Gasping for Air the Moment He Lay Down? Imperial Physician Gong Tingxian’s Around-the-Clock Rescue

Search terms patients use: Can’t breathe when lying down / Can’t lie flat at all / Coughing and wheezing with phlegm / Face bright red / Sweating at the slightest movement / Body too weak to go on

Medical terms: Consumption (xu lao) · Yin deficiency with blazing fire · Lung exhaustion (pulmonary tuberculosis) · Orthopnea · Sitting-up breathing

Opening: this 18-year-old son of a scholar-official family hadn’t been able to lie down for ten days

Today’s physician is the great Ming-dynasty master Doctor Gong Tingxian. In his day he was so famous that Prince Lu of the imperial family bestowed on him a plaque reading “Champion Physician of the Medical World” (yi lin zhuang yuan) — the finest doctor of his generation. That’s why so many of the cases that reached him were dire, bizarre, and urgent.

💬 Note from Doctor Luo: The illnesses he treated were often extremely serious and strange. Treat this as a story — but as you listen, savor how a physician who was the best in the world actually thought when facing a patient. That’s genuinely instructive for us.

The patient today is the son of Liu Cheng’an, an official of the Imperial Academy — the Taixue, the national university of the Ming dynasty. A household with a post there carried real status. His son, just 18 years old, in the very bloom of youth, had fallen into a miserable illness: consumption (xu lao).

💬 Note from Doctor Luo: Consumption was terribly common among the children of officials and rich families. Why? First, they never exercised. Second, in those days an 18-year-old was already married — sexual activity began early, and on top of that came the mental strain of studying for the imperial examinations. Consumption found them easily.

How sick was he? He couldn’t even lie down — death was visibly approaching

Just how depleted was this boy? The core symptoms were coughing, fever, and wheezing with phlegm — he coughed without pause, phlegm constantly pouring out. His face was flushed red, and he had spontaneous sweating — sweat broke out at the slightest movement. Worst of all: he could not lie down, day or night.

💬 Note from Doctor Luo: There really are patients like this — they can breathe standing up, but the moment they lie flat they choke and gasp. When depletion goes deep enough, even lying level cuts off the breath and every breath takes hard work. His case was more severe still: he simply could not lie down at all — the instant he did, the air stopped coming and the phlegm kept pouring out. After ten days of this, his life hung by a thread, and everyone could see the end coming.

In the old days, tuberculosis was called “lung exhaustion” (fei lao), and its terminal stage looked exactly like this — gasping, coughing, unable to lie flat. The old disease category of consumption covered a wide range of conditions, and many of them ended this way.

The family panicked; the doctors all backed away

With the son in this state, the household was frantic. They summoned physician after physician — a Taixue family could command any famous doctor in the land. But everyone who came took one look and threw up their hands: the boy was about to die, no medicine could possibly act in time, and nobody dared touch him.

That was when Doctor Gong Tingxian was called in.

One touch of the pulse: thready and rapid in all six positions — yin deficiency with stirring fire

Doctor Gong felt the pulse: thready and rapid in all six positions — the beat was weak and thin, yet very fast. He judged it a case of yin deficiency with stirring fire: the kidney yin was insufficient, the lung yin was insufficient, and once yin is depleted to a certain point, the hidden fire within begins to stir.

💬 Note from Doctor Luo: When kidney yin and lung yin are both insufficient, depletion reaches a threshold and fire stirs. The treatment must nourish and restore. But look at this patient — he can’t even lie down, he coughs endlessly, he’s full of phlegm, and he has heat. How do you tonify in a situation like that? That’s where the art comes in. Watch a master’s technique, and you’ll see it right here.

The plan: an around-the-clock protocol, from the fifth watch to nightfall

Doctor Gong Tingxian did not simply write a prescription and leave. He laid out a complete all-day plan, alternating food therapy and medicine. Let’s walk through it step by step.

