Loose Stools for Half a Year That Wouldn’t Form: Doctor Zhang Xichun’s Little Cakes of Raw Bai Zhu and Jujube Paste for Spleen-Deficiency Diarrhea
Opening: this illness dragged on for half a year, and she had tried every medicine there was
The patient we are talking about today had an illness that was not dramatic, but it wore a person down completely — she had had diarrhea for half a year. Every single day for six months, her stools never formed properly, and no medicine helped. She and her whole family were at their wits’ end: what kind of stubborn disease is this loose stool, and why, no matter what they treated it with, did it never get better?
💬 Note from Doctor Luo: A large category of chronic diarrhea has its root not in the intestines at all, but in the spleen and stomach. Today Doctor Zhang Xichun stepped in — and he did not even write out a decoction. He simply made a tray of little cakes, and cured a diarrhea that half a year of treatment could not touch. Hidden inside is his entire understanding of one herb: bai zhu.
Who was the patient: a woman in her thirties, leaking for six months
The patient was a woman in her thirties. Her problem was simple: she had been suffering from diarrhea for half a year — every day, loose stools that never formed, and whatever medicine she took, nothing helped. She had taken no shortage of medicine, yet the illness never improved, so she asked Doctor Zhang Xichun to take a look.
💬 Note from Doctor Luo: Notice these words — “medicine did not work.” She was not untreated; she had been treated for half a year and had not gotten better. This situation tests a doctor’s judgment most of all: you have to think through why all those earlier medicines failed. Was the prescription wrong for the condition — or was the whole line of thinking wrong to begin with?
Doctor Zhang Xichun felt her pulse: not external evil, but the spleen and stomach failing on their own
Doctor Zhang Xichun felt her pulse, and in an instant he understood. Her pulse was soft and weak (ru ruo) — very weak; and on closer examination, the right guan position was especially pronounced — the right guan position reflects the spleen and stomach, and its weakness stood out sharply, telling him the problem sat right in the middle burner.
💬 Note from Doctor Luo: A soft, weak pulse, with the right guan position most affected — this is the classic spleen-and-stomach deficiency pulse picture. Doctor Zhang Xichun’s judgment was clean and direct: there was no external evil in the belly; the spleen and stomach were simply deficient. When the spleen and stomach weaken, dampness flourishes; when dampness builds up and cannot be transformed and moved, it turns into diarrhea and pours out through the stool. So the root of the illness lay in “earth deficiency,” not in “enteritis.”
Why did she have diarrhea? The spleen belongs to Earth; when Earth weakens, water and dampness run wild
Here we should explain the reasoning of Chinese medicine. The spleen belongs to Earth, and Earth controls Water. When the spleen and stomach are strong, the water and dampness in the body are properly transformed and transported; once the spleen and stomach weaken, the earth qi loses its hold, and water and dampness are no longer restrained — dampness flourishes, cannot be transformed, and turns into fluid that drains out of the body.
That is why Doctor Zhang Xichun said: this diarrhea must be diarrhea caused by spleen deficiency, a completely different matter from diarrhea brought on by external epidemic qi or invading pathogenic influences.
💬 Note from Doctor Luo: Besides diarrhea, people with spleen deficiency show several other typical signs: bloating from spleen deficiency — the belly feels distended; thirst from spleen deficiency — water and dampness cannot be transformed, so the upper body feels thirsty even though fluids are stagnant; and weak limbs from a weak spleen — the spleen governs the four limbs, so if you feel sleepy and drained after meals, spleen deficiency is often the reason. You can check yourself against this list.
The prescription revealed: no decoction — she made a tray of little cakes
This time Doctor Zhang Xichun did not write a soup prescription. Instead he produced a small trick — little cakes to be eaten as a snack. The formula was extraordinarily simple, just two ingredients: raw bai zhu and cooked jujube flesh.
💬 Note from Doctor Luo: Everyone, note that here he used raw bai zhu (sheng bai zhu), not stir-fried bai zhu. Pharmacies carry two kinds of bai zhu: when a prescription simply says “bai zhu,” you usually get the stir-fried one — stir-fried bai zhu strengthens the spleen more strongly; but if you want strong dampness-dispelling power, you have to write out the two characters “sheng bai zhu” (raw bai zhu) explicitly — raw bai zhu is the stronger dampness-dispeller. Doctor Zhang Xichun wanted both to dispel dampness and to strengthen the spleen at the same time, so he chose raw bai zhu.
How to make them: parched bai zhu powder, mixed with jujube paste, baked into small cakes
Here is the method: grind the raw bai zhu into a fine powder, then parch it until cooked. What does parching mean? In the old days you would set a tile over the fire, spread the powder on it and heat it indirectly, turning it over and over until it was cooked through — at home today, you can dry it slowly in a microwave, or stir-fry it gently in a dry pan over low heat; stir-fried until cooked works just as well.
