Nocturnal Emission, Tinnitus, Dizziness and Chronic Fatigue? Doctor Wu Jutong’s Kidney-Yin Deficiency Cases Cured with Zhuan Xi Da Sheng Gao (Great Birth Paste)

What the patient was searching for: nocturnal emission / wet dreams / tinnitus / dizziness / heart palpitations / afternoon fever / no energy / dim vision Medical terms: kidney-yin deficiency · yin deficiency with internal heat · qi-yin dual deficiency · consumptive depletion (chronic wasting disease)

Opening: in the famous doctor’s consulting room, two patients who were “depleted to the bone”

Two patients with internal consumptive depletion walked into the consulting room of the great Qing-dynasty physician Doctor Wu Jutong (吴鞠通) one after another: one was 25, the other 42 — neither of them old, yet both bodies were profoundly depleted. In treating disease, a famous doctor’s skill with external-contraction illnesses lies in expelling evil, but his skill with internal-damage illnesses lies in supporting upright qi — and these two cases today are exactly where Doctor Wu Jutong’s mastery of tonifying depletion truly shows.

💬 Note from Doctor Luo: Doctor Wu Jutong is the great Qing-dynasty warm-disease specialist, the author of the Systematic Differentiation of Warm Diseases (《温病条辨》), and the inventor of Angong Niuhuang Wan (Bezoar Resurrection Pill) — world-famous for treating external-contraction disease. But today he sets external disease aside and speaks only of internal damage — because internal-damage cases are what reveal a doctor’s real skill at treating chronic illness.

The first patient: a 25-year-old young man with an abnormal flush on his face

The patient’s surname was Zong; he was 25 years old. Young in years, but his complexion was wrong — a pinkish-red face, with an abnormal tide of red flushing over both cheeks.

💬 Note from Doctor Luo: Old woodblock printing sometimes drops characters, and the text here reads “pinkish-red face” — what it really means is a flushed, reddened face. Remember: a young person should not have this kind of tidal flush. It is a signal that deficiency heat is rushing upward.

The symptoms one by one: dizziness, fever, palpitations, insomnia — all present at once

• Rapid but weak pulse (mai xu shu): the pulse beats fast, yet it is hollow and weak — a fast pulse usually means deficiency fire, deficiency heat;
• Dizziness: deficiency heat rushes upward because the root is not firm. Kidney yin is insufficient and can no longer nourish and restrain kidney yang, so the head is constantly dizzy;
• Body heat: deficiency heat, in waves, especially obvious in the afternoon (ri bu, around 3–5 p.m.) — this is the classic bone-steaming tidal heat of yin deficiency;
• Palpitations and shortness of breath: both qi and yin of the heart are injured. A palpitation is the heart giving one hollow “thump” of an empty beat — precisely what we today call premature beats, skipped heartbeats; shortness of breath is the labored breathing that abnormal heartbeats cause, a constant feeling of being stuffed up;
• Insomnia and poor appetite: with yin deficiency and heat, at night the yang cannot return to yin to rest, so he lies awake, vexed and sleepless; and with qi depleted, the spleen and stomach have no strength, so he cannot eat;
• Tongue: the tongue is red, with a very thin coating or none at all, and the pulse is thin and rapid — the classic indicators of yin deficiency.

💬 Note from Doctor Luo: Remember the combination of palpitations and shortness of breath — after COVID, many people’s hearts started “skipping” — thump, one hollow beat, and every breath feels like an effort, always stuffed up. That is palpitations and shortness of breath joined together. And a red tongue with no coating plus a thin, rapid pulse are the two hard criteria for judging yin deficiency. A young man depleted to this degree — in most cases it comes from over-consumption.

Big wisdom in a small formula: why did Doctor Wu Jutong insist on American ginseng?