💬 Note from Doctor Luo: What do we learn here? We learn the breadth of Doctor Gong’s thinking — treatment isn’t over when the prescription is written. Look how he brought in every form of food therapy: human milk, congee, cakes, working in tandem with the decoction, rotating back and forth, gradually kick-starting the spleen and kidneys until the illness slowly turned around. When you treat illness, you should coordinate food therapy, drinks, cakes and snacks with the medicine — whole-body, all-round regulation.

The fifth watch: a cup of human milk, warmed in a double boiler, fed slowly

The fifth watch — three to five in the morning, before dawn — what did he drink first? A cup of milk from a healthy nursing woman. How was it taken? Warmed by double-boiler (隔水炖) method, then swallowed in thirty or forty small sips, a little at a time, fed slowly.

💬 Note from Doctor Luo: Ancient Chinese medicine regarded human milk as deeply nourishing — it supplements yin and yang, qi and blood, with excellent results. A mother’s milk is the greatest nutritional source for her child’s growth. Different milks have different natures: goat’s milk is warm, cow’s milk is cool — when you need cooling, use cow’s milk; when primal yang is insufficient and warmth is needed, use goat’s milk. Human milk differs from both: goat’s and cow’s milk are prepared by animals for their own offspring, but human milk is prepared by humans for human offspring — it is the closest to us, and for a person who is profoundly depleted it works wonderfully. This isn’t the sort of thing you casually drink when you’re well — this was lifesaving medicine.

Dawn: Heche Dihuang Wan — the Six-Ingredient Rehmannia Pill plus human placenta

When dawn came and it was light, he took a dose of Heche Dihuang Wan (Placenta Rehmannia Pill). What is this pill? It is the Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill), with one extra ingredient added in the making: zi he che — a human placenta — ground into the powder and formed into pills.

💬 Note from Doctor Luo: Modern medicine has looked at the placenta and found hormone-like components in it — beyond nutrients, there are hormonal substances that are excellent for the fetus and have a regulating effect on the human body. It isn’t only the Chinese who use it — people in other countries eat placenta too; in parts of America it’s regarded as a good thing. This is something humanity discovered over the course of evolution: certain things genuinely benefit the body. Chinese medicine holds that zi he che supplements essence, qi and blood, and greatly restores the exhausted — when a person is desperately weak and the whole engine of life won’t start, this is the medicine, especially effective for women.

Mid-morning: yam, lotus seed, red date and walnut congee — build up the spleen first

A while after the pill, in the mid-morning, he was given congee made from rice and millet cooked together with Chinese yam (shan yao), lotus seeds (lian zi rou), red dates (hong zao), and walnut kernels (he tao ren). The yam strengthens the spleen and kidneys alike; lotus seeds tonify the spleen; red dates tonify the spleen and nourish the blood; walnuts tonify the kidneys.

💬 Note from Doctor Luo: Notice how well Doctor Gong understood timing: the morning hours correspond to the spleen channel, so from dawn through mid-morning everything he ate was spleen-strengthening — gently switching the digestive engine back on. And this congee is something everyone can copy: rice and millet, a piece of yam, a few lotus seeds with the bitter core removed, two red dates, a few walnut kernels — boil it into congee. It tonifies the spleen and tastes wonderful.

Then: two doses of Qing Li Zi Kan Tang — Anemarrhena-Phellodendron Rehmannia Pill with additions, to nourish yin and clear fire

A little later, he decocted Qing Li Zi Kan Tang (Clear the Heart and Nourish the Kidneys Decoction), two doses. This formula was made specifically for yin deficiency with stirring fire: cough, phlegm, fever, night sweats, palpitations, spleen and kidney weakness. What’s in it? Sheng di huang (fresh rehmannia) and shu di huang (prepared rehmannia) — the fresh one nourishes yin and cools the blood, the prepared one tonifies kidney essence; tian dong (asparagus root) and mai dong (ophiopogon root) — both nourish yin, paired with the fresh rehmannia to draw the kidney-essence tonifying power of the prepared rehmannia in the direction of nourishing yin; plus dang gui (angelica) and bai shao (white peony) to nourish the blood, shan yao (Chinese yam) to strengthen the spleen, and shan zhu yu (cornus fruit) to tonify the liver and kidneys.

