Short of Breath, Limp Limbs, Panting After Any Exercise? Doctor Zhang Xichun’s Answer
Patient search terms: shortness of breath / can’t catch the breath / panting after any exercise / weak limbs / listless, no energy / always wanting to lie down Medical terms: sinking of the great qi (da qi xia xian) · sunken chest qi · heart-lung qi deficiency with stagnant heat in the liver and gallbladder
The opening: a disease nobody notices — and the comment section exploded
As Doctor Luo Dalun worked through Doctor Zhang Xichun’s formulas, he stumbled onto something he hadn’t expected: the disease that got the most enthusiastic responses in his comment section was “sinking of the great qi.” Many listeners wrote that they had been shuffled between hospitals for years, treated for everything under the sun, never knowing they actually had this condition — and once they understood it, they used Doctor Zhang’s original formula and were better within a few doses.
💬 Note from Doctor Luo: Why is this disease missed so easily? Because even TCM practitioners today — not to mention ordinary people — barely know it anymore. Yet it may be everywhere. Modern people have lots of qi deficiency and lots of overwork, so quite a lot of people actually have sinking of the great qi. (A side note: I record one of these segments every morning. It sounds simple, but it isn’t always easy — sometimes I’m traveling, sometimes the house is being renovated with banging and drilling all around, and I still try my best to make sure you can hear me clearly.)
Who was the patient? A rickshaw puller who worked on an empty stomach
The patient was Li Denggao, from En County, Shandong, only thirty-two years old, living on Rui’an Street in Hedong, Tianjin, earning his living by pulling a rickshaw — hard physical labor.
How did he get sick? That day his stomach was a little empty, but a fare came up and he couldn’t refuse it. So on an empty stomach he pulled the rickshaw for a stretch of seven or eight li (about three or four kilometers) without stopping. By the time the job was done, the illness had arrived — what Doctor Zhang Xichun called sinking of the great qi.
💬 Note from Doctor Luo: This disease is not only for the elderly — young people get it too. Doing heavy physical labor on an empty stomach is one of the surest ways to drain the great qi from the chest. My advice to everyone: eat your meals on time, no matter what work shows up. So many people grit their teeth and push through, and they push themselves straight into illness.
The cause is identical: Li Dongyuan saw this disease centuries ago
Readers who know their history will think of someone here — Doctor Li Dongyuan (Li Gao, 1180–1251). Doctor Luo points out that when Li Dongyuan served as an official in the Jin kingdom, the capital was besieged by Mongol troops, and everyone had to defend the city on empty stomachs. A great many people fell ill with a similar condition, and it was for them that Li Dongyuan created Bu Zhong Yi Qi Tang (Tonify the Middle and Replenish Qi Decoction). Li Denggao’s cause was exactly what Li Dongyuan described: an empty stomach, a weakened spleen and stomach, then physical labor — the qi moves downward, and you get sinking of the middle qi.
So here’s the question: Doctor Zhang’s Sheng Xian Tang and Li Dongyuan’s Bu Zhong Yi Qi Tang are both tonics with a few lifting herbs. What’s the difference?
💬 Note from Doctor Luo: Doctor Zhang Xichun was certainly inspired by Li Dongyuan — he read the old masters, saw this line of thinking, and created Sheng Xian Tang. The two share essentially the same cause and similar logic; the difference is where each one focuses. Li Dongyuan focused on the whole spleen and stomach — more spleen-tonifying herbs, plus lifting herbs. Doctor Zhang Xichun noticed that when this condition flares up, the symptoms between the heart and lungs, in the chest, are the most obvious, so he leaned on sheng huang qi (raw astragalus) to tonify, then added jie geng, sheng ma and chai hu to lift the qi upward. The force is concentrated, which is why Doctor Zhang’s formula works on chest and heart-lung symptoms almost instantly.
But Doctor Luo adds a special reminder: after using Sheng Xian Tang, you absolutely must tonify the spleen and stomach. Lifting the qi back up isn’t the end of the story — you need to help the body reset and recover, then build up the righteous qi afterward. That foundation is something Doctor Zhang didn’t spell out in his book, but you need to know it.
