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Liver Fire - 
Red, Hot, Itchy and Pus

Liver Fire - Red, Hot, Itchy and Pus Formula is for any three of these four symptoms, coming from the inside the body to the outside, anywhere in the body. For conjunctivitis, ear infection, herpes simplex, zoster, red and weeping skin conditions all the way up to Pelvic Inflammatory Disease. This is an essential formula to keep at home for the family when these common problems arise.

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Liver Fire - Red, Hot, Itchy and Pus

INGREDIENTS

Each pill contains the equiv. to dry:

 

Rehmannia, root, fresh 53.6mg

Chinese Plantain, seed 53.6mg

Japanese Gentian, root 40.2mg

Chinese Thorow-wax, root 40.2mg

Water Plantain, rhiz. 40.2mg

Gardenia, flower, unopened 40.2mg

Baikal Skullcap, root 40.2mg

Dong Quai, root 26.8mg

Evergreen Clematis, stem 26.8mg

Licorice, root 13.5mg

 

 

Store below 30°C

Contains 200 x 200mg pills.

AUSTL 478645

Manufactured In Australia.

 

Indications: any three of the four symptoms, coming from the inside out, anywhere in the body.

Actions: drain the liver, clear toxic heat, dry pus and alleviate itch.

Dosages: 12 - 15 pills, 2 - 3 times per day, or as symptoms return. Take near food.

Children: 6 months an over 1 pill per year of age up to the age of 10 as directed above.

Over use, don’t under use. Treat sooner rather than later.

Long Dan Xie Gan Tang – "Liver Fire"

A classical Chinese herbal formula traditionally used to calm intense inflammation, clear excessive Heat and support conditions characterised by redness, heat, swelling and irritation.

 

What is Long Dan Xie Gan Tang?

Some inflammatory conditions are mild.

Others are impossible to ignore.

The skin becomes bright red.

The area feels hot to touch.

The itching becomes relentless.

Pus may begin to develop.

Traditional Chinese Medicine (TCM) recognised this pattern centuries ago and described it as Liver and Gallbladder Fire or Damp-Heat.

Long Dan Xie Gan Tang (龙胆泻肝汤) is one of Chinese medicine's most powerful formulas for reducing this type of excessive inflammatory Heat.

At Chiron Medical we call it "Liver Fire."

Although the name refers to the Liver in Chinese medicine, the formula is not limited to liver disease. Instead, it addresses one of the body's most recognisable inflammatory patterns—where tissues become red, hot, itchy and may produce pus.

 

A Formula with More Than 700 Years of History

Long Dan Xie Gan Tang first appeared in Lan Shi Mi Cang (Secret Treasury of Master Lan), written by Li Dongyuan during the 13th century.

It quickly became one of the defining formulas for treating conditions involving intense Heat, inflammation and Damp accumulation affecting the Liver and Gallbladder channels.

Today it remains one of the most widely prescribed formulas for inflammatory disorders throughout East Asia.

The Four Warning Signs

One of the easiest ways to recognise the traditional pattern treated by Long Dan Xie Gan Tang is to remember four words:

 

Red. Hot. Itchy. Pus.

When three or more of these features occur together, the traditional Chinese medicine pattern often points toward Liver Fire or Damp-Heat.

For example:

  • Red + Hot + Itchy

  • Hot + Itchy + Pus

  • Red + Hot + Pus

  • Red + Itchy + Pus

 

This is not a diagnosis, but rather a simple way to recognise when inflammation has become excessive.

Whether the problem is affecting the skin, ears, eyes, urinary tract or genital region, this combination of symptoms frequently reflects the classical pattern for which Long Dan Xie Gan Tang was developed.

 

Why We Call It "Liver Fire"

In Chinese medicine, the Liver governs the smooth movement of energy throughout the body.

When Heat becomes trapped within this system, symptoms often become intense.

 

People may experience:

  • red inflamed skin

  • burning sensations

  • severe itching

  • yellow discharge

  • pus formation

  • swollen glands

  • painful urination

  • genital inflammation

  • red eyes

  • headaches

  • bitter taste

  • irritability

Modern medicine recognises many of these as signs of significant inflammatory activation.

Chinese medicine grouped them together thousands of years ago.

 

What Is It Traditionally Used For?

Traditionally, Long Dan Xie Gan Tang is prescribed for Liver and Gallbladder Damp-Heat.

