Yellow Nasal Discharge and a Stuffy Nose That Won’t Clear? Doctor Zhang Xichun Treated Heat-Type Rhinitis with Sheng Shi Gao (Raw Gypsum)

Patient search terms: yellow nasal discharge / rhinitis with a stuffy nose / yellow, smelly snot / rhinitis with a foggy head / rhinitis and poor memory / chronic rhinitis — what to do

Medical terms for this condition: rhinitis (heat type) · bi yuan (deep-source nasal disorder) · nao lou (“brain leak”) · liver and stomach heat

Opening: first, tell the two kinds of nasal discharge apart — then the illness can be treated correctly

The worst thing you can do with a nose problem is rush in and treat it blindly. Doctor Luo Dalun says rhinitis actually comes in two types: one runs clear nasal discharge — usually a cold condition, deficient yang qi; the other runs yellow nasal discharge — usually a heat condition, and one that lingers longer and burns deeper. Get the direction wrong, and the medicine is all wasted.

💬 Note from Doctor Luo: For clear-discharge allergic rhinitis, I recommend Huang Yuanyu’s Jiegeng Yuanshen Tang (Platycodon and Scrophularia Decoction) — many patients have done very well on it. But yellow discharge is different — yellow discharge usually means stagnation that has turned to heat; the longer it goes, the deeper the heat gets. At that point, warm, pungent medicines no longer work. You have to change your whole approach.

So what do you do about yellow-discharge rhinitis? Doctor Luo says Doctor Zhang Xichun already gave us the answer — use sheng shi gao (raw gypsum).

But before that, one note: ordinary formularies treat rhinitis with xin yi (magnolia flower buds) and cang er (Xanthium fruit) — herbs that open the nasal passages. Doctor Zhang Xichun, however, said this condition has many causes — either wind evil blew into the pathway of the Lung channel, or liver heat moved up to the brain. Simply opening the nasal passages isn’t enough; you have to clear the heat at its root.

The patient: half a year of yellow, foul-smelling discharge, and a foggy head

While practicing in Fengtian (Shenyang), Doctor Zhang Xichun saw a patient named Guo Yutang, who lived at the Puyuan Crafts Workshop in the Daxiguan district of Fengtian. He had what was called “nao lou” — brain leak — the old Chinese name for rhinitis, because the discharge pours down as if the brain itself were leaking out.

The illness had dragged on for half a year without being cured. The discharge was thick and yellow, with a foul, fishy smell; the man also constantly felt heat in his chest and a clouded mind — his thinking was muddled and he felt dizzy and dazed all day long.

💬 Note from Doctor Luo: Folks, when rhinitis goes on for a long time, the head really does get foggy. On one side, the nose is blocked and breathing is poor; on the other, chronic inflammation of this sort genuinely affects local blood circulation in the brain. That’s why children with rhinitis often see their school grades slip and their memory worsen — it’s not that the child isn’t trying; the illness is doing it.

Doctor Zhang Xichun takes the pulse: wiry and forceful — this is heat!

For a disease that half a year of treatment couldn’t cure, Doctor Zhang Xichun was called in. He felt the pulse: wiry and forceful on both sides, and the stools were always dry — now he knew the score: this was a heat condition.

💬 Note from Doctor Luo: What kind of heat is it? Doctor Zhang Xichun’s analysis was that this man had liver heat transferred to the brain, and stomach heat rushing upward to the brain — the stomach qi fails to descend, and instead turns into stomach fire that surges upward; and the liver fire rises too, because liver qi by nature ascends. Once the liver has heat, it also travels upward. Both streams of heat press against the head, and the nose becomes the “pressure-release valve.” So this illness cannot be treated as ordinary rhinitis — you must clear the heat.

Sweat it out first: Doctor Zhang Xichun surprisingly reached for Western aspirin

Doctor Zhang Xichun judged that the illness had begun when wind evil blew into the man. So before any herbal decoction, he used aspirin — a Western medicine — to induce sweating and drive the wind evil outward.

