Sheng Xian Tang — Lift the Sinking Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Comparisons with related formulas
7. Cautions

Overview

Sheng Xian Tang — the “Lift the Sinking Decoction” — is one of Zhang Xichun’s (1860–1933) signature formulas from Yi Xue Zhong Zhong Can Xi Lu. Zhang Xichun introduced the concept of Da Qi (“great Qi” or “chest Qi”) as the foundational Qi accumulated in the chest that powers the heart and lungs. When Da Qi sinks, the patient develops severe shortness of breath, weak voice, dizziness, and a sense that breath cannot reach all the way down.

The formula combines Huang Qi (the chief Qi tonic for chest Qi), Sheng Ma and Chai Hu (to lift the sinking Qi upward), Zhi Mu (to balance the warming action) and Jie Geng (to direct the formula upward). It is the principal modern formula for severe chest Qi sinking syndromes.

I prescribe Sheng Xian Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Sheng Xian Tang is prescribed for severe Da Qi (chest Qi) sinking:

• Shortness of breath on minimal exertion
• Sensation that breath cannot reach down to the lower body
• Weak voice
• Profound fatigue
• Dizziness, especially on standing
• Mild palpitations
• Tongue — pale, possibly with teethmarks
• Pulse — weak, possibly soft, “sinking” quality

Key herbs

1. Huang Qi (large dose) — chief; tonifies chest Qi and lifts sinking
2. Sheng Ma — raises clear Yang
3. Chai Hu — raises Yang
4. Zhi Mu — balances the warming herbs; nourishes Yin
5. Jie Geng — directs the formula to the chest

Formula actions

1. Tonifies chest Qi
2. Lifts sinking Yang
3. Restores breathing capacity

Conditions treated

1. Severe Qi-deficient breathlessness in chronic illness
2. Cardiac failure with exertional breathlessness (alongside cardiology care)
3. Pulmonary hypertension
4. Chronic obstructive pulmonary disease with severe breathlessness
5. Postural hypotension with dizziness on standing
6. POTS (postural orthostatic tachycardia syndrome) — see POTS
7. Severe chronic fatigue with breathlessness
8. Convalescence from prolonged illness

Comparisons with related formulas

• Bu Zhong Yi Qi Tang — for milder middle-burner Qi sinking; broader application.
• Da Bu Yuan Jian — for Yuan Qi collapse with shortness of breath.
• Sheng Mai San — for Qi-Yin deficiency with cardiac symptoms.

Cautions

Severe breathlessness needs medical assessment to exclude heart failure, pulmonary embolism, anaemia and other serious causes.

Not appropriate for excess patterns or acute infections.

Always consult a qualified Chinese herbalist registered with the RCHM.

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