Cold During Your Period, Then Talking Nonsense and Seeing Ghosts at Night? Doctor Xu Shuwei Cures Heat Entering the Blood Chamber with One Needle at Qimen Point LR14
Search terms for this case: cold during your period / talking nonsense at night / seeing ghosts / chest tightness that hurts when pressed / memory suddenly worse / urinating more than usual Medical names for this condition: heat entering the blood chamber · chest binding (blood chest-binding) · delirium
Opening: Doctor Xu Shuwei, the Song dynasty master, and the final case in his Treatise on Ninety Cases of Febrile Disease
Today we continue the stories of Doctor Xu Shuwei and his classical prescriptions. Xu Shuwei was a famous physician of the Northern–Southern Song transition. He left behind a remarkable book, the Shang Han Jiu Shi Lun (Treatise on Ninety Cases of Febrile Disease) — ninety cases he treated with his own hands, each one recorded as a case with its accompanying discussion. It is the earliest surviving medical case-record book in Chinese history. The story today is Case Eighty-Nine, which took place in the ding-wei year — roughly 1127 CE.
💬 Note from Doctor Luo: This case is especially fascinating — the famous physician had already written the prescription, but the patient never took it. Instead she went to someone else and only got worse. In the end, Doctor Xu did not use medicine and did not need any other tricks — one needle, and the illness was cured.
Who was the patient? After a cold, “seeing ghosts” every night
The patient was a woman who had contracted a cold (an external contraction). What were her symptoms? Her body went hot and cold by turns — chills alternating with fever. Stranger still — when night fell she began to talk nonsense. During the day she was perfectly fine; once it got dark, something went wrong. And in her eyes she “saw ghosts” — she felt she kept glimpsing phantom figures. She was restless and manic, too agitated to settle.
Her husband hurried to Doctor Xu: “How should this illness be treated?”
💬 Note from Doctor Luo: Talking nonsense at night tells you the disease lies in the yin aspect — in the blood aspect. Mild by day, severe by night: that is the classic rhythm of heat entering the blood chamber.
One question from the master brought out the crucial fact: her period had just stopped
Doctor Xu knew these symptoms well. He asked: “Was she in the middle of her period when she caught the cold — and did the period stop dead the moment the cold set in?”
“Exactly right!” said her husband.
Doctor Xu rendered his verdict on the spot — this was heat entering the blood chamber (re ru xue shi). He said: “If the menstrual water has just come and just stopped, I fear this is heat entering the blood chamber.” And he wrote out the prescription: Xiao Chai Hu Tang (Minor Bupleurum Decoction).
💬 Note from Doctor Luo: Heat entering the blood chamber is a condition described by Zhang Zhongjing in the Shang Han Lun (Treatise on Cold Damage). During menstruation a woman’s qi and blood are depleted, and external pathogens can easily slip into the blood chamber on the weakness, causing a change peculiar to women. That is why even today, when a woman catches a cold during her period, Xiao Chai Hu granules are an excellent choice.
Sadly: the prescription was written — but the patient went to another doctor
The prescription was written. But back home the family did not follow Doctor Xu’s treatment. They called in another physician — and the other physician got it wrong.
💬 Note from Doctor Luo: What a pity — the famous doctor had analyzed everything clearly for you, and you did not even fill the prescription. When you meet a physician of Xu Shuwei’s caliber — he may not have been famous yet back then, but since you invited him and he analyzed the case, you should have trusted him to the end.
A day later the husband came rushing back in a panic: “Doctor Xu, it is bad! She has already turned into a chest-binding state!” — the family understood a little medicine, or another doctor had told them: the patient had developed chest binding (jie xiong).
What is chest binding? Why did the cold get worse with treatment?
Let me explain “chest binding” here. It is a concept in Chinese medicine: during an external contraction, if the physician mistakenly uses purging methods, the upright qi is wounded and the pathogen on the body surface sinks inward — it sinks into the chest, where it binds with the chest’s retained fluids, phlegm and heat, blocking the qi mechanism of the middle burner. That is chest binding. In another form, the taiyang disease pathogen transmits inward to the yangming and binds with the dampness and fluids already stagnating in the fu organs.
