Weak Spleen-Stomach, Always Coughing and Wheezing, No Energy, and Catching Every Illness Going Around? Doctor Zhang Xichun’s Very First Formula in Yi Xue Zhong Zhong Can Xi Lu — Zi Sheng Tang (Nourishing Life Decoction): Tonifying the Spleen-Stomach Is Tonifying the Lung Qi

What patients search for: weak spleen-stomach / always coughing and wheezing / no energy and fatigue / catch every illness going around / periods not coming / decreased appetite / low-grade fever / night sweats Corresponding medical terms: insufficient lung qi · yin deficiency with consumptive heat · tuberculous wasting (lao zhai) · amenorrhea

Opening: after finishing the lung cases, we turn back to page one of the book

Doctor Luo Dalun’s lectures on Doctor Zhang Xichun’s lung-disease case records pause at this point — because the remaining cases all use similar herbs, and by now listeners have grasped Doctor Zhang’s approach to treating lung disease. So Doctor Luo turns back and devotes himself to the formulas that Doctor Zhang Xichun himself summarized. The thinking behind these formulas is excellent, and they are used very widely in clinical practice. And the first formula today is the opening formula of the whole book Yi Xue Zhong Zhong Can Xi Lu (Records of Integrating Chinese and Western Medicine) — Zi Sheng Tang (Nourishing Life Decoction).

💬 Note from Doctor Luo: This is how we study: we go through several case records, then turn back to the formulas Doctor Zhang Xichun himself summarized. The thinking behind these formulas is excellent, so they work extremely well in clinical use. Today’s first formula is the very first one that opens the book Yi Xue Zhong Zhong Can Xi Lu — it is called Zi Sheng Tang.

Why is it called “Zi Sheng”? — the answer hides in the I Ching

The name “Zi Sheng Tang” carries real weight. Doctor Luo says it comes from the I Ching (Book of Changes).

💬 Note from Doctor Luo: In the I Ching there is a line: “Zhi zai kun yuan, wan wu zi sheng” — how great is the primal power of the Kun (Earth) hexagram! The earth belongs to the element of Earth; its virtue is deep and generous; all ten thousand things grow by drawing on the nourishment of the earth — hence the name Zi Sheng Tang (Nourishing Life Decoction).

What is the “earth” inside the human body? The spleen and stomach (pi wei). So the intent of this formula is written into its name from the very start — tonify the spleen-earth, so that all things in the body can be nourished into life.

What does it treat? — severe tuberculosis exhaustion, deficiency to the extreme

What exactly does Zi Sheng Tang treat? In the book, Doctor Zhang Xichun writes: “treats lao zhai ying ruo shen” — consumptive wasting so weak it is extreme, i.e. tuberculosis patients who are frighteningly depleted.

💬 Note from Doctor Luo: It specifically treats people whose tuberculous wasting has left them extremely weak. To what degree? Decreased appetite — after contracting tuberculosis, the person loses all appetite and cannot eat; then rapid breathing and coughing — the breathing is hurried; the body runs a fever — tuberculous patients do run fevers; and a deficient, rapid pulse (mai xu shu) — the pulse is very weak and beats very fast. It also treats women with blood exhaustion and loss of joy (xue ku bu yue): when the blood is so depleted that the period stops — amenorrhea before its time, caused by the blood being dried up. This formula treats all of these.

Don’t rush to file it away as a “tuberculosis formula” — its value is vastly underrated

At this point Doctor Luo deliberately pauses to warn everyone: do not think of this formula merely as a tuberculosis remedy — if you do, its value is greatly underestimated.

💬 Note from Doctor Luo: This formula is a qi-supporting (fu zheng) formula. Which upright qi does it support? Specifically the upright qi of the spleen and stomach. It is named after “zhi zai kun yuan” — it tonifies the spleen-earth: when the spleen-earth is sufficient, all things can be born, and your body can grow strong. So this is a formula for strengthening and nourishing the spleen and stomach. Because so many people see it only as a tuberculosis formula, its value is vastly underestimated and it is rarely used — people simply don’t know its worth.

Why did Doctor Zhang Xichun put this formula first in the entire book? Because he considered the spleen and stomach the core. Once the spleen and stomach are strong and can absorb nourishment, the body’s upright qi naturally becomes sufficient — not only can external pathogens like tuberculosis fail to enter, other illnesses also improve along with it.

