Wounds That Won’t Heal, Even Urine Leaking From the Belly? Doctor Zhang Xichun’s Case Treated with Raw Astragalus, Mending the Rotted Abdomen from the Inside Out
What people search for: wounds that won’t heal / chronic sores / a sore that never closes / a pale, lifeless wound Corresponding medical terms: chronic non-healing wounds (jiu bai chuang) · fistula (lou dao) · surgical sore · insufficiency of upright qi (zheng qi)
Opening scene: the case that stumped every doctor in Shenyang
Today’s story is a frightening one. A man in his early thirties had everything below his navel rot away — until, in the end, urine began to leak out of five holes in his belly. At the time, the Chinese physicians of Shenyang, the Western physicians, even the Japanese-run Western hospital — every one of them shook their heads and said there was no way to treat it. But when Doctor Zhang Xichun examined him, he said only: “This condition can still be treated (ci zheng shang ke wei).” Bowl after bowl of herbal decoction went in — more than twenty doses — and he actually mended that rotted-through abdomen from the inside out.
💬 Note from Doctor Luo: This case is Doctor Zhang Xichun’s masterpiece of using raw astragalus (sheng huang qi) to treat a surgical disease. First, some background: when Doctor Zhang Xichun used astragalus, he almost always used it raw — he rarely used the honey-fried form. I used to think raw astragalus worked mainly on the body surface — moving through the channels and protecting the stomach qi — while honey-fried astragalus (which in transcribed speech is often heard as “mi zhi huang qi”) tonifies the middle more strongly. But Doctor Zhang Xichun preferred raw astragalus for the most part, and my own experience now is the same: honey-fried astragalus very easily makes people hot, which is why famous senior doctors use it only in small doses; raw astragalus, by contrast, can be used in very large amounts without problems.
Who was the patient? — a clerk at Fengtian Higher Normal School
The patient was named Zhang Jishan, a clerk (shu ji) at Fengtian Higher Normal School. Don’t misunderstand the word “shu ji” — in those days it didn’t mean what “secretary” means today; it was simply a clerical job, a clerk or assistant. He was not old — in his thirties. Fengtian is the city we now call Shenyang.
The cause: a dose of “toxin” that never got out
How did the illness begin? According to Doctor Zhang Xichun’s record, the man had caught damp-toxic qi (shi qi zhi du) — he had suffered some external invasion, an infection of some toxic qi; the original text does not say exactly what the toxin was. Normally such a toxin should be gradually drawn outward and released. But the doctors he saw first handled it wrongly — they did not know how to vent and resolve it (xuan jie). As a result, instead of coming out, the toxin moved downward and sank inward, and finally stirred up a great disaster in the lower burner (xia jiao).
💬 Note from Doctor Luo: Here is a way of thinking about disease that I hope everyone remembers: when the body is invaded by an external toxin, the rule is “vent it out” (tou) — let the pathogen leave through the body surface. If the doctor gets the direction backwards and presses the toxin inward, a small illness turns into a great one. This lesson holds in every era.
How sick was he? — everything below the navel rotted through, and urine poured from five holes
After the toxin sank into the lower burner, everything from the navel down swelled up, and then began to ulcerate. How terrible was the decay? His testicles were exposed; and in the ulcerated area of the lower abdomen (shao fu), five holes broke open. Worst of all, whenever he urinated — all five holes passed urine at once, leaking it out together.
💬 Note from Doctor Luo: What had actually formed here was a lou dao, the passage that ordinary people call a fistula: a channel or tunnel forms inside the flesh, connecting with the ureter, so that when he urinated, the urine leaked out through these holes. I have seen fistulas that refuse to heal for years — they are extremely intractable. In that era, both Chinese and Western medicine considered this case untreatable.
Seeking help: every doctor in Shenyang shook his head
Shenyang was not without good physicians — it had Chinese medicine doctors, Western doctors, and even a Japanese-run Western hospital. But after examining him, they all said the same thing: there is no cure. The patient was carried to the Lida Hospital of Chinese Medicine (Li Da Zhong Yi Yuan) that Doctor Zhang Xichun had founded. He was terrified, certain he was going to die — and who could blame him? Anyone who saw that sight would have been frightened.
What did Doctor Zhang Xichun think? — the most crucial stroke of the whole case: grow from the inside out
After making his diagnosis, Doctor Zhang Xichun first did the psychological work: “Don’t worry, there’s nothing to fear — this condition can still be treated (ci zheng shang ke wei).” But he also made it clear: I will not use external medicines for you; you must take plenty of decoctions, and the wound will grow from the inside out.
