Delirious and Utterly Weak After a Cold? Doctor Zhu Danxi Tonifies Qi First
Patient search terms: talking nonsense after a cold / feeling weak after a cold / a cold that keeps getting worse / can’t sleep / cold hands and feet / wheezing at the slightest movement / fever burning like fire
Medical names for this condition: external contraction in a person with deficient upright qi · spirit not keeping to its dwelling · mistaken sweating and purging · dual deficiency of qi and yin
Opening: The cold was being treated — and then the patient started talking nonsense
A cold sounds like a small matter. But the patient Doctor Zhu Danxi tells us about today turned a simple cold into a crisis — he was sweated, then purged; after several rounds of heavy treatment, he began babbling nonsense and could no longer recognize his own uncles and aunts. The whole family panicked and sent urgently for Doctor Zhu Danxi.
💬 Note from Doctor Luo: Remember this: it is not just a scary story. When a cold is treated to the point of delirium, it means the upright qi (zheng qi) has been depleted to a dangerous degree. These two cases by Doctor Zhu Danxi are exactly about how to rescue people in this condition.
Who was the patient? Someone already depleted — then hit by wind-cold
Let us start with the first patient. The moment Doctor Zhu Danxi took his pulse, he knew this man already had internal depletion — nei shang. In Chinese medicine, nei shang does not mean an injury from a blow or a damaged internal organ; it means the organs have been slowly worn down by diet, overwork and worry: the qi mechanism disordered, the organs weakened, and the upright qi declining day by day.
💬 Note from Doctor Luo: Hold onto this logic: when the upright qi is insufficient, you are more likely to be invaded by external pathogens. So this already-depleted patient was blown by the wind, and the external contraction found its way in.
The trouble began with the previous doctor. He looked at the patient and thought: caught wind? Easy — sweat it out! Heat in the body? Easy — purge it! The sweating was done and the purging was done, yet the patient only got worse. During the Jin-Yuan period, the three methods of sweating, vomiting and purging (han tu xia) were the standard toolbox of physicians, and this doctor, without distinguishing the case, called on sweating first and purging second — all of it, without mercy.
How it turned grave: after sweating and purging, the babbling began
After the harsh medicines, trouble arrived. The patient began to zhan yu — to talk nonsense, with clouded consciousness. At first it was mild: he could still recognize people, pointing and saying “that’s my uncle,” “that’s my aunt.” After three or five days it grew worse, until he could barely recognize anyone at all; and after that, what he said became more and more confused and unreliable.
💬 Note from Doctor Luo: The term zhan yu may sound unfamiliar — it simply means talking nonsense, clouded consciousness. The upright qi was already insufficient, and when the sweating and purging methods battered it further, the person became even more deficient — and once the deficiency reaches a certain depth, the spirit and consciousness begin to fail.
Doctor Zhu Danxi’s examination: thin rapid pulse, no sleep, cold feet, panting on the least movement
When Doctor Zhu Danxi arrived and took the pulse, he found it xi shu — thin and rapid, beating fast yet thin and fine. This is the signature of insufficient upright qi: the vessels cannot fill. Looking at the symptoms: no sleep — the patient lay in a daze day and night; cold feet; panting at the slightest movement, with rapid, short breathing; a bluish complexion; and a very dry mouth.
💬 Note from Doctor Luo: Take each symptom apart and every one of them is a sign of deficiency. Sleeplessness — the blood no longer nourishes the heart, so the spirit finds no rest. Cold feet — the qi and blood are insufficient and cannot reach the extremities. Panting at the least movement — the qi is severely deficient. Dry mouth — the spleen qi is greatly damaged and the fluids are insufficient. In one sentence: this man’s foundation had been thoroughly hollowed out.
The diagnostic highlight: what does “the spirit not keeping to its dwelling” mean?
Doctor Zhu Danxi looked at the case for a long time and pronounced four words: ci shen bu shou she — this is the spirit not keeping to its dwelling.
What does this mean? Doctor Luo Dalun explains it very clearly — each of the five organs houses its own spirit. This “spirit” governs the functioning of our consciousness and awareness; it is formless. The organs themselves are the “dwelling” where it lives — the physical support. When the spirit is lodged in the organs, a person’s mind stays clear and lucid. But if the organs become so weak that they can no longer support the spirit, the spirit drifts away and scatters — and the person starts talking nonsense.