A modern lesson on tuberculosis: why deficient upright qi is the root basis

Speaking of tuberculosis, Doctor Luo adds a background lesson connecting to modern medicine.

💬 Note from Doctor Luo: As we all know, tuberculosis is caused by an external pathogen — infection with the tubercle bacillus. In ancient times, tuberculosis was a major illness and could genuinely kill. In the modern era, vaccines and antibiotics brought tuberculosis under effective control. But in recent years it has begun spreading again — antibiotics work less and less well. Many people today are actually carriers of the tubercle bacillus — infected with the external pathogen — but it simply hasn’t broken out. Once I was chatting with doctors at an infectious-disease hospital, and they said that in the skin tests they now run, many people react positively — and one doctor told me his own test came out positive. That shows many people are carriers but never develop the disease.

So under what conditions does it actually break out? Doctor Luo told the story of a friend from his youth:

💬 Note from Doctor Luo: An important foundation of tuberculosis is deficient upright qi (zheng qi). A friend of mine from my younger days — a tall, strikingly handsome young fellow — lived rather loosely, indulging in wine and women without restraint. Many years later I ran into him again, and that tall, handsome man had become bent over like a shrimp, hunched, haggard beyond recognition. He asked me to take his pulse. The moment I touched his forearm (chi fu — the skin of the lower arm), it was very hot. I said, something is wrong — you have an external pathogen. He admitted: “To tell you the truth, I have tuberculosis.” It was because in his youth his kidney qi was greatly depleted and his upright qi insufficient — only then could the pathogen truly enter. Sometimes even if you carry a bit of pathogen, if your upright qi is sufficient you can suppress it; it won’t run wild. So deficient upright qi is an important basis for tuberculosis — and Western medicine agrees: it must be a person whose resistance has dropped.

How does the spleen-stomach get damaged? — overeating plus bad emotions

Since tonifying the spleen-stomach is the core, how does the spleen-stomach get hurt in the first place? Doctor Luo summarizes two major causes, calling out a common failing of modern people.

💬 Note from Doctor Luo: How is the spleen-stomach injured? People stuff themselves with rich food and all kinds of things, wearing the spleen-stomach out in every way — and the spleen-stomach gets injured. What else? Bad emotions. Depressed thinking, mulling over problems, unable to let go — all kinds of constrained liver qi (gan qi bu shu): liver wood runs rampant and attacks spleen earth (gan mu heng ni ke pi tu), injuring the spleen and stomach. So the ancients held that one important cause of spleen-stomach injury is your bad emotions.

Excessive brooding injures the spleen — Doctor Luo has stressed this repeatedly while commenting on the formula: Chinese medicine teaches “excessive thinking injures the spleen” (guo si shang pi). Thinking all day about how to make money, comparing yourself with others, scrolling through social feeds — overthinking drains the heart-spleen qi and blood, and spleen-stomach illness naturally follows. That is why Doctor Zhang Xichun gave patients of this type a particular instruction — dan bo gua yu, yi yang qi xin: keep desires few and the mind tranquil, to nurture the heart.

💬 Note from Doctor Luo: Doctor Zhang Xichun specifically pointed out: what should a patient like you do? Dan bo gua yu yi yang qi xin — keep the emotions regulated. And then what? Use herbs that are good at tonifying the spleen and stomach, let the appetite gradually return, let the upright qi gradually fill up — only then can the body recover. So Doctor Zhang Xichun established this formula specifically to treat this situation.

First ingredient: raw Huai yam 1 liang — Doctor Zhang Xichun’s soul herb

The first ingredient in Zi Sheng Tang is raw Huai yam 1 liang (sheng shan yao yi liang, about 30 g). Doctor Luo says that by this point everyone is probably smiling — so many of the earlier case records also open with raw Huai yam 1 liang.

