Heart Racing, Chest Tight, Short of Breath, Palpitations After COVID — Even a Little Movement Makes It Pound? Doctor Zhang Zhongjing’s Famous Zhi Gan Cao Tang (Honey-Fried Licorice Decoction) Specifically Regulates Palpitations and Skipped Beats
The epidemic may be over, but many people have discovered that their heart seems to have become a different person after testing negative. Before, climbing three flights of stairs wouldn’t even make them flush — now, pick something up, walk a couple of steps, and the heart goes “thump, thump, thump” like mad. And while it’s pounding, every so often there’s a sudden “glug” — a hollow skip, as if one beat was missed. Some people also feel chest tightness and shortness of breath, and a few even have a dull ache in the heart. What on earth is going on? Today, Doctor Luo Dalun addresses the most common heart problem in these “post-pandemic aftereffects.”
💬 Note from Doctor Luo: Dear friends, good morning, everyone. Today we continue talking about recovery and care after COVID. We should strategically ignore the enemy — that is, we don’t need to think it’s so terribly serious, not as frightening as people imagine. But tactically we must take it seriously — because this disease really is not what people say, not exactly like a flu or an ordinary cold. It is a strange, strange pestilence.
Opening: How strange is this plague? — Even “growing a beard after testing negative”
Doctor Luo says COVID is no ordinary cold; the problems it leaves behind are bizarre in every imaginable way. In records from ancient times to the present, there has rarely been a plague like it, which is why some people say it was man-made, not originally from nature — we won’t argue whether that’s right or wrong, but it truly is strange, affecting an extraordinary number of bodily systems.
💬 Note from Doctor Luo: For example, I saw a news story — a woman grew a ring of beard after testing negative. Can you imagine how strange that is? And there are many similar cases — it causes all kinds of reactions in the body, and situations of qi and blood running wildly out of order are very common.
After testing negative, many people assume they’re “fine,” but ask them what symptoms remain, and the list is long. One of the more obvious and more common ones is a heart problem — it pounds wildly at the slightest movement, which never used to happen; easy fatigue; sometimes a “glug-glug” feeling in the chest, the sensation of skipped beats (premature beats); and a few people even have heart pain.
Why is the heart so tired after testing negative? — After a “fierce battle,” the upright qi has been hollowed out
Why has the heart become like this? Doctor Luo analyzes it from the root: this epidemic made one thing very clear to everyone — many people’s upright qi was never that abundant. It’s not the picture of abundant upright qi people imagine; lots of people were already deficient in qi and blood, in yin and yang — some deficient in qi, some in blood, some in yin, some in yang, and so on.
💬 Note from Doctor Luo: In that condition, when the external pathogen invades, the body mobilizes every ounce of strength to fight it — another fierce battle, another great drain. It’s like a war — look at how the Russia-Ukraine war has impoverished both sides; Ukraine keeps asking the Western nations for money, billions and billions. Why? Because the consumption is enormous. Our bodies are the same: they’re really mobilizing forces to fight a war, and after the battle, the upright qi is especially depleted.
What happens when the upright qi is insufficient? When qi deficiency turns severe, the qi sinks — qi normally holds its position, but now it’s so weak it can’t even be held up, so it sinks downward. This is called zhong qi xia xian (sinking of the middle qi) or da qi xia xian (sinking of the great qi). When qi sinks, what is affected most?
💬 Note from Doctor Luo: It’s the heart-lung function, and the heart especially suffers. So many people find after testing negative: why does my heart pound thump-thump-thump at the slightest movement? Because qi and blood are deficient and can’t get through, so the heart has to pump hard, bang-bang-bang, to push the qi and blood across — this is a manifestation of deficiency. When you’re deficient, the heart beats fast. Sometimes you feel stuffy and tight — it’s not that something is blocked in there; it’s that the strength is insufficient, the qi has sunk, and the heart is working desperately to keep going, which is why you’re so tired.
Others develop “skipped beats”: beating along, thump-thump-thump… then a pause. You can feel it if you put your hand on your chest or take your pulse — it feels like a “glug,” as if something churns briefly inside, a hollow skip.
