In Liu Yi San, what is the ratio of Hua Shi to Gan Cao?

• A. 6:1
• B. 3:1
• C. 1:6
• D. 2:1

Answer: (A)

In Liu Yi San the main action is to clear damp-heat and promote urination, with Hua Shi doing the heavy lifting and Gan Cao acting as a harmonizer. The formula is literally named Six-to-One Powder, reflecting 6 parts Hua Shi to 1 part Gan Cao. Hua Shi is a strong damp-heat-clearing ingredient that drives the diuretic effect, which helps relieve urine-burning symptoms and clear heat from the urinary tract. Gan Cao, in a smaller amount, moderates and harmonizes the formula, protecting the GI tract and preventing the harshness of Hua Shi from irritating the stomach or esophagus. Because the goal is to emphasize the damp-heat-clearing power of Hua Shi while keeping the preparation responsive and safe, the 6:1 ratio is the best fit. Smaller or larger proportions of Gan Cao would either dilute the primary action or increase potential adverse effects, which is not aligned with how Liu Yi San is traditionally formulated.