Always Cold, with Cold Hands and Feet, Late Scanty Periods, and Painful Menstruation? The Song-Dynasty Formula Ai Fu Nuan Gong Wan: Move Qi, Nourish Blood, Warm the Womb and Regulate the Periods

Opening: Why do some women never warm up, no matter what?

Over the past few days, Doctor Luo Dalun has been speaking about a single theme: women and cold. In the earlier lectures he took apart the two most common internal causes of cold: blood stasis (the formula Wen Jing Tang, Warming the Channels Decoction) and blood deficiency (the formula Jiao Ai Tang, Ass-Hide Glue and Mugwort Decoction). Today’s lecture is about the third factor — and the one most easily overlooked — constrained liver qi (gan qi bu shu), which simply means emotion.

💬 Note from Doctor Luo: Many friends write in saying, “Doctor Luo, what you’re saying is really useful — because I have a cold constitution, I’ve been cold-affected for years, and I have all sorts of body imbalances.” Yes, cold is a major cause of imbalance in women. Add today’s factor to the previous ones, and you’ll understand why you “never warm up no matter what.”

Cold is never a single factor: nobody gets sick by the textbook

Many women assume that if they feel cold, they have yang deficiency. But it’s not that simple. Doctor Luo first takes apart the very “feeling of cold”:

💬 Note from Doctor Luo: First, if you have a yang-deficient constitution, you can easily confuse it with several other situations. People with blood deficiency also fear cold — but that isn’t necessarily real cold damage. People with constrained liver qi and bad moods have their yang qi shut up inside, so their hands and feet are actually ice-cold. And there’s blood stasis — when circulation is poor, the whole body feels chilled. What are all of these? They are all a kind of illusion — you have the feeling of cold, but you aren’t necessarily yang-deficient.

But these factors are never a “single choice.” Doctor Luo stresses:

💬 Note from Doctor Luo: Nobody gets sick the way the textbook says. A person can have cold hands and feet, constrained liver qi, real cold invasion, and yang deficiency all at once — these combine. So in the previous lectures I took them apart one by one: blood deficiency combined with cold, blood stasis plus blood deficiency plus cold — three factors. Today we add one more: depressed, angry emotions — constrained liver qi. When all these factors pile together, the kind of cold that results is complicated.

To be honest, in modern society there is almost no such thing as a pure patient — “I’m purely blood-deficient,” “I’m purely yang-deficient.” It basically doesn’t exist.

Why “blood deficiency” and “constrained liver qi” are the standard package for modern women

Doctor Luo starts with a painful reality: which woman today dares to say her blood is sufficient?

💬 Note from Doctor Luo: Look at the office towers — people don’t exercise, they sit all day in air conditioning, they never see the sun. In that state, can the blood possibly be sufficient? Then they go home to cook and take care of the kids, and at night they work overtime on reports. In this kind of life, very few people have sufficient blood. In the old days we said the laborers working in the fields had strong bodies — that’s not necessarily true anymore. There’s too much worry now — rural women, when you look closely, often have quite severe qi and blood deficiency too.

Beyond blood deficiency, there is emotion. Women are naturally sensitive — the same stimulus a man can shrug off hits a woman harder. Add the pressures of modern society:

💬 Note from Doctor Luo: In the old village there were only a few matters to worry about. Now you know too much — who got rich, who bought a big house; on WeChat Moments everyone posts only their best side, and the more you scroll, the more ordinary you feel. At work, it’s whether the monthly targets got hit — and at the end of the month everything resets to zero and starts over. At home you’re raising the kids: in first grade they take a unified exam every week and a ranking board goes up, the teacher watches every day, and the scores are sent to the parents. Which woman dares say her mood is wonderful? Unless you’ve lived so clearly, so transparently, that you’ve let go completely the way the Dao De Jing teaches — then you’d be a master, not a normal person.

So Doctor Luo’s conclusion: for modern women, blood deficiency, blood stasis, constrained liver qi and cold invasion often arrive “as a full set” — the body breaks down because a whole mix of internal and external factors work together.

