Hiccups So Severe She Shook and Passed Out? Doctor Zhu Danxi: One Bowl of Ginseng Rhizome Decoction to Expel Stubborn Phlegm
What people search for: hiccups / body shakes with every hiccup / hiccups that make you pass out / hiccup blackouts / hiccups after getting angry / hot-tempered girl who hiccups constantly
In medical terms: hiccups (e ni) · excess pattern · liver fire attacking the stomach · phlegm clouding the heart orifices · summer heat disturbing the interior
Opening: have you ever seen hiccups knock someone unconscious?
Everyone has hiccuped. A chill, eating too fast, a surge of emotion — up comes the hiccup, and usually it stops on its own. But the case Doctor Luo Dalun tells today is hiccups with real fireworks: when a bout hit, her whole body jumped with it — until she blacked out.
💬 Note from Doctor Luo: Ordinary hiccups stop by themselves. But when hiccups get tangled up with a real illness, they genuinely have to be treated. Today’s patient hiccuped until she lost consciousness — that is already a very serious state.
Who was the patient? A “little hothead” just past fifteen
Doctor Zhu Danxi (朱丹溪) began the record by describing her background: “there was a girl just past the age of ji” — just over fifteen. The ji (笄) is the hairpin a girl wore at fifteen when she went through the ancient coming-of-age ceremony; “past the ji” means a girl who had just turned fifteen. Then came four more characters: “xing zao wei hou” (性躁味厚) — she was extremely quick-tempered, impulsive and easily angered; and as for eating, she went straight for rich, fatty, sweet food. She ate well, she was plump, and her body was solid and strong.
💬 Note from Doctor Luo: Isn’t it wonderful how Doctor Zhu Danxi wrote his cases? He didn’t begin with the disease — he began with the age, the temperament, the eating habits. That is his signature: he always recorded the patient’s character, because he wanted to find the connection between personality, mental state, and the illness that followed. This is something we should learn well — very few later doctors ever noted the patient’s character in a case record. It is extremely rare. Doctor Zhu Danxi managed it back in that era, which is truly remarkable.
Girls like this are everywhere today too: they eat very well, get chubby young, and have a temper to match.
A midsummer rage — and hiccups that shook her whole body
Doctor Zhu Danxi also fixed the time of onset: the height of summer — the hottest days of the year. The weather was scorching, and this girl flew into a great rage over something. “Because of the great anger, hiccups began” (因大怒而呃作) — the qi surged up, and she started hiccuping.
But these were not ordinary hiccups: “at every bout, her whole body jumped” (每作则举身跳动) — with each attack, her entire body shook; and “the spirit darkened and she knew nothing” (神昏不知人) — mid-bout, she simply passed out.
💬 Note from Doctor Luo: This was already serious. The family hurriedly called in Doctor Zhu Danxi. His first question: was this newly onset, or had it happened before? The family answered: bao bing (暴病) — it had just struck, suddenly. Doctor Zhu Danxi then observed: “xing qi ju shi” (形气俱实) — the girl was physically strong and her qi was ample; at first glance this was an excess pattern. Feel the contrast with the patient in the previous case, Zhao Lidao, who was nearly fifty: he too was quick-tempered, but after decades of rage, his body had been worn down to frailty. This girl was barely fifteen, her body’s momentum at full strength, the fight between upright qi and pathogens fierce — which is why the illness made such a scene the moment it struck. Yet her foundation was solid. Doctor Zhu Danxi set the two cases side by side — deficiency and excess — and the comparison was crystal clear.
The prescription: one bowl of ginseng rhizome decoction
The pattern was excess, yet the prescription was astonishingly simple: simmer ginseng rhizome in water and drink one bowl.
What is ginseng rhizome? It is the crown (rhizome) at the top of the ginseng root. Old-school practitioners believed it had an emetic effect — break off a few crowns, boil them in water, drink it down, lightly stroke the back of the throat, and vomiting came easily.
