Feeling Low, Crying for No Reason, Chills in the Afternoon and Fever at Night? Doctor Wang Mengying’s “Good-Tasting” Formula with Lotus Root Cured Her in Two Months
What the patient was searching for: feeling low / crying for no reason / emotional depression / chills in the afternoon and fever at night / sweating during sleep / light periods / getting thinner and thinner Medical terms: zang zao (visceral agitation) · yu zheng (depression syndrome) · neurosis (heart-liver-spleen disharmony, yin deficiency with internal heat)
Opening: this patient’s greatest fear was drinking herbal medicine
Today we continue with the medical cases of Doctor Wang Mengying (王孟英), the great Qing-dynasty master of warm diseases. I know many of you love hearing about patent medicines, but we must also tell the stories of how Doctor Wang treated patients — because that is how you learn the way Chinese medicine thinks and the theory behind it. Many friends say they want to study Chinese medicine. How do you actually learn it? You listen to the basic theory, then you read how the old physicians treated real patients, and you absorb it a little at a time — slowly it comes together. It is not something you can master overnight.
💬 Note from Doctor Luo: This case is especially interesting because the patient’s biggest fear was drinking herbal medicine. Some people are like that: the moment they smell the scent of Huoxiang Zhengqi liquid, they can’t stand it and immediately feel nauseous — it’s a physiological aversion. And of course, this is exactly the kind of person who fell ill. What do you do then?
Who was the patient? A daughter-in-law of the Zhu family who gagged at the smell of medicine
The patient’s family name was Zhu — she was the daughter-in-law of the household, recorded in the case book as Zhu shi fu (Mrs. Zhu). She had always been terrified of taking herbal medicine — “su wei yao” (素畏药, she had long dreaded medicine). Getting her to take a prescription was a huge effort: even an extremely mild, bland-tasting decoction made her vomit the moment she swallowed it. Her stomach had a physiological revulsion to medicine.
And yet this is precisely the woman who fell ill.
The illness: chills in the afternoon, fever at night, night sweats and a dry throat
Not long ago she became sick. What were the symptoms? Ri bu fa leng (日晡发冷) — chills that came on in the late afternoon, around four or five or six o’clock, as the sun was going down. The chills would last into the evening, and then fever came — waves of heat rising through the body, her arms burning hot in spells. Qin han yan gan (寝汗咽干) — she sweated in her sleep (night sweats) and her mouth and throat were parched and dry. She also had coughing with pain in both flanks (ke sou liang xie teng) — every time she coughed, the area beneath her ribs on both sides ached, in sharp, twitching spasms.
💬 Note from Doctor Luo: Reading this, many people will think: this woman is yin deficient, right? Yes — but read on. It turns out to be more than simple yin deficiency.
One month later: less appetite, lighter periods, a thinner frame
The illness dragged on for more than a month and grew steadily worse: her appetite gradually declined — she could barely eat; her menstrual flow became scanty; she grew thinner and thinner, her flesh wasting away, and she looked utterly drained and weary (shen qing pi bei). Scanty periods and weight loss are both signs of insufficiency of yin and blood. By this point the illness had become serious.
Doctor Wang Mengying arrives: one touch of the pulse and he knew
The family called in Doctor Wang Mengying. He felt the pulse: on the left, wiry and rapid (xian er shu) — wiry, taut like a lute string; rapid, beating fast — which points to yin deficiency and constrained, unhappy liver qi. On the right, rough and weak (se er ruo) — rough, not smooth and slippery; weak, lacking force.
Doctor Wang said: where does this illness live? “Ji duo yu yi, you shan si lü, suo wei bing fa xin pi shi ye” (既多抑郁，又善思虑，所谓病发心脾是也) — “She is much given to depression and much given to worry; this is what the classics call an illness that arises from the heart and spleen.” “Bing fa xin pi” is a phrase from the Huang Di Nei Jing (The Yellow Emperor’s Classic of Internal Medicine): illnesses in women readily arise from the heart and spleen.
