Vomiting Blood and Bloating After Every Meal? Doctor Zhang Xichun’s Wen Jiang Tang for Spleen-Stomach Deficiency Cold

Patient search terms: vomiting blood / coughing blood / cough with blood / bloated after eating / full after meals / don’t want to eat / no appetite / chilled spleen and stomach / nausea, vomiting and diarrhea / stomach pain Medical terms for this condition: spleen-stomach deficiency cold · stomach qi rebelling upward · phlegm-damp blocking internally · upper gastrointestinal bleeding (vomiting of blood)

Opening: that spice from the kitchen is actually a “warming general for the middle”

When you hear the words dried ginger (gan jiang), do they sound familiar? They should — in some places you can even buy dried ginger and dried ginger powder at the supermarket. Doctor Luo Dalun explains: the dried ginger used in pharmacies is made by drying old, mature ginger. Don’t be fooled because it’s “in the same family” as fresh ginger — its abilities are completely different.

💬 Note from Doctor Luo: Fresh ginger releases the exterior and disperses external cold — it makes you sweat — and ginger juice also descends rebellious qi and stops vomiting, which is why a sip of ginger juice can settle nausea. What about dried ginger? Its sweat-promoting power is much weaker. Its specialty is one word: warming. Doctor Zhang Xichun believed that dried ginger warms the upper and middle burners, and it is spicier and hotter than fresh ginger, warming the body from the inside out. In one sentence: fresh ginger takes care of the outside; dried ginger takes care of the inside.

The medical case today treats a disease of the middle burner, the spleen and stomach — a 14-year-old boy who could not stop vomiting blood.

An unexpected side of Zhang Xichun: he also taught geometry

To tell this boy’s story, we first have to tell a story from Doctor Zhang Xichun’s youth. Doctor Zhang’s hometown was Yanshan, Hebei Province, and when he was young he worked as a substitute teacher — teaching geometry.

💬 Note from Doctor Luo: Don’t assume that an old-style Chinese doctor never read outside books — Doctor Zhang Xichun was nothing like that. He was enormously curious. He read Western books — Western medicine, Western science, everything. By the end of the Guangxu era (around 1908), the imperial court was establishing new-style schools that taught foreign knowledge, but the county couldn’t find any teacher who could teach it — so they invited Doctor Zhang Xichun to teach geometry. He taught classes and treated patients on the side — and the boy in today’s case is from exactly that period.

The boy was a student at another school, only 14 years old. What was his illness? — Vomiting blood. He had been vomiting blood for several days and wasn’t getting better. And notably, the bleeding usually came when he coughed — one cough and it seemed like blood was about to come up. It was a frightening sight; this was a serious illness.

One touch of the pulse, and Doctor Zhang Xichun knew: this was not heat — it was cold

The parents quickly sent for Doctor Zhang Xichun. He felt the pulse — it was slow and soft (chi er ru), and the right guan position (the middle position on the right wrist) was especially slow and soft.

💬 Note from Doctor Luo: “Slow” (chi) means the pulse beats slowly; “soft” (ru) means it feels soft and yielding when pressed. The right guan position corresponds to the spleen and stomach. A pulse that is both slow and soft — and worst at the right guan — gave Doctor Zhang Xichun his diagnosis at once: this child has spleen-stomach deficiency cold. He has been chilled; his spleen and stomach can no longer transport and transform food — so eating must be a problem.

Why this conclusion? Doctor Luo Dalun explains the logic fully: when the stomach is chilled — or overheated — the digestive system changes. If there is deficient heat in the stomach, a person typically loves eating and has a huge appetite. But if the stomach is chilled — or the qi is deficient — the result is: bloated after eating, food not digesting, badly distended. So whether the cause is qi deficiency or cold, the result can be the same: stuffy, bloated, unable to digest after a meal.

Doctor Zhang Xichun asked the boy: “Do you feel bloated as soon as you eat, and don’t want to eat?” The boy nodded: “Yes, exactly that.”

Two questions, and the root of the disease was fixed: stomach qi not descending, phlegm-damp rushing upward

Once the root cause was confirmed, Doctor Zhang Xichun explained the mechanism of the vomiting of blood.

💬 Note from Doctor Luo: Vomiting blood usually happens because the stomach qi fails to descend and instead rushes upward — the stomach qi that should go down instead goes in reverse. On top of that, this boy’s spleen and stomach were chilled, so phlegm-dampness was abundant inside, and the phlegm-damp also rushed upward with it. All of it pushed up together — and the blood was pushed right out. That is the mechanism here: not heat, but cold; not descending, but rebelling upward; phlegm-damp rushing up.

