{
    "slug": "qi-deficiency-with-sinking",
    "name": "Sinking of Spleen Qi",
    "pinyin": "Zhong Qi Xia Xian",
    "chinese": "中气下陷",
    "organ": "Spleen",
    "nature": "deficiency",
    "family": "qi-deficiency",
    "summary": "Spleen qi so weak it can no longer hold things up. Exhaustion with a dragging, bearing-down feeling, prolapse of the uterus, rectum, or bladder, hemorrhoids, chronic diarrhea, frequent urination, and a low fever that comes with tiredness. Things sag because the qi that holds them has sunk.",
    "picture": "A tent whose poles have gone soft. Everything droops: the roof, the door, the floor. The fix is not more canvas. It is lifting the poles.",
    "signs": {
        "key": [
            "A dragging or bearing-down feeling in the lower belly",
            "Prolapse of the uterus, rectum, bladder, or stomach",
            "Hemorrhoids that sag, varicose veins",
            "Exhaustion, worse on standing and with effort",
            "Chronic diarrhea or frequent urination"
        ],
        "common": [
            "Shortness of breath, a weak voice",
            "Sweating on effort",
            "A low fever that comes with tiredness",
            "Dizziness on standing",
            "Poor appetite, loose stools"
        ],
        "tongue": "Pale with a thin white coat.",
        "pulse": "Weak, or large and empty."
    },
    "causes": [
        "Long Spleen qi deficiency",
        "Childbirth, heavy lifting, or long standing",
        "Chronic diarrhea that drained the qi",
        "Aging",
        "Overwork without rest"
    ],
    "tell_apart": [
        {
            "slug": "spleen-qi-deficiency",
            "how": "Plain qi deficiency is tired and bloated without the sagging and dragging. Add the prolapse or the bearing-down feeling and the formula must lift."
        },
        {
            "slug": "kidney-yang-deficiency",
            "how": "Kidney yang deficiency is cold with a sore back and night urination. Sinking qi is weak and dragging but not especially cold."
        }
    ],
    "formulas": [
        {
            "slug": "bu-zhong-yi-qi-tang",
            "role": "primary",
            "when": "The lifting formula. Built for this pattern.",
            "pinyin": "Bu Zhong Yi Qi Tang",
            "_links": {
                "self": "https://www.naturalherblibrary.com/api/v1/formula/bu-zhong-yi-qi-tang",
                "html": "https://www.naturalherblibrary.com/formula/bu-zhong-yi-qi-tang"
            }
        },
        {
            "slug": "shen-ling-bai-zhu-san",
            "role": "with diarrhea",
            "when": "When chronic loose stools lead and the sagging is mild.",
            "pinyin": "Shen Ling Bai Zhu San",
            "_links": {
                "self": "https://www.naturalherblibrary.com/api/v1/formula/shen-ling-bai-zhu-san",
                "html": "https://www.naturalherblibrary.com/formula/shen-ling-bai-zhu-san"
            }
        }
    ],
    "herbs": [
        {
            "pinyin": "Huang Qi",
            "role": "Astragalus tonifies and lifts the qi.",
            "herb_slug": "root-of-membranous-milkvetch",
            "_links": {
                "herb": "https://www.naturalherblibrary.com/api/v1/herb/root-of-membranous-milkvetch",
                "html": "https://www.naturalherblibrary.com/herb/root-of-membranous-milkvetch"
            }
        },
        {
            "pinyin": "Sheng Ma",
            "role": "Cimicifuga, a small dose, raises the sunken qi.",
            "herb_slug": "largetrifoliolious-bugbane-rhizome",
            "_links": {
                "herb": "https://www.naturalherblibrary.com/api/v1/herb/largetrifoliolious-bugbane-rhizome",
                "html": "https://www.naturalherblibrary.com/herb/largetrifoliolious-bugbane-rhizome"
            }
        },
        {
            "pinyin": "Chai Hu",
            "role": "Bupleurum, a small dose, lifts and spreads.",
            "herb_slug": "root-of-chinese-thorowax",
            "_links": {
                "herb": "https://www.naturalherblibrary.com/api/v1/herb/root-of-chinese-thorowax",
                "html": "https://www.naturalherblibrary.com/herb/root-of-chinese-thorowax"
            }
        },
        {
            "pinyin": "Dang Shen",
            "role": "Codonopsis restores the middle qi.",
            "herb_slug": "root-pilose-asiabell",
            "_links": {
                "herb": "https://www.naturalherblibrary.com/api/v1/herb/root-pilose-asiabell",
                "html": "https://www.naturalherblibrary.com/herb/root-pilose-asiabell"
            }
        },
        {
            "pinyin": "Bai Zhu",
            "role": "Atractylodes strengthens the Spleen.",
            "herb_slug": "rhizome-of-largehead-atractylodes",
            "_links": {
                "herb": "https://www.naturalherblibrary.com/api/v1/herb/rhizome-of-largehead-atractylodes",
                "html": "https://www.naturalherblibrary.com/herb/rhizome-of-largehead-atractylodes"
            }
        },
        {
            "pinyin": "Zhi Shi",
            "role": "Immature bitter orange, used with astragalus for prolapse.",
            "herb_slug": "immature-fruit-of-seville-orange",
            "_links": {
                "herb": "https://www.naturalherblibrary.com/api/v1/herb/immature-fruit-of-seville-orange",
                "html": "https://www.naturalherblibrary.com/herb/immature-fruit-of-seville-orange"
            }
        }
    ],
    "conditions": [
        "fatigue",
        "hemorrhoids",
        "diarrhea",
        "frequent-urination",
        "spontaneous-sweating",
        "dizziness"
    ],
    "habits": [
        "Rest lying down after meals and after effort while the qi rebuilds.",
        "No heavy lifting and no long standing until the dragging eases.",
        "Warm cooked food at regular times.",
        "Pelvic floor exercises alongside the formula for prolapse."
    ],
    "watch": [
        "The dragging feeling and the tiredness ease within two to four weeks.",
        "Prolapse and hemorrhoids improve over one to three months.",
        "Energy on standing returns."
    ],
    "sources": [
        {
            "title": "Maciocia, The Foundations of Chinese Medicine, 3rd edition",
            "note": "Spleen qi sinking."
        },
        {
            "title": "Bensky, Scheid, Ellis and Barolet, Chinese Herbal Medicine: Formulas and Strategies, 2nd edition",
            "note": "Bu Zhong Yi Qi Tang."
        }
    ],
    "meta": {
        "status": "published",
        "last_updated": "2026-10-12",
        "reviewed_by": null
    },
    "_links": {
        "html": "https://www.naturalherblibrary.com/pattern/qi-deficiency-with-sinking",
        "self": "https://www.naturalherblibrary.com/api/v1/pattern/qi-deficiency-with-sinking",
        "index": "https://www.naturalherblibrary.com/api/v1/patterns"
    }
}