💬 Note from Doctor Luo: Here “heart and spleen” does not mean just two organs — it actually involves three: the heart, the liver, and the spleen. Depression and low mood are the domain of the liver; once the liver has fire, the heart fire flares up, and when heart fire flares, heart yin is injured. At the same time, chronic depression makes liver qi attack the spleen (gan qi heng ni ke pi tu) — the spleen and stomach are suppressed. And the spleen governs thinking (pi zhu si lü): whether the spleen functions well is intimately tied to the emotions. So the heart, the liver, and the spleen all sit on one chain.
The root of the illness: the five organs and the emotions run on one chain
Doctor Wang Mengying laid out the mechanism like this: constant low mood and daily depression → liver fire injures liver yin, and liver yin becomes insufficient → kidney yin also becomes insufficient (the liver and kidney share the same source, gan shen tong yuan) → the liver belongs to wood and the heart to fire, and wood generates fire — the liver is the mother of the heart, so when liver yin is insufficient, heart yin is certainly insufficient too → yin deficiency generates internal heat, so a deficient fire smolders within. Meanwhile liver qi is bound up inside, and liver wood attacks spleen earth, injuring the spleen and stomach as well. So the patient gradually moved in the direction of yin deficiency — a dual deficiency of qi and yin, with yin deficiency predominating.
💬 Note from Doctor Luo: This is a chain — as soon as liver fire appears, none of the five organs can run properly: if heart yin is insufficient, can lung yin be sufficient? No. And if lung yin is insufficient, kidney yin follows. The five organs and the emotions are linked on a single chain.
The spleen governs thinking — the same idea as the gut microbiome
Speaking of the connection between the spleen and the emotions, Doctor Luo Dalun is especially struck by something: modern science has shown that the spleen in Chinese medicine overlaps to a remarkable degree with what Western medicine calls the gut microbiome.
💬 Note from Doctor Luo: The modern treatment called fecal microbiota transplantation is used mainly for emotional disorders — anxiety, depression, autism — and the results are very good. A depressed person who receives the microbiota of a happy person begins to feel happy almost immediately; this thing can genuinely be transplanted. That tells you how clever the ancient Chinese were — it is as if they already knew that the spleen is connected to the emotions, which is why they said “the spleen governs thinking.” The ancients said the spleen and the emotions were related; modern science has verified it through microbiota transplantation. Fascinating.
The problem: how do you prescribe for a patient who is afraid of medicine?
The pattern was clear, but Doctor Wang was stuck: this woman normally dreaded taking herbal medicine. If he prescribed something forceful, even slightly strong, her spleen and stomach couldn’t take it; if he prescribed something too mild, he feared it would not work. Doctor Wang said: “Cheng da jiong shi” (成大囧事) — in the Jiangnan dialect, this means “what a truly awkward, difficult business this is,” roughly the same as the Northeastern expression “cheng cheng nan ban le” (this has become a real problem).
💬 Note from Doctor Luo: He turned it over and over in his mind. Finally Doctor Wang hit on a solution — no bitter medicine at all; prescribe a formula that actually tastes good.
The breakthrough: four tasty ingredients, drunk like a daily drink
What did Doctor Wang Mengying prescribe? Just four ingredients: licorice (gan cao), wheat (xiao mai), jujube dates (da zao), and lotus root (ou), simmered together into a soup, with the instruction to drink it slowly, frequently, and over a long period — do not stop. When it was ready and the patient drank it — she was delighted! Dates, wheat, licorice — where is the strange taste? It all tastes good! So she drank it day and night (jing ri ye fu zhi), treating it as her beverage from morning to evening.
💬 Note from Doctor Luo: Can this formula actually cure illness? Licorice, wheat, and dates look utterly unremarkable — but put the first three together and you have one of the most famous formulas in Chinese medicine: Gan Mai Da Zao Tang (甘麦大枣汤, Licorice, Wheat and Jujube Decoction), from Zhang Zhongjing’s Jin Gui Yao Lue (Essentials from the Golden Cabinet), a formula made especially for women’s mental-emotional disorders. Doctor Wang added the fourth ingredient — lotus root — and that is his own special touch, which we will explain below.