💬 Note from Doctor Luo: Look at how Doctor Zhang Xichun used medicine — this is the hallmark of Records of Chinese Medicine with Western Reference: he advocated using both Chinese and Western medicines, classifying even Western drugs by the channel tropism and nature-and-flavor system of Chinese herbs. He frequently used aspirin to induce sweating and scatter wind evil. And what happened? The patient broke into a light sweat, and his head and eyes felt much clearer right away.

The prescription: raw gypsum leads, and a whole team of heat-clearing herbs follows

After the sweating, Doctor Zhang Xichun wrote out the formal prescription:

• Sheng shi gao (raw gypsum), 1.5 liang (about 45 g) — clears stomach heat; the vanguard
• Long dan cao (Chinese gentian), sheng hang shao (white peony root), xuan shen (figwort root), zhi mu (anemarrhena), tian hua fen (trichosanthes root powder), 4 qian each (about 12 g each) — clears liver fire, cools the blood, nourishes yin
• Lian qiao (forsythia), jin yin hua (honeysuckle), gan cao (licorice), 2 qian each (about 6 g each) — clears heat and resolves toxin
• Bo he (mint leaves) — lifts lightly upward, opens and penetrates the nasal passages

💬 Note from Doctor Luo: The logic of this formula is perfectly clear: sheng shi gao directly clears the Yangming (Stomach) heat, long dan cao clears the fire of the Liver channel, bai shao, xuan shen, zhi mu and tian hua fen nourish yin and cool the blood, lian qiao and jin yin hua resolve toxin, and bo he is light, clear and ascending — carrying the medicinal power up to the nasal passages. A whole team of heat-clearing herbs sweeps the “liver-and-stomach heat moved to the brain” fire down and away from the head and face.

The result: gypsum held steady, the rest trimmed down — cured in several doses

He took this formula for several doses. The interesting part is how Doctor Zhang Xichun adjusted it: every dose carried a fixed 1.5 liang of sheng shi gao — rock steady — while the other herbs were gradually reduced, some added, some subtracted, fine-tuned as he went. And in the course of this adjustment, the patient’s illness was suddenly cured.

💬 Note from Doctor Luo: This is Doctor Zhang Xichun’s experience with gypsum — once the heat condition is confirmed, hold the gypsum dose steady; the sovereign herb doesn’t move, and everything else revolves around it. Cured in several doses — it shows the pattern differentiation was right. When the direction is right, the medicine acts fast.

Bonus: Huang Yuanyu’s “Wuwei Shigao Tang” (Five-Flavor Gypsum Decoction) also works for yellow-discharge heat rhinitis

Can everyone use this formula? Doctor Zhang Xichun’s experience is: you can only use it this way when the heat condition is confirmed. Doctor Luo adds that you can also use the Wuwei Shigao Tang (Five-Flavor Gypsum Decoction) described by Huang Yuanyu (you can look it up online) — it also treats yellow-discharge heat rhinitis, and the thinking is the same: use gypsum to clear the heat.

💬 Note from Doctor Luo: But remember — it must be yellow discharge. Clear discharge with sneezing, the allergic kind of rhinitis, is a different animal: yellow discharge means there is inflammation — chronic inflammation at that — with a bigger impact and harder to treat. But sheng shi gao combined with other herbs works very well for it. People who have tried the Five-Flavor Gypsum Decoction have reported back that it really does work well.

Doctor Luo’s reminder: if you can’t tell cold from heat, don’t use the formula blindly

The core of this article in one sentence: first divide rhinitis into cold and heat — yellow discharge calls for gypsum. Clear discharge, aversion to wind, sneezing — that’s the cold condition, and Jiegeng Yuanshen Tang is for that; thick yellow, foul-smelling discharge with a foggy head and heat in the chest — that is the true territory of sheng shi gao.

💬 Note from Doctor Luo: So remember: not every rhinitis can use gypsum. Once the heat condition is confirmed, sheng shi gao genuinely works very well for rhinitis — this is a precious piece of experience Doctor Zhang Xichun left us. Tomorrow we’ll continue with how Doctor Zhang Xichun used sheng shi gao to treat illness.

Compiled from Doctor Luo Dalun’s commentary on the case records of Doctor Zhang Xichun; the case is from Records of Chinese Medicine with Western Reference (《医学衷中参西录》), published in installments 1918–1934.