💬 Note from Doctor Luo: What does this show? It shows that Doctor Zhang Xichun placed extraordinary importance on the spleen and stomach, and was exceptionally skilled at using Chinese yam to tonify them — this was his consistent thinking. When I first read Doctor Zhang Xichun’s case records, I was amazed: why could this man cure such severe illness with just a few doses? Later I discovered he used Chinese yam in large amounts. Why didn’t Chinese yam work for us? Later I went to the hard-plot (lu tu) fields of Jiaozuo, Wen County in Henan, again and again, searching for what the yam the ancients used actually looked like — and when I finally found it and used it, the results were extraordinary. Doctor Zhang Xichun’s thinking is genuine — it was worked out through real practice. He was a truly hands-on physician.

How should the yam be chosen? Here is a crucial detail — “raw yam” means dried Huai yam slices; never use stir-fried yam.

💬 Note from Doctor Luo: In the pharmacy, Chinese yam comes in two forms: one is raw yam — the dried Huai yam slices; the other is stir-fried yam. Doctor Zhang Xichun held that once yam is stir-fried, its medicinal effect is completely lost (yao xiao fen hao wu xiao), so he was strongly against using stir-fried yam. Following Doctor Zhang’s thinking, we use the raw yam, the dried slices.

What does yam actually tonify? Doctor Luo explains it thoroughly: it greatly tonifies the lungs, spleen and kidneys — above all, its spleen-stomach tonifying effect is very strong, and its lung-tonifying effect is also strong — and the lung tonification is achieved precisely through tonifying the spleen.

💬 Note from Doctor Luo: The spleen-stomach belongs to Earth, the lungs to Metal — earth generates metal (tu sheng jin) — so the spleen-stomach is the mother of the lungs. When he tonifies the lungs — the child — he achieves it by tonifying the mother. That is why his spleen-tonifying effect is so strong, especially on stomach yin — this is Doctor Zhang Xichun’s thinking.

Second ingredient: yu zhu 3 qian — authentic white atractylodes from Yuqian, Zhejiang

The second ingredient is yu zhu (3 qian, about 9 g). What is “yu zhu”? It is white atractylodes (bai zhu) produced in Yuqian, Zhejiang — an authentic regional herb (dao di yao cai).

💬 Note from Doctor Luo: Don’t misread this herb’s name — the “zhu” in bai zhu is slightly different from the “zhu” in “bamboo”; it is pronounced zhú. Atractylodes tonifies the spleen. The herb is very beautiful: when sliced, the grain looks like ruyi (auspicious cloud) patterns, like clouds. Raw atractylodes is slightly white; stir-fried, it turns yellow — but both carry an aroma.

What is the difference between raw and stir-fried atractylodes? Doctor Luo teaches a practical way to tell.

💬 Note from Doctor Luo: Raw atractylodes acts a bit more forcefully and drains dampness more strongly — because atractylodes strengthens the spleen and dispels dampness. Stir-fried, its nature becomes gentler and its spleen-tonifying effect grows a little stronger. So in use: if you need to drain dampness, use raw atractylodes; when the prescription doesn’t specify “raw,” the pharmacy will generally give you stir-fried. I sometimes use both — for example, raw atractylodes 15 g plus stir-fried 15 g together: I want both the dampness-draining effect and the spleen-tonifying effect.

What diseases can atractylodes treat? Doctor Luo lists a string: spleen-deficient diarrhea, abdominal bloating, spleen-deficient thirst, weakness of the four limbs, even aching limbs — because the spleen governs the four limbs (pi zhu si zhi).

💬 Note from Doctor Luo: Atractylodes greatly tonifies the spleen and stomach. When the spleen-stomach is strong, it can transform away dampness and stop diarrhea — it treats diarrhea from spleen deficiency, chronic diarrhea. It treats bloating from spleen deficiency, thirst from spleen deficiency (thirst caused by stagnated dampness), and weakness of the four limbs from spleen deficiency. Why? Because the spleen governs the four limbs — when the spleen is deficient, the limbs are weak, and even ache; as long as it is caused by spleen deficiency, it can be treated.

Doctor Zhang Xichun especially loved authentic regional herbs — he believed the atractylodes from Yuqian, Zhejiang is completely different from any other. But what if ordinary people cannot buy the authentic regional herb? Doctor Zhang thought of a solution for them too.

