Leg Pain So Bad You Cannot Stand or Sleep? Doctor Zhang Xichun’s Case of Cold-Attack Leg Pain

Search terms this page answers: leg pain / leg ache / leg pain so bad I cannot stand / both legs cannot bear weight / pain keeps me awake at night / cold-attack leg pain / knee pain / legs afraid of cold

Medical terms: leg pain · bi syndrome (arthralgia) · yang deficiency with cold congealing · deficiency of both qi and blood

Opening: eight out of ten people have met leg pain

Leg pain is an extremely common complaint. Today we look at how Doctor Zhang Xichun treated it — and this particular case is one he saw in his younger days.

💬 Note from Doctor Luo: This patient lived in a village next to Doctor Zhang Xichun’s. Notice that in this case the prescriptions still show a little of the hesitation and trial-and-error of youth — by the time Doctor Zhang Xichun was old and his learning mature, he usually ended such battles in just a few doses. So reading a case from his younger years lets us watch a great physician’s experience being accumulated, step by step.

Who was the patient? A village schoolmaster who slept one night in a cold room

The patient was named Dou Yingru, a private school teacher in a neighboring village — what we would call, in plain terms, the village schoolmaster. He was just past thirty, still a young man. He fell ill with leg pain in meng dong — the coldest stretch of winter.

💬 Note from Doctor Luo: Doctor Zhang Xichun recorded this man’s constitution very clearly: naturally weak (bing fu su ruo), never robust; and cold in the lower burner — he always felt cold down below, and a slight chill was enough to make him miserable. What is that? Very likely yang deficiency. When yang is deficient, external pathogenic factors find it easiest to slip in.

The trigger was simple: one day he went out on business and slept in a very cold room, with very thin bedding. The next morning he woke up with this leg pain.

How sick was he? He could not stand, and the pain kept him awake at night

When it first began, the pain was not severe — it just hurt. He called in several doctors; their medicines did nothing. Then one event became the triggering factor — he ate pig head meat.

💬 Note from Doctor Luo: Folk wisdom calls pig head meat a fa wu (a “trigger food” that provokes illness), and some people say it does nothing. In fact Doctor Zhang Xichun believed it really is a trigger food. Pork itself is not hot in nature — it is cool; Wang Mengying said pork nourishes yin. Doctor Zhang Xichun noted that there was an old saying that pork is “bitter-cold,” but in reality it is neither that bitter-cold nor poisonous — nothing so alarming. But pig head meat is indeed something special.

Doctor Zhang Xichun’s analysis is delightful: pig head meat is salty-cold in nature and has an “opening” quality — why? Look at a pig’s snout: it roots in the earth day after day and can plow a furrow, so it carries the nature of opening. A person with bound, dry stools can eat pig head meat and get the bowels open. But this salty-cold, opening nature is exactly wrong for leg pain.

The patient ate the pig head meat, and his leg pain suddenly flared up — how badly? Both legs could not bear weight — he could not stand on the ground at all.

💬 Note from Doctor Luo: This case record has one peculiarity: Doctor Zhang Xichun never wrote down exactly where on the legs it hurt. Actually most leg pain is knee pain, though it can be the whole leg — but the knee is the most common site. How bad was this patient? The pain kept him awake at night. When it reaches that point, the whole family is at their wit’s end.

How did Doctor Zhang Xichun think? The most crucial stroke of the whole case

Doctor Zhang Xichun was called in. He took the pulse: wiry, thin, and weak on both wrists, especially in the two chi positions; the rate slightly slow — the pulse beat a touch slowly.

He began to reason: this illness comes from decline of the ministerial fire of the lower burner (xia jiao xiang huo xu shuai). The body’s yang qi was never strong — the patient always felt cold below, a cold bench was enough to give him a bellyache or loose stools — so external pathogenic factors invade easily.

💬 Note from Doctor Luo: Now look at the pulse again: wiry, thin, and weak means qi deficiency — the qi is too weak to fill the body, so it cannot reach every part, and the limbs develop problems. People with qi deficiency easily have cold limbs and weak limbs. Moreover, qi and blood are bound together — when qi is depleted, blood is depleted too — so this is a person with deficiency of both qi and blood. Zheng qi (upright qi) cannot fill the limbs, so external pathogenic factors (cold-damp) get in. That is why warming yang alone is not enough: you must also tonify qi and blood, then move and unblock the qi and blood down to the legs. Only then will the leg pain resolve.

The prescription: warm yang, tonify qi and blood, unblock the channels — three roads at once

Doctor Zhang Xichun’s plan was set: assist the ministerial fire — build up the life-gate fire to expel external cold; then add medicines that tonify qi and blood, so that when the qi and blood are strong, the medicinal force can actually reach the seat of disease.