What does chest binding generally look like? The chest and hypochondrium are hard to the touch, with tenderness or stabbing pain, and sweating confined to the head — sweat only above the neck.
💬 Note from Doctor Luo: Chinese medicine classifies chest binding in great detail. Small chest binding (xiao jie xiong) is phlegm-heat binding below the heart: it hurts when pressed, but not when left alone. The treatment is Xiao Xianxiong Tang (Minor Chest-Binding Decoction) — gualou shi (trichosanthes fruit) with ban xia (pinellia) to transform phlegm, and huang lian (coptis) to clear heat; dissolve the phlegm-heat and that is done. Major chest binding (da jie xiong) is the dangerous kind: the taiyang exterior pattern is not yet resolved, a mistaken purgative drags the pathogen into the chest, and it binds with retained fluids — from below the heart down to the abdomen it is hard, full and painful, so tender that the hand cannot even approach it. In the afternoon the fever worsens; there is thirst, scanty dark urine, shortness of breath; the chest and abdomen are hard as stone; the patient cannot lie flat — the moment she lies down, breathing becomes a struggle. The tongue is red with a dry, yellow or yellow-greasy coating. This calls for Da Xianxiong Tang (Major Chest-Binding Decoction) — da huang (rhubarb), mang xiao (mirabilite) and gan sui (euphorbia root) — to drain heat and expel water, driving the chest’s fluid collections outward. Chinese medicine has worked out an extremely thorough set of treatments for chest binding.
Medicine could no longer reach it — Doctor Xu’s solution: one needle
Doctor Xu went to the patient and said: “If you had trusted me then and taken Xiao Chai Hu Tang at once, you would have been well by now. Instead the physician you hired did not understand the treatment and worked the illness into chest binding. Now with chest binding, medicine can no longer reach it — the herbs go down and cannot do their work. But I have one method: needle the Qimen point.”
Qimen (LR14) is a point on the liver channel, located on both sides of the body. For disorders of the liver channel — especially ones involving the chest — needling Qimen is extremely effective. Doctor Xu said: “Needle Qimen, and it may cure her.” Following his instructions, the needle went in, and the illness was cured — the woman recovered.
💬 Note from Doctor Luo: After the case, Doctor Xu left behind a long discussion explaining the reasoning thoroughly — he explained it himself, so let us translate it for you. Why does needling Qimen let the pathogen out? There is real scholarship in this.
Why needle Qimen? Doctor Xu’s “thief slips into the house” analogy
Doctor Xu’s reasoning ran like this: the pathogen enters the channels and collaterals and does battle with the upright qi. The battlefield shifts up and down, riding along the channels — like two fighters in a martial-arts film, now on the rooftop, now in the courtyard, now in the grass, now in the river. As it wanders, it happens to meet the menses: during menstruation a woman’s qi and blood are depleted — the blood is deficient — and the pathogen seizes the opportunity to enter, exactly as if the front door had been flung open and the pathogen slipped straight into the blood chamber.
The blood is pressed by the pathogen; the two do battle. Where does the fight carry them? Up into the liver channel — because the liver stores the blood, and every night the blood returns to the liver channel to be stored; when blood and pathogen fight, they easily enter the liver channel. What happens when the liver channel is attacked? Delirium as if seeing ghosts — talking nonsense, seeing things like phantoms. When the liver is diseased one sees ghosts; when the eyes are clouded one sees ghosts — both are signs of liver-channel attack. The fight moves on, and gathers again at danzhong — right in the chest. So the blood binds in the chest, becoming “blood chest-binding.”
💬 Note from Doctor Luo: Doctor Xu goes on to explain: in a woman’s ordinary life, water is stored in the kidneys and blood is stored in the liver. When she is not pregnant, the blood descends and there is a monthly period. When she is pregnant, the blood gathers to nourish the fetus. After childbirth, part of the blood rises and, transformed by lung qi, becomes breast milk — so breast milk and blood are one and the same substance. Now, the pathogen blocks the blood from returning to the liver; it gathers at danzhong and piles up beneath the breasts. At this point one must needle Qimen to drain it — Qimen is the front-mu point of the liver, one of the liver channel’s most important points. If the blood had not gathered at the breasts, Xiao Chai Hu Tang could still have been used; but since it has already gathered there, Xiao Chai Hu is no longer applicable.
