Fever and Lethargy After a Vaccine?
Patient search terms: fever after vaccination / fever after a shot / external contraction after vaccination / child listless and tired / fever and irritability
Medical terms for this condition: variolation (ren dou, human smallpox inoculation) · external contraction (wai gan) · smallpox (dou zheng) · external contraction combined with internal deficiency
Opening: the world’s earliest “vaccine” was blown up the nose
You may not know this, but the world’s earliest “vaccine” — immunization therapy — was invented in China.
The trail goes back roughly to the Northern Song dynasty. Legend says a monk on Mount Emei knew the method. At the time, a Song-dynasty prime minister’s child came down with smallpox (tian hua), and all the famous physicians had been called in; this monk from Mount Emei “worked wonders.” The method came to be called variolation (zhong dou fa): take the fluid from a smallpox patient’s blisters and dry it, or grind dried scabs into powder and blow it into the nostrils of a healthy person. The healthy person takes in this tiny amount of “mild poison,” the body mounts an immune response, and when a real smallpox epidemic later sweeps through and everyone else falls sick, he walks away untouched.
There was an even simpler version: wear the clothes of a smallpox patient — the virus on the clothing is nearly dead; the body senses an invading pathogen, immediately resists, and immunity is formed.
💬 Note from Doctor Luo: This is the earliest form of human variolation. By the Ming dynasty, it was already widely recorded in medical case literature. Later the foreigners came to learn it — the British royal family and nobility all used this method; they learned it from the Chinese. Only later did cowpox vaccination develop, on the same principle — taking cowpox fluid and inoculating humans, with better results and greater safety. That is how smallpox was gradually brought under control and finally eradicated. So is there a connection between vaccines and China? A very big one — this whole concept was originally thought up by us Chinese.
Who was the patient: an official’s children were variolated, and the doctor was all praise
Now, our protagonists. In the late Ming and early Qing dynasties, there was an official — Gu Timing (Doctor Luo Dalun suspects the “Gong” in the original text was a title of address; he was clearly an official). His two sons were to be variolated.
Variolation was a big family event, so a physician was engaged. The physician looked at the children’s pox rash and beamed from ear to ear, praising it to the skies: the rash was pale red and well spaced, holding clear fluid, bright, lustrous and lovely — and the pustules were sparse, like morning stars adorning the sky — beautiful as stars!
He gave the rash a grand name: the “Number One Scholar pox” (zhuang yuan dou)! Meaning: your son is going to be the top scholar in the imperial examinations one day — even his pox is better than everyone else’s!
💬 Note from Doctor Luo: This doctor was a master of flattery. He described a case of smallpox — one of the most deadly infectious diseases in the ancient world, which killed countless people — as “bright, lustrous and lovely, like morning stars in the sky.” Good heavens. Pox rashes were even graded — which kind was good, which was bad — and the household physician fawned that this was the top grade. Folks, hearing this flattery is enough to give you goosebumps.
The “Number One Scholar pox”? Doctor Yu Jiayan said: this pox hides a big problem
Gu also invited Doctor Yu Jiayan to examine the child. Doctor Yu Jiayan looked at the boy for a while, and his brow furrowed — “The pox heat has not yet receded!”
He said: this child has heat inside him. Look at his heavy head and limp neck — the head feels heavy, the neck goes soft; that is not right, it shows the upright qi (zheng qi) is insufficient; restless and agitated — the boy is irritable and unsettled; loose, clear stools — diarrhea, with thin, clear stools.
Doctor Yu Jiayan made his diagnosis: the child has an external contraction combined with internal deficiency — already weak in upright qi and frail of body, he has also caught an external contraction; variolating him now mixes two problems together.
💬 Note from Doctor Luo: Watch this — it is the key point. After variolation, the body needs to react, to bring the pox out a little; that is a normal immune response. But this child was externally contracted first, variolated second — the external pathogen is still inside the body, and now the pox toxin is introduced on top of it: it is as if two waves of “enemies” are attacking at once. Doctor Yu Jiayan said that if you treat this case by the routine smallpox playbook, it is “a road that leads to certain danger” — something will go wrong!
