Vomiting After Meals, Food Stuck in the Stomach, Constipation for Ten Days? Doctor Zhang Xichun’s Formula to Descend Stomach Qi and Settle the Chong Meridian
Patient search terms: food stuck in the stomach after meals / things coming back up / frequent vomiting / sour fluid rising / dry stool every few days / constant belching and bloating Medical terms: stomach qi failing to descend · rebellious stomach qi · disharmony of liver and stomach (vomiting, constipation, acid reflux esophagitis)
The opening: before describing the symptoms, the record describes the personality
Last time we talked about the ben tun (running piglet) syndrome, in which qi rushes upward. For the milder form, Zhang Zhongjing’s Fu Ling Gui Zhi Gan Cao Da Zao Tang (Poria, Cinnamon Twig, Licorice and Jujube Decoction) was enough. The ancients had already analyzed the mechanism of qi rushing upward long ago — whether in the Huang Di Nei Jing (Yellow Emperor’s Classic of Internal Medicine), the Shang Han Lun (Treatise on Cold Damage), or the Jin Gui Yao Lue (Essentials from the Golden Cabinet). Once you understand how rebellious qi rises, the old formulas work almost immediately. Today’s story is also about qi moving upward — but this time it is charging at the stomach. And right at the top of the case record, the patient is given a single telling note: hot-tempered and violent by nature (bing xing bao lie). A difficult personality.
💬 Note from Doctor Luo: A master physician looks first at how temperament and emotion affect the body. Doctor Zhu Danxi, one of the Four Great Masters of the Jin-Yuan period, begins most of his case records with a description of the patient’s personality — exactly like Doctor Zhang Xichun. Both understood that emotion is the foundation on which illness grows.
Who was the patient: a lady near forty, vomiting, constipated, and childless for years
The patient was the wife of Wang Yousan of Wangjiakou, Dacheng county, nearly forty years old. She had two problems. First, she vomited frequently: after a meal, the food simply stopped in her stomach and would not descend, as if a current of qi was pushing up against it, blocking the way down. Second, her bowels moved sluggishly — when the constipation was at its worst, she would go once every ten days or so. And whenever the stool became dry and would not pass, the vomiting grew worse — the whole qi mechanism was surging upward. The couple also carried a private grief: years of infertility — they had never had a child.
💬 Note from Doctor Luo: The root of this illness was emotion — a violent temper on top of a difficult family situation, constant irritations, and frequent anger. Liver qi became constrained, liver fire ran upward, and day after day this became the disease we see. Earlier doctors had given her anti-emetic and laxative medicines, but those only treated the surface — the trips to the toilet stayed exactly the same.
Traveling far for a doctor: the only physician they trusted was Zhang Xichun
Fortunately, her husband Wang Yousan had once been treated by Doctor Zhang Xichun — the doctor had cured a cold condition in his belly, and Wang trusted him completely. So he brought his wife all the way to Tianjin for a consultation. This is one of the cases from Doctor Zhang Xichun’s later years in Tianjin (most of his recorded cases come from his years practicing in Shenyang, but a portion are from Tianjin).
The pulse: wiry and long — Doctor Zhang Xichun read the Chong meridian
Doctor Zhang Xichun placed his fingers on her wrist: both the left and right pulses were wiry (xian) — taut as a lute string. A wiry pulse is the liver pulse; it speaks of constrained liver qi and pent-up liver anger. Then, on the right side, the pulse was wiry and also long (xian er chang) — extending beyond the normal cun-guan-chi range. Pressed down firmly, it still had strength, and the rate was roughly normal.
