Chest Tightness and Shortness of Breath: What Causes It and How to Nourish Yourself? Doctor Zhang Xichun’s “Sinking of the Great Qi” Supplement
Opening: after finishing the series, there were still things left unsaid
Doctor Luo Dalun had finished explaining Doctor Zhang Xichun’s concept of da qi xia xian (the sinking of the Great Qi), but thinking back, he felt something was missing — there were still things he hadn’t fully explained. So on a business trip, he recorded another audio session devoted entirely to material that isn’t in the books: what actually causes the sinking of the Great Qi, and how should you protect yourself in daily life?
💬 Note from Doctor Luo: Consider this my personal reflection, a few extra words of advice to friends. This condition doesn’t get enough attention these days, yet it genuinely and widely exists all around us.
Why is this condition overlooked? — Because it looks too much like “tonifying the middle”
The reason so few people know about the sinking of the Great Qi is that it is extremely close to what the Jin-Yuan physician Doctor Li Dongyuan taught about insufficiency of middle qi and his Bu Zhong Yi Qi Tang (Tonify the Middle and Replenish Qi Decoction).
💬 Note from Doctor Luo: Doctor Li Dongyuan’s fame is overwhelming, and his teaching on tonifying the middle is so good that people assume the two ideas are the same thing. So from the Republican era down to today, the sinking of the Great Qi has never received the attention it deserves. Doctor Zhang Xichun devoted enormous space to it in his writing and argued for it with great effort, yet it is still overlooked. In fact, the sinking of the Great Qi is more concentrated on problems of the heart and lungs.
Compare it with what Western medicine calls “poor cardiopulmonary function” — the symptoms are very similar: breathing that doesn’t flow smoothly, shortness of breath, coughing, and swelling in the lower legs. Western medicine adds one more sign — the veins of the neck become engorged, that is, the veins on the neck bulge out, because when heart and lung function decline, breathing keeps running into trouble.
💬 Note from Doctor Luo: But the symptoms Doctor Zhang Xichun described for sinking Great Qi go far beyond what Western medicine calls poor cardiopulmonary function — the territory is much larger. The two frameworks can be read alongside each other.
Cause one: an inherently weak constitution
A person with sinking Great Qi always has insufficient upright qi (zheng qi) and insufficient middle qi. The first type is the person with an inherently weak constitution — weak since childhood. Such people are more prone to the sinking of the Great Qi.
Cause two: damaging the spleen and stomach later in life
The source of our body’s upright qi is the spleen and stomach absorbing nutrients from food. If a person ruins their spleen and stomach, the source of upright qi is compromised, and the sinking of the Great Qi easily appears.
💬 Note from Doctor Luo: So dysfunction, injury, or weakness of the spleen and stomach is an important foundation for sinking Great Qi. As I mentioned earlier, some patients with sinking Great Qi have very prominent spleen-stomach symptoms precisely because this condition is intimately tied to the spleen and stomach.
Cause three: weakened lung qi
People with lung problems are also prone to sinking Great Qi: frequent external invasions — the lungs constantly attacked by external pathogens; frequent pneumonia; some have had tuberculosis; and some simply lack exercise, leaving their lung qi insufficient.
💬 Note from Doctor Luo: Modern testing of heart-lung function uses a blowing device — blow as hard as you can. People with large lung capacity have acceptable heart-lung function; people with very small lung capacity have poor heart-lung function. This point can actually be added to the diagnostic criteria for sinking Great Qi: shortness of breath and a stifling sensation, combined with very small lung capacity. People with chronic lung disease and weakened lungs are especially prone to sinking Great Qi.
Treated as asthma, getting worse and worse — two real examples of misdiagnosis
Many people with sinking Great Qi are treated as if they have lung disease or asthma, and that’s when problems arise.
💬 Note from Doctor Luo: A friend once wrote in: “Everywhere I go I’m treated for asthma, and no treatment ever works.” Later he read Doctor Zhang Xichun’s teaching on sinking Great Qi, decided that was his condition, used Sheng Xian Tang (Raise the Sinking Decoction), and his body recovered remarkably quickly. I have seen many cases like this.
In Doctor Zhang Xichun’s case records, this kind of misdiagnosis happens again and again — someone is wheezing; the doctor hears wheezing and prescribes qi-regulating herbs; the more they regulate qi, the worse it gets. What should actually be done is to tonify. But no one realizes it, so cough medicines and qi-regulating medicines do nothing at all — sometimes the patient only gets worse.
Doctor Luo has personally seen an elderly man who had suffered lung disease for years and later developed a wheezing sound on every breath he took. Everyone treated it as asthma: Western medicine wanted steroids, anti-wheezing drugs, and even considered a tracheotomy to open the airway — but the more they treated, the more stifled he became.
💬 Note from Doctor Luo: The moment I heard it, I thought: isn’t this exactly the kind of case Doctor Zhang Xichun described — “the sound of the gasping reaching outside the room”? It wasn’t stifling tightness; it was wheezing without force — the body straining to breathe. Doctor Zhang Xichun taught that people with sinking Great Qi have difficulty exhaling, and in fact inhaling can also be affected. We gave him Sheng Xian Tang, and with a single dose, the wheezing sound disappeared. This kind of situation is extremely easy to misdiagnose — just like that netizen, who carried steroid medication with him everywhere, and it still didn’t work.
What environment triggers it most easily? — bad air, too much moisture
People with frequent lung disease and weakened lung qi — in what environments are they most likely to develop sinking Great Qi? Doctor Zhang Xichun’s very first case was carbon monoxide poisoning — when the air quality is poor, people with weak lung function are especially vulnerable.
