Involuntary Emission at the Sound of a Woman’s Voice, Severe Deficiency? Doctor Wu Jutong’s Case Treated with San Jia Fu Mai Tang and Tian Gen Yue Ku Gao (A Powerful Paste of Blood-and-Flesh Substances)
Patient’s search words: emission at the sound of a woman’s voice / involuntary emission / nocturnal emission / body severely weakened / flushed red face / crimson tongue / no energy Medical terms: deficiency-consumption (xu lao · xu sun) · severe deficiency of kidney essence · yin deficiency with yang floating upward (a severe wasting disease)
Opening: this patient’s illness is a little unusual
Into the clinic of Doctor Wu Jutong, the great Qing-dynasty physician, came a Mr. Li, 40 years old — a middle-aged man. His illness was strange — so strange that Doctor Luo Dalun issues a warning before even beginning: if any children are listening, please skip this episode and come back tomorrow when we talk about something else.
💬 Note from Doctor Luo: Today’s case touches on the subject of involuntary emission, so I want to give the young listeners a heads-up. Adult listeners need not worry — the topic is sensitive, but hidden inside this case are three treasure-level methods that Chinese medicine uses to treat severe deficiency, and they are well worth hearing.
Who is the patient? Look at the face, look at the tongue, feel the pulse
What exactly was wrong with Mr. Li? The case record gives three characters: xu sun, xu lao — deficiency-consumption. The person was depleted. How depleted? Look at three signals:
First, flushed face and crimson tongue. His face was red; his tongue was a crimson (jiang) color.
💬 Note from Doctor Luo: You should know that tongue colors come in grades: pale white → pale red → red → deep red (chi) → crimson (jiang) → purple. Red is normal-but-warm; chi is stronger than red; jiang is that dark, deep red — and if it darkens further it turns purple. A red face plus a crimson tongue tells you there is heat in this person’s body.
Second, a deficient, taut, and rapid pulse. The pulse was deficient — if this were true excess heat, the pulse would thump with force; but when he pressed carefully, there wasn’t that much strength. Yet the pulse was strung taut like a zither string (xian), and it was beating fast (shu).
💬 Note from Doctor Luo: Deficient, taut, and rapid together indicate deficiency heat, not excess heat. A person with deficiency heat has fire in the body — the fire doesn’t always announce where it will erupt, and it can make certain parts of the body lose control.
How out of control? Emission at the sound of a woman’s voice
How out of control was it? The case record says it in four characters: “wen fu ren sheng ze yi” — at the sound of a woman’s voice, he would have an emission.
💬 Note from Doctor Luo: There are several kinds of emission. One kind happens while dreaming, and is called meng yi (nocturnal emission); another happens when the semen chamber has filled to the brim and slowly overflows by itself — jing man zi yi, which is natural. But the most extreme is this man — at the mere sound of a woman’s voice he lost control. You may remember old movies where the elderly master hears a woman speak and cries “Oh my, I can’t take it” — this is exactly that state. It shows he was deficient to a certain degree: upright qi insufficient, unable to consolidate and hold — the essence gate could no longer guard itself.
💬 Note from Doctor Luo: Why is there so much essence-damage in modern people? They scroll their phones all day, and all kinds of images on the internet trigger things without their even noticing — the essence is silently spent. People in ancient times had this problem too. How did the ancients treat it? Read on.
Move one: before any medicine — go live deep inside a big temple
The first prescription Doctor Wu Jutong wrote was not a medicine: “ling qi yi ju da miao shen chu” — order him to move into the innermost part of a large temple.
💬 Note from Doctor Luo: This move is brilliant. You usually have too many wandering thoughts, and living on the outside, with pilgrims coming and going — a beautiful woman comes to burn incense, you take one look, and it’s over again. So you must go to the innermost courtyard of the great temple, living together with the abbot and the monks, hearing the wooden fish and the chanting every day, letting the mind settle. That is step one — first anchor the spirit.
Move two: San Jia Fu Mai Tang — the famous yin-nourishing formula Doctor Wu Jutong derived from Zhang Zhongjing
Once the mind was settled, medicine was still needed. Doctor Wu used San Jia Fu Mai Tang (Three-Shell Pulse-Restoring Decoction).
