Short of Breath After Teaching or Talking Too Much? Doctor Zhang Xichun’s Case of Collapsed Chest Qi (Daqi Xiaxian) Treated with a Huangqi Medicated Wine
Patient search words: shortness of breath after teaching / tired after talking too much / the breath won’t come up / a feeling of qi moving downward
Corresponding medical terms: sinking of the chest qi (da qi xia xian) · deficiency of the great qi of the chest · qi deficiency (qi xu)
Opening: talking too much can wear a person down into a serious problem
In the last several episodes we talked about the various causes of sinking of the chest qi (da qi xia xian) that Doctor Zhang Xichun wrote about. Let us review them: what was the first one? Working on an empty stomach; what else? Getting angry; and also fright and panic. The case we tell today is a brand-new kind of trigger — talking too much can also drain your qi. Doctor Zhang Xichun warned that this was by no means a small matter.
💬 Note from Doctor Luo: Sinking of the chest qi means the “great qi” of the chest — what we usually call pectoral qi (zong qi), the yang qi of the chest — becomes deficient and sinks downward. The triggers we discussed before — working on an empty stomach, anger, fright — and today we add one more: talking too much.
Who was the patient? A 56-year-old school teacher
The patient was a scholar and bookish man, 56 years old, who taught at a school. He came to Doctor Zhang Xichun with a single complaint: after every class he gave, he felt short of breath. After a whole morning of teaching, his breathing felt as though it could not be drawn up, and the shortness was severe.
💬 Note from Doctor Luo: Notice this detail — a whole morning of teaching is exactly when the voice is used hardest and qi is drained most heavily. This was no coincidence; it is a textbook occupational pattern.
What did Doctor Zhang Xichun say? “This is a very dangerous illness”
Doctor Zhang Xichun understood at once and told him: this is insufficiency of the great qi of the chest, deficiency with a tendency to sink — the great qi is weak, it sinks downward, and the breath can no longer be drawn up. Doctor Zhang Xichun was emphatic: “This is by no means a small problem — you must pay attention to it.”
💬 Note from Doctor Luo: Doctor Zhang Xichun spoke gravely, because this is exactly the classic presentation of sinking chest qi. Do such things really happen to people? Yes, they do — talking too much easily drains qi. Doctor Zhang Xichun was absolutely not making this up. I (Doctor Luo Dalun) have experienced it myself.
Doctor Luo’s own experience: lecturing on an empty stomach in winter — he truly felt it
Doctor Luo Dalun tells a story from his doctoral student days: at the time he taught some classes on the side — a friend lectured at an evening Chinese medicine school and, having something come up, asked Doctor Luo to fill in for a few days. The school was extremely far away. On a winter morning, he had to set out before dawn, when the cafeteria had not yet opened, so there was no breakfast — he went to teach on an empty stomach.
And on that day, after the class was over, as he was riding the shuttle bus home, Doctor Luo truly felt the breath in his chest could not be drawn up — what did it feel like? The qi moving downward, breathing short and insufficient. At that moment he reacted instantly: this was exactly the sinking of the chest qi that Doctor Zhang Xichun described!
💬 Note from Doctor Luo: Fatigue, then going to lecture — talking too much drains qi — and the two stacked on top of each other, the qi really does sink. So I deeply appreciate that what Doctor Zhang Xichun said is true — after speaking, the breath really does become short.
The old masters’ trick: ginseng soaked in water, sipped while lecturing
Doctor Luo Dalun also mentions the senior professors at Beijing University of Chinese Medicine: how do some of them give lectures? They take a piece of ginseng, soak it in water, make a cup, and sip it while they teach. What is that for? — To tonify qi! This is the accumulated experience of the old masters.
💬 Note from Doctor Luo: Don’t underestimate that cup of ginseng water — after a whole morning of lecturing, qi is drained badly; replenishing while speaking is an experience built up over many years of practice. Teachers, hosts, and people who talk for a living can all take a leaf from this.
Here comes the trouble: this patient disliked medicine but loved alcohol
The diagnosis was clear, and Doctor Zhang Xichun was ready to write a prescription — he planned to administer medicines that raise and tonify the qi. But this teacher had a “quirk”: he did not like taking Chinese medicine — he found the decoction too bitter, no fun at all. So what to do? He said: “I like drinking alcohol. Could you turn the medicine into a medicated wine, and I’ll drink it as wine?”
Doctor Zhang Xichun had no choice — the man simply liked his liquor, so he made a small concession and wrote him a recipe for a medicated wine.
