Raving Mad, Tearing Off Her Clothes, Unstoppable Strength? Doctor Wu Jutong’s Case of Mania Cured with One Dose of Bitter-Cold Herbs at the Arrival of Autumn
Patient’s search words: raving mad / going crazy / tearing off clothes and running naked / mental breakdown / sudden superhuman strength Medical terms: mania (kuang zheng) · dian kuang (manic episode / schizophrenia) · phlegm-heat disturbing the heart · excess fire of the heart and liver
Opening: a 42-year-old woman strips naked and runs down the street in broad daylight
In the case records of Doctor Wu Jutong, the great Qing-dynasty physician, there is a patient like this: a 42-year-old married woman named Zhang. When her illness struck, she would suddenly tear off every stitch of clothing and run naked down the street — nothing could stop her. Her family was mortified beyond words; two strong men grabbed her, and they still could not hold her — her strength was terrifying.
💬 Note from Doctor Luo: This kind of illness is not rare even today. The doctor we are talking about is Doctor Wu Jutong, the great Qing-dynasty master of warm-pathogen disease — author of Wen Tiao Bian (Systematic Differentiation of Warm Diseases) and inventor of An Gong Niu Huang Wan (Bezoar Resurrection Pill). In his Case Records, the section on mania records several cases. This one is especially brilliant — not because of the prescription, but because of how he brought all the different factors together: emotion, season, and medication, three forces working as one.
How the illness began: first “absent-mindedness,” then being tonified straight into madness
This illness was not contracted in a day. In the second lunar month, she first became mentally unfocused — her spirit was a little off, and her speech began to make no sense. The family called a doctor. He felt her pulse, decided it was a deficiency pattern, and prescribed rou gui (cinnamon bark) and shu di huang (cooked rehmannia root) — warming tonics for the lower origin. This doctor did understand tonifying.
💬 Note from Doctor Luo: But tonics are not for every occasion! This woman’s condition was in fact an excess pattern — and the tonics made it worse: “yin er da kuang” — “and so she became violently mad.” Chinese medicine distinguishes dian (depressive madness) from kuang (manic madness): dian is muteness, mumbling nonsense; kuang is smashing things, leaping about, terrifying strength. Using tonics for an excess pattern is like pouring oil on fire — it literally tonified her into psychosis.
First visit in the third month: bitter-cold fire-draining, mania stopped in thirty days
In the third month, the family invited Doctor Wu Jutong. He saw at once: this was excess fire of the heart and liver, with internal exuberance of phlegm-heat. He used bitter-cold herbs to break the surging force — chiefly long dan cao (Chinese gentian root), together with huang lian (goldthread), hu huang lian (picrorhiza), huang bai (phellodendron bark) and similar bitter-cold medicines, plus a little shi chang pu (acorus root) and yuan zhi (polygala root) — aromatic orifices-opening herbs to dissolve the phlegm-heat that was clouding the heart orifices.
💬 Note from Doctor Luo: Long dan cao is the great general for draining liver fire; hu huang lian clears lower-burner damp-heat and heart fire even more than huang lian. The aromatic orifices-opening herbs open the portals of the heart; the bitter-cold herbs drag the fire downward — one attacking, one opening, a beautiful combination.
After thirty days of treatment, she was well — no more depressive stupor, no more mania, all symptoms gone. But when Doctor Wu felt her pulse: it still had strength — thump, thump, thump.
Residual heat not cleared: the doctor says “eat plainly,” the patient promptly forgets
A pulse that still has force means heat still inside. Where did it come from? Doctor Wu said it plainly: this lady ate meat and drank wine — strong liquor is hot in nature, and rich, fatty, sweet food generates phlegm and heat. As long as the phlegm-heat was not cleared, the root of the illness was not removed. So he told her: eat a light diet, and take some Zhuan Xi Da Sheng Gao (Special Great-Enrichment Paste).
