Always Angry and Suppressing It, with an Abdominal Lump and Irregular Periods: Doctor Xue Lizhai’s Two Gynecological Mass Cases (Buzhong Yiqi Tang + Liuwei Dihuang Wan Nourishing Liver Yin — Same Disease, One Cured and One Lost, All Because of Emotion)
Patient search terms: always angry / prone to anger / suppressing anger / big temper / hard lump in the belly / irregular periods / growing thinner and thinner / no appetite, cannot eat
Medical terms: liver qi stagnation · liver yin deficiency · abdominal mass (zheng jia / ji ju) · illness caused by emotion · spleen and stomach weakness · kidney water insufficiency
Opening scene: today the director of the Imperial Medical Academy tells of two gynecological patients — one cured, one lost
Today Doctor Luo Dalun tells the story of Doctor Xue Lizhai (Xue Ji), the director of the Imperial Medical Academy in the Ming dynasty, treating gynecological disease. Doctor Xue was a special figure — he deeply admired Doctor Zhu Danxi, and much of his theory came from the two great masters of the Jin-Yuan period, Li Dongyuan and Zhu Danxi. By the Ming dynasty, Doctor Xue had taken this body of theory and applied it to women’s diseases with extraordinary skill.
Today he tells two cases at once: the same disease, almost the same treatment — yet one patient recovered and one did not. The entire difference came down to two words: emotion.
💬 Note from Doctor Luo: Doctor Xue lived in the Ming dynasty; Li Dongyuan and Zhu Danxi lived in the Jin-Yuan period, several hundred years earlier. He studied the ideas of his predecessors thoroughly, then applied them to gynecology. He placed these two cases side by side deliberately — he wanted to tell you: emotion carries enormous weight in treating disease.
The first patient: quiet, industrious at needlework — and yet "prone to anger"
The first patient was a woman surnamed Chen. Doctor Xue had a habit — he always wrote the patient’s personality down first. Of this woman he wrote: quiet in temperament, industrious at needlework.
What does "quiet" mean? She was a very still, inward person. And what did she do all day? Industrious at needlework — the embroidery, the silk-threading, the sewing and weaving that women of that age excelled at. She threw herself into it with real energy.
But then Doctor Xue added two more words: shan nu — prone to anger. She angered easily.
💬 Note from Doctor Luo: Notice this combination: first "quiet," then "prone to anger." A person of this temperament gets angry and cannot let it out — she does not slam the table and shout; she swallows the fire and carries it home inside herself, turning it over in her mind, lying awake at night thinking about it. This is what we call suppressing anger (sheng men qi), and it is the most damaging kind. People of this temperament very easily develop liver qi stagnation.
The illness arrives: a lump in the lower abdomen and irregular periods — and the first doctors made it worse with "draining the liver and purging fire"
The anger stayed bottled up in her belly, and in time it produced trouble: a lump formed in her lower abdomen — a mass in the small belly, sometimes painful; huo zuo tong, huo pi men — sometimes it felt blocked and stuffy; yue jing bu tiao — her menstruation began to go irregular.
The family hurried to find a doctor. The doctor looked and thought: this must be liver fire! So he went to work felling the liver and moving qi — draining liver fire hard, moving qi, breaking qi, piling on fierce medicines like qing pi (green tangerine peel) and zhi qiao (bitter orange shell), used brutally.
And the result? It did not help — it made her worse: heat arose inside her body, with chills and fever coming and going; xiong ge bu li — her chest felt oppressed and breathing was uncomfortable; yin shi bu gan — food tasted bland and she lost her appetite; xing ti yu shou — she was visibly thinner every day; and in the end even her gums ulcerated.
💬 Note from Doctor Luo: Remember: soothing the liver must always be gentle. Use green calyx plum blossom (lü’e mei), rose (mei gui hua), Chinese rose (yue ji hua), matched with bai shao (white peony root), and gently knead the liver qi open; if truly necessary, add a little chai hu (bupleurum). But this doctor went straight for draining liver fire and breaking qi — qing pi, zhi qiao, long dan cao, a barrage of fierce herbs. The liver was not soothed; the spleen and stomach were wounded to the core. "Soothing the liver" and "felling the liver" — one word apart, and worlds between.
How did Doctor Xue see it? One sentence — "the spleen Earth cannot engender the lung Metal" — breaks open a vicious circle
At last she came to Doctor Xue Lizhai. He looked and shook his head: to attack the liver and drain fire with such force — that was wrong.
He said: what is the problem here? The spleen Earth cannot engender the lung Metal — this woman’s spleen and stomach were the first to fail. Why did they fail? Two reasons: first, worry and brooding injure the spleen; second, anger turned inward — the liver qi, running sideways, attacks the spleen Earth — when the emotions are bad, the spleen and stomach weaken.
