Face Swollen and Sores Weeping Yellow Fluid? Doctor Zhang Xichun’s Heavy-Dose Raw Gypsum Strategy for Epidemic Head-and-Face Swelling (Da Tou Wen)
Patient search terms: swollen head and face / swollen face / face breaking into sores / yellow fluid weeping from the skin / spots over the body / restless, always wanting something cold to drink Corresponding medical terms: da tou wen (epidemic “big-head plague”) · gua rang wen (melon-flesh plague) · epidemic febrile disease · blazing fire toxin in the yang ming · raw gypsum to clear heat toxin
Opening: the face swelled up, broke into sores, and wept yellow fluid — what kind of strange disease was this?
Today we continue with Doctor Zhang Xichun’s use of raw gypsum (sheng shi gao). Earlier we talked about gypsum clearing exterior heat and clearing hot, swollen throats. Today we look at a very special use of his — treating heat in the head and face.
💬 Note from Doctor Luo: Doctor Zhang Xichun summed up the many uses of raw gypsum, and one of them was: raw gypsum excels at clearing heat in the head and face. What does that mean? It means this kind of heat on the face, raw gypsum is especially good at clearing away. Why? Because raw gypsum enters the yang ming stomach channel, and the yang ming stomach channel happens to run right across the face — so many problems on the face are connected to the stomach.
Hidden inside this is a very important principle — remember it, because we will use it again: the channels are all connected. Once the fire in the stomach channel is cleared, the red, swollen, hot, painful face naturally subsides.
Who was the patient? A young soldier in Dezhou, in his twenties
At that time Doctor Zhang Xichun was serving as a military doctor in Dezhou — many of his cases were seen in the army. This patient was a soldier, in his twenties, and what did he come down with? An epidemic febrile disease (wen yi).
💬 Note from Doctor Luo: Notice that many of Doctor Zhang Xichun’s cases took place in the army — military cases, with young, strong patients, and illnesses that came on fast and hit hard.
How sick was he? Within three or four days the head and face swelled up completely, with yellow fluid under the skin
The epidemic struck fast and fierce: within three or four days, his head swelled up — head and face swollen entirely. Under the skin of the swollen areas there was yellow fluid; once the skin broke, it ulcerated — his face was truly a sight. Here and there spots appeared over his body.
💬 Note from Doctor Luo: What do people call this disease? Da tou wen — the “big-head plague.” Who had treated it before? Doctor Li Dongyuan of the Jin-Yuan period — the famous Pu Ji Xiao Du Yin (Universal Relief Toxin-Removing Beverage) was precisely the formula for da tou wen.
But look more closely, and the ulcerated appearance didn’t quite fit da tou wen — it looked more like another epidemic: gua rang wen, the “melon-flesh plague.” People buzzed with worry: this disease was very hard to treat — it could kill.
The soldier was terrified: “Doctor, save me, quickly!”
When the soldier heard this, he was frightened out of his wits and hurried to Doctor Zhang Xichun. Doctor Zhang took his pulse: slippery and long, very forceful (hua er chang, you li) — what did that show? The heat was blazing. Then he looked at the tongue: a white coating with a hint of yellow — also a sign of heat.
💬 Note from Doctor Luo: A slippery, long, forceful pulse is strong evidence of blazing heat; a white coating with a hint of yellow shows the heat signs were already clear — this disease was a mass of fire toxin at work.
Doctor Zhang Xichun asked how he felt. The soldier said: “I just feel restless — restless and hot inside. I always want to eat something cold; when I eat something cold, I feel better.” The more restless and hot, and with his face breaking into sores on top of it — who could stand that!
Doctor Zhang Xichun’s judgment: fire toxin entered the stomach channel and rode the stomach qi up to the face — use raw gypsum boldly!
Doctor Zhang Xichun listened and told him: “This disease is not hard to treat.”
