Always Tired, Breathless Climbing Stairs, and Catching Every Cold That Goes Around? Doctor Luo Dalun: If You Are Qi Deficient, Start With Bu Zhong Yi Qi Wan (Tonify the Middle and Augment Qi Pills)
Patient search terms: always tired / no energy / breathless climbing stairs / catch every cold / qi deficiency / teeth marks on tongue / prevent colds and flu
Corresponding conditions: qi deficiency (spleen qi deficiency) · middle qi sinking · recurrent respiratory infections · post-illness recovery
Opening: when we talk about preventing colds and flu, why bring up Bu Zhong Yi Qi Wan?
When people hear “preventing colds and flu,” what jumps into their heads is clearing heat and resolving toxins — Ban Lan Gen (isatis root) granules, Lianhua Qingwen capsules. Why is Doctor Luo talking about Bu Zhong Yi Qi Wan — a qi-tonifying medicine stocked in every pharmacy in China? What does that have to do with colds?
💬 Note from Doctor Luo: Today we continue our discussion of preventing external contraction. What are we talking about? Bu Zhong Yi Qi Wan — every pharmacy in China has it. You may ask: what does this have to do with preventing colds? If we are preventing colds, shouldn’t we be talking about heat-clearing and toxin-resolving medicines? Here is the thing — humanity has been fighting external contraction since humans first existed, always fighting, always negotiating. And in that struggle, what matters most? Upright qi (zheng qi) is extraordinarily important. Whatever problems we see — whether the approach is warming yang or clearing heat — protecting upright qi is always at the heart of it.
Humanity has fought external contraction for thousands of years — what kept us alive?
Human history is almost a history of fighting external contraction. Doctor Luo says that in this long war, the people who survived and thrived did not rely on anything else — just that one breath of upright qi.
💬 Note from Doctor Luo: The air outside is full of microorganisms — bacteria, viruses, all kinds. Why are we fine? Because our bodies have upright qi — it keeps circulating; an enemy comes in, we destroy it; another comes in, we destroy it. So upright qi is absolutely critical.
Where did this formula come from? — The siege of the Jin capital, the bitter lesson of a million dead
The ancestor of Bu Zhong Yi Qi Wan is Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction), created by the great Jin dynasty physician Doctor Li Dongyuan. To understand this formula, you must return to that era of starvation and corpses.
💬 Note from Doctor Luo: It was wartime — the Mongol army had come to destroy the Jin dynasty and besieged them inside the capital. Inside Bianjing (modern Kaifeng) an enormous number of people starved to death. When the Mongols withdrew, everyone could finally eat again. While starving they had been eating grass roots; once the siege lifted and food was available, what happened? They wrecked their spleen and stomachs — an enormous number of people died, and bodies were carried out of the city every single day.
About a million people died. Scholars have argued ever since: were they all starved to death? Could some have died of epidemics — plague, for instance?
💬 Note from Doctor Luo: Epidemics were certainly possible. But the question is: if there really was an epidemic, why did it suddenly explode? Why? Still because the spleen and stomach were damaged — once the spleen and stomach are hurt, upright qi becomes insufficient, so whenever any epidemic or plague circulates, many people die. Li Dongyuan concluded that the main cause of death was this: weakened, collapsed spleen and stomach.
Li Dongyuan himself was trapped in the city — even the Jin emperor was chewing grass roots, so what could he eat? Certainly nothing nourishing; his own spleen and stomach were injured too. He suffered deeply from spleen-stomach injury, and after bitter reflection he began to create formulas — a whole series of spleen-stomach tonics, the most famous of which is Bu Zhong Yi Qi Tang.
Why did later masters love it so much? — Three or four out of every ten formulas
Once created, the formula spread enormously and became a trump card in the hands of later physicians.
💬 Note from Doctor Luo: Look at all the physicians I have discussed over the years — many of them were especially skilled with Bu Zhong Yi Qi; some physicians, in their whole practice, write three or four Bu Zhong Yi Qi formulas out of every ten. Doctor Xue Lizhai, Doctor Gong Tingxian — they all recognized this approach deeply.
