Bloody Diarrhea Dozens of Times a Day, and No Appetite? Doctor Wang Mengying’s Light, Clear Herbs for Five-Colored Dysentery from Summer-Heat, Dampness and Food Stagnation

Patient search terms: bloody diarrhea / dozens of bowel movements a day / tenesmus (urgent urge that will not ease) / diarrhea with pus and blood / dysentery / unable to eat anything Medical terms: five-colored dysentery (wu se li) · locked-mouth dysentery (jin kou li) · summer-heat dampness with food stagnation (acute bacterial dysentery, amoebic dysentery)

The opening: the great Qing-dynasty warm-disease physician Doctor Wang Mengying — today’s case is a child’s dysentery

The case we discuss today comes from Doctor Wang Mengying (王孟英), one of the foremost physicians of the Qing dynasty. The Yu Ling Gao (Jade Spirit Paste) he created is wonderfully effective for nourishing the blood in women — and it works just as well for men, so famous is this blood-nourishing formula. Today’s case, however, has to do with an upset stomach — so if you are eating right now, you may want to pause before reading on, because this is quite a special illness.

💬 Note from Doctor Luo: Doctor Wang Mengying, personal name Shi Xiong, was a native of Haining in Zhejiang province, and the great synthesizer of the warm-disease school (wen bing xue pai). He wrote Re Wei Jing Wei (Warp and Woof of Warm-Heat), Wang Shi Yi An (The Medical Cases of the Wang Family), and Sui Xi Ju Yin Shi Pu (Dietary Guide of the Suixi Studio). His case records have one outstanding feature: detailed records and agile thinking — especially in treating warm epidemics, he had many methods, bold courage, and fine attention to detail. His cases are well worth studying.

Who was the patient? The younger son of the Jin family, struck in September by the severest kind of dysentery

The patient was the son of Jin Yuangu (金苑谷) — that is a person’s name; he held the office of she ren (舍人, a court gentleman) — specifically his second son (次郎), named Kuiguan (葵官), still a child. In September, at the very turn of summer and autumn, this child came down with five-colored dysentery (五色痢).

💬 Note from Doctor Luo: September, the turn of summer and autumn — this time marker is important. In Chinese medicine, “in autumn, injury by dampness; in winter, cough arises” is one matter, but the turn of summer and autumn is precisely the peak season for dysentery. Remember this seasonal background — Doctor Wang Mengying’s diagnosis later hangs on this one word “summer-heat” (暑).

What is five-colored dysentery? Far fiercer than ordinary dysentery

Everyone knows dysentery — a common acute intestinal infectious disease, especially frequent in summer and autumn. Its main signs are abdominal pain, diarrhea, and tenesmus (li ji hou zhong). What does tenesmus mean? It means when you feel the urge to go, the urgency is unbearable, yet after you finish, the pain remains. With ordinary diarrhea you feel relieved after a bowel movement — not with dysentery: the pain is dreadful, you go and feel you have not quite emptied, you stay squatting there, and the pain inside continues.

💬 Note from Doctor Luo: Remember these four characters, “li ji hou zhong” (里急后重): li ji is the urgent need to go; hou zhong is the dragging, painful sensation that remains after going. In modern medicine this corresponds to acute bacterial dysentery or amoebic dysentery — it is the classic picture of dysentery.

In severe cases, the stool may contain pus and blood — things like blood coming out; red ones are one type; some pass what is called red-and-white dysentery (chi bai li) — red and white mixed together. And five-colored dysentery is even more severe: the discharges come in many colors and include bleeding, hence the name “five-colored”; in Chinese medicine it is also called toxic dysentery (du li) — the pathogenic toxin is extremely severe. Ordinary dysentery is already deep and vicious with every passage; five-colored dysentery sits at the very top of the dysentery scale.

How bad was it? Dozens of trips a day — and after seven or eight days, he could not even eat

The child went dozens of times a day — “xia shu shi xing” (下数十行), as the text says. Imagine: squatting again and again, in agony. This dragged on for seven or eight days, until at last he could no longer eat at all — this is locked-mouth dysentery (jin kou li): the dysentery drains away below, yet he cannot take food, has no appetite whatsoever.

