Sleepy All Day, Restless at Night, Vomiting Clear Water, Headache at the Crown? Doctor Luo Dalun on Wu Zhu Yu Tang (Evodia Decoction): Four Herbs That Warm Yang Qi Back into the Whole Body

Patient search terms: sleepy all day and always wanting to sleep / restless and unable to sleep in the middle of the night / vomiting clear water / headache at the crown of the head / vertex pain / ice-cold hands and feet / fear of cold / dry retching and spitting drool / drowsiness in winter

Corresponding medical terms: Lesser Yin disease · Wu Zhu Yu Tang pattern · internal domination of yin cold · insufficient yang qi · weak kidney yang · dan yu mei (constant desire to sleep) · yin restlessness (yin fan) · excessive sleep (duo mei)

Opening: in times like these, learning how to stay alive matters more than anything

Doctor Luo did not start with the formula. First he spoke a few words from the heart: the climate has turned abnormal — in the past, how many summers reached 40 degrees? Now 40-degree days are everywhere; and there are food crises and plagues sweeping the world — in all of recorded history, plagues on this scale have truly been rare. If at a time like this you still think chasing fame, status and position matters, you really have not figured out life. What matters most? Learning how to protect yourself and your family — that is as important as eating.

💬 Note from Doctor Luo: The day before yesterday I went out on business. At mealtime the restaurant would not allow dine-in, so I bought a bowl of noodles and squatted by the roadside to eat — and when I looked around, everyone was squatting by the roadside eating. I posted about it on Weibo, and a friend asked: did you take a photo? I really did take one, but I did not post it. At a time like this, tell me — does wearing brand-name clothes help? Does driving a luxury car help? None of it helps. So really, learn more health knowledge, get your body in good shape, and be ready for whatever is coming. Nothing I teach here is empty talk — it all has theoretical basis and documentary evidence, taught the proper way. It would be a real shame not to learn it.

With the preamble done, what are we talking about today? Continuing yesterday’s Shang Han Lun (Treatise on Cold Damage) — the concrete applications and cases of Wu Zhu Yu Tang (Evodia Decoction), to help everyone use this formula thoroughly and correctly.

What is Lesser Yin disease? The external pathogen has breached the innermost layer

First, let us review the six-channel framework of the Shang Han Lun. When external pathogens attack, the body resists layer by layer: Tai Yang, Yang Ming, Shao Yang, Tai Yin… if none of the resistance holds, the pathogen keeps pushing inward until it reaches Shao Yin (Lesser Yin) — at that point the functions of every organ are in decline; this is the innermost, most critical moment.

💬 Note from Doctor Luo: Some TCM experts say Lesser Yin disease is also an exterior condition. Actually it is an interior condition — the body is resisting the external pathogen, so it carries a few exterior features, but in essence it is interior. When Zhang Zhongjing discussed Lesser Yin disease, he did not speak of organs; he described a state: the body’s functions are depressed, it has no strength to resist, it becomes very cold, yang qi is insufficient, and yin cold dominates internally. In this state a person can easily die — that is why in the Lesser Yin chapter Zhang Zhongjing gives many formulas, and also describes many situations of “not cured, then death.” You can see this is a critical condition.

Lesser Yin disease can also show heat signs — sometimes it transforms into heat — but that situation is far, far less common than cold transformation: the mainstream is turning cold, entering a state where yin cold dominates internally.

Zhang Zhongjing did not say Lesser Yin disease has to do with the heart or the kidney, but we should study the Shang Han Lun flexibly: the six channels can be linked to zang-fu organ differentiation and channel differentiation. Just like Shao Yang disease — Zhang Zhongjing did not mention emotions, yet nowadays we see very many people with constrained liver qi, liver-gallbladder disharmony and emotional stagnation presenting with Shao Yang or Jue Yin patterns — people with troubled emotions, when they catch an external pathogen, are more likely to enter that state.

💬 Note from Doctor Luo: The same logic: people with insufficient kidney qi, withered kidney channel — especially people with insufficient kidney yang — enter Lesser Yin disease quickly when they catch an external pathogen. Playing on the same playground, others do not catch cold but you do; others are not “hit by evil” but you are — why? Because you have an internal foundation in your body. Your constitution is closely tied to what state you tend to enter when you catch external contraction. Zhang Zhongjing does not say this is caused by kidney deficiency, but we ourselves must be clear about this layer of meaning.

Kidney-deficient people live in a “Lesser Yin state” every day

Doctor Luo says he has met far too many people — no external cold, no external contraction — but with kidney deficiency (excessive desire, over-consumption through sexual activity, and so on), the state they live in is exactly the same as Lesser Yin disease.

What are the main symptoms of Lesser Yin disease? The pulse is faint and thin — beating very thin and weak; then dan yu mei (a constant desire to sleep) — always wanting to sleep.

💬 Note from Doctor Luo: A patient once told me he had insufficient kidney qi — kidney deficiency, a bit of excessive desire, quite a few girlfriends. I tonified his kidney, and he said his energy had come back and he felt great — but after one sexual encounter — just half an hour, an hour — he immediately became drowsy, no strength at all, sleepy and wanting to lie down; after waking he felt a little more energetic, then wanted to sleep again. Hearing this example, I felt Zhang Zhongjing’s description was incredibly precise: a person whose kidney qi is truly depleted behaves exactly like the Lesser Yin disease Zhang Zhongjing described. Such people are “dan yu mei” all the time, and when they catch an external pathogen they are even more likely to feel chilled all over, terribly cold, lying in bed in a daze — entering the Lesser Yin state.

So protecting kidney qi is extremely important. Nowadays there are too many ways to consume kidney qi — heavy desire, staying up late, all kinds of consumption; society is full of temptations.

