TCM pattern · Qi deficiency

Sinking of Spleen Qi

中气下陷 Zhong Qi Xia Xian Spleen system

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.

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.

2 formulas Updated 2026-10-12 View API data

How to recognize Sinking of Spleen Qi

The signs that point most strongly to this pattern:

  1. A dragging or bearing-down feeling in the lower belly
  2. Prolapse of the uterus, rectum, bladder, or stomach
  3. Hemorrhoids that sag, varicose veins
  4. Exhaustion, worse on standing and with effort
  5. Chronic diarrhea or frequent urination

Also 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.

Formulas for Sinking of Spleen Qi

Herbs that matter most for Sinking of Spleen Qi

  • Huang Qi Root of Membranous Milkvetch Astragalus tonifies and lifts the qi.
  • Sheng Ma Largetrifoliolious Bugbane Rhizome Cimicifuga, a small dose, raises the sunken qi.
  • Chai Hu Chinese Thorowax Root Bupleurum, a small dose, lifts and spreads.
  • Dang Shen Dang Shen Root Codonopsis restores the middle qi.
  • Bai Zhu Rhizome of Largehead Atractylodes Atractylodes strengthens the Spleen.
  • Zhi Shi Immature Bitter Orange Fruit Immature bitter orange, used with astragalus for prolapse.

How Sinking of Spleen Qi differs from its look-alikes

  • Spleen Qi Deficiency 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.
  • Kidney Yang Deficiency Kidney yang deficiency is cold with a sore back and night urination. Sinking qi is weak and dragging but not especially cold.

What drains into Sinking of Spleen Qi

  • Long Spleen qi deficiency
  • Childbirth, heavy lifting, or long standing
  • Chronic diarrhea that drained the qi
  • Aging
  • Overwork without rest

Food and habits that help Sinking of Spleen Qi

  • 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.

What should change as Sinking of Spleen Qi improves

  • 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.

Conditions where Sinking of Spleen Qi shows up

Sources

  • Maciocia, The Foundations of Chinese Medicine, 3rd edition Spleen qi sinking.
  • Bensky, Scheid, Ellis and Barolet, Chinese Herbal Medicine: Formulas and Strategies, 2nd edition Bu Zhong Yi Qi Tang.

Important Note

A pattern is a picture, not a diagnosis. Most people carry two patterns at once, and the signs here are the classic ones, not a checklist. Use this page to recognize yourself, read a formula label with understanding, and ask a qualified practitioner a sharper question.