Bǔ Zhōng Yì Qì Tāng

Tonify the Middle and Augment the Qi Decoction

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Category: Tonify Qi ⌕ 
Subcategory: Middle Jiao ⌕   Source: Nei Wai Shang Bian Huo Lun  
Actions: Tonify middle Jiao qi, lift yang qi and sinking. [Song] Tonify middle, strengthen Qi.
Diagnosis
Tongue: thin, white coat      Pulse: weak, slow    Other:pale complexion 
Patterns: Qi Deficiency, SP Qi Deficiency with Qi Sinking, Yin Fire, Qi Deficiency Hernia 
Indications: SP/ST Qi deficiency causing intermittent fever; SP Qi sinking [35] • Spleen deficiency: poor appetite, loose stools, short of breath with no desire to speak. Fatigue, pale complexion. Qi sinking: rectocele, prolapse of uterus , chronic diarrhea, metrorrhagia and metrostaxis. Qi Deficiency: fever, clear yang sinking, SP dampness flow downward, obstruct yang qi, transform into fire and flam upward – Yin fire [31] • For Qi Xu fever 气虚发热 (i.e. Chronic Fatigue Syndrome or Lime Disease, Qi deficient hernia. Night time diarrhea incontinence.[42]
Contraindications: 
Description
Name Variations:Bu Zhong Yi Qi Tang , 补中益气汤, Tonify the Middle and Augment the Qi Decoction,
Herb List: Huang Qi(K) • Ren Shen(M) • Bai Zhu(M) • Dang Gui(A) • Chen Pi(A) • Sheng Ma(A) • Chai Hu(A) • Gan Cao(G)
Commentary: Does not have to have dampness; Yin fire from Qi deficiency. It is not Yin deficiency. Can not use herbs from clear heat category. Cold bitter herbs will weaken the yang Qi further. Sweet warm herbs to eliminate great heat (heat generated by Qi deficiency). This formula is best when there is no dampness signs. If there is dampness, then consider using Shen Ling Bai Zhu San. DIFFERENCE: Ren Shen (tonify yuan Qi, revives Qi, Qi collapse), Huang Qi(supports Qi to surface - skin issues or sweating disorders), Bai Zhu(supports SP Qi to promote dampness).
Related Formulas:
NCCAOM: The 6 NCCAOM formulas for Qi Deficiency are Sì Jūn Zǐ Tāng, Liù Jūn Zǐ Tāng, Shēn Líng Bái Zhú Sǎn, Bǔ Zhōng Yì Qì Tāng, Yù Píng Fēng Sǎn, and Shēng Mài Sǎn. • Si Jun Zi Tang is for Spleen/Stomach Qi deficiency (poor appetite, shortness of breath, fatigue) • Liu June Zi Tang is for Spleen/Stomach Qi deficiency + phlegm. • Shen Ling Bai Zhu San is for SP Qi Deficiency + dampness causing diarrhea. • Bu Zhong Yi Qi Tang is for Spleen/Stomach deficiency causing intermittent fever or Spleen Qi Sinking (prolapses). • Yu Ping Feng San is for Wei Qi deficiency causing sweating. For frequent common colds and aversion to wind. • Sheng Mai San is for Lung Qi and Yin deficiency with spontaneous sweating. Chronic cough.
Herbs Cat/Dosage Actions Attributes
Huang QiAstragalus • 黄芪  Tonify Qi Tonify Spleen and Lung Qi • Tonify Wei Qi • Tonify Qi to move blood • Raise Stomach Yang Qi • Improve urination • Relief Edema • Discharge pus • Generate flesh • Push Qi to the surfaceSheng - to dry damp • Chao - to tonify Spleen, stop sweating, calm fetus • Chao jiao - to stop diarrhea Antioxidant • Immune System Booster • Diuretic • Anti-aging • Hypoglycemic • Hypotensive • Hepatoprotective
Ren ShenGinseng • 人参 Tonify Qi Tonify yuan qi • Tonify lung qi • Tonify heart qi • Calms Shen • Stop thirst • Helps impotence • Treats qi collapse • Tonify Spleen • Generate fluid • Stop thirst • Strengthen anti-pathogenic qi • Can go to all 5 zang organsUnlike Huang Qi, Ren Shen is adaptogenic and may be used by people with autoimmune disorders. adaptogen • anti-aging • anticoagulant • antiplatelet • antioxidant • adrenalcortical • immunity booster • anti-inflammatory • antidepressant • hepatoprotective • stimulant
Bai ZhuWhite Atractylodes Root • 白术 ♥ Tonify Qi Tonify Spleen Qi • Stop sweating • Calms fetus • Dry dampness • Stabilize exteriorDao Di: Zhe Jiang Anti-inflammatory • Hepatoprotective • Immunity Booster • Hypoglycemic • Antibaterial
Dang GuiChinese Angelica • 当归   Tonify Blood Tonify blood • Move Blood and Qi • Regulate menses • Invigorate blood • Dispel cold • Unblock bowels • Reduce abscess swelling • Alleviate pain • Clear pus • Generate flesh • Moisten intestines Dang Gui Shen (body) - tonify blood • Quan Dang Gui - harmonize blood (tonify and invigorate) • Dang Gui Wei (tail) - invigorate blood • According to the Board Exams, this herb does not affect estrogen because it has not yet been determined in which way it does affect it. However, there are numerous research articles on Dang Gui and estrogen. phytoestrogen • antispasmodic • cholagogue • antibaterial • antiviral • antiobesity • anti-inflammatory • antifungal • mild laxative • immune system boost • volatile oil inhibits uterine contractions
Chen PiDried Tangerine Rind • 陈皮   Regulate Qi Stop cough • Stop vomiting • Regulate Qi • Harmonize middle burner • Transform phlegm • Dry damp • Prevent cloying of tonifying herbs Dao Di: Guang Dong • The older the Chen Pi, the better the quality • For moving Qi, Chen Pi is focus on moving Qi in the epigastric area regulate gastrointestinal smooth muscles, clear phlegm, hypertensive, aid digestion, hepatoprotective, anti-inflammatory, antioxidant, antiviral, expectorant
Sheng MaBlack Cohosh • 升麻   Release Exterior Wind Heat Vent measles • Clear Heat • Raise Yang Qi • Relieve toxins • Release exterior • Lifts and guides upward antibiotic, antipyretic, hypotensive, anti-inflammatory, analgesic[18]
Chai Hu • Thorowax • 柴胡   Release Exterior Wind Heat Harmonize interior and exterior • Reduce fevers • Reduce chills • Soothe liver Qi • Clear muscle layer heat • Tonify stomach Qi • Guide herbs to Shao Yang Jing Antibiotic • Antipyretic • Anti-inflammatory • Antibaterial • Antiviral • Analgesic • Hepatoprotective • Immunemodulatory • Chemoprotective • Anti-tumor • Cholagogic • Sedative • Immunostimulate
Gan CaoLicorice Root • 甘草   Tonify Qi Tonify Spleen Qi • Tonify Heart qi • Clear heat • Resolve toxicity • Stop cough • Dispel phlegm • Lubricate lungs • Stop wheezing • Reduce spasm • Relieve pain • Harmonize other herb effects • enters 12 channelsEnters all 12 channels, often serve as envoy in a formula. Hypoglycemic • Antiarrhythmic • Hypertensive • Expectorant • Antidiarrheal • Antiulcer • Hepatoprotective • Immunostimulant • Antitussive • Antiviral • Detox • Demulcent • Anti-inflammatory • Laxative • Emmenagogue • Antimicrobial • Spasmolytic • Corticosteroidal
King/Chief    ♥ Minister/Deputy      Assistant     ♦ Envoy
Directions: 
Modifications For
+ Man Jing Zi + Chuan Xiong + Gao Ben + Bai Zhi, Xi Xin  Headaches 31
+ Bai Shao Abdominal Pain 31
+ Mu Xiang + Zhi Ke Qi Stagnation 31
+ Zi Su Ye Deficient constitution and Wind Cold 31