The big direction of recovery: tonify heart qi + nourish heart yin — you need both
So what to do? Doctor Luo says this is the time to use various methods to tonify heart qi. But tonifying qi alone is sometimes not enough — you also need to nourish heart yin, because the heart governs the blood vessels.
💬 Note from Doctor Luo: What does yin include? Yin-type substances include blood — blood is a liquid substance; and jin and ye (thin and thick body fluids) — these fluids are liquids; and jing (essence) too — all of these yin-type substances are included. In the past, essence was generally also called yin, but now I think essence should be listed separately, between yin and yang. Blood and the fluids, at least, are certainly the material foundation that guarantees our body fluids and blood, so they are definitely included in yin.
So while qi is being consumed, yin is consumed too — qi and yin are both damaged. For different situations, Doctor Luo gives different formulas.
No skipped beats, just chest tightness and a racing heart? — Bu Zhong Yi Qi Wan, persist for one or two months
Situation one: no skipped beats, just a stuffy feeling, and the heart goes “ding-ding-ding” fast at the slightest movement. In this case, take Bu Zhong Yi Qi Wan (Tonify the Middle and Replenish Qi Pill).
💬 Note from Doctor Luo: You must persist with Bu Zhong Yi Qi Wan — truly, not just one or two days. Keep taking it for one or two months, to lift the qi up. And the dose can be a bit larger than the label: the dosage on the package insert is quite small, so you can take double that. You can take it that way.
Doctor Zhang Xichun’s Sheng Xian Tang: power concentrated on the heart and lungs, lifting the qi in three to five doses
For an even better effect, Doctor Luo recommends Doctor Zhang Xichun’s Sheng Xian Tang (Raise the Sunken Qi Decoction) — a famous formula he has explained many times.
💬 Note from Doctor Luo: In the old days, Zhang Xichun would definitely have used Sheng Xian Tang. Actually Sheng Xian Tang works even better — its main force is concentrated on the heart and lungs here. Its main ingredient is huang qi — raw huang qi (astragalus) — paired with herbs that lift upward; it adds zhi mu (anemarrhena) to check the heat of huang qi; then it adds the lifting herbs sheng ma (cimicifuga), chai hu (bupleurum), and jie geng (platycodon), which makes it more effective. I’ve explained Sheng Xian Tang many times before; everyone can look up the earlier articles. Generally in three to five doses, it basically lifts the qi back up and improves the condition.
If buying loose herbs is inconvenient, use Bu Zhong Yi Qi Wan in daily life — it tonifies the spleen as well, tonifying the spleen and lifting the qi; that also works.
Skipped beats in the heart? — Doctor Zhang Zhongjing’s Zhi Gan Cao Tang, specifically for “knotted and intermittent pulse and palpitations after cold damage”
Situation two: the heart skips beats — beating along, “glug,” a pause; beating along, “glug,” a pause. What is the best method here? Zhi Gan Cao Tang (Honey-Fried Licorice Decoction).
💬 Note from Doctor Luo: Zhi Gan Cao Tang is what Doctor Zhang Zhongjing used when treating cold damage — the Shang Han Lun states it plainly, opening with “cold damage,” which indicates this occurs in the setting of an external infection. After an external illness, when “mai jie dai, xin dong ji” appears — a knotted and intermittent pulse with palpitations — you can use this formula: that is, the heart has started skipping beats.
