Always Cold and Short of Breath, but Warming Herbs Don’t Help? Doctor Zhang Xichun’s Huiyang Shengxian Decoction (Return Yang, Lift the Sinking) for Heart-Lung Yang Deficiency with Sinking of Great Qi

Search terms this page answers: always cold / fear of cold / can’t catch my breath / shortness of breath / labored breathing / bloated after eating / bearing-down pain in the lower belly

Medical terms: heart-lung yang deficiency · sinking of great qi (da qi xia xian) · Huiyang Shengxian Decoction (Return Yang, Lift the Sinking Decoction)

Opening: one reader comment that moved Doctor Luo deeply

We’re continuing our stories of Doctor Zhang Xichun treating the sinking of great qi (da qi xia xian). Doctor Zhang wrote dozens of cases about this condition, and Doctor Luo Dalun has been telling them one by one. Along the way, many readers left comments in the background — and a good number of them suddenly woke up: so this is what I’ve had all along! They had been treated everywhere without success; then, following the approach they heard about, they used Shengxian Tang (Lift the Sinking Decoction) — and within days their symptoms improved.

💬 Note from Doctor Luo: What does this tell us? It tells us that the sinking of great qi that Doctor Zhang Xichun described is truly a very common condition damaging our health. People simply never listened carefully to what he taught, and so their problems were dragged on and on. Today we go deeper — what do you do when a yang-deficient person also has sinking of great qi?

Who was the patient? A boy of thirteen or fourteen who always felt chilled to the bone

The first patient today was a boy, just thirteen or fourteen years old. What kind of constitution did he have? A yang-deficient constitution — he constantly felt cold inside his heart and all over his body, with a constant fear of cold. And he had another problem: food not transforming (bu hua).

What does “food not transforming” mean? Doctor Luo explained two layers: one is that after eating or drinking, the food feels stuck in the stomach, unable to digest, blocked there; the other, more serious kind — food passes through whole in the stool, called “stubborn non-transformation” (wan gu bu hua), completely undigested. Sometimes the two appear together.

💬 Note from Doctor Luo: Doctor Zhang Xichun didn’t specify which kind this boy had, but we know one thing: his spleen and stomach must have been weak. And this kind of food non-transformation is usually tied to cold and yang deficiency — yang-deficient people are especially prone to stubborn non-transformation.

The strangest symptom: no warming herb made him feel warm at all

The boy also had a classic symptom: frequent shortness of breath — when he breathed, the qi always felt insufficient, without strength. In Doctor Zhang Xichun’s case records, whenever you see the words “shortness of breath,” a light should go on in your head — this is most likely connected to sinking of great qi.

The previous doctors did recognize he was yang deficient: fear of cold, food not transforming — so they gave him yang-warming herbs. And here came the strange part: no matter what warming medicine he took, he felt not a trace of warmth — absolutely nothing. The herbs went down, and he felt no warming effect at all; warming yang herbs were completely useless on him. That was so odd that they finally came to Doctor Zhang Xichun.

💬 Note from Doctor Luo: Why didn’t the warming herbs work? Because people saw only the yang deficiency and never noticed the sinking of great qi hiding underneath. Look at his “shortness of breath” — that is the signal of sinking great qi. If you only warm the yang but never lift the qi back up, of course it does nothing.

Doctor Zhang Xichun takes the pulse: heart-lung yang deficiency, with great qi also sinking

Doctor Zhang Xichun felt the pulse: weak and slow (wei ruo er chi) — slow means it beats very slowly; a cold constitution easily runs a slow pulse; weak and faint means the upright qi is insufficient. The right pulse was especially unusual — it sank down low and could only be felt with heavy pressure.

His judgment: this boy had deficiency of heart-lung yang — the yang qi of the heart and lungs was insufficient — and at the same time great qi was sinking. So he wasn’t merely yang deficient; he carried one more problem on top of it.

💬 Note from Doctor Luo: There is an important theory here. Doctor Zhang Xichun believed that all the warmth of the body depends on the yang of the heart and lungs to spread it — the yang of the heart and lungs is like a sun that keeps the qi of the channels warm. And what protects the yang of the heart and lungs? The great qi of the chest — its main seat is right in the heart and lungs. When great qi sinks, the yang of the heart and lungs loses its protection and grows weaker and weaker. Conversely, when the heart and lungs are yang deficient, great qi sinks more easily. The two illnesses feed each other, so you must lift the great qi quickly — otherwise the yang of the heart and lungs will keep draining away.

