Feeling Weaker and Weaker, Getting Worse No Matter How You Treat It? Doctor Zhang Xichun’s Philosophy of Strengthening the Upright Qi: When Zheng Qi Is Sufficient, Pathogenic Qi Leaves on Its Own

Search terms: body getting weaker and weaker / whole-body weakness / getting worse no matter how you treat it / postpartum weakness / sweating from qi deficiency / dizziness right after taking san qi powder / chronic fatigue and constant drowsiness Corresponding medical terms: insufficiency of upright qi (zheng qi bu zu) · dual deficiency of qi and blood (qi xue liang xu) · sinking of the great qi (da qi xia xian) · postpartum deficiency · chronic fatigue syndrome

Opening: Doctor Luo finally turns in his “homework”

It has been a long time since Doctor Luo Dalun last recorded a lecture, and he confesses that the whole time he felt as though he owed everyone something — like a schoolboy who hasn’t done his homework, with a slightly guilty knot in his stomach. So today he has to make good on that “homework” and pick up the microphone again.

💬 Note from Doctor Luo: For a long time now I’ve been telling you stories of how Doctor Zhang Xichun treated patients. But as I went along, I was actually selecting the cases — where the herbs used were too fierce, I left them out. Nearly everything I told you was gentle and mild, because I was teaching you the way of thinking about treatment.

So after all these stories, what should you take away? Doctor Luo says he wants to introduce you to Zhang Xichun’s tonifying philosophy — the idea of nourishing, building up and replenishing. His method of tonification is what you should learn.

💬 Note from Doctor Luo: Why? Because this is the master physician’s secret — he paid attention to the upright qi. Zhang Xichun’s skill in clearing heat and transforming blood stasis was extraordinary, his technique ran deep. But did you notice? When Zhang Xichun treated a patient, he always placed enormous importance on the person’s upright qi.

Zhang Xichun’s favorite herbs — huai shan yao, shan yu rou, shu di huang

In Zhang Xichun’s formulas, huai shan yao (Huai yam, Chinese yam from the Huaiqing region of Henan) appears constantly, and so does shan yu rou (cornus fruit, the medicinal dogwood berry).

💬 Note from Doctor Luo: What does huai shan yao do? It tonifies the spleen and kidney. And shan yu rou? It tonifies the heart and liver — both of them replenish the essence (jing). Then there is shu di huang, which tonifies the liver and kidney. He could have used many other herbs, but Zhang Xichun grasped the special character of these few and used them to fill the body’s upright qi back up. Because only when the upright qi is sufficient can you expel pathogenic qi, and only then does the body slowly recover.

The two great schools of Chinese medicine: Strengthening the Upright and Attacking the Pathogens

Over the centuries, Chinese medicine gradually formed many schools, and two of them are especially interesting: the fuzheng school (strengthening the upright) and the gongxie school (attacking the pathogens, also called the qi-expelling school).

💬 Note from Doctor Luo: The fuzheng doctors love to support the upright qi — it’s what they do best. Their view is: once your upright qi is sufficient, the pathogenic qi gets squeezed out on its own. Their analogy: if a room is full of gentlemen, and two thieves, two petty fellows, try to join the conversation — they find their talk is far too low-class, they feel ashamed of themselves, and they slip quietly out the back door. When the whole room is full of upright people, petty people simply cannot stay. So they say: once a person’s upright qi is full, the body can clear out pathogens by itself. That is the fuzheng school.

The attacking school is the opposite: it insists on driving out the pathogens, clearing them outward — either by purging downward, or by sweating them out, or by the many methods of transforming blood stasis.

💬 Note from Doctor Luo: Their argument: when pathogenic qi sits inside your body, the body cannot function properly, so I clear the pathogens out first — only then can your upright qi slowly recover. So you must attack the pathogens. Take the Jin-Yuan doctor Zhang Zihe (Zhang Congzheng): his treatment was the three methods of sweating, vomiting and purging to drive out disease. Looking at his cases, he seems to have relied mainly on attacking.

But does Chinese medicine really have to split into two camps, forcing you to pick a side? No — each school simply has its own strengths. When a genuine master meets a patient with deficient upright qi and rampant pathogenic qi, he holds the balance between the two.

Don’t learn the wrong lesson: fuzheng and gongxie are a question of proportion

Today, as we study, we must not study the wrong thing.

💬 Note from Doctor Luo: You must grasp the proportion: when pathogenic qi is strong, you may attack mainly with fuzheng as support; as the pathogens dwindle, you attack less and support more; and once the pathogens are essentially cleared, you focus entirely on strengthening the upright. At different stages of an illness the ratio changes — this is the fine art that has to be handled.

For ordinary people, expelling pathogens (transforming blood stasis, resolving phlegm-dampness, scattering stagnation, driving out external cold, clearing interior dampness) certainly matters for health. But the longer Doctor Luo works with wellness and chronic-condition care, the more he feels: strengthening the upright qi is absolutely critical.

