Dozens of Belches After a Few Bites of Food: Doctor Miao Xiyong Rebuilds Vital Qi with Shengmai Decoction and Cures His Stubborn Son-in-Law in Half a Year
Searched by patients: belching after meals / burping after eating / hiccups / qi pushing up after meals / can’t eat / dozens of belches during one meal Medical terms for this case: belching · stomach qi rebelling upward · spleen and stomach qi deficiency · failure of the middle burner to transport and transform (qi failing to return to its source) · Sheng Mai Yin pattern
The opening: after the pandemic, so many people say “my stomach keeps pushing things back up”
Ever since the pandemic, lots of people have told me: “I never had this problem before. Why does my stomach keep pushing things back up now?” It keeps rising — one moment sour fluid, the next moment food comes right back up, and there’s belching too. This has become a common complaint for many people.
💬 Note from Doctor Luo: This is stomach qi rebelling upward (wei qi shang ni) — the stomach qi is supposed to move downward, but instead it’s pushing upward in reverse. The case today is an extreme example treated by the Ming-dynasty master Doctor Miao Xiyong: the patient belched dozens of times after just one or two bites of food. When you finish reading, you’ll see that this kind of “pushing upward” illness is very often rooted in insufficient upright qi (zheng qi).
Who is the patient? The son-in-law of Gao Panlong, founder of the Donglin Academy
Today’s patient is the son-in-law of Gao Panlong (courtesy name Cunzhi) — a man named Pu Sheng. Gao Panlong was no ordinary person: he was one of the founders of the late-Ming Donglin Party (Donglin Dang). Together with Gu Xiancheng he established the Donglin Academy, where he lectured for more than twenty years. He was a Confucian giant — one of the supreme scholarly figures of the era — and his influence on late-Ming history was enormous.
How close were Doctor Miao Xiyong and Gao Panlong? Doctor Miao treated the illnesses of the entire Gao family — the sons, the whole household, even the neighbor who sold tofu. When anyone fell sick, they all went to Doctor Miao Xiyong.
💬 Note from Doctor Luo: Doctor Miao Xiyong (1546–1627), courtesy name Zhongchun, was a native of Changshu, Jiangsu — a famous physician of the late Ming and one of the originators of the wen bing (warm disease) school. He wrote Xian Xing Zhai Medical Notes (《先醒斋医学广笔记》) and Shen Nong Ben Cao Jing Shu (Commentary on the Divine Farmer’s Classic of Materia Medica). He was a generous, straightforward man who collected folk remedies everywhere — if anyone had a proven formula, he would learn it. In daily life he was close to the Donglin figures — Gao Panlong and Qian Qianyi were his friends, and when the eunuch faction drew up its blacklist, his name appeared on it too. He was a physician with a great many stories.
A few bites of food, dozens of belches — and this son-in-law didn’t even believe in Chinese medicine
What was Pu Sheng’s illness? Qi rebelling upward (qi shang ni) — the qi kept pushing back up. How bad was it? After every one or two bites of food, he immediately started belching (ai qi) — and each time it came, dozens of belches in a row. Two more bites, and dozens more belches came back up. During a single meal, this would happen three or four times (shi qing san si zuo).
💬 Note from Doctor Luo: This is not ordinary burping. Qi pushing upward this violently — Doctor Miao Xiyong saw the mechanism in one sentence: “Ci qi bu gui yuan, zhong jiao bu yun ye” — “This is qi failing to return to its source; the middle burner cannot transport and transform.” The qi cannot be gathered and held — it won’t return to its proper home. The middle burner’s qi cannot transport and transform, so the qi never returns to its origin; it refuses to run its normal course and insists on rushing upward instead.
What made it worse: Pu Sheng was a bit rebellious — he didn’t believe in Doctor Miao Xiyong. He went to other doctors, who gave him “qi-moving medicines” (kuai qi yao) — the usual qi-regulating herbs: “Your qi is pushing upward, so let me regulate your qi.” The result? The more he took them, the worse he got.
Ginseng raised from 2 qian to 6 qian — and he flat-out refused to take it
Doctor Miao Xiyong’s method was just one thing: rebuild the vital qi (yuan qi), with ginseng (ren shen). But Pu Sheng dragged the matter out for half a year without taking the medicine.
