Seeming Possessed or Haunted? Doctor Zhu Danxi Saved One Patient with a Bowl of Salt Water and Watched Another Die — Phlegm Clouding the Heart Orifices
Patient search terms: seems possessed / haunted by a ghost / talking nonsense / saying crazy things / speaking incoherently after being scolded / repeating “it’s all my fault” — what to do
Medical terms for this condition: phlegm clouding the heart orifices · phlegm-damp internal obstruction · phlegm-heat internal closure · mental confusion (from Doctor Zhu Danxi’s essay “On Deficiency and Phlegm Illnesses That Resemble Spirit Possession,” Extra Teachings on Attaining Knowledge)
Opening: “possession” again — this time one patient was saved, and one was not
Last time we told the story of a young man from an official’s family who chugged ice-cold sour plum soup on a scorching day, then suffered one fright after another, and began talking nonsense and seeing things that weren’t there. Doctor Zhu Danxi judged it to be phlegm with insufficient upright qi, made fortifying the upright his primary strategy, resolved phlegm on the side, and cured him.
Today’s story is about “possession” again — and this time there are two cases. In the first, the family was spinning in panic while Doctor Zhu brought the patient back with a single bowl of salt water. In the second, Doctor Zhu plainly said “she’ll recover in a few days,” but the family would not believe him — and a little over ten days later, the woman was dead.
Both illnesses looked exactly like possession. The outcomes could not have been more different. Where did the difference lie? In four words: whether the family trusted the doctor.
💬 Note from Doctor Luo: In the earlier case of the young man, Doctor Zhu’s guidance is especially important — fortifying upright qi is always the root of regulating patients like this. For such patients the usual approach is to make fortifying the upright primary and add just a little evil-removing medicine (resolving phlegm, resolving blood stasis, and so on), and the patient settles down very quickly. Why? Because talking nonsense comes from an unsettled heart and spirit — and the root of an unsettled heart and spirit is insufficiency of the qi of the five organs, leaving the spirit nothing to rest on. Hold on to this line of thinking — both of today’s cases are tied to it.
Who was the patient? Doctor Zhu’s cousin — drunk, overfed, and suddenly “possessed”
The first patient was Doctor Zhu Danxi’s cousin — the original text says zu wai di, a younger male relative of the same clan. One day he went to a banquet, got drunk, and ate far too much. Then, drunk and stuffed, he suddenly started talking nonsense.
And how he raved! He announced: “This is my deceased brother possessing me.” Then he began recounting the life of his late brother — and, unnervingly, he told it correctly, convincingly, as if it really were the dead man speaking. Everyone listening was terrified: isn’t this possession? A dead man has taken him over! The family hurriedly sent for Doctor Zhu Danxi.
💬 Note from Doctor Luo: When Doctor Zhu arrived, an elder uncle in the family shouted at the cousin: “Stop that nonsense!” The family was sure this was possession — but Doctor Zhu never believed such things. He saw it at a glance: he had eaten too much rich, greasy — especially fishy — food, and drunk too much wine. This man’s phlegm was already abundant to begin with; now the drink and the food thoroughly stirred it up, and it clouded his heart orifices.
One sentence from Doctor Zhu: this is not possession — it is phlegm at work
Doctor Zhu explained to the family: this is not possession at all; it is phlegm causing the trouble (tan zhi wei huan) — phlegm is lodged inside, blocking the mind and clouding it over.
Now, this “phlegm” is not the phlegm you cough up. The phlegm Doctor Zhu speaks of is a much larger concept in Chinese medicine.
💬 Note from Doctor Luo: Chinese medicine divides phlegm into two kinds: the phlegm you cough out is “visible phlegm” (you xing zhi tan); the thick, sticky fluids inside the body are “invisible phlegm” (wu xing zhi tan). When we say someone “has heavy phlegm-dampness,” we mean this broad, invisible phlegm — the various thick fluids inside the body, which disturb whatever part of the body they settle in. Heavy internal phlegm-dampness can also drag the visible phlegm along and make you cough stuff up; sometimes you don’t cough at all, yet the internal phlegm-dampness is still heavy. This cousin’s trouble was invisible phlegm clouding his heart orifices — that is why he raved and claimed he could see his dead brother.