• Wild codonopsis (ye dang shen) 18 g (six qian): tonifies qi;
• Chinese angelica (dang gui) 15 g (five qian): nourishes blood — two opening herbs, qi and blood together;
• Huai achyranthes root (huai niu xi) 15 g (five qian): tonifies liver and kidney, strengthens sinews and bones, unblocks the channels. When Chinese medicine meets disease of the lower limbs — especially knee problems — many doctors like to use achyranthes root;
• Walnut kernels (hu tao ren) 15 g (five qian): tonify the kidney (the life-gate) while strengthening sinews and bones — this is Doctor Zhang Xichun’s own special insight;
• Prepared black aconite (wu fu zi) 12 g (four qian): warms yang — kidney-warming, yang-warming;
• Stir-fried psoralea fruit (chao bu gu zhi) 9 g (three qian): warms the life-gate fire, tonifies the kidney and strengthens yang;
• Frankincense and myrrh (ru xiang, mo yao): unblock the channels and stop pain;
• Clematis root (wei ling xian), about 5.4 g (one qian eight fen): dispels wind, disperses damp, unblocks the channels.

💬 Note from Doctor Luo: See how clear this formula’s logic is: for yang deficiency, walnut, aconite, and psoralea tonify kidney yang; then codonopsis to tonify qi and angelica to nourish blood; frankincense and myrrh to unblock the channels, clematis to unblock the channels — warming and tonifying on one side, unblocking the channels on the other, nothing left out.

Two herbs deserve special attention — both are knowledge points.

First, Huai achyranthes root. There are two kinds of achyranthes: huai niu xi and chuan niu xi. Huai achyranthes has the stronger tonifying action on the liver and kidney — its power to build up is great; chuan achyranthes has the stronger unblocking action — stronger at dispelling wind-damp. Here Huai achyranthes was used, taking its double virtue of both unblocking and tonifying, and also drawing the medicinal force downward and strengthening sinews and bones — 15 g, a generous dose.

Second, walnut kernels. The old books record that walnut meat moves qi and blood. Doctor Zhang Xichun’s special insight is that walnut strengthens sinews and bones. So while tonifying the liver-kidney and the life-gate, he used it to strengthen sinews and bones — for every kind of sinew-bone pain, you may add walnut kernels. That is Doctor Zhang Xichun’s hard-won experience in treating low-back and leg pain.

💬 Note from Doctor Luo: Walnut kernels have many uses: everyone knows today that walnuts nourish the brain; they can also dispel wind-cold — in the old days people cooked scallion with walnut kernels into a soup to disperse wind-cold; and for kidney-deficiency cough and wheezing, they warm the lung and settle wheezing. Doctor Zhang Xichun used them for kidney-deficiency low-back and leg pain — that is his contribution.

The setback: five doses in, why was he not much better?

He first drank five doses. The leg pain was a little lighter, but he still could not stand on the ground; the pulse had a bit more strength than before. Doctor Zhang Xichun asked the patient: after all this medicine, do you feel hot? The patient said: “I don’t feel hot at all — I feel fine.”

💬 Note from Doctor Luo: Watch this detail — it is the turning point of the whole case. The illness sits in both legs; five doses brought some effect but no real improvement, and the patient still does not feel hot. What does that tell us? The warming power is still not enough. Doctor Zhang Xichun began to rethink.

The finishing touch: one herb of raw sulfur — eight doses, and the pain greatly lessened

Doctor Zhang Xichun’s judgment: the warmth is insufficient, the medicinal force is not reaching the seat of disease. So on the original formula he added raw sulfur — after the herbs were decocted, the patient took raw sulfur powder with the liquid.

💬 Note from Doctor Luo: Sulfur is a mineral. Its power to warm yang and warm the life-gate fire is very strong. Doctor Zhang Xichun was especially skilled with sulfur his whole life — but we will not go into his sulfur methods in detail, and I do not recommend people casually take sulfur. In treating disease it can be used; taken year-round it is another matter. Doctor Zhang Xichun regarded eating sulfur as a cultivation practice and took it regularly — I think no famous physician is perfect, and on this point we reserve our opinion. But for treating illness, it is effective.

With the sulfur added, eight doses greatly reduced the leg pain — he could walk again, and the pulse had harmonized. The patient felt slight heat in the chest — the warming-tonifying force had arrived. Doctor Zhang Xichun told him: your legs are basically out of danger.

Aftercare: a bowl of yam gruel, with Qing’e Wan sent down

Now the decoction was stopped. What did he take every day? About 21–24 g (seven or eight qian) of dried Chinese yam powder, cooked into a tea-gruel, and with this yam gruel he took 9 g (three qian) of Qing’e Wan, once or twice a day, as a slow aftercare.

