Always Feel Like You’re Catching a Cold, Chilly, with a Low Fever That Never Goes Away? Doctor Li Dongyuan’s Bu Zhong Yi Qi Wan: The Formula for the “Fake Cold”

Patient search words: always feel like catching a cold / chills / low fever that won’t go away / cold medicine doesn’t work / a chill at the slightest breeze Corresponding medical terms: internal-injury fever · spleen-stomach qi deficiency pattern · “fake cold” (pseudo-external contraction)

Opening: there is a kind of “cold” that cold medicine can never cure

Let’s start with two kinds of people. The first kind catches a cold when the cold wind blows — runny nose, sore throat, feeling chilled; that is a real cold. The second kind is strange: he always feels like he’s catching a cold — always slightly chilly, the skin turns cold at the slightest breeze, a little feverish, sometimes with a genuine fever; yet there is no sore throat, and it never gets worse or turns into pneumonia. This cold acts like a squatter who refuses to leave: it never gets better, but it never develops either.

💬 Note from Doctor Luo: People like this — no matter how much cold medicine they take, they don’t get better. The longest case I’ve seen lasted a whole year — the person kept feeling like he had a cold, taking cold medicine now and then, breaking a sweat, or clearing heat and toxins, thinking it worked a little, but then right back to the same state. Some people genuinely run a fever — I’ve seen people feverish for half a year. The temperature really was high, and the whole body feared cold, yet clearing heat and toxins did nothing, and dispersing wind and cold also did nothing.

So what disease does he actually have? Today we’re introducing a medicine — Bu Zhong Yi Qi Wan (Center-Supplementing Qi-Boosting Pill). It used to be called Bu Zhong Yi Qi Tang (the decoction form). Who created this formula? Doctor Li Dongyuan of the Jin-Yuan period.

Why did a rich young man devote himself to medicine? — His mother died, and even the disease name was never clarified

Doctor Li Dongyuan was from Hebei. As a child his family was extremely wealthy, and he was a student of noble character. But then something huge happened in his family that changed his life forever.

💬 Note from Doctor Luo: His mother fell ill, and they invited countless famous doctors — his family was the richest in Hebei at the time; what famous doctor couldn’t they summon? Yet in the end they could not cure her, and his mother died, possibly without even the disease name being clarified. Li Dongyuan was grief-stricken and furious: how could he have learned so much, and still be unable to save his own mother? So he threw himself into studying medicine, spent a great deal of money, and went to study under the most famous doctor of the era — Zhang Yuansu (also called the “Jie Gu Old Man”) of Yishui. In the end he mastered Zhang Yuansu’s medical art and became one of the Four Great Masters of the Jin-Yuan period.

The siege of the Jin capital: the bitter lesson of a million starved to death

Li Dongyuan lived in extremely turbulent times. He lived on the territory of the Jin dynasty, which was constantly invaded by the Mongols; after the wars, the people had no means to live. Especially when the Mongol armies laid siege to the cities of the Jin dynasty — once a city was surrounded, there was nothing to eat inside, everyone starved, and in the end people ate people.

💬 Note from Doctor Luo: Strangely, as soon as the Mongol soldiers withdrew, the people inside the city suddenly began dying in great numbers. At the time everyone assumed it was an epidemic, and many modern epidemiologists believe it was an outbreak of bubonic plague — but the truth may not have been that at all. Li Dongyuan lived through the final siege when the Jin dynasty was destroyed, when the dead numbered in the millions. Why did people who had been starving — who had nothing to eat for a long time — suddenly die once the city gates opened and they started eating again? Li Dongyuan studied exactly this — in a chaotic society, amid the suffering of ordinary people, he kept pondering the solution.

The truth about the starvation deaths: injured spleen and stomach presenting like an external contraction

Li Dongyuan finally found the cause: the spleen and stomach had been injured. When the spleen and stomach are severely damaged, spleen-stomach qi deficiency develops, and it shows symptoms very similar to an external contraction.

💬 Note from Doctor Luo: This is why he wrote Nei Wai Shang Bian Huo Lun (Clarifying Doubts about Internal and External Damage) and Pi Wei Lun (Treatise on the Spleen and Stomach). Clarifying Doubts specifically explains: after the spleen and stomach are injured, there are many manifestations that resemble external contraction. Why is this so? Li Dongyuan said that in ancient times people were deeply familiar with the principles of yin and yang — look at the Huang Di Nei Jing (Yellow Emperor’s Inner Classic): everywhere it treats the stomach qi of a person as the root and values spleen-stomach qi. When the spleen and stomach are strong, they can absorb the qi of water and grain — this is the clear qi, the nutritive qi, the stomach qi, the qi of spring growth; all are born from stomach qi and are one body. That is why Chinese medicine says “the stomach is the sea of water and grain,” and why we say today “the spleen and stomach are the source of postnatal generation.”

The three major causes of spleen injury — modern people hit all of them

When the spleen and stomach are strong and function normally, food enters the stomach, is transported and transformed by the spleen and stomach, and the nutrients are carried throughout the body — only then does the body have strength. But modern people have too many chances to injure their spleen.

