Vomited a Whole Basin of Blood at Dawn? What Do You Do When Your Body Burns Like a Steamer?

What the patient searched for: vomiting blood / spitting up blood / fresh blood from the mouth / stomach bleeding / blood right after waking up / about to pass out

What the doctors would call it: blood disorders (xue zheng) · hematemesis (upper gastrointestinal bleeding) · kidney yin deficiency with deficiency fire rushing upward · upper excess with lower deficiency

The opening scene: in the study at dawn, a mouthful of blood became a whole basin

One morning in the late Ming dynasty, a patient surnamed Huang — Huang Zhanhou — walked into his study as usual. Suddenly — pa — he spat out a mouthful of blood. It kept coming and coming, until he had vomited a whole basin of it. His family was terrified and hurried to fetch the famous physician Doctor Yu Jiayan (喻嘉言).

The moment Doctor Yu arrived, he took the pulse. It was running wildly and chaotically — an unmistakable danger sign. He asked directly: “Last night — did you overindulge yourself intimately?” The patient admitted it: yes, he had. In the case record, Doctor Yu wrote the blunt phrase “a night of heavy excess” without a trace of delicacy. This was no ordinary indulgence — it was playing with one’s life.

💬 Note from Doctor Luo: First, some background. In the old days, hygiene was poor, life was hard and exhausting, and meals were irregular — so people who vomited blood were everywhere. Blood disorders (vomiting blood, bloody stool, blood in the urine) were one of the great scourges of the past. Mr. Huang here already had a “bleeding disorder” — he bled often, so his constitution was already fragile underneath. Then, on top of that, he overindulged one night, and the balance shattered. The illness exploded.

Who was the patient: an old hand at “bleeding disorders”

Huang Zhanhou was a veteran patient — he had a long-standing blood-loss condition and regularly vomited blood. His body was already compromised, yet he couldn’t restrain himself. One night of excess sent him straight to the gate of death.

That morning, he didn’t just vomit a basin of blood. A whole chain of terrifying symptoms appeared:

• Qi surging in the throat — a feeling of qi rising and churning in his throat;
• A drifting, dazed mind — he was already growing faint, close to collapse; this was from losing so much blood;
• Body hot like a steamer — his body burned as if inside a steaming basket;
• Neck veins bulging out — the blood vessels in his neck were all standing out.

💬 Note from Doctor Luo: Pay attention to those four characters — “a drifting, dazed mind” (shen si piao dang). When you lose enough blood, you truly do go hazy and unreal. Later in this story I’ll tell you about my own cousin — a living example. In Chinese medicine this is the critical presentation of excessive blood loss. There is nothing funny about it.

At the crisis point: the tongue root went stiff, and Doctor Yu Jiayan said “we must think carefully”

The color of the blood told its own story. Old houses south of the Yangtze were very dark inside — no window glass, and the heat meant people shaded the windows, so the rooms were pitch black (visit Shen Wansan’s old mansion or any such Jiangnan residence and you’ll see). So the blood had to be carried into the light to be examined. It was bright red, the color of the sun. A servant watching along the way muttered: “This blood looks like the blood from the rear half of a butchered pig — it’s come from far down.” Doctor Yu almost laughed. The servant was uneducated, but the comparison was remarkably apt: this blood was not superficial — it had surged up from deep within.

Doctor Yu went back to his room and began to reason through the case seriously. He said: the shaoyin channel connects to the base of the tongue, and shaoyin is the kidney. Now the blood of the kidney was gushing out, and the root of the tongue had already gone stiff — “there is no way to rescue it in haste; we must think carefully.”

💬 Note from Doctor Luo: Let me make this clear. When Doctor Yu Jiayan says “the blood of the kidney gushes out,” does he mean the kidney itself was bleeding? No. Kidney bleeding would show up in the urine — hematuria. In modern medicine, red blood cells squeezed out through the glomerulus become deformed; checking the deformation rate lets you tell. Mr. Huang’s blood came out of his mouth — so this was essentially stomach bleeding — blood from the digestive tract reversing upward and pouring out of the mouth. When Doctor Yu speaks of the “kidney,” he doesn’t mean the organ itself sprayed blood. He means kidney deficiency led to yin deficiency, deficiency fire rushed upward, and heat broke the blood loose — the blood vessels of the stomach were already fragile, and one surge burst them.

Where was the root of the problem? Why would the “kidney” have anything to do with a “stomach bleed”?

So what exactly did last night’s excess do? Doctor Luo Dalun breaks it down:

💬 Note from Doctor Luo: A lot of people think overindulgence has nothing “scientific” to do with major bleeding. But the human body is exquisitely subtle. In Chinese medicine, excess drains kidney essence, severely depletes kidney yin, and deficiency fire flares upward. In modern terms, it is a violent readjustment of hormone levels. For a healthy person, that readjustment may mean nothing — a few days of rest and it passes. But for someone like Mr. Huang, who already had a bleeding disorder and a body that was already out of balance, it can genuinely trigger a catastrophe.

