In Traditional Chinese Medicine, there's a saying: "Ginseng kills without being blamed, rhubarb saves without being credited." This means that when tonics are prescribed incorrectly, patients don't blame the doctor; they still feel that the doctor who prescribed them is considerate, even a paragon of medical ethics. However, even when a purgative cures an illness, the doctor who prescribed it is rarely praised. They are clearly more willing to "act on" the patient than the one who prescribes tonics... This shows the high esteem in which tonics and nourishment are held by our people! Especially now that health preservation has become a fashion and self-care a hot topic, the use of tonic medicines is increasingly common, even trending from hospitals and pharmacies into homes and onto dining tables. However, even for a patient with a deficient and weakened body, it is not common knowledge where the deficiency lies or which tonic is suitable. Misunderstandings about tonics can be enough to undermine the efficacy of classic, time-tested medicines with a thousand-year history.
Buzhong Yiqi Wan (Tonify the Middle and Qi Pills)—The tonic to use for low-grade fever of unknown origin
Earliest Source: "Pi Wei Lun" (Treatise on the Spleen and Stomach) from the Jin Dynasty
History of Use: 980 years
Main Ingredients: Astragalus root, licorice root, Atractylodes macrocephala root, Ginseng, Angelica sinensis root, Cimicifuga foetida root, Bupleurum root, dried tangerine peel
Overall Nature: Warm
Functions and Indications: Tonifies the middle and qi, raises yang and lifts prolapse. Used for spleen and stomach weakness, and qi collapse in the middle jiao, causing fatigue, lack of strength, poor appetite, abdominal bloating, loose stools, chronic diarrhea, and a sensation of prolapse in the anus.
Typical Signs: Sallow complexion, thin and emaciated, with strength too feeble to even bind a chicken.
Buzhong Yiqi Wan is a pill form derived from "Buzhong Yiqi Tang" (Decoction to Tonify the Middle and Qi), the latter being the signature formula of Li Dongyuan, a famous physician of the Jin-Yuan period and the founder of the "Spleen and Stomach Theory" in TCM. Li Dongyuan placed special emphasis on the spleen and stomach, to the point of creating the "Spleen and Stomach Theory," because he lived during the war-torn Jin-Yuan period. Many history books and martial arts films we've seen depict the turmoil of that era, when people's lives were unstable, they were constantly displaced, and most experienced irregular meals and no fixed residence. Everyone felt overwhelmed by crisis. Against this backdrop, spleen and stomach diseases became the most prevalent illnesses.
In TCM theory, "Fire generates Earth," and the Heart, which belongs to the Fire element, is the "mother" of the Spleen and Stomach, which belong to the Earth element. When the "mother" is sick, it inevitably affects the "child." In turbulent times, people's emotions are certainly unstable, which is a problem with the "Heart" in TCM, as the "Heart" is associated with emotions. When a person is in a good mood, their appetite and digestion are good. But when a person is utterly disheartened and grief-stricken to the point of despair, they certainly have no appetite for food or drink.
A medicine often kept by "frail scholars"
Whenever life becomes turbulent, the first part of the body to be affected is the spleen and stomach. The spleen and stomach are what Western medicine calls the digestive system, and they are more sensitive to emotions than any other organ in the body. Therefore, medicine even has the concept of the "abdominal brain." This theory suggests that the human gastrointestinal system can be as sensitive as the brain!
Michael Gershon, a professor of anatomy and cell biology at Columbia University, proposed in his book "The Second Brain" that everyone has a second brain responsible for "digesting" food, information, external stimuli, sounds, and colors. This abdominal brain is the nerve plexus located in the walls of the gastrointestinal tract.
During an operation, a Chinese neurosurgeon named Wang Xining discovered that the wrinkles in human brain tissue are remarkably similar to the wrinkles in intestinal tissue... All of this confirms that the digestive system, or the spleen and stomach in TCM terminology, is the most susceptible to emotional and psychological influence.
For example, imagine we are already at the dinner table and suddenly hear sad news or a tense message. Even if your favorite dishes are in front of you, you will definitely lose your appetite. This is what the common saying "it puts a damper on things" means. Just think, this is just for one meal. If a person remains in this tense, sad, and unstable state for several years, their spleen and stomach will undoubtedly suffer severe damage. Li Dongyuan witnessed the impact of this unstable life on the spleen and stomach qi of his contemporaries, which is why "Buzhong Yiqi Tang" was created.
Thus, it can be seen that people suitable for taking Buzhong Yiqi Wan are often those who overwork their minds. Long-term mental work affects the function of the spleen and stomach, so Buzhong Yiqi Wan should also be a medicine often kept by "frail scholars."