A new formula appears: Huiyang Shengxian Decoction, five herbs

Could he simply use Shengxian Tang? Doctor Zhang Xichun did not. He set up a brand-new formula — Huiyang Shengxian Tang (Return Yang, Lift the Sinking Decoction).

What does it treat? Precisely heart-lung yang deficiency combined with sinking of great qi. What do such patients look like? A cold feeling in the heart — the heart always feels chilly; tightness across the back — the back always feels bound and constricted; fear of cold — a cold wind makes them miserable; and at the same time frequent shortness of breath. In yang-deficient people, especially heart-lung yang deficiency, the upper jiao feels cold — the front chest and back feel terribly cold; the sinking great qi adds the shortness of breath. Put the two symptom groups together, and you have your diagnostic basis for heart-lung yang deficiency with sinking of great qi.

The formula is simple: sheng huang qi, raw astragalus, eight qian (about 24 g) — the dedicated herb for tonifying the great qi of the chest; gan jiang, dried ginger, six qian (18 g) — warms the yang and the middle, the specialist for yang deficiency; dang gui shen, angelica body, four qian (12 g) — nourishes the blood; gui zhi jian, cinnamon twig tips, three qian (9 g) — carries the medicinal qi upward; gan cao, licorice, one qian (3 g) — harmonizes all the herbs.

💬 Note from Doctor Luo: Look — this formula is different from Shengxian Tang. Shengxian Tang is matched with zhi mu, sheng ma, chai hu, and jie geng; Huiyang Shengxian Tang is matched with yang-warming gan jiang, blood-nourishing dang gui, and ascending gui zhi jian. Both treat sinking great qi, yet the thinking is completely different — warming the yang and lifting the qi at the same time.

Why “the body” of the angelica? The fine points inside a single herb

Here’s something particularly interesting: Doctor Zhang Xichun wrote dang gui shen — the body of the angelica root — not just dang gui. In the old days, pharmacies sold the herb in separate parts, the head, the body, and the tail:

• Dang gui tou (the head): leans toward treating illnesses of the upper body, and carries a slight hemostatic action;
• Dang gui shen (the body): nourishes blood, very gentle and balanced;
• Dang gui wei (the tail): invigorates blood and breaks stasis.

Most pharmacies today no longer separate them — the “whole dang gui” they sell combines head and body, with a fairly gentle action of nourishing and invigorating blood.

💬 Note from Doctor Luo: Why did Doctor Zhang Xichun specifically use the body of the angelica? He didn’t explain it in the case, but we know how he viewed this herb: he believed dang gui moistens the dryness of lung metal — the Shen Nong Ben Cao Jing says dang gui “governs cough with rebellious qi.” Since he was using yang-warming, lung-tonifying herbs, he worried they would dry out lung metal and harm the body, so he used dang gui to nourish blood and moisten dryness, making up for the drawbacks of warming and tonifying. Beyond that, Doctor Zhang Xichun especially admired dang gui’s ability to both ascend and descend: it nourishes and invigorates blood, generates blood, and at the same time opens and circulates the qi — so that qi and blood each return to their own posts. That, in fact, is where the name “dang gui” (“ought to return”) comes from. Sinking of great qi means qi and blood have left their proper places; dang gui sends them home — and when it meets a stubborn one, it can even lift it back up.

Gui zhi jian: why must it be the “tips”?

The formula holds another fine point: gui zhi jian. Gui zhi is the twig of the cinnamon tree; gui zhi jian are the finest terminal branchlets. In the past, gui zhi and gui zhi jian were two separate medicines, and some pharmacies still pick out the tips to sell on their own.

Doctor Zhang Xichun used gui zhi because this herb can ascend and can descend: gui zhi is by nature smooth and communicative — it can guide the true qi of the organs upward and sprout liver qi — because it is a twig, reaching upward, it carries an ascending function; at the same time gui zhi can descend rebellious qi and press upward-rushing qi back down — for instance, when ben tun qi (running piglet syndrome) rushes upward, Gui Zhi Jia Gui Tang (Cinnamon Twig Decoction Plus Cinnamon) brings it down.

