Driving Out Evil Qi Only Treats the Symptoms — Strengthening Upright Qi Is the Real Cure: A Stage Summary of the Tonifying Earth School

💬 Note from Doctor Luo: Today let’s pause — I won’t tell another of Luo Tianyi’s case stories. After we’ve gone through a stretch of cases, we should stop and review from the beginning, to deepen the impression. After this summary, tomorrow we’ll go back to Luo Tianyi’s case stories.

One: The family tree of this school — three generations of famous physicians, the most classic master-disciple model in the history of Chinese medicine

We’ve been talking for a while — what school of thought is this? It is the Tonifying Earth School (bu tu pai, also called the Spleen-Tonifying School or the Yishui School). The lineage is perfectly clear: Zhang Yuansu was the founder who laid the theoretical foundation; his disciple Li Dongyuan went on to become famous and eventually an imperial physician; and Li Dongyuan passed his whole body of learning to his own student Luo Tianyi — who reached an even higher social position, serving as an imperial physician in the Imperial Medical Academy (Taiyuan), recording many case histories, writing many books, and passing the earlier masters’ learning down intact.

💬 Note from Doctor Luo: Zhang Yuansu’s influence on the Chinese medicine world was enormous, and his status was extremely high. I remember a teacher at Beijing University of Chinese Medicine, Mr. Ren Yingqiu (he was my mentor’s teacher). Once he said: I really want to see Zhang Yuansu’s book — Yixue Qiyuan (The Origin of Medical Learning). Why? Because this teacher actually used this textbook to teach a great physician like Li Dongyuan! So the textbook must be extraordinary. After he finally obtained the Yixue Qiyuan and read it carefully through, he genuinely felt it was remarkable.

Luo Tianyi was an especially humble man — he always began by saying “my teacher, the late master, did this or that” — how the master’s learning, the school’s secret knowledge, had been handed down. These three masters and disciples are a particularly classic model of the master-disciple relationship in the whole history of Chinese medicine: the bond was good, their virtue was good, and the academic transmission was exceptionally good.

Two: The orthodox martial lineage — why is it called the “Tonifying Earth School”?

The defining trait of this school is its great emphasis on the role of the spleen and stomach in the human body — on primal qi (yuan qi) and on the body’s upright qi (zheng qi).

💬 Note from Doctor Luo: This school is a bit like the orthodox lineage in martial arts novels — like the Shaolin School, very upright. Of course, this doesn’t mean they only tonify the spleen when treating illness; they used every method available. But a very important part of their medicine was valuing the spleen and stomach and valuing upright qi.

The Jin-Yuan period (12th–13th centuries) produced other schools as well. For instance, Zhang Congzheng’s Attack-Evil School advocated the three methods of sweating, vomiting, and purging — evil qi in the upper body, vomit it out; evil qi at the surface, sweat it out; evil qi in the lower body, purge it out. Zhang was a man of strong character, and his treatments were bold and dramatic. But his methods were too fierce for his own time and were not widely accepted; later generations only adopted parts of his approach. Li Dongyuan and Luo Tianyi, by contrast, belonged to the Upright-Fortifying School.

💬 Note from Doctor Luo: What exactly is the relationship between fortifying upright qi and attacking evil qi? I’ve written articles about this: the two need to be used in combination to be complete. But I must be very clear with everyone — if you truly want to regulate your body, you must attach great importance to the upright-fortifying approach. Many friends are confused: should I first resolve blood stasis, or first nourish blood and supplement qi? Today let’s sort out this relationship.

Three: Why does evil qi linger in your body at all?

Have you ever thought about it: why should evil qi enter your body at all? It doesn’t just. The reason is that something has gone wrong inside your own body.

What goes wrong inside the body? Nothing more than diet, overwork and fatigue, and the internal injuries of the seven emotions: poor eating; overwork — excessive consumption, exhausting labor; plus the seven-emotion internal injuries, which cause liver qi to become constrained (gan qi bu shu) and qi and blood to stagnate. In summary, the internal problems come down to a few categories: first, qi deficiency; second, blood deficiency; third, yin deficiency; fourth, yang deficiency — these four are the foundation, the most important. On top of this foundation, sometimes there is stagnation (liver qi constraint, qi getting stuck), sometimes blood stasis, sometimes phlegm-dampness, and so on.