💬 Note from Doctor Luo: How did Doctor Zhang Xichun analyze the pattern? He said: ulcerated head and face, spots over the whole body — nothing more than fire toxin that had entered the stomach, entered the yang ming stomach channel. The fire toxin then moved outward with the stomach qi — the stomach channel runs across the face, so it manifested on the face; the spots over the skin came from the same principle. Wherever the fire toxin reached, it erupted there.
He went on: “At this point you must boldly use raw gypsum — it can save your life.”
The soldier replied: “Then what are you waiting for, Doctor Zhang? Give me the medicine now! I’m restless, I’m hot, my face is breaking into sores — I can’t wait another minute!”
Breaking down the prescription: three liang of raw gypsum leads the charge to clear the yang ming fire toxin
So Doctor Zhang Xichun wrote a formula — let’s look at the combination:
💬 Note from Doctor Luo: In the formula, raw gypsum was used at three liang (about 90 g) — a very large dose! This was Doctor Zhang Xichun’s special skill with gypsum: when the illness is heavy, the dose must be sufficient. He paired it with two qian (about 6 g) of antelope horn (ling yang jiao) — antelope horn, as we discussed earlier, clears heat from the liver and gallbladder; eight qian (about 24 g) of anemarrhena (zhi mu) to clear heat and bring down the fever; one and a half qian each of stiff silkworm (jiang can), qian jin chong lou (Paris polyphylla, also called zao xiu), and licorice (fen gan cao) — stiff silkworm and cicada slough (chan tui) both resolve toxin and vent it outward, pushing the fire toxin out through the surface; and in the formula he also added a little lotus leaf edge (he ye bian) — for what? To clear summer-heat, to drive off summer-heat.
The result: one dose halved the illness; a second dose, and the face deflated in a flash
Once the medicine was decocted, it was taken while still warm. How did it work? After one dose, the illness was half gone!
The next day, Doctor Zhang Xichun removed the lotus leaf and the cicada slough from the formula and gave another dose — and the man was cured. In a flash, the red, hot, swollen, painful face all subsided, and the disease was gone.
💬 Note from Doctor Luo: Which herb in this formula worked best? Raw gypsum. Doctor Zhang Xichun pushed raw gypsum to three liang — a very large dose — with a single purpose: to clear the yang ming heat. That was his experience — once the heat of the yang ming channel is cleared, the fire toxin goes with it.
The finishing touch: why do you treat the stomach for a disease on the face?
What do we learn from today’s case?
💬 Note from Doctor Luo: Doctor Zhang Xichun believed that fire toxin in the head and face is usually connected to the stomach channel. If the stomach channel has heat and the fire toxin vents outward, manifesting on the head and face, use raw gypsum to clear the heat — once the yang ming channel’s heat is cleared, the fire toxin resolves on its own.
From now on, whenever you see raw gypsum in a formula, you know: this is for resolving yang ming channel fire toxin. Whatever disease of the face, whatever sore has grown there, if raw gypsum appears in the formula, this is the reason. Understand this one point, and today’s case was worth listening to!
A bonus: why are a woman’s melasma spots also connected to the stomach?
To close, here is a phenomenon Doctor Zhang Xichun often mentioned: some women have melasma covering their whole face (huang he ban), and no matter what they do, the spots will not go away.
💬 Note from Doctor Luo: Doctor Zhang Xichun said that is because the spleen and stomach are not doing well. Once the spleen and stomach recover, the spots gradually fade — because the yang ming stomach channel runs across the face, and the face’s qi-blood supply, its heat toxin, and its clear-and-turbid exchange are all connected to the stomach channel. So to treat a condition of the face, first look at the stomach — that is one of Doctor Zhang Xichun’s great lessons.
Case source: Records of Chinese Medicine with Reference to Western Medicine by Doctor Zhang Xichun; commentary based on public lectures by Doctor Luo Dalun (PhD in TCM diagnostics, Beijing University of Chinese Medicine).