Bloody Diarrhea in Summer Heat? Doctor Miao Xiyong Cured Dysentery with Blood in Two Doses

Patient’s search words: diarrhea with blood / bloody stools / bloody dysentery / summer-heat diarrhea / palpitations after diarrhea Medical terms: dysentery (summer-heat damaging qi · qi sinking with bloody dysentery) · heart-blood deficiency

Opening: this famous physician came to patients at a gallop

In the late Ming dynasty, the Jiangnan region produced a legendary physician: Doctor Miao Xiyong. What did he look like? A big bushy beard, a thunderous voice — when he shouted, the pots and pans hanging on the wall rattled. Other doctors made house calls by sedan chair; Doctor Miao — he rode a fast horse! The moment he heard someone was dying, he swung into the saddle and galloped off, every inch a knight-errant. That is why Doctor Luo Dalun calls him “chivalrous, loyal Doctor Miao Xiyong.”

💬 Note from Doctor Luo: This is what set Miao Xiyong apart. When he heard a patient was in danger, he grew frantic with worry and rode through the night to save the person — this knight-errant style is truly admirable. Ancient Chinese medicine speaks of “the physician’s benevolent heart,” and Miao Xiyong literally ran that benevolence out on horseback.

Who was the patient? Commissioner Chen, who ran the imperial examinations

The patient that day was an Imperial Education Commissioner (du xue) — the official in charge of the provincial civil-service examinations — named Chen, given name Chishi. How did he fall ill? Two words: overwork plus summer-heat injury.

It was high summer in Jiangnan. The Commissioner supervised the students’ examinations; the official business was heavy, and he worked himself to the bone day after day. On top of that came the Jiangnan summer heat — heat and dampness pressing in on the body from every side — and the man collapsed.

💬 Note from Doctor Luo: Young people today have no idea how hot a Jiangnan summer was back then. In the era before air conditioning, forty degrees Celsius of heat — an elderly person without AC could genuinely die of heatstroke. I once heard a true story: a friend in Changshu came from a family of physicians, and one of his ancestors died of heat on the road while returning from a house call — in the old days doctors carried their medicine chests and walked everywhere; summer-heat injury was no joke. It is especially the foggy dampness mixed with heat that harms people most.

How bad was it? Everything he passed was pure blood

Commissioner Chen’s illness had a formal classical name: “zhi xia” — another term for dysentery. What did it feel like? He felt the urge to go, with severe abdominal pain, yet could not pass anything; and when he finally did manage to empty his bowels, the pain did not stop.

Far more frightening — everything he passed was pure blood.

💬 Note from Doctor Luo: An ordinary bout of diarrhea is miserable enough; passing pure blood is a severe, difficult disease. When dysentery comes with blood, it means the pathogen has already wounded the blood level. The physicians who saw him all scratched their heads, not knowing where to begin.

The doctors summoned were helpless, and everyone panicked. Then an official surnamed Chen standing nearby said something weighty: “Ci fei Miao Xiyong bu neng liao ye!” — “This illness, if not for Miao Xiyong, no one could cure!”

💬 Note from Doctor Luo: At the time, Miao Xiyong’s prestige among the official class and the whole cultural world was enormous — even the learned men of the Donglin Party respected him deeply. So when everyone heard those words, their hearts settled: send for Miao Xiyong!

The rescue: a fast horse chased from Suzhou to Hangzhou

Miao Xiyong was in Suzhou at the time, while Commissioner Chen lay ill in Hangzhou — called “Wulin” in ancient times. The family sent a messenger galloping to Suzhou, who cried out the moment he saw Miao: Save him! Our Commissioner has dysentery — everything he passes is blood — the other doctors cannot treat him — only you can save him!

Miao Xiyong heard this and thought: this is serious! He mounted his horse at once — one day and one night, riding from Suzhou to Hangzhou — through daylight and darkness, racing onward without stopping, as if he were on a high-speed train.

💬 Note from Doctor Luo: Riding from Suzhou to Hangzhou in a single day and night — that is the knight-errant way. The family was pacing in circles at home; the moment they heard hoofbeats, everyone’s heart finally relaxed: Mr. Miao has come — there is hope!

The diagnostic highlight: overwork with deficient upright qi, plus summer-heat

Miao Xiyong dismounted, took the pulse, and diagnosed in his mind: this Commissioner is overworked, his upright qi deficient; and on top of the exhaustion he caught summer-heat pathogen, which entered the blood level — hence the pure-blood stools. The direction was clear: support the upright qi on one hand, and clear the summer-heat and regulate the blood level on the other.

Miao Xiyong was famous for his mastery of dysentery and diarrhea, and he had a mature, systematic approach. He wrote the prescription on the spot:

💬 Note from Doctor Luo: This formula’s logic is crystal clear — let’s walk through it herb by herb. Ren shen (ginseng) leads — this supports the upright qi. Someone may ask: he is losing blood, how can you use warming ginseng — won’t that make the heat worse? No. This patient’s illness came from exhaustion; his upright qi is clearly deficient, and diarrhea is the very thing that drains qi most — without supporting the upright qi, recovery is impossible. You see, people with blood in the stool or the urine sometimes genuinely need qi-tonifying, astringent formulas like Gui Pi Wan (Spleen-Returning Pill). So leading with ginseng is Miao Xiyong’s heart-method.

