Coughing Up Blood for Years That Won’t Heal? Doctor Zhang Xichun’s Experience Using Shan Yu Rou (Cornus Fruit) to Stop the Bleeding
What people search for: coughing blood / vomiting blood / coughing up blood-streaked sputum / night sweats / sweating while sleeping Corresponding medical terms: coughing blood (ke xue) · vomiting blood (tu xue) · hemoptysis · bleeding from injury to the internal collaterals
Opening scene: how can a single astringent herb stop bleeding?
Last time we got to know shan yu rou — cornus fruit (dogwood fruit), one of the most intriguing herbs in Doctor Zhang Xichun’s hands. Today we continue the story, because shan yu rou has a second talent that nobody expected: it is remarkably good at stopping bleeding.
💬 Note from Doctor Luo: Let me first recap what we covered before. Shan yu rou (shan zhu yu, cornus fruit) has the ability to astringe and secure the body’s original qi (yuan qi), and it can also unblock the channels — the kind of pain in the lower back, legs, chest, or abdomen that comes from anger damaging the qi and blood and blocking the channels, shan yu rou clears and soothes very well. That was last time. Today we look at another wonderful use of its astringent nature: stopping bleeding.
Doctor Zhang Xichun’s own words: when a vessel breaks, it can close it shut
Doctor Zhang Xichun’s understanding of shan yu rou as a hemostatic is stated very plainly. He held that the nature of shan yu rou is excellent for treating rupture of the internal blood vessels or the collaterals of the lungs, so that long-standing cases of coughing blood and vomiting blood finally heal.
💬 Note from Doctor Luo: What he meant is — when a blood vessel inside you has broken and the bleeding goes on and on no matter how long you treat it, shan yu rou, with its astringent nature, can close it up and cure you. And where did this insight come from? He did not dream it up sitting in his study — Doctor Zhang Xichun discovered it by chance, then tested and verified it again and again.
Who was the patient? A young woman in Luzhuang Village, Cangzhou, coughing blood for three years
The patient was a young woman surnamed Ma, from Luzhuang Village in Cangzhou, who had been coughing blood for three years.
💬 Note from Doctor Luo: Where did the blood come from? She herself could not say — was it blood from the lungs or from the stomach? Unclear. Our analysis is that it was blood from the lungs, because it came up by coughing. Three years of coughing blood, with a hundred remedies tried and none working — no matter what treatment, it would not heal. Occasionally it would ease for a short stretch, then immediately flare up again. For three years she suffered terribly.
At last her family called in Doctor Zhang Xichun. When he arrived, he first asked about her symptoms — and found a crucial clue.
The key clue: drenched in sweat every night in bed
The young woman had profuse sweating at night — every night when she slept, she sweated heavily. In Chinese medicine this is called night sweats (dao han).
💬 Note from Doctor Luo: Night sweats usually belong to yin deficiency — of course, yin deficiency does not rule out qi deficiency; some people with qi deficiency also have night sweats, but the majority are yin deficient. Doctor Zhang Xichun reasoned: let me first treat your night sweats. Because the constant sweating shows that the qi and blood are insufficient and the upright qi (zheng qi) is not secured — and there may be some yin deficiency with heat. So he decided to astringe first. Shan yu rou also has some yin-nourishing action — it nourishes yin and blood, astringes, and gently tonifies at the same time.
The prescription: three astringent herbs, one liang each
The formula Doctor Zhang Xichun used was his familiar combination — shan yu rou (cornus fruit), sheng long gu (raw dragon bone), and sheng mu li (raw oyster shell), one liang (about 30 g) each, boiled into a decoction to drink.
💬 Note from Doctor Luo: Notice — this is his customary combination: shan yu rou astringes, and long gu and mu li are astringent too. One liang each is a fairly large dose. Doctor Zhang Xichun only intended to stop the sweating first. But then something completely unexpected happened —
Sweating stopped after one dose, bleeding stopped after two — Doctor Zhang Xichun was stunned
After the first dose, the sweating stopped. The next day she took another dose, and what happened? The coughing of blood was cured from then on.
💬 Note from Doctor Luo: Doctor Zhang Xichun was a man who loved to ponder. In his early clinical years he accumulated a vast store of experience — and how did he accumulate it? Exactly this way, adding a little understanding with every single use of a medicine. This is the precious quality of the old masters. Why did he end up with such extraordinary experience? Because every time he used a remedy, he asked himself: why does this work? Through this case he wondered: after shan yu rou was used, why did the bleeding stop?
The principle he worked out: when the collaterals break, you must “close” them
Doctor Zhang Xichun’s analysis: when coughing blood refuses to heal after a long time, the problem must lie in the collaterals (luo mai) of the lungs — the collaterals have ruptured, so the blood cannot be stopped.