Doctor Wu Jutong’s formula was not large, but every ingredient had its reason: xi yang shen (American ginseng) at the head, paired with dan pi, lotus seeds with their hearts intact, mai dong, dan shen, sheng di, wu wei zi, fu ling, and stir-fried suan zao ren, with a little rock sugar at the end.

• Dan pi (moutan bark) clears liver fire; lian zi with the heart intact clears heart fire and also tonifies the spleen — this young man had a touch of spleen deficiency too;
• Mai dong (ophiopogon root) nourishes yin; the lotus-seed hearts were blended with cinnabar (zhu sha) — cinnabar settles the spirit, and blended into the medicine it is used precisely for that calming effect;
• Dan shen (salvia root) nourishes the blood and quickens the blood; sheng di (raw rehmannia) cools the blood and nourishes yin; wu wei zi (schisandra) gathers and holds the essence of the five organs; fu ling (poria) drains dampness and strengthens the spleen;
• Stir-fried suan zao ren (sour jujube seed) nourishes liver blood and heart blood;
• Rock sugar is cool and clear, and paired with wu wei zi it performs the sour-sweet yin transformation (suan gan hua yin) — sour flavor combined with sweet generates yin fluids.

💬 Note from Doctor Luo: That first herb, “洋参” (yang shen), is xi yang shen — American ginseng. When I first read Doctor Wu Jutong’s book I was puzzled too — “yang shen” appears constantly in his writings; is it American ginseng or Japanese ginseng? Later he explained it himself: this ginseng is bitter and cold, and in his day it was very cheap — much cheaper than ren shen — so people who could not afford ren shen would process it, remove the bitter-cold quality, and use it in ren shen’s place. The moment I read “bitter and cold,” I understood — he meant American ginseng. When someone with heat in the body needs to tonify qi, ren shen tends to feed the heat, and you have to work hard to restrain it; xi yang shen tonifies both qi and yin, its nature is cool, it both nourishes yin and tonifies qi — two birds with one stone. As for the cinnabar-blending technique — do not copy that today. Cinnabar is fine as long as it is not heated, but once heated it can release toxicity. The ancients’ thinking has things worth keeping, but some of their practices we simply cannot repeat today.

Five days to effect, one batch of the great paste to finish

He took this formula for five days, and gradually he calmed — the attacks subsided. Do not be fooled: his symptoms sounded “mild,” but his depletion was severe. For the aftercare, Doctor Wu Jutong brought out his signature: Zhuan Xi Da Sheng Gao (the Focused-Contraction Great Birth Paste), coated with cinnabar, and one batch finished the job — the whole person was turned around.

The second patient: 42 years old, married at 13, nocturnal emission for years

The patient’s surname was Luo; he was 42. The cause of his illness is written plainly at the start of the case: the gate of essence opened too early — in those days people married young, and he married at 13, so his essence-qi was drained prematurely; on top of that came study and worry — reading every day for the imperial examinations, and worry injures the spirit. The result was nocturnal emission and spontaneous seminal emission for years — a classic male consumptive depletion.

Go through the symptoms one by one: kidney deficiency — the kidneys lose the strength to hold and secure, hence the emissions; because of kidney deficiency, tinnitus; blurred vision — as dusk falls each evening, his 42-year-old eyes begin to go dim; dizziness — a fog in his head, and when he turns, he feels something spinning inside his skull; low spirits — listless and dispirited; shrinking appetite — once depletion reaches a certain depth, the spleen and stomach lose their transport power and the appetite shrinks day by day.

💬 Note from Doctor Luo: When kidney yin is exhausted, yang qi runs upward — that is why yin-deficient people tend toward dizziness and tinnitus. And “a fog in the head, something spinning inside the skull” — dizziness that severe is a very typical expression of liver wind stirring internally (gan feng nei dong). The liver wood depends entirely on kidney water for nourishment; when kidney water runs short, the liver develops problems.

