Chronic Dysentery That Turned into an Intestinal Ulcer?

The patient and how he got sick

The patient was Yang Qingxi, 35, a businessman from the Yang family stone bridge in Cang County.

💬 Note from Doctor Luo: Notice that Doctor Zhang Xichun always records the patient’s occupation at the very start of a case — that’s not a throwaway detail. What’s the life of a businessman like? Constant worry, constant stress. When business is good, fine; when it’s bad, the mind churns.

Mr. Yang had run a weaving factory in Tianjin. It kept losing money and finally closed. He was left with a heavy knot of frustration and resentment in his chest.

That emotional blockage quietly generated internal heat, which pressed down from the liver and gallbladder into the digestive system. Then came contaminated food — he caught dysentery. It dragged on without healing and slowly turned into an intestinal ulcer.

💬 Note from Doctor Luo: The path is clear: emotion is a major trigger for these gut diseases. In TCM terms, “the wood of the liver runs wild and attacks the earth of the spleen” — when your mood sours, the digestive system suffers first. Western medicine agrees: the gut is lined with billions of neurons that are exquisitely sensitive to emotion. So many cases of chronic colitis and chronic diarrhea are tightly linked to stress and mood. The sequence here was: emotional trouble first (internal cause), contaminated food second (external cause), dysentery that never healed, and finally an intestinal ulcer.

How sick was he?

It began as dysentery with tenesmus — urgent cramping in the belly, frequent runs to the toilet, passing little, never feeling finished, pain unchanged.

Within one day and night he had 17 or 18 bowel movements, dark in color with fresh blood and white mucus. Two months of treatment changed nothing; the illness worsened. What came out was mostly bloody fluid mixed with shreds of intestinal lining, rotten in color and rank in smell.

After that, any belly pain meant an urgent dash to the toilet — more than 20 times a day and night. With all that blood loss he grew weak, his mouth dry, his heart pounding with anxiety. His pulse was thin and wiry on both wrists, the left one hard as well; about 92 beats per minute.

💬 Note from Doctor Luo: How severe was this? More than twenty bowel movements a day, mostly bloody fluid, even shreds of intestinal lining — today this is textbook severe ulcerative colitis. Such patients are not rare. A gut that damaged is a very complicated situation.

The key move: what was the real problem?

Doctor Zhang Xichun reasoned: when dysentery goes on and on, the fatty membrane lining the intestine rots, and rot deepens into ulceration — hence the bloody fluid and membrane in the stool. This was the old “intestinal ulcer” disease.

The thin, wiry pulse showed both qi and blood exhausted; the hard left pulse showed liver and kidney yin depleted; the dry mouth came from heavy blood loss (blood and fluids share the same root); the pounding heart came from blood no longer nourishing the heart.

💬 Note from Doctor Luo: Watch this. Most doctors, seeing bleeding this severe plus belly pain, would immediately think: “The evil qi is raging — clear the damp-heat, attack the pathogen!” But Doctor Zhang said: you’ve been sick for two months, your body is this weak — the main problem now is deficiency, not excess. The priority is to rebuild qi and blood, to lift up the root, with only a little detoxifying and blood-moving support on the side. Knowing when to strengthen and when to attack — that stage judgment is the most valuable lesson in this whole case.

The prescription: three heavy tonics as the foundation

💬 Note from Doctor Luo: Three main herbs at 30 g each — that’s a heavy dose, aimed squarely at pulling the qi and blood back up.

• Longan fruit: sweet, enters the spleen to build spleen qi; red, enters the heart to nourish heart blood and calm the spirit — it strengthens both heart and spleen. Strengthening the spleen also gives it power to “hold the blood,” so it specifically treats bleeding from spleen weakness. This patient’s pounding heart? Just right.
• Chinese yam: the real thing from Wen County, Henan. Strengthens the spleen to hold blood, and is a classic for spleen-deficient diarrhea — it both nourishes blood and stops loose stools.
• Prepared rehmannia: also from Wen County. When a person is depleted to the roots, you must restore kidney essence and kidney yin — rebuild the foundation.
• Honeysuckle: clears heat and detoxifies — the heat pathogen is still there and must be addressed.
• Licorice: harmonizes the formula and helps detoxify.
• Notoginseng powder: the finishing touch — treat the ulcer in the gut like a wound on the skin. Notoginseng removes dead tissue and promotes new growth, so the ulcer can heal over.

Three doses, and the disease was mostly gone

After three doses, the illness was more than half resolved: bowel movements dropped to three or four a day, the bleeding stopped, the pounding heart quieted, and the hard quality of the left pulse softened.