Why does this formula work? Because after an external infection, qi and yin are both deficient, and Zhi Gan Cao Tang is precisely a formula that harmonizes both yin and yang. Doctor Luo unpacks its ingredients one by one:
💬 Note from Doctor Luo: In Zhi Gan Cao Tang, there are qi-tonifying herbs — for example ren shen (ginseng); we can use hong shen (red ginseng); ginseng tonifies qi. There’s gui zhi (cinnamon twig) — gui zhi not only warms yang, it also has an opening, freeing action; these all tonify yang. Then add some sheng jiang (fresh ginger) and some huangjiu (yellow rice wine) — both warm yang and free the channels. Then there are the yin-nourishing herbs — sheng di huang (raw rehmannia), mai dong (ophiopogon), and e jiao (donkey-hide gelatin), for instance. And there’s huo ma ren (hemp seed) — huo ma ren actually nourishes the heart muscle; some people say it moistens the intestines and moves the bowels, and of course it does have that laxative effect, but it also nourishes the heart muscle and regulates the heart’s channels. So this formula is quite complete. As for the honey-fried licorice, its role is fu mai — restoring the pulse: fu mai means nourishing yin and blood and restoring the pulse vessels; that’s the work of honey-fried licorice. So this formula harmonizes yin and yang, balancing both sides, with excellent results and very strong nourishing power.
The sheng di huang (raw rehmannia) in here nourishes yin and restores the pulse. Doctor Luo notes especially that the yin-nourishing herbs were used in generous doses even in Doctor Zhang Zhongjing’s era.
💬 Note from Doctor Luo: Nowadays we generally use about 30 g. There are professors today — Professor Ke Xuefan in Shanghai — who says this truly treats the aftermath of external infections. If it’s palpitations from ordinary high blood pressure, it really doesn’t work; but for myocarditis after an external illness — and we see a lot of myocarditis after COVID these days, the premature beats that myocarditis brings — the effect is excellent. What does this show? It shows that in ancient times, people already knew what problems arise after a plague; Doctor Zhang Zhongjing’s era had already summarized it all. Our ancestors were truly wise — they had it all worked out for you long ago. So everyone can make use of it.
How to decoct Zhi Gan Cao Tang? — Break the jujubes open, two or three spoonfuls of huangjiu, crush the e jiao and dissolve it while hot
A good formula, but the decoction method has its refinements too. Doctor Luo goes through the details of preparing the medicine meticulously.
💬 Note from Doctor Luo: Once Zhi Gan Cao Tang ingredients are ready, you supply the sheng jiang and jujubes yourself. Break the jujubes open, slice the ginger, and cook them together. Then the huangjiu — in the old days they used a lot, almost half water and half wine; we don’t need that much, two or three spoonfuls is enough. The huangjiu provides a warming, channel-opening function; in fact by the time the medicine is fully boiled, the alcohol has long since evaporated, leaving only its warming, freeing medicinal nature. Once it’s boiled, strain out all the dregs and pour the liquid into a bowl. Now add the e jiao — crush it first; crushed, it dissolves most easily. If you don’t crush it, it’s harder to dissolve, but it can still work. Once it’s crushed, the decoction is boiling hot, isn’t it? Drop the crushed e jiao in, stir it around, and it dissolves. After it dissolves, divide into two portions, one in the morning and one in the evening. The effect is excellent — for this condition it can almost be called a miracle, a miracle. Take three to five doses to nurse the heart back to health — this is very important.
Don’t forget: COVID also leaves blood stasis — open the heart channels while nourishing the heart
Besides tonifying heart qi and nourishing heart yin, there is one more important task: open the heart channels.
💬 Note from Doctor Luo: While we nourish the heart, we must also open the heart channels. Because COVID causes blood stasis — and where does stasis fear to go most? The heart. So if your symptoms include the heart beating very tightly, tiring at the slightest movement, a stuffy feeling in the chest, skipped beats, and sometimes a stabbing pain — then while nourishing, you should also free the channels. What to buy? Tongxinluo Capsules — worth trying; Naoxintong — you can take it; among such channel-opening remedies, Xue Fu Zhu Yu Tang (Blood Mansion Stasis-Expelling Decoction) can be taken. Always remember to free the channels. Adding some san qi powder (Panax notoginseng) works even better — the difference with or without san qi is real; with it, the effect is clearly better.
