Leg Pain Worse After Heating or Sweating? Doctor Zhang Xichun’s Huoluo Xiaoling Dan Case

Search terms this page answers: leg pain / leg ache / cold-attack leg pain / leg pain worse after heating / leg pain worse after sweating / both legs sore and numb / cold air rising out of my legs / rheumatic leg pain

Medical terms: leg pain · bi syndrome (arthralgia from cold-damp) · cold pathogen in the sinews and bones · qi and blood stasis (qi zhi xue yu)

Opening: yesterday leg pain, today leg pain again — because Doctor Zhang Xichun had one famous formula for it

Yesterday we told the story of Doctor Zhang Xichun treating leg pain. Today we continue with leg pain again. In yesterday’s formula there were Chinese angelica, frankincense, and myrrh — in fact, for this kind of limb pain, Doctor Zhang Xichun had one especially good formula, called Huoluo Xiaoling Dan.

💬 Note from Doctor Luo: Huoluo Xiaoling Dan is simply Chinese angelica (dang gui) plus salvia root (dan shen), plus frankincense (ru xiang) and myrrh (mo yao) — four herbs. If the legs hurt, add achyranthes root (niu xi); if the arms hurt, add forsythia (lian qiao); and so on with different additions for qi-blood stasis in different parts of the body. This is one of Doctor Zhang Xichun’s most famous formulas — it appears in the standard textbooks of Chinese herbal formulary, so everyone should remember it.

Who was the patient? A friend of Doctor Zhang Xichun’s, about fifty, never strong

The patient in today’s case was Gao Luxuan (高鲁轩) from a neighboring village. The very name tells you this is a case from Doctor Zhang Xichun’s younger years — Gao Luxuan was his friend, nearly fifty years old, and naturally weak in constitution (zi bing su lei ruo), a man who had never been robust.

💬 Note from Doctor Luo: Notice that the root of the illness is buried right in the opening line — a weak body, insufficient zheng qi (upright qi). When a person like this meets an external pathogen, trouble follows easily. Watch how Doctor Zhang Xichun analyzes it step by step.

The cause: drinking all night in winter, walking home in the cold dawn, and sitting down on a cold stone

One day Gao Luxuan went to a neighboring village to visit a friend. They ate, talked, drank some wine, and were very happy — he stayed up the entire night without sleeping. It was winter, and in the early morning he walked home. The morning was very cold, and after walking about half a mile, midway he felt both legs grow sore and numb, and he had broken into a light sweat — he could not go on.

What did he do? He sat down on the cold ground (on a stone by the road) to rest for a while. When he got up and walked on, he reached home with leg pain.

💬 Note from Doctor Luo: Look at how the illness began — he was sweating after drinking, so the pores were open; then he sat on a cold stone, and the cold pathogen slipped in through those open pores. And in a person with insufficient zheng qi, external pathogens go in especially deep. This is a textbook case of cold attack (shou han).

Two rounds of treatment that made things worse: hot-brick ironing, then a sweating remedy that ended in blood

With his legs hurting, Gao Luxuan decided it was cold, so he took a hot brick — a brick heated on the stove — and ironed his legs with it. The result: the pain got worse and worse.

Now, Gao Luxuan knew a little medicine himself. He thought: I caught cold while sweating, so I should sweat it out! He took a sweating medicine. To his surprise, not only did the leg pain not improve — it got worse. And because that medicine was too hot, he vomited several mouthfuls of blood, and his stools became dry and bound. Now he was in real trouble, so he hurriedly called for Doctor Zhang Xichun.

💬 Note from Doctor Luo: This is the part of the whole case most worth pondering: why does heat make the pain worse? Why does sweating make it worse? — Remember both questions; Doctor Zhang Xichun will answer them in a moment.

How sick was he? Lying supine with knees bent, two men holding his legs, singing and crying by turns

When Doctor Zhang Xichun arrived, he saw Gao Luxuan lying on his back with his knees bent, two men each supporting one of his legs with their hands. He would sing a moment, then cry — the picture of utter agony (tong chu wan zhuang) — the pain was unbearable. Doctor Zhang Xichun took the pulse: thin and fine, with a slightly rapid rate (xi wei shu).

