Bu Zhong Yi Qi Tang, formulated by Li Dongyuan (also known as Li Gao; 1180-1252 A.D.) in Jin-Yuan Dynasty, traditionally has been one of the best Chinese herbal formulas for coordinating spleen and stomach. Thanks for the perfect fusion of benefiting Qi and promoting yang, it is still one of the most frequently used tonics clinically even to this day.
Simple as it is like any other Chinese formulas at first sight, it keeps amazing and inspiring many herbalists on treatments of countless severe and lingering illness in history, which substantial proof could be found in Xu Mingyi Lei’an (Supplement to Classified Case Records of Celebrated Physicians) to support.
There must be something worthwhile behind the proven effects and popularity. So, let’s go and look into this amazing prescription now.
What is Bu Zhong Yi Qi Tang (Ginseng and Astragalus Combination)?
Known as Astragalus Ginseng Combination in English, it was first seen in the Volume II of Nei Wai Shang Bian Huo Lun (Treatise on Clarifying the Doubts About Internal and External Damage) and late in the Volume II of the famous Pi Wei Lun (Treatise on the Spleen and Stomach) by Li Dong-yuan, published in 1247 and 1249 respectively.
In the chapter of Pi Wei Sheng Shuai Lun (Treatise of Prosperity and Decline on the Spleen and Stomach), Li Dong-yuan mentioned about Ping Wei San (Calm the Stomach Powder), Huang Qi Jian Zhong Tang (Astragalus Fortify the Center Decoction), Si Wu Tang (Four Substance Decoction), Si Jun Zi Tang (Four Gentlemen Decoction), and Wu Ling San (Five [Ingredient] Poria Powder), which were the main formulas he ever used for treating stomach and spleen Qi deficiency. In addition, he ever said that it worked in almost all cases by adding or subtracting herbs based on the individual diagnosis if one or two mutual syndromes revealed in patterns of five zang viscera. Thus it can be inferred that he was good at theory of visceral mannifestations and treating spleen-stomach disease previously.
He continued that in the case of shortness of breath and frequent micturition Si Jun Zi Tang should subtract Fu Ling (Poria) and add Huang Qi (Astragalus) for tonifying purpose, namely the early form of Bu Zhong Yi Qi Tang, which, as revealed in the context, evolves from Si Jun Zi Tang based on zang-fu theory combined with his famous ascending-descending-floating-sinking-reinforcing-purging principles. This is a step forward on therapeutic methods in history and also the highlight of Dongyuan theory’s fascination.
Huang Qi – Astragalus Root
Dang Shen – Codonopsis Root
Bai Zhu – Atractylodes Macrocephala
Chen Pi – Tangerine Peel
Dang Gui – Dong Quai
Gan Cao – Licorice Root
Chai Hu – Bupleurum
Sheng Ma – Black Cohosh Rhizome, Bugbane Rhizome
Benefits and indications
In practice of Traditional Chinese Medicine (TCM), its functions are to tonify middle-Jiao and Qi and lift yang and the sinking. Main uses and indications are stomach and spleen Qi deficiency, lack of Qi and no desire to speak, weakness in limbs, easy fatigue, loss of appetite, breathing difficulty, or other symptoms and signs like fever and fidget, thirst for hot drink, surging but weak pulse, fever with aversion to cold, headache, sinking of Qi due to spleen deficiency, and rectocele causing by prolonged diarrhea. Now it is widely used for hysteroptosis, gastroptosis and ptosis in other viscera.
Modern experimental studies also show additional benefits as follows:
(1). It has selective excitation on uterus or isolated uterus and surrounding tissues, especially after added Yi Mu Cao (Chinese Motherwort) and Zhi Ke (Ripe Fruit of Zhi Shi). It excites cardiac muscle in small dosage but inhibit in over dose. Its effect on small intestine is complicated, slowing peristalsis and reducing the tension when hyperfunction while boosting peristalsis when suppression, which confirms that this prescription’s function is two-way;
(2). It has stronger antimutator and antitumor effects than Four Gentlemen Decoction. Meanwhile, it boosts immune function to prolong animal’s survival time, which reveals that clinically the combination with antineoplastic chemotherapy will improve efficacy and reduce the undesired side effects of chemotherapy agents and radiation treatment;
(3). Wangshi and others used this recipe to treat 36 cases, 58 eyes, of drooping eyelids, among them 37 eyes cured, 20 eyes markedly improved, and 1 eye improved, with the effective rate of 100%.
Medical principles behind the formula
As the founder of spleen-stomach theory in Chinese medical science history, Li Dongyuan valued the spleen-stomach function on the physiological and pathological changes of the human body. He believed that primordial Qi is the health foundation while spleen and stomach are the source of the generation and transformation of primordial Qi and the hub of body’s Qi movement. The impairment of spleen-stomach would lead to deficient primordial Qi and disorder of Qi movement, which thus is the culprit of all diseases. Based on this idea, he put up Bu Zhong Yi Qi Tang, the representative formula stressing on stomach Qi’s ascending and dredging.
- Huang Qi, the sovereign herb, invigorates middle-burner and Qi and raises yang and consolidates superficies;
- Ren Shen, Bai Zhu, and Gan Cao, the minister herbs, benefit Qi by sweet and warming nature and supplement spleen-stomach;
- Chen Pi and Dang Gui, the assistant drugs, regulate Qi movement and nourish blood to harmonize nutrient Qi respectively;
- Sheng Ma and Chai Hu, the envoy drugs, assist Astragalus and Codonopsis in helping the lucid Yang ascend.
- In severe sinking of spleen Qi, add Ren Shen to 15 grams and 12 grams of Shan Yu Rou (Asiatic Cornelian Cherry Fruit);
- If accompanied with dropping sensation in lateral lower abdomen or spasm, add more Sheng Ma to even 24 grams;
- If abdominal pain involved, add 10 grams of Bai Shao (White Peony Root) and 8 grams of Yan Hu Suo (Corydalis Rhizome);
- If rheumatism and general arching found, add 12 grams of Fang Feng (Ledebouriella Root), 10 grams of Qiang Huo (Notopterygium Root), 9 grams of Gao Ben (Chinese Lovage Root), and 12 grams of Cang Zhu (Atractylodes).
Potential side effects and contraindications
Regarded as it is a Chinese herbal formula, cares should be taken when symptoms, indicating fever caused by deficiency of Yin, occur like irritation, thirst, and feverish palms and soles. Else, it is not suitable in decline vital gate fire and deficient-cold or dampness-heat diarrhea.
By the way, in order to cater for the demands of the modern world, now Bu Zhong Yi Qi Wan (teapills) and Bu Zhong Yi Qi Pian (tablet) are also available in most drug store, online or offline.
(1). Tian Jin Yi Yao Za Zhi (Tianjin medical magazine) 1960 (1):4 – 12;
(2). Zhong Chen Yao Yan Jiu (Research of Chinese Patent Medicine) 1985 (12): 27;
(3). Shi Yong Zhong Yi Yao Za Zhi (Journal of Practical Traditional Chinese Medicine) 1996 (4): 11;
(4). Pi Wei Lun, Zhong Juan (Treatise on the Spleen and Stomach, Volume II).