💬 Note from Doctor Luo: This is the watershed in treatment strategy. Many people today treat fistulas and sores by habit — applying medicine from the outside. The result: the outside closes up, but the fistula inside remains, the pus still cannot drain, and the disease never heals. Doctor Zhang Xichun did the opposite: he gave medicine internally, let the pus drain out little by little, and the disease was cured. When treating a surgical disease, think first of regulating the interior — that is Doctor Zhang Xichun’s great principle.
The prescription: six herbs — one to tonify qi and carry out the toxin, the rest to clear and resolve
The formula was very simple, just six herbs:
Raw astragalus and trichosanthes root (tian hua fen), one liang (about 30 g) each; frankincense (ru xiang), myrrh (mo yao), honeysuckle flower (jin yin hua) and licorice root (gan cao), three qian (about 9 g) each.
💬 Note from Doctor Luo: The composition of this formula is highly deliberate. Raw astragalus tonifies the upright qi and carries the toxin outward (tuo du) — it is the absolute sovereign herb (jun yao). Trichosanthes root clears heat and generates fluids, resolving the heat of the toxin. Frankincense and myrrh — Doctor Zhang Xichun explained specifically that these two herbs move qi and relieve pain, and have the effect of promoting wound healing. Honeysuckle flower is the saintly herb for clearing heat and resolving toxin. Licorice harmonizes all the herbs. One tonifies, one clears, and four help push outward: build the upright qi up to full strength, and let the sore expel its pus and grow its own flesh.
After twenty-odd doses: the flesh grew back, the pus drained, and a scar sealed the wound
What was the result? After more than twenty doses, the ulcerated area began to grow new flesh, the pus drained out bit by bit, and at last a scar formed — he was well. Throughout the entire course, not one grain of external flesh-promoting medicine was used.
💬 Note from Doctor Luo: But please don’t learn this lesson the wrong way — raw astragalus is not for every kind of wound. When astragalus is used for trauma, the pattern must be insufficiency of upright qi (zheng qi bu zu): the wound refuses to heal for a long time, its color is pale and white, with no fresh red granulation tissue. Only then is it the right herb. In hospitals today there are elderly patients who stay in for months; their wounds are dressed every day but simply will not close, the wound surface pale and stale, not healing for a month or two — that is insufficiency of upright qi. Tonify the upright qi, and the wound closes by itself.
Why is raw astragalus so miraculous for wounds? — the nemesis of the chronic non-healing sore
That raw astragalus can treat wounds was recorded in ancient times. The Shennong’s Classic of the Materia Medica (Shennong Bencao Jing) states that astragalus governs the chronic non-healing sore (jiu bai chuang) — and what is a jiu bai chuang? It is exactly the sore that never gets better, never closes over. Doctor Zhang Xichun believed astragalus was truly effective for this, and so it proved in fact.
💬 Note from Doctor Luo: This gives us an important insight: external wounds can be regulated internally. Many injuries fail to heal over a long time because something is wrong inside the body — the qi and blood are not moving through, the upright qi is insufficient. Regulate the interior, and the outside recovers quickly; the body’s power of repair is in fact very strong. That is also why I sometimes recommend stewing san qi (notoginseng) with chicken leg bones into a soup to help fractures recover — the same idea: invigorate the blood and unblock the channels from within, so that qi and blood move freely and the bone knits as fast as possible.
Bonus: Bazhen Gao and Doctor Xue Lizhai — the “internal regulation” skill of the surgical masters
When it comes to treating surgical disease by regulating the interior, two names must be mentioned:
💬 Note from Doctor Luo: The first is Bazhen Gao (Eight-Treasure Cake, 八珍糕). Many people think Bazhen Gao is for building children’s strength and treating allergic rhinitis — but in the past it was a formula that Chen Shigong (陈实功), the great Ming dynasty surgical master, prescribed specifically for patients with long-unhealing wounds and sores: when the patient’s upright qi was insufficient and the swelling would not heal, eating Bazhen Gao to build up the upright qi allowed the wound to heal quickly. The second is Doctor Xue Lizhai (薛立斋, also known as Xue Ji, 薛己), the famous Ming dynasty physician. He became famous through surgery — he was a surgical master — yet look at the formulas he wrote: a great many of them regulate the interior of the body. This is the Chinese medicine approach to surgical disease: do not clash head-on with the local lesion; first stabilize the “rear base” of the body.
💬 Note from Doctor Luo: Starting tomorrow, we will talk about another lifesaving weapon in Doctor Zhang Xichun’s hand — Huai yam (怀山药), the genuine, authentic yam produced in Huaiqing Prefecture, Henan. Remember the secret of Doctor Zhang Xichun’s use of astragalus: raw astragalus; and when emergencies struck, he had another herb he used even more often — find out what it is tomorrow.
Compiled from Doctor Luo Dalun’s narration of Doctor Zhang Xichun’s medical cases; the original case comes from Yixue Zhongzhong Canxi Lu (Records of Chinese Medicine with Reference to Western Medicine).