A bowl of salt water: the “emetic method” invites the phlegm out
So what did Doctor Zhu do? His method was so simple that a modern person can hardly believe it — he dissolved salt in water to make a bowl of salt water and had the cousin drink a large bowl of it.
Why salt water? Because salt water induces vomiting. In the old days, when a doctor wanted to make a patient vomit, he gave salt water; for most people the gagging starts on its own. For those who couldn’t bring it up, a goose feather was pushed down the throat to tickle it — or a finger was used — helping the vomit come up.
And the result? The cousin vomited a great deal — one or two liters of thick, sticky liquid, all phlegm. Then “sweat poured down like rain” — a great drenching sweat broke out over his whole body.
💬 Note from Doctor Luo: What does the sweating mean? Remember this: sweating means qi and blood have opened up and are circulating normally again. The phlegm came out, the blockage opened, qi and blood began to move, and the sweat followed — it showed the phlegm had been dispersed. After vomiting the phlegm and sweating, the cousin was exhausted, fell asleep, slept through the night, and the next morning his speech was normal and the illness was gone. That fast.
Why does vomiting cure it? When qi movement is free, evil qi walks out the door
This treatment is called the emetic method (tu fa) in Chinese medicine. In the Jin-Yuan period there was a physician named Zhang Zihe (Zhang Congzheng) who excelled at the three methods of sweating, vomiting, and purging — and vomiting was his most frequent weapon. What is the reasoning? When evil qi is lodged in the middle and upper burner — when the evil is up high — you should use vomiting to throw it out. This is especially true of the stomach: when sticky phlegm and gluey pathological products accumulate there, they obstruct the movement of qi, and all kinds of illnesses arise. Use vomiting to expel those pathological products, qi movement opens up, and the illness is cured.
Doctor Zhu Danxi was also particularly skilled with the emetic method. Later, when we tell how he treated his teacher, Xu Wenyi, you will see him use vomiting again.
💬 Note from Doctor Luo: The emetic method is, in plain words, a way to free up the movement of qi. Remove what is stuck there and qi can move at once — that is why the patient sweats: it was blocked before, and now it is open. Resolving phlegm is one of Doctor Zhu Danxi’s great academic contributions — he was especially good at seeing how phlegm caused illness and how to resolve it. This line of thinking passed to many later physicians — for example, the great Qing-dynasty master of warm-disease treatment Wang Mengying (Wang Shixiong), who treated patients by resolving phlegm all the time: he would often see heat trapped inside that would not come out — why? Phlegm-dampness at work! Resolve the phlegm, add a little heat-clearing medicine, and the illness clears up. Many later doctors who treated phlegm learned from Doctor Zhu. Illnesses caused by phlegm can be extraordinarily strange — hence the saying “strange illnesses are mostly blamed on phlegm” (guai bing duo ze yu tan). Some illnesses are bizarre beyond explanation — like this cousin raving and telling the exact story of a dead man — and strange illnesses very often have phlegm behind them. Doctor Zhu could grasp these hidden connections, which is why his treatments worked so well. And about the emetic method itself — something like this happens all the time in ordinary life: people with gut problems drink a purgative before a colonoscopy, flush everything out, and afterwards tell the doctor, “How come my chronic diarrhea is gone?” — the pathological products and garbage inside were all washed out. The ancients even had health regimens of periodically clearing the bowels. This was not unique to China — ancient Arabia and other places did it too, taking something regularly to lighten the gut. And some people who vomit violently during an illness find afterwards that their other complaints are better as well — the vomiting carried pathological products out of the body. If you have ever seen what comes up — sticky, gluey, translucent stuff that clings to your fingers — those are the accumulated wastes of the body. What the ancients called “phlegm” is one of these pathological products.
The second patient: scolded by her mother-in-law after a banquet, a daughter-in-law begins to talk nonsense
After recording the case he saved, Doctor Zhu wrote up another case — and reading it leaves a heavy feeling in the heart.
