Sore Throat That Isn’t Heat: Doctor Wu Jutong Warms Yang to Cure a Sore Throat of Over Ten Years
What the patient was searching for: sore throat / throat pain / swollen throat / a throat that has hurt for ten years / afraid of cold Medical terms: throat obstruction due to yang deficiency and cold (hou bi) · yang-deficient sore throat · cold in the liver channel · amenorrhea and infertility
Opening: who says a sore throat always has to be cooled?
Mention a sore throat, and the first character that pops into almost everyone’s head is “fire.” You’ve got too much heat, you’re inflamed — clear the heat, remove the toxin, take an anti-inflammatory. That is the instinctive first reaction of the vast majority of people. The famous Qing dynasty physician Doctor Wu Jutong (吴鞠通) treated exactly such a case earlier in his records — throat obstruction (hou bi) — and he used Li Dongyuan’s Pu Ji Xiao Du Yin (普济消毒饮, Universal Benefit Toxin-Resolving Beverage). That was a heat case brought on by an external pathogen, and the approach was correct. But the patient Doctor Wu meets today runs completely against cooling: every time she was cooled, the illness only got worse.
💬 Note from Doctor Luo: To understand disease you must know that illness comes in all shapes and forms — some are cold, some are hot. Most of the throat-obstruction cases we have seen so far were heat patterns. But today’s case is the other kind entirely — a cold pattern.
Who was the patient? 35 years old, with a face both blue and yellow
The patient who came to Doctor Wu Jutong was a woman, 35 years old — just past her youth, at a fine age. But one look at her face: a blue-yellow complexion (mian se qing huang). That already signals trouble — it tells you the qi and blood are not full and flourishing. Then Doctor Wu took the pulse: breathing settled, the pulse came twice per breath, wiry and tight (mai zai zhi er xian jin) — between one breath and the next the pulse beat only about two times: slow, wiry, and tight all at once.
💬 Note from Doctor Luo: A healthy person’s pulse beats four or five times per breath. Hers beat only about twice — remarkably slow. A blue face points to disease in the liver channel; a yellow face means qi and blood are not flourishing. This complexion alone already tells you: her body is cold.
How far had the illness gone? A body full of ailments
Now look at the troubles all over her body: reduced appetite (yin shi jian shao) — she could hardly eat; her menses had stopped (jing bu xing) — at 35, her periods had been gone for years; two or three masses in the abdomen (fu zhong you kuai er san mei) — hard lumps you could feel in her belly, the largest three or four cun across; and liver syncope (gan jue) — when this condition struck, she would suddenly black out and collapse, and it attacked roughly every five days without fail; worst of all, her throat had hurt without stopping for over ten years (hou tong shi shu nian bu xiu). On top of all that: twelve years of infertility.
💬 Note from Doctor Luo: Just imagine how tangled this illness was: a throat that had hurt for a decade, liver syncope, stopped periods, lumps in the belly — not one of them minor. Yet with all these conditions piled together, no one had ever read the case correctly.
Doctor Wu looked at the old prescriptions: they had it completely backwards
Doctor Wu Jutong asked to see the formulas she had taken over the years, and what he found was: nothing but cooling medicines and gynecological herbs — either cold formulas to clear heat and resolve toxins, or blood-nourishing cooling herbs for women such as bai shao (white peony) and sheng di (raw rehmannia). Sore throat? Clear the toxin and cool the heat. This same logic had been applied, unchanged, for over ten years.
💬 Note from Doctor Luo: What happens when you take cooling, bitter-cold medicines for years on end? They chip away at your yang qi, little by little. That is why this woman had been sinking in exhaustion year after year (li nian chen kun bu xiu) — always drowsy, heavy, and worn out, with not a shred of energy — and the illness grew heavier with every passing day. The more she was cooled, the colder she got; the colder she got, the worse it became.