💬 Note from Doctor Luo: Doctor Zhang Xichun said you can also choose the cheaper kind — the one with a yellow color and a very fragrant smell; the moment you smell it, it is strongly fragrant. Even if it is cheap, the effect is just as good, because what we take is the qi and aroma. Some atractylodes smells rank when you sniff it — that one was processed badly. So when laypeople choose the herb, pick the yellow one that smells distinctly fragrant.

Atractylodes’ “virtue of earth” — one herb, four talents

Speaking of atractylodes, Doctor Luo shares a prescribing insight of Doctor Zhang Xichun’s — just a few lines, yet a great clinical experience.

💬 Note from Doctor Luo: Doctor Zhang Xichun’s insight: when atractylodes is combined with cool-moistening herbs, it is excellent at tonifying the lungs — because the spleen-stomach is the mother of the lungs; you tonify the spleen on one side while matching it with cool-moistening herbs, and once the spleen is strong, the lungs grow strong. Combined with dispersing-rising herbs (that soothe the liver and raise the liver qi), it is excellent at regulating the liver. Combined with herbs that calm and settle the spirit, it is excellent at nourishing the heart. Combined with yin-nourishing herbs, it is excellent at tonifying the kidneys. Why? Because atractylodes possesses the virtue of earth — the beauty of earth is that it nourishes all things, so every other organ receives its benefit.

About this “regulating the liver” idea, Doctor Luo says he has used it all along in his own liver-disease practice, with remarkably good results.

💬 Note from Doctor Luo: In my daily practice I often see liver patients — chronic hepatitis and the like, in poor health. How do people usually treat them? Soothe the liver, course the liver qi, nourish the liver blood — eyes all fixed on the liver, and it simply doesn’t improve. My approach is learned from Doctor Zhang Xichun: when a patient comes in, I certainly don’t attack first — I use Huai yam and atractylodes; whatever liver-soothing, liver-softening is needed, I do it, but I always pair it with spleen-tonifying herbs like Huai yam and atractylodes. Why? Because Doctor Zhang Zhongjing said: “When you see disease of the liver, know that the liver disease will transmit to the spleen — first strengthen the spleen” (jian gan zhi bing, zhi gan chuan pi, bi xian shi pi). If you see liver disease and know it will pass to the spleen, fill up the spleen first and you can turn the illness around. Once I did this, the patients’ condition turned around immediately. You see — it looks simple, he wrote only a few lines, but it is his hard-won insight. These words are classics.

One spleen, one stomach, one yin, one yang: yam with atractylodes completes the spleen-stomach

When Chinese yam and atractylodes are paired, Doctor Zhang Xichun has a brilliant angle on it — the two together cover the entire spleen-stomach.

💬 Note from Doctor Luo: Doctor Zhang Xichun held that Chinese yam can tonify stomach yin, while atractylodes can tonify spleen yang — one spleen, one stomach, one yin, one yang: the spleen and stomach are then completely tonified. We say yam tonifies the essence (jing), but Doctor Zhang considered it yin-tonifying. Yam and atractylodes together are an extremely important combination for tonifying the spleen and stomach — together they are fairly complete.

Third ingredient: raw ji nei jin — transports the tonics, and transforms blood stasis

The fourth herb in the formula is raw ji nei jin (raw chicken’s gizzard lining). The moment it is mentioned, Doctor Luo says everyone probably laughs — it appeared in so many earlier formulas.

💬 Note from Doctor Luo: Doctor Zhang Xichun considered ji nei jin to be the chicken’s spleen-stomach, corresponding to your own spleen-stomach. A chicken’s digestive system is remarkable — chickens eat stones, eat anything, so their transporting power is strong. When we take tonics, if the spleen-stomach is weak you may not be able to transport and transform those herbs — what to do? Put ji nei jin in there to strengthen spleen-stomach function so the herbs can be transported — this is very important. Second idea: ji nei jin can transform stasis. Deficient people often have blood stasis; while I tonify you, I also transform some stasis and open the channels, so the tonifying power enters more easily.

Doctor Zhang Xichun also had a curious theory: he believed the spleen-stomach contains many extremely fine vessels, and if those vessels are blocked, the spleen-stomach cannot absorb food — ji nei jin is precisely for opening those fine vessels. Tonify on one side, open on the other — this thinking runs through the whole formula.

