Dizzy the Moment You Close Your Eyes, Spirit Floating, Too Tired to Talk? Imperial Physician Gong Tingxian’s Treatment of Deficiency with Zhusha Anshen Wan and Buzhong Yiqi Tang
Search terms patients use: Dizzy the moment I close my eyes / Room spins with eyes shut / Spirit floating / No breath when talking / Can’t catch my breath / No appetite / Exhausted all the time / Heart fluttering with anxiety
Medical terms: Deficiency and exhaustion (xu sun) · Sinking of middle qi · Deficiency of the heart-spirit · Insufficiency of original qi · Deficiency of both heart and spleen
Opening: this Ming imperial physician’s way of treating illness suits modern people especially well
Today’s story is about the famous Ming-dynasty physician Doctor Gong Tingxian — the man who lived to 97, the “Champion Physician of the Medical World” (yi lin zhuang yuan), an imperial physician at the Academy of Imperial Physicians, the doctor who cured a strange illness of the Prince of Lu’s consort. Doctor Luo Dalun says Doctor Gong’s approach to treating illness has a feature that makes it especially suitable for modern people.
💬 Note from Doctor Luo: His way of treating illness, I think, suits modern people especially well — and that is his idea of supporting the upright (fu zheng). Because so many people today are deficient; far too many people have insufficient upright qi (zheng qi). So Doctor Gong’s whole line of thinking fits our times perfectly.
And today’s episode is also the grand finale of the Gong Tingxian series — after this one, Doctor Luo says, “basically the Gong Tingxian series is complete,” and listeners will have a fuller picture of this “Kingly Way of medicine” (yi zhong wang dao) — the method of curing illness by supporting the upright.
Who was the patient? An old gentleman who waited on the emperor
The patient’s surname was Zhou; everyone called him Zhou Gong — he was a court official who attended to the emperor’s daily needs (in the transcript the name sounds like “Shiyu Jixi Zhou Gong” — an official title plus a personal name, the phonetics are a bit muddled; the original text is the authority).
💬 Note from Doctor Luo: In general, anyone called “Gong” — like the Liu Gong we talked about earlier — is no ordinary person; these are all officials of the palace. The illness this Zhou Gong caught was deficiency and exhaustion (xu sun) — that is made explicit: not an external contraction, but insufficient upright qi, worn away by long-term consumption of one’s own qi.
Is it easy attending on the emperor? The emperor calls at any hour, day or night; you worry constantly, you’re tense constantly. So Doctor Luo says: “This is certainly from exhaustion.” How exhausted? Look at the symptoms.
How strange was the illness? — He dared not close his eyes; the moment he did, he “floated”
Zhou Gong’s symptoms, Doctor Luo says, are “interesting”: mu bu gan bi — he dared not close his eyes. The instant he shut them, his spirit floated and drifted (shen hun piao dang), the sky and earth spun, as if he were flying — beyond his control, even losing awareness: a dizzy, almost disembodied state.
💬 Note from Doctor Luo: This kind of dizziness — quite a lot of people have this symptom, you know? Many of you will recognize it: when you’re exhausted to a certain point, the moment you close your eyes you feel light and unsteady, as if you were about to float away.
And more: he dared not speak — yan ze qi bu jie: the moment he talked, his breath gave out and he couldn’t catch it; yin shi bu si — no desire to eat; and he was drowsy and groggy all day long.
One touch of the six pulses: original qi weak, heart-spirit deficient
Doctor Gong was an imperial physician. He came, took the pulse: the six positions were all weak — faint and feeble everywhere he pressed.
💬 Note from Doctor Luo: He said: “This is deficiency of original qi and deficiency of the heart-spirit” (yuan qi xu ruo, xin shen xu sun). First the original qi is insufficient; then the heart-spirit is depleted. What to do? He first gave Zhusha Anshen Wan (Cinnabar Spirit-Settling Pill), one dose — after taking it, the patient was a little calmer. Step one: steady the heart-spirit.