💬 Note from Doctor Luo: Once dysentery turns into “locked-mouth dysentery,” it is a very grave signal — below, still draining; above, nothing going in; fluids, qi and blood cannot hold out. This can turn into a catastrophe. In the old days, with poor medical conditions, such an infection could genuinely kill. Even today, acute dysentery is not an ordinary diarrhea — the pain and the misery are not to be taken lightly.

By this point the child was groaning in pain, in mortal danger, and the family urgently called for physicians.

The previous doctors quarreled: the ginseng faction versus the rhubarb faction — and Su Dongpo’s death was brought up

The first physician proposed warming tonics with ginseng — with all this draining, the child must be terribly deficient, so cook up some ginseng and feed it to him. Here Doctor Luo told a painful historical anecdote:

💬 Note from Doctor Luo: Su Dongpo was ruined exactly this way. After being pardoned from exile on Hainan island and heading back inland, he was overjoyed, and rushed to Zhenjiang on the Yangtze to gather with Mi Fu and his friends. After so many years of deprivation in Hainan and Lingnan, with nothing good to eat, he let himself go once he was back — and got an upset stomach, pouring diarrhea. Su Dongpo knew some medicine, and thinking himself so deficient, gave himself a bowl of ginseng soup. The result? Blood began to seep from between his teeth, oozing out like earthworms. He went through several more gatherings after that, and finally lay down in a small boat — in scorching heat, the moisture steaming up like a sauna, until he could bear it no longer, and so he passed away. He had actually also eaten ginseng porridge and astragalus porridge hoping to support his upright qi — but this was the moment for clearing summer-heat dampness, not for supporting upright qi; taking ginseng at such a time is fatal. So when a physician wants to prescribe ginseng for such a patient, think carefully: what season is it, and what disease is this?

The other physician advocated rhubarb to purge (da huang xie xia): flush it all out. That is somewhat closer to the mark, but rhubarb alone will not do — it must be combined with other herbs. With the two physicians at odds, the whole family was in a panic, not knowing what to do.

Doctor Wang Mengying settles the case at once: summer-heat dampness with food stagnation — and hot medicines had been mistakenly taken

Then Doctor Wang Mengying was summoned. One look, and he said the child’s condition was “summer-heat dampness with food stagnation” (暑湿食滞) — he had been affected by summer-heat qi. What is summer-heat? Summer-heat is heat pushed one step further (暑为热之渐) — something fiercer than plain heat. Wind, cold, summer-heat, dampness, dryness and fire are the six exogenous pathogenic qi (wai gan liu yin); summer-heat is stronger than heat: that scorching weather with summer-heat qi intertwining — weather that is especially hot is called summer-heat; and summer-heat is usually tangled together with dampness — some parts of the North China Plain are terribly dry, but many places are stifling, muggy-hot, and that is summer-heat combined with dampness.

💬 Note from Doctor Luo: Why, eating the same food, did others stay fine while this child fell ill? Because the child’s spleen and stomach were weak, with food stagnation inside — he had eaten too much, things got stuck, the circulation of qi and blood was obstructed, food could not be properly transformed and transported, and so external pathogens could invade easily. Thus it was summer-heat dampness + food stagnation combining to cause the illness.

Moreover, the earlier physicians had already written prescriptions — in this summer-heat dampness situation, they gave hot-natured medicines, so hot medicines had been mistakenly taken. Doctor Wang Mengying said: at this point neither attacking nor tonifying can be applied (攻补皆不可施) — both approaches are flawed.

💬 Note from Doctor Luo: Here is a very important illusion to explain to everyone: a person with dysentery or diarrhea, when the urge to go comes, will feel extremely cold — a gust of cold wind makes the abdominal pain worse, the legs go numb, and immediately another trip; sit down on a cold bench and it is unbearable, you must rush to the toilet; thin trousers, a cold wind — cannot stand it. So many people (including physicians) conclude this is yang deficiency and want to warm and tonify. Not at all! This is pathogens blocked inside, the qi mechanism failing to flow, so yang qi cannot reach the extremities, and that is why the person feels cold — this is the manifestation of a damp-heat infection. The textbooks describe this syndrome differentiation clearly, but in clinical reality it is all illusion; and a small child cannot explain himself, only says his stomach hurts and he cannot eat, so you must be all the more careful in distinguishing. If at such a time you still warm and tonify, is that not adding frost to snow?