The prescription: Wen Jiang Tang — warming the middle and sending the qi back down at the same time

Doctor Zhang Xichun wrote a formula called Wen Jiang Tang (Warming and Descending Decoction), eight herbs in all:

• Gan jiang (dried ginger), bai zhu (atractylodes), ban xia (pinellia), 3 qian (about 9 g) each — dried ginger and atractylodes build the spleen and warm the middle; pinellia descends rebellious qi and stops vomiting;
• Huai shan yao (Chinese yam), 6 qian (about 18 g) — Doctor Zhang Xichun specifically insisted on Huai yam (the genuine article from Huaiqing Prefecture). It is one of the strongest herbs for starting up spleen-stomach function, a dedicated spleen-stomach tonic;
• Sheng zhe shi (raw hematite), ground to a fine powder, 4 qian (about 12 g) — hematite is a heavy, settling herb that descends rebellious qi; its mineral heaviness presses the qi downward;
• Bai shao (white peony) and sheng jiang (fresh ginger), 2 qian (about 6 g) each — white peony reins in the warmth of the formula, fresh ginger warms the yang;
• Hou po (magnolia bark), 1.5 qian (about 4.5 g) — moves the qi and eliminates distension.

💬 Note from Doctor Luo: Look how clear the logic of this formula is: dried ginger, atractylodes and yam warm up the spleen-stomach yang and start its functions; pinellia and hematite press the rebelling stomach qi and phlegm-damp back down; magnolia bark helps disperse the bloating; white peony astringes; fresh ginger assists the warming — one part lifting, one part descending, cold and warm used together. That is the rule Doctor Zhang Xichun built his formulas on.

One dose, and the blood stopped

How did the formula work? After one dose, the boy’s vomiting of blood stopped.

💬 Note from Doctor Luo: Pay attention: when the body is chilled, it can react in many ways — and one of those ways is bleeding, vomiting blood. We are used to assuming that all bleeding means heat — but that’s wrong. Doctor Zhang Xichun recorded several cases of bleeding caused by cold. Today, the moment anyone bleeds, we rush to the hospital for a gastroscopy and endoscopic hemostasis; in ancient times, the doctor had to judge whether the case was cold or heat, and treat it with herbs.

After the first dose stopped the bleeding, Doctor Zhang Xichun had the boy continue for several more doses. After a few days of medicine, the digestion opened up: no more bloating after meals, the stuffed, distended feeling was gone, eating returned to normal — and, along with it, the boy’s cough cleared up too.

💬 Note from Doctor Luo: You see — Doctor Zhang Xichun built formulas with great discipline and care: few herbs, and usually a few doses were enough. Why did the whole of Republican-era China say Doctor Zhang Xichun was the finest physician alive? This is why.

Doctor Luo’s reminder: cold drinks and air conditioning in summer — the classic way to chill the spleen and stomach

What lesson does this case teach? — A chilled spleen and stomach can cause all kinds of problems. Today the illness was cough and vomiting of blood, but what do we usually see when the spleen and stomach are chilled? Nausea, vomiting, diarrhea, then belly pain and stomach pain.

💬 Note from Doctor Luo: Many people drink cold drinks and sit in air conditioning all summer, chill their spleen and stomach, and end up vomiting and having diarrhea at the same time. What should you do? Huoxiang Zhengqi (Agastache Qi-Rectifying formula) and Fuzi Lizhong Wan (Prepared Aconite Center-Rectifying Pill) both work — and dried ginger is a major ingredient in Fuzi Lizhong Wan. So we must understand this kind of cold evil injuring the spleen and stomach: it brings vomiting and diarrhea, nausea, and spleen-stomach pain — and in this state the tongue color turns pale, and what you need is to warm the yang.

There is also an extremely common mistake that Doctor Luo Dalun specifically calls out:

💬 Note from Doctor Luo: The moment many people get diarrhea, they grab berberine (Huang Lian Su) to stop it. But if your diarrhea comes from cold, taking a bitter-cold medicine like berberine only makes you colder and colder — it may not work at all. What actually helps is warming the yang — herbs in the dried ginger family go down and you recover quickly.

So remember this: a chilled spleen and stomach leads to vomiting and diarrhea, stomach pain and belly pain. This happens often in winter, but it happens even more often in summer, when we sit in air conditioning and drink cold drinks. Be alert to it.

Compiled from Doctor Luo Dalun’s commentary on Doctor Zhang Xichun’s case records; the case is from Records of Chinese Medicine with Western Reference (《医学衷中参西录》).