This is where Chinese medicine is brilliant: it looks for the root of the bleeding. If you bleed, your body must be out of order — how? Analyze it clearly, adjust the body back to its foundation, and the ground on which bleeding happens disappears. If you only stop the bleeding and do nothing else, the underlying disorder remains, and the bleeding will easily return.

💬 Note from Doctor Luo: Today, stomach bleeding is usually stopped under gastroscopy — find the bleeding point, coagulate it, seal it. In the old days there was no such tool, so they used herbs. If qi deficiency had let the blood collapse, they tonified qi; if there was blood stasis, they moved the stasis — Doctor Zhang Xichun, for example, gave patients with stomach bleeding large doses of san qi (notoginseng) powder. If yin was deficient, they nourished yin. The ideal is actually both together: modern medicine seals the bleeding, Chinese medicine rebalances the body. That is the most complete solution.

First move: ginseng decoction to send down Heixi Pills — pull the qi back first

The tongue root was stiff. How to save him? Doctor Yu Jiayan thought for a long while, then said: there is only one way — reluctantly, use a pill preparation, first to steady the primordial qi. If the qi could “turn back to the dantian (the lower elixir field),” then there would be room to work slowly.

What medicine? A concentrated ginseng decoction to send down thirty Heixi Dan (Black Tin Pills).

Ginseng greatly supplements primordial qi — at this moment supplementing qi to generate blood is the key; only when qi is sufficient can it “hold” the blood. As for Heixi Dan, it was a famous prepared medicine of the old days. What’s in it? Fu zi (aconite), rou gui (cinnamon bark), hu lu ba (fenugreek), liu huang (sulfur), chen xiang (agarwood) — all herbs that warm the kidneys.

💬 Note from Doctor Luo: What does Heixi Dan do? It warms and tonifies kidney qi and reinforces the lower origin, and with chen xiang it draws the qi downward and gathers it. It is made specifically for upper excess with lower deficiency — the condition where kidney qi and kidney yang are depleted and “qi floats upward”: all the qi in the body rushes to the top while the lower origin is empty. At that point Heixi Dan can pull the floating qi back down. Rou gui (cinnamon) in particular has the effect of leading fire back to its origin (yin huo gui yuan) — gathering the deficiency fire back into the kidneys — paired with the kidney-tonifying herbs. So Doctor Yu used it to rapidly draw the kidney qi back home.

After the concentrated decoction went down, the patient’s belly began to rumble audibly, the qi slowly descended, and his tongue seemed to soften. He could mumble a few words, though no clear voice came out yet.

Second move: one liang of donkey-hide gelatin, melted down and swallowed slowly

No sooner had the qi been gathered than Doctor Yu Jiayan added a second medicine: e jiao (donkey-hide gelatin) — a bit over one liang (about 30 g) — melted and slowly drizzled down, taken in three portions, dissolved little by little in hot water and drunk.

💬 Note from Doctor Luo: Why donkey-hide gelatin? E jiao tonifies the kidney and nourishes the blood, and at the same time it stops bleeding. The Heixi Pills before it were purely warming and astringent — warming alone is not enough; you need a soft, moistening medicine alongside it, and that is e jiao. One warms yang, the other nourishes and moistens — both ends taken care of. E jiao stops bleeding and nourishes blood. That was a very refined pairing.

Within half a day of taking it: the body heat gradually receded, and the bulging veins in the neck slowly went down as well.

Third move: five days of kidney tonics, then one more herb — “qiu shi”

Heat gone, veins gone. What next? Porridge, together with kidney-tonifying herbs, taken for five days. Now that he could drink porridge, what did the tonic contain? Shu di huang (prepared rehmannia) paired with rou gui (cinnamon) — that sort of formula. That night of heavy excess had wounded the kidney essence: once kidney essence is depleted, kidney yin, kidney yang, and kidney qi are all deficient together. So the first step was to gather the qi back down, and the next step had to be tonifying the kidney — replenishing the kidney essence.

💬 Note from Doctor Luo: After those five days of kidney tonics, Mr. Huang’s voice came back, his throat cleared, and he grew calm and clear-headed. But it wasn’t over yet — every morning he still vomited a small cup of dark red blood. Why? Because it was the height of summer — the seasonal heat was at its peak, and deficiency fire was pushing upward again. Doctor Yu Jiayan recalled the guiding principle of the Neijing: “When heat prevails, treat it with salty and cold” — when heat evil dominates, use salty-cold medicines to restrain it. So he added one more herb to the kidney tonic: qiu shi. Once he took it, the illness resolved.

What is qiu shi? A “salty-cold” medicine refined from urine

The most distinctive thing in this whole case is this one herb, qiu shi. What exactly is it? Doctor Luo Dalun devoted a whole lesson to it.

💬 Note from Doctor Luo: Qiu shi comes in two kinds: dan qiu shi (light qiu shi) and xian qiu shi (salty qiu shi). In ancient times, most qiu shi was made from urine — sometimes children’s urine, usually adult urine. The urine was left to crystallize and then processed into blocks of white substance — that is dan qiu shi. Xian qiu shi is made by dissolving salt in water and evaporating it into crystals — most of what is sold as qiu shi in shops today is essentially just table salt. But what the ancients used was almost always made from urine.