Breaking down the prescription: neither attack nor tonify — take the juice lightly, and the illness is cured

How did Doctor Wang Mengying treat it? He said: “Take the juice lightly, and the illness is cured” (轻轻取汁，即可愈病). The formula he wrote used very light herbs:

• Bei sha shen (coastal glehnia root) — placed first; what for? To replenish fluids. After so many days of pouring diarrhea, fluids are already insufficient — should they be supplemented or not? They should.
• Huang lian (coptis) and huang qin (scutellaria) — clear heat and dry dampness; jin yin hua (honeysuckle) — resolve toxins. Is there toxic pathogen? Of course there is — heat toxin. Not warming yang: resolving toxins.
• Fresh lian zi (fresh lotus seeds) — tonify the spleen and dispel summer-heat. Lotus seeds grow inside the lotus flower, which has various summer-heat-dispelling properties; growing in water, cool and refreshing, they can clear summer-heat.
• Zhi zi (gardenia) — clears heat and frees the triple burner.
• Pi pa ye (loquat leaf) — opens the lung qi, because the lung and the large intestine are paired as exterior and interior (fei yu da chang xiang biao li); opening the lung qi clears summer-heat; loquat leaf is cool and clears summer-heat.
• Shi hu (dendrobium) — nourishes yin, replenishes fluids.
• Bian dou (white hyacinth bean) — tonifies the spleen, stops diarrhea.
• Jie geng (platycodon) — works together with loquat leaf to open the lung qi: loquat leaf moves down, platycodon moves up, opening the lung qi — to treat disease of the large intestine, regulate the lung, for the lung and the large intestine are paired as exterior and interior.
• Shan zha (hawthorn) and shen qu (medicated leaven) — resolve food stagnation. With stagnation stuck inside, the qi mechanism cannot turn or generate, so it must be cleared away.
• Hua shi (talc) — clears heat outward, guiding summer-heat out through the urine.

💬 Note from Doctor Luo: Look at this line of thought: there are herbs clearing substantial heat, herbs nourishing yin and replenishing fluids, herbs opening the lung qi, herbs resolving food stagnation — four battle groups joined together. For a formula like this, the doses are all small, all light, because when regulating the qi mechanism, light is enough. This is Doctor Wang Mengying’s brilliance: not smashing the illness with fierce drugs, but gently turning the blocked qi mechanism around bit by bit.

The treatment twist: can such light medicine possibly work? — “Even if the medicine cannot overcome the disease”

When the formula was written out, the family looked at it and thought: “Heavens, the child is at death’s door, and your formula is this light? Can it possibly work? Serious illness with light medicine — surely that will not do?” At that point, there was in the household a resident scholar (xi xi xian sheng — an educated man living in the house, something like a private adviser), named Zhuang Xiaochun (庄晓春), who spoke up. He said: “Even if the medicine cannot overcome the disease” (纵使药不胜病) — even granting that the strength of the medicine cannot press down the illness — the reasoning Doctor Wang Mengying explained, I find profoundly sound. Since that is so, let the child try it; the medicine is so light that it cannot possibly worsen the condition — let him taste it.

💬 Note from Doctor Luo: Savor what Zhuang Xiaochun said: “Even if the medicine cannot overcome the disease” — a man who understands reason, having heard Doctor Wang Mengying explain the medical principle, chose to trust. Doctor Wang Mengying’s greatest ability lies precisely here: the formula is light, but the reasoning is explained so thoroughly that people are convinced. Treating illness sometimes depends not only on the medicine, but also on the trust and cooperation of the patient’s family.

And what happened? After drinking it, “abdomen and back were both at ease” (腹背皆安) — after taking it, the abdominal pain greatly improved, the child settled down, and the illness seemed to vanish. Doctor Wang Mengying then adjusted the formula for another ten days or so, and the illness was completely cured.