So what should be done? Doctor Yu Jiayan said it plainly: “One or two doses of medicine are needed first, to clear the external contraction” — use one or two doses of Chinese medicine to clear the external contraction. Once the contraction recedes, “the pox will heal of itself without treatment” — the variolation will succeed on its own.
He stressed: if you delay two or three days, the pox toxin and the external contraction will merge, and “it will be too late.”
No one listened: the father went off to disaster relief, and the children were surrounded by sweet talk
Unfortunately, Gu did not move an inch at Doctor Yu Jiayan’s words — he heard them as if he had not heard them at all.
Why? Because the other physician had made everything sound so wonderful: “bright, lustrous and lovely,” “like morning stars adorning the sky,” “Number One Scholar pox”… Gu trusted that doctor completely and thought: this man says such beautiful things — why are you, this man, saying only gloomy words?
At just that moment, a famine broke out in the region, and two officials (Doctor Yu Jiayan records them as “er yin,” one named Liang Guangyan) invited Gu to go on a door-to-door famine relief inspection. Gu accepted gladly and threw himself into the public business.
💬 Note from Doctor Luo: Gu went off to relieve the famine — a good deed of a kind-hearted elder, and no one objected. But once he left, the children were handed over entirely to the doctor who had said “Number One Scholar pox.” Doctor Yu Jiayan saw the danger and hurried to the relatives’ house to beg them to intervene: “I explained this illness clearly to Mr. Gu, but he would not listen a word; now he has gone off to the relief work. Please go and stop him — if you delay two or three days, the children cannot be saved!”
Even the errand boy was embarrassed: “You run to the official’s gate three or four times a day — aren’t you ashamed?”
Doctor Yu Jiayan went home, but he did not rest. He wrote a letter — setting out the whole sequence of events clearly — and had it delivered to Gu. The letter was “vehement in tone, heedless of suspicion”: I do not care that you are a high official; when a child’s life is at stake, the words must be said plainly.
That evening, Gu’s servant returned with a reply — he tossed the letter onto the table and stormed out, indignant. Doctor Yu Jiayan’s heart sank: oh no, the old gentleman has taken offense; he thinks I spoke too harshly.
But when he opened the letter, it read: “My master insists that you provide the prescription before he will give the children medicine.”
Doctor Yu Jiayan was overjoyed. He wrote the prescription immediately, explained the reasoning in full, and sent the errand boy to deliver it.
The errand boy, however, was most reluctant and muttered to himself: Sir, you are not being sensible at all — running to the official’s gate three or four times a day is bringing shame upon yourself!
💬 Note from Doctor Luo: How did Doctor Yu Jiayan answer? He said: “Do I not love my own dignity?” — Am I not mindful of my own face? But right now a pack of petty men is clouding the truth; everyone around the child is under the spell of those flattering words. If I try just one more time, there may still be a chance to turn it around, and the child may live; if I wash my hands of it, those petty men will go on flattering, and if something happens to the child, what then? When you hear this, it is genuinely moving.
That night, Doctor Yu Jiayan personally carried the prescription to Gu’s gate. But the gate was already closed. The doorkeeper took the letter: “The master has retired for the night. I will send it in first thing in the morning. Please go home.”
Doctor Yu Jiayan turned and walked back — there were no streetlights in those days. He walked alone in the dark, six or seven li round trip. Why did he run back and forth in the black of night? “To set his own mind at ease” — since the child had been seen by him, he could not bear to watch the child come to harm.
The outcome: within six days, both children were gone
The next day, Doctor Yu Jiayan again asked a relative to press the matter. The answer that came back: “The pox is thriving — why take medicine?”
After that, Doctor Yu Jiayan had no more excuse to knock on that door.
He later lamented: at court, people may debate right and wrong with one another; but in this household, not a single honest word could be tolerated. “If I had been allowed to stay by his side, this child would not have died even without taking medicine.”
But there was no “if.” The child carried an external contraction; the pox toxin had come on top of it; and the family fed him shrimp, fish, chicken, bamboo shoots — all the pox-drawing foods — whatever was best went right into the pot. It was like pouring oil on a fire: “adding on top of what was already piled high, and so hastening his death.” Within six days, the child was gone.