Doctor Xu also drew an especially vivid analogy. Imagine a villain — a thief — walking down the street, and suddenly he runs into a patrol. The thief dodges everywhere; and just then a household’s woman opens her door. The thief sees the door open, and in a flash he is inside the house. The woman sees the villain has come in and flees inward, hiding in the most secluded corner of her own chambers. The villain chases after her and hides in the most secret spot, refusing to come out.
What to do? You must open a small door and let him run out — that is the principle of needling Qimen: once the blood has bound in the chest, needling Qimen gives the pathogen a way out, draws it forth, and the illness naturally heals.
What does blood chest-binding look like? Forgetful, urinating more, no thirst
Blood chest-binding is a special subtype within chest binding — pathogenic heat binding with blood in the chest and hypochondrium. What are its traits? The chief symptoms are fullness and distension in the chest and epigastrium, some pain, pain on pressure — a hard, swollen, distended feeling inside. But it has its own distinguishing marks: such a person shows signs of blood stasis — she forgets things easily, her memory suddenly deteriorates; urination is instead free and copious — she urinates more, not less; and she is not thirsty — no sensation of thirst at all.
💬 Note from Doctor Luo: Blood chest-binding is not commonly seen. Doctor Xu records this case to warn us: if heat entering the blood chamber is not treated in time, the pathogen presses deeper and forms blood chest-binding. Blood chest-binding is very serious — even Doctor Xu could no longer write a prescription for it; he solved it with the needle at Qimen.
Where is Qimen (LR14)? Rubbing it helps in daily life too
Qimen sits directly below the nipple, in the sixth intercostal space, four cun lateral to the midline of the body. This point specializes in chest and hypochondrial fullness and pain; it soothes the liver and regulates qi, invigorates blood and resolves stasis, and drains heat. So when chest inflammation is pronounced — pleurisy, for instance — needling Qimen can genuinely unload the pathogen. And even in ordinary life, when your mood is off and your liver qi is stuck, rubbing Qimen helps too — it is the topmost point of the liver channel.
💬 Note from Doctor Luo: Doctor Xu’s method was to give the bandit an exit and let him leave instead of lingering inside — and the illness untied itself. In this case Doctor Xu laid out in full detail how a woman’s blood moves when she is attacked by external pathogens: a woman is rooted in blood — blood matters more for women than anything. Each month during the period, qi and blood are depleted, and pathogens enter easily. So women should take extra care of themselves during menstruation: if you catch a cold during your period, take it seriously — do not let the pathogen march straight in.
Bonus: Doctor Xu Shuwei and the Treatise on Ninety Cases of Febrile Disease — China’s first case-record book
And with this, the story of Doctor Xu Shuwei comes to an end. Doctor Luo Dalun selected a number of cases from the Shang Han Jiu Shi Lun to share with us. Having studied them, you now have a real grasp of the Shang Han Lun, of how classical formulas are applied, and of how to protect your own body.
💬 Note from Doctor Luo: If you want to go deeper into the Shang Han Lun, I recommend the lectures by Professor Hao Wanshan — they are easy to find online; and many other experts have written excellent books on it. The Shang Han Lun is the foundation of Chinese clinical medicine. Master it, and its methods — the way it is constructed — become the cornerstone of all later study: once the foundation is laid, every other school of Chinese medicine becomes clear. Look at how I present Doctor Zhang Xichun: he constantly pulls out the Shang Han Lun to discuss. Why? The Shang Han Lun is his root — many of his formulas were born from insights into it. That is how every great physician grows.
One preview: next, Doctor Luo Dalun will turn to Doctor Gong Tingxian, the Ming dynasty imperial physician — honored as the “Number One Scholar of the Medical World.” His father was an imperial physician too. Doctor Gong’s skill was superb, and he was especially good at tonification — just right for modern people whose upright qi is insufficient. Well worth looking forward to.
Compiled from Doctor Luo Dalun’s commentary on Doctor Xu Shuwei’s case records; the case comes from the Shang Han Jiu Shi Lun.