What does constrained liver qi look like? — First, ask how you feel

The first step in judging whether you have constrained liver qi is not to look at symptoms, but to ask your own feelings:

💬 Note from Doctor Luo: People with emotional troubles know it in their own hearts — how much pressure you’re under, whether you’re depressed, anxious, unhappy — you know best. Judge yourself first; that’s primary. No matter what anyone else says, you may not believe them; your own judgment comes first.

Step two is the classic Chinese medicine presentation. Doctor Luo lists a long string of signs, and almost everyone can find themselves in it:

Bitter taste, dry throat, dizziness. People with constrained liver qi tend to have a bitter mouth — bitter when they wake up; they drink something and everyone else tastes nothing but they taste bitter. They always feel their mouth is dry — but look at the tongue and there’s plenty of saliva on it; they still feel dry. They are also prone to dizziness — severe cases spin, mild cases leave you hazy. This is the classic trio “bitter mouth, dry throat, dizzy vision.”

Quiet, without desire for food; alternating chills and fever; irritability with a tendency to vomit. Hot and cold in turns — put on a coat and you’re hot, take it off and you’re cold. Irritable, quick to anger, or depressed and always sighing.

Stomach qi rushing upward. Normally stomach qi descends; that’s the healthy direction. When the wood of the liver runs wild and attacks the earth of the spleen, stomach qi gets pushed upward — belching, burping, acid reflux, even vomiting.

💬 Note from Doctor Luo: I’ve seen severe cases — women who vomit. After a meal they walk a few steps into the next room, and the whole meal comes rushing back up. That’s liver fire shoving the stomach qi upward.

Appetite and the gut. Emotionally depressed people almost all have stomach trouble and stomach ulcers — stomach disease is hugely tied to mood. The intestines either constipate or loosen; one nervous moment and the belly hurts. And why are there so many colon polyps these days? Stress is connected.

💬 Note from Doctor Luo: All kinds of pressure converge at the sharp bend of the colon — it tends to gather right there, and the rhythm of peristalsis goes erratic, fast and slow, so the colon is prone to polyps.

Palpitations and chest tightness. You always feel something is wrong with your heart and run to the hospital — but in Chinese medicine terms, the liver belongs to wood and the heart to fire; wood catches fire and the heart fire blazes even higher, throwing the heart into disorder.

Rib pain and breast distension. These are areas the liver channel travels through. Some women feel a very characteristic distending pain inside the breast.

Insomnia and vivid dreams. Dreams that run on like a TV series. Insomniacs divide into two groups: one from blood deficiency, one from liver fire — and plenty are a mix of both.

💬 Note from Doctor Luo: Some people wake at four in the morning every single day — that’s severe constrained liver qi. Of the long-term insomniacs I’ve met, the severe ones are mostly women with constrained liver qi, bad moods, or heartbreak that triggered it. I even believe that behind severe lung disease in women there is often a shadow of emotional imbalance, of emotional trauma. The very first symptom of lung cancer is often waking early in the morning: you used to sleep until seven, now you’re wide awake at 4:30 and can’t get back to sleep. If that pattern lasts a long time, be alert for liver fire invading the lungs.

Problems along the liver channel’s path. The liver channel runs along both sides of the body and up the sides of the neck: thyroid nodules are often tied to constrained liver qi; breast disease sits on the side and is related too; the lower abdomen on both sides is liver-channel territory — some women get left- or right-sided lower-abdominal pain, think it’s appendicitis or adhesions, and no test anywhere finds anything.

Doctor Luo tells a real story:

💬 Note from Doctor Luo: The wife of the publisher who prints my books had pain in her left lower abdomen. Nobody knew what it was. She went to Peking Union Medical College Hospital and was tested at length, every test, all normal. Finally she asked me. I took one look — she was under huge pressure — and gave her liver-soothing, qi-moving treatment. The pain vanished. Later she called me from a high-speed train: “Doctor Luo, I have to tell you something wonderful — my insomnia is cured!” She had never even mentioned the insomnia to me. One round of soothing the liver, and it was gone — because she’d had it all along.