💬 Note from Doctor Luo: This is “shen bu shou she,” also called “hun bu shou she — the ethereal soul not keeping to its dwelling.” This patient’s organs were already deficient to begin with; after the sweating and purging battered them further, the spirit could no longer hold its dwelling, and naturally the mouth ran on with nonsense. Doctor Zhu Danxi’s judgment at that moment was — shen wu gong fa: absolutely do not attack the pathogen again. No more purging, no more sweating — or the person is finished.
The prescription explained: Bu Zhong Yi Qi Tang plus half a liang of ginseng — using tonics even for an external contraction
So what was to be done? The formula Doctor Zhu Danxi wrote is especially interesting: Bu Zhong Yi Qi Tang (Tonifying the Middle and Augmenting the Qi Decoction), with half a liang of ren shen (ginseng) added, plus zhu ye (bamboo leaf), decocted in water.
💬 Note from Doctor Luo: Notice: this man clearly had an external contraction, yet Doctor Zhu Danxi did not use a single herb to expel the pathogen — because the main problem now was insufficiency of the upright qi. The qi of the organs was deficient, and the spirits of the five organs could no longer hold their dwellings. At this point you must set aside the work of expelling the pathogen and quickly support the upright qi. When the qi of the organs is sufficient, the spirits of the five organs return to their posts — above all the spirit of the heart — and the nonsense stops. When the upright qi is too weak to drive out the pathogen, the only route is to support the upright qi first.
What is the ginseng for? To supplement the upright qi. Why half a liang — such a large dose? The Shen Nong Ben Cao Jing (Divine Husbandman’s Classic of the Materia Medica) says ginseng has the power to settle the ethereal and corporeal souls (an hun po) — when the upright qi is replenished, the souls can return to their posts and the spirits of the five organs can dwell in peace. As for the few slices of bamboo leaf — small in amount, yet the finishing touch: this patient’s pulse was thin and rapid and his mouth dry, which tells you there is also some deficient heat. The bamboo leaf is there to clear and resolve that deficient heat — supporting and clearing at the same time, so that the tonics do not build up more heat.
💬 Note from Doctor Luo: Bu Zhong Yi Qi Tang is the formula of Doctor Li Dongyuan. Doctor Zhu Danxi used it to treat an external contraction — and this is not recklessness. Many colds arise precisely because the upright qi is insufficient; for a qi-deficient type of cold, tonics such as Bu Zhong Yi Qi Tang really are the right foundation. This thinking applies just as well today.
What was the result after taking the medicine? The original text uses a single character: xiao — it worked. The patient recovered.
The second case: a laboring man, treated with sweating and purging until he burned “like a roast over fire”
Doctor Zhu Danxi then told of another patient: yi ren nei ruo, ben lao ku — a man whose constitution was weak to begin with, from a hard-laboring family, working every day, suffering greatly.
💬 Note from Doctor Luo: Doctor Zhu Danxi always recorded how his patients lived — a frail constitution, laboring day after day; these were the grounds for his treatment. Unfortunately the previous doctor did not think about any of this. He saw an external contraction and again called for sweating and purging — and after the sweat and the purge, the man was completely hollowed out.
Taking the pulse, it was again thin and rapid (xi shu); the body was re like huo jiu — hot as if roasted with fire; and there was shortness of breath (qi duan), much like the first patient. This is great deficiency of the lung qi, with yin deficiency mixed in — deficient fire rising upward.
Doctor Zhu Danxi said that you can never treat every cold with a single formula — each person’s habits of living are different, their constitutions are different, rich and poor are different, so the treatment must differ. This man’s body was already so weak, and then the sweating and purging battered him further — how could he possibly hold on? The answer: support the upright qi! Ren shen (ginseng) to supplement the qi, dang gui (angelica) to nourish the blood, bai zhu (atractylodes) to supplement the spleen, huang qi (astragalus) to augment the qi — ren shen, bai zhu, huang qi and dang gui: this is the combination Doctor Zhu Danxi used over and over to support the upright qi. Add gan cao (licorice) to harmonize; wu wei zi (schisandra) to supplement the primal qi of the five organs, sour in taste and able to restrain and gather; and zhi mu (anemarrhena) with zhu ye (bamboo leaf) to nourish yin and clear deficient heat. Finally, the medicine was decocted in water together with boys’ urine (tong bian), and the patient drank two doses — two doses and he was settled.
