Talking Nonsense and Seeing Things That Aren’t There? Doctor Zhu Danxi Fortified Upright Qi and Resolved Phlegm to Cure a Case That Looked Like ‘Possession’
Patient search terms: talking nonsense / saying crazy things / seeing things that aren’t there / seeing ghosts / acting possessed / confused after a fright / heart palpitations / fear / fear of dying — what to do
Medical terms for this condition: phlegm clouding the heart orifices · phlegm-damp obstruction · mental confusion · deficiency and phlegm illness resembling spirit possession (from Extra Teachings on Attaining Knowledge)
Opening: a boy chugged iced sour plum soup on a scorching day — then he seemed “possessed”
In the dead heat of midsummer, under a blazing sun, a young man of about seventeen or eighteen, the son of a government official, worked hard all day. He sweated buckets and was desperately thirsty — so he picked up a jug of ice-cold sour plum soup and gulped it down, glug, glug, glug, one huge jar in a single breath. What a relief.
But no one could have guessed what came next. One after another, he suffered three or four terrible frights: riding in a carriage, it nearly tipped over; walking downstairs, the staircase almost collapsed beneath him… Before his startled family could recover, the boy came apart — he began talking nonsense and saying he could see things nobody else could see. “There’s an animal over there,” he’d say. “There’s a person standing there.” But the room was empty. His family was terrified: wasn’t this possession — some ghost or evil spirit?
💬 Note from Doctor Luo: When you see an illness that looks like possession, don’t jump straight to ghosts and spirits. Doctor Zhu Danxi wrote a famous essay with exactly this title — “On Deficiency and Phlegm Illnesses That Resemble Spirit Possession.” Deficiency illnesses and phlegm illnesses can look remarkably like an evil spirit at work, and this essay records precisely this case: it looks like possession, but the real roots are “deficiency” and “phlegm.” If you treated it as true possession, not only would you fail to cure it, the patient could die — what a tragedy that would be.
Who was the patient? An official’s son, seventeen or eighteen, whom Doctor Zhu called “elder brother”
The young man was the son of a certain official (the title is unclear in the original recording). In the case record, Doctor Zhu Danxi addresses him as “xiong” — “elder brother.” You may wonder: a lad of seventeen or eighteen, why “elder brother”?
💬 Note from Doctor Luo: This was a traditional honorific. Regardless of age, you could call someone “xiong” — “Brother Zhang,” “Brother Li.” Even today, I call friends a few years younger than me “xiong” — it’s politeness, respect, not a ranking by age. So Doctor Zhu calling this youth “elder brother” is nothing strange at all.
How did the illness come about? Three things piled on top of each other
Doctor Zhu Danxi had a habit of sorting out the causes of an illness one by one. In this case, the causes were perfectly clear:
First, heavy labor and thirst. It was the hot summer month, he worked hard and sweated heavily, his fluids were badly damaged, and his upright qi was consumed as well — this is what Chinese medicine calls labor injuring upright qi.
Second, gulping down iced sour plum brew. Sour plum soup is sour and cold — a fine summer drink in itself — but he downed far too much in one go, and all that sour, cold liquid stagnated in the middle burner (zhong wan, the stomach region), pooling there undigested.
Third, three or four great frights in a row. Fright disturbs the spirit.
💬 Note from Doctor Luo: Notice that this kind of “messy” illness is what Chinese medicine calls a miscellaneous disease (za bing). Look how complicated the causes are: summer heat, heavy labor, heavy sweating, iced drinks, fright… several threads tangled together. If you can untangle the threads of a miscellaneous disease, you’re a master. Doctor Zhu Danxi was especially good at exactly this kind of case — which is why there’s an old saying among the people: “For miscellaneous diseases, use Danxi.” One more note: sweating a lot in summer, a bowl of plum and rock-sugar water is genuinely good for you — it clears summer heat and generates fluids. His mistake wasn’t drinking plum soup; it was chugging an entire pot of iced plum brew in one breath. A normal amount is fine; drinking like a madman causes trouble.
How bad did it get? Delirious speech and hallucinations — sick like a ghost story
The youth talked nonsense and saw things that weren’t there: his words were garbled and disconnected, his eyes saw things that didn’t exist, and he was as sick as if he’d been possessed, as if he’d seen a ghost. The family hurriedly called in Doctor Zhu Danxi.
Doctor Zhu felt his pulse: both hands were empty (xu), wiry (xian), and carried a deep, rapid quality (chen shu) — the pulse ran like a taut bowstring, but with no strength behind it; it was only felt on deep pressure, and it beat fast.