💬 Note from Doctor Luo: Pay attention to those four characters, “singing and crying by turns” (you ge you ku) — this is not exaggeration. When ancient physicians recorded patients in severe pain, this is exactly how people behave; when pain reaches a certain level, a person loses control. A thin pulse means blood deficiency and insufficient zheng qi; a rapid rate means heat signs or a pathogen stirring inside.

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

Doctor Zhang Xichun began to reason. Why would the hot brick make the pain worse? — Because it drove the cold deeper inside. And why did the sweating medicine make it worse?

💬 Note from Doctor Luo: Doctor Zhang Xichun’s analysis is brilliant. The sweating medicine he took scatters cold in the muscles — it cannot scatter cold in the sinews and bones — because the cold had already penetrated into the sinews and bones. On top of that, the excessive sweating wounded his qi and blood, which is why he vomited blood; the more qi and blood were damaged, the less strength the body had to push the pathogen out, and the less able it was to restore itself. You see — the very same cold, in the muscles versus in the sinews and bones, requires completely different treatment. That is the art of pattern discrimination (bian zheng).

The prescription: Huoluo Xiaoling Dan plus deer antler glue and gastrodia — and drink it slowly

The plan was set. Doctor Zhang Xichun used Huoluo Xiaoling Dan — Chinese angelica, salvia root, frankincense, myrrh — plus deer antler glue (lu jiao jiao) 12 g (four qian) and gastrodia rhizome (ming tian ma) 6 g (two qian). What is gastrodia for? Unblocking the channels and dispelling wind.

💬 Note from Doctor Luo: One thing to remember when taking this medicine — drink it slowly. Frankincense and myrrh make some people nauseous, especially those with weak stomachs; they may feel like vomiting. Start with small sips, take it gradually, and let the stomach get used to it before drinking it normally.

The twist in treatment: the left leg healed — why did the right leg not budge?

He drank the medicine, and something amazing happened. The man holding his left leg felt cold air escaping from between his fingers — cold air rising out from inside the leg. The pain in the left leg was cured. But the right leg was completely unchanged!

💬 Note from Doctor Luo: Now this is strange — one leg cured, the other not. Anyone would wonder: why on earth? Doctor Zhang Xichun wondered too, and as he pondered, he had a sudden flash of insight — hidden here is a very deep principle of Chinese medicine.

The finishing touch: left dragon, right tiger — deer antler glue enters the left, tiger bone glue enters the right

Doctor Zhang Xichun said: throughout a person’s life, the left is yang and the right is yin (ren zhi yi sheng, zuo yang you yin). The deer is called the “spotted dragon” (ban long) — a creature of pure yang — so its glue enters the left side and not the right.

💬 Note from Doctor Luo: This statement deserves our deep thought. Chinese medicine says “left and right are the pathways of yin and yang” — that is from the Inner Canon (Huangdi Neijing). Usually we say the left is yin and the right is yang — look at pulse diagnosis: on the left wrist the cun-guan-chi positions correspond to the heart, liver, and kidney (which govern yin), on the right wrist to the lung, spleen, and life-gate (which govern yang), so the common view is left yin, right yang: the right side is qi, the left side is blood. But the theory of Chinese medicine indeed contains many schools, and physicians analyze it differently. Doctor Zhang Xichun says left dragon, right tiger — this comes from the Book of Rites (Liji): on the left, the Azure Dragon, which is yang; on the right, the White Tiger, which is yin. Hence left yang, right yin. The deer is a creature of pure yang, so deer antler glue works for the left leg.

Then what about the right leg? Left dragon, right tiger — on the right, use tiger bone glue (hu gu jiao) in place of the deer antler glue. In those days tiger bone was still obtainable; today tigers are a protected species, so tiger bone is certainly unavailable. He swapped the deer antler glue for tiger bone glue, and with the same formula the right leg also expelled cold qi — the man holding it felt the cold air escaping between his fingers — and the right leg healed too.