Same office, why do some catch everything and others nothing? — It all comes down to upright qi
Why start with Bu Zhong Yi Qi when talking about colds? Doctor Luo says it is because too many people today are looking in the wrong place.
💬 Note from Doctor Luo: Many of us walk down the street — other people don’t get infected, but you do. It is the same at work, in the office. I have a friend working in Singapore; one by one everyone in his office went down, and he was the only one who stayed healthy — why? He grew up in a village in Shandong, eating coarse grains — corn, sweet potatoes. His constitution was good, so he stayed well. In the end, what does it come down to? Upright qi.
💬 Note from Doctor Luo: So please do not fixate on clearing heat and resolving toxins — that is when the fire has already started and you are thinking about how to put it out. What matters more is: how do I keep the fire from reaching me in the first place? Everyone must understand this.
So how do we protect upright qi? Not everyone needs tonics — first correct your own imbalanced constitution:
💬 Note from Doctor Luo: If you are yin deficient, nourishing yin protects upright qi; if you are qi deficient, supplementing qi protects upright qi; if you are yang deficient, warming yang and keeping the body warm also protects upright qi; if your blood is insufficient, nourishing blood protects upright qi; if your liver qi is uncomfortable, soothing the liver and regulating qi protects upright qi. We are simply adjusting the constitution.
Why single out Bu Zhong Yi Qi? — Because qi-deficient people are everywhere today
There are several types of constitutional imbalance — why does Doctor Luo single out Bu Zhong Yi Qi Wan? Because today, qi deficiency is the most common.
💬 Note from Doctor Luo: Among people with insufficient upright qi, what we see most today is qi deficiency. Is there yin deficiency? Yes — but far fewer people than qi deficiency; sometimes it is both qi and yin deficiency together. And qi deficiency is closely linked with yang deficiency — the two often move together.
Li Dongyuan’s era starved for it; today’s people eat their way into it — the same spleen-stomach injury, from opposite directions
The spleen and stomach get injured in ancient and modern times for completely opposite reasons — with exactly the same result.
💬 Note from Doctor Luo: In Li Dongyuan’s time, people starved — hunger injured the spleen and stomach. But today? People eat too well and too chaotically. We eat chaotically, not whole grains — can you really eat whole grains every day? No. Everyone eats white rice and polished rice, a single grain refined and processed. Do we get enough vegetables every day? Not necessarily. And we skip meals, then gorge on rich, fatty, sweet food — meat pumped full of hormones. So the way we injure our spleen and stomach today is overeating and eating chaotically — the outcome overlaps heavily with Li Dongyuan’s era, except that today more people have heavy phlegm-dampness.
Stick out your tongue — the vast majority have teeth marks. The qi-deficiency self-check list
How do you tell whether you have spleen deficiency and qi deficiency? Doctor Luo gives a very practical self-check, starting with the tongue:
💬 Note from Doctor Luo: Ask everyone to stick out their tongue — the vast majority have teeth marks along the edges. Why? Less exercise, poor and chaotic eating — the spleen and stomach are hurt. When upright qi is insufficient and dampness is heavy, the tongue swells — a swollen tongue presses against the teeth and leaves marks.
Then look at the whole body — if several of these apply to you, you are basically qi deficient:
💬 Note from Doctor Luo: No energy all over; after a meal you collapse onto the bed or the sofa, arms and legs feeling weak; you get breathless from walking — climbing three flights of stairs leaves you panting; you sweat at the slightest movement; your complexion is pale; your stool is loose and unformed. Are there many such people? Very many. Look at the white-collar workers in offices — basically sixty to seventy percent of them have a swollen tongue with teeth marks, a pale face, weakness on movement, breathlessness on exertion, a weak voice, dizziness when tired, and loose stools — this is spleen deficiency.
Why is spleen deficiency so common? — From lung metal to kidney fire, and on to the gut microbiome
Why are there so many spleen-deficient people? Doctor Luo walks the whole chain, from classical theory to modern research.