Then Doctor Xue laid out a complete five-element vicious circle:
Bad emotion → liver fire flares → liver qi runs sideways and attacks spleen Earth, injuring the spleen and stomach → spleen (Earth) weakens and can no longer engender the lung (Metal) → the lung, deficient, cannot engender kidney Water (Metal engenders Water) → kidney Water runs short → kidney Water can no longer nourish liver yin (Water engenders Wood) → the more deficient the liver yin, the fiercer the liver fire → the fiercer the liver fire, the harder it attacks the spleen and stomach…
Round and round, each turn making things worse.
💬 Note from Doctor Luo: Do you see the circle? When the emotions are bad, liver fire flares; the first thing liver fire bullies is the spleen and stomach; when the spleen and stomach weaken, the lung follows; when the lung weakens, it cannot engender kidney Water; when kidney Water runs short, liver yin has nothing to nourish it, and the liver fire flares even higher. It is a death spiral. So look at this woman — fever, no appetite, wasting away, ulcerated gums — all of it began with those three words: suppressing anger.
Doctor Xue’s signature move: for masses, start from "nourishing liver yin"
Here is something particularly interesting. In treating mass-type diseases (whether gynecological or anywhere else), Doctor Xue held a distinctive view: he believed masses to a large degree relate to liver yin deficiency — when liver yin is depleted, the liver qi stagnates, and the gathered qi forms a mass. So in treating masses, he used the method of nourishing liver yin to dissolve them.
💬 Note from Doctor Luo: This is a very distinctive idea, and few later physicians carried it on. I have read a great many case records, and to be honest — among those who advocated it strongly and practiced it on a large scale, Doctor Xue is unique. Today, when people treat masses, they basically still reach for the standard arsenal: invigorate blood, resolve stasis, break accumulations. Doctor Xue believed the attacking method easily goes wrong, so he used the approach of regulating the liver and nourishing liver yin to let the mass slowly scatter. Why this method was not handed down to later generations, we leave as an open question. But in his case records, this is genuinely how he treated a great many of them.
The prescription: Buzhong Yiqi Tang + Liuwei Dihuang Wan — walking a "circulation of yin" through the body
So how did he treat her concretely? The thinking was clear: the spleen and stomach are insufficient, so supplement the spleen and stomach; the liver yin is insufficient, so nourish the liver yin. The formulas were even simpler — just two classical ones: Buzhong Yiqi Tang (Supplement the Middle and Boost Qi Decoction) and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill).
Why Buzhong Yiqi Tang? Doctor Xue regarded it as the formula that supplements the original qi (yuan qi) — when the original qi and the middle qi run short, the qi sinks downward. This woman’s spleen qi was insufficient and she had no appetite, so he had to supplement spleen qi and nourish the source of transformation (zi hua yuan) — to fill up the spleen and stomach, the "source." Once the spleen and stomach are full, what happens? The spleen Earth engenders the lung Metal, and the lung Metal is full; the lung Metal engenders the kidney Water, and the kidney Water is full; and when the kidney Water is full, it can at last nourish the liver yin.
And then why add Liuwei Dihuang Wan? To enrich kidney Water and kidney essence, in order to nourish the liver yin.
💬 Note from Doctor Luo: Do you see it? In Doctor Xue’s hands, Buzhong Yiqi and Liuwei Dihuang form a circulation — Buzhong Yiqi is the "starting engine": first build up the spleen and stomach, spleen Earth engenders lung Metal, lung Metal engenders kidney Water — and at that point Liuwei Dihuang helps you fill the kidney Water to the brim, and the kidney Water goes to nourish liver yin. Walk the whole circle, the liver yin becomes sufficient, the liver’s yin and yang come into balance, the liver’s function of free flow (shu xie) is restored, and the mass itself slowly dissolves — because at bottom it is a clump of gathered liver qi that was never allowed to flow. The same goes for menstruation: the period is intimately tied to the liver — the liver governs free flow, and the slightest stasis immediately makes the period stop or go wild. Once the liver qi flows freely, the period naturally returns to normal.
And the outcome? Just these two formulas, taken all the way into spring — this woman’s illness was cured: the mass in her belly dissolved, and her periods returned to normal.
