A "spleen-and-stomach tonifying, qi-raising" formula with a long history of use for fatigue, post-illness weakness, and the kind of tiredness that does not feel fully physical.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Compiled by the Jin-Yuan dynasty physician Li Dongyuan (李东垣, 1180–1251) in his influential 1247 text "Treatise on the Spleen and Stomach" (《脾胃论》). Li's school of "tonifying earth" (补土派) reshaped how Chinese medicine understood chronic fatigue and weak digestion, and Bu Zhong Yi Qi Wan became its flagship prescription.
From the source text
This page is cultural documentation, not medical advice.
From the source text · 卷中·饮食劳倦所伤始为热中论·补中益气汤·立方本旨
Classical text
《内经》曰：劳者温之，损者温之。惟当以甘温之剂，补其中，升其阳，甘寒以泻其火则愈。
Modern Chinese rendering
《内经》说：劳倦所伤宜用温补，亏损所伤也宜用温补。此时只宜用甘温之品来补益中气、升举清阳，再佐以甘寒之品来泻其阴火，即可痊愈。这是李东垣创制"补中益气汤"的核心思路——后世称为"甘温除大热"。
Editorial translation
The Inner Canon says: "What is taxed should be warmed; what is depleted should be warmed." One should therefore use sweet and warming agents to tonify the center and raise the yang, with sweet and cooling agents to drain the fire, and the condition will resolve. This is the core reasoning behind Li Dongyuan's construction of the Center-Supplementing, Qi-Boosting Decoction, known in later tradition as "using the sweet and warm to remove the great heat."
In tradition
In TCM tradition, often associated with patterns described as "spleen qi sinking" or "middle-jiao qi deficiency": a sense of heaviness or fatigue that is worse after exertion, shortness of breath on mild effort, loose stools, a feeling that internal organs are not well supported, post-illness weakness, low voice, and what Chinese texts sometimes call "qi sinking", a sense of physical and mental low. Historically also used for "organ prolapse" patterns in TCM framing. It is one of the formulas most often reached for in China for "tired but cannot quite explain why" fatigue.
Formula composition
Monarch1
- Astragalus root (Huáng Qí / 黄芪)
Minister3
- Ginseng (Rén Shēn / 人参)
- White atractylodes (Bái Zhú / 白术)
- Licorice, honey-fried (Zhì Gān Cǎo / 炙甘草)
Assistant4
- Dong quai (Dāng Guī / 当归)
- Bupleurum (Chái Hú / 柴胡)
- Cimicifuga (Shēng Má / 升麻)
- Citrus peel (Chén Pí / 陈皮)
Envoy2
- Ginger (Shēng Jiāng / 生姜)
- Jujube (Dà Zǎo / 大枣)
International availability
Cautions & context
- Considered unsuitable during a fever, common cold, or active digestive upset, the formula is "lifting and tonifying" and may "trap" external pathogens in TCM framing.
- People with what TCM texts describe as pronounced "yin deficiency" (night sweats, dry mouth, heat in the palms) or high blood pressure are typically advised to use with caution.
- Long-term daily use is common in China but should be reviewed periodically with a practitioner.
- Pregnant or breastfeeding people should consult a qualified practitioner before use.
Common questions about this formula
Related formulas
Other formulas by this contributor· Li Dongyuan
Browse by Pattern
Related concerns
Concern · stress
Stress & Mood
Everyday tension, low mood, irritability, the sense of being "wound up but tired". The cluster of complaints that brings many Chinese adults to the family 中成药 drawer before they ever see a doctor.
Concern · immune
Immune Support
The everyday language of "wanting to stay well", a sense of being run down, the change of seasons, occasional mouth ulcers, the slow recovery after a cold.
Editorial note
Compiled from "Treatise on the Spleen and Stomach" (1249).
Last reviewed: July 18, 2026
Three layers of evidence
Classical source
≈ 800 years · "Treatise on the Spleen and Stomach" (1249)
Pharmacopoeia indication
"Tonify the middle and benefit qi, raise yang and lift the sunken. Used for diarrhea, rectal prolapse, and uterine prolapse due to spleen-stomach weakness and sinking of middle qi: bodily fatigue, reduced food intake with abdominal distension, loose stools and chronic diarrhea."
Modern research status
As of 2026-07-18, a PubMed search using the formula name and the Latin / Korean / Japanese transliterations together with "systematic review" and "meta-analysis" did not identify a dedicated systematic review for this formula. Any clinical evidence that does exist is fragmented across small individual trials or covered in broad herbal-medicine umbrella reviews, which do not allow a per-formula evidence assessment; the absence of a dedicated SR is itself the relevant editorial fact here.
References
References reviewed on July 18, 2026 · PubMed search on 2026-07-18
- 01ClassicalLi Dongyuan (李东垣, 1180–1251), 《脾胃论》 (Pí Wèi Lùn / Treatise on the Spleen and Stomach), Jin-Yuan dynasty, compiled 1249, the middle volume, the essay "When Taxation by Diet and Toil Injures, Heat in the Middle Arises" (饮食劳倦所伤始为热中论) with the section "Bǔ Zhōng Yì Qì Tāng — Original Reasoning of the Formula" (补中益气汤·立方本旨) being the canonical passage for the "use the sweet and warm to remove the great heat" (甘温除大热) treatment principle.
- 02TextbookDuan Fuqin (段富津) et al. (eds.), 《方剂学》 (Fāngjìxué / Textbook of Formulas), Shanghai Scientific and Technical Publishers, 1995, the standard modern university-level formula textbook in mainland China, with Bǔ Zhōng Yì Qì Wán analysed as the representative "tonify the middle and benefit qi, raise yang and lift the sunken" formula of the "tonify earth" (补土派) lineage, used for spleen qi deficiency and qi-sinking patterns.
- 03PharmacopoeiaChinese Pharmacopoeia Commission, 《中华人民共和国药典》 2020 年版一部 (Zhōnghuá Rénmín Gònghéguó Yàodiǎn, Pharmacopoeia of the People's Republic of China, 2020 Edition, Vol. I), China Medical Science Press, 2020, the official monograph for Bǔ Zhōng Yì Qì Wán (and Tāng) dosage forms, with the "functional indications" reading "补中益气，升阳举陷" (tonify the middle and benefit qi, raise yang and lift the sunken).