💬 Note from Doctor Luo: Logically he could have stayed on the same formula. But oddly, the next few doses produced no further progress.

Doctor Zhang thought it over: with dysentery this chronic, there might be parasites (amoeba-like organisms) living in the gut. He added to the formula: sheng liu huang (sulfur) to warm yang and kill parasites, and ya dan zi (brucea seeds), 60 whole seeds, swallowed with the decoction.

💬 Note from Doctor Luo: Brucea seeds are wonderfully effective against stubborn gut infections — but there’s a rule: they must never be broken. The oil inside is corrosive; broken seeds cause nausea, vomiting and belly pain. The classical trick was to wrap them in longan pulp and swallow whole; today people use capsules. Any cracked seed must be picked out. Doctor Zhang prized this medicine and said it cured many baffling cases — yet today almost nobody uses it. I’ve asked many TCM colleagues; the answer is always “I’ve heard of it, never used it.” It’s become one of the puzzles of studying Doctor Zhang Xichun.

Result: still bloody stools several times a day. No clear improvement.

The finishing touch: one mineral, five doses, cured

Doctor Zhang changed the formula: longan 30 g, fresh Chinese yam 30 g, prepared rehmannia 30 g, licorice 9 g, notoginseng powder 9 g (as before), plus chi shi zhi (halloysite), 30 g, pounded fine, simmered in the same pot, with the notoginseng taken in the strained liquid.

💬 Note from Doctor Luo: Halloysite is a mineral — today’s “smectite” used for children’s diarrhea is essentially the same kind of thing. It has three great powers: astringent anti-diarrheal action (absorbs water and firms the stool), adsorption of filth (draws out the bad stuff in the gut), and stopping bleeding while helping wounds heal. It’s one of the oldest medicines in the Chinese pharmacopeia — the main ingredient of the famous Tao Hua Tang (Peach Blossom Decoction) in the Shang Han Lun, specifically for long-standing dysentery and bloody stools.

One warning: when a live pathogen is still present, don’t use halloysite alone — pair it according to the pattern, with damp-heat clearing herbs or yang-warming herbs. Chinese medicine is all about combination.

After five doses, the bleeding stopped completely. His mouth was no longer dry; he had two or three stools a day, soft but no longer painful.

The crisis past, he stopped the decoction and finished with food therapy: 30 g of Chinese yam powder daily, cooked into a thin porridge-drink (with a little sugar), taken as a snack. Gradually the stool firmed up completely.

What this case teaches us

1. Stage judgment — strengthen or attack — is the real skill. An old hand like Doctor Zhang saw at once that deficiency was the main problem. Many people treating gut disease panic at the sight of blood and charge in attacking the pathogen, staring only at the local lesion. Doctor Zhang instead filled up the qi and blood first — when the foundation is strong, the body heals itself. That’s the real thinking.

2. Notoginseng powder for intestinal ulcers. When the gut is ulcerated or eroded, notoginseng removes dead tissue and grows new flesh — taken internally, it works.

3. Halloysite for stubborn diarrhea. When diarrhea simply won’t stop, consider chi shi zhi — one of the oldest astringents in Chinese medicine.

A bonus food-therapy story

💬 Note from Doctor Luo: One more story to close with —

A five-year-old boy had eaten fruit all summer and wrecked his spleen. Come autumn, the diarrhea poured out — first loose stools, then dysentery. Two months of it, and he was thinner and weaker no matter what was tried. Doctor Zhang’s prescription was so simple it was almost unbelievable: duck liver! One duck liver a day, boiled, eaten twice daily. After just two days, the dysentery was cured.

This wasn’t even Doctor Zhang’s own formula — it was the secret recipe of his friend Qi Ziyun in Shenyang. Qi Ziyun was the head of the Shenyang tax bureau and Doctor Zhang’s devoted admirer — in fact, he was the one who insisted on bringing Doctor Zhang to Shenyang to found China’s first TCM hospital, the Lida Hospital of Chinese Medicine.

Doctor Zhang reasoned the prescription made sense: gut trouble is often linked to the liver channel, and duck liver nourishes the liver by the principle of “like treats like.” A five-year-old, dysentery for two months, cured in two days with duck liver — Doctor Zhang recorded it, so the reliability is high. Next time you meet dysentery, duck liver is worth a try.

Case source: Records of Chinese Medicine with Western Reference by Doctor Zhang Xichun; commentary based on public lectures by Doctor Luo Dalun (PhD in TCM diagnostics, Beijing University of Chinese Medicine).