💬 Note from Doctor Luo: Tong bian is the urine of a young boy; ancient formulas often used it to draw deficient fire downward. It sounds strange to modern ears, but in ancient times it was a carefully considered method. The key is the overall strategy: on the one hand generously supplement the upright qi, on the other clear away the deficient heat — and in two doses the patient recovered. When the supplementation is correct, the illness resolves quickly.
Deeper layer: the great wisdom Doctor Zhu Danxi learned from Luo Zhiti
Placed side by side, these two cases tell the same story: when a person with insufficient upright qi has been injured by harsh sweating and purging, how should they be rescued? And behind it lies an important chapter in Doctor Zhu Danxi’s own education.
💬 Note from Doctor Luo: Of the first three of the Four Great Masters of the Jin-Yuan period, Zhang Zihe was the great champion of the sweating, vomiting and purging methods — he used them fiercely and became famous for it. Doctor Zhu Danxi had long doubted: can every illness really be solved by sweating, vomiting and purging from the start? It was only when he met Luo Zhiti that he truly understood.
This Luo Zhiti was the great synthesizer of the academic ideas of the first three Jin-Yuan masters. He had been a eunuch of high rank, serving Emperor Lizong of the Southern Song. When the Yuan dynasty destroyed the Southern Song and Emperor Lizong was taken north, Luo Zhiti followed him to Beijing, and there in the north he learned the teachings of all three schools — Liu Wansu, Zhang Congzheng (Zhang Zihe) and Li Dongyuan, who had practiced in the Hebei and Henan region. What he showed Doctor Zhu Danxi was not “sweat, vomit and purge at once,” but this: for a deficient person, support the upright qi first, then attack the pathogen — and the illness is cured at once.
💬 Note from Doctor Luo: Only then did Doctor Zhu Danxi grasp the true meaning of the attacking methods — you need ammunition, grain and resources in hand before you can attack. When a person is nearly gone and you attack straightaway, they die on the spot. The opposite — attack first, supplement later — heals slowly at best, and the attack itself may well be the disaster. These two patients had been ruined by the previous doctors, and Doctor Zhu Danxi came to mend the damage. Without his supplementation, the man who talked nonsense really would have been in mortal danger.
Extension story: an elderly bedridden patient with a cold, or a child with a fever — don’t rush to attack
Doctor Zhu Danxi’s principle of “look at the person, not just the disease, and judge the moment” is worth studying especially today — because there are so many people with insufficient upright qi.
💬 Note from Doctor Luo: The simplest example: a ninety-year-old lying in bed, already being treated for a list of chronic conditions, when a cold with fever arrives — what matters most? The person. If you drive out the pathogen single-mindedly, the body cannot bear it. You must slowly support the upright qi, adding just a trace of pathogen-expelling herbs — that is enough.
This is even more true for children. A child’s upright qi is not yet full; the qi of the organs has not completely grown, and the body is delicate. So when a child catches cold, sometimes simply boiling huai shan yao (Huai yam) into water can cure it — that is exactly the supporting-the-upright-qi route. And parents often ask: when a child has a fever from a cold and drinks a little San Dou Wu Mei Bai Tang Tang (Three-Bean Soup with Black Plum and Sugar) — not a single herb to clear heat or resolve toxins — why does the fever subside?
💬 Note from Doctor Luo: That is supporting the upright qi! Lift the upright qi up, regulate the body’s qi and blood, and the body itself pushes the pathogen out — because in these cases the pathogen was never severe. Of course, if it is truly pneumonia or a fever of over forty degrees, you must expel the pathogen. But in most of the situations parents face, the child is simply in the stage of insufficient upright qi.
Yet some parents do the exact opposite: they “hate” the illness and want to drive it out for the child. The child catches a cold — and five or six kinds of medicine are poured in at once, heavy herbs to clear heat and resolve toxins, cold and warm mixed together, as if the illness must be gone by morning. In doing this, they injure the child’s body instead.
💬 Note from Doctor Luo: Compared with a vigorous young man built like a brick wall, a child’s body is a completely different matter. When the upright qi is sufficient, the pathogen will leave sooner or later — why the rush? Doctor Zhu Danxi balanced the forces of supporting and attacking perfectly — which is why, of the Four Great Masters, he was the one who ultimately gathered all the learning into himself. This wisdom is worth remembering for every one of us.
Compiled from Doctor Luo Dalun’s interpretation of Doctor Zhu Danxi’s case records; the original cases are from Doctor Zhu Danxi’s medical writings (the chapter on wind-cold ailments, shang feng men).