In the formula, sheng ma (cimicifuga rhizome) lifts the qi upward — his qi was sinking; the abdominal pain and uncontrollable diarrhea came precisely from qi sinking with deficiency, and sheng ma raises the qi back up. Zhi gan cao (honey-fried licorice) harmonizes the whole formula. Wu mei (smoked plum) is sour and astringent, gathering and holding — and it also regulates the jueyin liver channel: Zhang Zhongjing’s Wu Mei Wan for chronic dysentery likewise leads with wu mei.

Then comes the most distinctive herb in this case: hong qu (red yeast rice), one qian five fen (about 4.5 g).

💬 Note from Doctor Luo: What is hong qu? Every household in Jiangnan knows how to make it — rice fermented until it turns a beautiful red. Red-yeast rice wine, red-yeast vinegar, natural food coloring — it is used for all of these. What does it do? It promotes digestion, moves stagnation, invigorates blood and dissolves stasis, and it strengthens the spleen and stomach. And what is it especially good at? Dysentery with bloody stools! The more blood in the stools, the better it works. Miao Xiyong was particularly skilled with hong qu — it was one of his signature tricks.

Then huang lian (coptis), three qian (about 9 g) — it clears damp-heat and resolves toxins; dysentery always involves toxic pathogen, and huang lian clears it. Bai shao yao (white peony root), two qian (about 6 g) — it softens the liver and relieves acute pain; when the abdomen cramps in spasms, peony relaxes it. Lian zi rou (lotus seed), forty grains — it tonifies the spleen and stops diarrhea, working together with the ginseng.

💬 Note from Doctor Luo: Lotus seed must be distinguished from shi lian zi (stone lotus seed). Stone lotus seed is a lotus seed that falls into the water and, after years, turns black and hard as stone — its diarrhea-stopping power is even better, and Miao Xiyong often used it. Unfortunately, many pharmacies today cannot stock it — a friend of mine wanted to buy some a few days ago and asked at shop after shop without success; in the end he found it at Beijing Tongrentang, which can mail-order it. If you truly want to stop dysentery and diarrhea, stone lotus seed is the better choice when you can get it.

Once the decoction was ready, a little hua shi (talcum) powder was stirred in — for what? To dispel summer-heat. He had been struck by summer-heat pathogen, and talcum guides the heat out through the urine.

Cured in two doses!

Just one formula: qi-tonifying, lifting, astringent, blood-level, heat-clearing, pain-relieving, spleen-tonifying, summer-heat-dispelling — every angle covered, arranged clearly and deliberately.

And the result? Two doses and he recovered — two bowls of medicine, and the disease was gone!

💬 Note from Doctor Luo: You see, when Miao Xiyong treated disease, he prized precision and decisiveness. This formula had ginseng to tonify qi, sheng ma to lift upward, wu mei to astringe, hong qu to enter the blood level and dissolve stasis, huang lian to clear heat, peony to relieve acute pain, lotus seed to tonify the spleen, and talcum to drain the summer-heat through the urine — every aspect covered, and two doses did the job. That one-day-one-night gallop from Suzhou to Hangzhou was truly worth it!

A twist: the diarrhea stopped, but his heart began to tremble

The dysentery settled, the abdominal pain vanished — but Commissioner Chen developed a new complaint: “xin yao yao, bu neng yue juan” — his heart was floating and trembling, unsteady, and he could not even sit still long enough to read examination papers.

Miao Xiyong heard this and knew the answer at once: overwork of the mind (lao xin tai guo)!

💬 Note from Doctor Luo: The Commissioner’s profession — reading papers and judging essays day after day — drains the heart and blood enormously. With the mind overworked, heart-blood deficient, the external pathogen — in this case the summer-heat — took the chance to lodge in the heart channel. So no sooner had the bloody diarrhea left than the palpitations arrived. How to treat it? Clear the heat from the heart channel on one side, and tonify the heart blood on the other.

Miao Xiyong added to the original formula zhu ye (bamboo leaf) — to clear heart-channel heat — and suan zao ren (sour jujube seed) — to nourish the heart blood.

💬 Note from Doctor Luo: Sour jujube seed was a herb Miao Xiyong used with special mastery. I told you before: he treated a postpartum woman with blood deficiency using large doses of sour jujube seed to nourish the blood — she slept soundly for days, then woke with a rosy complexion and flourishing qi and blood. Bamboo leaf clears heart heat; sour jujube seed tonifies heart blood. Fill the blood back up, clear the heat away, and the heart naturally steadies.