💬 Note from Doctor Luo: Within qi deficiency there is lung qi deficiency and spleen deficiency. What is lung qi deficiency related to? Spleen deficiency — when the spleen is deficient, spleen earth can no longer generate lung metal, so lung qi becomes deficient; the spleen earth is the core. Modern people also drain kidney qi heavily, so kidney qi lacks the strength to rise, and ming men fire (the fire of the life gate) can no longer warm and generate spleen earth — so spleen earth becomes deficient as well.
Modern research offers an even fresher angle — the relationship between immunity and the digestive system:
💬 Note from Doctor Luo: Our immune function is closely related to our digestive system. The gut microbiome contains many beneficial bacteria; it is an organ of the human body, and it is now generally recognized that it participates enormously in immunity. So when the gut flora is disturbed, the immune system certainly declines. And what is this? The spleen of Chinese medicine overlaps heavily with the gut microbiome.
Modern life is full of things that damage the gut flora:
💬 Note from Doctor Luo: Antibiotics are added to the food we eat — when raising chickens and ducks you feed them antibiotics so they don’t die. Testing once found antibiotic residues in the urine of many children in the Jiangsu–Zhejiang–Shanghai region — meaning the meat they eat contains antibiotics. Vegetables? Those too — pesticides and the like. All of these kill gut flora and interfere with its healthy growth — and this is also injuring the spleen. It is exactly the same as the spleen deficiency caused by rich, fatty food or by going hungry.
Nutritive and defensive qi: the spleen and stomach are the Ministry of Defense — when spleen qi fails, the front line collapses
So how does injuring spleen qi actually let external pathogens slip through? Here we need a key concept — nutritive and defensive qi (ying wei zhi qi).
💬 Note from Doctor Luo: Ying wei qi is what the spleen and stomach produce by absorbing the nutrients and the finest essence from food and transforming it into nutritive and defensive qi, which travels through the whole body, nourishing everything — and then what does it do? It defends against external pathogens. Think about it: your spleen qi is already injured, your upright qi is insufficient, so your ying wei qi certainly has problems too — your ability to resist external pathogens declines. What to do then? Strengthen the spleen.
Who is the best fit for Bu Zhong Yi Qi Wan? — Qi deficiency, spleen qi deficiency, even sinking of the qi mechanism
There are many spleen-strengthening formulas — when is Bu Zhong Yi Qi Wan the right choice? Doctor Luo is very specific:
💬 Note from Doctor Luo: Bu Zhong Yi Qi is truly an excellent formula for modern people to strengthen their constitution. For those with qi deficiency and spleen qi deficiency — especially when it reaches the point of qi mechanism sinking: you don’t feel like eating, because the spleen and stomach lack the strength to transport and transform, no appetite; the body is exhausted, limbs weak, after a meal you collapse onto the sofa with no energy at all, not even wanting to move; the voice is weak, the complexion pale or sallow, stools loose; you feel the qi sinking downward, can’t muster strength — walking tires you, talking tires you, and in severe cases the organs truly prolapse. Such people can take Bu Zhong Yi Qi Wan.
How to prevent illness during an epidemic? — If you are qi deficient, Bu Zhong Yi Qi is prevention
People ask Doctor Luo: during an epidemic, what medicine can you take to prevent infection? His answer is very down-to-earth:
💬 Note from Doctor Luo: If you are qi deficient, taking a little Bu Zhong Yi Qi counts as prevention. In this formula, Li Dongyuan especially loved huang qi (Astragalus root) — huang qi is the first and foremost ingredient, the most important and core component. We can also brew huang qi in hot water and drink it ourselves, to increase upright qi.
Breaking down the formula: huang qi leads, sheng ma and chai hu lift upward, chen pi prevents cloying
Why is this formula so classic? Break it apart — every herb has its place:
💬 Note from Doctor Luo: First is huang qi — it supplements qi. Then a little ren shen (ginseng) — today we often say dang shen (Codonopsis), also supplementing qi; bai zhu (atractylodes) strengthens the spleen; a little dang gui (Chinese angelica) nourishes the blood; sheng jiang (fresh ginger) and da zao (jujube) regulate the spleen and stomach — ginger warms the middle, jujube harmonizes and also tonifies. Then sheng ma (cimicifuga) and chai hu (bupleurum) lift the qi upward — isn’t your qi sinking? Lift it up a little. Add a little chen pi (aged tangerine peel) so the tonics don’t become cloying and stagnant — so they don’t pile up inside and fail to be absorbed; chen pi moves the qi and opens things up. So this formula is a strategy of strengthening the spleen and supplementing qi, lifting the qi and blood upward, with a touch of blood nourishment.