💬 Note from Doctor Luo: These latter three, strictly speaking, all count as evil qi — they are internally generated evil qi. But remember: even internally generated evil qi always arises on the foundation of qi deficiency, blood deficiency, yin deficiency, or yang deficiency. The one slightly special case is liver qi constraint — qi becoming stuck. It can, in turn, cause the earlier problems; it’s a special situation. Apart from that, blood stasis and phlegm-dampness are usually linked to those four kinds of deficiency.

When does external evil qi get in? When the inside of your body is disordered, external evil qi can enter. If your qi is deficient and your yang deficient, a slight invasion of cold is enough to floor you; but if your yang qi is flourishing, does a little cool breeze make you sick? It doesn’t.

💬 Note from Doctor Luo: So you must realize: whenever we speak of evil qi in connection with the diseases we suffer, always think first of our own upright qi — our qi and blood, yin and yang — having gone wrong, plus one more factor, liver qi constraint (bad emotions). Bad emotions in turn disturb the qi and blood, yin and yang, making the foundation even worse. This is mutually causal.

Four: Why is “fortifying upright qi always the root”?

When something goes wrong inside the body, what is one important way to regulate it? First regulate the qi and blood, yin and yang inside — slowly supplement and restore what’s deficient — and then the other evil qi becomes easy to deal with.

💬 Note from Doctor Luo: Your upright qi is insufficient and your qi, blood, yin, and yang are a mess — if you only resolve the phlegm-dampness, once you’re done resolving it, will it come back? Of course it will come back! If inside you the spleen is deficient, the qi deficient, the yang insufficient, dampness will gather again, and phlegm-dampness will return. So fortifying upright qi is always the root.

Then when is driving out evil qi very important? When the evil qi has reached a certain level — extremely severe, threatening the entire balance of health.

💬 Note from Doctor Luo: For example: heavy phlegm-heat, phlegm clouding the heart orifices (tan mi xin qiao) — a stroke is already underway: constipation, bloodshot eyes, very high blood pressure, twisted mouth and slanted eyes, uncoordinated limbs. At this point life is in danger — are you going to slowly fortify upright qi? Too slow! At this moment you must quickly clear the phlegm-heat, transform the phlegm-heat, and unblock the bowels, bringing the acute crisis under control. And then? Why is this person’s phlegm-heat so heavy? There must be a problem inside — then regulate the organs: supplement what needs supplementing, unblock what needs unblocking, supplement the qi of liver and kidney, cultivate the qi of spleen and stomach, transform phlegm-dampness, slowly fortify upright qi, and add collateral-unblocking (resolving blood stasis — blood stasis is also evil qi). At this stage it is often fortifying upright qi and driving out evil qi together.

Five: How does this show up in the case histories? Supplement qi as the base, with a little evil-dispelling added

Look back at the cases we’ve discussed: Luo Tianyi and Li Dongyuan both placed great emphasis on supplementing qi — herbs like huang qi (astragalus), ren shen (ginseng), and bai zhu (atractylodes) appear constantly.

💬 Note from Doctor Luo: Look at their formulas: supplement qi as the base, add a bit of fu ling (poria) to drain dampness (that’s dispelling evil), add a little chen pi (aged tangerine peel) to regulate qi (if qi is stuck, help it open — that’s also a form of dispelling evil) — fortify upright qi plus a touch of dispelling evil. They were also very skilled with wind herbs (feng yao): fang feng (saposhnikovia), jing jie (schizonepeta), du huo (pubescent angelica), bai zhi (angelica dahurica), and so on. Wind herbs are wind-dispelling medicines with pungent, dispersing, ascending properties. What are they used for? To free up the channels and collaterals — when dampness is heavy inside, the channels are blocked, and qi is stuck, I use wind herbs to open them up.

The formulas also contain guiding herbs (yin jing bao shi yao) — medicines that carry the formula into a specific channel. Where did this theory come from? Zhang Yuansu invented it.