Worse: two days later, Gu’s third son also ran a fever before the pox had even appeared; the family variolated him anyway, under the same “Number One Scholar pox” physician — and he, too, died within six days.
💬 Note from Doctor Luo: Within ten days, two children were killed by one doctor. Ten days, two children, dead at the hands of a single physician. Doctor Luo Dalun says: this Mr. Gu really did have a problem with judgment. Being an official is not all good — when you are surrounded by people who only say pleasant things, a child’s life can be buried under flattery. And Doctor Yu Jiayan? He ran back and forth in desperation; he wrote the letter, sent the prescription, walked six or seven li in the dark — and could not save a single one. This is one of the rare “failed cases” in his collected works — and precisely because it failed, it shows most clearly what a physician’s conscience looks like.
The doctor who cried “Number One Scholar pox” died suddenly soon after
When both children were gone, Gu blamed himself — he considered it his own fault, and so he set up a charity medicine station at the City God temple, giving medicine to the common people as an act of merit: “My fortune is too shallow; I have been too sinful.”
Doctor Yu Jiayan happened to pass by and saw it. He frowned and sighed: Gu is a man of deep virtue — gentle and kind, blaming himself when things went wrong, even setting up an altar to give medicine in atonement. But the doctor who killed the two children — how is it he never thought to hold him accountable?
Not long after — overnight, that physician died suddenly.
When Doctor Yu Jiayan heard of it, he too was startled: heaven really does have eyes. But he still had a lingering regret: the doctor was dead, but the flattering petty men beating the drum beside Gu — the ones who chimed in with sweet words — had yet to receive their punishment.
💬 Note from Doctor Luo: This case ends there. Doctor Luo Dalun says it reminds us of two things. First, a physician’s heart must be upright and his skill must be refined; he must never harm people — a doctor who could kill two children in one stroke should not exist. Second, look at Doctor Yu Jiayan’s sense of responsibility toward his patients — it was not because the man was powerful that he tried so hard; he was like this with every patient, unable to bear watching a sick person be ruined by delay, so he wrote letters, sent prescriptions, ran in the dark — everything that could be done, he did. Read this four hundred years later, and that heart is still warm.
Doctor Luo Dalun’s closing note: vaccine + Chinese medicine — the real “double insurance”
With the story told, Doctor Luo Dalun returns to “variolation” itself — the most practical part of this case.
Does getting variolated (vaccinated) mean you can relax completely? No. Doctor Yu Jiayan saw it long ago: every body is different — the strong, with abundant upright qi, naturally mount a good immune response; the weak need help adjusting; those whose channels for expelling external pathogens are blocked need help driving the pathogen out. So if external-contraction symptoms appear after variolation, one or two doses of Chinese medicine should be used to help the body clear the pathogen out — not to just sit and wait.
In those days human variolation was never a perfect guarantee — some people were fine, some had problems; that is why it was gradually replaced by the safer cowpox vaccination, and later by modern inactivated vaccines and other advanced technologies. But back when the early method was still imperfect, pairing it with a formula like Doctor Yu Jiayan’s greatly increased the safety.
💬 Note from Doctor Luo: This case reads like a prophecy. Put it in today’s terms: the vaccine is given, but many people still catch external pathogens afterward — what then? Use Chinese medicine to clear them out. Chinese medicine works with your body: where support is needed, it supports; where clearing is needed, it clears — the methods are many. The record shows that wherever an epidemic appears and Chinese medicine steps in, the rate of severe cases and deaths drops to nearly zero. Relying on immunization alone to fight a fierce external pathogen may not be enough; immunization + Chinese medicine working together is the real guarantee of safety for ordinary people — this is wisdom handed down from the Chinese ancestors, and it is exactly the principle Doctor Yu Jiayan was teaching centuries ago.
In this case, the medicine was never given and the children were never saved — but the principle was set down clearly: variolation requires first clearing the external contraction. Vaccine and Chinese medicine have never been an either/or — they are “double insurance.” The same principle, then and now — that is the most valuable thing in this failed case.
Compiled from Doctor Luo Dalun’s commentary on the case records of Doctor Yu Jiayan, from Yu Yi Cao (the case of Gu’s two sons, ruined by petty men).