 

Skin Disorders

  • infected eczema

  • inflamed dermatitis

  • severe acne

  • folliculitis

  • shingles (pattern dependent)

  • cellulitis (adjunctive care)

  • boils

 

Eye Conditions

  • red eyes

  • painful eyes

  • conjunctival inflammation

 

Ear Conditions

  • acute ear inflammation

  • painful ears

  • infected external ear

 

Urinary and Genital Conditions

Traditionally prescribed for:

  • painful urination

  • urinary burning

  • genital inflammation

  • Damp-Heat affecting the lower body

 

Other Applications

  • migraines associated with Liver Fire

  • bitter taste in the mouth

  • rib-side discomfort

  • emotional irritability with Heat

 

 

The Ten Herbs That Make the Formula

 

Inflammation rarely stays where it starts. Like a bushfire driven by a strong wind, Heat can spread through the Liver and Gallbladder, affecting the eyes, ears, skin, urinary tract and reproductive system.

 

Long Dan Xie Gan Tang was designed to stop that process quickly. Some herbs extinguish the inflammatory fire, others drain away the Dampness that fuels it, while several protect healthy tissues and help the body safely eliminate the excess Heat. Together they restore balance without allowing inflammation to continue smouldering beneath the surface.

 

Long Dan Cao (Gentian Root)

 

Traditional Role

Long Dan Cao is the firefighter leading the response. It rapidly extinguishes intense Liver and Gallbladder Fire, cooling the fierce inflammation responsible for red eyes, headaches, tinnitus, genital inflammation and Damp-Heat throughout the lower body.

 

Biomedical Role

Modern research demonstrates anti-inflammatory, antioxidant and hepatoprotective effects together with modulation of immune responses. It remains the principal herb responsible for reducing excessive inflammatory Heat within the formula.

 

Huang Qin (Baikal Skullcap Root)

 

Traditional Role

If Long Dan Cao extinguishes the flames, Huang Qin cools the surrounding forest. It clears Heat throughout the upper body while drying Dampness, preventing inflammation from spreading into the lungs, digestive system and biliary tract.

 

Biomedical Role

Rich in baicalin and baicalein, Huang Qin demonstrates potent anti-inflammatory, antibacterial, antiviral and antioxidant activity together with protection against inflammatory tissue damage.

 

Zhi Zi (Gardenia Fruit)

 

Traditional Role

Heat must leave the body once it has been extinguished. Zhi Zi opens the exits, directing excess Heat downward through the San Jiao and out via the urine while calming the agitation and irritability that often accompany inflammatory illness.

 

Biomedical Role

Research suggests antioxidant, neuroprotective and anti-inflammatory properties together with modulation of inflammatory signalling pathways.

 

Ze Xie (Alisma Rhizome)

 

Traditional Role

Ze Xie acts like the drainage system after heavy rain. It removes excess fluids carrying Damp-Heat while protecting Yin, helping flush inflammation without drying the body unnecessarily.

 

Biomedical Role

Studies suggest mild diuretic, anti-inflammatory and lipid-regulating effects together with support for healthy renal function and fluid homeostasis.

 

Che Qian Zi (Plantain Seed)

 

Traditional Role

Che Qian Zi continues the cleansing process. It encourages Damp-Heat to leave through the urinary tract while soothing inflamed tissues and helping clear Heat affecting both the bladder and the eyes.

 

Biomedical Role

Modern research demonstrates anti-inflammatory, antioxidant and urinary tract supportive properties together with beneficial effects on renal physiology.

 

Sheng Di Huang (Raw Rehmannia Root)

 

Traditional Role

Intense Heat scorches the body's fluids. Sheng Di Huang replenishes what the fire has consumed, cooling the Blood and restoring Yin so healing can begin once the inflammation settles.

 

Biomedical Role

Research demonstrates antioxidant, immunomodulatory and anti-inflammatory effects together with protection against oxidative stress and support for healthy tissue repair.

 

Dang Gui (Chinese Angelica Root)

 

Traditional Role

Inflamed tissues still require nourishment. Dang Gui restores healthy circulation, delivering fresh Blood to damaged areas while supporting repair once the acute inflammation has passed.

 

Biomedical Role

Modern studies suggest improved microcirculation, vascular protection, tissue repair and anti-inflammatory activity that complements the cooling herbs within the prescription.