💬 Note from Doctor Luo: Because in modern society, an astonishing number of people are deficient in upright qi. Walk into any office and line up the employees for a diagnosis — how many have rampant pathogenic qi, running a high fever right now? Very few. How many have insufficient upright qi? A huge number! Nearly everyone has a scalloped tongue, nearly everyone feels weak all day long, nearly everyone is exhausted by evening. That’s the signature of modern society: people work too hard, think too much, and are especially quick to drain their spirit and their essence, staying up all night instead of sleeping. So when we talk about wellness, the fuzheng philosophy deserves serious study. When you study Zhang Xichun, study his fuzheng thinking — learn it well, and never attack recklessly. That is very important.

Tragic case one: the woman whose body was wrecked by “blood-breaking” herbs after childbirth

Doctor Luo offers a real example — a woman who tracked him down through friends for a very long time, sending messages for two years hoping to see him, and finally did.

💬 Note from Doctor Luo: What had happened? When she gave birth, she went to a Chinese medicine practitioner to regulate her body afterwards. The practitioner looked at her and said: “You have blood stasis. What to do? Transform it!” And he prescribed something extremely fierce — a formula in the family of Zhang Zhongjing’s Di Dang Tang — with heavy doses, including shui zhi (leeches), blood-breaking herbs, and tu bie chong (ground beetles). This wasn’t moving blood — it was breaking blood!

After taking the medicine, the woman felt her body collapse all at once — her vision went black, her mind became disturbed, even her thinking slowed down. Her spleen and stomach weakened, her body never recovered, and the more she “treated,” the worse she got: thinner and thinner, weaker and weaker, until life itself felt unbearable.

💬 Note from Doctor Luo: She later consulted many doctors, but none of them could put her back together. She could hardly manage housework anymore — from a healthy, capable person she had slowly turned into something close to an invalid. It was deeply painful. When we met I said: what a shame. You had just given birth, your qi and blood were at their most depleted — and that doctor recklessly attacked: seeing “blood stasis,” he threw everything at moving and breaking the blood, and in one stroke destroyed your body. If the ditch has no water in it, digging the ditch harder won’t help.

So what to do? Strengthen the upright qi.

💬 Note from Doctor Luo: Over a long period, I slowly rebuilt her with Zhang Xichun’s formulas, like Shi Quan Yu Zhen Tang — little by little, tonifying. Gradually her body began to recover, until she reached seventy or eighty percent — the overall situation was secured. Then I had her grind up grains — yam (shan yao), lotus seeds (lian zi), gorgon fruit (qian shi), coix seed (yi mi) and the like — into powder and take a little every day as slow nourishment. This is the lesson: if you don’t strengthen the upright qi and instead recklessly attack the pathogens, the upright qi is easily wounded — and that person’s body may never truly recover.

Tragic case two: the netizen driven into da qi xia xian by “qi-moving and qi-breaking” herbs

Every day, Doctor Luo’s microblog receives messages from friends asking for help — how many? At the moment, he has more than eight thousand unread emails.

💬 Note from Doctor Luo: Some friends don’t understand: “I wrote to you, why didn’t you reply?” With more than eight thousand messages, I truly can’t read them all — and every single one is complicated in its own way. Some ask simply: “How do I treat my father’s cerebral thrombosis?” — explaining that properly is no small task. Others write hundreds or thousands of words describing their illness, and sometimes one message takes me half a day to get through.

One netizen’s story made Doctor Luo especially sorry.

💬 Note from Doctor Luo: This friend said: before, my body was acceptable. Before I started taking Chinese herbs, I thought I might have a bit of qi-blood deficiency — I’d feel slightly hot at times and sweat easily. Then I went to a practitioner who prescribed a formula, and my body collapsed overnight: sweat poured out like running water, my back burned with heat, and my whole qi seemed to sink downward. Later, listening to your lectures on Zhang Xichun’s da qi xia xian (sinking of the great qi), I realized I probably had exactly that.

Looking back at the expert’s formula: it contained yu jin (turmeric root tuber), hou po (magnolia bark), lai fu zi (radish seed), qing pi (green tangerine peel), zhi ke (bitter orange) — all qi-moving and qi-breaking herbs. After taking them, his body went downhill: profuse sweating, fierce heat, and a painful distension under the left ribs (the liver region), as if a lump of qi was stuck there.

💬 Note from Doctor Luo: He then saw several more experts — some of them recipients of the State Council special allowance. The moment they heard that qi was stuck under the left ribs, they piled on even more qi-moving and qi-breaking herbs. So his body only got worse. He said he took more than two hundred doses of Chinese medicine, and it wrecked his spleen and stomach: now he drools constantly, has phlegm in his throat, and feels weak all over; he used to be in decent shape, but now the flesh around his abdomen is all loose and flabby. When he saw one expert, he mentioned that he’d listened to my lectures on Zhang Xichun and asked whether he had da qi xia xian. The expert replied: “You’re taking that out of context — that’s not it.” And he kept prescribing — including Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction), because he thought the patient was running a fever. And the patient only sank deeper and deeper.

