Coughing, Wasting, and Stopped Periods? Doctor Zhang Xichun’s Zisheng Tang (Nourishing Life Decoction) for Tuberculosis (Consumption) and Amenorrhea

Search terms this page answers: coughing / wheezing and shortness of breath / period not coming / no period / very weak and thin / low fever / don’t want to eat / too much vaginal discharge

Medical terms: tuberculosis (consumption · lao zhai) · amenorrhea (stopped menstruation) · deficiency of both lung and spleen · cultivating earth to generate metal (pei tu sheng jin)

Opening: the very first formula in Doctor Zhang Xichun’s book holds the key to his whole way of thinking

In the last few sessions we walked through how Doctor Zhang Xichun chose and used individual herbs. Today we begin something new — how he built formulas. His Records of Chinese Medicine with Western Reference records so many formulas. What is the very first one? Zisheng Tang (Nourishing Life Decoction) — a formula made especially for tuberculosis (called lao zhai, consumption, in the old days). It is also the opening door to his entire medical philosophy.

💬 Note from Doctor Luo: Doctor Zhang Xichun’s formulas are his own original creations. Once you’ve understood the herbs we discussed earlier, look at these formulas and it becomes clear how a master puts a prescription together. And this first formula — Zisheng Tang — looks simple, but behind it lies the principle he valued most in his whole life.

Who was the patient? In 1913, an unmarried girl in Daming Prefecture

This case took place in the second year of the Republic (1913). At that time Doctor Zhang Xichun was staying in Daming Prefecture (in today’s Daming area of Hebei Province). The patient who came to him was a shi nv — an unmarried young woman.

💬 Note from Doctor Luo: What does shi nv mean? It means a girl who has never married. And what illness did this girl have? Tuberculosis — and she had already been ill with it for more than a year. In ancient times, diseases of this kind were called lao zhai (consumption), famous as a wasting, devouring illness.

How ill was she? Her period was gone, and her body was frail almost beyond endurance

Just how sick was this girl? Her period had already stopped completely. Her body was weak and wasted (lei ruo) — extremely, extremely weak. She came asking Doctor Zhang Xichun what could be done, and the moment he saw her he knew: someone this fragile — this illness would not be easy to treat.

💬 Note from Doctor Luo: Everyone, remember: tuberculosis is a consumptive disease — it drains the qi, blood, and fluids of the body a little at a time until they are nearly dry. When a girl’s period stops, it means the sea of blood (xue hai) is empty — her qi and blood have been depleted to the limit. Add the extreme weakness on top of that, and this is no longer a simple lung disease — the whole person has been hollowed out.

Doctor Zhang Xichun’s reasoning: when someone is this weak, grasp the spleen and stomach — the root

Facing a patient this depleted, what was Doctor Zhang Xichun’s strategy? He did not rush in to “kill the tuberculosis bug.” Instead, he wrote a prescription that tonified the spleen and stomach.

💬 Note from Doctor Luo: This is where Doctor Zhang Xichun is most extraordinary — he grasped the idea that the spleen and stomach are the foundation of the body. No matter how gravely ill a person is, as long as the spleen and stomach can still transform and transport, can still take in food, there is a chance of life. Once the spleen and stomach collapse, no medicine will do any good.

The prescription: Zisheng Tang, with yam leading the charge

What is this formula called? Zisheng Tang (Nourishing Life Decoction) — made specifically for lao zhai with wasting and weakness: after contracting tuberculosis a person becomes extremely frail, eats less and less, pants and coughs, runs a low fever, and the pulse races while being weak (xu shu mai — a rapid, deficient pulse). It also treats amenorrhea caused by blood deficiency and dried-up blood (xue xu xue ku) in women.

💬 Note from Doctor Luo: This formula today is not only used for tuberculosis — anyone who is extremely weak, especially with constant coughing and wheezing from a weak spleen and stomach, can also use it.

The formula (original dosages):

• Sheng shan yao (dried Chinese yam slices), one liang (approx. 30 g) — the chief herb, the largest dose; tonifies the spleen and the lung
• Xuan shen (figwort root), five qian — cool in nature; clears deficiency heat
• Bai zhu (atractylodes), three qian — tonifies the spleen
• Sheng ji nei jin (dried chicken gizzard lining), two qian, crushed — resolves stasis, opens the appetite
• Chao niu bang zi (stir-fried burdock seed), three qian — clears the throat, resolves toxins, and expels pathogenic qi outward

💬 Note from Doctor Luo: Why pair it with xuan shen? Xuan shen is cool in nature, and these patients run hot — xuan shen takes that heat away. And there is something special about pairing xuan shen with yam. Everyone, Chinese yam is traditionally described as a yin-nourishing herb — it nourishes spleen yin and lung yin — but yam sits right in the middle, between yin and yang, just like shu di (prepared rehmannia). Try eating yam yourself: after eating it, you will feel slightly warm, maybe break a light sweat. That gentle warming it produces is the body’s own functions switching on. Yam and xuan shen together stay quite balanced. Bai zhu tonifies the spleen. What is sheng ji nei jin for? Resolving stasis — by this stage the patient may well have blood stasis inside — and it also mildly opens the appetite. The stir-fried niu bang zi paired with yam tonifies the spleen while clearing pathogenic qi outward — this combination is exceptionally good for coughs.