 

Chai Hu (Bupleurum Root)

 

Traditional Role

Fire often rises because Liver Qi has become trapped. Chai Hu releases that pressure, allowing constrained Liver Qi to move freely so Heat is less likely to build again.

 

Biomedical Role

Research suggests immunomodulatory, hepatoprotective and anti-inflammatory effects together with regulation of inflammatory signalling pathways involved in chronic stress and liver disease.

 

Gan Cao (Liquorice Root)

 

Traditional Role

Every emergency response needs coordination. Gan Cao harmonises the prescription, protecting the digestive system while ensuring the stronger Heat-clearing herbs work together without becoming overly harsh.

 

Biomedical Role

Liquorice possesses anti-inflammatory, antioxidant and gastroprotective properties while demonstrating immunomodulatory effects that support recovery.

 

Why These Herbs Work Together

Long Dan Xie Gan Tang is one of Chinese medicine's most powerful formulas for clearing inflammatory Heat, but its strength lies in its balance.

 

Long Dan Cao, Huang Qin and Zhi Zi rapidly extinguish the inflammatory fire. Ze Xie and Che Qian Zi drain away the Dampness that feeds it, while Sheng Di Huang replenishes the fluids consumed by prolonged Heat. Dang Gui restores healthy circulation to damaged tissues, Chai Hu releases the underlying Liver Qi stagnation that allowed the Heat to build, and Gan Cao harmonises the entire prescription.

 

In Traditional Chinese Medicine, the formula clears Liver and Gallbladder Fire, drains Damp-Heat, cools the Blood and restores the smooth movement of Liver Qi. It is particularly suited to conditions where inflammation is intense, localised and accompanied by obvious Heat signs.

 

From a modern biomedical perspective, the constituent herbs have demonstrated anti-inflammatory, antioxidant, antimicrobial, hepatoprotective and immunomodulatory effects together with actions supporting endothelial function, urinary elimination and tissue repair. These complementary mechanisms reflect current understanding that inflammatory disease involves immune activation, oxidative stress, impaired circulation and tissue injury occurring simultaneously.

 

Rather than simply treating red eyes, eczema, urinary infections or genital inflammation as isolated problems, Long Dan Xie Gan Tang addresses the inflammatory environment driving them all.

What Does Modern Research Say?

Research has explored Long Dan Xie Gan Tang in relation to:

 

Dermatology

  • eczema

  • acne

  • dermatitis

  • psoriasis (selected patterns)

 

Liver Disease

  • hepatitis

  • fatty liver disease

  • inflammatory liver disorders

 

Urology

  • urinary tract inflammation

  • prostatitis

  • pelvic inflammatory conditions

 

Neurology

  • migraine

  • inflammatory headache

Experimental studies suggest actions involving:

  • NF-κB inhibition

  • inflammatory cytokine regulation

  • antioxidant activity

  • antimicrobial effects

  • immune modulation

Although further clinical research is required, the pharmacological profile closely mirrors its traditional use.

 

Comparing the Major Heat-Clearing Formulas

Many Chiron Medical formulas reduce inflammation, but each has its own specialty.

Long Dan Xie Gan Tang - Liver Fire - Intense inflammation with red, hot, itchy and pus

Wu Wei Xiao Du YinI - Inflammation - Skin infections, boils, cellulitis and acute inflammatory swelling

Yin Qiao San - No.1 Fever & Flu - Early viral respiratory infections

Huang Lian Jie Du Tang - Sudden Diarrhea - Severe Heat and toxicity affecting the digestive system and multiple organs

Si Miao Yong An Tang - Bleeding - Inflamed blood vessels, ulcers and damaged vascular tissue

 

Together these formulas demonstrate one of Chinese medicine's greatest strengths—not every inflammatory condition is treated the same way.

 

For Traditional Chinese Medicine Practitioners

 

Classical Pattern

Liver and Gallbladder Damp-Heat

Typical presentation:

  • red lesions

  • burning pain

  • itching

  • yellow discharge

  • pus

  • bitter taste

  • irritability

  • dark urine

  • red tongue with greasy yellow coating

  • wiry rapid pulse

 

Formula Strategy

Long Dan Xie Gan Tang:

  • Clears Liver Fire.

  • Drains Damp-Heat.

  • Resolves toxicity.

  • Protects Yin.

  • Harmonises Liver Qi.