💬 Note from Doctor Luo: This was Doctor Wu’s own creation. In the course of treating warm-pathogen disease, he discovered: warm disease carries heat, and heat massively consumes yin fluids and yin blood — so in the end you must nourish yin and nourish blood. Which formula is best for nourishing yin and blood? He chose Zhang Zhongjing’s Fu Mai Tang — that is, Zhi Gan Cao Tang (Honey-Fried Licorice Decoction), which Zhongjing used for palpitations and knotted/intermittent pulse (heart damaged in both qi and yin) after an external pathogen attack. That formula is yin-yang balanced: it has ren shen (ginseng), gui zhi (cinnamon twig), sheng jiang (fresh ginger), and rice wine — the warming-yang side — and also sheng di (raw rehmannia), mai dong (ophiopogon), and e jiao (donkey-hide gelatin) — the yin-nourishing side. It is like a seesaw, tonifying both qi and yin.
But Doctor Wu wanted pure yin-nourishing. He removed the warming herbs — ren shen, gui zhi, sheng jiang — and kept only the yin-nourishing ones; then, according to how deeply the heat had damaged yin, he added “shells” level by level:
- Yi Jia Fu Mai Tang (One-Shell): adds raw oyster shell (sheng mu li) — to nourish yin and submerge yang;
- Er Jia Fu Mai Tang (Two-Shell): further adds freshwater turtle shell (bie jia);
- San Jia Fu Mai Tang (Three-Shell): further adds tortoise plastron (gui ban).
💬 Note from Doctor Luo: Oyster shell, turtle shell, and tortoise plastron are all shelled, heavy substances. They can press the floating deficiency-fire downward — this is what we call nourishing yin and submerging yang (zi yin qian yang). For every layer of yin damaged, add one shell — from one to two to three. That is the origin of the name “Three-Shell.”
The case record of Mr. Li’s formula has some missing characters in the middle (how it was decocted, how many servings — some characters dropped out), but the strategy is complete: one decoction divided into cups, one dose a day, for a total of forty doses. While living in the temple and eating the yin-nourishing, yang-submerging medicine, he gradually improved — you jian er xiao, “improvement by degrees.”
Move three: Tian Gen Yue Ku Gao — a 24-jin great paste of blood-and-flesh substances
Once the medicine showed results, Doctor Wu wrote one more prescription — a paste formula (gao fang). This was his grand finale.
💬 Note from Doctor Luo: Doctor Wu Jutong was especially skilled at using paste formulas — that is one of his trademarks; remember it. This time he prescribed Tian Gen Yue Ku Gao (Heavenly Root and Moon Grotto Paste), and one batch weighed 24 jin (about 12 kg)! That is truly formidable.
What does Tian Gen Yue Ku Gao treat? It treats damage to both yin and yang in the lower origin — that is, deficiency of both yin and yang in the kidney channel — and especially “ba mai gao sun”, when all Eight Extraordinary Vessels (qi jing ba mai) are depleted.
💬 Note from Doctor Luo: The Eight Extraordinary Vessels are hard to treat with ordinary herbs — sometimes you cannot find which herb enters them. How do you get in? Substances of blood and flesh, possessed of feeling (xue rou you qing zhi pin) enter the Extraordinary Vessels more easily. Tian Gen Yue Ku Gao has one precondition: the kidneys are deficient, but the spleen and stomach are still all right — if the stomach is too weak, this paste cannot be taken, because it is too rich, heavy, and turbid. Also anyone with damp-heat cannot take it — this is a purely tonifying formula.
Who is it suitable for? People with depletion of blood and essence, deficiency of both yin and yang — especially women: deficiency after childbirth, increasing dai discharge (white, yellow, and other vaginal discharges), cold uterus with infertility, repeated miscarriages, or women who had many children when young and in old age suffer aching hips and knees (severe soreness of the hip bones) — those who are depleted, deficient in both yin and yang, without damp-heat — this formula is especially right for them.