💬 Note from Doctor Luo: This was Doctor Zhang Xichun’s plan B — the patient did not like decoctions and wanted wine, so he gave him a medicated wine. Please don’t imitate this; if you can take a decoction, take a decoction.
The prescription: raw astragalus 4 liang as the base, with wild Taitai codonopsis, bupleurum and platycodon steeped into a wine
How was the formula composed? Sheng huangqi (raw astragalus) 4 liang — note, 4 liang (about 120 g) is actually not a large amount; ye tai shen (wild Taitai codonopsis) 2 liang — what kind of ginseng is wild Taitai codonopsis? A type of dangshen (Chinese codonopsis), which Doctor Zhang Xichun explained in his writings; chaihu (bupleurum) and jiegeng (platycodon), 8 qian (about 24 g) each. How was it prepared? More than a jin of yellow rice wine (huangjiu) was used to decoct these herbs — boiled until bubbling — and then the brew was steeped into white liquor (shaojiu).
💬 Note from Doctor Luo: Huangqi tonifies qi, wild Taitai codonopsis (dangshen) also tonifies qi, and what are chaihu and jiegeng for? Lifting the qi upward — chaihu raises and lifts, jiegeng carries the medicine upward. This is precisely the classic structure for treating sinking chest qi: tonify qi + lift it upward.
Cured in about ten days — but two years later…
The medicated wine worked quickly — after drinking it for about ten days, the illness was cured and the shortness of breath disappeared. But friends, don’t imagine that was the end of the story. Once the man recovered, he stopped drinking it — the illness was gone, so why bother. The man was quite overweight — a stout fellow.
Two years later, Doctor Zhang Xichun learned what happened: one day after finishing his class, the man walked two li home from school — and suddenly felt that the breath could no longer come up. When he reached home, he could not speak, could not utter a word, and then he died suddenly — in an instant, the man was gone.
💬 Note from Doctor Luo: Looking back now, it is such a pity. If he had taken the medicine seriously, followed the method and kept drinking it, and also exercised and lost weight, I believe this man would have been basically fine.
Doctor Luo’s analysis: why did this happen? Where did things go wrong?
Doctor Luo Dalun’s analysis: as we see it now, this man probably had other problems in his heart, such as blockage of the blood vessels (xue mai yu zu). But why do the blood vessels become blocked? This is often related to qi deficiency as well — when qi is deficient, the blood cannot be pushed along, so it stagnates.
At this point Doctor Luo Dalun also frankly points out that in this case Doctor Zhang Xichun made a slightly flawed decision: the prescription was too light. He indulged this patient too much at the time — if he had insisted on a decoction, perhaps nothing would have happened. And allowing him to drink wine — sheng huangqi 4 liang is actually a small dose; with Doctor Zhang Xichun’s skill, he would normally not prescribe such a small amount. Unfortunately, the patient himself did not take the matter to heart, and in the end he was gone.
💬 Note from Doctor Luo: Doctor Zhang Xichun saved countless lives, yet this case stands as a regret. The saddest part is not that the illness could not be cured, but that it was cured and then never consolidated — the root of the disease remained, the body’s foundation was never rebalanced, and two years later, when a trigger appeared, he could no longer hold on.
What does this case teach us? People whose work means constant talking must learn to tonify qi
This case teaches us one principle: those who talk excessively — especially people in professions like teaching — for example, people who have to explain things all day long, like telephone operators, like receptionists and counter staff, who speak countless words every day — people who talk a lot, if they judge themselves to have qi deficiency, should learn to tonify qi, because talking too much drains qi. Above all, do not do such work on an empty stomach.
When we meet this situation, we should keep it in mind: speaking as a kind of work — talking too much easily drains qi, and you need to protect yourself. People who usually pay attention to health should also learn to be sparing with words (shen yan yu) — there is no need to chatter from morning to night for no reason; it is better to let the mind settle. Pouring out every thought does not necessarily prove how clever you are — does it?
💬 Note from Doctor Luo: This case gives us a new reminder: some occupations easily bring on sinking of the chest qi and drain the upright qi — we need to guard against it — that is the lesson of today’s episode. Tomorrow we continue: what other problems can sinking chest qi cause?
(Compiled from Doctor Luo Dalun’s explanations of Doctor Zhang Xichun’s case records; the case is from Yixue Zhongzhong Canxi Lu, Records of Chinese Medicine with Reference to Western Medicine.)