💬 Note from Doctor Luo: On days of very heavy smog, people with poor lung function readily show the signs of sinking Great Qi; the same happens when the air is extremely humid. I once met a woman who, while showering in the bathroom, would collapse “thud” several times a year — her vision would go black and she’d fall; after getting out to breathe fresh air, she’d gradually recover. She had a distinctive way of speaking: when her body was weak, the end of her sentences trailed off, as if flicked away, producing a strange intonation — it sounded exactly like she didn’t have enough breath. That is sinking Great Qi, and Sheng Xian Tang gradually restored her.
Cause four: insufficient heart qi
People with heart problems and weak heart function are also especially prone to developing sinking Great Qi.
💬 Note from Doctor Luo: Let me give an example. A woman had surgery for congenital heart disease as a child, leaving her heart function on the weak side. Once, at a wedding banquet in a restaurant — the bride and groom were lighting cigarettes, many people were smoking, the noise was loud, and in a northern winter the heavy door curtain sealed the room, so the air was filthy. In that environment, she would feel her heart racing, her hands sweating, her whole body trembling, her breath failing to come up, and her head spinning — she had to walk straight out of the hotel, crouch down, and breathe fresh air before she could recover after a while. That is sinking Great Qi brought on by insufficient heart qi.
Whether it is blood stasis, yang deficiency, qi deficiency, or yin deficiency — whatever causes heart function to decline and heart qi to become insufficient — it can all lead to sinking Great Qi. This is another important foundation of the disease.
The knowledge in the pulse: the pulse can also beat very fast
When sinking Great Qi is caused by weak heart function, the pulse can even show jie dai (irregularly interrupted pulse) — the pulse beats chaotically, beating and then stopping.
💬 Note from Doctor Luo: A friend wrote in to ask: Doctor Zhang Xichun said the pulse in sinking Great Qi is always slow and delayed — so why is my pulse beating so fast? In fact, many patients with sinking Great Qi have a fast pulse — because the heart is running itself ragged, beating rapidly again and again in hopes of turning the situation around. We need to extrapolate: once you understand how a condition forms, you can predict what signs will appear.
What to do when you have symptoms? — Sheng Xian Tang is very gentle
If you have the signs of sinking Great Qi, how should you take care of yourself? When symptoms appear, you can take a little Sheng Xian Tang (Raise the Sinking Decoction).
💬 Note from Doctor Luo: Sheng Xian Tang is a very gentle Chinese herbal formula. Except for pregnant women, except for patients with severe conditions such as cerebral hemorrhage (and for prescribing, please leave it to a physician), generally speaking, a person in otherwise normal health who shows signs of sinking Great Qi can use it. It is mainly one herb — raw huang qi (astragalus) — paired with a little zhi mu to check its warmth, plus three lifting herbs in very small doses. The composition is extremely simple, and many people feel the effect immediately — a sense of relief right away.
But remember: this is only temporary. What truly needs adjusting is upright qi — afterward you must nourish the spleen and stomach and build up qi and blood, slowly restoring upright qi to full strength so that sinking Great Qi does not return.
Daily care: six things, don’t slack on any of them
People with insufficient upright qi, weak bodies, and a lack of exercise need to slowly build upright qi back up. Six things in daily life matter especially.
First, walk as much as you can manage. Walk a little more each day — a bit more than yesterday, a bit more again the day after — stopping at the point where you’re not exhausted.
💬 Note from Doctor Luo: On WeChat Moments, some people walk 50,000 or even 70,000 steps a day — I think that kind of walking can itself lead to sinking Great Qi; it’s excessive. Seven or eight thousand steps, even ten thousand, is perfectly fine.
Second, sing deliberately. Singing trains your lung capacity — but—
💬 Note from Doctor Luo: Don’t sing while you’re actually in a state of sinking Great Qi — that can cause problems. I once watched a video: a woman in a park was singing, pushed her high notes until her voice gave out, threw her head back, and “thud” — collapsed to the ground. That’s sudden sinking Great Qi. So when you sing, choose calm, gentle melodies, nothing too high. Don’t be in the middle of sinking Great Qi and insist on belting out “Ya-la-so” — that’s how you get “the Qinghai-Tibet high” and then no voice at all, with your breath stuck in one place.
Third, don’t exhaust yourself in extreme weather. On heavy fog days, on days with especially heavy humidity — going out to walk or sing anyway is not acceptable.
Fourth, try to avoid high altitudes. Some friends ask who is suitable for a trip to Tibet — people with sinking Great Qi and poor heart-lung function will have especially severe altitude reactions and should try to avoid it.
Fifth, avoid violent emotional swings. Doctor Zhang Xichun gave two examples: one is great rage — rage makes qi rise, qi moves upward, yet the Great Qi instead sinks downward, and great rage seriously damages heart-lung function; the other is sudden fright, which can also cause sinking Great Qi.
Sixth, keep a regular routine. Eat meals on time — some people postpone meals to wait for clients. People with sinking Great Qi are very prone to attacks when hungry, even to life-threatening situations, so no matter how important the matter, eat first when mealtime comes. Sleep must also be guaranteed — staying up late drains upright qi and also invites sinking Great Qi.
💬 Note from Doctor Luo: Keep your routine regular, gradually regulate your diet over time, and slowly return to normal — only then have you truly left that danger zone. Today’s session is a supplement to yesterday’s. Tomorrow I’ll continue with the other formulas Doctor Zhang Xichun used for sinking Great Qi — once those are covered, you’ll have a comprehensive picture of the various concurrent patterns and accompanying symptoms of this condition.
What to take away
Compiled from Doctor Luo Dalun’s commentary on Doctor Zhang Xichun’s case records.