Legs Aching So Bad After Getting Cold That He Couldn’t Walk: Doctor Zhang Xichun’s Huoluo Xiaoling Dan for Cold Trapped in the Sinews
Opening: one night of drinking, two legs too painful to sit still
Today we continue our look at how Doctor Zhang Xichun used ru xiang (frankincense) and mo yao (myrrh) — and the main character is again his trusted experiential formula, Huoluo Xiaoling Dan. But this case is even more twisted than the last one. The patient first tried heating a brick and pressing it on his legs — the more he pressed, the worse the pain. Then he took sweating herbs — the pain didn’t stop, and instead he vomited blood. In the end, how bad was the pain in his two legs? He was alternately singing and crying, and two people had to hold his legs, one on each side, before he could even bear to lie down.
💬 Note from Doctor Luo: This case shows a principle particularly clearly — with the same exposure to cold, cold lodged in the muscles and cold that has drilled into the sinews and bones call for completely different treatments. Use the wrong approach and the more you treat, the worse it gets.
Who was the patient: an old friend from the next village, frail from the start
The patient’s name was Gao Luxuan. He lived in the village next to Doctor Zhang Xichun’s, and was also his friend, appearing often in Doctor Zhang’s case records. That year he was nearly fifty years old, and his constitution had never been strong — he was frail by nature.
💬 Note from Doctor Luo: Remember this starting point — a person with a weak foundation cannot withstand rough handling. Every step this case takes from here on is tied to those three words: weak foundation.
How the illness began: walking home in the freezing dawn and resting on cold ground
On this particular day, Gao Luxuan went to the neighboring village to visit a friend. They drank and ate, and stayed up very late — the whole night without sleep. By dawn he had to go home — and it happened to be winter, with bitterly cold weather. After a night of drinking, he set out into the cold morning air and walked a very long way.
Midway, he felt his two legs growing numb and sore, and he was sweating. Unable to walk any further, he sat down on the cold ground to rest.
💬 Note from Doctor Luo: The problem was born the moment he sat down. Early morning in deep winter, sweating after a night of alcohol — the pores were wide open. He sat on cold, damp ground, and the cold qi slipped straight in.
The self-inflicted mess: a hot brick, and pain that only got worse
Back home, his legs began to hurt. Gao Luxuan thought: this must be from cold — so wouldn’t heating the area drive it out? He heated a brick and pressed it on his legs.
And the result? The more he pressed, the worse it hurt.
💬 Note from Doctor Luo: You see, this is exactly opposite to what most people expect. He had caught cold and assumed heat would expel it — but the hot brick didn’t drive the cold out at all. Instead, it pushed the cold deeper into the body. Doctor Zhang Xichun called this driving the cold inward (bi han nei xian) — a very special situation.
Then sweating herbs: the cold stayed, but he vomited blood
Gao Luxuan knew a little medicine himself. Seeing that pressing didn’t work, he reasoned: if it’s cold, then sweat it out! So he took sweat-inducing herbs himself, several doses of them.
The result: far from improving, the pain grew worse. And because the medicines were too hot, he also vomited a few mouthfuls of blood, and his stools became dry and bound. Now he was truly out of options — even though he knew medicine himself, pride had to go. He hurriedly sent for Doctor Zhang Xichun from the neighboring village.
💬 Note from Doctor Luo: Why didn’t the sweating herbs work either? Doctor Zhang Xichun’s explanation is the crucial point: sweating herbs scatter the cold in the muscles; they cannot scatter the cold in the sinews and bones. Once the cold has drilled down into the sinews and bones, sweating on the outside never reaches it.
Doctor Zhang Xichun’s arrival: singing and crying, legs held by two men
When Doctor Zhang Xichun arrived and saw the state he was in — how miserable was it? Gao Luxuan lay on his back with his knees bent, while two men, one on each side, held up his legs with their hands — without that support, even the weight of the legs caused pain. He sang and cried by turns, now a snatch of song, now sobs — the pain was so severe that even his mind was unhinged. Doctor Zhang Xichun’s words: the appearance of his agony defied description — you have never seen such suffering.
Then he felt the pulse: it was wiry and thin (mai xuan xi), and it beat somewhat rapidly — a slightly rapid (wei shu) pulse.
💬 Note from Doctor Luo: A wiry pulse indicates pain and cold; a thin pulse tells us qi and blood are already depleted; a rapid pulse reveals heat — and that heat is exactly the damage done by all those warming and sweating medicines before. The disease mechanism was right there before his eyes.
The most critical move in the whole case: the cold was not in the muscles, but in the sinews and bones
Doctor Zhang Xichun pondered carefully: what exactly is going on with this illness?
First, the man had originally caught cold, but the hot brick drove the cold deeper inside — cold driven inward. Second, the sweating herbs made the pain worse — because sweating herbs scatter cold in the muscles, not cold in the sinews and bones. Third, and most importantly: all this rough handling caused excessive sweating that wounded his qi and blood. Once qi and blood were injured, the body had even less strength to expel the cold.