First move: Zhusha Anshen Wan — “pin down” the wildly flying spirit
What is this cinnabar pill? It is Li Dongyuan’s Zhusha Anshen Wan — the formula is written in Li Dongyuan’s Nei Wai Shang Bian Huo Lun (Clarifying Doubts About Injury from Internal and External Causes), right after the Buzhong Yiqi Tang entry.
💬 Note from Doctor Luo: Li Dongyuan said, “When heat evil prevails, treat it with sweet and cold, and drain it with bitter” (re yin suo sheng, zhi yi gan han, yi ku xie zhi). So the formula contains zhu sha (cinnabar), then huang lian (coptis) — for clearing heart fire; dang gui (angelica) nourishes the heart blood, sheng di huang (raw rehmannia) nourishes yin and clears deficient heat, and a little gan cao (licorice) is added. After the pills are formed, the outside is coated in cinnabar (the cinnabar coat). What does cinnabar do? Heavy settling to calm the spirit.
Why cinnabar specifically? Doctor Luo put it in a picture: when the heart qi is restless and floating, without cinnabar you cannot pin it down. This kind of agitation and dread of the spirit can also be treated with Zhusha Anshen Wan at ordinary times. But take note —
💬 Note from Doctor Luo: There is a patent medicine today called “Zhusha Anshen Wan,” and it must not be taken for a long time. Generally, for this sort of spiritual dread and drifting, take it once or twice, then use other medicines to regulate. Its job is a heavy one — to stabilize the situation in one stroke. Otherwise the other medicines you take will work too slowly; cinnabar pins down that scattered, disordered spirit all at once.
So after Zhou Gong took Zhusha Anshen Wan, he was “a little settled” — he felt somewhat better. Stabilize the situation first; then regulate slowly.
The main formula: Buzhong Yiqi Tang, with ginseng and astragalus doubled
Step two, Doctor Gong brought out his signature formula — Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction). Note well: this “Champion Physician of the Medical World” was, in fact, Li Dongyuan’s devoted follower.
💬 Note from Doctor Luo: You see, Doctor Gong was a fan of Li Dongyuan — he genuinely learned a great deal from Li Dongyuan, and a great many of his treatment strategies use Li’s formulas — when he treated the Prince of Lu’s consort, for example, he also used Buzhong Yiqi.
This time he also used Buzhong Yiqi Tang, but he performed surgery on it: he doubled the amounts of ren shen (ginseng) and huang qi (astragalus), then added yuan zhi (polygala) — which nourishes the heart, calms the spirit and opens the heart orifices; fu shen (poria with root) — also a spirit-calming herb; suan zao ren (sour jujube seed) — nourishes the heart blood and liver blood and calms the spirit; bai shao (white peony) — astringes the liver yin; and sheng di huang (raw rehmannia) and mai dong (ophiopogon) — both yin-nourishing, engendering yin blood.
💬 Note from Doctor Luo: Why add yin-nourishing herbs? Because Buzhong Yiqi Tang leans toward raising the spleen-stomach yang qi; add a little yin nourishment here, and yin and yang cooperate. Doctor Gong also noted specifically, after the Buzhong Yiqi Tang formula: if one uses the mind too much and the spirit is restless — worrying day after day, heart blood depleted, the heart-spirit starved of nourishment — one develops palpitations and fright (zheng chong jing ji): a dread in the heart, a sudden start when someone slams a table — sometimes the heart races and pounds, thump-thump-thump — then add yuan zhi (polygala), fu shen (poria with root), suan zao ren (sour jujube seed), and one may also combine shi chang pu (acorus, transcribed as “chang pu,” which opens the orifices and settles the spirit) and bai zi ren (platycladi seed, transcribed as “bai zhi ren,” which nourishes the heart and calms the spirit) — these heart-nourishing medicines. And what was the result? Several doses in succession — after drinking the decoction a number of times, the illness gradually got better.