One formula for two years: Doctor Wu Jutong did not even prescribe a decoction

For this patient, Doctor Wu Jutong did not even prescribe a decoction. He went straight to Zhuan Xi Da Sheng Gao, one liang (about 30 g) daily, tonifying carefully and earnestly, taken day in and day out like a tonic food — after two years, completely cured. Not only were the symptoms gone, his body was strong again, and his constitution was thoroughly reversed.

💬 Note from Doctor Luo: You may wonder — Zhuan Xi Da Sheng Gao again? He used this same formula to finish several of his cases. That is precisely the hallmark of Doctor Wu Jutong’s treatment of internal damage and depletion: once the formula takes effect, close with a paste formula (gao fang). With some patients he prescribed nothing else at all — they simply ate this paste directly.

What makes Zhuan Xi Da Sheng Gao so powerful? — “Blood-and-flesh, sentient” products

Zhuan Xi Da Sheng Gao is a famous yin-nourishing formula of Doctor Wu Jutong’s own invention. Its theoretical foundation: the kidney governs the five fluids and abhors dryness (shen zhu wu ye er wu zao) — when warm-heat evil injures kidney yin, kidney yin runs short; and the liver wood depends entirely on kidney water for nourishment — when kidney water is depleted the liver develops problems, liver wind stirs internally, and the person becomes dizzy, with things spinning in the head. So the treatment must work on liver and kidney together: nourishing kidney yin is treating liver yin.

How does he tonify? Doctor Wu Jutong has a characteristic — he insists on using “blood-and-flesh, sentient” products (xue rou you qing zhi pin), meaning animal medicines — and these medicines all have strong smells.

💬 Note from Doctor Luo: The Nei Jing (Inner Classic) says “the kidney’s odor is rotten” (shen qi chou fu) — the smell the kidney likes is that of decay and fermentation. Watch people: the older they get, the more they crave fermented bean curd, soybean paste and the like. No craving when young, but as the years pile up they long for them — why? Because the kidney grows more and more deficient, and the body instinctively reaches for fermented things from the outside world to make up for the kidney’s losses. Our bodies are deeply connected with fermenting microorganisms. So when Doctor Wu Jutong tonified the kidney, he deliberately chose heavy-tasting, even slightly fishy-smelling seafood and animal medicines — strong flavor, and he used exactly that flavor on purpose. He even made a boast: set the Zhu Danxi school’s Liu Wei Di Huang-type formulas against his, and they “are not on the same level” — his kidney-yin tonics worked better. Whether that claim is fair we can debate; the approach is certainly distinctive.

One formula, 21 ingredients: sea cucumber, abalone, black-boned chicken — all good things

Doctor Luo Dalun has explained the composition of Zhuan Xi Da Sheng Gao in detail:

• Ren shen (ginseng) two jin — those who could not afford it substituted xi yang shen (in those days American ginseng was dirt cheap; foreigners shipped in huge quantities and everyone looked down on it, but once processed to remove its coldness it could stand in for ren shen);
• Fu ling (poria) two jin to strengthen the spleen and drain dampness; gui ban (tortoise plastron) to nourish yin; one pair of wu gu ji (black-boned chickens); bie jia (softshell turtle shell) one jin, separately simmered into paste, to retreat deficiency heat and nourish yin while subduing yang;
• Mu li (oyster shell) one jin, bao yu (abalone) two jin, hai shen (sea cucumber) two jin — all seafood;
• Bai shao (white peony) two jin to gather yin; wu wei zi (schisandra) half a jin to gather the essence of the five organs; mai dong (ophiopogon root) two jin to nourish yin;
• Yang yao zi (lamb kidneys) eight pairs — nourishing yin while also tending a little to yang; zhu ji sui (pig spinal cord) one jin to tonify essence and yin; ji zi huang (egg yolks) twenty to tonify essence;
• E jiao (donkey-hide gelatin) two jin to nourish yin and blood; lian zi (lotus seeds) two jin and qian shi (foxnut) to strengthen the spleen; shu di huang (prepared rehmannia) to tonify kidney essence; sha yuan ji li (flatstem milkvetch seed) to nourish yin; bai mi (white honey) to harmonize all the ingredients; gou qi zi (wolfberry) to boost essence and tonify the essence of the liver and kidneys.