Bonus method: when the illness is tangled beyond sorting out, "support the upright qi" — Buzhong Yiqi in the morning, Liuwei Dihuang at night
Doctor Luo says that Doctor Xue’s pairing of "Buzhong Yiqi + Liuwei Dihuang" regulates the circulation of yin and yang among the five organs exceptionally well. Doctor Luo himself has been recommending this method to everyone ever since:
💬 Note from Doctor Luo: If your body is extremely complicated, you have been treated everywhere without success, and you have run out of ideas — remember: when an illness is tangled beyond sorting out, support the upright qi. When the upright qi is sufficient, some problems simply resolve themselves. How to do it concretely? Take Buzhong Yiqi Wan in the morning and Liuwei Dihuang Wan at night; if liver qi is deficient, add a little Xiao Yao Wan (Free and Easy Pill) at midday; if yang qi is deficient, use Jinkui Shenqi Wan (Kidney Qi Pill from the Golden Cabinet) at night. Where did these methods come from? Entirely from Doctor Xue Lizhai — he was exceptionally skilled at using them this way.
The second patient: the Prefect of Songjiang’s wife — a temper so enormous even the imperial physician could not hold it
Now the second case — this time, Doctor Xue Lizhai could not save her.
The patient was the wife of the Prefect of Songjiang (the local magistrate), a titled gong ren (a noblewoman of honorific rank). And her character? The same two words: shan nu — prone to anger. Her temper was enormous.
Her symptoms were similar: a great lump had gathered in her belly, and it had been there for over a year; xing ti gu li — how thin was she? Standing there she looked like a rack of bones — nothing but skeleton left; han re wang lai — alternating chills and fever; yi jia kui lan yu tou (tou sai) — the inside of her cheeks had rotted almost all the way through.
How had the previous doctors treated her? Again felling the liver and draining fire, used ferociously: qing pi to break qi, long dan cao to drain fire — a thorough, violent purge.
💬 Note from Doctor Luo: How many times have I said it: to soothe the liver use gentle medicines — lü’e mei, rose, Chinese rose, bai shao, gently kneading the liver open. And here came another doctor with the heavy artillery: qing pi, breaking qi, draining liver fire. That is not treatment; that is adding to the chaos. When Doctor Xue later felt her pulse, he understood at once — this illness had already gone deep.
Taking the pulse: liver pulse surging, large, taut and tight; the other pulses faint — "the liver channel’s true qi is deficient while its pathogenic qi is excessive"
In winter the lady came to Doctor Xue Lizhai. He pressed the pulse, and his heart sank: the liver pulse was surging and large, taut and tight on deeper pressure, while all the other pulses were extremely faint.
Doctor Xue said: the liver channel’s true qi (zheng qi) is already deficient, while its pathogenic qi is excessively solid. He made an analogy: this liver channel barely has strength enough to protect itself — how could it still have strength to attack the Earth? Her complexion was qing bai — greenish-white — a sign of kidney water insufficiency and liver Wood depletion, with the lung Metal coming to overrestrain it as well.
And what did Doctor Xue fear most? He feared the coming of spring. In spring the liver Wood surges upward; with kidney water depleted to this degree, when the liver Wood rises with no water to nourish it, something terrible would happen.
So he reluctantly wrote a prescription: strengthen the spleen and stomach, enrich kidney water — still the Buzhong Yiqi / Liuwei Dihuang line, building up the spleen and stomach, enriching the kidney water, letting the liver yin recover a little. After a period of treatment, the liver pulse receded somewhat, and her condition improved.
One twist after another: a great fury, bleeding from the ear, restlessness and thirst — "fire without root," and cinnamon bark to guide the fire home
But who was this lady? The wife of a great official, who ruled her own household. Her temper was enormous. For some reason or other, she flew into another rage — and this time she bled from the ear!
Doctor Xue felt her pulse: the liver pulse was still large; pressed deeper, it faded to nothing — as before, the true qi was insufficient again. And now she was restless and thirsty (fan zao zuo ke).
Doctor Xue spoke four words: ci wu gen zhi huo — this is fire without root. It was deficiency fire, with no foundation. He instructed: although she is restless and thirsty, do not on any account drain the fire again! In the previous formula (the Liuwei Dihuang line), add a little rou gui (cinnamon bark), and give two doses.
Two doses down, the liver pulse receded at once, and the heat and thirst subsided immediately — that fire had been guided back to its origin (yin huo gui yuan) by the cinnamon bark.
💬 Note from Doctor Luo: This is the difference between "deficiency fire" and "excess fire." Excess fire is drained; deficiency fire must be led back — rou gui guides the fire home, drawing the floating deficiency fire back into the kidney. If Doctor Xue had only seen the "restlessness and thirst" and drained the fire, this lady would have been gone long ago. The pity is — he could rescue her once, but not a second time.
The ending: one more great rage, and she was gone — Doctor Xue sighed: a patient like this, even an immortal could not save her
Everyone thought she was better and would just continue recuperating, right? Not long after, this lady flew into another fury — over some matter or other — and as a result she stopped eating altogether. And indeed, as spring approached, this titled noblewoman died.