Why does san qi pair so well here? Doctor Luo reveals the clever thinking behind it:
💬 Note from Doctor Luo: San qi is also a medicine, and it resembles ginseng — it opens channels and nourishes at the same time; it also builds you back up. So after testing negative, many people are left with heart deficiency — this is a hidden danger, a sign that the body’s qi and blood are insufficient, and this is how we regulate it. You say Zhi Gan Cao Tang supplements — tonifying both qi and yin. Do you think it only supplements the heart? Think about it: when this medicine goes down, do I aim straight at the heart and only nourish the heart? No — it nourishes the whole body. And the huangjiu helps you free the channels, the gui zhi helps you open them — whatever should be nourished, qi and yin, is all nourished for you. It’s just that your problem happens to erupt most violently at the heart, so Zhi Gan Cao Tang concentrates on relieving that heart problem for you. It regulates your whole body, and the place where your symptoms are most prominent gets brought back into order. This is what everyone should pay attention to and learn.
Ending: Two steps — first restore what’s deficient, then combine channel-opening herbs
Finally, Doctor Luo sums up today’s content in two crystal-clear steps, and sets the tone for this whole “recovery.”
💬 Note from Doctor Luo: Today I’ve talked to you about these symptoms — remember: you must supplement — restore what’s deficient, that’s the first thing. Second, there may be some blood stasis, so combine a little channel-opening medicine; it will do you good. I hope I can talk through these symptoms one by one and gradually eliminate them all. This body of ours — the point isn’t really just for this plague, to treat the plague, to adjust the plague state. No, actually the purpose is to raise your whole constitution, to correct your body’s original imbalances, and that’s what we’re adjusting. That way the external pathogen is cleared, and by the end your constitution is even better than before.
Tomorrow, Doctor Luo will continue discussing recovery and care in the aftermath of the epidemic.
What to take away
- After COVID, a pounding, easily tired heart is usually deficiency, not a blockage: the battle against the pathogen drained the upright qi; when qi is deficient it sinks (zhong qi xia xian / da qi xia xian), and the heart has to pound hard to push qi and blood through — so it races and feels stuffy at the slightest movement.
- Step one, no skipped beats, just tightness and a racing heart: Bu Zhong Yi Qi Wan — persist one or two months, dose can be doubled; or Doctor Zhang Xichun’s Sheng Xian Tang, which concentrates on the heart and lungs (raw huang qi + zhi mu to check its heat + sheng ma, chai hu, jie geng to lift), usually improving things in three to five doses.
- Step two, skipped beats (premature beats): Doctor Zhang Zhongjing’s Zhi Gan Cao Tang from the Shang Han Lun — treating “cold damage with a knotted and intermittent pulse and palpitations.” Ren shen/hong shen tonifies qi; gui zhi, sheng jiang and huangjiu warm yang and free the channels; sheng di huang, mai dong and e jiao nourish yin; huo ma ren nourishes the heart muscle; honey-fried licorice restores the pulse. It harmonizes yin and yang with strong nourishing power — Professor Ke Xuefan of Shanghai confirms it specifically treats myocarditis and premature beats after external infections (not palpitations from ordinary hypertension).
- How to decoct Zhi Gan Cao Tang: break the jujubes open, slice the ginger, cook together; two or three spoonfuls of huangjiu (in old times almost half water, half wine — the alcohol evaporates, leaving only the warming, channel-opening nature); crush the e jiao and stir it into the boiling-hot decoction to dissolve; divide into two portions, morning and evening. Three to five doses — almost a miracle for this condition.
- Don’t forget blood stasis: COVID leaves stasis behind, and stasis most fears the heart. If the heart feels tight, stuffy, with skipped beats or stabbing pain, combine Tongxinluo capsules, Naoxintong, or Xue Fu Zhu Yu Tang; adding san qi powder works better — like ginseng, it opens channels and nourishes at the same time.
- The deeper purpose: this is not just about “treating the plague” — it’s about raising your overall constitution and correcting your body’s original imbalances, so that the pathogen is cleared and your health is better than before.
Compiled from Doctor Luo Dalun’s post-epidemic recovery lectures; the formulas come from Doctor Zhang Zhongjing’s Shang Han Lun (Treatise on Cold Damage).