Bu Zhong Yi Qi Tang — Tonify the Middle and Augment the Qi Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Conditions treated
5. Cautions

Overview

Bu Zhong Yi Qi Tang — Tonify the Middle and Augment the Qi Decoction — was created by the great physician Li Dongyuan (1180–1251 CE) and forms the cornerstone of his school, which emphasised the central importance of the Spleen and Stomach as the source of postnatal Qi. It is specifically designed to tonify Spleen and Stomach Qi and to raise Qi that has sunk downward — a condition Li identified as the root of many chronic diseases. It remains one of the most widely prescribed Chinese herbal formulas in contemporary clinical practice worldwide.

TCM pattern

Bu Zhong Yi Qi Tang is prescribed for Spleen and Stomach Qi deficiency with sinking of Middle Qi, characterised by: persistent fatigue that improves with rest, spontaneous sweating, shortness of breath on exertion, poor appetite, loose stools, a bearing-down sensation in the abdomen or pelvis, a pale tongue with thin white coating, and a weak, empty pulse particularly in the right Guan (middle) position.

Key herbs

1. Huang Qi (Astragalus membranaceus root) — the principal herb; powerfully tonifies Spleen and Lung Qi and raises Yang
2. Ren Shen (Panax ginseng root) — powerfully tonifies Yuan Qi and Spleen Qi
3. Bai Zhu (Atractylodes macrocephala rhizome) — tonifies Spleen Qi and dries Dampness
4. Zhi Gan Cao (honey-fried Glycyrrhiza root) — tonifies Qi and harmonises
5. Dang Gui (Angelica sinensis root) — nourishes Blood and prevents dryness
6. Chen Pi (Citrus reticulata peel) — regulates Qi and prevents stagnation from the tonifying herbs
7. Sheng Ma (Cimicifuga heracleifolia rhizome) — raises and lifts Yang Qi; the key herb for addressing sunken Middle Qi
8. Chai Hu (Bupleurum chinense root) — raises Yang and spreads Liver Qi; works with Sheng Ma to lift sunken Qi

Conditions treated

1. Chronic fatigue syndrome and burnout — the most widely used formula for post-viral and occupational exhaustion
2. Long COVID — specifically studied for post-COVID fatigue and respiratory weakness
3. Organ prolapse — uterine prolapse, rectal prolapse, gastric ptosis and haemorrhoids from sinking Middle Qi
4. Low-grade persistent fever from Qi deficiency (fever that worsens with exertion)
5. Recurrent infections and poor immune resilience from chronic Spleen Qi deficiency
6. Fertility support where Spleen Qi deficiency underlies poor uterine function or recurrent miscarriage

Cautions

Always consult a qualified Chinese herbalist registered with the Register of Chinese Herbal Medicine (RCHM). online herbal consultations are available. See the prices page for costs.