan Dynasty, Wang Haogu proposed in the “Materia Medica of Decoctions” that Gan Cao (Licorice) enters the Foot Jueyin, Taiyin, and Shaoyin Meridians. Combining ancient texts that record Gan Cao (Licorice) as being able to “open the meridians, benefit blood and qi,” “calm the spirit and stabilize the soul, nourish the five labors and seven injuries, all deficiencies, palpitations, anxiety, forgetfulness, open the nine orifices, and benefit the hundred vessels,” it is evident that Gan Cao (Licorice) has a nourishing effect on the heart.
(1)Nourishing the Heart and Reviving the Pulse
This function of Gan Cao (Licorice) primarily targets the treatment of “palpitations and irregular pulse,” with the representative formula being Zhi Gan Cao Tang (Honey-Fried Licorice Decoction). This formula is a tonic for qi, blood, yin, and yang, and besides a large dose of Zhi Gan Cao (Honey-Fried Licorice), it also includes Ren Shen (Ginseng) for qi tonification, Sheng Di Huang (Rehmannia) and Mai Dong (Ophiopogon) for yin nourishment, Gui Zhi (Cinnamon Twig) and Sheng Jiang (Fresh Ginger) for yang activation, and A Jiao (Donkey-hide Gelatin), Ma Ren (Sesame Seed), and Da Zao (Jujube) for blood nourishment. The combination of Zhi Gan Cao (Honey-Fried Licorice) with these qi, blood, yin, and yang tonifying herbs can exhibit its “sweet and pure dual nature,” having the effects of tonifying qi, blood, yin, and yang.
Additionally, Zhi Gan Cao Tang (Honey-Fried Licorice Decoction) is effective for other diseases caused by qi and blood deficiency, yin deficiency with excess heat, and fluid deficiency, such as insomnia, fatigue, lung consumption, blood deficiency, and convulsions. Clinically, this formula is often used to treat cardiovascular diseases, including arrhythmias such as premature ventricular contractions, bradyarrhythmias, and tachyarrhythmias, as well as viral myocarditis, coronary heart disease, and dilated cardiomyopathy.
(2)Nourishing the Heart and Calming the Spirit
The heart-nourishing and spirit-calming effects of Gan Cao (Licorice) are primarily used to treat insomnia, palpitations, and other conditions of disturbed spirit. Insufficient heart qi and blood deficiency lead to a lack of support for the heart and spirit, resulting in insomnia and palpitations. Zhi Gan Cao (Honey-Fried Licorice) can be used alone or combined with Shi Chang Pu (Acorus), Ren Shen (Ginseng), and Yuan Zhi (Polygala) to nourish the heart and calm the spirit, as seen in Gan Cao Wan (Licorice Pill) from the “Emergency Essentials of the Golden Chamber”.
Disturbed spirit is often caused by liver stagnation, insufficient heart qi, and blood deficiency, primarily manifesting as symptoms of depression. The treatment should focus on tonifying qi and blood, alleviating urgency, and calming the spirit. The “sweet and gentle” nature of Gan Cao (Licorice) can calm urgency and stabilize the spirit, often combined with Hua Xiaomai (Wheat) and Hong Zao (Red Dates) for the treatment of disturbed spirit, such as in Gan Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction).
2. Nourishing the Lungs
Gan Cao (Licorice) is sweet and neutral, entering the lung meridian. Li Dongyuan stated that it can “moisten the lungs” and can treat various lung deficiency symptoms. Depending on the combination, it can tonify lung qi, benefit lung yin, and moisten lung dryness. For lung qi tonification, it is often combined with Ren Shen (Ginseng) and Huang Qi (Astragalus), such as in the treatment of lung and kidney qi deficiency cough and asthma with Ren Shen Ge Jie San (Ginseng and Gecko Powder); for lung yin tonification, it is often combined with Bai He (Lily), Xuan Shen (Scrophularia), and A Jiao (Donkey-hide Gelatin), such as in Bai He Guo Jin Tang (Lily and Donkey-hide Gelatin Decoction) for lung and kidney yin deficiency; for moistening lung dryness, it is often combined with Mai Dong (Ophiopogon), Pi Pa Ye (Loquat Leaf), and A Jiao (Donkey-hide Gelatin), such as in Qing Zao Jiu Fei Tang (Moistening Dryness and Rescuing the Lungs Decoction).