💬 Note from Doctor Luo: Zhuan Xi Da Sheng Gao is a formula Doctor Wu used constantly. It is full of xue rou you qing zhi pin — “substances of blood and flesh, possessed of feeling”: animal medicinals that chiefly nourish yin — nourishing yin and submerging yang, supplementing yin to match yang, tucking the deficiency-fire away. But a doctor’s advice is not always followed — some patients listen, some do not.
This one did not. The festival came, and she threw open the wine and meat — feasting and drinking without a care. And the result? The mania came back, unstoppable.
💬 Note from Doctor Luo: What is a convalescent most afraid of? Of being a creature of sentiment and face. The aunts and uncles arrive, and the scene takes over: “Second Brother, you’re here! Third Brother! It’s been years! Today you’re both drinking, how can I not drink?” — face is worth more than life, and down goes one round of strong liquor after another, and the body is wrecked. When the relatives leave, they don’t care about you anymore; you alone know how miserable you feel. Many people fail to recover because they cannot control themselves.
The relapse: foul feet, naked running, superhuman strength — mania at its peak
This time the illness was wilder than before. The case record notes the details: her feet stank unbearably — the neighbors could smell it from their own houses (the body’s turbid qi had become overwhelming); from time to time she tore off all her clothes and ran naked into the street, barging into one restaurant after another, until people threw basins of water at her; her strength was such that two or three men could not hold her down, and she would leap up onto rooftops she could never normally climb, with a single bound.
💬 Note from Doctor Luo: This is textbook psychosis — completely unable to control herself. You cannot communicate with her at all: you say, “Do you know this is wrong?” and she says, “A cloud came from the sky.” When you find you simply cannot communicate with a person, the illness is very hard to treat. In today’s society, with its stress and psychological strain, there really are many such patients; the family cannot manage them, and hospital beds are limited — it is heartbreaking.
Re-examined in May: two days of effect, then relapse
On the fourteenth of the fifth month, the family called Doctor Wu again. He used the bitter-cold fire-draining method as before — it worked at once, but two or three days later she relapsed.
Doctor Wu analyzed it himself: this was the ministerial fire (xiang huo) of the shaoyang being too exuberant — the ministerial fire seized control from the sovereign (the heart channel), so the heart-spirit could no longer govern. Opening the orifices had only checked the tip of the problem (zhe qi wei) — the moment the ministerial fire stirred again, she reverted. He admitted himself that this prescription was not working well.
By the sixteenth of the sixth month, this lady tore her trousers to shreds and ran out the gate again. Doctor Wu recorded four characters: “yu zuo shi bu ren” — “in this matter I could not bear it” — he himself was profoundly ashamed.
The clever trick: have her brother thrash her with a small bamboo board
Seeing that medicines were failing, Doctor Wu thought of an unconventional measure. He said to the patient’s brother: This illness must be beaten out of her — beat her until the pain is unbearable, until she puts her own trousers back on!
💬 Note from Doctor Luo: Doctor Wu explained a whole doctrine: the sense of shame (xiu e zhi xin) is governed by benevolence (ren) — a person of true benevolence, having done something shameful, feels “bu ren” (“I cannot bear it”); and “bu ren” and “ren” are opposites. A person who has lost face to the absolute extreme, whose sense of shame is entirely gone, is at “the extreme of non-benevolence.” Beat them to extreme pain — pain so unbearable that the heart comes back — this, he said, is the ancient principle on which the sages founded punishment. Today this sounds harsh; of course we do not advocate hitting people. But the principle is worth pondering: use a measure of fear to drive the chaotic qi downward.
The brother was furious at the shame his sister had brought on the family. To preserve his parents’ dignity, he really did take a small bamboo board, dragged her home, and whacked her legs — crack, crack, crack. It truly hurt! In pain, she pulled her own trousers back on, and her mind cleared a little.
One dose at the autumn equinox: when the season arrives, the medicine works
After the beating, Doctor Wu Jutong did not prescribe immediately — he waited.
The seventeenth of the following month was li qiu — the autumn equinox. On that day Doctor Wu prescribed one large dose of bitter-cold herbs (long dan cao and company) — one single dose, and she was cured!