💬 Note from Doctor Luo: Prepared rehmannia, Chinese yam, cornus — ladies and gentlemen, this is the very foundation of Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill)! Later, when Doctor Zhang Xichun tonified patients, he too led with prepared rehmannia, yam and cornus — he loved those three herbs, and always used them when building the body back up.

Then came fu ling (poria) to drain dampness, mu dan pi (moutan bark) to clear liver fire — that completes the Six-Ingredient Rehmannia base; bai zhu (atractylodes) to strengthen the spleen alongside the yam; ze xie (alisma) to drain dampness from the kidneys; and huang bai (phellodendron) plus zhi mu (anemarrhena) — with those two added, it becomes the Zhi Bai Di Huang Wan (Anemarrhena-Phellodendron Rehmannia Pill); still more fresh rehmannia, tian dong and mai dong to nourish yin, dang gui and bai shao to nourish the blood, and a little honey-fried licorice to harmonize. What does the whole formula do? Nourish yin and clear deficient fire. Why? Because his face was flushed — the yin was severely depleted and the fire floated up on top.

💬 Note from Doctor Luo: Note that Doctor Gong did not start with this cooling formula. He first stabilized the vital qi and the spleen — built up the foundation — and only then brought in the yin-nourishing, fire-clearing decoction. He used two doses, and added zhu li (bamboo sap) — why? To transform phlegm — the boy had a great deal of phlegm, and it would have been yellow; bamboo sap also moistens the bowels, cools the blood and clears heat. Then a little jiang zhi (ginger juice) as a counter-balance — “don’t make it too cold; balance it with some ginger juice.” And he had him drink it frequently — slowly, in small amounts. That was the morning.

Bai Xue Gao eaten as staple food — Doctor Gong’s food-therapy cake, even the Prince of Lu’s consort ate it

Before noon, more congee — the same pot of rice and millet with yam, lotus seeds, red dates and walnuts. And with it, what? Bai Xue Gao (White Snow Cake).

💬 Note from Doctor Luo: White Snow Cake is not an ice-cream snow cone! It’s a steamed cake of rice flour and glutinous rice flour, plus Chinese yam, lotus seeds and qian shi (fox nut / Gordon euryale seed), ground fine, a little white sugar added, and steamed through. Qian shi is the “chicken-head rice” — Doctor Luo himself loves fresh qian shi from Suzhou: thaw it, drop it in a pot with a piece of yam, boil, drink — fragrant and spleen-strengthening; a few bowls and you’re hooked. Doctor Gong said that people with internal injury, weakness, or consumption could eat this cake as their staple food. Bai Xue Gao and Rui Lian Wan (Lotus-Seed Pill) were Doctor Gong’s everyday tools — when he treated the Prince of Lu’s consort, he prescribed medicine and had her eat this cake to strengthen the spleen at the same time. See how everything starts from the spleen: he drinks congee of rice and millet with yam, lotus seeds, red dates and walnuts; he eats White Snow Cake; yam, qian shi and all the rest are worked in. The whole approach is spleen-first.

And so it cycled for three days and nights — the medicine never stopped until the fire went down

In the afternoon, past mid-day, he decocted two more doses of the previous formula (Qing Li Zi Kan Tang) and drank it slowly — a small sip every little while. Toward nightfall, congee again to strengthen the spleen, and after that two more doses of the decoction.

💬 Note from Doctor Luo: Count how much he took in one day: two doses in the morning, two in the afternoon, two in the evening — an enormous daily intake. Congee, human milk, Heche Dihuang Wan, Qing Li Zi Kan Tang, White Snow Cake, more congee — cycling through all of it. Three days and nights of this, and the medicine never once stopped.

The boy had been so depleted that he hadn’t lain down to sleep for ten days. After this continuous three-day-and-night assault — the medicine boiling, the fire subsiding — he could finally lie down. At last he slept.