Moreover, due to the phlegm-resolving, cough-relieving, and asthma-alleviating properties of Gan Cao (Licorice), it is also commonly used in non-lung deficiency cough conditions, which are not directly related to lung tonification, such as in the treatment of external cough with San Yao Tang (Three Yao Decoction), Zhi Sou San (Cough-Stop Powder), Hua Gai San (Flower Canopy Powder), for lung heat cough and asthma with Jie Geng Tang (Platycodon Decoction), for phlegm-heat cough with Qing Jin Hua Tan Tang (Clearing Metal and Transforming Phlegm Decoction), for lung dryness cough with Xing Su San (Apricot and Perilla Powder), and for cold phlegm cough with Leng Xiao Wan (Cold Cough Pill).
3. Nourishing the Spleen
The sweet flavor belongs to the earth and enters the spleen, effectively harmonizing the middle. The “Shen Nong’s Materia Medica” states that Gan Cao (Licorice) “strengthens muscles and bones, promotes muscle growth, and enhances strength,” as the spleen and stomach are the foundation of postnatal life, governing muscles and the four limbs. By tonifying the spleen, it can strengthen muscles and develop the limbs. The spleen-nourishing effect of Gan Cao (Licorice) is widely applied in the treatment of various conditions related to spleen deficiency.
(1)Nourishing the Middle and Benefiting Qi
The spleen governs transportation and transformation, and the key to normal transportation and transformation depends on sufficient spleen qi. Therefore, tonifying spleen qi to restore its function is fundamental in treating spleen-related conditions. Zhi Gan Cao (Honey-Fried Licorice) is sweet and neutral, entering the spleen meridian, and is effective in tonifying spleen qi, often combined with Ren Shen (Ginseng), Bai Zhu (Atractylodes), and Fu Ling (Poria), forming the Si Jun Zi Tang (Four Gentlemen Decoction), which is both a basic spleen tonifying formula and a foundational qi tonifying formula. The role of Zhi Gan Cao (Honey-Fried Licorice) in the formula has three aspects: it assists Ren Shen (Ginseng) in tonifying qi, maintains the potency of the formula, and benefits the stomach and harmonizes the middle. There are numerous modified formulas based on Si Jun Zi Tang (Four Gentlemen Decoction) that have spleen qi tonifying effects, such as Liang Jun Zi Tang (Six Gentlemen Decoction), Xiang Sha Liang Jun Zi Tang (Aromatic and Sand Six Gentlemen Decoction), Bao Yuan Tang (Preserving Origin Decoction), and Yi Gong San (Different Function Powder).
(2)Raising Yang and Lifting the Prolapse
Insufficient spleen qi and inability to hold can lead to the descent of middle qi, resulting in conditions such as gastric prolapse, kidney prolapse, rectal prolapse, and chronic diarrhea. The treatment should not only raise yang qi but also tonify middle qi. While Gan Cao (Licorice) does not have a lifting effect, it can enhance the effect of raising yang qi through its ability to tonify the middle and harmonize, often combined with Huang Qi (Astragalus), Chai Hu (Bupleurum), and Sheng Ma (Cimicifuga) to increase the effect of tonifying qi and raising yang, as seen in Buzhong Yiqi Tang (Tonifying the Middle and Benefiting Qi Decoction). Additionally, Gan Cao (Licorice) has similar effects in formulas for treating spleen not governing blood, such as Huang Tu Tang (Yellow Earth Decoction) and Juyuan Tang (Raising the Origin Decoction).
(3)Strengthening the Spleen and Transforming Accumulation
Insufficient spleen qi and loss of proper transportation can lead to food stagnation, abdominal distension, loose stools, and fatigue. The treatment should not only focus on timely digestion and transformation to address the symptoms but also appropriately tonify spleen qi to restore its transportation function for a fundamental cure. Gan Cao (Licorice) combined with Bai Zhu (Atractylodes) and Ren Shen (Ginseng) can tonify spleen qi, while combined with Shan Zha (Hawthorn), Shen Qu (Fermented Barley), and Mai Ya (Barley Sprout) can strengthen the spleen and aid digestion, as seen in Jian Pi Wan (Strengthening the Spleen Pill), Zhi Shi Xiao Pi Wan (Bitter Orange and Digestive Pill), and Zi Sheng Wan (Nourishing Life Pill).
(4) Strengthening the Spleen and Eliminating Dampness
The spleen governs the transportation of water and dampness; sufficient spleen qi ensures proper transportation. Insufficient spleen qi leads to the spleen’s inability to transport, resulting in dampness retention, which can lead to mixed conditions of deficiency and excess, and even phlegm retention and edema. The treatment should focus on strengthening the spleen and eliminating dampness, either by tonifying spleen qi or warming spleen yang, as seen in Ren Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Powder), Hou Po Wen Zhong Tang (Magnolia Bark Warming the Middle Decoction), and Ling Gui Zhu Gan Tang (Poria, Cinnamon, Atractylodes, and Licorice Decoction).