💬 Note from Doctor Luo: What does a wiry and long pulse mean? It points to the Chong meridian. The Chong meridian is one of the Eight Extraordinary Meridians (du, ren, chong, dai — Governor, Conception, Thoroughfare, Belt). It runs mainly along the front of the abdomen, rising to the mouth and descending along the inner legs to the feet. Its nickname is the Sea of Blood, also called the Sea of the Twelve Meridians: it stores blood and regulates the qi and blood of all twelve regular meridians — when qi and blood run low, it supplies them. It is also closely tied to reproduction, especially in women: when the Chong meridian is disordered, the uterus and the menstrual cycle go wrong. And it regulates the ascent and descent of qi — the rising of kidney qi, the outgrowth of liver qi, and the orderly descending of stomach qi all depend on it. One touch of the pulse, wiry and long, and Doctor Zhang Xichun knew the Chong meridian was involved — this was his own distinctive insight. A wiry, long, forceful right pulse is the pulse of rebellious stomach qi: on the left, cun-guan-chi govern the heart, liver, and kidney; on the right, the lung, spleen, and ming men — the spleen and stomach sit in the right guan position. The qi of the liver, stomach, and Chong meridian all rose without descending, the qi mechanism was thrown into disorder and surged upward — hence vomiting above and constipation below.
The strategy: drain the liver, descend the stomach, settle the Chong — plus one herb to build the spleen
Doctor Zhang Xichun settled on the treatment principle: first, drain the liver (the root is a habit of anger, so the liver fire must be discharged); second, descend the stomach qi (the liver fire runs horizontally and attacks the spleen earth, shoving the stomach qi upward); third, settle the Chong (the Chong meridian’s upward push is too strong, so heavy, weighty herbs are used to press it down) — and hidden in the formula is a fourth move: build the spleen.
💬 Note from Doctor Luo: Liver fire rushing upward, stomach qi rebelling, the Chong meridian surging — treat all three paths at once, and the logic is perfectly clear. With medicine like this, the bowels ought to open and the vomiting ought to stop.
Breaking down the prescription: one “trump card” leads, ten herbs each with a job
Raw hematite (sheng zhe shi), half a liang (about 15 g), ground to a fine powder, leads the formula. This is Doctor Zhang Xichun’s signature trump card: whenever qi rushes upward, he uses raw hematite to press it down. Hematite settles the blood and cools the blood; its nature is cool, and being a mineral, it is heavy — it can press rebellious qi downward by weight. Its beauty is that it does not harm the upright qi and it also opens dry, bound stools. In his major writings Doctor Zhang Xichun ranks raw hematite very early in the materia medica, right alongside raw yam — whenever qi rebels upward, he reaches for it; descending, it settles the qi of the Chong, stomach, and liver meridians.
💬 Note from Doctor Luo: Next comes raw Hangzhou peony root (sheng hang shao / bai shao) 6 qian (about 18 g) — softening and restraining the liver, the herb that treats the liver. Arborvitae seed (bai zi ren) 6 qian (about 18 g) — we usually use this to nourish the heart and calm the spirit, but Doctor Zhang Xichun used it here to nourish and soften the liver. The ancients observed that arborvitae branches and leaves grow toward the northwest; in Chinese medicine the west corresponds to Lung Metal — and Metal controls Wood. The arborvitae tree communicates with the qi of Lung Metal, and so it can restrain the violence of Liver Wood. That is why arborvitae seed is especially good for the flank pain caused by liver qi running horizontally and constrained liver qi. Then Chinese angelica root (dang gui) 4 qian (about 12 g) nourishes the liver blood — when the blood is replenished, the liver no longer turns violent and charges upward. Raw malt (sheng mai ya) courses the liver, gently and mildly, without the risk of over-coursing that some herbs carry (over-coursing can actually drag the qi upward). Yin chen (capillary wormwood — the young shoots of Artemisia capillaris; the old saying goes "the third month, yin chen; the fourth month, hao; by the fifth month, cut it and burn it as firewood") clears damp-heat from the liver and gallbladder and courses the liver — also gentle in nature.