What is this netizen like now? His face is sallow yellow, his five organs all seem to be sagging downward, and the discomfort is unbearable — he has to strap a wide belt tightly around his abdomen just below the navel, and he wears it all day long.

💬 Note from Doctor Luo: This is such a shame. A person in this situation, if he knew even a little about tonifying, could slowly rebuild himself — don’t be fooled by the symptom of fever. Why? Li Dongyuan’s principle of “sweet-warm clears great heat” (gan wen chu da re): when your qi deficiency reaches a certain depth, the body also runs a fever. So at this point there’s no need to panic — using warm herbs, sweet-and-warm herbs, actually clears that kind of heat. But the moment someone hears “fever,” he reaches for Zhu Ye Shi Gao Tang with its gypsum — that’s wrong, it’s backwards. At this stage you should not attack the pathogens; you should strengthen the upright qi.

This follower asked Doctor Luo: can I use Zhang Xichun’s Sheng Xian Tang (Raise the Sunken Qi Decoction)?

💬 Note from Doctor Luo: What can I say? You took more than two hundred doses and got steadily worse — hasn’t that made you stop and reflect? In fact Zhang Xichun’s Sheng Xian Tang is extremely gentle; you could try it, it wouldn’t hurt. Even without Sheng Xian Tang, a bit of Bu Zhong Yi Qi (Tonify the Middle and Augment Qi) would already help. So I advised him to take Zhang Xichun’s Shi Quan Yu Zhen Tang — strengthen the upright qi first, and only then gradually lift the qi upward.

Formulas we’ve discussed like Shi Quan Yu Zhen Tang and Li Quan Yin (Sweet Spring Drink) all embody Zhang Xichun’s tonifying approach. If your upright qi is insufficient, if you’re chronically fatigued and long-term depleted, you can use Zhang Xichun’s tonifying approach to regulate your body — the formulas are simple, built on huai shan yao, with a few supporting herbs, slowly replenishing. It does the body a world of good.

Strengthen the upright qi first, then transform stasis — san qi powder is not to be taken carelessly

Some people with deficient upright qi hear that activating blood and transforming stasis is good for you, and immediately start taking san qi powder (Panax notoginseng) — and the moment they do, they feel dizzy.

💬 Note from Doctor Luo: Why the dizziness? Your upright qi is severely deficient, and you jump straight into activating blood — that won’t do. The right order: build up the upright qi, cultivate it, and only then add a little san qi powder to move blood and dissolve stasis — that’s when the effect is genuinely good. Once the upright qi is strong, it helps expel phlegm-dampness — only when the upright qi is sufficient can dampness be cleared; only when the upright qi is sufficient can qi and blood flourish and circulate, and only then can stasis slowly dissolve in the end. So: on the foundation of strengthened upright qi, add a formula that activates blood and transforms stasis — that is how you see results.

A word to TCM colleagues: don’t be a “reckless prescribing” doctor

Doctor Luo says both of the cases above are examples of Chinese medicine practitioners prescribing recklessly.

💬 Note from Doctor Luo: What does reckless prescribing mean? It means attacking before you understand the situation, using herbs too fiercely, and wounding the patient’s upright qi — that is very bad. Among my eight thousand messages, a huge proportion are cases where the previous doctor got the treatment wrong. Why are so many people anti-Chinese-medicine these days? Because treatment went wrong! These two patients happen to be good-tempered people — but imagine if either of them had a way with words, wouldn’t they be online cursing Chinese medicine right now? So my colleagues in Chinese medicine need to reflect: scholarship must be thorough, and in treating illness you must weigh what matters most — otherwise, one wrong prescription, and the harm to that patient may take a very long time to undo.

Doctor Luo also has a wish: to gather the letters from his followers and distill where Chinese medicine tends to go wrong, so that these mistakes are not repeated — today’s two cases are both heartbreaking, both patients felt life was not worth living, and this kind of work would genuinely benefit the development of Chinese medicine.

Ending: when we study Zhang Xichun, what exactly do we study?

A little aside to close with — when ordinary people study Zhang Xichun, what should they study?

💬 Note from Doctor Luo: Never recklessly experiment — “I learned it! So I’ll use big doses of raw gypsum every day!” Please, nobody do that. But the philosophy of strengthening the upright qi — you absolutely must learn it, because it is one of the biggest and most important pieces of Zhang Xichun’s thought. Once you’ve learned it, you build a solid foundation for the body, then — with a doctor’s help or your own analysis — you clear away the pathogens bit by bit, and the body returns to health. That is one of the central points of my whole series on Zhang Xichun; as you listen, you can give it special attention.

Tomorrow, Doctor Luo continues with more of Zhang Xichun’s healing stories.

This article is compiled from Doctor Luo Dalun’s lecture series on Doctor Zhang Xichun.