So Doctor Zhang Xichun wants you to remember: Huoluo Xiaoling Dan is especially skilled at loosening the sinews — when there is stagnation deep in the sinews and bones, it can open it up. That was the guiding idea of this prescription.
💬 Note from Doctor Luo: You see, Doctor Zhang Xichun’s pattern differentiation did not stop at the two words “caught cold.” He distinguished clearly whether the cold sat in the muscles or in the sinews and bones, and he also factored in the heavy damage to qi and blood left by the earlier mistreatment — this is the difference between a master and an ordinary doctor.
The prescription: Huoluo Xiaoling Dan plus deer antler glue and tian ma
Once the reasoning was clear, the formula followed: Huoluo Xiaoling Dan, plus deer antler glue (lu jiao jiao) 4 qian (about 12 grams) and tian ma (gastrodia tuber) 2 qian (about 6 grams), decocted and drunk as a soup.
What is deer antler glue? Deer antler is what antler velvet becomes when it matures and ossifies; boil that antler down and you get lu jiao jiao. What does it do? It supplements yang, scatters cold, and opens the channels, and it is especially good at tonifying kidney yang. Tian ma, meanwhile, opens the channels and stops spasms and pain.
💬 Note from Doctor Luo: Huoluo Xiaoling Dan moves qi and blood and opens the channels; deer antler glue supplements yang and scatters cold, topping up the body’s yang qi; tian ma helps open the channels and stop pain — supplement, open, and scatter, all three prongs working together. That is the complete treatment strategy.
The left leg recovered, but the right still hurt — enter tiger bone glue, and cold air leaking out
After he drank the medicine, something remarkable happened. The man holding Gao Luxuan’s left leg suddenly felt cold air seeping out between his own fingers — the pathogenic qi was leaving the leg! The left leg stopped hurting.
But the right leg still hurt exactly as before.
Doctor Zhang Xichun thought it over, and suddenly understood: left is yang, right is yin — the left side belongs to yang, the right side to yin (of course, some traditions in Chinese medicine say the reverse, right yang and left yin; the theories are not all identical). The deer is a creature of pure yang — the ancients also called it the spotted dragon (ban long). Pure yang enters the yang division, so the left side recovered first; the medicine never entered the right side.
So he proposed a change: replace the deer antler glue with tiger bone glue and continue taking it. The result? The man holding the right leg also felt cold air seeping between his fingers, and the right leg healed too.
💬 Note from Doctor Luo: Doctor Zhang Xichun observed that the ancients spoke of left green dragon, right white tiger — the left is the dragon, the right is the tiger, and using medicine according to this imagery can produce wonders. The ancients used the image; Doctor Zhang Xichun used the function. Of course, tigers are now a protected species, we can no longer obtain tiger bone glue, and we do not advocate using it — in this case, we are simply admiring the ancients’ way of thinking about medicine.
Two health reminders
Doctor Luo says ordinary people can learn two lessons from this case.
First, in bitter cold weather, avoid going out at dawn, and never court the cold qi. If you must go out, keep yourself warm — in olden days, when people went out in cold, damp weather, they held a slice of ginger in their mouths precisely to keep the body warm along the way. What Gao Luxuan did — walking until tired and sitting down to rest on cold ground — is something you must never do.
Second, when the sinews and bones are affected, Huoluo Xiaoling Dan is an excellent remedy for regulating the body. It opens the channels, and especially when there is stagnation in the sinews and bones, it can clear the blockage for you. The ru xiang and mo yao in this formula don’t taste good when decocted — they are tree resins, of course they don’t taste good — but it cures illness, and its results are often surprisingly good.
💬 Note from Doctor Luo: This is Doctor Zhang Xichun’s experience: remember these four herbs — dang gui (Chinese angelica), dan shen (red sage root), ru xiang (frankincense), and mo yao (myrrh). When you run into problems of stagnation in the sinews and bones or qi and blood not flowing, you will know what they are for, and ordinary people will have some idea in mind.
Finally, here is a review question for you to ponder: why do some say the left side is yang and the right is yin in Chinese medicine, while others say the reverse? The body has a left and a right — why are there different explanations? Once you have thought it through, we will continue tomorrow.
What to take away: cold is not always a simple enemy to be sweated out. When the cold has been driven deep into the sinews and bones — by hot compresses, by improper sweating, by a weakened body — the treatment changes completely. Doctor Zhang Xichun’s lesson is to ask where the cold is before reaching for a remedy: cold in the muscles calls for one approach, cold in the sinews and bones calls for opening the channels with a formula like Huoluo Xiaoling Dan. And when the constitution is frail, never rattle the cage — the body needs support, not more rough handling.
Arranged from Doctor Luo Dalun’s commentary on Doctor Zhang Xichun’s case records; the case originates from Records of Chinese Medicine with Reference to Western Medicine (《医学衷中参西录》), published in installments 1918–1934.