Doctor Wang Mengying’s lotus seed classic: dry lotus seeds, fresh lotus seeds, and stone lotus seeds — each with its own use

The most distinctive element in this case is the lotus seed (lian zi) — Doctor Wang Mengying made the lotus seed come alive. At the end of the case record, Zhou Guangyuan (周光远) recorded the content of his long conversation with Doctor Wang Mengying:

💬 Note from Doctor Luo: Doctor Wang Mengying said, the lotus seed can tonify stomach qi and make qi move downward. When the spleen and stomach are weak, qi tends to move upward; the lotus seed tonifies the spleen and stomach, then makes the qi mechanism descend. If there is regurgitation (fan wei) — because the stomach is deficient, qi rushes upward, and the stomach cannot hold things down — then every day take dry lotus seeds, chewing slowly and swallowing (gan lian zi xi jiao man yan), chewing them thoroughly and swallowing, eating them this way daily. Doctor Wang Mengying said this effect surpasses taking many medicines (胜于服药多矣). This is his personal experience.

There is also a food-therapy formula called Yu Zhi Wan (Lotus-Seed-Stuffed Pig Stomach Pills): take one pig stomach, wash it clean, fill it full of de-pitted lotus seeds, tie the opening shut, boil it in water until soft, take it out and dry it, then pound both pig stomach and lotus seeds together into a fine powder and form it into pills. People with weak stomach qi who take this regularly will grow plump and strong (令人肥健). This is the same approach as Doctor Wang Mengying’s Yu Ling Gao: both are food therapy, both nourish and regulate the body.

💬 Note from Doctor Luo: Finally, about stone lotus seeds (shi lian zi). In autumn, when the lotus flowers wither and the seed pods ripen, some are never picked and fall into the water by themselves; soaking there they finally turn black, like stones — those are stone lotus seeds. They specifically tonify the spleen and stomach and stop diarrhea, and in treating dysentery they are often used. In the past, stone lotus seeds were a common Chinese medicine, dug out of the mud of lotus ponds; but now many pharmacies no longer stock them — ask for stone lotus seeds and most will say no. Even in the Qing dynasty Doctor Wang Mengying said that many stone lotus seeds sold in pharmacies were fakes. He sometimes had patients with diarrhea mail-order them from Tong Ren Tang in Beijing, because that pharmacy had purchasing channels. When he truly needed stone lotus seeds and could not get them, he had no choice either — so he used fresh lotus seeds instead: fresh lotus seeds decocted are fragrant and clear, not turbid, and their stomach-settling action is also good. For true locked-mouth dysentery, stone lotus seeds stop diarrhea better; but better to use fresh ones than to buy fakes.

As for locked-mouth dysentery — when the diarrhea reaches the point of being unable to eat — Doctor Wang Mengying said: in that state, heat pathogen has injured the stomach, harmed its pure harmonious qi; at that point do not think about warming yang or anything of the sort — patients at that stage basically have severe heat toxin. So use huang lian (coptis), bitter, to drain the pathogen (huang lian ku xie qi xie) — coptis resolves toxins, clearing away the heat toxin; and use lian zi (lotus seeds), sweet, to settle the stomach (lian zi gan zhen qi wei) — lotus seeds are sweet, and settle and guard the stomach. One bitter, one sweet — a wonderfully matched pair.

What to take away: recognizing summer-heat dampness — and one lotus seed, three uses

💬 Note from Doctor Luo: What can we learn from this case? How Doctor Wang Mengying recognized summer-heat dampness, cleared damp-heat, nourished yin, and used bian dou (white hyacinth bean), jin yin hua (honeysuckle), and the rest — lightly turning the qi mechanism around and removing summer-heat dampness together with food stagnation — that is his skill. Even more worth learning is his life wisdom: dry lotus seeds, fresh lotus seeds, stone lotus seeds — one lotus seed, three uses explained; add Yu Zhi Wan and Yu Ling Gao, and it is all the craft of putting medicine into food (寓医于食). Learn a little more of such Chinese medicine knowledge, and it can genuinely help you take care of yourself and your family.

Based on the lectures of Doctor Luo Dalun (PhD in TCM diagnostics, Beijing University of Chinese Medicine) explaining the medical cases of Doctor Wang Mengying; the case is from Wang Shi Yi An (The Medical Cases of the Wang Family).