💬 Note from Doctor Luo: First is irregular diet — full one meal, starving the next, eating all sorts of junk, overindulging, and wrecking the spleen and stomach. Second is cold-heat disharmony — cold one moment, hot the next; some eat freezing food, some eat scalding hot food. Many people eat hotpot while drinking ice-cold beer — that is a textbook case of cold-heat disharmony. Third is emotional disharmony — we know that worry and brooding damage the spleen; modern people think about making money every day and brood constantly. Add to that constrained liver qi — the wood of the liver runs wild and attacks the earth of the spleen — and the spleen and stomach are injured again.

Once the spleen and stomach weaken, yuan qi (original qi) is consumed. As Li Dongyuan put it: when the spleen and stomach decline and yuan qi is insufficient, the heart fire blazes alone.

Yin fire, ministerial fire, dragon-thunder fire: the puzzle Li Dongyuan left behind

In Clarifying Doubts about Internal and External Damage, Li Dongyuan discusses several concepts that even modern people cannot fully explain why he framed them this way.

💬 Note from Doctor Luo: He first says “the heart fire blazes alone,” then says this heart fire is called “yin fire” — yin fire arises from the lower burner; its tie is to the heart, so the heart does not take command. Then he speaks of “ministerial fire” — ministerial fire is the fire of the pericardium in the lower burner; it is the thief of yuan qi, constantly invading it. So Li Dongyuan says “fire and yuan qi cannot coexist” — when one wins, the other loses. Look: heart fire, yin fire, ministerial fire — these concepts confused every later physician. Everyone kept trying to work out whether he was talking about one and the same thing. Let’s park that puzzle for now; it is not today’s main topic.

What is interesting is that later famous doctors understood the matter from a different angle.

💬 Note from Doctor Luo: Physicians like Doctor Zhang Jingyue and Doctor Chen Shiduo invented a concept called “dragon-thunder fire” (long lei zhi huo) — when the water and fire in your kidneys cannot harmonize, when kidney essence is depleted and kidney water is insufficient, the deficiency fire in the kidneys rises up; that is dragon-thunder fire. Li Dongyuan was talking about another route: when you are qi-deficient, a stream of deficiency fire also rises from the lower burner, and this deficiency fire often affects the state of the upper burner and the body surface.

What does a “fake cold” look like? — The more you look, the more it looks like a cold, but it is actually deficiency fire

Li Dongyuan said that people with injured spleen and stomach do not feel cold all the time — what they feel first is heat.

💬 Note from Doctor Luo: In Li Dongyuan’s own words: “Qi rises high and one wheezes” — constant wheezing, the qi stuck up above; “the body is hot and vexed” — the body feels hot, sometimes with a genuine fever, and the heart is vexed; “the pulse is huge and forceful, with headache” — the pulse looks like a person full of energy, but that is not so; the qi is simply stuck up above. Many people see someone who is vexed, wheezing and headachy and think there is fire above, so they use cold herbs to drain the fire — and that is the mistake.

And there is something even more deceptive: the skin does not recognize wind and cold, so chills and fever arise — sometimes extremely cold, more afraid of a breeze than anyone else; sometimes hot, even with a genuine fever. Why is this?

💬 Note from Doctor Luo: Li Dongyuan’s explanation: yin fire rushes upward, hence the wheezing with qi held high, the vexing heat of the body, the headache, and the huge pulse; while the qi of the spleen and stomach flows downward — the clear qi that should rise does not rise, the grain qi cannot float upward, and the order of growth does not run, so there is no yang to protect the nutritive and defensive (ying and wei) — without yang protecting the body surface, the surface does not recognize wind and cold; when the cold wind blows outside, one fears cold, and fever may even appear. This is illness caused by insufficiency of spleen-stomach qi.

Never treat it as a cold! — Internal injury and external contraction have completely different roots

With this kind of “fake cold,” the worst thing is to treat it as an external contraction.

💬 Note from Doctor Luo: Li Dongyuan said explicitly: do not treat this as an external contraction. If you use cold herbs, heat-clearing and toxin-resolving medicines, you damage spleen-stomach qi more and more, and the symptoms will not go away. Some people use dispersing, cold-dispelling methods to push the cold out — but at this point the problem is insufficient righteous qi; the more you disperse outward, the more your righteous qi is used up, and you hurt it further. So the key is to determine whether it is external contraction or internal injury — that is precisely the title of Li Dongyuan’s book, Clarifying Doubts about Internal and External Damage: external contraction and internal injury both present with cold-like symptoms, but their roots are completely different. For such people you must use the warm-tonifying method, the sweet-warm qi-tonifying method. Li Dongyuan’s Bu Zhong Yi Qi Tang, later made into the patent medicine Bu Zhong Yi Qi Wan, is precisely the formula for this illness.

What is hidden inside Bu Zhong Yi Qi Wan? — Breaking down Li Dongyuan’s formula herb by herb

Li Dongyuan’s reasoning in this formula is extremely clear.