Your tongue can show it too. Constrained liver qi shows on the tongue in two ways:

💬 Note from Doctor Luo: One type comes out pointed, like a tip — most people with it are prone to liver fire. Another type, the deeply depressed kind: a plump, sluggish, stiff tongue, with two saliva lines along the edges — saliva lines mean qi and blood are not flowing freely; that’s qi stagnation. Both tongues are constrained-liver-qi tongues.

The famous formula arrives: Ai Fu Nuan Gong Wan from Song-dynasty Yang Shiying

So what formula should a woman use when she is blood-deficient, a little blood-stagnant, liver-qi-constrained, and then catches cold? Doctor Luo introduces a famous formula everyone knows — Ai Fu Nuan Gong Wan (Mugwort and Cyperus Uterus-Warming Pill).

💬 Note from Doctor Luo: Where does this formula come from? In the Song dynasty there was a book called Ren Zhai Zhi Zhi Fang (Ren Zhai’s Direct Formulas), written by Yang Shiying. In the Song dynasty I think he stood apart as a unique figure — he emphasized pattern discrimination and treatment. Most Song books just list formulas; he explained under what circumstances you use a formula. This one has now been made into a patent medicine and is used widely everywhere.

The action of Ai Fu Nuan Gong Wan is eight characters: move qi, nourish blood, warm the womb and regulate the periods. First move the qi — soothe the liver, regulate the flow of qi; then nourish the blood; and on that foundation, warm the womb and regulate the periods (warming yang). It treats: blood deficiency with qi stagnation (blood deficiency + the blocked qi of constrained liver qi) plus deficient cold in the lower burner (cold invasion). Such women have late periods, scanty flow, pale color, clots, or painful menstruation, lower-abdominal pain, and at the same time severe cold intolerance and aching lower back and knees.

The formula, layer by layer: warming, liver-soothing, blood-nourishing, qi-tonifying — it covers everything

Why is this a famous formula? Look at its structure and you’ll understand. Doctor Luo takes it apart layer by layer:

Group one: the warming trio — mugwort leaf charcoal, wu zhu yu, rou gui. You caught cold, didn’t you? First, let’s warm you up.

💬 Note from Doctor Luo: Ai ye is mugwort. It’s mostly used externally — rolled into cones and sticks for moxibustion. When taken by mouth, it’s usually stir-fried into charcoal. Don’t say, “I’ll just boil mugwort and drink it” — drinking large amounts long-term harms the liver a little; it does have mild toxicity, especially the raw form, which should not be used. Making it into charcoal removes that toxicity, which is why the formula uses mugwort charcoal — very sensible. Wu zhu yu (evodia fruit) was used as a seasoning in ancient times — the Chinese didn’t have chilli peppers for a very long time; peppers arrived late. Sichuanese people used to flavor food with prickly ash and wu zhu yu in the morning. We may not accept that taste today. Wu zhu yu warms the channels and frees the collaterals — it both warms and moves, so it can help open up blood stasis too. Rou gui (cinnamon bark) and gui zhi (cinnamon twig) come from the same tree. Rou gui warms the yang and has the special action of “guiding fire back to its source.”

Group two: xiang fu — soothe the liver and move qi. Xiang fu (cyperus/nutgrass rhizome) specializes in dissolving stagnation in the liver channel.

💬 Note from Doctor Luo: When I write formulas to regulate constrained liver qi, I love xiang fu — yu jin, yuan zhi, xiang fu, chen pi; I use them all the time. Since you carry the shadow of bad emotions, the formula gives you xiang fu to help the qi flow smoothly.

Group three: Si Wu Tang — dang gui, chuan xiong, bai shao, shu di huang. Nourish the blood on one side, invigorate it on the other.

💬 Note from Doctor Luo: Shu di huang (prepared rehmannia) tonifies the essence of the liver and kidneys; dang gui (Chinese angelica) nourishes and invigorates blood; chuan xiong (ligusticum) and bai shao (white peony) do the same — nourishing while moving. Bai shao especially: it’s sour and astringent, softening the liver. Since your liver qi is a bit constrained, send in bai shao to soothe it, let the liver soften — stop being so violent.