Caution

ALERT: Contraindications of each herb - use with caution under these conditions:

Huang Qi: Autoimmune diseases • Exterior excess • Qi stagnation • Damp obstruction • Food stagnation • Yin deficiency
Ren Shen: Blood thinner medication • Diabetes medication • Blood pressure medication • Caffeine • Yin deficiency • Stagnant fire • Hypertension • Bleeding disorders • Pain in chest • Excess heat • food: onion, garlic, radishes, tea, turnips
Bai Zhu: Autoimmune disorder • Yin deficiency with heat • Dehydration • Foods: black carp, Chinese cabbage, peach, plum and coriander
Dang Gui: Autoimmune disorder • Pregnancy • Blood thinner drugs (Wafarin) • Diarrhea • Yin deficiency with heat • Dampness abdominal distention
Chen Pi: Excess internal heat • Dry cough from heat, yin deficiency or qi deficiency • Cough with blood • Red tongue • Fluid deficiency
Sheng Ma: Yin deficiency • Liver yang rising • Complete eruption of measles
Chai Hu: Dries Yin and can exacerbate the Yin deficiency • Do not use as intramuscular injections • Liver fire • Hyperactive liver yang • Cytochrome P450, 2C9, 2E1, 2D6, and 3A4 • Greater than 19g may lead to liver injury
Gan Cao: High blood pressure • Low potassium • Seaweed • Medications: Gan Cao can interact with various medication. See Pharma Interaction section.

Notes

 

Bibliography: [3], [8], [9], [14]

Information in this post came from many sources, including class notes, practitioners, websites, webinars, books, magazines, and editor's personal experience.  While the original source often came from historical Chinese texts,  variations may result from the numerous English translations.   Always consult a doctor prior to using these drugs.  The information here is strictly for educational purposes. 

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