💬 Note from Doctor Luo: First use huang qi (astragalus) to tonify lung qi — when the lung qi is attacked, a person sweats spontaneously; move a little and the sweat pours out; that is a sign of qi deficiency. When the lung qi is sufficient, the interstices (pores) can tighten, and the wei qi (defensive qi) becomes sufficient as well. Then use ren shen (ginseng), bai zhu (atractylodes) and zhi gan cao (honey-fried licorice) to tonify the spleen and stomach in the middle burner — bai zhu is bitter, sweet and warm; it can remove heat from the stomach and benefit the blood around the waist and navel; zhi gan cao is sweet and warm, used to drain fire-heat, because you have deficiency fire. Once the spleen-stomach function weakens, the clear qi does not rise and the turbid qi does not descend, and the whole circle of qi movement in the body stops turning — heat stays above, cold stays below, so you always feel a false heat up top. From this angle you can also understand the mechanism of the yin fire Li Dongyuan spoke of.

The formula also contains three more herbs, each with its own subtlety.

💬 Note from Doctor Luo: Chen pi (tangerine peel) is added because he feared that when tonics are used, things can become stagnant and greasy; chen pi regulates the qi movement and smooths it out — Li Dongyuan said that in the body right now yin and yang are in disorder and clear and turbid are mixed in the chest; when the chest qi is chaotic, use chen pi to regulate qi, helping yang qi rise so as to disperse stagnant qi. The most brilliant part of the formula is chai hu (bupleurum) and sheng ma (cohosh) — the clear qi of the stomach is sinking below; to make the clear qi rise and the turbid qi descend, these two herbs are the key. The Qing-dynasty physician Zhang Bingcheng explained: chai hu raises the clear qi of the liver and gallbladder, rising from the left up to the surface; sheng ma raises the clear qi of the spleen and stomach, rising from the right up to the surface — the left and right directions are different. Finally dang gui (Chinese angelica) is added: the whole formula tonifies qi, so adding a little blood-regulating herb makes qi and blood unite; adding dang gui was a very fine touch.

Li Dongyuan’s caution: he knew the temperament of every single herb

In his books Li Dongyuan detailed many modifications to this formula — what to add in what situation, which herb’s dose to increase — he prescribed with great care.

💬 Note from Doctor Luo: Later people said that Li Dongyuan used very small doses of each herb and that his formulas had too many herbs and seemed messy. In fact he was extremely careful and explained the drawback of every herb clearly. Chen pi, for example, is used in a very small dose — Li Dongyuan pointed out specifically that chen pi’s qi-moving action is strong; if you must use it, it is best combined with spleen-tonifying, qi-tonifying herbs. Used alone, a weak person probably could not tolerate it. See how careful he was.

How to tell whether you have a “fake cold”? — Qi-deficient people should know this

Now let’s return to the opening question: who gets this “fake cold”?

💬 Note from Doctor Luo: They are all qi-deficient people, people with insufficient righteous qi — especially those with spleen-stomach qi deficiency. On one side, the qi mechanism of the body always sinks downward; they have no strength and no righteous qi. On the other side, they show cold-like conditions — always feeling the body is chilled, always feeling a little like they have a cold. Is it a real cold? Cold medicine barely works, and the duration is extraordinarily long — a normal cold should resolve in a few days; when a person has been “catching a cold” for two months, or half a year, with symptoms identical to the first day, something is probably wrong. Now I receive consultations from many people, and I find quite a few really do have this fake cold — especially elderly, weak people with insufficient righteous qi and weak spleen and stomach, both men and women; it is not a real cold at all. I tell them: this is called a fake cold, learn about it, use a little Bu Zhong Yi Qi Wan to adjust, and the results are quite good.

💬 Note from Doctor Luo: Don’t rush with Bu Zhong Yi Qi Wan — take it slowly. As you keep taking it, the spleen-stomach qi fills up and the clear qi rises. Then adjust your diet sensibly, keep a regular routine, and nourish the body well — and you’ll find that these cold-like symptoms genuinely disappear.

Ending: the spleen and stomach are the root of the body — and this formula can treat many diseases

In short, the spleen and stomach are the root of our body. How do we protect them? Eat sensibly, keep a regular routine, and keep your emotions in good order — that is the greatest protection for the spleen and stomach.

💬 Note from Doctor Luo: Bu Zhong Yi Qi Wan can treat far too many diseases, and there is a great deal of detail hidden in it. Take the Ming-dynasty Doctor Xue Lizhai — an imperial physician and head of the Imperial Academy of Medicine — he used just a few formulas: Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet), Bu Zhong Yi Qi, Gui Pi Wan (Spleen-Restoring Pill) and Xiao Yao Wan (Free and Easy Powder) — and with them he treated a great many diseases; his case records are numerous. We can talk about that in detail another time.

Compiled from Doctor Luo Dalun’s lecture series on Doctor Li Dongyuan’s medical cases. The formula comes from Doctor Li Dongyuan’s Jin-dynasty works Pi Wei Lun (Treatise on the Spleen and Stomach) and Nei Wai Shang Bian Huo Lun (Clarifying Doubts about Internal and External Damage).