💬 Note from Doctor Luo: There is a mystery here. Many ancient physicians left case records of using ginseng rhizome to induce vomiting, yet today almost nobody uses it. We have grown uncomfortable with the “vomiting method” — vomiting feels awful, so later generations used it very rarely, and experience with emetic herbs has dwindled. Ask a modern Chinese medicine doctor whether ginseng rhizome can induce vomiting and few have the experience to answer. Some even say it cannot — you drink it and feel no urge to vomit at all. I have also talked with ginseng farmers in the northeast growing region: they told me they often snap off the crowns and steep them as tea, saying the qi-tonifying effect is nearly as strong as the main root — since “the crown is useless anyway,” they just drink it as tea.
Ginseng rhizome and ginseng proper do differ in nature and in constituents — the rhizome is notably higher in hemolytic components. So can it really induce vomiting?
💬 Note from Doctor Luo: My view is that in ancient times vomiting was chiefly driven by mechanical stimulation — a goose quill, a finger, or some object to tickle the throat. Where does ginseng rhizome fit in? It activates and mobilizes qi. Suppose phlegm-solid stagnation sits in the upper burner, qi blocked and congested there; the rhizome goes down, its tonifying force makes the congestion feel even more obvious, and it also has a flowing, circulating nature — so when you lightly tickle the throat, the vomit comes out more readily. That is why the ancients used ginseng rhizome to vomit: there is no harm in it, and — the crucial part — after vomiting, the qi is not damaged. Ordinary emetics can badly wound upright qi; ginseng rhizome itself has a tonifying quality, so you can vomit and still come out intact.
Several bowls of stubborn phlegm — and the disease was gone in a day
The girl drank the single bowl of ginseng rhizome decoction and “vomited up several bowls of stubborn phlegm” (大吐顽痰数碗) — that sticky, scorched-looking phlegm, bowl after bowl. After the vomiting she broke into a heavy sweat, then fell into a deep sleep. In one day, the illness was resolved.
💬 Note from Doctor Luo: Vomiting up several bowls of phlegm tells you how heavy her phlegm-dampness really was — turbid phlegm had clogged the middle burner, throwing the qi mechanism into chaos, upper and lower no longer communicating. So the moment liver fire surged upward, she hiccuped. Now the phlegm was thoroughly expelled and the spleen and stomach unblocked; the heavy sweat showed the qi mechanism was flowing again, the channels able to run, and the sweat could be released; and the deep sleep let the body repair itself. One day to settle the battle — that is how clean it was.
Where was the root? Three accounts: liver fire, lung qi, and phlegm
Doctor Luo Dalun says the case looks bizarre, but when Doctor Zhu Danxi analyzed it with Five Phase theory, everything became clear.
First account: liver wood attacks spleen earth. The girl was quick-tempered, her liver fire enormous; liver wood ran rampant and bullied the spleen and stomach, throwing their ascending-descending qi mechanism into disorder — and hiccups are directly tied to that spleen-stomach mechanism.
Second account: wood fire torments metal. The lung governs all the qi of the body and governs descending and purification — it is what pushes qi downward. Now the liver fire was so fierce that it bullied the lung metal — mu huo xing jin (木火刑金) — throwing the lung channel into chaos, so the qi was hijacked and driven upward. Qi rushing upward: that is the direct cause of the hiccups.
Third account: phlegm clouding the heart orifices. She had long eaten rich, fatty food, so phlegm-dampness ran heavy in her body. Liver fire blazed, dragging heart fire up with it; the qi surged upward and the heart fire burned hotter still, baking dampness into phlegm. More and more phlegm accumulated until it clouded the heart orifices (tan meng xin qiao) — the heart governs the spirit, and when its orifices are shrouded, the mind darkens and consciousness is lost.
💬 Note from Doctor Luo: So Doctor Zhu Danxi’s treatment killed two birds with one stone. First: expel the phlegm — throw out what was smothering the heart orifices and blocking the qi mechanism, and once the qi flowed, the illness was over. Second: the ginseng rhizome itself. Ginseng enters the lung channel of the hand taiyin and supplements the yin within the yang; the rhizome does exactly the opposite — it strongly drains the yang of the taiyin. So in one move he expelled phlegm and drained the fire of the heart and lungs, leaving the lung channel clear, cool, and clean. Once the lung cooled, the qi descended, and the stomach qi descended with it. One “scrap” of an herb, one vomiting method — and a disease this complicated was cured in a day. That is the mark of a master.