The patient was a woman surnamed Jin, in the prime of life, in generally good health. In summer, her whole family attended a banquet at another household — a celebration of some kind. On the way home, her mother-in-law scolded her: “You sat in the wrong seat! How could you be so ill-mannered? I took you to the banquet and you sat up at the front!” In a family that cared about such things, seating order at a banquet was a serious matter of propriety and status; sitting in the wrong place looked like a lack of breeding. Under this scolding, the daughter-in-law felt deeply ashamed and hurt.
And so — from this came her illness (yin cheng ci bing). What was it like? Her speech became disordered (yan yu shi lun) — she began to talk confusedly; and again and again she repeated one phrase: “nu nu bu shi” — roughly, “It’s my fault, I’m wrong, it’s my fault.”
💬 Note from Doctor Luo: Doctor Zhu observed such things very closely. In many of his case records he noted this pattern — discord between mother-in-law and daughter-in-law, with the mother-in-law’s scolding making the daughter-in-law ill — and he even recorded cases that ended in breast cancer. So you see, ancient times had their family problems and modern times have theirs; this thread has never broken from antiquity to today. This woman was scolded by her mother-in-law day after day — in that atmosphere, how could her body stay well?
Doctor Zhu takes her pulse: “This is not an evil spirit — it is an illness,” and she would recover in days
Doctor Zhu came to see her. He felt her pulse — wiry and rapid (xian shu), beating fast and with force. And he said: “Ci fei xie, nai bing ye” — “This is not possession; this is an illness.”
How to treat it? Fortify the spleen and build up the upright qi, then clear heat and resolve phlegm. Doctor Zhu said: treated this way, “shu ri dang yu” — she will recover in a few days.
But here was the problem: the family did not believe him. They were certain this was possession! So they called in the spirit-practitioners. They hired a shaman (wu zhe), who sprayed water on her, burned talismans and stirred the ashes into water for her to drink, and sprayed charms over her body…
And the result? After ten-odd days of this, the woman died.
💬 Note from Doctor Luo: This case is heartbreaking — Doctor Zhu never even got to write a prescription; he never had the chance to show his skill. From his judgment, the treatment should have been fortify the upright, resolve phlegm, clear heat, plus a little soothing of the liver and relief of stagnation — relieving stagnation was his specialty. If that plan had been carried out, it would very likely have worked, exactly as he said, in a few days. But the family chose ghosts and rituals, and sent a patient who could have been saved to her death.
Ten days and she was gone — Doctor Zhu’s chilling analysis of why
Someone asked: even if it were treated as possession, how could the woman die in ten days? Doctor Zhu’s analysis is extraordinarily penetrating:
It was midsummer, and the family went to a hot, crowded banquet — in those days there was no air conditioning; a roomful of people packed together eating and drinking, stuffy and hot; spicy food went in — the dishes of the day were much like today’s fiery, pungent fare; the woman probably carried heat inside her already (liver fire and the like); on top of that the weather was boiling; and she had old accumulated phlegm from before. Then she came home, was scolded by her mother-in-law, and felt ashamed… Put it all together: phlegm and heat combined — phlegm-heat internal closure (tan re nei bi).
Then the shamans came in and performed their rites: “jing qi shen, er xue bu ning” — they frightened her spirit, and her blood could not settle. And they sprayed cold water — in the summer heat her body was trying to sweat and release heat, but the cold water sealed the body’s surface, trapping the sweat inside; the heat had no way out either. So qi and blood fell into disorder, blood could not settle, and “yin disappeared while yang could not survive alone” (yin xiao er yang bu neng du cun) — the heat inside consumed her yin fluids until yin and yang lost their balance, and that is how she left this world.
💬 Note from Doctor Luo: Doctor Zhu reduced it to phlegm-heat internal closure. But as I (Doctor Luo) see it, in the end, it was her environment that killed her. In an extremely closed, poisonous family atmosphere, watching her mother-in-law’s face every day, some daughters-in-law suffer liver-qi stagnation for years and their bodies are already badly damaged — she may have looked like a healthy middle-aged woman, but imagine what her daily life was really like. A person like that has had her upright qi severely wounded, and can walk through death’s door on the back of any illness at all. If someone had immediately fortified her upright qi, resolved phlegm and cleared heat, and slowly soothed her liver and untied her stagnation, there could well have been a chance of life. This sort of thing happened often in the old countryside: a woman is struck down by rage — she fumes and fumes, cannot let it go, and suddenly her body will not move; some even die on the spot — qi movement suddenly reverses and the person is finished. So don’t underestimate emotions, and don’t underestimate family environment. They can genuinely kill.