Why does closing the eyes make you “float”? — Spirit and body: each of the five organs houses its own spirit
The illness was cured; the story is told. But Doctor Luo says we should savor the reasoning behind this little case — why does closing the eyes cause “floating”?
💬 Note from Doctor Luo: Chinese medicine holds that the body (xing, the form) and the spirit (shen) are closely bound together. In the normal state, yi shen yu xing — the spirit controls the body; the two combine to make the person we are. Concretely, a person has three hun and seven po (ethereal and corporeal souls) governing the various systems of the body. Chinese medicine says each of the five organs houses its own spirit: the heart houses shen (spirit), the lung houses po (corporeal soul), the liver houses hun (ethereal soul), the spleen houses yi (intent), and the kidney houses zhi (will) — every organ has its own spiritual function, in charge of one aspect of the mind’s activity.
Here is the problem: bad emotions wound the spirit, and further wound the five organs; conversely, when the five organs become deficient, the spirit has nowhere to attach — and so it flies away and scatters.
💬 Note from Doctor Luo: People like those who attend on the emperor — or people in certain special jobs — are tense and anxious. Really, people today are basically all like that, worn down little by little; sometimes a fright, sometimes worry and brooding slowly wound the heart and spleen. Bad emotions cause the organs to be injured; when the organs become weak, the spirit has nowhere to settle.
Li Dongyuan said it long ago: this illness is named “men” (悗)
This whole theory, Li Dongyuan explained thoroughly when he wrote Buzhong Yiqi Tang. He said: when spleen qi is weak, the clear yang qi cannot rise, and yin fire wounds its engendering qi — at that point yin blood becomes greatly deficient — that is, the blood is depleted.
💬 Note from Doctor Luo: And when the blood is depleted? Blood nourishes the heart — the heart governs the blood vessels and is nourished by blood. When yin blood is deficient, the heart loses its nourishment; its function is certainly affected, and so the spirit is disordered, oppressed, vexed — what is this illness called? It is named “men” (悗). How is this character written? On the left is the “heart” radical (忄), on the right the character “mian” (免) — it is that feeling of dread, confusion, vexation and unrest — the heart always feeling uneasy.
Li Dongyuan’s terminology is deep, so Doctor Luo translated it into plain words: the spleen engenders blood — the spleen-stomach absorbs the nutrients of food and transforms them into blood. When the spleen-stomach is injured, the source of blood goes wrong; the blood is deficient, the heart loses its nourishment, and the emotions and spirit are bound to go wrong. This is blood deficiency giving rise to deficient fire and a scattered spirit.
💬 Note from Doctor Luo: This situation is seen constantly in modern life. What level of exhaustion does it take? Lately you’re terribly depleted; the moment you close your eyes you feel as if you’re floating — a spinning sensation — do you recognize it? That very likely means you’re deficient. Where is the root? Look at whether your body’s upright qi is sufficient, whether your spleen-stomach has been injured, whether the clear yang qi fails to rise, whether the blood is deficient. So many emotional and mental problems ultimately trace back to deficiency of the internal organs — tonify the organs to fullness, add a little spirit-calming medicine to regulate, and it becomes easy to treat.
No breath when talking — the signal of sinking middle qi
Zhou Gong had another symptom: yan ze qi bu jie — he dared not speak; the moment he talked, his breath gave out. Folks, this is a classic case of sinking of the middle qi (zhong qi xia xian).
💬 Note from Doctor Luo: This is close to the sinking of the large qi (da qi xia xian) that Doctor Zhang Xichun talked about earlier — the breath simply cannot catch up, because the middle qi has sunk and the qi is weak. You talk and you pant; especially, the tail of your voice disappears — after speaking a few sentences, you feel the qi in your chest can no longer keep up. That is sinking of the middle qi. At that point, hurry up and tonify the spleen-stomach, tonify the qi, and lift it upward.
