Belly Pain, Diarrhea and a Lingering Fever? Doctor Zhang Xichun Softened the Liver with White Peony Root to Stop the Wood Attacking the Earth
Patient’s search terms: belly pain / diarrhea / fever / always feeling hot / not wanting to eat / no appetite / each bowel movement is distressing Medical terms: liver wood attacking spleen earth · latent pathogen turning to heat · liver-spleen disharmony · tenesmus
Opening: the peony flower is beautiful, but its root can save a life
Everyone knows how gorgeous peony flowers are — the star of any garden. But what many people don’t know is that the peony’s root is also a medicine that can cure illness. Today Doctor Luo Dalun tells the story of how Doctor Zhang Xichun used the peony — more precisely, its root.
💬 Note from Doctor Luo: Peony root comes in two kinds — white peony (bai shao, 白芍) and red peony (chi shao, 赤芍). Today’s story is about white peony. In Doctor Zhang Xichun’s hands this herb had enormous uses — he could lecture for days about its properties and how to deploy it. Today let’s start from its single most important quality: bai shao’s power to astringe and soften the liver.
What does bai shao do? Draining the heat that floats up in the upper burner, out through the urine
What does bai shao do? It excels at nourishing yin and blood, and can clear heat and ease vexation. Doctor Zhang Xichun held a distinctive view — he believed bai shao can restrain the heat that floats up and disperses in the upper burner, pulling that heat downward until it is finally drained out through the urine.
💬 Note from Doctor Luo: Think about the logic: heat floating emptily in the upper burner that can’t be pressed down — bai shao drags it down and sends it out through the urine. That’s why Doctor Zhang Xichun considered bai shao the principal herb for people with yin deficiency with heat and poor urination — scanty urine with a lurking deficiency heat: bai shao is exactly the right match.
Why does bai shao “soften the liver”? When the liver has blood, it stops bullying the spleen and stomach
Because bai shao tastes sour, and by the doctrine of flavors entering meridians, a sour flavor enters the liver meridian and generates liver blood. In plain words — bai shao can soften the liver. When the liver is nourished by blood it stays gentle — it won’t become that “stiff” and won’t stir up wind; but if the liver runs out of blood, trouble begins, and the liver wood will harm the spleen earth.
💬 Note from Doctor Luo: Doctor Zhang Xichun also held that bai shao tastes slightly bitter and enters the gallbladder, benefiting the bile. Sour with a touch of bitter, cool in nature, it can drain heat from the liver and gallbladder and resolve the tenesmus of dysentery — that feeling where your belly hurts, still hurts after you’ve gone, and each bowel movement is truly distressing. Today we’ll put exactly that to use.
Who was the patient? A Mr. Chen in his forties, living in Fengtian city
Doctor Zhang Xichun used bai shao with great flexibility. Today’s example: a Mr. Chen who lived at Daxiguan in Fengtian (today’s Shenyang), in his forties. From midway through the first lunar month, he kept feeling hot — what Doctor Zhang Xichun often described as “heat in the heart region” (心中发热), a heat he sensed within himself — and he was lazy to eat, without any appetite.
💬 Note from Doctor Luo: Notice — this is not a cold with a fever. It is a chronic, internal sensation of heat. And that heat dragged on and on, from the first month all the way to late spring, growing worse as it went.
How sick was he? Belly pain, diarrhea — and every bowel movement was a misery
By late spring the heat had grown worse, and he now suffered frequent abdominal pain — his belly ached — and at the drop of a hat he would have diarrhea, loose bowels. The worst part: each bowel movement was distressing. Even after going, the belly still hurt.
💬 Note from Doctor Luo: This sensation — “still hurting after you go, each movement distressing” — is what Chinese medicine calls tenesmus (里急后重, li ji hou zhong). Friends, this symptom carries great diagnostic value: it usually points to the liver and to the movement of qi, not simply to the spleen and stomach.
The turning point: he went to Lida Hospital of Chinese Medicine and found Doctor Zhang Xichun
What to do at this point? Mr. Chen came to the Lida Hospital of Chinese Medicine (立达中医院) — founded by Doctor Zhang Xichun, the earliest Chinese medicine hospital in China. Doctor Zhang Xichun felt his pulse and found the right position taut and hard beyond the ordinary (右部弦硬异常); pressing deeper, the pulse was full and forceful; he looked at the tongue — the coating was slightly yellow.
