Herbal medicine Martial Arts

Lifting the Earth element: Bu Zhong Yi Qi Tang

Talking to parents outside my son’s taekwondo class, I hear women say, “I can’t join class because I can’t do the jumping jacks.” You could substitute in run, trampoline. laugh or sneeze hard, or any high impact cardio activity. For so many women it isn’t possible to do these activities without leaking urine.

And it seems this is just a problem many women endure.

WHY?? You don’t have to!


There is something that can help: acupuncture and herbal medicine.

In fact, there is a specific, archetypal, classic formula for this problem. This formula has been around for centuries, dating to the 13th century. It’s kept up with the times, though, and an online search will show quite a few controlled trials on this herbal formula. I’ve included a few links at the end of the blog if you’d like to see how modern science views the formula.


You don’t have to miss out on a 90 minute class and a shared experience with your kids because five of those minutes are jumping jacks.


If you’re wary of herbs (and if you’re using a state and nationally certified herbalist, like me, you shouldn’t be) then there are acupuncture points that can be used to also help this issue.  If you do both–herbs and acu together–it’s far more efficient and you’ll get relief up to 40% faster.


How can Chinese herbal medicine help with this?


Energetically, the Earth element holds and gives day to day energy. This can get depleted over time, through overworking and not resting enough. Both of those seem to be requirements of pregnancy, childbirth and having a newborn! Running a deficit on Qi is frequently seen in women post-pregnancy.


In traditional systems and cultures, mother and baby are given a confinement time to help them recover. They were cared for, fed nourishing soups and foods (often with herbs added!) to help build them up and rest from their journey.


The Earth element also helps hold everything up and in place. When the Earth energetic is depleted, we feel depleted and tired. We fall asleep, our arms and legs feel lethargic, we may get symptoms like fuzzy-headedness, varicose veins, and as it gets more depleted, stronger symptoms like leaking urine, prolapsing organs and fatigue. Coffee becomes something we rely on to get us through each day.

And while everyone needs a formula modified for them specifically, there is an archetypal formula for this problem, that nourishes and lifts the Earth element back to where it should be: Bu Zhong Yi Qi Tang, or Tonify the Middle and Augment the Qi. Simply put, the formula builds up your Earth element, gives you energy, helps you digest and eliminate properly without giving false energy like coffee or energy drinks.  Bu Zhong Yi Qi Tang makes a deposit in your savings account, not running up a credit card bill with false energy like caffeine. Historically, in the middle ages in Japan, it was used after times of war for physical depletion and recovering from the problems seen during wartime like inadequate nutrition.


Please don’t go online and just order a bottle. In an acupuncture and herbal medicine practice, nothing is prescribed without talking to the person in-depth about ALL health concerns and taking into account all factors. Sometimes there are other imbalances contributing to the problem, and this formula alone, unmodified, is not what is needed. Take the time to visit an acupuncturist, or find an herbalist (like me!) who offers distance consults.


If you are still breastfeeding, you can take this formula, in most cases, while breastfeeding. (There’s also an amazing postpartum formula that can help for the six months to a year after birth.)


You don’t have to keep suffering with this, and you don’t have to miss out on things because of it!

For the herbalists reading this, I want to talk about Western herbs that could be used along with or instead of the Chinese herbal formula Bu Zhong Yi Qi Tang.


The classic ingredients in BZYQT are:

  • Ren Shen ginseng
  • Bai zhu atractylodes
  • Huang qi astragalus
  • Dang gui angelica
  • Chen pi tangerine peel
  • Da zao dates
  • Chai hu bupleurum
  • Zhi gan cao honey-fried licorice
  • Sheng ma cimcifuga


I have a few issues with this formula has an herbalist today:


First, it’s hard to find Ren Shen ginseng sustainably grown and harvested. One indicator is that the price has gone up exponentially in the last decades. Second, Ren Shen is warming and I find with many women experiencing these imbalances, especially post-pregnancy, heat is a factor and Ren Shen is just too warming. You COULD switch for Xi Yang Shen American ginseng, which is more cooling, but again you run into factors of cost and sustainability. Better is to use Rhodiola (you can now get it sourced organically from Canada) or another substitute like Dang Shen codonopsis.

  1. I’ve found in practice that Chai Hu can have adverse reactions, like feeling ‘heady’ or having a headache or getting too much energy rushing up. The substance (yin, blood) can be insufficient to balance the upward and outward energy. Chai Hu is very moving and a release exterior herb.


For these, I would lower the dose of Chai Hu or eliminate it Sheng Ma and Huang Qi are still there to lift the qi, and Bai Zhu continues to tonify the spleen qi.


In Western herbs, you have options to recreate this formula:


  • Rhodiola (as I mentioned above, now we can get organic Rhodiola grown in Canada! I was super excited to see Mountain Rose offer this option.)
  • Astragalus (Huang Qi) is easily available, and is a key player in this formula for it’s earth-building and lifting abilities.
  • Elecampane, like Bai Zhu, helps the spleen, especially in it’s dampness elimination. Honey-frying it makes it even more spleen qi tonifying and, in my opinion, the honey-frying makes it more analogous to Bai Zhu.
  • Black cohosh in the Western pharmacopeia is fairly analogous to Sheng ma
  • Goji berry is amazing in its ability to build blood, and can be grown in many parts of the US. Also, cheaper than Dang Gui angelica. Along with or instead of Goji, you can use:
  • Milk thistle–I love milk thistle. It is a Liver blood and yin tonic, it also helps the Spleen, and can help harmonize the Liver/Spleen Wood/Earth dynamic.
  • Chamomile or citrus/orange peel to move qi in the middle jiao. Moving qi in the middle jiao also helps with any fluid management problems, further helping the spleen.


A star of any formula for the Earth element is Bai Zhu atractylodes, a workhorse herb that isn’t glamorous, isn’t expensive but works hard at keeping the earth element functioning, keeping the tank full for the stomach and spleen energies. Elecampane is somewhat similar, but if I could find any herb to be grown locally and add to the toolboxes of Western herbalists, it would be Bai Zhu. Keep your expensive ginseng in the vast majority of cases and give me Bai zhu to get the work done without fanfare and a hefty price tag.


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