A pediatric master’s aftercare secret: after a child’s cold is better, four or five days of Bu Zhong Yi Qi
The formula has another wonderful use — aftercare for sick children. Doctor Luo shares what he learned from visiting senior practitioners:
💬 Note from Doctor Luo: When I used to visit senior physicians who treated pediatric disease — whenever a child recovered, after an external contraction resolved, they would have the child take four or five days of Bu Zhong Yi Qi. Why? Because upright qi is insufficient, and next time the external pathogen won’t come so easily. Otherwise the child catches a cold and upright qi drops; after fighting the pathogen, the body’s upright qi is even lower — so you need to build it back up. This is the aftercare of a cold.
Qi-deficiency fever, false colds? — Sweet and warm herbs dispel high fever
Bu Zhong Yi Qi Wan treats many conditions, but one deserves special attention — people who keep running a fever like a cold, when it is actually qi deficiency:
💬 Note from Doctor Luo: When you hear me talk about Doctor Xue Lizhai and Doctor Gong Tingxian and all the strange diseases they treated — many strange diseases, in the end, are caused by insufficient upright qi, by qi deficiency. Some qi-deficient people even run a fever — the body feels hot as if burning, always seeming like a cold that never quite clears — this is a false cold. This too is treated with Bu Zhong Yi Qi, pulling the heat back and clearing it — this is gan wen chu da re, “sweet and warm herbs dispel high fever.” So you see, supporting upright qi is the method of prevention.
Who must NOT take it? — People with a red tongue: remember these two rules
Bu Zhong Yi Qi Wan is good, but not everyone can take it. Doctor Luo stresses two groups of contraindications — everyone should remember these:
💬 Note from Doctor Luo: Who can’t take it? Yin-deficient people and people with liver fire. Yin-deficient people basically have no coating on the tongue, or a very thin one, and a red tongue — remember this, family members with a red tongue cannot take it. Supplementing qi won’t work for them; they need to nourish yin, even clear heat, clear deficient heat. Second, people with liver fire — their tongue is pointed at the tip, red at the edges, even slightly purple, very red — they can’t take it either; taking it would be adding fuel to the fire.
What about other constitutions? Doctor Luo says yang deficiency and blood deficiency can actually take it:
💬 Note from Doctor Luo: People with yin deficiency and heat should take yin-nourishing medicines — Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pills) and the like. People with liver fire should take Jia Wei Xiao Yao Wan (Augmented Free and Easy Pills) to soothe liver qi and drain liver fire — that also raises upright qi. Yang deficiency can take it — as you gradually lift spleen yang, it also helps kidney yang recover. Blood deficiency works too, because the formula contains dang gui; pairing it with some blood-nourishing herbs may be even better — qi and blood generate each other: once you top up the qi, blood deficiency improves as well.
Move the front line beyond the trenches — not getting infected is the best prevention
To close, Doctor Luo gathers the whole lecture into one sentence: when preventing external contraction, don’t keep your eyes fixed on clearing heat and resolving toxins.
💬 Note from Doctor Luo: In fact, not getting infected in the first place is the best outcome. Most people won’t get infected — but we should try our best to prevent; fight a preventive war, move the front line beyond the trenches. Don’t fight inside the trenches — that is exhausting. Bu Zhong Yi Qi is a ready-made medicine available in every pharmacy in China. Qi-deficient people who take a little every day will find their constitution markedly improved and their ability to resist pathogens strengthened.
This article is compiled from Doctor Luo Dalun’s lecture series on preventing external contraction. Bu Zhong Yi Qi Tang originates from the Pi Wei Lun (Treatise on the Spleen and Stomach) by Li Dongyuan of the Jin dynasty.