Then steam dried red dates until soft, steaming them to a jujube-paste consistency, and remove the pits. Mix the jujube paste with the parched bai zhu powder evenly, shape it into small cakes, and bake them dry on the stove. Eat them as a snack — chew slowly, swallow slowly.
💬 Note from Doctor Luo: In the original case record Doctor Zhang Xichun wrote only that the cooked jujube flesh was six liang; he did not write how much raw bai zhu. In practice, use six liang of raw bai zhu as well — a one-to-one ratio — so that anyone following the recipe at home knows exactly what to do.
The result: before the cakes were even finished, the diarrhea was gone
And what happened? The patient took the cakes home and ate them as a snack — before she had even finished them, the diarrhea was cured. An illness that half a year of treatment could not fix, solved by a tray of little cakes.
💬 Note from Doctor Luo: This is the charm of food therapy. The medicinal strength is gentle, but the direction is completely right — bai zhu strengthens the spleen and dispels dampness, the jujube flesh supplements the spleen and nourishes the stomach; the two together, bit by bit, rebuild the foundation of the spleen and stomach, and the diarrhea stops on its own. Once the spleen and stomach — this “root of acquired constitution” — stand firm, a great many ailments simply resolve themselves.
Why is bai zhu so powerful? It is “the herb that carries the virtue of Earth”
Taking this case as his cue, Doctor Zhang Xichun sang the praises of bai zhu. He said bai zhu is warm in nature and drying in action — dryness dispels dampness; it has a fragrant aroma — fragrance repels foul qi; and it is fragrant yet not scattering, it does not dart about everywhere or clump and stagnate, so its medicinal nature is especially gentle. Its flavor is bitter, slightly sweet, slightly pungent, and its chief functions are strengthening the spleen, dissolving phlegm and water, and stopping diarrhea.
Even more wonderful is how it pairs with other herbs: paired with cool, moistening herbs, it excels at supplementing the lungs; paired with herbs that raise and scatter, it supplements the liver and regulates liver qi; paired with herbs that settle and calm, it excels at nourishing the heart; paired with yin-nourishing herbs, it excels at supplementing the kidneys.
💬 Note from Doctor Luo: Doctor Zhang Xichun said that bai zhu carries the authority of the virtue of Earth — Earth sits in the center and gives life to all things. That is why bai zhu can work with anything: with cool moistening herbs it supplements the lungs, with raising and scattering herbs it supplements the liver, with settling and calming herbs it nourishes the heart, with yin-nourishing herbs it supplements the kidneys. All four organs of metal, wood, water and fire, it can benefit — it is the most fundamental herb for the “root of acquired constitution.” You see, a single spleen-strengthening herb can have such broad uses, all because of those two words: “the virtue of Earth.”
A bonus precedent: Xu Shuwei of the Song dynasty made jujube cakes too
This kind of food therapy was done by the ancients long ago. The famous Song dynasty physician Xu Shuwei once made cakes of cang zhu with cooked jujube flesh, also to treat diarrhea — that was for cases of very heavy dampness, where the stronger cang zhu was called for; in our case, using bai zhu, the approach is more gentle.
💬 Note from Doctor Luo: Cang zhu and bai zhu are both fine herbs for dispelling dampness and strengthening the spleen. The difference: when dampness is heavy and you need vigorous drying, use cang zhu; for ordinary spleen deficiency where gentleness is wanted, use bai zhu. Xu Shuwei was a great master of classical formulas in the Song dynasty, and his precedent shows that pairing jujube flesh with drying, dampness-dispelling herbs to treat chronic diarrhea is a route the ancients already proved. Doctor Zhang Xichun’s case is a continuation of that same road.
Closing
Bai zhu — a fine herb for dispelling dampness and strengthening the spleen, and exceptionally gentle in nature. In Doctor Zhang Xichun’s hands, this one herb had many more brilliant uses. Today is only the beginning; in the coming days, we will continue with how Doctor Zhang Xichun used bai zhu.
What to take away: chronic loose stools are not always an intestinal infection. When the pulse is soft and weak, with the right guan position most deficient, the root is the spleen: earth qi is failing, dampness flourishes, and the body pours it out as diarrhea. Doctor Zhang Xichun’s answer was food therapy in its gentlest form — little cakes of raw bai zhu and jujube paste, eaten slowly as a snack. Note the detail: raw bai zhu for dispelling dampness, stir-fried bai zhu for strengthening the spleen — when both are wanted, the raw herb is the one to name. And the deeper teaching of the case is that bai zhu carries “the virtue of Earth”: it can pair with almost anything, supplementing lung, liver, heart or kidney depending on its companion — one humble herb, the quiet anchor of the acquired constitution.
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.