Doctor Zhang Xichun had a distinctive insight about yin chen: yin chen behaves much like bupleurum (chai hu) — both resolve the Shao Yang and vent pathogenic qi outward — but bupleurum is dry and harsh, and people with yin deficiency and weak constitutions cannot tolerate it. In those cases he substituted yin chen, soft and moderate, which patients of ordinary constitution can accept. On the spleen-building side: raw Huai yam (sheng huai shan yao) 6 qian (about 18 g) holds the center and supports the upright qi; licorice (gan cao) holds the middle burner and harmonizes all the herbs. Because the patient tended toward dryness from yin deficiency, asparagus root (tian dong) was added to nourish yin and moisten dryness. Finally, Huai achyranthes root (huai niu xi) — grown in Wen County, Jiaozuo, Henan — nourishes the liver and kidney and is excellent for weak lower back and legs; and achyranthes has a descending nature, so when qi rebels upward it draws the medicinal force downward. Chuan niu xi (Sichuan achyranthes) is more of a mover (dispelling wind-damp and freeing the sinews and bones), while Huai niu xi is more of a tonic — it both nourishes and guides the qi downward.
💬 Note from Doctor Luo: See how clear the logic of this formula is: raw hematite, heavy, settles rebellious qi; peony, arborvitae seed, and angelica soften, restrain, and nourish the liver; malt and yin chen course the liver qi; yam builds the spleen; asparagus root nourishes yin; achyranthes guides the qi downward — soften the liver, course the liver, drain the liver fire on one side; build the spleen in the middle; and add two herbs that press the qi mechanism downward.
The result: after one dose the bowels moved
The medicine was decocted into one large bowl and taken warm. After a single dose, the bowels moved. The original formula was modified slightly and continued for a few more doses; bowel movements settled into once a day, food no longer clogged or stagnated in the stomach after meals — and from then on the root of the illness was gone.
💬 Note from Doctor Luo: Another complex illness of years standing, solved in a few doses in Doctor Zhang Xichun’s hands — one dose showed the effect, a few more removed the root. That is the bearing of a master physician. Doctor Luo often sighs that compared with Doctor Zhang Xichun he cannot even touch the hem of his garment: the master left behind case records after healing people, while he only analyzes with knowledge — the actual healing skill is far behind. So whatever the "TCM-bashers" say, we must strengthen our own competence — read widely, study closely how the masters actually cured patients, and learn with humility. If every Chinese medicine doctor were like Zhang Xichun — healing patient after patient, snatching people back from death — who would still be a TCM-basher? They would all be lining up for treatment. And Doctor Luo hopes more students in TCM colleges will listen to these case records and grow into physicians who can truly cure the sick.
What ordinary people can learn: settle your emotions first — that is how you remove the root
This formula also carries a reminder for all of us: if you are quick to anger, if your mood is poor, if your stomach locks up after meals and refuses to let food descend, if your stools are dry — Doctor Zhang Xichun’s answer was to build the spleen and stomach while softening and coursing the liver. And even after the illness is cured, the most important thing is to adjust your own temperament. Where did the illness come from? The case record tells you in its very first line: from a violent temper and blocked emotions. Set the emotions right — that removes the root cause; then slowly build up the spleen and stomach, use a little raw malt to course the liver, and the body will gradually recover.
💬 Note from Doctor Luo: People with stomach qi failing to descend are extremely common today, and the symptoms are not limited to food stuck and refusing to go down. Some get a gush of sour fluid after meals; some get sour fluid coming up even while lying in bed; some belch constantly; some feel their stomach always aching, tight, bloated, and full — all of these are rebellious stomach qi. A survey in Taiwan found that acid reflux esophagitis (gastroesophageal reflux disease) is extremely common among white-collar workers — the cause is rebellious stomach qi, and in a considerable number of those cases the qi of the Chong meridian is surging upward too forcefully. Understand Doctor Zhang Xichun’s thinking, and you gain one more measure of vigilance — and one more direction for self-care.
Based on Doctor Luo Dalun’s narration of Doctor Zhang Xichun’s case records, from Yi Xue Zhong Zhong Can Xi Lu (Records of Integrating Chinese and Western Medicine).