Edema, Urinary Difficulty, and Cold Hands and Feet from Years of a Bad Temper: Doctor Xue Lizhai Warns Yang and Strengthens the Body After Previous Doctors Made It Worse
Patient search terms: edema / whole body swelling / bloated belly / cannot urinate / cold hands and feet / irregular periods / food not digesting / irritable temperament / quick to anger
Medical terms: edema (shui zhong) · spleen and lung qi deficiency with cold · yang deficiency with water flooding · liver wood encroaching on spleen earth · irregular menstruation
Opening scene: first, a rule — if your temper is bad, your spleen and stomach are sure to suffer
Today’s case comes from Doctor Xue Lizhai (Xue Ji), the director of the Imperial Medical Academy in the Ming dynasty — a gynecology case. The patient was a woman of forty — middle-aged. And she had one outstanding trait: su xing ji — by nature extremely quick-tempered, always in a hurry, always impatient.
💬 Note from Doctor Luo: I have said this many times — it is really a law of everyday life: when a person has a bad temper, some organ is certainly being injured. It may not be only one; two, three, even four organs can be damaged. But one thing is certain: the spleen and stomach will never be well. Why? Impatience easily kindles liver fire; the liver qi runs sideways and bullies the spleen earth, and the spleen and stomach take the first blow. An experienced doctor only needs one look at a patient’s character to know what is going on — this is layer upon layer of clinical experience.
The patient’s situation: food no longer digests, and her periods go wrong
Sure enough, this woman’s problems all sat in the spleen and stomach: yin shi nan hua — food would not digest; yue jing bu tiao — her menstruation went irregular.
💬 Note from Doctor Luo: What does an irregular period have to do with the spleen and stomach? Everything. When the spleen is weak, it lacks the strength to turn the essential nutrients in food into blood; when blood runs short, the periods go wrong. This is exactly what traditional Chinese medicine means when it calls the spleen “the source that engenders qi and transforms blood.” So her belly and her period were actually the same disease root — the spleen and stomach badly wounded by liver fire.
Mistake number one: the doctor moves qi and resolves phlegm — and her belly swells
A doctor was called. His reasoning: food not digesting — that must be a blockage! So he gave her qi-moving and phlegm-resolving herbs, trying to open things up and dissolve things. The result? Du fu peng zhang — her belly swelled up.
💬 Note from Doctor Luo: Normally, for a quick-tempered person, moving qi and resolving phlegm is no problem. But this woman was different — she had not been angry for a few days; she had been this way for decades. Her spleen and stomach had been injured for far too long, and were already weak to a serious degree. At that point, even a modest dose of qi-moving, phlegm-resolving medicine was more than the body could bear. The belly swelled, and diarrhea was added on top.
Mistakes two and three: the more they “unblock,” the worse it gets — the woman nearly falls apart
Seeing the swelling, the doctor was even more certain it was a blockage: he added wu yao (lindera root) to move qi, and peng e zhu (zedoary) — a blood-breaking, blood-activating herb. The result: du fu zhong zhang, xiao bian bu li — the belly swelled further, and urine would not come out. The doctor still would not give up: urinary difficulty? Then drain the urine! He added zhu ling (polyporus) and ze xie (alisma) to push water and damp out of the body. And that finished it: tan chuan qi ji — phlegm congestion with rapid, labored breathing; shou zu jue leng — hands and feet ice cold; tou mian zhi ti zhong zhang — the face and body all swollen, so that a finger pressed into the skin left a pit.
💬 Note from Doctor Luo: Step by step, it was like a machine already rusted almost to pieces: instead of replacing the steel beams and supporting the upright qi, you keep poking it and turning it — and it clatters apart. Qi-moving herbs, blood-breaking herbs, water-draining herbs — all of them consume the body’s energy. When the upright qi has sunk this low, the more you “unblock,” the more it collapses. Remember this: when the upright qi is insufficient, even a water-draining herb like fu ling (poria) must be used with care when taken alone. I have seen people with badly deficient qi drink fu ling water every single day — and suddenly their bodies caved in. They tasted old age early, could barely walk.