💬 Note from Doctor Luo: Here’s a lesson in pulse diagnosis. Our left-hand pulses correspond to the heart, liver and kidney; the three positions of the right hand correspond to the lung, spleen and mingmen (the life gate). If the liver wood runs sideways to attack the spleen earth, then the spleen position on the right becomes taut and hard — the taut pulse is the liver’s pulse. A liver pulse showing up at the spleen position of the right hand — what does that tell you? Liver wood attacking spleen earth, nailed down beyond doubt.
The diagnosis in the spotlight: why did it flare up in spring? A latent pathogen plus liver wind, both bullying the spleen and stomach
Doctor Zhang Xichun was now clear: this was a latent pathogen from an external contraction, stirred into action by the spring (外感伏邪，因春萌动). What does that mean?
💬 Note from Doctor Luo: Old-school Chinese medicine has the “latent pathogen” (伏邪, fu xie) theory — a pathogen contracted in ordinary times that never breaks out, hiding quietly in the body; then when spring opens and the qi mechanism begins to rise, the latent pathogen comes out with it. That’s illness from a latent pathogen. Here the pathogen had reached the stomach fu organ and was turning to heat. Add to that: spring corresponds to wood, and wood corresponds to the liver — in spring, people whose liver blood and liver yin are insufficient develop liver wind stirring internally; once liver wind stirs, it runs sideways and attacks the spleen earth, bullying the spleen and stomach — and so the abdominal pain and diarrhea all arrive together.
The prescription: white peony paired with Chinese yam — one astringes the liver qi, the other fortifies the spleen and stomach
How was it treated? Doctor Zhang Xichun’s approach in eight characters: soften and astringe the liver, tonify the spleen and strengthen the earth (柔肝敛肝，补脾强土). He wrote:
- Sheng hang shao (raw white peony root) 1 liang (about 30 g) — “Hang shao” is the authentic white peony. Purpose? Softening and astringing the liver — using its sour, astringent nature to pull the liver qi back;
- Huai shan yao (Chinese yam) 1 liang (about 30 g) — purpose? Fortifying the spleen and stomach. The wood has come to bully the earth: on one side pull the wood back, on the other build the earth up solid;
- Hua shi (talcum) 1 liang (about 30 g) and xuan shen (figwort root) 1 liang (about 30 g) — clear heat and guide it downward;
- Gan cao (licorice) 3 qian (about 9 g) and lian qiao (forsythia) 3 qian (about 9 g) — licorice harmonizes all the herbs and has some detoxifying power; lian qiao resolves toxins.
💬 Note from Doctor Luo: The hallmark of this formula is the pairing of bai shao with huai shan yao: bai shao astringes, softens and nourishes liver blood; shan yao tonifies the qi of the spleen and stomach — one astringing, one tonifying, and the relationship between the liver and the spleen is set right. Top it with herbs that clear heat and guide it downward — that simple. Once the spleen earth is no longer attacked and subdued by the liver wood, the pain naturally stops and the diarrhea naturally ends.
The result: one dose made him half well; the reduced second dose cured him completely
How did it turn out? After one decocted dose, both the heat and the abdominal pain were more than half gone — and he could eat again. But after taking the medicine he had two more bowel movements — diarrhea twice more.
💬 Note from Doctor Luo: At this point an ordinary person would panic — “the more I take it, the more I run!” But Doctor Zhang Xichun stayed perfectly calm: the pulse had already become calm and even — no problem, keep going. He had the bai shao, hua shi and xuan shen all halved, and one more dose brought the patient to complete recovery. Friends, look how effective this treatment was — one formula hitting the very crux, a handful of herbs dissolving an illness that had tangled on through an entire winter.
Bonus: Doctor Zhang Xichun’s use of bai shao — there is far more to come
This story shows us that bai shao’s power to astringe and soften the liver is one of the great treasures of Doctor Zhang Xichun’s pharmacy. Doctor Luo Dalun offers a preview: in the coming days he will keep explaining, case by case, how Doctor Zhang Xichun used bai shao — tomorrow he continues with more of its wonderful applications.
💬 Note from Doctor Luo: Bai shao — an herb that looks perfectly ordinary, yet used well it becomes a life-saving medicine. The core lesson it teaches us: when treating belly pain and diarrhea, don’t stare only at the spleen and stomach — look and see whether the liver is stirring up trouble. Set the liver-spleen relationship right, and the illness cures itself.
Arranged from Doctor Luo Dalun’s commentary on Doctor Zhang Xichun’s case records; the case comes from Records of Chinese Medicine with Reference to the West (《医学衷中参西录》), published in installments 1918–1934.