Breaking down the formula: Gan Mai Da Zao Tang, Zhang Zhongjing’s prescription for “zang zao”
What does the Jin Gui Yao Lue call this illness? “Fu ren zang zao” (妇人脏躁, visceral agitation in women). What are its symptoms? “Xi bei shang yu ku, xiang ru shen ling suo zuo, shu qian shen” — “given to grief, sadness and weeping, as if moved by some spirit; and frequent yawning and stretching.” Her moods swing back and forth — cheerful one moment, sad and tearful the next — as if possessed, quite unlike normal behavior; and she yawns and stretches constantly (shu qian shen), as if moved by some unseen deity. Later physicians added more features of zang zao: insomnia; during episodes, chills and fever with trembling of the whole body; talking nonsense, jumbled speech; and mental confusion, restless and unable to sit or lie still — the heart cannot find peace.
💬 Note from Doctor Luo: In modern language, these are women’s psychiatric and psychological disorders, or neuroses (shen jing guan neng zheng) — they all fall within this category. Zhang Zhongjing established this formula two thousand years ago specifically to regulate this kind of condition.
Wheat (xiao mai) — this is the monarch herb (jun yao) of the formula. The Huang Di Nei Jing says “xin bing zhe, yi shi mai” — “those with disorders of the heart should eat wheat”; wheat is called the “grain of the heart” (xin zhi gu). It is sweet and cool (gan liang) in nature: it nourishes heart qi and heart yin, and it can resolve the stagnation of the liver channel — wheat carries an upward, spreading energy that helps the liver qi unfold. The ancients also recorded that wheat can nourish liver yin and heart fluids, and that it clears vexation, promotes urination, and stops sweating. One note here: when we want to check sweating we usually use fu xiao mai (floating wheat) — the blighted, shriveled grains that float when put in water; but Gan Mai Da Zao Tang in its proper form calls for sprouting wheat, the ordinary wheat grains we mill into flour.
Licorice (gan cao) — Chinese medicine says “gan ku ji, ji shi gan yi huan zhi” (肝苦急，急食甘以缓之): “when the liver suffers from urgency, quickly give it something sweet to relax it.” When the liver wants to spread out but cannot, sweet-tasting herbs help it ease. Licorice relaxes the urgency of the liver, and at the same time guards the middle (shou zhong) — it protects the spleen and stomach; it can also drain heart fire.
Jujube dates (da zao, hong zao) — boosts qi, nourishes blood, and tonifies the spleen; jujube is sweet and warm (gan wen), and it sits at the center, guarding the middle just as licorice does. Even if you are drunk, a bowl of jujube soup helps.
💬 Note from Doctor Luo: Just these three herbs, working on the liver, the heart, and the spleen, with a light yin-nourishing action. Why do they cure zang zao? Because zang zao is an emotional illness: liver fire injures yin, heart yin becomes insufficient, spleen earth is attacked — and these three herbs happen to cover all three organs at once.
Doctor Wang’s special touch: adding lotus root
Licorice, wheat, and dates are Zhang Zhongjing’s; the fourth ingredient, lotus root (ou), is Doctor Wang Mengying’s own insight. Doctor Wang was extremely particular about food-therapy ingredients.
Raw lotus root (sheng ou) is sweet and neutral (gan ping): it generates fluids, resolves stasis, stops thirst, clears vexation, and opens the appetite. Cooked lotus root (shu ou) tonifies deficiency, nourishes the heart, generates blood, opens the appetite, and relaxes depression (shu yu) — it can open up emotional stagnation and regulate the mood.
💬 Note from Doctor Luo: The ancients were so clever. Can lotus root really regulate the mood? I didn’t believe it either at first — but think about it: when you eat lotus root, doesn’t your gut microbiome change? The beneficial bacteria love things like Chinese yam (shan yao), lotus seeds (lian zi), lotus root (ou), Poria (fu ling), Atractylodes (bai zhu), and white hyacinth beans (bian dou). And the gut microbiome is intimately connected to the emotions — the whole world is studying microbiota transplantation for depression, autism, and anxiety. So when Doctor Wang said lotus root can “open the appetite and relax depression,” if you think it through carefully, there is real truth to it.