💬 Note from Doctor Luo: Watch Doctor Miao Xiyong’s dosing rhythm. At first he said 2 qian (6 g) of ginseng; two or three months later, with the illness progressing, he said 4 qian (12 g); two or three months after that, he said “jin xu shen” — “now the deficiency is severe” — and prescribed 6 qian (18 g). The ginseng dose kept climbing, but Pu Sheng simply refused to believe him, and three times he didn’t take the medicine. And so it dragged on for another month, and then it broke bad: he could no longer eat at all (yin shi bu xia) — food completely refused to go down. Every time he vomited, it was clumps of cold air (leng qi ru tuan) coming up from his stomach, and qi was blocked between the upper and lower body (shang xia qi bu zu) — the whole qi mechanism was stuck. Everyone concluded: this man is surely going to die.
His father-in-law takes command in person: you will take this medicine!
At this point Gao Panlong panicked — he went personally to his son-in-law’s house and sat there to supervise: “You must take Doctor Miao Xiyong’s medicine. Not taking it is not an option!” The father-in-law was the elder; no matter how stubborn the son-in-law was, he had to listen respectfully — and only then did he take the medicine.
💬 Note from Doctor Luo: You see how close Doctor Miao Xiyong and Gao Panlong were — it got to the point of forcing the medicine down. This son-in-law was lucky, really: he had a master like Miao Xiyong watching over him; he just didn’t know to cherish it at first. A great Confucian like Gao Panlong entrusted the lives of his whole family to Doctor Miao Xiyong — that alone shows the reputation Miao Xiyong’s medicine enjoyed in his day.
The formula: Shengmai Decoction as the base, with a line-up of descending herbs
The formula Doctor Miao Xiyong wrote: ren shen 6 qian (18 g) to rebuild the vital qi — Miao Xiyong used ginseng with great precision; mai men dong 3 qian to nourish yin, moisten dryness and generate body fluids, balancing the ginseng so it doesn’t create dry heat; wu wei zi 2 qian to gather with its sour, astringent nature — holding in the qi that has just been supplemented.
💬 Note from Doctor Luo: Ren shen, mai dong, wu wei zi — this is Sheng Mai Yin (Pulse-Engendering Decoction)! The very same Sheng Mai Yin they sell in pharmacies — ginseng, dwarf lilyturf root and schisandra, three ingredients. The Qianlong Emperor took Sheng Mai Yin every single day — 1 qian (3 g) each of ginseng and mai men dong, equal amounts, day in and day out. Here the ginseng went up to 6 qian — that’s a large dose, because this man’s upright qi had been drained too severely.
The formula also carried a whole team of herbs to regulate the qi mechanism and pull qi downward:
- Ju hong 1 qian — red tangerine peel from the south: the white pith is scraped off, leaving the red outer skin. It regulates qi and opens the lung, with a warming nature;
- Sha ren (amomum fruit) — moves the stomach qi; once the stomach qi opens, dampness can be transformed. It can also guide qi back to its source, pulling qi downward. Old doctors often use sha ren as an “opening herb” — first use sha ren to open the spleen and stomach, and only then can the medicines behind it get in and do their work;
- Bai shao (white peony root) — relaxes spasm, relieves pain, and softens the liver;
- Chen xiang 5 fen (agarwood) — its medicinal nature moves downward; it descends the qi;
- Yi zhi ren (black cardamom fruit) — warms the spleen and stomach;
- Shan zhu yu (cornus fruit) — supplements liver yin and nourishes liver blood; together with bai shao it restrains the liver qi — because qi rushing upward is linked to liver qi rebelling, so while supplementing qi you must not forget to nourish the liver;
- Su zi (perilla seed) and pi pa ye (loquat leaf) — descend the lung qi. The lung sits at the very top — it is the “canopy” (hua gai) of the body. When lung qi descends, heart fire moves down and stomach qi descends with it; the qi of the whole body follows.
The administration was equally refined: decoct in water, and just before drinking add 15 spoonfuls of chen xiang juice and one large cup of lu gen (reed rhizome) juice. In addition, the herbs were ground to powder and bound with a paste of shan yao (Chinese yam) into pills, taken on an empty stomach with plain water — the pills were kept for the slow, long-term supplementation afterward.
A “pop” under the heart — and everything opens up above and below
The first dose went down with no change. The second decoction, still nothing — but there was one difference: he no longer threw the medicine back up the way he always had before. Then the third decoction (fu san jian): suddenly, a sound like a report under the heart (xin kou xia ru bao yi sheng) — “pop!”