💬 Note from Doctor Luo: Here I need to explain the difference between the channels (jing) and the collaterals (luo). What are the channels? They are the great thoroughfares, the major pathways. And the collaterals? The fine, tiny passageways. They are different — the collaterals are extremely small channels. If there is a break in the collaterals of the lung, or in the blood vessels of the stomach, then shan yu rou used together with long gu and mu li can astringe, sealing the rupture in the collaterals and stopping the blood. That is Doctor Zhang Xichun’s insight.
Another case: cousin Zhang Quan, vomiting blood every day
Later, Doctor Zhang Xichun put this method to use. In his home village there was a cousin named Zhang Quan, in his thirties. At first he vomited mouthfuls of blood several times a month — once every ten days or half a month. Gradually it developed until he vomited every single day, and repeated treatments all failed — nothing could cure him.
💬 Note from Doctor Luo: Because word had spread that Doctor Zhang Xichun could now treat illness, the cousin invited him over. Doctor Zhang Xichun took his pulse — the pulse was level and calm, with only the slightest hint of a hollow quality (kou xiang).
The hollow pulse: a pulse that feels empty when pressed down — the signature of blood loss
What is a hollow pulse (kou mai)? It is like pressing down on a scallion stalk — the vessel feels hollow at the core; when you press down, underneath is empty. Even just a hint of that feeling is a sign of blood loss.
💬 Note from Doctor Luo: The pulse felt level, but carried a hollow quality — meaning the blood was already depleted. Doctor Zhang Xichun thought: in this state, I will astringe again. So he used the same three herbs — shan yu rou, sheng long gu, sheng mu li — and the cousin recovered completely in three doses. Just three doses of medicine and he was well.
Cured in three doses — and with san qi powder added, it healed almost effortlessly
Later, Doctor Zhang Xichun began adding a little san qi powder (notoginseng) to this formula — three qian (about 9 g) of fine san qi powder, taken down with the strained decoction — and used it for these long-drawn-out, never-healing cases of vomiting blood and coughing blood. The result: they all healed almost effortlessly.
💬 Note from Doctor Luo: Everyone, this is one of Doctor Zhang Xichun’s experiences. In fact, this kind of experience is rarely used today — who treats coughing blood with shan yu rou anymore? But Doctor Zhang Xichun’s experience is genuinely worth studying. Why? Because it all came from practice, and there is not a word of exaggeration in it — in every case he recorded the patient’s address and name. This is absolutely solid, down-to-earth experience. If we dig into it, we may well find new ideas for treatment.
Half a million formulas: a treasure house waiting to be mined
Doctor Luo then widens the lens from Doctor Zhang Xichun alone to the whole treasure house of Chinese medicine:
💬 Note from Doctor Luo: Ideas and methods like this are found in enormous numbers throughout every dynasty of Chinese medicine. The methods of Chinese medicine, counted up, number in the hundreds of thousands — over half a million formulas. Among those half a million formulas, a great many are the fruits of our predecessors’ practice, refined through massive clinical use. If we study them today, the gains could be enormous. Think about it — Tu Youyou found artemisinin in the Zhou Hou Bei Ji Fang (Handbook of Prescriptions for Emergency Treatments) and went on to win the Nobel Prize, contributing to the health of all humanity. If we genuinely research the formulas of Chinese medicine and study the proven effective ones, the future is very likely to yield many new approaches to treatment. This is one of the special strengths of the Chinese materia medica.
What you really learn: the way of thinking that infers from one case to many
Of course, Doctor Luo also adds an important caution: learning that shan yu rou stops bleeding does not mean you can treat every person who spits blood —
💬 Note from Doctor Luo: We are not saying that once you learn this, you can treat anyone you see vomiting blood or bleeding from the stomach — not necessarily. What we are teaching you is a way of thinking. More important still: learn from Doctor Zhang Xichun’s spirit of thought and exploration. He simply reasoned — shan yu rou can astringe — then he tried it in practice, discovered that it stopped the bleeding, and thereby broke out of the herb’s usual range of uses, extending it to hemostasis. This shows that Doctor Zhang Xichun’s thinking has the quality of drawing inferences from one case (ju yi fan san). If we learn this way of thinking and apply it to problems in our own lives, we may achieve breakthroughs in any field we work in — this is what we want to pass on to you.
What else can shan yu rou do?
To close, Doctor Luo fills in the last corner of the portrait of shan yu rou:
💬 Note from Doctor Luo: The final characteristic of shan yu rou is — excellent at stopping bleeding. Doctor Zhang Xichun believed shan yu rou has other qualities too: for example, in critical signs such as sweating all over the body without stopping, or convulsions of the four limbs, he would also turn to shan yu rou. That is all for today. What will we discuss tomorrow? We begin on huang qi (astragalus) — this herb is especially important, and Doctor Zhang Xichun was especially skilled with it. Tomorrow we’ll look at exactly how Doctor Zhang Xichun used astragalus.
Compiled from Doctor Luo Dalun’s commentary on Doctor Zhang Xichun’s medical cases; the original case comes from the Yixue Zhongzhong Canxi Lu (published in installments c. 1918–1934).