💬 Note from Doctor Luo: Chai hu (bupleurum) enters the Shaoyang channel, sheng ma (cimicifuga) enters the Yangming channel… letting the medicine enter precisely that channel, move upward or downward, precisely targeting a channel and a region — this theory was invented by Zhang Yuansu. In a formula’s hierarchy of sovereign, minister, assistant, and envoy (jun chen zuo shi), that “envoy” is the guiding messenger, leading you to a place, to a part of the body. Guiding herbs, plus the sovereign-minister-assistant-envoy compatibility system — see? This is why he is called the founder of the school: many of the most important things in Chinese medicine theory were invented by him. The core of this school is: on the foundation of fortifying upright qi, combine a little dispelling of evil.

Six: What does dispelling evil dispel? What does fortifying upright fortify?

What exactly is included in dispelling evil? Roughly these approaches:

External evil qi (the six excesses: wind, cold, summerheat, dampness, dryness, fire): caused by changes in outside temperature — if it’s cold, warm the body up and drive the cold out; if it’s heat, cool it down in the opposite direction; dryness gets moistened; dampness gets drained.
Internal evil qi: keep the channels and collaterals open — resolve blood stasis, and drain phlegm and dampness (both evil qi); when the channels are blocked, use wind herbs to open the passages. This too counts as dispelling evil.

What does fortifying upright qi fortify? Qi, blood, yin, and yang. And where is the core of qi and blood? In the spleen and stomach.

💬 Note from Doctor Luo: Where does blood come from? Chinese medicine holds it comes from the spleen and stomach — the spleen and stomach absorb nutrients from food and transform them into blood, hence the saying “the spleen generates blood.” Someone might object: hematopoietic stem cells make blood — saying the spleen generates blood just shows how naive Chinese medicine is? I think that’s a shallow understanding — where do the hematopoietic stem cells get their nutrition? Still from the spleen and stomach absorbing food nutrients. Once the spleen and stomach are injured, the source of blood is compromised. That’s why the Neijing (Yellow Emperor’s Inner Classic) says of the nutritive and defensive qi, “nutritive qi arises from the middle burner” — from the spleen and stomach too.

Where does qi come from? Most fundamentally, from kidney qi — the primal qi and essence in the kidneys; kidney qi generates the qi of the spleen and stomach. So the spleen is the source of acquired (postnatal) generation and transformation, while the kidney is the root of the innate (prenatal).

💬 Note from Doctor Luo: The prenatal we can’t really adjust — whatever your parents gave you is what you have; it declines naturally with age, and there isn’t much we can interfere with. All we can do is avoid excessive consumption. Kidney essence follows natural law — being able to preserve it and not overuse it is already very good (though most people burn through it heavily). As for the acquired: the spleen and stomach absorb food nutrients, combine them with the fresh qi of breathing, form acquired essence, and nourish kidney essence. The most important link here is the spleen and stomach: when the spleen and stomach are strong, qi is strong. Don’t believe it? Skip a few meals and see — you’ll have no strength even to talk. When spleen qi is sufficient, lung qi becomes sufficient, and only then can it protect the body surface. Even acquired kidney qi must be nourished by spleen-stomach qi for kidney essence to keep regenerating. So both qi and blood depend on the strength of the spleen and stomach to be continuously replenished — the spleen and stomach are incredibly important.

Seven: Regulate yin and yang while tonifying the spleen and stomach; different schools actually all cover both

While tonifying the spleen and stomach, what if yin and yang are out of balance? Just add a little yin-nourishing or a little yang-warming medicine, and that’s enough.

💬 Note from Doctor Luo: If the patient caught cold, take spleen-tonifying herbs like ren shen, bai zhu, fu ling, and gan cao (licorice), and add some gan jiang (dried ginger), rou gui (cinnamon bark), or fu zi (aconite) — shifting toward warming yang; if the spleen and stomach have yin deficiency, add sheng di huang (raw rehmannia), sha shen (glehnia), and mai dong (ophiopogon) — shifting toward nourishing yin. It can be adjusted quickly.

Ancient physicians formed different schools: some emphasized the spleen and stomach, some emphasized the kidney. Zhang Jingyue, for example, talked constantly about shu di huang (prepared rehmannia) and emphasized the kidney; Li Dongyuan’s school particularly emphasized the spleen and stomach.