Group four: xu duan — strengthen the lower back and free the channels. When women’s qi and blood are insufficient, they often feel their lower back aching as if it’s about to snap.

💬 Note from Doctor Luo: Xu duan (dipsacus root) is commonly used in treating bone injuries — it strengthens bones and the lower back, and at the same time reconnects blood vessels, dissolves blood stasis and opens the channels. Here it’s added to strengthen your lower back while invigorating blood and freeing the collaterals.

Group five: huang qi — tonify qi. Why add huang qi?

💬 Note from Doctor Luo: Those who listened to my last lecture know that qi deficiency is also among the causes of cold. Qi and blood generate each other — if you truly want to nourish blood, you have to tonify some qi; only when qi is sufficient can blood be produced. So when qi is deficient, add huang qi (astragalus). Ren shen and huang qi can substitute for each other; it’s just a strategy. When qi is insufficient, dampness easily stagnates and external evils — cold — easily invade, so a bit of huang qi helps lift your upright qi.

Why is a famous formula famous?

All five groups lined up, Doctor Luo marvels: this formula touches every idea he’s been teaching —

💬 Note from Doctor Luo: Blood-deficient? I nourish the blood while freeing the channels — Si Wu Tang plus xu duan. Liver-qi-constrained? Add xiang fu. Qi-deficient? Use huang qi to lift the upright qi. And at the same time I warm your yang — mugwort charcoal, wu zhu yu, rou gui. Every factor is accounted for. Why is this a famous formula? From the Song dynasty to today, every pharmacy in China carries Ai Fu Nuan Gong Wan, precisely because it’s so classic — basically everything that might be wrong with your body, this formula has thought of. That’s the charm of a classic formula.

Once you understand the logic, it’s also flexible in use: you can modify it — if your mood is bad, add more liver-soothing, qi-moving herbs like chen pi and rose buds; you can take the honey pill every day; you can even soak your feet in it.

Understanding matters most: why “I eat fu zi and gan jiang every day and still never warm up”?

After the formula, Doctor Luo pulls the topic back to the most fundamental point — understanding the principle (ming li).

💬 Note from Doctor Luo: It’s not that moxibustion and hot water alone will solve it — the body has many other factors in play. What’s the benefit of knowing these factors? First, you can stop causing further harm. Many people don’t understand: I’m furious inside, and I go get moxibustion, thinking warmth is all that matters — wrong! You feel cold, yes, but you don’t know that inside there’s also the shadow of anger, the qi stagnation of constrained liver qi. Or I’m blood-deficient, so I stuff myself with fu zi and gan jiang — you’re still blood-deficient. Second, when you do adjust, you can be more thorough.

Why do some people go to the hospital every day, eat fu zi and gan jiang, and still never warm up? Doctor Luo says there are other factors inside:

💬 Note from Doctor Luo: Your emotions are bad — you’re depressed. Your blood is deficient — accumulated over many years. Your qi is deficient — the spleen and stomach aren’t strong. All the factors together. So you have to adjust one by one: regulate the spleen and stomach — eat whole grains, huai yam (huai shan yao), lotus seeds; nourish the blood — take some Yu Ling Gao (Jade Spirit Paste); for the emotions — listen to the Dao De Jing, brew rose buds and chen pi as tea. Whatever aspect you identify, tend to it individually — that’s good too. While you resolve the internal causes, warm the yang as well, and the warming will work far better.

Finally, Doctor Luo states the core purpose of this whole series:

💬 Note from Doctor Luo: There are so many women today with yang deficiency, afraid of cold. On the surface it all looks like yang deficiency, but under this big umbrella of yang deficiency hide many, many small problems. If you can see them all, your solution will be more thorough than anyone else’s. My purpose in teaching about women’s yang deficiency is to help everyone understand the principle — once you understand, you can adjust more carefully.

Compiled from Doctor Luo Dalun’s lecture series. Core formula: Ai Fu Nuan Gong Wan, from Yang Shiying’s Song-dynasty Ren Zhai Zhi Zhi Fang (《仁斋直指方》).