Vomiting and Diarrhea After Eating Mushrooms? What Doctor Zhang Jingyue Did About It
Patient search terms: mushroom poisoning / poisoned by eating mushrooms / vomiting and diarrhea / severe vomiting and diarrhea / bloated belly / can’t catch breath / dry mouth
Medical terms for this condition: mushroom poisoning · cold toxin (han du) · yin-cold toxin · food poisoning · acute gastroenteritis
Opening: in Beijing, a basket of “plump, lovely” fresh mushrooms flattened a military officer
Today Doctor Luo Dalun tells the case of Doctor Zhang Jingyue, the great physician of the Ming dynasty — a doctor Luo admires enormously. Zhang Jingyue examined patients with extraordinary thoroughness and thought through every case from every angle. Doctor Luo’s advice: whenever you are weighing any illness, always consult Zhang Jingyue’s view.
💬 Note from Doctor Luo: Zhang Jingyue (Zhang Jiebin, style name Jingyue, 1563–1640) was a native of Shaoxing, Zhejiang. As a boy he studied in Beijing, where his father served as a staff officer (mu liao) in a noble household. Later he joined the army and went to Korea with the famous Ming general Li Rusong to fight Toyotomi Hideyoshi’s invading forces. After the war he returned to Beijing and lived there several more years before finally going back to his home in Jiangnan. This case was treated while he was living in Beijing.
The case happened in Beijing. There was a Wu Canjun — canjun was a military rank, an officer in the garrison — who saw fresh mushrooms at the market that were plump and tender, clean and white, so lovely to look at that he had his cook buy a basket and stew them for dinner. What happened after he ate them? Violent, gushing vomiting and diarrhea — up and down at the same time, nearly draining the life out of him.
Who was the patient? “It looks white, so it must be safe” is the biggest mistake of all
Doctor Luo pauses here to share a hard-won lesson about identifying mushrooms:
💬 Note from Doctor Luo: The mistake so many people make is seeing mushrooms that are plump, tender and cleanly white, and assuming they’re harmless. My father grew up in the countryside and knew his mushrooms — this one is a pine umbrella mushroom, that one’s a sticky ball — he had them all down cold. When I was a child, teachers and neighbors would pick mushrooms and bring them to him: “Is this one poisonous?” You really have to know this stuff. Look — some perfectly white mushrooms are poisonous too. Every year when mushroom season arrives, the emergency rooms of Yunnan’s hospitals fill up with mushroom-poisoning cases. This is no joke; if you get it wrong, it can be a disaster. I once saw a patient sitting in a Yunnan emergency room saying there were lots of little people dancing on the ground in front of him — he was already hallucinating. That’s the mushrooms talking.
How bad was it? After the great vomiting and diarrhea, every treatment made it worse
Back to Wu Canjun: after the violent vomiting and diarrhea, he was nearly dead. The family hurriedly called in a nearby doctor.
💬 Note from Doctor Luo: Actually, vomiting and diarrhea are the body’s own defense response — if he hadn’t vomited, the hospital would have induced vomiting and pumped his stomach anyway, to get the poison out. If the toxin stays in the belly and gets absorbed into the blood, into the body, the trouble is much bigger. So that great purge of vomiting and diarrhea was itself the body expelling the poison.
The doctors who came all said the same thing: this is poisoning — detoxify at once! So they gave huang lian (coptis), hei dou (black soybean), jie geng (platycodon root) and gan cao (licorice), boiled and drunk, cup after cup. And what happened? The more he drank, the worse he got — his chest and belly swelled up enormously (xiong fu da zhang), he panted until he couldn’t catch his breath, and he reached the point where he couldn’t even swallow water (shui yin jie bu neng shou). The man was in truly critical danger (wei jiong yi shen).
Doctor Zhang Jingyue takes one look: this is not heat toxin — it’s cold toxin! He writes a Fuzi Lizhong Wan prescription
At his wit’s end, the family called in Zhang Jingyue. One look at the tongue, one touch of the pulse, and Zhang Jingyue pronounced it: this is cold! The poison this man had eaten was yin-cold toxin, and the cold-natured herbs the other doctors had given were exactly the wrong direction.
His prescription: ren shen (ginseng), bai zhu (atractylodes), gan cao (licorice), gan jiang (dried ginger), fu zi (aconite), fu ling (poria) — warming herbs like dried ginger and aconite, spleen-strengthening qi tonics like ginseng, atractylodes and poria, with licorice and dried ginger harmonizing the middle. This is essentially the road of today’s Fuzi Lizhong Wan (Aconite Center-Regulating Pill) — warming yang and strengthening the spleen.
💬 Note from Doctor Luo: This is the discipline of ge wu zhi zhi — “investigating things to extend knowledge.” How did the ancients know whether a herb or a food was cold, hot, warm or cool? By tasting, slowly, and thinking hard about it. The ancients lived simple lives; they ate more or less the same things every day. Suddenly eat something new — say, watermelon, which you never normally eat — and observe what the body does. Think about it a while, and you know: watermelon is cold-natured. A man might spend months contemplating just that one thing, and naturally he would figure it out. We can’t do that anymore — every day it’s MSG, chicken bouillon and salt by the spoonful, and if the chili oil isn’t fierce enough it doesn’t count. Our taste buds have been scrambled and our spleen and stomach damaged; we can hardly taste anything properly. The ancients’ monotonous diet made them far more sensitive to the nature of the natural world around them.