It should be noted that traditionally, it is emphasized that Gan Cao (Licorice) should not be used in cases of “phlegm-damp fullness,” as it is purely sweet and can easily generate dampness and phlegm. However, the formation of phlegm-damp fullness should be distinguished between deficiency and excess; if it is due to spleen deficiency, Gan Cao (Licorice) can still be used.
4. Soothing the Liver
The therapeutic effect of Gan Cao (Licorice) on the liver is reflected in its gentle nature, which can target the characteristics of the liver, such as softening and nourishing the liver, alleviating urgency, and calming wind. As mentioned in the “Huangdi Neijing (Yellow Emperor’s Inner Canon)”, “the liver is bitter and urgent; sweet foods can alleviate it.” In light of these characteristics, Gan Cao (Licorice) is often combined with Bai Shao (White Peony), as seen in Shao Yao Gan Cao Tang (Peony and Licorice Decoction), Si Ni San (Four Counterflow Powder), Xiao Yao San (Free and Easy Wanderer Powder), and Chai Hu Shu Gan San (Bupleurum Liver-Soothing Powder).
Modern pharmacological studies have found that licorice extract has a significant protective effect on experimental liver damage in animals, as well as strong anti-inflammatory properties, protecting liver cell membranes and improving liver function.
5. Regulating the Kidneys
Due to the physiological and pathological characteristics of the kidneys conflicting with the properties of Gan Cao (Licorice), historically, almost all kidney tonifying formulas do not contain Gan Cao (Licorice). Since the kidneys are located in the lower jiao of the body and govern water, dysfunction of the kidneys often leads to water retention. The “gentle” nature of Gan Cao (Licorice) is not only difficult to reach the lower jiao but also hinders other herbs from reaching it, potentially exacerbating water retention conditions rather than facilitating their elimination. Therefore, it is rarely used.
It is worth mentioning that there is one formula for treating kidney conditions that contains Gan Cao (Licorice), namely Feng Sui Dan (Sealing Marrow Pill) (also known as Feng Sui Dan (Phoenix Marrow Pill)). This formula consists of Huang Bai (Phellodendron), Sha Ren (Amomum), and Gan Cao (Licorice), first recorded in the “Imperial Pharmacy Formula” compiled by Xu Guozhen in the Yuan Dynasty, which has the effects of lowering heart fire and benefiting kidney water, primarily used for the syndrome of heart and kidney not communicating and excessive heart fire. However, the role of Gan Cao (Licorice) in this formula has not been uniformly recognized throughout history and remains a topic for discussion.
6. Assisting Yang and Transforming Yin
The so-called “combination reaction” of medicinal flavors refers to the phenomenon where two different medicinal flavors combined produce effects that the original flavors do not possess. This phenomenon is observed in single herbs and is more evident in the combination of different medicinal flavors. The most representative examples are “spicy sweet transforms yang” and “sour sweet transforms yin,” with Gan Cao (Licorice) being a representative herb in the “spicy sweet transforms yang” and “sour sweet transforms yin” categories due to its “extremely sweet and pure” characteristics.
Spicy Sweet Transforms Yang
A typical combination is the pairing of Gui Zhi (Cinnamon Twig) and Gan Cao (Licorice). For treating heart yang deficiency and palpitations, formulas such as Gui Zhi Gan Cao Tang (Cinnamon and Licorice Decoction), Gui Zhi Jia Gui Tang (Cinnamon Plus Cinnamon Decoction), Gui Zhi Xin Jia Tang (New Cinnamon Decoction), and Gui Zhi Gan Cao Long Gu Mu Li Tang (Cinnamon, Licorice, Dragon Bone, and Oyster Shell Decoction) can warm and promote heart yang; for treating middle jiao deficiency and cold, formulas such as Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) and Huang Qi Jian Zhong Tang (Astragalus Construct the Middle Decoction) can warm and assist spleen yang; for treating yang deficiency with phlegm retention and mixed deficiency and excess, Ling Gui Zhu Gan Tang (Poria, Cinnamon, Atractylodes, and Licorice Decoction) can warm yang and transform phlegm; for treating yang deficiency with cold stagnation and obstructed meridians, formulas such as Wen Jing Tang (Warming the Meridians Decoction) and Dang Gui Si Ni Tang (Angelica Four Counterflow Decoction) can warm yang and open the meridians.
Sour Sweet Transforms Yin
The Shao Yao Gan Cao Tang (Peony and Licorice Decoction) established by Zhang Zhongjing is a representative formula of the sour-sweet combination. The combination of Gan Cao (Licorice) with sour-flavored herbs is widely used to treat various conditions of yin deficiency and fluid loss with spasms, with typical combinations being Bai Shao (White Peony) and Gan Cao (Licorice). The pairing of Bai Shao (White Peony) and Gan Cao (Licorice) can be found in formulas such as Gui Zhi Tang (Cinnamon Decoction), Jian Zhong Tang (Construct the Middle Decoction), and Si Ni San (Four Counterflow Powder).