💬 Note from Doctor Luo: But if you say “I’ll just emphasize the spleen and stomach and skip regulating the kidney” — no, that’s not right. In fact they all covered both — Zhang Jingyue used ren shen and bai zhu plenty, supplementing qi and tonifying the spleen and stomach a great deal; and Li Dongyuan’s school also used kidney-tonifying herbs. It’s just that because they were especially good in their own area, they emphasized it especially strongly. It’s precisely because they kept elaborating on it that this part of Chinese medicine theory became rich. When we study, we should study it all. Where should fortifying upright qi be directed? The spleen and kidney are the most critical. If you master Li Dongyuan’s school — if you grasp the spleen and stomach well — you’ve essentially completed more than half of upright qi fortification.

Eight: Zhu Danxi’s insight — first fortify upright qi, then drive out evil

Who was it who realized this truth — that all evil-dispelling must rest on a foundation of upright-fortifying? It was the last of the Four Great Masters of the Jin-Yuan period — Zhu Danxi.

💬 Note from Doctor Luo: Zhu Danxi didn’t understand at first either. The first three masters were long before his time, and he pondered: Zhang Congzheng’s attack method is so fierce — can it really work? Later he learned from his teacher Luo Zhiti, who had synthesized the learning of the first three masters. How did he treat? Before driving out evil, he slowly supplemented the patient — slowly cooking congee to nourish them. Only when he felt the upright qi was sufficient did he give a purging decoction, and in one move the illness was cured. Zhu Danxi watched and understood: whatever aspect you study, don’t study it lopsidedly — these masters used it all combined — and they fortified upright qi for such a long time before finally dispelling the evil in one strike. If you skip that long fortification and go straight to dispelling, the evil won’t be driven out — the patient collapses from deficiency first. So Zhu Danxi specifically wrote essays arguing: fortifying upright and dispelling evil must be combined, mutually causal — fortifying upright is absolutely key.

Nine: The Kingly Way of medicine — driving out evil only treats the symptoms; the root lies in fortifying upright

What is the Tonifying Earth School praised as? The Kingly Way of medicine (yi zhong wang dao) — like governing a country by benevolent rule: first let the people eat their fill; don’t rely on constant military campaigns and slaughter.

💬 Note from Doctor Luo: If you can master the thought of the Tonifying Earth School, you can solve most health problems. The logic of Chinese medicine is actually very clear — it’s just this theoretical framework. But if you don’t grasp it well, you easily use it wrongly and get it confused. What can patients learn from this? — you absolutely must learn the idea of fortifying upright qi. When we get sick, we tend to fix our eyes on the evil qi, because the evil qi makes you miserable; you wish you could rip it out in one yank, so you rush to dispel it. But you must recognize: dispelling evil only treats the symptoms; the root is fortifying upright qi. Dispelling evil is easy — sometimes it’s over in a day or two. But the work of fortifying upright qi is slow — your deficiency didn’t start a day or two ago; you have to fortify upright qi bit by bit.

How do you fortify upright qi? First, through diet: regulate the spleen and stomach — eat whole grains and vegetables, keep meals light, and nourish the qi of the spleen and stomach. This is food therapy, and it comes first. Second, through spleen-tonifying herbs: ren shen, bai zhu, and the huai shan yao (Chinese yam) we’ve talked about — fortifying upright qi little by little.

Ten: Tonics make you flare up? Being able to flare up a little is a good thing!

During the process of fortifying upright qi, there can be a contradiction: the evil qi is still there, and you may not know how to dispel it. The ancient famous physicians knew — while fortifying upright qi they’d pair it with a couple of herbs, and in two or three doses the problem was solved. Our pattern identification nowadays isn’t that good, and we can’t always see exactly where the problem is — no need to panic: as long as you keep fortifying upright qi, the conflicts will gradually expose themselves.

💬 Note from Doctor Luo: Some people take tonics, flare up, and panic: “Did I take the wrong thing? Does this medicine have side effects?” Let me tell you the truth: being able to flare up a little is a good thing. First, your medicine has provoked a response; second, your body has started to show itself — it has begun fighting the enemy. A pimple on your face doesn’t necessarily mean you took the wrong thing — keep taking it, your upright qi grows stronger and stronger, and eventually it pushes the problem out. Some people even develop a fever while fortifying: how can tonics give you a fever? The truth is the evil qi has been living in your body, and for a long time you’ve had no strength to fight it. This time your upright qi is finally sufficient — it’s like a thief who has lived in your house for two months and you couldn’t drive him out; now that you’ve eaten well and grown strong, you start wrestling with the thief. This is a good thing — don’t stop.