How sick was he? The classic sign: “limp and listless”
What were the symptoms? Doctor Zhang Xichun laid them out clearly.
First, shortness of breath — both the exhale and the inhale feel labored, as if the breath can’t quite reach, and you have to strain to breathe. Second, heat in the chest. Third, loss of appetite — no desire for food, because when the righteous qi is insufficient, the spleen and stomach qi can’t move and transform food, and the receiving function fails.
Fourth — and this is the most important symptom: weak, limp limbs. In the northeastern dialect of Chinese it’s called “lan tuo tuo de” — a lazy, droopy, boneless feeling, nothing like a lively, vigorous state. With the slightest exercise, the breath comes up short and you’re panting immediately — this tells you the heart and lung function is declining.
💬 Note from Doctor Luo: Please remember: weak, limp limbs are one of the most important diagnostic signs of sinking of the great qi. Some people also alternate between chills and fever (what TCM calls “alternating cold and heat”) — when the righteous qi rallies, you feel hot; when it’s insufficient, you feel cold. Then there’s dry throat and thirst, fullness in the chest with palpitations, even poor memory — because qi and blood can’t rise to supply the head, which affects the spirit and thinking; in the daytime you feel foggy, as if in a dream. Doctor Zhang listed all these symptoms in his writing, and we’ll collect them one by one over the coming sessions.
One touch of the pulse, and the root of the illness was clear
Doctor Zhang Xichun always observed the patient’s family situation, his joys and sorrows. Looking at this man, he saw: a laborer, the main breadwinner of his household — now too weak to work. How would the family survive? There was fire in this man’s heart; he was worrying himself sick.
Then the pulse: left side wiry and hard; right side, both the inch and bar positions, deep and weak. The left wrist corresponds to heart, liver and kidney — a person with fire in the heart and liver shows a wiry, hard pulse. The right wrist’s inch and bar positions correspond to lung and spleen — the lung and spleen are deficient, the righteous qi is insufficient, and the great qi has sunk. The pulse matched the analysis perfectly.
💬 Note from Doctor Luo: This is the classic picture — deficient on one side, fire on the other: the great qi of the chest has sunk, and at the same time there’s heat in the liver and gallbladder. So the strategy is clear — tonify and lift on one side, drain the liver-gallbladder fire on the other. Tonifying alone won’t do it, and just draining the fire is also wrong.
The prescription: modified Sheng Xian Tang, seven herbs each doing its job
Doctor Zhang Xichun prescribed Sheng Xian Tang with additions (Lift the Sunken Qi Decoction). This formula treats sinking of the great qi with breath too short to be completed: the qi is always insufficient, the patient must strain to breathe, it looks like wheezing, and in severe cases breathing seems about to stop — danger within the hour.
The formula is simple, just seven herbs:
Sheng huang qi (raw astragalus) — eight qian (24 g) in this case; the original formula uses six qian. Astragalus tonifies the qi of the whole body, raises the yang, secures the exterior and stops sweating; it can also expel pus and grow flesh, and drain water to reduce swelling. Its nature is especially gentle and mild.
Zhi mu (anemarrhena) — clears heat. Why pair it in? Because astragalus has a warming nature, and you need zhi mu’s cool, moistening quality to restrain it. This was Doctor Zhang’s design: don’t finish the course only to find yourself hotter than before.
The remaining three all lift upward: chai hu (bupleurum) enters the shaoyang channel and moves upward, letting the great qi of the chest rise on the left side; sheng ma (cimicifuga) enters the yangming channel, letting the great qi rise on the right side — stomach qi normally descends on the right, and sheng ma pulls it back up; jie geng (platycodon) — the old saying is that it acts like a boat, carrying the medicinal action upward. In the original formula these three are all small doses, about one and a half qian each; in this case jie geng and chai hu were two qian each, and sheng ma one qian.