💬 Note from Doctor Luo: This is the most wonderful part of the case — why did he not use the medicine earlier? Doctor Wu explained it clearly: three conditions had to come together. First, the beating opened the upper orifices — mania is qi rushing upward; the beating made her qi move downward — “when the orifices are open, the qi descends.” Second, the season — autumn had arrived; the metal qi of autumn descends, the weather turns clear and contracting; the lung-metal corresponds to autumn, and once the cool qi comes down, the fire in the body naturally descends too. Third, the bitter-cold herbs drain downward — sour, bitter, vomiting and draining are yin. The beating made the qi descend, the season made the qi descend, the bitter-cold herbs made the fire descend — three forces combined, and with a single dose, both the heart fire and the ministerial fire were drained away. So Doctor Wu had not been stingy with medicine — he simply had not prescribed at the wrong moment. It was a question of timing.
Bonus: why do big red welts appear on the skin in autumn?
Doctor Wu also explained a common autumn ailment: around the autumn equinox, many people break out in large, red, raised patches.
💬 Note from Doctor Luo: The principle is the same. In summer the body’s damp-heat disperses outward — it is expelled through sweating. When autumn arrives, the weather turns downward, the skin and body hair begin to close — the damp-heat can no longer escape, so it gathers in the skin, producing big red welts; in severe cases it can develop into ulcers or erysipelas. What to do? Doctor Wu’s method: add a little bitter-cold, heat-clearing, detoxifying medicine to drain it downward, giving the damp-heat an exit — and it disperses.
Completion and lesson: nourish yin, submerge yang, and finish the cure
The illness was cured — now the relapse had to be prevented. Doctor Wu finished the treatment with Zhuan Xi Da Sheng Gao (Special Great-Enrichment Paste) — the substances of blood and flesh nourish yin, tucking the yang down so that fire can no longer rush upward, and the person is completely settled.
💬 Note from Doctor Luo: The value of this case is that it combines psychological treatment with seasonal timing. Anger makes the qi rise; fear makes the qi descend (kong ze qi xia) — using one emotion to regulate another. The great ancient physicians, from Zhu Danxi onward, all used this method. But what if the illness strikes in spring? Two remedies: one, keep adjusting the medication continuously; two, substitute medicine for the season — use lung-channel herbs like xing ren (apricot kernel) and pi pa ye (loquat leaf) to artificially create an “autumn” configuration, so that the lung-qi descends and clears. That is what we call manufacturing the season. The West also has chronomedicine — steroid drugs work best taken in the morning. Chinese medicine has spoken of following the body’s natural rhythms from ancient times to today: there are rhythms within a single day, and within a single year. A healer like Doctor Wu Jutong mobilized emotion, season, and medicine all at once, waited for the right moment, and struck — that is the truly brilliant pattern of healing.
This case looks simple, but every layer repays study: the pattern was diagnosed precisely (an excess pattern must not be tonified), the mind was treated ingeniously (fear drives qi downward), and the timing was seized firmly (one dose on the day of the autumn equinox) — three in one. No wonder a single dose completed the cure.
What to take away
- Mania is an excess pattern — never tonify it blindly. When a patient is raging, tearing off clothes, and displaying superhuman strength, the fire is surging upward; tonics like rou gui and shu di huang will fan it into fury.
- Fear makes the qi descend. A controlled dose of fear (in this case, a beating administered by family) can break a manic spiral by forcing the qi downward — a classic psychological lever used by the great physicians of old.
- Timing is part of the prescription. Doctor Wu waited for the autumn equinox — the seasonal descent of metal qi — before giving his one decisive dose. Medicine works best when it rides the body’s natural rhythms; when the season is wrong, you can “manufacture” one with lung-clearing, qi-descending herbs such as xing ren and pi pa ye.
- A diet of wine and rich food feeds the fire. Phlegm-heat is the fuel of mania; clearing the fire is only half the cure — the patient must keep the diet light, or the illness returns.
Compiled from Doctor Luo Dalun’s commentary on Doctor Wu Jutong’s case records; the case is from Wu Ju Tong Yi An (The Case Records of Doctor Wu Jutong, Qing dynasty).