💬 Note from Doctor Luo: After that sound, the belching stopped above, and below, xiao sou wu suan — urine poured out endlessly; nobody knew how much he passed. This is ti hu jie gai — “lift the pot lid”: once the lid is lifted, the water can flow out. The lung qi opened, and the whole qi mechanism above and below cleared — even the water-dampness that had been stuck in the middle burner began to dissolve. Then he got hungry and asked for congee. He drank three or four bowls in a row — and nothing happened! Before, the merest bite of food brought cold air rushing up and lodging stuck inside; now three or four bowls of congee went down with no rebellion at all. That was a tremendous turn for the better.
Cut 2 qian and it relapses: rebuilding qi can’t be rushed
He continued the medicine for five or six more doses, and then Doctor Miao Xiyong cut the ginseng by 2 qian — and the belching flared up a little. Back up to 6 qian at once. After another month, the ginseng was reduced again by 2 qian (6 g), and he kept taking it. Finally he switched to the pills, supplementing slowly.
After half a year, he was completely cured. This time, Pu Sheng was thoroughly convinced of Doctor Miao Xiyong.
💬 Note from Doctor Luo: The root cause of this illness was insufficient upright qi — vital qi severely depleted. Water-dampness lingered in the body, the ascending and descending functions of the organs were disordered — the spleen failed to send clear qi up, the stomach failed to send turbid qi down — the middle burner was blocked, and so he couldn’t eat, and everything came back up. Doctor Miao Xiyong’s strategy: Sheng Mai Yin to rebuild the vital qi as the main line, plus herbs to open the lung qi and descend the qi (ju hong, sha ren, yi zhi ren, chen xiang, su zi, pi pa ye), and bai shao and shan zhu yu to restrain the liver — a very precise combination. The core is one word: supplement (bu). Draining downward is easy; rebuilding upright qi is genuinely hard — you have to persist and build it up bit by bit. Do you think you can take 300 g of ginseng in one dose and be instantly restored? No way. Take a small amount every day, keep at it over the long term — only when the vital qi gradually fills will the body recover. Half a year was a long time even for Doctor Miao Xiyong, but when upright qi is depleted, this is exactly how you have to nourish it back.
Bonus 1: chen xiang and the incense ceremony — don’t treat chemical incense as a treasure
That chen xiang (agarwood) in the formula deserves a few extra words. Why is it called “sinking fragrance”? Because the wood is very heavy — it sinks in water. The key is that its medicinal nature moves downward — so for vomiting caused by a cold stomach, or qi rushing upward, agarwood warms the stomach while descending the qi; for wheezing and rebellious qi, agarwood likewise pulls the qi back down.
💬 Note from Doctor Luo: A lot of people today practice incense ceremonies (xiang dao) and burn agarwood. I have to warn you: much of the incense people burn is chemical incense, made from chemical materials — burning and inhaling it is like breathing chemical products, and it harms countless people. Some places even have people inhaling it daily, and it’s actually very bad for the body. And even with genuine agarwood, not everyone should smell it: if your qi is already sinking in the middle burner (zhong qi xia xian) — if you’re usually too weak to speak and your qi feels like it’s sagging downward — then inhaling an incense that pushes qi down, as agarwood does, is exactly wrong for you. A little knowledge of Chinese medicine teaches you how to choose.
Bonus 2: answering a listener’s question — treating retained fluids without promoting urination misses the root
At the end of the program, Doctor Luo answered a listener’s message: in the earlier case of Ge Wenxue of Danyang (the eye ailment, a retained-fluid case), the previous doctor had also used strengthening the spleen, moving qi, regulating stagnation and clearing phlegm — more or less the same thinking as Doctor Miao Xiyong’s. Why didn’t the previous doctor’s approach work, while Miao Xiyong’s did?
💬 Note from Doctor Luo: The difference lies in promoting urination (li shui). When Doctor Miao Xiyong treated that eye ailment, he added three herbs to promote urination on top of Er Chen Tang (Two Aged Decoction): fu ling, zhu ling and ze xie. A retained fluid (yin) is after all water — if you only transform the phlegm and never drain the water out, it won’t work. The previous doctor strengthened the spleen, moved qi and transformed phlegm, but did not promote urination — so treating retained fluids without promoting urination misses the root. This is where Miao Xiyong’s mastery shows: the same phlegm-transforming, spleen-strengthening approach, but with one extra herb to move water — and the disease was cured. That level of prescription, miraculous and fully refined, is worth savoring and studying slowly.
Compiled from Doctor Luo Dalun’s commentary on Doctor Miao Xiyong’s case records; the case comes from Xian Xing Zhai Medical Notes (《先醒斋医学广笔记》) by Doctor Miao Xiyong (Ming dynasty).