Finally, two additions: sheng bai shao (white peony) softens and restrains the liver, and long dan cao (Chinese gentian), two qian, drains damp-heat and fire from the liver and gallbladder — you’ve got fire? While we tonify, we also massage the liver and drain the fire.
💬 Note from Doctor Luo: Note that the formula uses sheng huang qi (raw astragalus), not honey-fried astragalus. Pharmacies carry both. Raw astragalus is gentle in force and neutral in nature, with strong exterior-securing and sweat-stopping action — it’s used for spontaneous sweating from deficiency, wounds that never heal, and edema from dampness. Honey-fried astragalus is better at nourishing and generating blood, but its nature leans warm; in large doses it can easily turn into a heat pattern, so you have to handle it with care. When I use astragalus to tonify, I prefer the raw form and use a generous dose — when I treated my own elderly mother’s chronic nephritis, every formula carried raw astragalus at 30 g or more, sometimes up to 50 g.
Two doses, and all the illnesses suddenly vanished
How did it go? Doctor Zhang Xichun says: after two consecutive doses, all the illnesses suddenly healed — every symptom disappeared at once.
💬 Note from Doctor Luo: This is Doctor Zhang Xichun’s standard of practice: accurate analysis of the symptoms, a prescription that hits the core of the problem, simple medicines — just a few herbs — with clear intention, and results that show immediately. That’s why we often say with feeling: after Doctor Zhang Xichun, no master of this caliber ever appeared again in Chinese medicine. No one has stood shoulder to shoulder with him.
The pity: such a wonderful formula, later neglected
What’s truly regrettable is that after Doctor Zhang Xichun, the TCM world didn’t pay enough attention to sinking of the great qi. Search through the books of all the famous physicians, and you’ll find few case records devoted to it.
Why? Doctor Luo’s analysis: one reason is that Sheng Xian Tang and Bu Zhong Yi Qi Tang are so similar in approach — Li Dongyuan’s fame was greater, so everyone treated along his lines, gradually overlooking the concentrated manifestation in the chest that defines sinking of the great qi. The result? Modern people have plenty of qi deficiency and overwork; many, many people carry the symptoms of sinking of the great qi — and no matter how they’re treated in hospitals, nothing works, because no one even thinks of this diagnosis.
💬 Note from Doctor Luo: Since I started presenting Doctor Zhang Xichun’s formulas, I’ve received many messages: “I’ve been treated for two or three years and nothing ever got better — then I heard your talk, realized this is sinking of the great qi, used Sheng Xian Tang, and was better in two or three doses.” This shows sinking of the great qi is not some vague phantom — it truly exists, and we’ve simply been ignoring it. Over the next stretch of time I’ll work through the sinking-of-the-great-qi cases one by one and summarize the symptoms — once you can recognize it, adjusting it becomes simple.
Bonus: Doctor Luo’s own “empty stomach” experience
Speaking of which, Doctor Luo shared a personal story: during his doctoral studies, he was invited to give a guest lecture at a school far away. In the morning the dining hall wasn’t open yet, so there was no time to eat — he caught the shuttle bus and went, lecturing on an empty stomach. After the class, he found it hard to pull his breath up. It hit him at once: this is exactly the sinking of the great qi Doctor Zhang Xichun described.
And then there are the elderly: going out to exercise on an empty stomach in the morning, walking a full loop of the park, and coming back unable to get their breath up — it won’t lift. They think there’s something wrong with their heart, so they go to the hospital again and again, endlessly treating “heart disease.” In fact? It’s sinking of the great qi.
💬 Note from Doctor Luo: You can’t know this feeling until you’ve lived it — but once you have, you know: that breath genuinely will not come up. And the formula is so simple — just astragalus with a little zhi mu, plus three herbs that lift upward, small doses, all mild herbs, nothing toxic — yet the effect is this good. It’s worth studying carefully.
Case source: Records of Chinese Medicine with Western Reference by Doctor Zhang Xichun; commentary based on public lectures by Doctor Luo Dalun (PhD in TCM diagnostics, Beijing University of Chinese Medicine).