Look at the ingredients — all fine things:
💬 Note from Doctor Luo: Lu rong (deer antler velvet), 1 jin; wu gu ji (black-boned chicken), 1 jin; bao yu (abalone), 2 jin; lu jiao jiao (deer-horn gelatin), 1 jin; ji zi huang (egg yolks), 16; hai shen (sea cucumber), 2 jin; gui ban (tortoise plastron), 2 jin; yang yao zi (lamb kidneys), 16; sang piao xiao (mantis egg case — consolidates and secures essence), 1 jin; wu zei gu (cuttlefish bone), 1 jin — all of these are blood-and-flesh substances, tonifying kidney yin, kidney yang, and kidney essence. Then add fu ling (poria), 2 jin; mu li (oyster shell), 2 jin; xi yang shen (American ginseng), 1 jin (Doctor Wu liked American ginseng — the “yang shen” written in the case record is the same thing), tu si zi (dodder seed), 1 jin; long gu (dragon bone), 2 jin; lian zi (lotus seed), 3 jin (strengthens the spleen and astringes), gui yuan rou (longan pulp), 1 jin (nourishes blood), shu di huang (cooked rehmannia), 4 jin (the largest amount — tonifies kidney essence), sha yuan ji li (flatstem milkvetch seed), 2 jin (nourishes the liver), bai shao (white peony), 2 jin (nourishes liver and astringes blood), qian shi (euryale seed), 2 jin (tonifies spleen/kidney and astringes), dang gui shen (angelica root body), 1 jin (nourishes blood), xiao hui xiang (fennel seed), 1 jin (warming), bu gu zhi (psoralea fruit), 2 jin (warms kidney yang), gou qi zi (goji berry), 2 jin (tonifies liver-kidney essence), rou cong rong (desert cistanche), 2 jin (tonifies kidney yang), shan yu rou (cornus fruit), 1 jin (tonifies liver and kidney), zi shi ying (purple fluorite), 1 jin (a mineral — heavy and settling, quiets the spirit and warms the woman’s uterus — for a cold uterus you want this), du zhong (eucommia bark) (strengthens the lower back), niu xi (achyranthes root) (strengthens the lower back and tonifies the kidney), bi xie (fish-poison yam rhizome) (drains turbid damp), and bai mi (white honey), 3 jin.
Why must it be blood-and-flesh substances?
Put the formula out and it is all fine things — but why does a deficiency-consumption illness need so many animal medicinals?
💬 Note from Doctor Luo: This is a special concept in Chinese medicine. Normally we use plant herbs; in a paste decoction you have herbs, but also deer antler, sea cucumber, abalone — these are substances of blood and flesh, possessed of feeling — “what has feeling returns to feeling; what has no feeling returns to no feeling.” For mild deficiency, herbs alone can restore you; but when the deficiency is truly severe, even reaching the Eight Extraordinary Vessels, then you generally need blood-and-flesh substances — and the effect is excellent. Why? Because they are closer to the human body’s own structure, the body accepts them more readily, and they nourish more deeply than plants.
How is it made, how is it taken? One batch, two years
How is Tian Gen Yue Ku Gao made? Refine it over fire, take the juice, slowly boil nine times, reduce it to a paste, then add the gelatin and honey; the ingredients without juice (fu ling, lian zi, qian shi, mu li, long gu, lu rong, bai shao, wu zei gu) are ground into an extremely fine powder, mixed into the paste, and rolled into pills the size of wu-tong tree seeds.
💬 Note from Doctor Luo: Take 3 qian (about 9 g) each time, three times a day — about 27 g a day, taken with water. Mr. Li’s batch was 24 jin; at this rate, it would last him nearly two years! Storage must be good, or it will spoil. Twenty-four jin sounds alarming, but spread over each day, the cost is not much — only 27 g a day, after all. Doctor Wu had him take it slowly; when the upright qi was sufficient and the body recovered, the illness was cured.
Is a paste formula expensive? Doctor Luo does the math
At this point someone will surely ask: this paste is so expensive — does it work? Can we make it?
💬 Note from Doctor Luo: To be honest, it is expensive. It is full of fine ingredients. Someday I’ll take it to Tong Ren Tang and ask them to price out one batch. But as for whether it works — paste formulas really can treat illness and nourish the body. Every autumn now, many people have paste formulas made, and they too use good ingredients. Also note: in the Qing dynasty, Mr. Li was not a rickshaw puller — a rickshaw puller could never eat sea cucumber daily; he must have had some money.
