Stomach Pain So Bad He Couldn’t Sit Up? Doctor Luo Tianyi’s Fuyang Zhuwei Tang (Yang-Supporting Stomach-Helping Decoction)

Opening scene: twelve characters that paint the whole constitution

💬 Note from Doctor Luo: Today’s patient is a rich man’s son — the eldest son of the Salt Transport Commissioner of the two Zhejiang and Jianghuai regions (surname Cui). His name is Cui Yunqing, 25 years old — an age when a man should be at the peak of his strength.

Doctor Luo Tianyi sketched this man’s condition in a few strokes (twelve characters):

• Ti ben feng fei (naturally stout and overweight) — he was a chubby fellow to begin with
• Feng yang gao liang (fed on rich, fatty food) — he ate extremely well (his father was an official, so he grew up white and plump)
• Shi you re zheng (frequently had heat symptoms) — he often felt hot

💬 Note from Doctor Luo: Why do overweight people always feel hot? Because they eat too well — the nutrients stagnate inside and generate heat; and what the body can’t absorb turns into phlegm-dampness, and phlegm-dampness that builds up over time produces heat.

Do fat people have sufficient upright qi? People assume a fat person looks solid and substantial, but in fact the upright qi of such people is often deficient — the form (body) scores 150 points, while the qi (the invisible) only scores sixty or seventy — it cannot govern the body. The more the body flourishes, the more qi it consumes, and the more qi is depleted — so among the obese, deficiency is the rule, not the exception. Keep that thought — you’ll see why later.

One injury after another: cold medicine, malaria, arsenic, well water…

Because he always felt hot, people urged him to eat more cooling foods (watermelon and other cold-natured things) and take cold, fire-dispelling medicines.

Then in the autumn of the gengchen year of the Zhiyuan era (1280), he caught malaria, and it dragged on for a long time without healing.

💬 Note from Doctor Luo: Why did he catch malaria (an externally contracted illness) so easily? Insufficient upright qi. Essentially every externally contracted disease is the result of internal and external factors working together — malaria parasites are everywhere and spread from person to person, yet some people catch them and some don’t; it all depends on whether your upright qi is sufficient. This young man was fat and weak (basically never exercised), heavy with phlegm-dampness, deficient in upright qi, and on top of that had damaged his spleen and stomach with cold food — first deficiency, then added cold, then external pathogens — and infection becomes easier. It was the stacking of one factor on another.

The doctor treated his malaria with arsenic (a violent medicine), to be taken with xin ji shui (freshly drawn well water — cold water straight from the well), and told him not to eat anything hot (only cold food). The result: the malaria didn’t improve — instead he got vomiting and diarrhea, and his spleen and stomach were badly injured!

💬 Note from Doctor Luo: His middle qi had never been sufficient to begin with (he panted after walking, sweated when tired, and had a pale face). Now his spleen and stomach grew even weaker: abdominal pain with rumbling bowels (his gut gurgled audibly) and pain right at the pit of the stomach (pain in the center of the stomach region so bad he couldn’t bear it). This illness was self-inflicted, step by step — first he ate his way to obesity and depleted his middle qi, then he was persuaded to eat cold food, then he caught malaria and was dosed with arsenic and cold well water… layer upon layer, with a quack doctor’s help pushing it along — the spleen and stomach were thoroughly wrecked.

Dragging on into the fourth month: overwork and worry, the old symptoms erupt

He went home in the winter and tried every kind of treatment without success, until it dragged on to the fourth month. Then, on top of everything, came excessive labor and worry (physical exhaustion + anxieties + emotional strain), and all the old symptoms erupted — worse than ever. Only then did the family call in Doctor Luo Tianyi.

Doctor Luo Tianyi’s diagnosis: pulse and symptoms considered together

Taking the pulse: the pulse was wiry, thready and faint; his hands and feet were slightly cold (jue ni — cold reversal, yang qi unable to reach the extremities); his complexion was greenish-yellow and lusterless (yellow = spleen deficiency, green = liver qi constraint); his spirits were low (depressed); he disliked being disturbed by others (irritable when bothered); his appetite had decreased; a little food made his chest stuffy (he felt blocked after eating even a little); he vomited sour fluid; he had attacks of pain (pain on exposure to cold); he broke out in cold sweats; he was short of breath, restless and agitated; he was so weak he could only sit propped against someone else (he needed another person to brace him before he could sit up) — he was severely debilitated.

💬 Note from Doctor Luo: Whenever Doctor Luo Tianyi treats a patient, he absolutely must quote the Huangdi Neijing (Yellow Emperor’s Classic of Internal Medicine) in the case record — because treatment must have a basis:

“Zhong qi bu zu, sou bian wei zhi bian, chang wei zhi ku ming” — when the middle qi is insufficient, urination and defecation change, and the intestines suffer with rumbling. The Classic had already summarized this mechanism; memorize the Neijing well, and you’ll know where to start the moment you see a case.