Bonus: lotus root powder, thick lotus root soup, and clay-pot braised lotus root
Doctor Wang Mengying had several other ways of eating lotus root, all of which he treasured:
Lotus root powder (ou fen) — made from old lotus roots ground into powder. Doctor Wang said lotus root powder is a wonderful food for women after childbirth, for the recovering, for the aged, and for those wasted by deficiency-consumption (xu lao). Thick lotus root soup (nong ou tang) — if the patient has yin deficiency with liver hyperactivity (yin xu gan wang) — liver fire with internal heat, scanty blood, or various blood-loss disorders — then boil a thick lotus root soup every day, simmer it slowly until rich and concentrated, and drink it daily; given enough time it will heal by itself, with no other medicine needed. And one more method: put raw lotus root in a clay pot, slowly braise it until extremely tender, add a little white honey (bai mi), reduce until almost dry, then eat it slowly — this is the most nourishing of all for the heart and spleen.
The follow-up visit: the pulse greatly improved, the family wanted a new formula — Doctor Wang said no
She drank it for about ten days, then returned for a follow-up. Doctor Wang felt her pulse: the pulse and symptoms had greatly improved (mai zheng da jian) — she was recovering beautifully. The family said: this food-therapy stuff is not very strong; won’t you switch her to a real prescription? Doctor Wang said: No need to change it! — “This is Zhong-jing’s marvelous formula for zang zao” (ci fang zhong sheng zang zao zhi miao ji). “I made only a small adjustment: I changed the red dates to da zao (large jujubes), taking their red color to nourish the heart (se chi bu xin) and their fragrance to please the stomach (qi xiang yue wei). I added lotus root to relax the depression and delight the emotions (shu yu yi qing). Lotus root together with Gan Mai Da Zao Tang boosts qi, nourishes blood, moistens dryness, and relaxes urgency. It is plain and unremarkable, but unlike fierce medicines it will never injure the stomach — keep drinking it for a long time. Whatever you do, do not dismiss it just because it is a ‘fruit medicine’ (guo zi yao) — everything in it is delicious.”
💬 Note from Doctor Luo: Doctor Wang’s remark is especially important: “Never dismiss it just because it is called a fruit medicine.” Medicine does not have to be bitter and fierce to be good — what matters is that it matches the pattern and cures the illness. That is what makes a good formula.
Two months later: the illness was indeed cured
The family listened and kept it up — a full two months — and the illness was indeed completely cured (bing guo huo ran)!
Look back at the whole story: emotional distress → liver fire → yin deficiency → chills in the late afternoon, night fever, night sweats, dry throat; liver fire attacking the lung → cough with pain in both flanks; the spleen and stomach growing weaker → loss of appetite; the spleen and stomach unable to transform food into blood → scanty menstruation; on top of that, the emotional distress → wasting of flesh, weariness of spirit, insufficiency of spleen qi. What Doctor Wang prescribed was, at bottom, food therapy — a big handful of wheat, plus jujubes and licorice, with slices of lotus root, drunk every day. That cured the illness.
💬 Note from Doctor Luo: Some people say Gan Mai Da Zao Tang has no effect on women’s emotional disorders — someone once ran an experiment giving emotional-disorder patients “dry glucose,” and the vast majority showed no improvement. In fact this formula must be taken slowly and steadily; sometimes it needs to be combined with other medicines according to the situation — as Doctor Wang combined it with lotus root. As long as you nourish yin, regulate the spleen and stomach, and soothe the liver, this illness will heal. Eating it for a few days naturally won’t cure it — Doctor Wang used two months. Keep taking it: there is nothing unpleasant about it, it is gentle and harmless. Drink it slowly and steadily, and your mood will surely improve.
What to take away: a formula you can “drink” your way to a better mood
Today we learned one of Doctor Wang Mengying’s clinical experiences. Doctor Wang was a master of warm diseases — he could wield the fierce, forceful White Tiger Decoction (Bai Hu Tang, with raw gypsum) for emergencies, and he could also use gentle food-therapy formulas like Gan Mai Da Zao Tang for slow, steady regulation — able to be fierce and able to be gentle (neng gang neng rou). This is a formula we can learn from, and more importantly we can learn its thinking: for a woman with yin deficiency, dryness and heat, and emotional distress, Gan Mai Da Zao Tang with lotus root is a truly excellent formula for regulating the mood — nourishing heart yin, regulating the spleen and stomach, soothing the liver and resolving stagnation. Drink it day after day, slowly — and drink your way to a better mood.
Compiled from Doctor Luo Dalun’s commentary on the case records of Doctor Wang Mengying; the case is from Wang’s Case Records (《王氏医案》).