Herb Formulas Notebook

Bu Zhong Yi Qi Tang

Tonify the Middle to Augment the Qi Decoction

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Source: Clarifying Doubts About Damage from Internal and External Causes (1247)
Author: Li Gao / Dong-Yuan

Category: Formulas that Tonify Qi

Pattern: Spleen and Stomach deficiency with inability to raise the Clear, Chong Mai counterflow due to internal damage (with modifications).

Key Symptoms: Lack of physical and mental stamina and vitality, all symptoms worsen with fatigue and exertion, weak muscles and connective tissue, impaired or cloudy vision, lack of appetite
Secondary Symptoms: Dizziness, unsteadiness, deafness, tinnitus, shortness of breath, laconic speech, weak voice, digestive weakness, intermittent fever that is worse upon exertion, spontaneous sweating, aversion to cold, thirst for warm beverages, loose stools, chronic diarrhoea or dysentry, haemorrhoids, recal or uterine prolapse, prolapse of the internal organs, irregular uterine bleeding

Tongue: Pale and wet body, scanty or no coating
Pulse: Frail, large, forceless
Abdomen: Weak and soft, slight tenderness under the ribs, pulsations around the umbilicus, may have pencil line tension above the umbilicus

Huang Qi 18-30g
Ren Shen 6-9g
Bai Zhu 6-9g
Zhi Gan Cao 9-15g
Dang Gui 6g (wine washed)
Chen Pi 6-9g
Sheng Ma 3-6g
Chai Hu 3-6g

Preparation: Decoction.

Actions: Tonifies the middle Jiao, augments the Qi, raises the Yang, lifts what has sunken

Contraindications: Fever due to Yin deficient Heat, External patterns, Kidney deficiency

Really for three patterns that might occur together or separately:
1. Spleen and Stomach Deficiency with inability to Raise the Clear leading to fatigue and impaired senses
2. Qi deficiency fever
3. Sinking of Spleen Qi leading to prolapse, diarrhoea or haemorrhoids


Extraordinary Vessel attributions come from Li Gao's Discussion of the Spleen and Stomach (Pi Wei Lun), cited by Li Shi-Zhen's (1577-8)in his Exposition on the Eight Extraordinary Vessels (Qi Jing Ba Mai Kao), trans. Chace & Shima (2009) with the addition of dry fried Huang Lian, dry fried Huang Bai and Zhi Mu to drain the Chong.


Ploberger (2017), in Westliche und traditionell chinesische Heilkräuter, offers the following alternative using western herbs:

Rhizome Cimicifugae(Black Cohosh)4g(Emperor & Envoy)
Radix Ginseng(Ginseng root)3g(Minister)
Pericarpium Citri ret.(Orange peel)5g(Minister)
Herba Absinthii (Wormwood)1g(Minister)
Fructus Juniperi(Juniper berries)3g(Minister)
Herba Alchemillae vulgaris(Lady's Mantle)3g(Minister)
Radix Glycyrrhiziae(Licorice root)2g(Minister)
Radix Paeoniae alba(White Peony)3g(Assistant)

Research Links:
Science Direct
Google Scholar
Journal of Chinese Medicine
American Dragon

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.