Doctor Luo also took the opportunity to point out a lineage in the history of Chinese medicine: Zhang Xichun’s Shengxian Tang (Qi-Raising Decoction) was actually learned from Li Dongyuan — it did not spring from nowhere; it is simply that Zhang Xichun concentrated on the heart and lungs, while Li Dongyuan’s Buzhong Yiqi Tang concentrated on the spleen-stomach, adding a few herbs to strengthen the power directed at the heart and lungs.
💬 Note from Doctor Luo: When spleen qi is insufficient and lung qi is not secure, the whole qi becomes deficient and then sinks; speech develops problems — some people’s voices go hoarse, some can’t catch their breath and it seems to break off mid-sentence, so they must lift the qi up to speak; some have insufficient voice endings — the strength fades as they talk. All of this is sinking of the middle qi. Actually, the experience of Xue Lizhai, Gong Tingxian and others in using Buzhong Yiqi — if I get the chance, I’ll summarize it for everyone; then this formula will be basically fully covered.
No appetite — yet still hungry: the spleen-stomach too weak to transport
Zhou Gong also had yin shi bu si — no desire to eat. What is the reasoning here? The spleen-stomach is weak, unable to transform and transport. But there is a particular point Doctor Luo stresses — people with insufficient middle qi, with sinking middle qi, do not “not want to eat” — they “cannot eat”:
💬 Note from Doctor Luo: Such people have no strength to eat, no appetite — but they are hungry, hungry and craving food. Yet if you try to eat more, you can’t take much — a few mouthfuls, and as soon as some oil or sugar goes in, you’re immediately full and stop. Eat a bit more? Folks, the belly bloats! The stomach and abdomen both swell. Why? Unable to transform and transport — it gets stuck inside. Some people even have severe afternoon bloating. It looks like a poor appetite, but actually it isn’t — they have an appetite; when hungry they truly want to eat, but they lack the capacity to receive.
What to do? Still Buzhong Yiqi Tang — tonify the spleen-stomach and restore the original qi. When the spleen-stomach is sufficient, it can absorb the finest essence of food, and the original qi has a source of replenishment. In the formula, chai hu (bupleurum), sheng ma (cimicifuga) and jie geng (platycodon) are what lift the qi upward — otherwise the qi sinks and he can’t speak.
Another cause of the floating spirit: clear yang sinking, the upper burner losing nourishment
Earlier we explained the floating spirit as insufficiency of yin blood and the blood failing to nourish the heart. But Doctor Luo says there is another angle — sinking of the large qi, sinking of the middle qi.
💬 Note from Doctor Luo: When the qi sinks, the body’s main functions gradually move downward, running feebly below, and the upper part (the upper burner) nearly loses its nourishment — hence that floating sensation. Clear yang sinks, the upper burner loses support, the heart-spirit scatters — this is a kind of “qi-sinking” feeling, called separation of form and spirit (xing shen fen li) — the sensation that yin and yang are about to part company. That is not a good sign. So by explaining it from several angles, you can fully account for why closing the eyes makes one float, the world spin, and the mind go dim.
At this point Doctor Luo also threw in a “why” of health preservation — standing meditation (zhan zhuang).
💬 Note from Doctor Luo: Why does standing meditation improve heart-lung function and immunity? You hold your hands up at the level of the chest, in the upper burner — although you stand still, you must raise your arms to this height, and the body’s qi and blood have to make an effort to supply the arms. Look at it horizontally — this is already the chest! So as you stand, the functions raise themselves up to the heart and lungs of their own accord; the heart-lung function is nourished. People who once had some heart trouble and felt better after standing meditation — that is the reason. If you combine standing meditation with some spleen-stomach-tonifying medicine, like Buzhong Yiqi, the qi rises more easily and the effect is even better.
Bonus big story: why did Li Dongyuan write the Treatise on the Spleen and Stomach?
In this episode Doctor Luo devoted a passage to the story of Li Dongyuan — this founder of the “earth-supplementing school” was himself a man tormented by deficiency.