Doctor Xue Lizhai arrives: this is spleen and lung qi deficiency with cold — not a blockage
At last Doctor Xue Lizhai was called. He felt the pulse: chen xi — deep and thin, with the right cun position especially weak (on the left wrist, cun-guan-chi correspond to heart, liver, kidney; on the right, to lung, spleen, and mingmen — a weak right cun means the lung qi is even more deficient). His verdict was crisp: ci pi fei zhi qi xu han — this is deficiency and cold of the spleen and lung qi. And he added one telling sentence: mai zheng xiang ying — the pulse and the symptoms correspond. When pulse and symptoms match each other, the case is treatable; had they contradicted each other, something far more serious might be going on.
💬 Note from Doctor Luo: You ask, what do edema and the spleen and lungs have to do with each other? In Chinese medicine, the lung is the upper source of water, the spleen is the middle source of water, and the kidney is the lower source of water — these three organs govern water. Now the spleen and lung qi were deficient and cold, the water channels were frozen and stagnant, the body could no longer regulate and conduct the waterways, the water could not be drained — it all piled up inside. Doctor Li Dongyuan used a picture: dampness lingering in the body is like earth soaked in rain, turned all to mud — what do you do? You need the sun to shine on it! When the sun comes out, the damp evaporates, the earth dries, and everything can grow again.
The prescription: the Golden Cabinet Kidney Qi Pill with modifications, made into a decoction — urination returns after a single dose
The treatment principle was now clear: warm yang and transform water. Doctor Xue used Jinkui Shenqi Wan with modifications — that is, the Kidney Qi Pill from the Golden Cabinet, the formula later generations call Jisheng Shenqi Wan (Life-Preserving Kidney Qi Pill): the Cinnamon and Aconite Rehmannia Pill (shu di huang, shan zhu yu, shan yao, rou gui, fu zi, and the rest) plus niu xi (achyranthes) and che qian zi (plantago seed) to strengthen the downward action of moving urine and draining damp. And he did not form it into pills — he made it into a decoction for her to drink.
The result: xiao bian ji tong — urination returned at once. After a few doses, half the swelling was gone, and si zhi jian wen — the hands and feet that had been icy were warm again, and she could move about once more.
💬 Note from Doctor Luo: Where is the genius of this formula? Jinkui Shenqi Wan warms kidney yang — it supplements kidney essence in order to warm kidney yang. When kidney yang is sufficient, the fire of mingmen rises, fire engenders earth, and the spleen yang is warmed in turn. Once the damp has yang qi to vaporize and transform it, it naturally drains away. The kidney is the lower source of water — first build up the yang that governs water at the lower source, and the damp finally has a way out.
Settling the case: the Six Gentlemen Decoction warms and supplements the spleen and stomach — one small addition of fu zi and she is at peace
With the swelling gone, Doctor Xue changed the formula: Liujunzi Tang (Six Gentlemen Decoction: ren shen, bai zhu, fu ling, gan cao, plus chen pi and ban xia) with mu xiang, rou gui, and pao jiang — supplement the spleen and stomach, then warm them a little more, turning the cold around. After this adjustment, she was cured.
💬 Note from Doctor Luo: The kidney is the lower source of water, so first warm kidney yang; the spleen is the middle source, so then use the Six Gentlemen Decoction to fill the spleen qi and correct the chilled state — one above, one below, and both sources are taken care of. The Kidney Qi Pill managed the kidney; the Six Gentlemen Decoction managed the spleen. The two fit together flawlessly.
Later, on one occasion, her emotions flared again and her diet was not looked after — and diarrhea returned. Doctor Xue used the same formula, adding fu zi (aconite) in a small dose — about five fen, roughly 1.5 g — to increase the warming power a little. After taking it she was at peace.
The key lesson: why did Doctor Xue not use a single herb to soothe the liver and move qi?
You will ask: her illness clearly came from bad moods and a quick temper — why did Doctor Xue never once prescribe a liver-soothing, qi-moving herb from beginning to end?