As the saying goes, "a doctor is like the person." This means a doctor's style of diagnosis and prescription is very similar to their personality. Ancient records describe Li Dongyuan as a thorough and self-disciplined person. Once, someone disbelieved his integrity and特意 had a prostitute tempt him during a banquet. How could Li stand for this? After throwing away the clothes the prostitute had grabbed, he stormed out of the room, upholding his rigorous character.
His formulas are also like him—they are steady, comprehensive, and meticulous. They are often safe for long-term conditioning and use. If you want to improve a constitution of spleen qi deficiency with Buzhong Yiqi Tang, you need to take it for one to two months, because the damage and depletion of spleen qi are like "a three-foot-thick sheet of ice formed over three winters"—the dire result of a long, turbulent life.
However, if you only use Buzhong Yiqi Wan according to the indications on its drug label—for example, only using it to treat organ prolapse like gastric ptosis caused by emaciation—you will miss the precious value of this classic formula. Because in his "Pi Wei Lun," Li Dongyuan's annotation for this formula is for cases of "qi rising with panting, body heat with vexation, a full and rapid pulse with headache, or unquenchable thirst, and skin that cannot withstand wind and cold, leading to chills and fever." If you understand this point, many difficult-to-treat diseases can be solved with this old medicine.
Administration Method
The Buzhong Yiqi Wan available in pharmacies today is mainly in water-pilled form. The general dose is 6 grams per time. If used for conditioning and improving constitution, you can take it once on an empty stomach in the morning and once again before bed at night. If you need to use it to reduce low-grade fever, you can add an extra dose at noon.
Some people with a weak stomach may find hard pills difficult to digest. They can dissolve the water pills in boiling water and drink it like a decoction to reduce the burden on the gastrointestinal tract. If the tongue coating is very clean, you can add a little honey when taking it to enhance the nourishing effect.
Sijunzi Wan (Four Gentlemen Pills)
This medicine's indications are very similar to Buzhong Yiqi Wan, both addressing problems by tonifying the middle qi. However, for symptoms caused by qi deficiency, Sijunzi Wan mainly improves the weakness of having no strength, while Buzhong Yiqi Wan, containing many sweet and warm ingredients, can also eliminate the low-grade fever caused by qi deficiency.
Generally speaking, cases of fever due to qi deficiency are few, and when they do occur, they are often intractable diseases that have not responded to other treatments. In comparison, Sijunzi Wan and Buzhong Yiqi Wan are used more often for routine qi deficiency and can be used interchangeably. As long as you have a constitution of "strength too feeble to bind a chicken," a "sallow and thin" body, with a tendency to have diarrhea and poor digestion, this medicine can be taken long-term to nourish the "acquired foundation."
Xiangsha Sijunzi Wan (Aucklandia and Amomar Four Gentlemen Pills)
This medicine adds Aucklandia and Amomar to the Sijunzi Wan formula, making it suitable for spleen and stomach qi deficiency manifested in the digestive system, such as diarrhea, a feeling of blockage, fullness, and bloating in the stomach after eating. Compared to Buzhong Yiqi Wan, this medicine treats patients with qi deficiency who often also have indigestion. Therefore, it is not a simple qi-tonifying medicine; its goal is to aid digestion by tonifying qi and expel food stagnation caused by qi deficiency. It is a special digestive medicine for people with qi deficiency. If the spleen qi is not deficient and the problem is simply from overeating ("being stuffed from a full meal"), you can directly take Xiangsha Zhizhu Wan or Jiabai He Wan, which are specifically for resolving food stagnation and promoting digestion.
Shenling Baizhu Wan (Ginseng and Poria Atractylodes Macrocephala Pills)
Many people with spleen deficiency often ask me how they can gain weight. They typically have very poor digestive function; they get diarrhea after eating uncomfortably, and their stools are consistently unformed with a poor texture. In TCM, this is described as "grain not fully digested"—meaning what you eat comes out whole. For people like this who want to gain weight and improve digestion, they must replenish their spleen qi, and Shenling Baizhu Wan is the top choice. Besides ginseng and Atractylodes macrocephala, all the other ingredients in this medicine are foods that can tonify the spleen, such as Chinese yam, Job's tears seeds, lotus seeds, and hyacinth beans. Therefore, it is a very gentle spleen-tonifying medicine. Many people with chronic enteritis, or even chronic nephritis, who have persisted in taking this pill daily have, as a result, actually gained weight, become stronger, and their chronic illnesses have improved because their spleen qi has been restored.