Fever, Belly Pain and Diarrhea Several Times a Day? Doctor Zhang Xichun Combined White Peony Root with Fresh Imperata Root to Clear a Warm-Heat Illness
Patient’s search terms: fever / belly pain / diarrhea / two or three bowel movements a day / frequent stools / thick tongue coating Medical terms: warm-heat disease (wen bing) · heat in both interior and exterior · liver wood running rampant and attacking spleen earth · heat entering the yangming fu-organ
Opening: the same formula as yesterday — with one fresh herb added
Yesterday we told the story of how Doctor Zhang Xichun used white peony root (baishao) to treat belly pain and diarrhea, and many readers said: so that’s how baishao works! Today Doctor Luo Dalun continues the story — it is still baishao paired with Chinese yam, but Doctor Zhang Xichun added one fresh herb to the formula — and the effect was just as startlingly fast.
💬 Note from Doctor Luo: Two days in a row on baishao — don’t find it tedious. Doctor Zhang Xichun could lecture on the nature of baishao for days, because in his hands this single herb had so many transformations. Today’s case is another brilliant use of it.
Who was the patient? The wife of Commander Chen of the Fengtian Gendarmerie Battalion, in her twenties
The patient that day was the wife of a soldier — the wife of Commander Chen of the Fengtian Gendarmerie Battalion, and she was in her twenties. Fengtian is today’s Shenyang, and it was also Doctor Zhang Xichun’s home turf. The lady caught a warm-heat disease in the spring.
💬 Note from Doctor Luo: What is a warm-heat disease? An externally contracted heat illness is called a warm-heat disease — an illness caused by catching warm pathogenic qi from the outside. Notice that Doctor Zhang Xichun’s case records generally give names, and even record what the patient did for a living — that is rigor.
How sick was she? Heat inside and out, a pulse like a flooding river
Four or five days into the illness, the family called Doctor Zhang Xichun in. His diagnosis: heat in both the interior and the exterior — in a warm-heat disease both inside and outside run hot, the mark of heat pathogen invading the body. And the pulse: flooding on both the left and right wrists.
💬 Note from Doctor Luo: What is a flooding pulse? Hong means flood. The flooding pulse surges in fiercely, like a wave — strong on arrival, fading as it leaves (来盛去衰): forceful as it rises, suddenly weak as it subsides. What does a flooding pulse indicate? It indicates heat pathogen blazing fiercely inside the body. Touch a flooding pulse, and a heat syndrome is beyond doubt.
What bothered her most: severe belly pain, and two or three bowel movements a day
Then the patient told Doctor Zhang Xichun her misery: my abdomen constantly hurts, very painfully; and I go to the toilet two or three times a day — clearly more often than normal — and my belly keeps aching.
💬 Note from Doctor Luo: Everyone take note — belly pain is one of Doctor Zhang Xichun’s diagnostic indicators. The moment he heard belly pain, together with the increased frequency of stools, he had a clear picture in his mind, and his prescribing became deliberate. This is the crucial stroke of the whole case.
The diagnostic highlight: one look at the tongue — heat has already entered the yangming fu-organ
Doctor Zhang Xichun then examined her tongue: the coating was very thick, and slightly yellow. What did that mean?
💬 Note from Doctor Luo: Doctor Zhang Xichun also read tongues. A thickened coating means the external heat pathogen has entered the yangming fu-organ (the stomach fu); a yellow coating means the pathogen is heat. Add in the season — it was spring, and spring corresponds to liver wood — so at this time liver wood runs rampant and attacks spleen earth (肝木横逆克脾土)! Liver and gallbladder qi, carrying warm-heat pathogen, ganged up on the spleen and stomach; the spleen and stomach could not take it, hence the belly pain and the frequent stools. This is what the classics call wood overcoming middle earth (木克中土). On the strength of that belly pain, Doctor Zhang Xichun judged that the patient most likely had excess liver wood running rampant and attacking spleen earth — which also matched the spring season.
The prescription, taken apart: baishao softens the liver, shanyao tonifies the spleen, imperata root sends the heat out through the urine
How did he treat it? The formula Doctor Zhang Xichun used is very interesting — the same idea as yesterday: baishao paired with shanyao, plus a group of herbs to clear heat and guide it downward, and today one new herb:
- Sheng baishao (raw white peony root), 1 liang — what for? Softening and restraining the liver, pulling the rampant liver qi back;
- Huai shanyao slices (Chinese yam), 1 liang — what for? Strengthening the spleen and stomach, fortifying spleen earth, rebuilding the bullied earth so it stands firm;
- Xuanshen (figwort root) and huashi (talc), 1 liang each — clearing heat and guiding it downward;
- Gancao (licorice) and lianqiao (forsythia), 3 qian each — licorice harmonizes all the herbs; forsythia resolves toxins;
- Xian maogen (fresh imperata root), 3 qian (the new addition today) — this is baimaogen (imperata root, woolly grass root), found all over the wild, in most parts of China. It clears heat, and it can drain the heat out through the urine.