The preparation is exacting too: the herbs are handled as herbs and the animal medicines as animal medicines — each group simmered separately, then combined into a paste, with the lotus seeds, foxnut, and poria ground to powder and made into pills.

💬 Note from Doctor Luo: There is a famous controversy here — Xu Lingtai was fiercely opposed to seafood, saying the fishy smell was unbearable: put sea cucumber and abalone in a formula and taste it yourself — who could swallow something that fishy? He could not understand Ye Tianshi’s seafood formulas either. Doctor Wu Jutong, by contrast, approved completely: “I have a special use for it — I use it specifically to tonify the kidney.” Abalone nourishes yin; sea cucumber tonifies yang a little. The ancients figured this out long ago — abalone and sea cucumber are both fine foods for tonifying essence.

Closing with the paste: not just curing the disease, but reversing the constitution

At this point Doctor Luo Dalun shares a very honest reflection of his own:

💬 Note from Doctor Luo: In the past, when I closed out a case I would usually prescribe a patent medicine — Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill), Gui Pi Wan (Spleen-Restoring Pill), that sort of thing — and once the symptoms disappeared, that was that. But Doctor Wu Jutong’s closing has far more staying power: after the patient responds, he finishes with Zhuan Xi Da Sheng Gao, eating the whole batch slowly — and when it is done, not only are the symptoms gone, the patient has a ruddy complexion and abundant heart-qi — the entire constitution has been reversed. A paste formula looks complicated, but it truly can turn a body’s condition around; it is a higher grade of regulation. All these ingredients can be bought at a market; if someone in your family is clearly yin-deficient, depleted for many years, and you want to reverse the constitution, you can genuinely prepare this yourself on this model — make the pills, keep them refrigerated, and finish the whole batch. Regulations do not allow private manufacture for sale, but making it for yourself and your own family is fine.

Bonus: two stories about “living well at a higher level”

Tian Gen Yue Ku Gao (Heaven’s Root and Moon’s Cave Paste) — another famous paste of Doctor Wu Jutong’s invention, and the name has a deep origin:

💬 Note from Doctor Luo: “Tian gen” (heaven’s root) and “yue ku” (moon’s cave) come from the Book of Changes (《周易》). The Song-dynasty scholar Shao Yong wrote the lines: “When the earth meets thunder, one sees the root of heaven” (about the Fu hexagram, 复卦), and “When qian meets xun, one observes the moon’s cave” (about the Gou hexagram, 姤卦). Doctor Wu Jutong was deeply versed in the Changes, and he chose this name to mean “tonifying the root” — the very root of the kidney’s yin and yang.

Gong Tingxian lived to 97 — the famous Ming-dynasty physician Gong Tingxian:

💬 Note from Doctor Luo: Gong Tingxian lived to 97 — in the Ming dynasty that was “living at a higher level.” He had all kinds of nourishing pastes and secret formulas in his hand, and he prepared them carefully and took them himself and fed them to his family. Compare us today: we feel quite sophisticated if we can prescribe a decoction, or take a bit of Bu Zhong Yi Qi Wan (Center-Supplementing Qi-Boosting Pill) or Gui Pi Wan — but really, that is only the beginner stage of Chinese medicine. Even Procter & Gamble, a Fortune Global 500 cosmetics company, has its chief scientist researching traditional Chinese medicine — one of my classmates is P&G’s chief scientist, and he says TCM research is one of their most important future directions. Someday these “higher-level living” things will be needed by all of humanity.

Compiled from Doctor Luo Dalun’s commentary on Doctor Wu Jutong’s case records; the cases come from Wu Jutong’s Case Records (《吴鞠通医案》, Qing dynasty).