Who was Doctor Xue? The director of the Imperial Medical Academy — the man who had attended the emperor himself. Day after day in the academy he faced patients like this; anger and exhaustion finally wore his own body down. Yet even a master of his caliber could not save this lady — why?
💬 Note from Doctor Luo: This woman’s temper was simply too terrible. She flew into rages over nothing — the maid handed her water at the wrong angle or the wrong temperature, and she would erupt: "This water is boiling — are you trying to scald me to death? Beat her!" A person like that: every time you dragged her back from the gates of death, she turned around and flew into another rage; her ear bled, and she raged again. Who could endure it? It was like serving the emperor. A patient like this cannot be regulated — because the root of the illness is emotion, and if the emotion does not change, the medicine is drunk in vain.
Two patients, same disease — why did one recover and one die? Emotion is the master switch of gynecological disease
Set the two cases side by side, and the meaning is profound: the same disease (abdominal mass, irregular periods, emaciation), the same treatment (Buzhong Yiqi + Liuwei Dihuang) — one recovered, one died. Where was the difference? Entirely in temperament, entirely in emotion.
The first woman, Mrs. Chen, was also prone to anger — but she was inward by nature, knew how to hold herself in, and with slow, steady treatment her illness healed. The second, the great official’s wife, had a temper so enormous that even the director of the Imperial Medical Academy could not hold it back — each time she was rescued, she dragged herself back into the pit, and in the end no one could do anything.
Doctor Luo says: in diseases like abdominal masses, irregular periods, and wasting of the body, emotion carries an especially large share of the weight. He has met countless people in poor health, and most of them are tied to emotion.
💬 Note from Doctor Luo: I once chatted with a friend who ran an e-commerce business. He used to sell ordinary household goods; later he switched to traditional Chinese medicine products. He said: "Your Chinese-medicine fans have terrible tempers — they ignite at the slightest touch." I said that cannot be right — people who study Chinese medicine should be even-tempered. He said it was unmistakable — before, when he sold household goods, customer service was easy; once he started selling Chinese-medicine products, everyone he met was a patient, and patients had big tempers — respond a little slowly and they explode. Why? I thought it through: who goes to the Chinese-medicine world? Patients. Why does a person become a patient? Very often precisely because of liver qi stagnation and bad emotion — and they do not even know it themselves; they think they are fine, and the fire flares up at the first provocation. We only see that we are sick; we never think it is connected to emotion. But it is intimately connected.
Bonus story: the lady who fought over two yuan in the parking lot — that bowl of medicine, drunk in vain
Doctor Luo told of an example he saw with his own eyes: at a hospital, a lady came out carrying large bags of Chinese medicine, and at the parking lot she got into a furious argument with the attendant because the parking fee was two yuan more than she thought it should be. She argued and argued, then swung her car across the entrance — and backing up, nearly hit Doctor Luo. He jumped out of the way. Her old mother stood beside her joining in the argument.
💬 Note from Doctor Luo: Tell me — could that bag of decoction in her hand possibly work? She is exactly like the Prefect of Songjiang’s wife — the medicine is good, the formula is correct, but if the temper does not change, the decoction is drunk in vain. Even Doctor Xue could not cure his patient, because she tormented herself. Small things in life — a package that arrives late, a food delivery two minutes behind — can make a person furious. What medicine could ever regulate an emotion like that?
Closing: if you do not want to become a "patient," then learn to be happy
Finally, Doctor Luo spoke to the root of the matter: many people in poor health are tormenting themselves — they fly into rages, anger themselves into illness, and cannot step out of the circle. It is deeply pitiable. Why does he keep talking about the relationship between emotion and the body? To tell everyone: do not walk down that road.
💬 Note from Doctor Luo: Always remember: be happy every day, laugh, be open-minded, and let things go. No matter what it is — "whatever will be, will be; let it go, let it pass" — keep these words on your lips. Learn to go with the flow, learn to be magnanimous, learn to let go. For the physical side, you can learn from Doctor Xue: Buzhong Yiqi in the morning to supplement the spleen and stomach, Liuwei Dihuang at night to enrich kidney yin and knead the liver qi. But regulating the body alone is not enough — even with the body in good order, if the temper does not change, the body will break down again. Regulate the emotion, and you are not a patient — you may never become one. When the body is healthy, when you live joyfully and well — that is a happy life.
Compiled from Doctor Luo Dalun’s commentary on Doctor Xue Lizhai’s case; the case is from Records of the Xue Family Medical Cases (《薛氏医案》, Ming dynasty, by Xue Ji).