💬 Note from Doctor Luo: This is what we mean when we say treating illness is a craft. Deficient fire can be truly terrifying: the patient is drained to nothing — tonify and the fire won’t go down; clear the fire and the vital qi can’t take it. You have to alternate food therapy and medicine, grinding away little by little, wearing the fire down.

Recovery: half the dose, months of gentle regulation, fully cured

Once he could lie down and sleep, Doctor Gong cut the dose in half. Within half a month the illness was six or seven parts gone; after another ten-odd days, most of it had cleared. From then on he took a single dose of decoction a day, regulated gently for several months, and finally recovered completely.

Doctor Gong’s warning: one cup of water cannot put out a great fire — but the spleen-weak with diarrhea are the exception

Doctor Gong said: for this illness, if you follow the ordinary approach — one or two doses a day, drunk once or twice — it will almost certainly fail, and the patient may die. Why? One cup of water cannot save a great fire. When a big fire is raging, does pouring a single cup of water on it help?

💬 Note from Doctor Luo: Doctor Gong said that when you meet such a patient, you may have them drink the medicine exactly the way he did. In a crisis of this severity, everyone who persists with this approach recovers. But there is one group outside this rule: those with weak spleen who have diarrhea. Why? Because Qing Li Zi Kan Tang is cool in nature. Generally, only someone with dry stools and genuine heat should use it. If the spleen is weak and the bowels are loose, giving this cool formula will chill the spleen further — the more you take, the colder it gets. So before prescribing, you must be certain the patient is yin-deficient with heat. Get the direction wrong and you’ve done real harm.

Bonus: National Master Yan Dexin’s “steroid substitute” formula

Speaking of zi he che (human placenta), Doctor Luo shares a personal story.

💬 Note from Doctor Luo: Years ago my sister came back from abroad. She couldn’t conceive overseas — Western medicine had no answer and told her to wait; she waited into her mid-thirties. Back in China she developed chronic nephritis. I treated the nephritis, got it under control, and took the chance to regulate her constitution as well. The formula I used wasn’t mine — it was the “steroid substitute” method of National Master Yan Dexin in Shanghai. When he treated nephritis, especially in children, he would sometimes need steroids; instead, he used herbs to stand in for them — zi he che (human placenta) with tai zi shen (pseudostellaria), zhi shou wu (processed fleeceflower root), and huang qi (astragalus), plus a few other herbs in equal measure, ground to powder and put in capsules, taken daily — with good results in chronic nephritis. I judged my sister’s kidney qi insufficient and regulated her with this formula. Today the sale of placentas is banned, so they’re hard to get — though a few small pharmacies still sell them. I know the full processing method: take a fresh placenta, wash it clean, boil it briefly in a pot with a little Sichuan pepper, then steam it, dry it thoroughly, and grind it to powder — then mix the powder into the ingredients of Liu Wei Di Huang Wan, grind and form the pills. That is Heche Dihuang Wan: it nourishes kidney yin and liver-kidney yin while greatly replenishing vital qi.

💬 Note from Doctor Luo: One closing thought on food therapy: Chinese yam, lotus seeds and qian shi (fox nut) are all gentle and balanced — slowly strengthening the spleen is always good for the body, and people who are run down can all use them. If there’s liver fire, add something to soothe the liver; if yin is deficient, add something to nourish yin — you can build on top of them. But the core — strengthening the spleen — is never wrong. Adjusting the spleen and stomach step by step, eating these whole grains, is an excellent way to regulate the body. Restoring the body is a whole system, not the job of a single formula. Learn a little Chinese medicine in peacetime so you’re not scrambling at the last minute, sharpening your spear only when the battle is already on.

Case source: Wan Bing Hui Chun (All Diseases Return to Spring) by Doctor Gong Tingxian (Ming dynasty, published 1587); commentary based on the public lectures of Doctor Luo Dalun (PhD in TCM diagnostics, Beijing University of Chinese Medicine).