💬 Note from Doctor Luo: This pulse is full of information. Rapid (shu) means heat: summer heat steamed and mingled with him, and on top of that heavy labor and sweating had badly depleted his fluids, so there was deficiency heat inside. Empty (xu) means insufficient upright qi: a person with strong upright qi could drink plum soup while hot and thirsty and not be harmed so much — but this young man had already worn down his upright qi through labor, and with the heat and the sweat, his upright qi grew weaker still. Wiry (xian), like a bowstring, is tied to fright — Doctor Zhu put it plainly: “an empty-wiry pulse means a great fright.” When the emotions are suddenly shocked, the pulse shows this wiry quality.
The key move: this was not possession — it was phlegm clouding the heart orifices
Doctor Zhu laid out the whole chain of events, and everyone understood: the sour plum brew was sour and cold and stagnated in the middle burner; dampness pooled there and congealed into phlegm; the phlegm grew and grew until it clouded the heart orifices (tan meng xin qiao) — and so he talked nonsense and saw things that weren’t there.
💬 Note from Doctor Luo: Doctor Zhu’s theory goes like this: qi and blood are the foundation of the body — they are the dwelling place of the spirit (shen). When qi and blood are sufficient, the spirit has a home, and a person’s mind stays clear. When qi and blood are depleted, evil qi can slip in. If at that point phlegm lodges in the middle burner, squats there, and blocks the rise and fall of qi movement, then the qi and blood of the whole body can no longer circulate properly — the twelve officials (the heart, liver, spleen, stomach, kidneys and the other organs) each lose their proper functions — and a person’s seeing, hearing, speech, and movement all go wrong. That is the mechanism of “delirious speech and hallucinations.” So he said: fortify upright qi and resolve phlegm — that is treating the root.
The prescription: ren shen and bai zhu at the base, huang qin and huang lian to clear heat, fu ling and chen pi to resolve phlegm
Doctor Zhu wrote his formula: ren shen (ginseng), bai zhu (atractylodes), fu ling (Poria), and chen pi (tangerine peel), together with huang qin (Scutellaria root) and huang lian (Coptis root), decocted into a strong brew, with zhu li (bamboo sap) and ginger juice stirred in.
💬 Note from Doctor Luo: Look at Doctor Zhu’s prescribing habits — ren shen tonifies upright qi, bai zhu strengthens the spleen and generates qi and blood, chen pi regulates qi to keep the tonics from clogging things up. These are his signature trio for fortifying the upright — of all the Zhu Danxi cases we’ve told, seven or eight out of ten carry these three herbs. He added fu ling to resolve phlegm and drain dampness, and huang qin and huang lian to clear heat. This pattern — heavy spleen-tonifying qi herbs paired with a little heat-clearing dampness-eliminating medicine — was used by all the great masters of antiquity; you see it everywhere in Li Dongyuan’s formulas too. Modern research on the gut microbiome confirms the wisdom: spleen-tonifying herbs are food the beneficial gut bacteria love and help them multiply; heat- and damp-clearing herbs help suppress the harmful bacteria. The ancients were using this combination to regulate upright qi hundreds of years ago — a superb line of thinking.
A signature touch: bamboo sap paired with ginger juice — one cold, one warm
The zhu li (bamboo sap) in the formula is one of Doctor Zhu’s specialties. What is bamboo sap? Roast a stalk of bamboo over a fire, and collect the juice that drips out of it — that is zhu li, and it resolves phlegm-heat.
💬 Note from Doctor Luo: Bamboo sap is cool in nature, and Doctor Zhu had his own rules for using it: use zhu li for “deficient phlegm” — phlegm in a person whose upright qi is insufficient; use zhu li when the appetite is poor and one eats little — these are his special insights, worth learning. Because bamboo sap is cool, he matched it with ginger juice: ginger juice breaks up phlegm, and it also moderates the coldness of the bamboo sap — this patient’s upright qi was too depleted to tolerate strong cold. One cold, one warm, paired together, the formula’s nature becomes balanced, and the effect is better. And note: fu ling and chen pi, together with ban xia (pinellia) and gan cao (licorice), form Er Chen Tang (Two-Cured Decoction) — the classic base formula for resolving phlegm. Adding bamboo sap and ginger juice on top makes the phlegm-resolving action even sharper.
The setback: ten days with no change, and the family panicked
The medicine was prepared, bamboo sap and ginger juice stirred in, and he drank it slowly. Ten days went by with not the slightest change. The family couldn’t sit still: had the doctor prescribed the wrong formula?
💬 Note from Doctor Luo: Doctor Zhu ran into this situation often. His approach to fortifying the upright had a hallmark: as long as the direction is right, don’t rush ahead — build the upright qi up a little at a time, and don’t let people second-guess you into chaos. A swift attack on evil qi looks fast, but if you never fortify the upright, the evil comes right back a couple of days later. Doctor Zhu made fortifying the upright primary, with a little evil-removing medicine on the side — the process is slower, but in the end it pulls out the root: by the time the evil qi is gone, the upright qi is already full, and the evil finds it very hard to get back in. This is the “kingly way” (wang dao) of prescribing.