💬 Note from Doctor Luo: Look — the dried Chinese yam powder appears again. This shows that even in his younger years, Doctor Zhang Xichun was already using yam powder for aftercare. It was a habit he kept his whole life.

The result: the patient went on like this for about a month — both legs completely free of pain, walking exactly like a normal person.

What is Qing’e Wan? It is a patent formula made of walnut meat, psoralea fruit, and stir-fried eucommia bark — it tonifies the liver and kidney, tonifies the life-gate, unblocks the channels, and strengthens sinews and bones, and it is specifically for low-back and leg pain caused by cold.

💬 Note from Doctor Luo: Qing’e Wan is a very old formula, from the Taiping Huimin Heji Jufang — the Song dynasty’s imperial collection of proven folk prescriptions, a truly classic book. Our Huoxiang Zhengqi, Sijunzi Tang, and Siwu Tang all live in it. Qing’e Wan is aimed precisely at cold-caused low-back and leg pain — very sharply targeted. That is knowledge point number one today.

Bonus: is pig head meat really a “trigger food”?

This case record states it plainly: the patient’s illness was indeed triggered by eating pig head meat. So remember — when you are carrying a serious illness, especially a cold-type illness, pig head meat truly is a fa wu (trigger food). That is knowledge point number two.

💬 Note from Doctor Luo: Speaking frankly, most ordinary leg pain — apart from sprains and falls — is caused by cold. Why? The limbs are long and far from the trunk, easily affected by the outside world. When your zheng qi (upright qi) is insufficient, external cold and cold-damp easily get in. I have seen many people whose low-back and leg pain began after sleeping on cold, damp concrete — pain that lasted a very long time. When this happens, remember: if your zheng qi is insufficient, never go sleep in a cold place.

One more gift: notoginseng powder on the knee — joint fluid gradually melts away

One last knowledge point, connected to knee pain. If you or an elderly family member has knee pain, cannot stand, and examinations show stasis, cold-damp, or even joint fluid, synovitis — Doctor Luo Dalun teaches an external application:

💬 Note from Doctor Luo: Buy good, genuine notoginseng powder (san qi fen). Use about two grams at a time, mix with water into a paste, and every night before bed spread it on the front of the knee where it hurts (around the knee joint; the back generally does not need it). Then wrap one or two turns of plastic wrap around it — if you do not wrap it, during the night it rubs off onto the bedding and by morning it is gone. After wrapping, put on a pair of long underwear to hold it in place, and sleep. Notoginseng moves blood, resolves stasis, and unblocks the channels — and the wonder is that it draws the fluid inside out — some patients find in the morning that the plastic wrap holds only a thin film of notoginseng, all the paste seemingly gone, and when they touch the leg it is all water. Within a few days, the joint fluid slowly melts away, the knee swelling subsides, and gradually they can walk again — people who may not have been able to stand at all before.

Doctor Luo Dalun did not invent this method at first: originally he simply told people to spread notoginseng powder on the knee, and everyone reported that it all rubbed off onto their backs overnight. Later it was the patients themselves who invented the plastic-wrap method — once wrapped, the medicine stays right on the spot, and the effect is even better.

💬 Note from Doctor Luo: This is what is meant by jiaoxue xiangzhang — “teaching and learning promote each other.” I offer a method, people take it into clinical practice, and their practice invents even better methods. True wisdom lives in ordinary people’s hearts; people know how to make connections. I have recommended this to many elderly people whose knees failed, ached, and could not hold them up — the results were excellent. The only caution: the notoginseng powder must be genuine, proper, authentic notoginseng — that is very important.

Doctor Luo’s closing: the complete approach to leg pain — do not lose a single piece

This case of Doctor Zhang Xichun’s basically covers most leg-pain situations. His logic is remarkably clear:

💬 Note from Doctor Luo: For ordinary leg pain, apart from sprains and falls, cold is the commonest cause. Doctor Zhang Xichun’s approach is — warm and tonify, you must warm and tonify; while warming and tonifying, tonify qi and blood, and then unblock the channels. What tonifies qi? Codonopsis. What nourishes blood? Angelica. What warms and tonifies? Walnut, aconite, psoralea — three classic herbs. What unblocks the channels? Clematis, frankincense, myrrh. Once you have heard this logic, when you look at a doctor’s prescription you will know what he is thinking.

Compiled from Doctor Luo Dalun’s lectures on Doctor Zhang Xichun’s cases; source: Records of Chinese Medicine with Western Reference (《医学衷中参西录》), published serially 1918–1934.