In summary, the nourishing effects of Gan Cao (Licorice) encompass qi, blood, yin, and yang, particularly focusing on nourishing the upper and middle jiao, while having no significant nourishing effect on the liver and kidneys. Moreover, the emphasis of its nourishing effects is related to the herbs it is combined with and the diseases it addresses. The diverse characteristics of Gan Cao (Licorice) in its nourishing effects are related to its extremely sweet and pure nature, as well as its dual characteristics of sweetness, which is a specific manifestation of its extensive clinical applications.
Warm Reminder
Although Gan Cao (Licorice) is beneficial, it is not suitable for everyone. Many practitioners believe that “sweetness promotes dampness,” thus avoiding its use in dampness-clearing and bitter-cold drying formulas. Some practitioners also believe that its sweetness is not conducive to regulating qi, hence avoiding its use in formulas for treating qi stagnation, imbalance of ascent and descent, and qi depression.
In traditional Chinese medicine, the “Eighteen Contradictions” record that Gan Cao (Licorice) is incompatible with Da Ji (Euphorbia), Yuan Hua (Genkwa), Gan Sui (Kansui), and Hai Zao (Sargassum), listing it as a contraindicated herb.
Modern research shows that long-term excessive use of Gan Cao (Licorice) may produce side effects similar to adrenal corticosteroids, leading to increased blood sodium, increased potassium excretion, resulting in hypertension, hypokalemia, and clinical manifestations such as edema and muscle weakness.
Therefore, in clinical prescriptions, it is essential to fully utilize the multifunctional effects of Gan Cao (Licorice), maximizing its strengths while avoiding its weaknesses, discerning the syndrome, and carefully selecting formulas and medications, strictly adhering to the compatibility rules of Gan Cao (Licorice) in formulas. Not every prescription should casually include Gan Cao (Licorice), nor should it be regarded as an optional ingredient. Specific applications should still be used rationally under the guidance of a professional physician!
Daily Dietary Therapy with Gan Cao (Licorice)
1. Chrysanthemum and Licorice Decoction:Take 120 grams of white chrysanthemum and 12 grams of Gan Cao (Licorice), soak for 30 minutes, then boil for 10 minutes, strain, and take while warm in four doses.
It can clear heat and detoxify, used for patients with carbuncles and swelling.
2. Gan Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction): Take 100 grams of Huai wheat, 10 jujubes, and 10 grams of Zhi Gan Cao (Honey-Fried Licorice). First, boil the Zhi Gan Cao (Honey-Fried Licorice) in water, extract the juice, then use the juice to cook the wheat and jujubes, simmer until the wheat is soft and forms a porridge.
Take one bowl on an empty stomach in the morning and evening, which has the effects of nourishing the heart, calming the spirit, harmonizing the middle, and alleviating urgency. It is used for mental confusion, sadness, and irritability caused by heart and liver blood deficiency.
3. Licorice and Mung Bean Soup: Take 100 grams of mung beans and 10 grams of raw Gan Cao (Licorice). Cook slowly with water and consume.
It can relieve summer heat and drug poisoning.
4. Sleep-Inducing Licorice Soup: Take 9 grams of Gan Cao (Licorice), 50 grams of wheat, and 9 jujubes, with 1000 milliliters of water. After boiling, simmer for 15 minutes, strain, and drink as tea.
It has the effects of relieving depression and anxiety, benefiting qi, and strengthening the spleen. It is used for patients with anxiety, difficulty falling asleep, or light sleep with frequent awakenings.
5. Licorice and Two Flowers Drink: Take 9 grams of white chrysanthemum, 6 grams of safflower, 6 grams of Gan Cao (Licorice), and 10 grams of sugar. First, wash the chrysanthemum and safflower to remove impurities, then add them and Gan Cao (Licorice) to 250 milliliters of water, boil on high heat, then simmer for 10 minutes, and finally add sugar to drink as tea.
It has the effects of soothing the liver, dispelling wind, and clearing heat and detoxifying, used for chronic hepatitis with symptoms of headache and red eyes.
6. Honey Date Licorice Soup:Take 8 honey dates and 6 grams of raw Gan Cao (Licorice). Add the honey dates and raw Gan Cao (Licorice) to 2 bowls of water and boil until reduced to 1 bowl, then strain and consume.
It has the effects of tonifying the middle, benefiting qi, detoxifying, moistening the lungs, and resolving phlegm. It is suitable for dry throat, sore throat, chronic bronchitis cough, and tuberculosis cough.
Source: Journal of Traditional Chinese Medicine
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