Diagnosis: this is yang deficiency — the true yang must be rescued at once
Doctor Wu saw it in a glance: this is yang deficiency! He set the treatment strategy accordingly — the bitter-acrid-hot method, to urgently restore true yang (ku xin re fa, ji hui zhen yang). Let us try to rescue the yang qi before it is gone.
The prescription: cinnamon, galangal, Sichuan pepper… not a single sore-throat herb
The formula he wrote astonished everyone: rou gui (cinnamon bark) — warms the yang and guides fire back to its source; gao liang jiang (galangal), 3 qian (about 9 g) — similar to dried ginger but fiercer, hotter, and faster-acting; chuan jiao (Sichuan pepper), 3 qian (about 9 g) — warms the yang and dispels dampness; guang chen pi (tangerine peel) — regulates the qi; dan wu zhu yu (evodia) — warms the liver channel, for it was the cold in the liver channel that produced the liver syncope and the blue face; ban xia (pinellia) — transforms phlegm and descends rebellious qi, its nature pushing downward, working with the cinnamon to bring the fire back down to its origin.
💬 Note from Doctor Luo: Notice that Doctor Wu did not use dried ginger or aconite (fu zi). Instead he built the formula from galangal, Sichuan pepper, and evodia — a thoroughly yang-warming prescription. Look closely, and you will see that it contains not one herb that is normally used for the throat! He was not treating the throat at all; he was treating the whole body’s state.
Two doses: the throat stopped hurting, and the fainting stopped
After two doses of this formula, what happened? The throat pain eased by more than half (hou tong jian qing da ban). The liver syncope — that sudden fainting feeling — did not return (gan jue wei fa), because the liver channel had been warmed back up. She could eat again, and the abdominal pain had eased somewhat.
Seeing the formula working, Doctor Wu built on it, adding ren shen (ginseng), 2 qian (about 6 g), and fu ling (poria), 4 qian (about 12 g) — ginseng to restore upright qi, poria to drain dampness. After another four days: the pulse had risen from two beats per breath to three, the throat pain had stopped completely, her appetite had grown greatly, and the abdominal pain had eased further.
💬 Note from Doctor Luo: Adding ginseng and poria means he had started to build up the upright qi. The pulse beating faster and faster is exactly what you want: when she was cold, her yang qi was insufficient, so the pulse was slow; now that qi and blood are moving again, the pulse speeds up.
Withdrawing the strong herbs: galangal cannot be used for long
At this point Doctor Wu did something very careful: he removed the galangal. Galangal is extremely hot; it is meant to handle cold in the moment and cannot be used for a long time — leave it in too long and trouble follows. Dried ginger is different: its power is gentler, it is warming rather than scorching. He also cut back the fiercer items — the Sichuan pepper, the evodia — reducing their doses. The formula was then taken for another seven days — and the six pulses approached four beats per breath (liu mai jiang jin si zhi), the heartbeat growing faster and faster.
💬 Note from Doctor Luo: Look at how cautious Doctor Wu was with his herbs: the moment the warming medicines worked, he withdrew the strong ones and cut the doses, moving step by step. Once the qi and blood were circulating, it was time to switch to tonics and finish the job.
The finishing formula: Tong Bu Qi Jing Wan — pregnant within half a year
At this stage Doctor Wu prescribed a round of pills — Tong Bu Qi Jing Wan (通补奇经丸, Penetrating and Supplementing the Extraordinary Channels Pill). This is a famous formula of Doctor Wu’s own creation, and it treats a wide range of conditions: irregular menstruation, vaginal discharge disorders, and more — it penetrates and supplements the eight extraordinary channels, and it can even treat malaria. What is in it? Lu rong (deer antler), 8 liang (about 240 g), zi shi ying (fluorite), gui ban (tortoise shell), gou qi zi (goji berry), dang gui (Chinese angelica), rou cong rong (Cistanche), xiao hui xiang (fennel), lu jiao jiao (deer antler glue), sha yuan ji li (flatstem milkvetch seed), bu gu zhi (Psoralea fruit), ren shen (ginseng), du zhong (eucommia bark) — formed into pills, a little taken each time.