He also added gan ge — that is, kudzu root (ge gen). Miao Xiyong deliberately wrote “gan ge” here, and there is a reason: kudzu root comes in two kinds. Fen ge gen (starchy kudzu) has large roots rich in starch; it excels at releasing the muscle layer, abating fever and generating fluids — it can even be made into kudzu starch powder for eating. Chai ge gen (fibrous kudzu, also called gan ge) is slender with more fiber and less starch; its specialty is raising yang and stopping diarrhea — it lifts the yang qi upward and stops the bowels more strongly. The Commissioner was still in recovery, so Miao Xiyong chose gan ge.

💬 Note from Doctor Luo: You see how intimately Miao Xiyong knew his materia medica — when to use starchy kudzu, when to use fibrous kudzu — he distinguished them perfectly. That is true skill.

And the result? One dose settled it — the trembling, swaying heart calmed in a single bowl of medicine.

Miao Xiyong’s heart-method for dysentery: a Huang Lian Wan base, adjusted to each case

Doctor Luo Dalun emphasizes: Miao Xiyong treated this class of dysentery and diarrhea with special insight, and he wrote his whole system into the Xian Xing Zhai Yi Xue Guang Bi Ji (Extensive Medical Notes from the Studio of First Awakening), in great detail.

💬 Note from Doctor Luo: His method went like this: for any dysentery, use huang lian (coptis) as the core — soak the coptis in ginger juice, then fry it over earth (ru fa chao) nine times, grind it to a fine powder, and form pills with ginger-juice water. This Huang Lian Wan was then swallowed with various decoctions prepared according to the case: for a weak spleen and stomach, send it down with a decoction of lotus seed, tangerine peel, ginseng and sheng ma; for abdominal pain, send it down with a decoction of bai shao yao and honey-fried licorice. His additions and subtractions were written out very finely: if what the patient passed was more red, add wu mei, hawthorn flesh and hong qu — do you see? That is exactly the thinking behind the formula he gave Commissioner Chen today! This is the accumulated experience of an old master — if you memorize this method, the next time the disease arrives you will know what to do.

Bonus: red yeast rice — a Chinese treasure that foreigners value more than we do

The herb in this case most worth discussing on its own is hong qu (red yeast rice). Doctor Luo says he means it seriously — he wants to recommend red yeast rice to everyone:

💬 Note from Doctor Luo: Red yeast rice lowers blood lipids and regulates lipid metabolism — its effects are excellent! How highly do foreign countries value it today? More than you can imagine — far more than ginkgo leaf and the like. Why? Because red yeast rice contains natural “statins” — research has confirmed it has statin-class lipid-lowering activity with almost no side effects. Abroad, many people buy red-yeast-rice preparations to lower cholesterol; Taiwan television runs red-yeast-rice commercials every day. And yet here in China — our own ancestors’ treasure — domestic use is surprisingly limited. What a pity. If your blood lipids are high, instead of taking pharmaceutical statins that require regular liver-function checks (they can sometimes hurt the liver), you really should try red-yeast-rice preparations — natural, and highly effective.

Doctor Luo also told a personal story: he visited Yiwu to see the descendants of Doctor Zhu Danxi brewing red-yeast vinegar and red-yeast wine, and tasted the red-yeast rice lees — a red fermented rice wine, its liquid the color of red wine, sweet and sour, delicious. Sadly, you cannot get hold of it now.

💬 Note from Doctor Luo: If a person could genuinely drink that stuff daily, their blood lipids would certainly stay normal. China has far too many good things that are simply too little promoted. This case also confirms Miao Xiyong’s therapeutic principle: value supporting the upright qi — even with bleeding as severe as this, he dared to use ginseng. Supporting upright qi, lifting, clearing heat, regulating the blood level, invigorating blood and dissolving stasis — the logic is perfectly clear. Listen and learn — you will gain something real.

What to take away

1. Dysentery with blood in hot weather is a severe illness — the pathogen has reached the blood level. Do not just reach for a general diarrhea remedy; this is a case for professional treatment.
2. Support the upright qi even when there is bleeding. Bloody diarrhea drains qi; a physician with Miao Xiyong’s confidence dares to lead with ginseng precisely because the root is deficiency-plus-heat — tonify, lift, astringe, clear, and stop pain all at once.
3. Hong qu (red yeast rice) is a special herb for bloody dysentery — it resolves stasis in the blood level, and the more blood, the better it works. As a modern bonus, its natural statin content makes it a fine choice for high blood lipids.
4. After the acute illness resolves, watch the heart. Overwork of the mind plus residual heat can leave the heart-blood deficient — that floating, trembling chest is the signal. Bamboo leaf clears the heart, sour jujube seed nourishes the blood, and kudzu root raises the yang.
5. If you have bloody stools, abdominal pain with urgent straining, and palpitations — consult a qualified practitioner of Chinese medicine near you.

Arranged from Doctor Luo Dalun’s commentary on Doctor Miao Xiyong’s case; the case comes from the Xian Xing Zhai Yi Xue Guang Bi Ji (Extensive Medical Notes from the Studio of First Awakening).