Can’t Eat, Just Drinking Tea and Eating Fruit All Day — Even Your Period Has Become Light and Late? Doctor Xue Lizhai Treats Spleen Deficiency with Guipi Tang (Spleen-Returning Decoction) and Liujunzi Tang (Six Gentlemen Decoction) plus Wu Zhu Yu
Patient’s search terms: can’t eat / no appetite / living on plain tea and fruit every day / period getting lighter and later / puffy yellow face / soft puffy body
Medical terms: spleen deficiency · spleen qi constraint · liver wood invading the spleen · phlegm from spleen deficiency · delayed and scanty menstruation
Opening: two young women who had not eaten properly for years
Doctor Xue Lizhai (Xue Ji) was the director of the Imperial Academy of Medicine in the Ming dynasty and left behind more than three thousand case records. Today Doctor Luo Dalun talks about two patients he encountered back to back, whose symptoms were almost identical — both were young women, and both had not eaten properly for years, getting by on plain tea and fruit. Does that scene look familiar today?
💬 Note from Doctor Luo: Isn’t this exactly what a lot of people do now? Even without being sick — dieting, not eating real meals, just eating fruit. This first patient was genuinely ill: more than three years of abnormal eating. But even a healthy person who managed to keep that up for three years would be in serious trouble.
Who was the patient: a woman in her thirties who suddenly lost her appetite
The first patient was a woman in her early thirties. One day, suddenly, she no longer wanted to eat — no appetite at all. What did she do? Every day she drank three or four bowls of plain tea and ate a little fruit to take the edge off her hunger. That “just a snack” went on for more than three years.
Slowly, a problem appeared: her period came late and light every time — the flow got less and less, and the cycle kept getting pushed later and later. Alarmed, the woman came to see Doctor Xue Lizhai.
The diagnostic high point: Doctor Xue Lizhai’s four-word verdict — spleen qi constraint
After examining her, Doctor Xue Lizhai said just four words: spleen qi constraint (pi qi yu jie).
💬 Note from Doctor Luo: What he really meant was liver qi stagnation — liver qi stagnation that leads to spleen qi constraint. Worry, gloom, and bad moods are all signs of constrained liver qi. Worrying injures the spleen, and when the spleen qi is constrained it cannot do its normal work: it cannot receive food, cannot ripen and transform it, cannot move the nourishing essences. So she could not eat, her qi and blood gradually became insufficient, and her period got lighter and later — there simply was not enough blood. Constrained liver qi also comes in two flavors: some people explode in anger and let it out on the spot, which is actually a little better; others brood and swallow their frustration, bottling it all up inside — that injures the spleen far more deeply.
Anatomy of the prescription: Guipi Tang — treating heart and spleen together, tonifying qi and blood
The formula Doctor Xue Lizhai chose is a classic: Guipi Tang (Spleen-Returning Decoction) — one he was especially good at and used constantly.
💬 Note from Doctor Luo: Guipi Tang is a famous formula that treats the heart and spleen together and tonifies both qi and blood. Its base is Sijunzi Tang (Four Gentlemen Decoction) — ren shen (ginseng), bai zhu (atractylodes), fu ling (poria), and gan cao (licorice) — which tonify qi. On top of that, long yan rou (longan flesh) nourishes heart blood and tonifies the spleen qi — longan is sweet, and sweet flavor enters the spleen to tonify it; once dried it turns red, and red enters the heart, nourishing heart blood and calming the spirit (it is the main ingredient of Yu Ling Gao, Jade Spirit Paste, which we have talked about). Then suan zao ren (sour jujube seed) nourishes liver blood, huang qi (astragalus) tonifies qi, mu xiang (costus root) moves the qi, and yuan zhi (polygala root) settles the spirit. Qi and blood are both tonified — a truly classic composition.
The master stroke: one herb — wu zhu yu — warming the liver and the stomach
But Doctor Xue Lizhai added one more herb: wu zhu yu (evodia fruit).