💬 Note from Doctor Luo: The beauty of this formula is “one leading pair, three supporting lines”: baishao restrains the liver, shanyao tonifies the spleen — one restraint and one tonification that settle the liver-spleen relationship; xuanshen and huashi clear heat and guide it downward; imperata root escorts the heat out through urine; licorice and forsythia harmonize and resolve toxins. Heat has a way out, the liver stops bullying the spleen, and the belly naturally stops hurting.
The result: one dose stopped the pain and the diarrhea; a second dose finished the cure
How did it turn out? After one dose, the abdominal pain and the diarrhea stopped — one dose and the belly pain plus the frequent stools were solved on the spot! A second dose completed the cure — after one more dose the illness was gone. To treat this illness, Doctor Zhang Xichun used just two doses of medicine in total.
💬 Note from Doctor Luo: What does that tell you? It shows how exacting Doctor Zhang Xichun was with herbs — when the pattern is correctly identified, you don’t need many herbs; two doses cure it. Compare that with the approach of prescribing a mountain of herbs for months without effect — the difference in level is plain to see.
The principle remains the same: in spring, liver wood is at its strongest and most likely to bully the spleen and stomach
What this case teaches is still yesterday’s principle: Doctor Zhang Xichun believed this patient’s belly pain and frequent stools were caused by liver wood running rampant and attacking spleen earth. And the season matched — spring corresponds to liver wood, and problems like this tend to arise then. What to do? Doctor Zhang Xichun used baishao to restrain the liver and shanyao slices to tonify the spleen — those two herbs resolved the fundamental conflict.
💬 Note from Doctor Luo: This kind of thinking runs through countless formulas in ancient China. Remember this rule: when belly pain or diarrhea strikes in spring, first consider whether liver wood is attacking spleen earth — treating only the spleen and stomach is often not enough; you have to smooth the liver as well.
Bonus: Doctor Zhang Zhongjing’s Huangqi Jianzhong Tang — remarkable results for gastric ulcers
Speaking of the “baishao softens the liver, shanyao tonifies the spleen” approach, Doctor Luo Dalun wants to give you a famous formula as a bonus — Doctor Zhang Zhongjing has a celebrated formula called Huangqi Jianzhong Tang (Astragalus Middle-Fortifying Decoction).
💬 Note from Doctor Luo: I often use this formula for gastric ulcers and stomach pain. How do gastric ulcers arise? A significant proportion come from stress — mental tension, pressure; combined with deficiency-cold and insufficiency of yang qi. Put those two factors together, and conditions like gastric ulcers easily develop. How to treat? As long as I judge that the person is not in an excess-heat state but is somewhat deficiency-cold, I use Huangqi Jianzhong Tang. What are huangqi (astragalus) and yitang (malt syrup — the kind of chewy sorghum candy called gaoliangyi) for? Fortifying the middle — tonifying the spleen and stomach; baishao here again softens and restrains the liver; guizhi (cassia twig) soothes the liver and also frees the blood vessels. You see — among the few herbs, some soften and restrain the liver, some fortify the middle and strengthen the spleen: put the two approaches together, and many spleen-stomach disorders caused by bad emotions can be regulated. So this Huangqi Jianzhong Tang works remarkably well for cold-type gastric ulcers. Many people, after taking it, slowly stop hurting, are delighted, and the condition stays away for a long time.
Today’s lesson: when the spleen and stomach keep misbehaving, emotions are usually the troublemaker
What does today’s case tell us? The same as yesterday — when a person’s liver qi is in excess, with liver yin and liver blood insufficient, liver qi runs rampant and attacks spleen earth, stirring liver wind internally, you get belly pain, changed bowel habits, diarrhea and the like. In that situation, baishao can restrain and soften the liver and resolve the problem.
💬 Note from Doctor Luo: So my friends — many of our spleen-stomach and gastrointestinal disorders are linked to mental stress and bad emotions like tension. In that kind of regulating, baishao has a great deal to offer — that is today’s lesson. Tomorrow, we continue with how Doctor Zhang Xichun used baishao.
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》).