Urinating Drip by Drip, Each Trip Takes Half an Hour? Doctor Zhang Xichun Used Raw Astragalus (Huangqi) to Promote Urination and Cure Liver Qi Deficiency

Patient search words: urinating drip by drip / difficulty urinating / straining to urinate / urine won’t come out in a stream / pain in the flanks running down into the legs

Corresponding medical terms: liver deficiency (gan xu) · liver qi deficiency (gan qi xu) · difficult urination (xiao bian bu li) · hypochondriac pain (xie tong)

Opening: yesterday he tonified liver yang — today he promotes urination. How many more talents does huangqi have?

In the past several episodes we talked about Doctor Zhang Xichun’s signature use of huangqi (astragalus) in his series on sinking of the chest qi (da qi xia xian). Then yesterday we told you how he used huangqi to tonify liver deficiency — and many listeners had an “aha!” moment: so that’s why my left side has never been as good as my right — the liver qi is insufficient! Today we stay with huangqi, and Doctor Zhang Xichun tells us this one herb is also excellent at promoting urination — you heard that right. The number-one qi-tonifying herb can also treat difficult urination.

💬 Note from Doctor Luo: Some friends listened to the sinking-chest-qi episodes and felt the symptoms fit them very well — for example, teachers who after a long lecture feel their qi sinking downward, and after using Sheng Xian Tang (the Chest-Qi-Raising Decoction) their bodies immediately feel much better. What does that tell us? In daily life many people genuinely have a tendency toward sinking of the chest qi; once you understand this principle, a little adjustment brings you back. Studying Chinese medicine is learning how to keep yourself living in a normal, healthy state.

Who was the patient: Wang Yunjin, a clerk at the Benxihu Coal and Iron Company

The story takes place in Fengtian — today’s Shenyang, which at the time governed the city of Benxi. At the Fengtian Benxihu Coal and Iron Company there was a clerk named Wang Yunjin, in his forties. Notice that when Doctor Zhang Xichun wrote up his case records, he recorded even the work unit and full name clearly — that was entirely normal in his books.

💬 Note from Doctor Luo: This kind of “real-name system” is extremely common in Doctor Zhang Xichun’s case records — “an employee of such-and-such company,” “a man from such-and-such village in such-and-such county,” even official rank and profession are written down. This left later generations extremely precious source material, and it also shows that these cases were all real and verifiable.

How bad was it? Urinating drip by drip, each trip taking half an hour

What illness did Wang Yunjin have? Difficult urination. When he passed urine it felt especially blocked and rough; the urine came out drip by drip, unable to form a stream — in plain words, it could not come out in a straight line, just one drop after another. How long did each trip to urinate take? More than half an hour! Standing there, anxious and helpless, the urine simply would not come out freely.

💬 Note from Doctor Luo: This scene sounds familiar, doesn’t it? Just like the man in the movie Crazy Stone — anxious and desperate, but the urine simply would not flow smoothly. The patient himself knows best how miserable this feeling of being “blocked up” is.

And one more strange thing: pain from below both hypochondria running down the legs, stabbing like an awl

What made it worse: Wang Yunjin had pain below both hypochondria — the two sides of the body running down into the legs — all aching. How severe was the pain? When it was acute, it felt like an awl stabbing inward. Difficult urination plus that tearing flank-to-leg pain, both at once — this patient really suffered terribly.

Taking the pulse: the right wrist normal, the left wrist especially weak

Wang Yunjin came to Doctor Zhang Xichun’s hospital (the Lida Hospital of Chinese Medicine) for treatment. The moment Doctor Zhang Xichun took his pulse, he found the key clue: the right pulse was normal, but the left pulse, when pressed, was especially weak. The two wrists did not match! Then he looked at the body — the left half did not show any obvious difference from the right half, yet the pulse told you plainly: the left side is deficient.

💬 Note from Doctor Luo: Comparing the two wrist pulses is one of Doctor Zhang Xichun’s special diagnostic skills. Yesterday’s liver-deficiency case followed exactly this pattern — weak left pulse, left half of the body functioning less well than the right. The two words “less well” are crucial — they point to a decline in function.

What did Doctor Zhang Xichun think? “In truth this is a case of liver deficiency (gan xu)”

Other doctors had failed to cure this illness, but Doctor Zhang Xichun pronounced his verdict at once: “In truth this is a case of liver deficiency” — the liver qi was weak. But you may ask: what does liver deficiency have to do with urination? Doctor Zhang Xichun explained the reasoning: the course of the liver channel passes through the genital region, and the liver qi’s proper duty is to dredge and discharge, to keep things free-flowing; it delights in smooth passage. Now that the liver qi was weak, its dredging and discharging function was out of order — it could no longer govern the lower part of the body, so urination naturally became difficult.