💬 Note from Doctor Luo: Why wu zhu yu? The commentators say it warms the liver channel and releases constraint in the Jueyin liver channel. But there is another layer: this woman had been eating fruit for three years, so the yang qi of her spleen and stomach must have been wounded by cold. Fruit comes in cold, cool, warm, and hot natures, but it is after all raw and cold food. Humans are not monkeys — we have long been used to cooked, warm food. If you eat raw and cold things every day, when your spleen and stomach are already constrained and weak, and you are using fruit to replace meals on top of that, the spleen and stomach get even weaker and the yang qi even more damaged.
The result: within a few doses, she was eating normally again
A few doses in, her appetite returned to normal — the spleen qi was topped up, the qi and blood were sufficient, the transformation could proceed, and of course she wanted to eat again.
Case two: a girl just past twenty, two years without proper food, a sallow, puffy face
The second patient was even younger — just over twenty — and had not eaten properly for two years. Like the first, she drank plain tea and ate a little fruit every day. Her symptoms were heavier: her face was slightly yellow and puffy — spleen-deficiency edema, the spleen qi scattering outward. Her body was very tired, yet her build looked normal, she still appeared fine and could walk around.
The pulse said it all: the liver and spleen positions were floating and wiry, weak and constrained under pressure — once again, liver wood running sideways to attack the spleen earth.
Why Liujunzi Tang this time? — the puffiness hides phlegm-damp
Same spleen deficiency, same refusal to eat — yet this time Doctor Xue Lizhai did not use Guipi Tang. He switched to Liujunzi Tang (Six Gentlemen Decoction) plus mu xiang (costus root) and wu zhu yu (evodia fruit).
💬 Note from Doctor Luo: This is what skill looks like. The first woman had abnormal periods — clearly blood deficiency — so Guipi Tang, which tonifies qi and blood together, was right for her. This one was tired, sallow, and puffy: qi deficiency was the obvious problem, and the puffiness tells you there is water-damp and phlegm accumulated inside — so Liujunzi Tang was chosen. Liujunzi Tang is Sijunzi Tang plus ban xia (pinellia) and chen pi (tangerine peel): it tonifies the spleen and transforms phlegm. Mu xiang moves the qi; wu zhu yu warms the middle. Phlegm never transforms without warmth (fei wen bu hua) — once you warm it, the congealed cold phlegm melts away.
A twist in treatment: she discharged an enormous amount of phlegm — not bad news, good news
After the medicine went down, the girl began expelling phlegm in great quantities — the record says “she discharged phlegm extremely copiously.” Once it was out, her appetite immediately returned — she started eating; and her body began to slim down — the puffy, deficiency-bloated look gradually melted away.
💬 Note from Doctor Luo: Where did all that phlegm come from? Spleen deficiency generates phlegm — when the spleen is too weak to transform water-damp, the dampness congeals into phlegm. Eating fruit every day weakened the spleen and stomach, and the phlegm accumulation became even more obvious. When the body discharges phlegm, you may have some reactions — but you should know this: discharging phlegm is a good thing; it is the body clearing out its garbage. Take people who are puffy from deficiency: their muscles feel like cotton when you touch them — that is water, dampness, and phlegm packed inside. Give them upright-tonifying medicine — some huang qi, Sijunzi Tang, sometimes fu zi (aconite) or gan jiang (dried ginger), or even Fuzi Lizhong Wan (Aconite Center-Regulating Pill) — and they immediately drain it out, right away diarrhea. Some people take spleen-tonifying herbs and get diarrhea, then ask me whether the medicine was wrong — no! It is the upright qi starting to move, pushing the garbage out. Some people do moxibustion at Guan Yuan (CV4); as soon as the body warms up, they run to the toilet — that is also a good sign. If you panic at the diarrhea and stop the medicine, the garbage can never get out.
After the phlegm was out, she felt “tired” — a sign the body was healing
After the phlegm discharge, the girl lay in bed for a few days and, for the first time, truly felt exhausted. It looked like the illness had gotten worse — in fact, it was exactly the opposite.