💬 Note from Doctor Luo: This is where Doctor Xue’s mastery shows — and it is the most valuable lesson in this entire case. Her liver fire was not a matter of a day or two; it was decades of impatience. There really was fire at the start. But year after year, the liver fire bullied the spleen and stomach, the spleen and stomach were wounded, and the person’s yuan qi (original qi) grew more and more insufficient — for every one part of liver fire, the spleen and stomach were injured nine parts. By the later stage, the fire was no longer obvious; the body had instead become afraid of cold and weak. Would you still go clear away that one part of liver fire? No need — there was hardly any fire left. The deficiency of upright qi was the main contradiction. That is why the previous doctors, charging ahead with qi-moving, blood-breaking, and water-draining herbs, made it worse at every step; while Doctor Xue, from the very first dose, warmed yang and supported the upright qi and did not take a single wrong turn. That is what a master looks like.
💬 Note from Doctor Luo: The disease was cured, but this patient’s road of recuperation was still long — the thinking of supporting the upright qi had to continue for a while, slowly supplementing the spleen and stomach: eat more whole grains and whole-grain powder, use the Buzhong Yiqi (Supplement the Middle and Boost Qi) approach, and little by little the upright qi is raised back up. Only then is the foundation truly restored. And on the other side, her temperament had to be adjusted too — the kind of person who is thin, with a dull, dark complexion, quick-tempered and driven, tormenting herself every day — this is exactly how such bodies collapse.
Advice for every woman: keep rose buds and Xiao Yao Wan at home
Doctor Luo says this kind of illness is especially common in women — women meet far too much emotional stagnation in life.
💬 Note from Doctor Luo: Let me say it bluntly: every woman should keep some rose buds (mei gui hua) and Xiao Yao Wan (Free and Easy Powder) at home, ready at any time to dissolve emotional knots. Look at how well Xiao Yao Wan’s formula is composed — herbs to soothe the liver (chai hu, bo he), herbs to supplement the spleen (bai zhu), herbs to nourish blood, all together: soothe the liver plus support the upright qi — that is a complete, well-rounded approach. But if a person has truly been angry and anxious for years, until the body has been drained of its strength, then treatment must center on supporting the upright qi, with only a little rose bud and chen pi to open the qi gently. Do not come in swinging hard at the liver. I can recognize this kind of patient at a glance: the body is thin — the spleen governs the muscles, and a badly deficient spleen leaves a thin body; the complexion is dark and dull — people who have been quick-tempered for years never have good color; and inside they are still desperate to get things done, while the body has already been worn out. Such bodies cannot be hurried. The upright qi must be raised slowly.
💬 Note from Doctor Luo: So the message of this case is: supporting the upright qi is always the correct approach — and only on the foundation of supporting the upright qi do you then drive out evil, resolve phlegm, move qi, and drain water. If you are still busy clearing obstacles while the upright qi is insufficient, the body will be wounded very deeply. People who have carried bad moods for years are weak to begin with — their treatment must not go wrong.
What to take away
- A bad temper injures the spleen first. Years of impatience and suppressed anger wear down the spleen and stomach until the upright qi is deficient — and at that point, the fire is long gone, while the cold and weakness remain.
- Treat the deficiency, not the symptom. When edema and urinary difficulty arise from spleen and lung qi deficiency with cold, the answer is to warm yang and support the upright qi (here, the Kidney Qi Pill as a decoction, then the Six Gentlemen Decoction) — not to keep poking the body with qi-moving, blood-breaking, and water-draining herbs, which only make it collapse faster.
- For long-term emotional sufferers, support the upright qi first. If the body has truly been drained by years of anger, soothe the liver only gently — a little rose bud and chen pi — and put the main effort into building up the spleen and stomach. Every woman can keep rose buds and Xiao Yao Wan at home for the ordinary, everyday knots.
Arranged from Doctor Luo Dalun’s lecture on the cases of Doctor Xue Lizhai; the case comes from Records of the Xue Family Medical Cases (《薛氏医案》, by Xue Ji, Ming dynasty).