💬 Note from Doctor Luo: Li Dongyuan was truly extraordinary. What he wrote came from his own direct experience — he himself said his body later became unwell. Why? Li Dongyuan had a run of terrible luck in his life; he met everything: plague, famine, war. He was besieged in the capital together with Yuan Haowen; when the Jin dynasty fell he was inside the siege — he saw the starved dead carried out every day; starving himself, he ate grass and bark; when the city gates opened, the dead were so many that corpses streamed out of every gate day after day.
Li Dongyuan went through all this, and his own body was injured too. In his old age he was shen zhi xie duo, lan yu yan yu — sluggish in spirit, reluctant to speak. That was what he himself had experienced: what it feels like when the spleen-stomach is deficient. So he knew the consequences of spleen-stomach qi deficiency were enormous, and he resolved to create Buzhong Yiqi Tang.
💬 Note from Doctor Luo: At the time he was so exhausted he didn’t even want to write; he felt his state was too poor. Then he went to Mount Kunyu in Shandong, where he met a descendant of Fan Zhongyan — a Daoist master named Fan Zunshi. Fan Zunshi told him: even if you can’t go on, you must write the book — this book is not written for yourself; it is written for the people of the world, so that the people of the world may not die young. This is a most compassionate deed. Even if you write until your strength is exhausted and you die — as long as the book is completed, your death with the book left behind is more meaningful than your life. Li Dongyuan was deeply moved, and he truly wrote Fan Zunshi’s words into his book.
So, combining the bodily experience of his own hunger and hardship, Li Dongyuan set down one by one the symptoms that appear when the spleen-stomach is injured and how to regulate them, and wrote the classics Nei Wai Shang Bian Huo Lun and Pi Wei Lun (Treatise on the Spleen and Stomach). Later physicians — Xue Lizhai came to learn from it, Gong Tingxian came to learn from it too — and what they learned was this one sentence:
💬 Note from Doctor Luo: The Kingly Way of medicine (yi zhong wang dao). What is the Kingly Way? Put the inside (the spleen-stomach) in order, and the outside resolves itself. Regulate the spleen-stomach, regulate the spleen and kidney — that is the true path of medicine. Look how simple Doctor Gong was: he began with Zhusha Anshen Wan to settle the heart-spirit; then Buzhong Yiqi with a few blood-nourishing, spirit-calming herbs — a few doses and it was regulated — that is the Kingly Way of medicine. Let us learn it bit by bit, and experience it bit by bit.
Ending: a small case, a great lesson
Doctor Luo’s final reflection: this looks like a small case, but if you actually take a patient who spins the moment he closes his eyes, floats in spirit, and cannot even speak — sometimes such a case is genuinely hard to regulate. Doctor Gong, however, handled it with effortless ease — first pin down the spirit, then tonify the qi and nourish the blood — several doses and it was cured.
💬 Note from Doctor Luo: Everyone, remember what a person with insufficient upright qi looks like: the complexion is rather pale, somewhat plump, or in some people thin; the tongue is large with teeth marks on the edges, sometimes with rather more saliva; speech is breathless; they are tired and weary easily, and doing a bit more work brings dizziness; closing the eyes brings a buzzing and spinning, the sense of mind barely staying seated — even standing with eyes shut, they sway; they are terribly fatigued, groggy by day. At a glance this is a person with insufficient upright qi — and Doctor Gong used Li Dongyuan’s Buzhong Yiqi approach to cure this illness. The spirit and the organs support each other: sometimes the spirit affects the organs, sometimes organ problems affect the spirit — so the two must be regulated together. In this case, Doctor Gong regulated the spirit by regulating the organs — that is the Kingly Way of medicine: support the upright first.
Case source: Shou Shi Bao Yuan (Longevity and Preservation of Vitality) by Doctor Gong Tingxian (Ming dynasty, published 1615); commentary based on the public lectures of Doctor Luo Dalun (PhD in TCM diagnostics, Beijing University of Chinese Medicine).