💬 Note from Doctor Luo: Before, her body had been running at low level — the channels and the middle jiao were stuffed with phlegm, she was puffy and weak, her muscles felt like cotton. That was not her real body. Now the garbage was cleared out and the pipes were clean, so the body urgently needed food and nourishment to rebuild the upright qi — that is why she felt tired. This is the process of cleaning out the garbage and unclogging the digestive pipeline; it is a little uncomfortable, but Doctor Xue Lizhai looked at it and said, no problem — keep taking the Liujunzi Tang, and slowly she got better.
Both cases together: emotional constraint and cold raw fruit — the same pair of culprits
The two cases look so alike because they share one underlying truth: emotional constraint injured the spleen, and cold raw fruit poured salt on the wound.
💬 Note from Doctor Luo: Both of these women fell ill from constraint. In the old days women had low status and carried a whole household of worries; constraint was everywhere. Why didn’t they collapse sooner? Because they were young — one in her twenties, one in her thirties — their constitutions could carry two or three years of abuse. But eventually trouble always comes: for the first, qi and blood deficiency — the blood ran short, the period went wrong, and left unchecked she would have gone into premature menopause. I have seen girls dieting on cucumber every single day whose periods stopped completely and whose uterus and ovaries shrank. For the second, qi deficiency — the sallow, puffy face; qi too weak to transform water-damp, so the water flooded the body and finally congealed into phlegm. Both were the same story: the spleen, exhausted.
Commentator’s note: for emotional stomach disorders, first tonify the upright qi — don’t rush to soothe the liver
In both cases Doctor Xue Lizhai made tonifying the spleen the main strategy. Doctor Luo Dalun says this approach is exactly what modern people need to learn.
💬 Note from Doctor Luo: These days, people whose stomachs and spleens are knocked out of balance by emotion are everywhere — stress is high. But simply soothing the liver does not work. Why? Because the spleen has been too badly wounded; the upright qi cannot stand up, vitality does not flourish, so no matter how much you soothe, nothing moves. First tonify the spleen so that vitality flourishes; once the spleen qi is full, it can in turn check the liver wood — this is a crucial strategy for modern people regulating emotional stomach-and-spleen disorders. At the end of the case, Doctor Xue Lizhai added one more piece of hard-won experience: when a person is deficient in both spleen and kidney and will not eat, use Sishen Wan (Four Spirits Pill) — warming the spleen and kidney. That was his signature move.
Bonus life topic: can we still eat fruit?
After the cases, Doctor Luo Dalun talked specially about fruit — a question so many people are asking.
💬 Note from Doctor Luo: I am not saying nobody should ever eat fruit. People all over the world eat fruit; fruit supplies vitamins and plant fiber, and of course it is fine. But it depends on the person: if your yang qi is sufficient, a little fruit is no problem; but if your spleen and stomach are weak, your yang qi insufficient, and cold things give you diarrhea — and you still wolf down raw fruit by the bowlful — that is genuine harm to your body. How should you eat it? Soak it in hot water, cook it — stewed apple is delicious. I have seen people in Hainan dip fruit in pepper powder, Sichuan pepper powder, and chili flakes. At first I was dumbfounded; then I thought about it and saw the wisdom — ordinary people had already figured it out long ago: if you dip raw, cold food in something pungent and warming, it no longer wounds the spleen and stomach. And please, do not sit down and eat half a big watermelon in one go — that way of eating is very bad for the body.
Two young women, restored to normal eating with a few doses of spleen-tonifying medicine. In the end, Chinese medicine does not treat the surface symptom — “can’t eat” — it lifts up the spleen and stomach that were wounded by emotions and cold raw food, bit by bit.
Compiled from Doctor Luo Dalun’s lecture explaining the case records of Doctor Xue Lizhai; the cases are from Xue’s Case Records (《薛氏医案》).