Common Clinical Modifications

Frequently adapted for:

  • herpes zoster

  • severe acne

  • eczema

  • prostatitis

  • urinary tract inflammation

  • pelvic inflammatory disorders

  • genital herpes (pattern dependent)

 

For Medical Doctors

 

Proposed Biomedical Actions

Current research suggests the constituent herbs influence:

  • NF-κB signalling

  • inflammatory cytokines

  • oxidative stress

  • antimicrobial pathways

  • hepatoprotection

  • immune modulation

  • urinary inflammatory responses

Major bioactive compounds include:

  • gentiopicroside

  • baicalin

  • baicalein

  • geniposide

  • catalpol

  • glycyrrhizin

 

Collectively these compounds demonstrate anti-inflammatory, antimicrobial, antioxidant and hepatoprotective properties.

 

Potential Herb–Drug Considerations

Clinical monitoring is appropriate when patients are taking:

  • antibiotics

  • antiviral medications

  • corticosteroids

  • immunosuppressive therapies

  • anticoagulants (general precaution)

 

The formula should not delay appropriate medical management of severe bacterial infection, rapidly spreading cellulitis, ocular emergencies or significant urinary tract infections.

 

When Inflammation Becomes Obvious

Inflammation isn't always hidden.

Sometimes the body makes it impossible to ignore.

The tissues become:

  • Red.

  • Hot.

  • Itchy.

  • Filled with pus.

When three of these four signs appear together, Traditional Chinese Medicine recognises a classic inflammatory pattern that has guided practitioners for centuries.

That is why we call this formula "Liver Fire."

Not because the liver itself is necessarily diseased, but because Chinese medicine uses the term "Liver Fire" to describe a pattern of excessive inflammatory Heat that can appear throughout the body. It is one of the clearest examples of how traditional pattern recognition often parallels modern understanding of acute inflammatory processes.

 

Key Takeaways

  • Long Dan Xie Gan Tang is a classical Heat-clearing formula first developed during the 13th century for intense inflammatory conditions.

  • At Chiron Medical it is called "Liver Fire" because it treats the traditional pattern of excessive Heat affecting the Liver and Gallbladder channels.

  • A simple memory aid is "Red, Hot, Itchy, Pus." When three of these four features occur together, the classical pattern often points towards this formula.

  • Modern research supports anti-inflammatory, antimicrobial, antioxidant and immunomodulatory actions that align closely with its traditional indications.

  • Long Dan Xie Gan Tang should be prescribed by a qualified Chinese medicine practitioner after individual assessment and used alongside appropriate medical care. Severe infections, rapidly spreading skin disease, painful red eyes, urinary obstruction or high fever require prompt medical evaluation.

 

Clinical Perspective

Within the Chiron Medical range, Long Dan Xie Gan Tang ("Liver Fire") occupies a central role among the Heat-clearing formulas. While Yin Qiao San ("Fever & Flu") targets the earliest stages of viral respiratory illness and Wu Wei Xiao Du Yin ("Inflammation") focuses on superficial infections and abscesses, Long Dan Xie Gan Tang is selected when inflammation has become intense, localised and unmistakable. Its characteristic pattern—redness, heat, itching and pus—provides one of the simplest and most memorable clinical guides in Traditional Chinese Medicine. It reflects an enduring principle that remains relevant today: the quality of inflammation often tells us as much as its location, helping practitioners choose the most appropriate treatment for the pattern in front of them.

Clinical Insights

 

Organ-Specific Inflammatory Heat

Liver Fire is designed for inflammatory conditions where excessive Heat has become concentrated within particular organs or tissues.

Typical presentations include:

  • red inflamed skin

  • acne

  • eczema

  • psoriasis

  • urinary burning

  • genital inflammation

  • bitter taste

  • red eyes

  • irritability

  • headaches

Rather than simply reducing inflammation throughout the body, the formula helps regulate excessive inflammatory activity where it has become localised.

 

Mild to Moderate Acne

When acne presents with:

  • red pimples

  • oily skin

  • mild pustules

  • facial inflammation

practitioners frequently combine:

This combination addresses both the local skin inflammation and the underlying inflammatory Heat contributing to acne formation.

 

Moderate to Severe Acne

As acne becomes increasingly inflamed with:

  • painful pustules

  • widespread redness

  • multiple inflamed lesions

practitioners commonly combine:

This reflects progression from local inflammatory Heat to more active Heat Toxin affecting the skin.