💬 Note from Doctor Luo: So when does it ascend, and when does it descend? That depends on how your body has gone out of balance. If your great qi has sunk, gui zhi can lift it; if your ben tun qi is rushing upward, gui zhi can press it down. With the guidance of the rest of the formula, it can go either way. Doctor Zhang Xichun also marveled: herbs this useful almost always have unfathomable natures — truly astonishing. As for why the tips — the tip is the end of the twig, and its ascending force is especially strong. When you want the medicinal qi to rise, using gui zhi jian alone packs a harder punch.

Gui zhi’s two other talents: unblocking the blood vessels and promoting urination

Besides lifting, Doctor Zhang Xichun stressed gui zhi’s other functions. First, it excels at unblocking the blood vessels and harmonizing ying-wei (nutritive and defensive qi). Second, it promotes urination — especially when the body holds excess dampness and stasis: gui zhi warms yang, transforms qi, and opens the blood vessels, breaking up the excess water of the three jiao and draining it out through urine. That’s why the Shang Han Lun (Treatise on Cold Damage) so often uses gui zhi to warm yang and unblock the vessels.

There’s one more of Doctor Zhang Xichun’s insights: when the sinking of great qi involves upward development that overshoots, he often uses gui zhi to replace sheng ma, chai hu, and jie geng. In earlier cases we saw the pair sheng huang qi with gui zhi used to treat sinking great qi.

💬 Note from Doctor Luo: Gui zhi warms the yang and lifts the medicinal qi upward at the same time; matched with sheng huang qi, gan jiang, and dang gui shen, the formula is fairly complete, with gan cao harmonizing at the end. A case this complicated, and Doctor Zhang Xichun cured it in a few doses.

The result: five doses and the shortness of breath was gone; reduced dose, then cured

The formula was written out and the boy began drinking it. After five doses total, the shortness of breath — the symptom of sinking great qi and insufficient qi — was gone, and his body was no longer as cold as before.

Doctor Zhang Xichun then reduced the gui zhi jian: from the original three qian down to one and a half qian (4.5 g), and after several more doses, he was cured.

💬 Note from Doctor Luo: Once he recovered, Doctor Zhang Xichun stopped the medicine and had him take a tiny bit of raw sulfur (sheng liu huang) every day as aftercare — raw sulfur warms the primordial yang of the lower jiao; it is a yang-warming substance. But honestly, this particular method of Doctor Zhang Xichun’s, I personally do not recommend. Even famous physicians aren’t right about everything; taking raw sulfur leaves me doubtful, so I’ll keep my reservations. And please don’t assume that just because it comes from Doctor Zhang Xichun, you should try it. There are plenty of ways to warm the yang — moxibustion, warming foot soaks, and so on. Chinese medicine has too many yang-warming paths to need raw sulfur specifically.

The second patient: after a great rage, diarrhea for over a month

Let’s move to another case. A man in his fifties had once flown into a great rage — and mark this, great anger can also cause sinking of great qi — and after it, he developed diarrhea. His qi mechanism was already moving downward, and now, angry, he pushed it down further; the diarrhea went on for over a month before it stopped.

From then on he carried a stubborn problem: fullness in the chest, labored breathing, and food that would not digest. He consulted doctor after doctor. Seeing the chest fullness, they said: clearly qi stagnation! So they moved and opened the qi; others gave him warming tonics for the spleen and stomach, but always with qi-moving, qi-breaking herbs mixed in. The result? Instead of improving, the more medicine he took, the worse he got. Finally, at his wit’s end, he came to Doctor Zhang Xichun.

💬 Note from Doctor Luo: These patients were all fortunate — they could find Doctor Zhang Xichun. We don’t have that blessing today. Where would you go looking for a Doctor Zhang Xichun now? Truly hard to find.

The same judgment: sinking great qi, plus upper-jiao yang deficiency

Doctor Zhang Xichun took the pulse: deep, thin, faint and weak — faint and weak means qi is insufficient; deep and thin means both qi and blood are inadequate; very slow on top of it — beating slowly, yang qi is deficient. He asked further: the man often felt cold in the center of his chest.

Combining pulse and symptoms, Doctor Zhang Xichun concluded: the great qi of his chest was sinking, with deficiency of upper-jiao yang — yang deficiency and sinking great qi again. So it was the same bowl of Huiyang Shengxian Decoction: sheng huang qi with gan jiang and dang gui shen, plus gui zhi jian, finished with a thread of gan cao.