💬 Note from Doctor Luo: My view is: life comes first. Anything that money can solve is a stroke of luck — some patients spend hundreds of thousands on surgery and still cannot be saved; but if money can build up the upright qi and nurse the body back to health, that is a good thing. If you compare cost, Chinese medicine is still cheaper than Western medicine — Western medicine’s tests alone cost a fortune, and imported drugs are expensive later. It depends how you compare.
💬 Note from Doctor Luo: Spread out, it really is not that costly: one batch lasts two years, 27 g a day — not much per day. And if it can genuinely nurse the body back — some people are depleted beyond belief, skin and bone, kidney essence insufficient — especially some women who are very weak after childbirth, or elderly women who worked hard in their youth and now have both yin and yang deficient — taking a little of this is beneficial.
Digression: the autumn tonic tradition of paste formulas
Paste formulas are not Doctor Wu Jutong’s monopoly — they are a whole strand of Chinese health culture.
💬 Note from Doctor Luo: Chinese people believe in autumn tonic. Those with means make a paste formula in autumn; simpler households can take some e jiao, ren shen, shu di and simmer it at home, a spoonful every day in winter. Many elderly people persist this way: eat it through the winter, and the following spring the body is visibly different. In the Jiangnan region there are elders who take a spoonful of paste every winter and are exceptionally healthy with black hair — ask them how, and they say: in winter you should tonic. Things like e jiao gao (donkey-hide gelatin cake) and yu ling gao are all, in a sense, paste formulas.
Another story: the grandmother in the ICU who came back thanks to bird’s nest
Doctor Luo also told a story from his own experience, related to “tonifying.”
💬 Note from Doctor Luo: A patient once told me: the grandmother in their family was failing, rushed to the ICU, unable to eat anything. I had them feed her bird’s nest — every day, spoonful after spoonful — and later she was discharged, recovered! Someone asked what is so magical about bird’s nest? I said I don’t know — I’ve barely eaten it myself. You see: an ordinary Chinese-medicine practitioner who has never eaten bird’s nest has no experience of it. Why do so many paste formulas lack real experience today? Because the practitioners themselves have never eaten them, and making them is complicated. So these things are worth studying on our own: prepare and process them at home, scale the proportions down — you don’t need one jin or two jin; make a smaller amount, as far as you can manage, and gently supplement a frail elderly relative or a badly depleted woman — over time, they may well recover.
Epilogue: what does this case teach us?
The case is recorded simply, but the treatment strategy is crystal clear: first settle the mind, then nourish yin and submerge yang, and finally great supplementation with blood-and-flesh substances.
💬 Note from Doctor Luo: Two fine things to learn today: one is San Jia Fu Mai Tang — now you understand what One-Shell, Two-Shell, and Three-Shell mean; these are three formulas Doctor Wu Jutong created. The other is Tian Gen Yue Ku Gao — it tonifies both yin and yang, all great tonics; it is Doctor Wu’s famous paste formula, and practitioners still use his approach today. He also created Zhuan Xi Da Sheng Gao and other celebrated pastes. I truly wish someone would develop and market these ancient formulas — for those with the means, an elderly mother or grandmother who is depleted could slowly take one for a year or two, and what a fine thing it would be to see the body grow strong. Unfortunately, today almost nobody makes animal-based tonics anymore — but this is a part of Chinese medicine culture, well worth inheriting and researching.
Mr. Li, 40 years old, was so depleted that the mere sound of a woman’s voice could breach his essence gate. Doctor Wu Jutong applied three moves — quiet in the temple, pulse-restoring shells to submerge yang, and the great paste — and gradually the upright qi filled, and the man recovered. Deficiency is not drained in a day, and supplementation is not finished in a day; the art of Chinese medicine in treating such illness lies precisely in this patient, steady, un-hurried work of slow nourishment and steady rebuilding.
Compiled from Doctor Luo Dalun’s commentary on the case records of Doctor Wu Jutong; the case is from Wu Ju Tong Yi An (The Case Records of Doctor Wu Jutong, Qing dynasty).