That is why Doctor Zhang Xichun himself said: raw Huai yam, atractylodes and raw ji nei jin are the soul and core of this formula — immovable. Other herbs can be swapped freely, but these three cannot be moved or changed; even if you removed all the other herbs and kept only these three, the formula would still work.

Fourth ingredient: xuan shen — white, hollow, straight into the lung channel

With the spleen-tonifying mainstay settled, the heat in the lungs still needs attention. Tuberculosis patients run low fevers — how is that heat cleared? Doctor Zhang Xichun chose very carefully.

💬 Note from Doctor Luo: Xuan shen (figwort root, Scrophularia) is generally said to clear heat and nourish yin, but Doctor Zhang Xichun had a special use for it: xuan shen enters the lungs. Look at xuan shen: the middle is white — white and hollow (se bai zhong kong) — so it enters the lungs, clears lung-channel heat and generates body fluids. Thus when treating lung disease with a touch of yin deficiency and heat, Doctor Zhang Xichun often added xuan shen — in this formula he used 15 g (5 qian). He did not choose the strongly heat-clearing herbs; he chose cautiously — xuan shen clears heat and nourishes yin, yet it is not cold.

Fifth ingredient: niu bang zi — disperse wind, soothe the throat, reduce swelling, transform phlegm: one herb, four uses

The last herb in the formula is niu bang zi (burdock seed, 3 qian, stir-fried then crushed, about 9 g). Doctor Zhang Xichun loved to use this herb.

💬 Note from Doctor Luo: Burdock seed’s first action is to disperse wind and scatter the pathogen — when an external pathogen arrives, it can disperse wind and scatter evil. Second, it clears the throat and benefits the larynx — when the pathogen reaches the throat, it soothes it. It also resolves toxin and reduces swelling — not only in the upper burner; all toxic swellings of the body, burdock seed can reduce. And it transforms phlegm and stops cough. It especially suits lung disease paired with Chinese yam — yam with burdock seed is a combination Doctor Zhang Xichun particularly loved.

Modifications: add sheng di huang when heat is heavy, drop xuan shen when there is no heat

The formula is basically complete, and Doctor Zhang Xichun also gave instructions for modifying it.

💬 Note from Doctor Luo: If the patient is running a high fever, add sheng di huang (raw rehmannia), 5 or 6 qian (about 15–18 g). Look at Zi Sheng Tang — it is really the yam-plus-burdock-seed formula we discussed before, upgraded one level: atractylodes and ji nei jin are added, plus a bit of xuan shen, and the heat-clearing effect is better. If there is no heat, you can remove the xuan shen. This formula is very simple and the logic very clear — yam and atractylodes tonify the spleen-stomach, ji nei jin helps transport and transforms blood stasis: these three are indispensable; when the lung channel has heat, pair in xuan shen; when there is a bit of pathogen, add burdock seed; when the heat is clearly marked, pair in some yin-nourishing sheng di huang.

How to use it? — for the frail and constantly coughing-wheezing, it fits exactly

So which modern people does this formula suit? Doctor Luo gives very practical guidance.

💬 Note from Doctor Luo: When you encounter someone frail and weak who coughs, you can apply it. Even without coughing — just general weakness — you can also adopt the raw yam-plus-atractylodes-plus-ji-nei-jin approach: that is spleen tonification. Many elderly people have lots of phlegm — at that point don’t imagine the pathogen is the main issue; it is deficiency of upright qi that dominates. Bring Doctor Zhang Xichun’s formula straight over and it works immediately. But if a young or middle-aged adult has caught cold, the cold has entered the interior and turned to heat, coughing yellow phlegm with fever — that should be treated as an ordinary external contraction: you cannot start tonifying right away. External contractions sometimes need pathogen-dispelling as primary and qi-supporting as secondary; in the recovery phase you switch to supporting upright qi as primary and dispelling pathogen as secondary.

An unexpected use: when dieting stops your periods, the problem is also the spleen-stomach

This formula also treats a very modern condition — amenorrhea from dieting.