“Xia qi bu zu, ze wei wei jue xin man” — when the lower qi is insufficient, the limbs grow weak (wei), qi and blood go into reversal (jue, cold hands and feet), and the heart is vexed (xin man).

“Han qi ke yu chang wei zhi jian, ze cu ran er tong, de gui ze yi” — when cold qi lodges between the intestines and stomach, sudden pain arises, and applying something warm brings relief.

So Doctor Luo Tianyi concluded: spleen-stomach weakness (insufficient middle qi) + injury from cold pathogens (cold-natured medicines, cold foods, well water) — the spleen and stomach were weak, and then they were wounded by cold.

The prescription: Fuyang Zhuwei Tang (Yang-Supporting Stomach-Helping Decoction)

Doctor Luo Tianyi said: “Only a great sweet-pungent, greatly hot formula can cure this” — you need sweet flavors to tonify the spleen plus pungent-hot flavors to warm the intestines and stomach. So he created Fuyang Zhuwei Tang:

💬 Note from Doctor Luo: This formula is remarkably precise and ingenious — warming the spleen and stomach and tonifying their qi is the core, but it also takes care of the liver (peony restraining liver yin + evodia warming liver yang). Why add liver herbs? Because his liver qi was constrained (low spirits, disliking disturbance), and constrained liver wood attacks the spleen earth horizontally; the water pathogen also rode on the liver’s strength to bully the spleen and stomach — which is why the pain came on suddenly.

How to take it: grind into a powder for one dose, decoct with three cups of water plus three slices of fresh ginger (ginger and jujube harmonize the spleen and stomach), reduce to one cup, strain and take warm.

The result: after three doses, the main force of the illness was gone (mostly well), and the pain was reduced by more than half.

Aftercare: moxibustion + Huan Shao Dan + Yuping Tang, a full year of gentle regulation

• In autumn: first moxa Zhongwan CV12 with 21 cones (to assist the stomach qi), then moxa Qihai CV6 with over 100 cones (to engender yuan qi and nourish all the channels)
• Paired with Huan Shao Dan (Return-to-Youth Pill) (a classic formula: shu di huang (prepared rehmannia), shan yao (Chinese yam), shan zhu yu (cornus), gou qi zi (wolfberry), etc. — tonifies the kidney and the five viscera, because “when lower qi is insufficient there is wei and jue” — the kidney qi was insufficient too) — after treating the spleen and stomach, regulate the root and tonify the kidney
• His appetite returned, he began to eat, gained flesh and his skin grew moist
• The next spring: moxa Zusanli ST36 with 14 cones (to tonify the spleen and stomach and guide qi downward), and Yuping Tang with added bai tan xiang (white sandalwood) to level and regulate (Yuping Tang = a spleen-tonifying formula with huai shan yao, bai zhu, ren shen, mu xiang, huo xiang, sha ren, etc., tonifying the spleen while moving qi; the white sandalwood was added for gentle tonification)
• His instructions: don’t get angry, restrain desire, talk less, be careful with speech and moderate the diet (the family’s rich food was no good for him)

The result: fully recovered after one year — an entire year, and his body was completely well.

💬 Note from Doctor Luo: Some people ask why Doctor Luo Tianyi’s treatment was so slow (a whole year to heal)? For a man like this, recovering at all was already a win — fat and weak, with damage accumulated over a very long time. Most people in this condition never get regulated properly in the end (the foundation is too poor, the fat never comes off, panting after a few steps).

This case reminds us: most complicated illnesses come from treating your body badly — piling injury upon injury, factor upon factor, and then meeting a quack who prescribes in the opposite direction, until the body finally collapses.

What Doctor Luo Tianyi shows us is the way out: regulate one thing at a time, remove one factor at a time — tonify the spleen and stomach, warm away the cold pathogen, soften and warm the liver, tonify the kidney, gently tonify the spleen and stomach while regulating qi, use moxibustion to support yuan qi and the spleen and stomach, and at the same time tell the patient how to regulate his emotions, his daily routine, talk less, stop being angry, restrain desire, and moderate his diet — adjust a little at a time, and in the end it all comes right.

Almost every serious illness is something you did to your own body with a series of mistakes. True regulation is systems engineering — step by step, respond to each problem as it appears, dig up every landmine you find, one at a time, and eventually the field is clear. Don’t be impatient; regulate slowly, and in the end it will come right — but the direction must be clear: if you truly want your body to recover, change one thing after another.

The danger is when you can’t control your desires: “Just one skewer of barbecue — oh my god, I have to eat it, I’d die happy afterwards” — and off you go for another barbecue, another drinking session. Then there’s no remedy, and no one can help you.

Case source: Wei Sheng Bao Jian (Precious Mirror of Health) by Doctor Luo Tianyi; commentary based on public lectures by Doctor Luo Dalun (PhD in TCM diagnostics, Beijing University of Chinese Medicine).