What does urine do? As I mentioned when I told the story of Doctor Xue Lizhai: Xue went to the army camps and saw that wounded soldiers were first given tong bian (children’s urine) to drink — urine moves blood stasis, and in moving stasis it generates the new. So what does qiu shi, made from urine, do? It nourishes yin and descends fire, and it can stop bleeding and resolve stasis.

💬 Note from Doctor Luo: Later researchers have found that qiu shi contains hormones — urine naturally carries some hormone content. Some scholars have studied how different preparations and methods of boiling yield different hormone levels, and some argue that ancient Chinese physicians already understood extracting hormones. The British historian of science Joseph Needham said that the Chinese learned to extract hormone-like substances centuries before Europe. But the ancients weren’t necessarily thinking that far — they were clever, but they mainly used it to nourish yin and descend fire: bring the deficiency fire down, and the blood naturally cools and stops. What’s more, it can work in both directions — for “stasis caused by bleeding” and “bleeding caused by stasis.” That is why, in the old days, qiu shi was commonly used for conditions like vomiting blood.

Bonus story: my cousin’s “drifting, dazed mind”

The case is told. Doctor Luo Dalun then shares a personal experience — the story of his own cousin. The first time he heard it, he and his sister were stunned.

💬 Note from Doctor Luo: My cousin is from my hometown in Liaoyang. In his youth — many, many years ago, when everyone was poor — he had stomach trouble and started bleeding. Suddenly blood poured out of him; he was rushed to the hospital, they stopped the bleeding under gastroscopy and it stopped. He told us a very strange story afterward: dazed and drifting, he arrived somewhere and met two officials holding a ledger. They said: “Mistake. You can go back — you’re not on the list.” Just as he was leaving, the officials added: “Wait. You’ll have to come back again in a little while.” Then he woke up, and the bleeding had stopped. The doctor finished his shift and went home. But my cousin said: “I’ll have to go back again in a little while.” The doctor shrugged it off and left. Sure enough, a short while later the bleeding started again — a second gush of blood — and the doctor had to be called back urgently to save him a second time. Afterwards the doctor asked him: “How did you know you’d be coming back?” He couldn’t explain it, of course. I’ll take it as a curiosity — maybe it was a hallucination of watching himself being rescued. But it proves the point: when you lose enough blood, the mind truly does drift and go hazy; and after the bleeding is stopped, the body’s underlying condition is still there, so it will bleed again. The ideal approach is to stop the bleeding and rebalance the body at the same time. Otherwise the kidney deficiency and deficiency fire are still parked there, and sooner or later there will be trouble.

Doctor Luo’s closing note: don’t just stop the bleeding — the body’s imbalance is the root

What can we learn from this case?

First, the body is a whole. Seeing stomach bleeding, don’t assume the problem lives only in the stomach. Doctor Yu Jiayan immediately connected the illness to the patient’s lifestyle — what did he do last night? Was his kidney qi already weak? Mr. Huang had a bleeding disorder all along; the root of the disease had been planted long ago. Then one night of excess shattered the balance, the whole body went into disorder, and the stomach bleeding erupted in a flood.

Second, when your body is not well, never do anything to extremes. Doctor Yu wrote “a night of heavy excess” — the patient was already kidney-deficient, and then he pushed himself hard at night, draining himself severely, and suddenly everything broke. Doctor Luo Dalun says the same pattern shows up everywhere: a man with a fragile constitution meets his friends, gets happy, drinks hard and harder — and that night something bursts; he’s carried into the ER with a cerebral hemorrhage. You see it in hospitals all the time. A kidney patient wolfs down a whole pot of braised beef and his kidneys take a sharp turn for the worse — hospitalized immediately. And a health-program editor told of his father, who after cancer surgery got thirsty one night and ate an entire watermelon at once — vomiting, diarrhea, a sudden collapse, and in the end the man passed away. When your body is compromised, keep your balance — don’t push anything to the limit. Pushing to the limit is a test the body cannot pass; it stirs up chaos in qi and blood and invites great danger.

💬 Note from Doctor Luo: Finally, let me lay out the logic of stopping bleeding once more. Modern medicine has excellent ways to stop bleeding. What’s the Chinese medicine approach? If qi is deficient, supplement qi; if there is blood stasis, move the stasis; if kidney essence is depleted, tonify the kidney; if the dragon-thunder fire is rushing upward, lead the fire back to its origin; if yin deficiency has fire blazing, nourish yin and descend the fire — in every situation, adjust from the root, and the result will be better. This case teaches us: don’t drain yourself to excess. That is what Doctor Yu Jiayan most wanted to tell us in this case record.

Based on Doctor Luo Dalun’s explanation of a case by Doctor Yu Jiayan, from Yu Yi Cao (Records of Meaningful Insights).