The most heart-wrenching moment: the patient refused the medicine, said farewell to his family, and swallowed it in tears
The prescription was written — but the patient didn’t dare take it. His belly was distended like this, he was panting like this, and his mouth was parched. He protested: “My mouth is this dry — how dare I take this medicine?” (Kou gan ru ci, an gan fu ci yao?) You’re giving me dried ginger and aconite, ginseng and atractylodes, when I’m this dry? So he stopped, and went a day without taking anything.
After one day, he was worse — wasted away like dew at dawn (ruo zhao lu yi), on the verge of vanishing. The family came and begged again. Zhang Jingyue held firm: my formula is right; it’s the same formula.
💬 Note from Doctor Luo: This Wu Canjun was a man of real feeling — suspicious, frightened, out of options. He said goodbye to his family: “I’m already this sick. If this medicine is to make me live, it will make me live; if it is to make me die, it will make me die. My life and death rest on this single dose!” And with tears in his eyes, he gulped it down, mouthful by mouthful. Look at how the ancients took their medicine — with that kind of tragic resolve.
The turnaround: one dose stopped the vomiting, the second eased the bloating — over twenty doses, restored as before
And what do you know — the medicine went down, and the vomiting gradually stopped! Another dose, and the bloating eased too! Zhang Jingyue then prescribed large amounts of shu di huang (prepared rehmannia) — because the violent diarrhea had injured the kidney yin (the kidney channel), and the kidneys needed restoring. In all, Wu took more than twenty doses, and he recovered completely, restored as before — fully cured.
The patient couldn’t believe it: you didn’t detoxify the poison — how did you cure it?
Once well, this Wu Canjun still loved to ponder medical theory. He asked Zhang Jingyue: I was clearly poisoned by mushrooms. The other doctors’ detoxifying herbs didn’t work. But you — ginseng, dried ginger — not one of your ingredients detoxifies anything. How on earth did you cure my poisoning?
Zhang Jingyue seized the moment and explained the whole matter:
Poisons are not all the same. Who says only huang lian, gan cao and jie geng can resolve poison? Consider this mushroom — where does it grow? Have you ever seen a mushroom blooming in the blazing sun? No. Mushrooms grow only in shady places: under fallen leaves, in damp corners after rain, in dry wells and deep pits — places of deep cold and extreme yin. Mushrooms receive the most yin qi of anything; they love shade and loathe the sun — one good baking and they shrivel up. So this poison is yin-cold poison.
💬 Note from Doctor Luo: When someone is poisoned by yin-cold, and you “resolve” it with cold-natured herbs like coptis — that’s not detoxification, that’s adding cold to cold — you’re acting as the poison’s assistant! In this situation you must use dried ginger and aconite to warm and scatter the cold toxin, and ginseng and prepared rehmannia to replenish the yuan qi (original qi) — the original qi had been wounded, after all. It doesn’t look like detoxifying, but it actually is: when the upright qi is sufficient, the body can resolve the poison on its own.
Wu Canjun bowed his head and sighed: that makes perfect sense! “But for you, sir, I would have become a wronged ghost!” He begged Zhang Jingyue to record this case so that later generations could take warning and never repeat that mistake.
What to take away: treating an external poison by reading the body’s state
💬 Note from Doctor Luo: What can we learn from this case? Whether mushroom poison is hot or cold isn’t a fixed fact — it takes more clinical experience to judge. But Zhang Jingyue’s approach is crystal clear, and it has two layers. First: ge wu zhi zhi — if you can determine the nature of the poison, that’s your cleverness. If you can’t, then look at what reaction it produced in the body — this patient must have had a white tongue coating, abundant saliva on the tongue, and a body that felt cold all over — a full picture of cold. Once you identify cold, you regulate with the warming-yang, spleen-strengthening route. Never reflexively “detoxify” just because it’s a poison — reaching for coptis, forsythia and honeysuckle would pile cold on cold. It’s the same reason people asked during COVID whether they could take Lianhua Qingwen: it depends on what state your body is in. For a heat pattern it can be used; in a cold state, the more you use it, the worse you feel.
There’s a second key point: supporting the upright qi (fu zheng). Zhang Jingyue didn’t just warm the yang — he added ginseng, atractylodes and poria (the road of Sijunzi Tang, the Four Gentlemen Decoction) to build up the upright qi. Why? Because this patient had been violently vomiting and purging for days; his body’s functions were failing fast — chest and belly hugely distended, panting, unable to circulate. Supporting the upright is the crux. It’s like war: for a cold pattern you warm the yang, for a heat pattern you clear heat and resolve toxin — but a soldier with a thin foundation comes out of battle wrecked, and without reinforcement you can never turn the tide. In this case, most of the mushroom toxin had already been expelled by the vomiting and diarrhea; what was truly damaged was the body’s own function. So the tonic herbs lifted the upright qi and let the body restore itself. It looks like a case about mushroom poisoning — but it’s really a lesson in Chinese medicine’s grand strategy for treating every external pathogen.
Arranged from Doctor Luo Dalun’s commentary on Doctor Zhang Jingyue’s medical cases. The original case appears in the Jingyue Quanshu (Complete Compendium of Jingyue), chapter on vomiting.