Doctor Zhu felt the pulse again: the upright qi was still insufficient — the deficiency had not yet been restored — and the phlegm was not yet fully cleared. So he added one more ingredient to the formula: jing li (Vitex sap).
💬 Note from Doctor Luo: Jing li is the juice that drips out when you roast mu jing (Vitex negundo) — a plant that looks rather like grass — over a fire. Like bamboo sap it resolves phlegm, and it also invigorates blood and unblocks the collaterals. Bamboo sap is on the cool side and clears phlegm-heat; Vitex sap is mild and balanced in nature. Doctor Zhu’s rule: use zhu li for deficient phlegm, and jing li for excess phlegm. At this point the patient’s upright qi had begun to recover — he was no longer so depleted — so Doctor Zhu used jing li and zhu li together, fortifying the upright and resolving phlegm at the same time.
After another ten days — the illness was cured
With the Vitex sap added, he took the medicine for another ten days — and the young man recovered.
💬 Note from Doctor Luo: Let’s be honest: when a mental or spirit illness invades the brain, it is extremely hard to treat, and medicines may not work quickly. Why did this young man recover? Because Doctor Zhu saw clearly: insufficient upright qi was the key — hard labor damaged his fluids, the brutal summer heat consumed his heart yin, chugging iced drinks fed dampness and generated phlegm, and then came the repeated frights — several factors stacked together, and only then could phlegm cloud his heart orifices. An ordinary person drinking sour plum soup like water every day doesn’t start talking nonsense — the difference lies in that foundation of whether the upright qi is sufficient or not. So Doctor Zhu started right away with ren shen and bai zhu to fortify the upright, cleared heat where there was heat, resolved phlegm where there was phlegm — the direction was clear, and he held to it to the end.
Note from Doctor Luo: when your heart and mind are restless, don’t rush to “calm the spirit”
This line of thinking doesn’t only apply to severe delirium. Many people’s “little problems” have exactly the same root.
💬 Note from Doctor Luo: Some friends always have this feeling: their heart flutters, and they sense something bad is about to happen. Someone slams a hand on the table — everyone else is fine, but they jump a foot in the air. Some even fear death — lying in bed at night, they feel their breathing grow faint and worry they’ll fall asleep and never wake up. This is a restless heart and unsettled spirit (xin shen bu ning). What is the fundamental treatment? Fortify the upright qi! The ancients said ginseng can “calm the spirit and settle the mind” — why? Because when upright qi is replenished, the spirit can settle down — the spirit finally has a place to live.
Doctor Luo also told a case he encountered himself: a grown man was so frightened and anxious that he banged his head against the wall and crouched in a corner weeping. Doctor Luo prescribed for him — and the core of the formula was fortifying the upright qi. At first there was no effect, and the patient grew irritable — don’t rush, keep taking it — after a few days, the man calmed down.
💬 Note from Doctor Luo: This requires steadiness of purpose: when the direction is right, you must persist. People whose hearts and minds are already unsettled are exactly the ones most likely to “switch doctors after two days of no effect” — and then all the work is thrown away. The approach Doctor Zhu Danxi left us is absolutely correct — for illnesses of the heart and mind, resolving phlegm and clearing heat are fine, but never forget that “fortifying the upright qi is primary”: build the upright on one side, resolve the phlegm according to cold or heat on the other, and the person gradually recovers.
Bonus: “for miscellaneous diseases, use Danxi” — don’t be led astray by hearsay
The story is done, but Doctor Luo has a couple more things to say.
💬 Note from Doctor Luo: There’s an old saying — “strange illnesses mostly arise from phlegm.” When you meet a puzzling, messy disease, much of the time you should consider treating phlegm. But please don’t fall into the habit of chanting “resolve phlegm, resolve phlegm” at every mental illness — where does phlegm come from? The root is still insufficient upright qi. Doctor Zhu Danxi is honored with the saying “for miscellaneous diseases, use Danxi,” and look at how he resolves phlegm: he never once forgot to fortify the upright. Some people who have never read Doctor Zhu’s books repeat what they’ve heard and claim Zhu Danxi only nourished yin and damaged yang qi — but open his cases and look: he starts with ren shen and bai zhu, every time, this is how he regulates. Let the facts speak. It’s a sad thing not to read. Read the books of the great masters and you build up a “database” inside your head — when you meet a similar problem someday, you’ll have one more layer of understanding than everyone else.
Based on Doctor Luo Dalun’s lecture on Doctor Zhu Danxi’s case, from Doctor Zhu’s essay “On Deficiency and Phlegm Illnesses That Resemble Spirit Possession” (Extra Teachings on Attaining Knowledge, 《格致余论》). Tomorrow, Doctor Luo continues with more stories of Doctor Zhu Danxi at work.