 

Chronic or Refractory Acne

When acne has persisted for many months or years with repeated flare-ups, practitioners frequently combine:

Long-standing acne often involves persistent inflammation with impaired circulation and deeper tissue involvement. This combination supports both inflammatory control and healthy tissue repair.

 

An alternative approach, particularly where metabolic congestion is evident, is to combine:

This recognises the close relationship between liver metabolism, hormonal regulation and chronic inflammatory skin disease.

 

Acute Hepatitis

When inflammatory Heat affects the liver with:

  • hepatitis

  • jaundice

  • right upper abdominal discomfort

  • elevated liver enzymes

practitioners frequently combine:

This combination supports healthy liver function, bile flow and recovery from acute inflammatory liver disease.

 

Acute Urinary Tract Infection

When inflammatory Heat extends into the urinary tract with:

  • burning urination

  • urgency

  • frequency

  • bladder irritation

practitioners commonly combine:

Where infection becomes more severe or penetrates more deeply into surrounding tissues, practitioners frequently progress to:

 

Eczema and Dermatitis

When eczema becomes:

  • intensely red

  • hot

  • inflamed

  • weeping

practitioners commonly combine:

If inflammation becomes severe or secondary infection develops, practitioners frequently add:

This progression reflects the movement from inflammatory skin disease towards deeper tissue involvement.

 

Vaginitis and Damp-Heat

Inflammatory conditions affecting the female reproductive tract may present with:

  • yellow or green discharge

  • offensive odour

  • itching

  • burning

  • pelvic discomfort

Practitioners frequently combine:

This layered approach addresses local inflammatory Heat, microbial activity and deeper tissue inflammation.

 

Perianal Furuncles

Painful perianal boils and abscesses often represent intense localised Heat Toxin.

Practitioners commonly combine:

to improve circulation through inflamed tissues while supporting resolution of deep infection.

 

Chronic Psoriasis

Psoriasis frequently evolves from active inflammation to chronic tissue change.

Where plaques become:

  • thick

  • persistent

  • inflamed

  • difficult to resolve

practitioners commonly combine:

This recognises that successful treatment often requires reducing inflammation while restoring healthy circulation through chronically affected skin.

 

Understanding the Chiron Medical Inflammation Network

 

One of the central concepts of the Chiron Formula Network is that inflammation evolves in stages.

Colds, Shivers & Sniffles (Gui Zhi Tang)

The immune system first encounters an invading pathogen.

No.1 Flu, Fever, Virus & Infection (Yin Qiao San)

Early inflammatory Heat develops.

X Factor (Xiao Chai Hu Tang)

The illness reaches the physiological pivot point between exterior and interior disease.

Throat Infection (Yang Yin Qing Fei Tang)

Inflammation localises within the upper respiratory tract.

Liver Fire (Long Dan Xie Gan Tang)

Inflammatory Heat becomes concentrated within specific organs, particularly the liver, gallbladder, skin and urogenital system.

Inflammation (Wu Wei Xiao Du Yin)

Local inflammatory Heat progresses to Heat Toxin, producing red, swollen and painful soft tissue infections.

Bleeding (Si Miao Yong An Tang)

Inflammation penetrates more deeply into tissues with vascular involvement, impaired circulation and risk of tissue destruction.

Break High Fever (Chuan Xin Lian Jie Du Tang)

Inflammation becomes systemic with severe constitutional symptoms and widespread immune activation.

 

Inflammation Changes Location as Disease Progresses

One of the most valuable lessons taught by Liver Fire is that inflammation is not static—it migrates and localises.

Early in illness, inflammation may be generalised, producing fever and malaise. As disease progresses, inflammatory activity often concentrates within particular organs, leading to acne, eczema, urinary tract infections, hepatitis or genital inflammation. If this localised inflammatory response is not controlled, it may progress further into deep tissue infection, impaired circulation and tissue damage.

Liver Fire therefore occupies the critical middle ground within the Chiron Medical Infection Network. It teaches practitioners to recognise when inflammation has moved beyond a simple viral illness but has not yet progressed to destructive infection. Early intervention at this stage may prevent the development of chronic inflammatory disease and reduce the risk of more severe complications.

One of the core principles of the Chiron Formula Network is reflected here:

Inflammation does not simply become more severe—it becomes more organised. Recognising where inflammation has localised allows treatment to be matched to the affected tissue before deeper damage occurs.

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