Brought to a modern hospital, this would first require a full round of tests
Doctor Luo Dalun reflects: bring this patient to a hospital today, and she would most likely start with an MRI and a brain CT — she lost consciousness, after all — to see what lesion lurks in the head; then check the cardiac system, the circulatory system, the nervous system — why does her whole body jump? The workup would take forever, because the disease looks so strange.
💬 Note from Doctor Luo: And Doctor Zhu Danxi? A bit of Five Phase theory, one herb — ginseng rhizome, not even a “proper” medicine but a leftover scrap — used as an emetic, and the battle was over in a day. That is the power of the great physicians of antiquity: however complex the illness, they could lay out the relationships among the five organs and the mechanism of onset through the Five Phases, then match the remedy at once. When we read case records, what we should read is the reasoning underneath.
Bonus: every thing embodies its own taiji
Hidden at the end of this case is a small, delightful reflection of Doctor Zhu Danxi’s. Nature is wonderful, he said: the body of the ginseng root supplements — it supplements the yin within the yang, supplements the taiyin; yet the crown of the ginseng root drains — it drains the yang of the taiyin. Similar pairs are everywhere: ephedra (ma huang) induces sweating, but ephedra root (ma huang gen) checks sweating; millet belongs to metal, yet millet chaff (gu kang) is hot in nature; wheat belongs to yang, yet wheat bran (mai fu) is cool in nature.
💬 Note from Doctor Luo: Doctor Zhu Danxi marveled that the sages said every thing embodies its own taiji — each object carries both yin and yang, two attributes coexisting. Much of the medicinal nature of Chinese herbs was deduced exactly this way: observe that every thing holds yin and yang, reason it through, then test it in practice — and so it proves. That is one of the theoretical foundations behind the channel attribution of herbs, and it is well worth pondering slowly.
Ending: the disease was cured — but the habits had to change too
The disease was cured in a day, yet Doctor Luo Dalun reminds us that the true value of this case is its warning.
💬 Note from Doctor Luo: If Doctor Zhu Danxi had only cured the girl’s hiccups without changing her condition, she would slowly have turned into the state of Zhao Lidao from the previous case — the body wearing thinner and thinner, until even walking left her breathless. By then, treatment would be very hard. Look at the pattern Doctor Zhu Danxi laid out: liver fire; liver fire bullying the heart-lungs and the spleen-stomach, throwing the spleen-stomach qi mechanism into chaos with ascending and descending out of order; rich, fatty food condensing into phlegm, heavy phlegm-dampness; liver fire surging upward, heart fire unable to descend… She was only fifteen, and her body was already this disordered — one illness and she shook all over and blacked out. With that constitution, health cannot be maintained.
First, don’t overeat. Eating well is fine, but rich, fatty, sweet food every day, in excess, guarantees trouble. Second, regulate the emotions. Bad emotions mixed with rich food will inevitably throw the body into disorder. Today there are so many young, plump girls — eating too much, under pressure, anxious, quick to anger. People like that have endless opportunities for their bodies to malfunction: you break down here or you break down there — rashes all over, menstrual chaos, problems in pregnancy… all of it is the normal circulation of qi and blood gone wrong.
💬 Note from Doctor Luo: Hiccups were only an extreme little signal; the ailments that could follow would be far more numerous. People like this have no healthy body by their forties or fifties. Especially after fifty, when kidney qi begins to decline, all kinds of diseases erupt — and by then they are very hard to regulate, because upright qi is difficult to restore. So in youth, put your habits back in order and fix your temperament — this is preparation for the future. Why did Doctor Zhu Danxi record his patients’ personalities and eating habits in so many cases? To show you where the disease came from — from your lifestyle, from your temper. Medicine can regulate, but after the regulation, the lifestyle has to begin changing too. That is the lesson for us today.
Based on Doctor Luo Dalun’s lecture on a case of Doctor Zhu Danxi, from Ge Zhi Yu Lun (Extra Teachings), chapter on hiccups (呃逆论).