Can talismans actually cure illness? Doctor Zhu’s reply is brilliant
After recording the case, Doctor Zhu added a passage answering a question: the Wai Tai Mi Yao (Arcane Essentials from the Imperial Library) contains a whole category of “talisman prohibitions” (fu jin, the zhu you arts) — are these things useless? Can illnesses like this not be treated?
Doctor Zhu’s answer is superb. He said: “Yi jing bian qi” — at the point where the illness has transformed the body’s qi — these talismans and incantations are all small arts (xiao shu); they can cure minor ailments. But when the situation is truly one of insufficient upright qi, deficiency inside and evil qi waiting outside, one must use the great upright method (zheng da zhi fa) — fortify the upright qi, then gradually expel the evil. Only by this “great upright way,” this “kingly way” (wang dao), can the illness truly be cured.
He gave an example: a person with phlegm-heat in the stomach drinks some talisman water — cool water with the charm burned into it — and feels better. But drink any plain cool water without the talisman, and he feels just as good — that is simply the effect of cool water. But if a person is internally deficient, and it is winter, and you make him gulp down talisman water — his yang qi is further wounded, and he is worse off. Take the woman surnamed Jin: heat evil lay at the surface; the proper treatment was to let it out through sweating. But the cold water sealed her body’s surface and closed the interstices (cou li), and the heat could not get out. Did the talismans work? No — the direction was entirely reversed.
💬 Note from Doctor Luo: I deeply admire Doctor Zhu for this: use the great methods, see the principal contradiction, walk the great upright path. My grandfather was an old Chinese doctor, and in the medical books he handed down, at the back, there were instructions for writing talismans — written in cinnabar, on certain paper, placed in a certain southeast corner of the wall, which illness treated with what. All of it there. But as Doctor Zhu said, these things are mostly small arts. What has Chinese medicine’s mainstream become today? The mainstream is the great upright methods — formulas, acupuncture, moxibustion. Small arts can work for a while — they feel “immediately effective” at the moment — but watch: a few days later the problem returns. I have observed this many times with my own eyes. So: when the great upright methods are used well, there is room for a small art at a small point; but you must never wield a small art as if it were a great blade.
What Doctor Zhu left us: fortify upright qi, resolve phlegm-heat, untie stagnation
After these two cases, Doctor Luo concluded with words from the heart:
In modern society, mother-in-law and daughter-in-law relations still exist; in the workplace, the relationship between director and employee sometimes resembles that of mother-in-law and daughter-in-law. The environment has changed, but the mechanisms by which people fall ill are the same as they were hundreds of years ago. The approach Doctor Zhu Danxi pioneered is immensely important: fortify upright qi, resolve phlegm-heat, untie stagnation.
💬 Note from Doctor Luo: When you read these cases, don’t tell yourself that they are only about the old countryside — that “confusion, raving, talking nonsense” has nothing to do with us. In fact, they bring great inspiration to the treatment of modern emotional and mental illnesses: fortifying upright qi is an extremely important part of regulating emotional illness. Build the upright qi up, fill the qi of the five organs, and the hun and po (the spiritual souls) have somewhere to rest, each returning to its proper place — only then can the body truly recover. Then remove what obstructs the movement of qi and blood — phlegm, damp-heat — and open the stagnation, and emotional illnesses can truly be cured. So sometimes what you see is a mental problem, but the strength of the body’s qi and blood is enormously involved. If you can understand Doctor Zhu’s cases thoroughly, you will have a clear approach to a great many of modern society’s emotional illnesses.
Based on Doctor Luo Dalun’s lecture on Doctor Zhu Danxi’s case records, from the series “On Deficiency and Phlegm Illnesses That Resemble Spirit Possession” in Extra Teachings on Attaining Knowledge (《格致余论》).