Where the name comes from: one sentence in the Book of Changes

Look at where this formula’s emphasis lies: on the spleen. Why is it called “Zisheng Tang”? The Book of Changes (Yi Jing) has a line — “Zhi zai kun yuan, wan wu zi sheng” — How great is the primal force of Kun, from which all things draw their life. The “kun yuan” here is the spleen (the Kun trigram belongs to earth and corresponds to the spleen and stomach), so a formula that tonifies the spleen is called Zisheng Tang.

💬 Note from Doctor Luo: The word “zisheng” may sound familiar — the famous Ming-dynasty physician Miao Xiyong had a pill called Zisheng Wan, also a celebrated formula for tonifying the spleen and stomach. Doctor Zhang Xichun’s thinking runs in the same line: fill the spleen qi up fully, then add a little xuan shen to clear heat and a little niu bang zi to drive pathogens outward — and the situation turns around. So the main force of this formula is tonifying the spleen, with just a small addition of herbs that clear out pathogenic qi.

The treatment: bringing the body back, step by step

What was the result? After several doses, her appetite began to increase — this was the most crucial step. The spleen and stomach could eat again!

💬 Note from Doctor Luo: Eating again is step one. But the body still ran a little hot, so what to do? Add sheng di huang (fresh rehmannia), five qian. After five or six more doses, the fever was gone and she could get out of bed.

A twist: leg pain, the period, vaginal discharge — cleaned up one by one

At this point the girl added a new complaint: pain in the legs — she could not walk. Doctor Zhang Xichun added dan shen (salvia root) and dang gui (angelica), three qian each — what for? To invigorate blood and unblock the collaterals. After about ten doses, the leg pain was cured — and her period came back.

💬 Note from Doctor Luo: For her period to return, the sea of blood must have filled again — her qi and blood had been nursed back. That is wonderful news. But it wasn’t over — the girl then said: her vaginal discharge was very heavy (she had forgotten to mention it before). Doctor Zhang Xichun removed the dan shen, added sheng mu li (raw oyster shell), six qian, and doubled the bai zhu. After ten more doses, the discharge problem was cured as well. And so, one by one, this girl’s whole basket of illnesses was cleaned up by Doctor Zhang Xichun.

Verified by a disciple: a man, years of infertility from tuberculosis, cured in ten doses

Later, one of Doctor Zhang Xichun’s disciples used this same formula to treat a man in a neighboring village — also a tuberculosis patient, ill for years and unable to father a child. No one knew how many physicians he had consulted; he had taken countless medicines without effect. That spring he suddenly began coughing and wheezing violently — he could hardly catch his breath — his food intake dropped, and his pulse raced. The disciple simply used Zisheng Tang — ten doses, and the man recovered.

💬 Note from Doctor Luo: This is why Doctor Zhang Xichun said this formula can be relied upon. What idea does it embody? — Tonifying the spleen and stomach to regulate lung disease. In Chinese medicine this is called “pei tu sheng jin” — cultivating earth to generate metal. Earth is the spleen, metal is the lung: when the spleen earth is strong, the lung metal naturally gains strength. This principle is extremely important.

The narrator’s closing note: five herbs — how can they treat a serious illness?

Look at how simple Doctor Zhang Xichun’s formula is — as the first formula in Records of Chinese Medicine with Western Reference, it contains only a large amount of yam, some bai zhu to tonify the spleen, some sheng ji nei jin to unblock the channels, resolve stasis, and open the appetite, plus xuan shen and niu bang zi to clear heat — five herbs in all. So why can it genuinely cure a serious illness?

💬 Note from Doctor Luo: Because it seizes on the idea that the spleen and stomach are the foundation of the body. What are the key features of the condition this formula fits? — reduced food intake, extreme weakness, coughing and wheezing that come from spleen-and-stomach deficiency — and in this state the pulse races, called xu shu mai (a rapid, deficient pulse). When you see that picture, this is the approach to use. Today we have only introduced Zisheng Tang briefly — tomorrow, we’ll continue with how Doctor Zhang Xichun used this same approach to regulate people’s health. Everyone, see you tomorrow!

What to take away

1. The very first formula in Doctor Zhang Xichun’s book is a spleen-tonifying formula. When a consumptive lung disease like tuberculosis has drained the body, his first move was never to attack the pathogen — it was to rebuild the granary.
2. The spleen and stomach are the foundation of the body. No matter how ill a person is, as long as the spleen and stomach can still transform food, there is life; once they collapse, no medicine can help.
3. A stopped period in a girl wasted by chronic illness means the sea of blood is empty. The treatment is not to chase the disease, but to fill the blood and qi back up — and that begins with the spleen and stomach.
4. Zisheng Tang in brief: yam (one liang) leads, with bai zhu to tonify the spleen, sheng ji nei jin to resolve stasis and open the appetite, xuan shen to clear heat, and stir-fried niu bang zi to expel pathogens — the main force tonifies the spleen, with a small amount of clearing added.
5. “Pei tu sheng jin” — cultivating earth to generate metal. Strengthen the spleen earth, and the lung metal naturally gains strength. This is the principle behind treating lung disease through the spleen.
6. Watch for the pattern: reduced appetite, extreme weakness, cough and wheezing from a weak spleen and stomach, with a rapid, deficient pulse (xu shu mai). This is the signature picture that calls for this approach.

Adapted from Doctor Luo Dalun’s explanation of Doctor Zhang Xichun’s case records. Source: Records of Chinese Medicine with Western Reference (《医学衷中参西录》), published in installments 1918–1934.