Doctor Zhang Xichun exclaimed with feeling: “The Book of Rites records the left dragon and right tiger, and using medicines in accord with it has produced such miraculous results — how could the ancients have deceived us!”

💬 Note from Doctor Luo: “How could the ancients have deceived us” (gu ren qi wo zai) — Doctor Zhang Xichun was genuinely delighted. This story tells us: those seemingly mystical statements in the ancient books may be conclusions the ancients drew from clinical observation, simply at a level we have not yet understood. Doctor Zhang Xichun added that once one grasps this principle, “all the Six Classics become my annotations” (liu jing jie wo zhu jiao) — everything in the classics can serve my use, like a fish in water. Chinese medicine’s theory and clinical practice confirm each other exactly this way.

A corroborating case: Li Jingnan’s left leg and right leg

Doctor Zhang Xichun then told another case to confirm it. He had a friend named Li Jingnan (李景楠), who also had left leg pain; he drank deer antler glue and was cured. Several years later his right leg hurt again; he drank deer antler glue again — not the slightest effect. At just that time a man arrived from Beijing who was drinking the tiger bone wine made by the Tongrentang pharmacy, so Li Jingnan drank that tiger bone wine — and the right leg healed too.

After he recovered, he did not understand why. Later he read Doctor Zhang Xichun’s case record of Gao Luxuan and could not help clapping his hands in delight — “There is real truth in this!”

💬 Note from Doctor Luo: You see, the two cases confirm each other: left leg pain — deer antler glue works; right leg pain — deer antler glue fails, tiger bone works. This is not coincidence; this is a rule. So the experience of the ancients truly deserves our careful study.

Doctor Luo’s analysis: what kind of medicine is deer antler glue, really? — “Yang within yin,” the saintly tonic of essence and blood

At this point we should analyze deer antler glue and tiger bone properly.

First, what is deer antler glue? Everyone knows deer velvet (lu rong) — the deer’s antler while still young and soft is called deer velvet. If that velvet is not cut off, it gradually ossifies into the large, branched antler — that is deer antler (lu jiao); the glue decocted from deer antler is deer antler glue (lu jiao jiao). Deer velvet is known as a great tonic of the du (governing) channel and a yang-warming herb; deer antler glue, by contrast, can benefit the kidney, strengthen the bones, engender essence and blood, and unblock the du channel — a truly intriguing medicine.

💬 Note from Doctor Luo: Deer velvet and deer antler glue both come from the deer’s antler, but one is the yang-tonifying young horn and the other is the essence-and-blood tonic glue — do not confuse them. This is the key to understanding today’s case: deer antler glue is not a purely yang-tonifying medicine.

Now tiger bone: this medicine is warm, pure yang, with the actions of dispelling wind-damp and strengthening sinews and bones. This medicine no longer exists, because of animal protection, but we can still study it theoretically. From Doctor Zhang Xichun’s cases we know that tiger bone is excellent for pain on the right side of the body — why? The right side belongs to yang; tiger bone is pure yang; like seeks like (tong qi xiang qiu).

💬 Note from Doctor Luo: But — we are not saying the famous physician got everything right. The phenomenon Doctor Zhang Xichun observed is real: tiger bone acts on the right, deer antler on the left. But when he explained it with yin-yang theory, his explanation is somewhat reversed. Look carefully through the ancient literature and you will find: deer antler glue is a tonic of essence and blood. True, the deer is a yang animal, carrying abundant yang qi, and deer antler does strengthen sinews and bones; but most ancients regarded deer antler glue as “yang within yin” (yang zhong zhi yin) — it is yang in nature, yet it also carries yin qualities. That is why some physicians say it enters the foot jueyin (Liver) channel, foot shaoyin (Kidney) channel, hand shaoyin (Heart) channel, and hand jueyin (Pericardium) channel, and the ancients held that it can simultaneously engender essence and blood, nourish essence and marrow, and stop uterine bleeding.

So besides tonifying the du channel, deer antler glue can also engender essence and blood — it tonifies both qi and blood. Some physicians call it the “saintly herb of the blood system” (xue jia zhi sheng yao): for bleeding and all blood-level disorders, it is an irreplaceable medicine.