💬 Note from Doctor Luo: This formula is chiefly about supplementing yang — and above all it uses flesh-and-blood sentient products (xue rou you qing zhi pin) like deer antler and deer antler glue, which supplement yang qi far more effectively than plant medicines. Inside it there are also a few herbs to nourish yin and supplement essence, but the overall purpose is to penetrate and supplement the eight extraordinary channels. And the result? After taking it for half a year, she became pregnant (fu zhi ban nian er shou yun) — twelve years without conceiving; once the body was set right, the child came.
Note from Doctor Luo: for a sore throat, first tell apart excess fire, deficiency fire, and yang deficiency
The case is finished, but Doctor Luo Dalun distills three lessons from it.
💬 Note from Doctor Luo: First, throat conditions come in three kinds: excess fire, deficiency fire, and yang deficiency. When the kidney yang is deficient, qi and blood cannot circulate to every part of the body — wherever the body is weakest, that is where trouble breaks out; for this woman, the weak spot was her throat. Second, Doctor Wu was not treating the throat at all — his formula did not contain a single throat herb. He was adjusting the whole body: yang deficiency, so restore true yang; cold in the liver channel, so warm the liver. Once the body was warm, the other illnesses resolved one after another. Third, Chinese medicine treats the overall state of the body, not the name of the disease — warm the body up, and the symptoms that were caused by cold vanish on their own.
Bonus: Zhang Jingyue’s deficiency-fire case, and a “pale and gray” throat
💬 Note from Doctor Luo: Never assume that every swollen, painful throat is a heat pattern. Red, swollen, hot, painful throats are mostly external-pathogen heat. But there are also cases of kidney essence deficiency with deficiency fire flaring upward — Zhang Jingyue (张景岳) recorded exactly such cases: he supplemented the kidney essence with shu di huang (cooked rehmannia) and added a little rou gui (cinnamon) to guide the fire back to its source, and by the next day the patient had thinned out — the round, full face had slimmed until you would hardly recognize it. Excess fire and deficiency fire both exist — and cold patterns exist too. How do you tell them apart? A cold-pattern throat looks pale and gray (fa bai, fa cang) — not that bright red of heat. I have seen people who caught cold and lost their voice entirely, unable to speak a word — that is yang deficiency; the answer is to warm the yang, sometimes even with Ma Huang Tang (麻黄汤, Ephedra Decoction), occasionally carrying a touch of the Ma Xing Shi Gan idea, but usually plain warming of yang. In a yang-deficient person, qi and blood move slowly, the heart beats slowly, the whole body is icy, hands and feet cold.
Now look back at this woman: blue-yellow complexion — and I suspect she also bottled up a great deal of resentment (sheng men qi). Her liver channel was cold as well, which is why she fainted so often, toppling over at the slightest trigger. People with this blue-yellow complexion used to be common in the countryside: that greenish-yellow face, that cheerless expression — you knew at once they had swallowed no small amount of grievance and could never voice it.
💬 Note from Doctor Luo: I read in the news the other day about a newly married bride whose in-laws filled the table for a family meal — and made the new bride eat in the kitchen. The internet was furious. Such things really happened in the countryside in the old days. Why do I bring this up? Because a stifled heart and unexpressed liver qi (gan qi bu shu) are one of the most important sources of liver-channel illness. Where Doctor Wu Jutong was truly brilliant: he did not merely warm the body with cinnamon and galangal — he also added wu zhu yu (evodia) to warm the liver. The liver governs free flow (zhu shu xie); if the liver channel is congealed, how can qi and blood circulate? The herbs slowly opened the passage, the pulse quickened, tonics were added, and after half a year of Tong Bu Qi Jing Wan she conceived — proof that her body had returned completely to normal.
Compiled from Doctor Luo Dalun’s explanation of Doctor Wu Jutong’s case records; the original case is from Wu Jutong’s Case Records (《吴鞠通医案》).