💬 Note from Doctor Luo: Most people I meet nowadays, when they have a slight reaction to Chinese medicine — flare up after taking it — feel like the sky is falling: “This doctor is no good.” That’s wrong. You can resolve it: after eating and drinking, help it digest smoothly; or stop for two days, then resume. As long as the general direction of yin and yang isn’t mistaken, flaring up a little from tonics is normal — it’s a good response showing upright qi is sufficient. What people don’t realize is that they easily stop the upright-fortifying and switch entirely to dispelling — which at that moment may not be appropriate at all.

Eleven: Evil qi is only that much — don’t get the direction backwards

For ordinary people, fortifying upright qi is the key.

💬 Note from Doctor Luo: The people I see are not mostly those with rampant evil qi. Most are people who have tormented their bodies for a long time and finally reduced their upright qi to a very weak state — which is why the evil qi lingers on. For such people, fortifying upright qi is absolutely critical. Evil qi, after all, is only that much: externally there’s wind, cold, summerheat, dampness, dryness, fire — basically one coordinate of cold, heat, dampness, and dryness; internally there’s blood stasis, phlegm-dampness, and qi stagnation — that’s all. Think it over and you can figure out where your own problem is. On the foundation of fortifying upright qi, clean up these evils bit by bit — only then can they truly be cleared. If you don’t put the work into fortifying upright qi, and you expect to wipe out the evil in one go, a month and a half later the evil qi comes right back.

What the Tonifying Earth School points us toward is the importance of the spleen and stomach. Regulating the spleen and stomach is a very important link in fortifying upright qi — a very important direction. If you can master spleen-stomach regulation, for anyone who cares about health and values wellness, that should be the greatest gain.

💬 Note from Doctor Luo: So let’s absorb the thought of this school little by little. I talk to you every day, and every now and then I stop to review, pointing out where the emphasis lies. With this framework in place, when you go back to studying, it becomes much clearer. What we covered today is the relationship between fortifying upright qi and dispelling evil qi — the core message is the importance of fortifying upright qi: never fix your eyes tightly on the evil qi. Driving out evil only treats the symptoms; the root lies in fortifying upright qi. Only when you dispel evil on the foundation of fortifying upright qi can the dispelling be genuine. Tomorrow, we’ll continue with Luo Tianyi’s case stories.

What to take away

Evil qi only enters when the inside is disordered — the internal roots are qi deficiency, blood deficiency, yin deficiency, and yang deficiency; stagnation, blood stasis, and phlegm-dampness grow on top of those, plus liver qi constraint from bad emotions. It is mutually causal.
Fortifying upright qi is always the root. If you only clear phlegm-dampness while the spleen remains deficient, the dampness and phlegm will come straight back. Dispel evil forcefully only when evil has become life-threatening (for example, phlegm clouding the heart orifices in a stroke) — and even then combine it with fortifying upright qi.
Qi and blood both come from the spleen and stomach — the spleen generates blood, the spleen-stomach qi generates the qi that protects you; the kidney is the prenatal root, the spleen is the postnatal source of generation and transformation. Strong spleen and stomach = sufficient qi and blood.
Fortify where? The spleen and kidney are the most critical — different schools (Zhang Jingyue favoring the kidney, Li Dongyuan favoring the spleen) actually all cover both; learn them all.
If tonics make you flare up a little — that’s a good sign: it means your medicine has provoked a response and your body has started fighting the enemy. Don’t panic and don’t stop; just digest it well or pause a couple of days, as long as the yin-yang direction is right.
Driving out evil only treats the symptoms; the root lies in fortifying upright qi — via diet first (whole grains, light meals), then spleen-tonifying herbs. Don’t fix your eyes on the evil qi; in the end, “evil qi is only that much” — a coordinate of cold, heat, dampness, dryness outside, and blood stasis, phlegm-dampness, and qi stagnation inside.

This article is compiled from Doctor Luo Dalun’s lecture series on Luo Tianyi’s case histories (stage summary edition).