💬 Note from Doctor Luo: Everyone must remember — deer antler glue belongs to “yang within yin”: it not only tonifies yang, it tonifies yin; it not only tonifies yang qi, it tonifies yin blood and essence blood. This is the greatest characteristic of deer antler glue. So why does it work for left-leg pain? — The left side belongs to blood, and deer antler glue tonifies essence and blood, hitting the pattern exactly. Doctor Zhang Xichun’s clinical experience is correct; how one rounds out the yin-yang theory is another matter — clinical effectiveness always comes first.

Bonus knowledge one: how did Doctor Zhang Jingyue praise deer antler glue?

The great Ming-dynasty physician Doctor Zhang Jingyue (张景岳) evaluated deer antler glue: it greatly tonifies the wasted and weak (da bu xu lei); benefits qi and blood, fills the essence and marrow, strengthens sinews and bones, builds muscle, and brightens the complexion (yue yan se); and prolongs life and years.

What does it treat? Vomiting blood, blood in the stool, spermatorrhea, blood in the urine — you see, all blood-related; women’s uterine flooding and dribbling discharge, red and white vaginal discharge, blood deficiency with inability to conceive, stopping pain and calming the fetus; falls and fractures — all kinds of bone and sinew injuries; sores, ulcers, swelling and pain. Doctor Zhang Jingyue concluded that it excellently assists the yin within the yang and is the foremost yin-tonifying medicine.

💬 Note from Doctor Luo: See — Doctor Zhang Jingyue’s understanding of deer antler glue matches exactly what we just explained: it tonifies yin as well as yang, and what it is best at is nourishing essence and blood. Once your understanding goes deeper, Doctor Zhang Xichun’s case becomes clear: the left side belongs to blood, so left-leg pain responds to deer antler glue. Deer antler glue is sold in shops on the street today; with this knowledge, when you meet this situation you can use it. Please note this is medical-case knowledge sharing — for actual medication, always follow your doctor’s instructions.

Bonus knowledge two: the complete modification guide for Huoluo Xiaoling Dan

Doctor Zhang Xichun used this formula for many conditions, and he summarized a whole set of modifications:

• Leg pain: add achyranthes root (niu xi);
• Arm pain: add forsythia (lian qiao);
• Women’s blood stasis and abdominal pain: add peach kernel (tao ren) and trogopterus dung (wu ling zhi);
• Red, swollen sores that are yang-type: add honeysuckle (jin yin hua), gardenia (zhi zi), and forsythia (lian qiao);
• Pale sores that are yin-type: add cinnamon (rou gui) and deer antler glue (lu jiao jiao);
• When uncertain whether yin or yang: you can add deer antler shavings (lu jiao shuang) — deer antler shavings indeed have a special detoxifying action on sores and ulcers;
• When flesh grows slowly after a sore opens: add raw astragalus (sheng huang qi) and anemarrhena (zhi mu), and you may also add licorice (gan cao);
• When an abscess forms inside the organs: add notoginseng powder (san qi fen), burdock seed (niu bang zi), and so on.

💬 Note from Doctor Luo: This is the accumulation of Doctor Zhang Xichun’s experience — one empirical formula with endless variations. Remember Huoluo Xiaoling Dan well; it will truly serve you later — for limb pain from qi-blood stasis, it is an excellent base formula.

Closing: Doctor Zhang Xichun had many more leg-pain cases

Doctor Zhang Xichun had many other leg-pain cases — for example, leg pain caused by anger, treated with cornus fruit (shan yu rou) and so on — that was liver qi deficiency; there were also cold-caused, heat-caused, and damp-heat-caused kinds, all different.

💬 Note from Doctor Luo: Today we have only introduced a few points. Remember today’s star — Huoluo Xiaoling Dan; the story of deer antler glue entering the left and tiger bone glue entering the right; and the knowledge point that deer antler glue is “yang within yin,” the saintly tonic of essence and blood. Tomorrow we continue with more of Doctor Zhang Xichun’s stories of treating patients.

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.