Vomiting After Eating and Gurgling in the Chest? Doctor Zhu Danxi on “Ye Ge” (Dysphagia) Triggered by Eating in Anger
Patient search words: vomiting after eating / food stuck when swallowing / can’t get food down / gurgling sounds in the chest / food coming back up after meals
Corresponding medical terms: ye ge (dysphagia) · fan wei (regurgitation) · phlegm and blood stasis bound together · liver qi stagnation (in classical times often associated with esophageal and stomach cancer)
Opening scene: a very strange patient
In the case records of Doctor Zhu Danxi (朱丹溪) — the great Yuan-dynasty physician and one of the “Four Great Masters” of Jin-Yuan medicine — there is a story about a strong man in the prime of life. He was exactly at the age of full vigor, yet he had developed the strangest complaint: every time he finished a meal, a little while later he would throw up a few mouthfuls. Notice — not the whole meal, just a few mouthfuls. And his chest, up around the diaphragm (xiong ge), was constantly making sounds — rumbling, gurgling, always some noise in there.
Strangest of all: this man’s face looked exactly like a healthy person’s. You could not see a trace of illness on him.
💬 Note from Doctor Luo: A face that looks perfectly normal — that is a very distinctive detail in the “ye ge” (dysphagia) family of diseases. It tells you the problem is not in the spleen and stomach themselves, but up in the chest and diaphragm. That is why Doctor Zhu Danxi placed this case specially in the chapter on ye ge and fan wei (regurgitation), using it to explain this class of illness.
What exactly are ye ge and fan wei?
Let’s first get the names straight. Ye ge (噎膈) means food constantly getting stuck at the esophagus — it won’t go down, and sometimes comes back up. Much of what the ancients called ye ge would be esophageal cancer today. Fan wei (翻胃) is when food comes back up like rumination: what you ate in the morning comes up at night (zhao shi mu tu), and what you ate at night comes up in the morning (mu shi zhao tu) — much of it corresponds to stomach cancer today.
💬 Note from Doctor Luo: Of course, not every case of ye ge or fan wei is cancer. Some are functional — when emotions are bad and liver qi is depressed, food feels stuck. Some fan wei comes from stomach qi rebelling upward due to phlegm-fire. But the ancients took this disease extremely seriously, because it truly is hard to treat. The old saying listed “four great hard-to-treat diseases”: wind, consumption, drum, and diaphragm (feng, lao, gu, ge) — wind is stroke, consumption is tuberculosis, drum is the big-bellied disease of liver ascites, and diaphragm is this class of esophageal and stomach cancer. In the ancients’ view, once you got a “diaphragm” disease, it was nearly a death sentence.
How did the illness start? One question uncovered the truth
Since the seat of the illness was between the chest and diaphragm, Doctor Zhu Danxi asked: how did you get this? What happened before it began?
The patient thought for a moment: I had flown into a great rage — and before my anger had settled, I sat down and ate a bowl of noodles. Right after that meal, the illness began — from then on, a few mouthfuls would come back up after every meal.
💬 Note from Doctor Luo: Eating right after a fit of rage — that is the trigger. Doctor Zhu Danxi explains it very clearly in the case record: rage sends qi upward (nu ze qi shang). When you are furious, qi and blood surge upward, while the food is trying to move downward. The two collide, and the knot lands in the chest, diaphragm, and esophagus. Normally stomach qi should descend smoothly; now it can’t get down, it’s blocked above the stomach, and the whole downward rhythm of the digestive system is wrecked. This patient is exactly like the woman who ate roast pork in anger that we told you about before — rage, then eating, then trouble in the chest and diaphragm. It is almost a rule: when you are angry, do not eat.
Qi follows emotion: rage sends qi upward
Why does qi and blood rush upward the moment you get angry? Here we need to talk about the rules of qi movement in Chinese medicine:
Joy disperses qi (xi ze qi san) — happiness loosens and scatters it. Rage sends qi upward (nu ze qi shang) — anger drives qi up, and blood follows. Fear sends qi downward (kong ze qi xia). Grief consumes qi (bei ze qi xiao). Shock disorders qi (jing ze qi luan). Worry and brooding knot qi up (you si ze qi jie) — the qi simply binds and stops moving.
💬 Note from Doctor Luo: Rage sends qi upward, blood surges up with it — but if the liver qi is not flowing freely, the blood gets stuck. Qi and blood then knot together right between the chest and diaphragm. Once the rising-and-falling movement of qi is disordered, fluids can no longer be distributed; they accumulate where they’re blocked and condense into phlegm. The phlegm-fluid then binds with blood stasis, blocking the diaphragm, and as qi and blood rush against it, the chest keeps making sounds. So the root is crystal clear: phlegm-fluid plus blood stasis, bound together at the chest and diaphragm. The ancients summed all this up in one blunt proverb — the liver qi runs sideways and attacks the spleen earth (gan qi heng ni ke pi tu; “spleen earth” means the spleen and stomach): when your emotions go bad, the first thing they bully is your digestive system.
A surprising treatment: not moistening, but resolving phlegm first
When the ancients treated ye ge, they usually used the moistening method — assuming the esophagus was dry and rough, so they tried to lubricate it. But Doctor Zhu Danxi deliberately did the opposite this time. He took the phlegm-resolving route — because he had seen clearly that this was phlegm-fluid and blood stasis bound together above the diaphragm.
What was the prescription? Er Chen Tang (Two Aged Decoction) as the base — fu ling (poria), chen pi (tangerine peel), ban xia (pinellia), and zhi gan cao (honey-fried licorice) — the classic formula for transforming phlegm. To this he added xiang fu (cyperus rhizome) to soothe the liver and move qi; lai fu zi (radish seed) to digest food, move qi downward, and carry the phlegm down with it; and finally leek juice — a signature move of Doctor Zhu Danxi for ye ge, because leek juice dissolves blood stasis. The patient drank this for one day.