💬 Note from Doctor Luo: Some girls damage their spleen-stomach through dieting, become extremely thin and weak, and their periods stop — this condition is notoriously hard to treat. Many people try to treat it by opening the channels and nourishing the blood — let me tell you, treating it that way alone doesn’t work well. What to do? Use Doctor Zhang Xichun’s approach: greatly tonify the spleen-stomach, then transform blood stasis; let the spleen-stomach slowly grow strong, so the blood has a source and fills up — only then can the period return. The root of amenorrhea in women is an injured spleen-stomach: once the spleen-stomach is injured, it cannot transform food into blood — cannot turn nutrients into blood — and the period closes. Doctor Zhang Xichun used this very formula to regulate the spleen-stomach; once the spleen-stomach was sufficient, the woman’s period returned. So if you only see this formula as a tuberculosis remedy, what a pity.

Doctor Zhang Xichun’s “dividing the troops” strategy: why does one dose work?

Finally, Doctor Luo points out the great prescribing wisdom running through the whole book — dividing the troops (fen bing).

💬 Note from Doctor Luo: Look at this formula — we have already discussed yam and ji nei jin, so its structure feels familiar. Then as we go through formula after formula, you will discover: why did Doctor Zhang Xichun’s medicine take effect in a single dose, and in two doses soon work? Because he divided his troops with perfect clarity — each unit fights its own battle, and each battle is fought with precision. As we study bit by bit like this, everyone will develop a feel for the human body and for prescribing.

Doctor Zhang Xichun’s approach to this kind of deficiency-caused cough and wheezing is always consistent: protect the spleen-stomach as primary, support the upright qi as primary, then add a little yin-nourishing, heat-clearing, phlegm-transforming, or toxin-resolving herb according to the situation. First the cases, then the formulas — cases teach you the story and how it was used; formulas show you the combinations and let you grasp the rules. This is the most solid way to learn.

What to take away

Zi Sheng Tang is the opening formula of Yi Xue Zhong Zhong Can Xi Lu: raw Huai yam 1 liang (about 30 g) + yu zhu 3 qian (about 9 g) + xuan shen 5 qian (about 15 g) + raw ji nei jin 2 qian (about 6 g) + stir-fried, crushed niu bang zi 3 qian (about 9 g). If the fever is high, add sheng di huang 5–6 qian (about 15–18 g); if there is no heat, drop the xuan shen.
The name comes from the I Ching: “Zhi zai kun yuan, wan wu zi sheng” — Earth’s virtue nourishes all things into life. The “earth” of the body is the spleen-stomach; tonify the spleen-earth and the whole body is nourished.
It treats severe tuberculous wasting (decreased appetite, rapid breathing and coughing, body heat, deficient rapid pulse) and blood-exhausted amenorrhea — but it is really a spleen-stomach-tonifying, upright-qi-supporting formula. File it away only as a “tuberculosis formula” and you will miss its real value.
The three untouchable herbs are raw Huai yam, atractylodes and raw ji nei jin: yam tonifies stomach yin, atractylodes tonifies spleen yang (one yin, one yang — the spleen-stomach is fully covered), and ji nei jin transports the tonics and transforms stasis so the medicine can reach where it needs to go.
Use dried Huai yam slices, never stir-fried yam — Doctor Zhang Xichun said stir-fried yam is completely useless. Authentic atractylodes from Yuqian, Zhejiang is best; if you cannot buy it, choose the yellow, strongly fragrant kind, because what you take is the qi and aroma.
Deficient upright qi is the basis of tuberculosis and of catching every illness: when the spleen-stomach is strong and absorbs nourishment, the body’s upright qi fills up — external pathogens cannot enter and existing illness improves. For frail people who always cough, wheeze and fall ill, and for girls who dieted their periods away, the answer is the same: tonify the spleen-stomach first.

Compiled from Doctor Luo Dalun’s lecture series on Doctor Zhang Xichun’s first formula, Zi Sheng Tang (Nourishing Life Decoction, an yin-deficiency consumptive-heat formula), in Yi Xue Zhong Zhong Can Xi Lu (Records of Integrating Chinese and Western Medicine). The formula: raw Huai yam 1 liang, yu zhu 3 qian, xuan shen 5 qian, raw ji nei jin 2 qian, niu bang zi 3 qian (stir-fried, crushed); when heat is severe, add sheng di huang 5–6 qian. It treats weakness of the spleen-stomach and insufficiency of lung qi accompanied by deficiency heat; it also treats blood-exhausted amenorrhea.