Ten doses of the decoction, and he was genuinely cured.

💬 Note from Doctor Luo: Notice that in this case Doctor Zhang Xichun emphasized “very slow on top of a count” — the pulse raced in count but was slow in beat? Actually the core is the slowness — yang deficiency beats slowly. Sinking great qi combined with yang deficiency shows up as heart palpitations, shortness of breath, and fullness — exactly like the first boy. So the same formula worked just as well.

A setback in treatment: one added herb — hou po — brought pain that kept him up all night

He was cured. But this man could not control himself — he got angry again, and the illness relapsed. A doctor was called. Hearing that the original formula had cured him in ten doses, this doctor thought: fine formula, then let me double it — and on his own authority added one herb, hou po (magnolia bark).

What does hou po do? It moves qi and transforms dampness — it has a qi-moving action. And what happened? After taking it, his lower abdomen began to bear down and ache — a dragging, sinking pain in the small belly — and it hurt so badly that he could not sleep the whole night.

Back he came to Doctor Zhang Xichun. One look: fire-producing pain — how did this happen? As we’ve said before — this is exactly what sinking great qi does. So Doctor Zhang said: remove the hou po, go back to my original formula and keep taking it. He did — and it healed again.

💬 Note from Doctor Luo: This is the great taboo with sinking great qi — you must not casually move or break the qi. The qi is already sinking downward, and you add a qi-moving herb like hou po to “open” things up — the qi sinks deeper and deeper, and the bearing-down lower-abdominal pain appears. It’s exactly like the earlier carbon-monoxide-poisoning case: the deficiency is real, you must not attack it as if it were excess. So when a physician prescribes, he must see the mechanism clearly — never add herbs on a whim.

Summary: when sinking great qi meets yang deficiency, this is how to handle it

Today’s two cases, taken together, teach us this: when Doctor Zhang Xichun treated sinking great qi, he sometimes had to accommodate other problems — for instance, when yang deficiency was present, he adjusted the formula. At that point “lifting upward” was no longer the most important thing, so he left out the strongly ascending sheng ma, chai hu, and jie geng, and used instead the yang-warming gan jiang, matched with gui zhi jian, which warms and ascends at the same time.

Sheng huang qi paired with gui zhi jian is Doctor Zhang Xichun’s common herb pair for sinking great qi; add gan jiang and dang gui shen, and you have the complete idea of Huiyang Shengxian Decoction.

💬 Note from Doctor Luo: The Shengxian Tang we discussed before suits most people, but for those who feel especially cold in the upper body, with insufficient yang — particularly when the yang of the heart and lungs up top is deficient — Huiyang Shengxian Decoction is the matching formula. Today we’ve introduced another approach to regulating sinking great qi: warming the yang and lifting the sinking. Listen, broaden your horizons, know that different situations exist — that’s enough for today.

What to take away

1. “Shortness of breath” is the alarm bell. Whenever you see it, think of sinking great qi — don’t assume it’s just asthma or heart disease and stop there.
2. Warming the yang alone fails when great qi has sunk. The boy felt no warmth from any warming herb, because the qi wasn’t lifted. Warm the yang and lift the qi together.
3. The heart-lung yang and the chest great qi protect each other. When great qi sinks, the heart-lung yang loses its shelter and grows weaker — the two are mutually causal, so treat both at once.
4. Huiyang Shengxian Decoction is the formula: sheng huang qi (8 qian, about 24 g) to tonify the chest great qi, gan jiang (6 qian, 18 g) to warm the yang, dang gui shen (4 qian, 12 g) to nourish and moisten the blood, gui zhi jian (3 qian, 9 g) to warm and ascend, gan cao (1 qian, 3 g) to harmonize.
5. Never casually move or break the qi in a sinking-great-qi patient. The second patient’s relapse was caused by a doctor adding hou po to “move the qi” — it drove the qi further down and produced excruciating bearing-down pain. When the qi is sinking, don’t push it down further.
6. Great anger can sink the great qi too. The second patient fell ill after a rage — strong emotion depletes and disturbs the qi mechanism. Watch your temper; it’s good medicine in itself.
7. A note on aftercare: Doctor Zhang Xichun used raw sulfur to warm the yang afterward, but Doctor Luo does not recommend raw sulfur — moxibustion and warming foot baths are safer, gentler ways to warm the yang.

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.