💬 Note from Doctor Luo: Xiang fu moves qi, lai fu zi sends qi down, leek juice dissolves stasis — three lines of attack at once: transform phlegm, move qi, dissolve stasis, to loosen up the phlegm-stasis blocking the diaphragm. And once it’s loosened? The next step is to “invite” it out.
Three days of vomiting: the phlegm came out, and the blood stasis came out too
After one day of the medicine, Doctor Zhu Danxi used the vomiting method (tu fa): he made up Gua Di San (melon-stalk powder — melon stalk is an emetic) and mixed it with sour vinegar (suan jiang) — vinegar is sour, and sourness has a contracting, dispersing quality; it reduces swelling and also drains dampness — then had the patient drink it and vomit.
On the first day, phlegm came out. On the second day, he vomited again, and among the phlegm there was a bowlful of blood — the blood stasis had been dissolved. On the third day, more vomiting, and again a cupful of blood. Three days of vomiting, and all the phlegm-fluid and blood stasis blocking the chest and diaphragm came out. The illness — was cured.
💬 Note from Doctor Luo: The whole treatment took just three days: first transform the phlegm, then use the vomiting method to expel the pathogen — and the blood stasis came out along with it, and the patient recovered. See how crisp Doctor Zhu Danxi’s thinking is — he did not reach for moisturizing herbs just because it was ye ge. He identified the true pattern of phlegm and stasis bound together, and moved through transforming phlegm, moving qi, dissolving stasis, and inducing vomiting in one smooth sequence. This is a classic case.
Two bonus stories: the rules of eating, and a great doctor with a fiery temper
At this point, Doctor Luo Dalun tells two true stories.
The first is about eating properly. He once dined with Master Li Yan of Maoshan (a Daoist priest). Everyone at the table chatted as they ate, firing questions about spiritual practice. The master, however, quietly ate his meal, mouthful by mouthful, without saying a word. Only when he had finished and set down his bowl did he speak: “Now I am done eating — let me answer your questions.” — When you eat, just eat.
💬 Note from Doctor Luo: Christians give thanks before meals; the Japanese press their palms together to thank the food before eating. These rituals all do the same thing: settle the emotions down, and eat in a normal state. What do we do today? We argue at the office, swallow our anger, then shovel down a few hurried mouthfuls. Eating while angry knots up the qi and blood — day after day, illness arrives. The ritual of eating is actually a piece of health wisdom the ancients left us.
The second story is about Zhu Weiju (祝味菊), a famous Shanghai physician of the Republican era. He was a great scholar and a brilliant healer, a leading figure of the “warming yang” school who excelled with fu zi (aconite) — he was nicknamed “Zhu the Aconite.” He also had a fierce temper and an unbending personality. Once he treated a child with warming-yang herbs. A famous physician of the warm-disease school was also consulted, and he denounced the use of warming herbs for a high fever, then stormed off. Zhu Weiju refused to back down: “You couldn’t cure him — I’ll keep treating him!” He continued the treatment, and indeed cured the child. Later, at a meeting, he even insisted the other doctor publish a newspaper apology before he would let the matter drop.
💬 Note from Doctor Luo: Doctor Zhu Weiju eventually died of throat cancer, and not at an old age. When I read his books back then, I thought it had a great deal to do with his unbending temperament — the more liver-fire and anger a person carries, the more easily qi knots up in the upper burner. Rage sends qi upward; qi and blood surge up, phlegm-dampness and blood stasis gather up with them, and blocked at the throat and esophagus, they become throat cancer and esophageal cancer. Bad emotions — and anger above all — most easily make the upper body sick.
Esophageal and throat cancer: what other triggers are there?
Doctor Luo also reminds us of other triggers for esophageal and throat cancer. First: food that is extremely hot — in some high-incidence regions for esophageal cancer, people drink scalding corn porridge and boiling-hot soup every day. Second: too much barbecue. Third: viral infection — especially abroad, where HPV (human papillomavirus) infection is strongly linked to throat and esophageal cancer.
💬 Note from Doctor Luo: When Doctor Zhu Danxi wrote about this class of disease, emotion-triggered cases were especially common — though not everything he recorded was cancer. Much of it was functional. For example, women whose emotions were thwarted might feel a “kernel” in the throat that they could neither swallow nor spit out — that is mei he qi, “plum-pit qi.” In Doctor Zhu Danxi’s era, Chinese medicine already paid this much attention to the damage emotions do to the body. That experience is something we absolutely should draw on today.
Conclusion: emotion is the “vaccine” against disease
What this case most wants to tell us is not how to treat ye ge — it is don’t let rage wreck your body. After a great fury, don’t rush to eat. In daily life, learn to adjust your emotions: read the classics of the sages, cultivate the heart and mind, make one good intention every morning — the occasions for anger will grow fewer.
💬 Note from Doctor Luo: Some people say, “I can just think myself out of it” — but that is very hard, which is why we need to study and practice. Be at ease, go with the flow, find joy in what you see — and the occasions for anger naturally become fewer. While the body is still healthy, get the “vaccine” of good emotion in first. That is the most valuable lesson these case records of Doctor Zhu Danxi teach us.
Compiled from Doctor Luo Dalun’s explanations of Doctor Zhu Danxi’s case records. The original case comes from the Dan Xi Xin Fa (Teachings of Danxi), chapter on ye ge and fan wei (as told by Doctor Luo Dalun).