💬 Note from Doctor Luo: Notice — when ordinary people speak of “tonifying the liver,” what comes to mind is nourishing liver yin — using zhi shou wu (fo-ti), shan yu rou (cornus) and the like to astringe and nourish. But the liver deficiency Doctor Zhang Xichun spoke of was weakness of liver qi and liver yang, so his method of tonification was completely different — he used huangqi. This was a major breakthrough beyond the traditional way of tonifying the liver.

The prescription: sheng huangqi 8 qian as the base, with shan yu rou and zhi mu following

When Doctor Zhang Xichun wrote the prescription, he said, “Let us give it a try.” The formula was: sheng huangqi (raw astragalus) 8 qian — 8 qian (about 24 g) is a substantial amount; in Doctor Zhang Xichun’s view this dose ought to be on the heavier side; shan yu rou (cornus) and zhi mu (anemarrhena), 6 qian (about 18 g) each — one to tonify the liver, one to clear heat; then dang gui (angelica) to nourish the blood, and dan shen (salvia), ru xiang (frankincense), mo yao (myrrh) and xu duan (dipsacus), 3 qian (about 9 g) each — ru xiang and mo yao regulate qi and relieve pain, dan shen dissolves stasis, xu duan frees the channels — all herbs that get the qi and blood moving and open up the passages.

💬 Note from Doctor Luo: The thinking behind this formula is very clear: huangqi tonifies liver qi as the foundation, shan yu rou tonifies the liver substance, zhi mu restrains huangqi’s warmth and clears deficiency heat, dang gui nourishes the blood, and dan shen, ru xiang, mo yao and xu duan invigorate the blood, free the channels and stop pain. Tonification with free movement, movement within tonification — while tonifying the liver, it opens up the blocked channels.

One dose and improvement! Then add chaihu — Doctor Zhang Xichun’s special move

How did the formula work? After just one dose, both the difficult urination and the hypochondriac-leg pain clearly improved! At that point Doctor Zhang Xichun added one more herb: chaihu (bupleurum), 1.5 qian (about 4.5 g). This was Doctor Zhang Xichun’s special move — he often used sheng huangqi and chaihu together: sheng huangqi itself tonifies the liver, and its nature moves upward, able to lift up the sagging and sinking caused by weak liver qi; adding chaihu makes the lifting power even greater — chaihu’s nature also moves upward, and it specializes in soothing and unbinding the liver channel. The two herbs together — huangqi in large amount, chaihu in small amount — exactly lift the liver qi of the left half of the body.

💬 Note from Doctor Luo: Huangqi paired with chaihu is Doctor Zhang Xichun’s classic combination for tonifying the liver and lifting qi — heavy huangqi tonifies qi and raises it, light chaihu soothes the liver and shows the way; one leads, one assists, and both point in the same direction. This pairing strategy was later adopted and passed on by countless doctors.

More than twenty doses — completely cured

And so, Wang Yunjin took more than twenty doses in a row, and the illness was completely cured. You should know that when Doctor Zhang Xichun treated functional disorders, a few doses usually brought results; this case, however, needed twenty-odd doses — which shows the man’s illness really was severe, with deep roots, not something to be undone in a day.

💬 Note from Doctor Luo: In this case Doctor Zhang Xichun emphasized again and again: liver deficiency, weakness of liver qi — such a diagnosis is hardly ever mentioned nowadays, and many doctors no longer know it. Doctor Zhang Xichun accumulated a great deal of experience in this area; if we can recognize this condition, we can save many people.

What to take away: people whose left side is not as good as their right are often short of liver qi

What is this case meant to teach us? What these two episodes have introduced is liver deficiency — that is, weakness of liver qi. There are actually many such people — the functions of the left side of the body always lag behind the right, with small problems on the left that never show up as any major disease on examination. If you understand this principle and use sheng huangqi to regulate it, the problem can often be solved.

💬 Note from Doctor Luo: This is precious experience the doctors of antiquity left us. Once we understand it, we can protect our own bodies — many seemingly unsolvable “little complaints” actually have their root in insufficient liver qi. A little Chinese medicine knowledge can really come in handy at the critical moment.

(Compiled from Doctor Luo Dalun’s explanations of Doctor Zhang Xichun’s case records; the case is from Yixue Zhongzhong Canxi Lu, Records of Chinese Medicine with Reference to Western Medicine.)