💬 Note from Doctor Luo: The ancients saw little; they worked in nature all day. Now? Everyone opens Douyin or any short-video platform and it is all pretty girls dancing. Some friends call this “feasting the eyes” — stop it, do not feast anything. This is secretly consuming your kidney qi. The ancients said “the image of fire has already moved”: your body starts preparing, secreting hormones — consumption has already begun, it just has no outcome. Consume too much, and it turns into deficiency fire that runs to the body surface and to various places, causing all kinds of local heat signs; overall, you are being drained. Add cold foods and staying up late, and the opportunities to damage kidney qi are countless. What the ancients taught really matters.

Wu Zhu Yu Tang: made for “vomiting and diarrhea, ice-cold hands and feet, restless to the point of death”

Among Lesser Yin diseases Zhang Zhongjing gave many formulas and many approaches. In general: cold conditions must warm the yang. Which Lesser Yin situation does Wu Zhu Yu Tang treat? Tu li — vomiting and running to the toilet; shou zu jue leng — ice-cold hands and feet; fan zao yu si — restlessness to the point of death. Its hallmark is the character “fan” (restlessness).

💬 Note from Doctor Luo: This restlessness is the restlessness of internally generated yin cold — and it tends to appear at night. So all the cases today are Wu Zhu Yu Tang patterns.

Wu Zhu Yu Tang is not only for Lesser Yin disease. Jue Yin disease — vomiting, spitting drool, and headache (where? the very crown of the head — the vertex) — can also use Wu Zhu Yu Tang; and Yang Ming disease — shi gu yu ou (vomiting on eating grain) — when eating makes you want to vomit, if that vomiting is caused by cold, Wu Zhu Yu Tang also works, and very well.

The formula is very simple, just four herbs: Wu Zhu Yu (evodia fruit) (the main force), Ren Shen (ginseng) (to tonify upright qi), Sheng Jiang (fresh ginger) (to help warm the body), and Da Zao (jujube dates) (to harmonize the spleen and stomach).

💬 Note from Doctor Luo: Vomiting can be hot or cold. Vomiting caused by cold brings up clear water — and for this kind of vomiting, Wu Zhu Yu Tang works extremely well. Remember this feature: vomiting food and vomiting clear water are two different things.

Case one: endless clear-water vomiting with vertex and forehead pain — three doses, all symptoms gone

First, the case of Doctor Liu Binggeng: the patient’s water came endlessly — vomiting clear water, continuous and unbroken; and the vertex and forehead ached — pain in the head.

💬 Note from Doctor Luo: What is this connected to? Yin cold dominating internally. Wu Zhu Yu Tang hits the target. The differentiation: cold deficiency of the liver and stomach, with retained fluids — there is also water-rheum inside, so Wu Zhu Yu Tang is used.

Prescription: Wu Zhu Yu 9 g, Sheng Jiang 15 g, Dang Shen (Codonopsis) 12 g, Da Zao 12 pieces. After three doses, all symptoms disappeared — every complaint was cured.

Doctor Luo uses this case to teach the differentiation essentials — the method he himself used when learning Chinese medicine:

💬 Note from Doctor Luo: When I studied Chinese medicine, I read seriously, wrote down all the symptoms, and looked for which ones I could recognize when I met a patient. The differentiation points of Wu Zhu Yu Tang: the person is vomiting, vomiting clear water, with cold hands and feet (jue leng), with restlessness — especially restlessness, especially restlessness at night; then look at the tongue — its color is white (pale white), not red — if you judge it a cold condition, basically it works extremely well. Vomiting food and vomiting clear water are different; you must distinguish what the person is vomiting. This patient was restless, especially at night — when you meet night restlessness, immediately keep in mind: could this be a Wu Zhu Yu Tang pattern? Then your diagnostic hit rate is very high. Add headache, vertex headache — Wu Zhu Yu Tang patterns sometimes have headaches, especially at the vertex of the head — that is yin cold dominating internally, dampness rushing upward. Warm it up, and the body recovers.

Case two: Mr. Li, whose head ached whenever the weather turned cold — four doses to ease, several more to cure

The second is also Doctor Liu Binggeng’s case. Mr. Li, male, 59, seen on May 4, 1973. Nearly sixty, generally in good health. What was his standing complaint? Tu qing xian — spitting clear saliva; sometimes things like water coming up from the stomach. He had this history.

Then, when the climate shifted — when the temperature changed, headaches struck suddenly.

💬 Note from Doctor Luo: Guess — do they appear when the weather turns cold, or when it turns hot? Basically when it turns cold — for example in autumn, when the cold wind blows, the head starts to ache. And the vertex is worst — the very crown of the head hurts badly. Headaches are also differentiated by channel: forehead pain is Yang Ming (stomach); pain on both sides is Shao Yang, related to the gallbladder and liver; back-of-head pain is the Tai Yang bladder channel, related to surface cold; vertex pain is Jue Yin. Roughly these regions — keep them in mind.

Earlier doctors gave some warming herbs, which helped a little. But in recent years family affairs caused excessive strain and exhaustion, and the headaches worsened day by day — the body’s upright qi was declining. He also often coughed and spat phlegm drool (white foam, or clear water-like stuff); stomach cold and aversion to wind — afraid of cold and wind — which indicates insufficient yang qi. Both Chinese and Western treatments failed, so Doctor Liu was called in.

Doctor Liu observed him: spirit weary and drowsy, carrying that “dan yu mei” feeling; poor appetite; slippery-moist tongue coating, lots of saliva on it; fine-slippery pulse.

💬 Note from Doctor Luo: Based on the headache (vertex pain), the spitting of drool (clear water, not yellow phlegm), and the stomach cold with fear of cold, the judgment is: yang qi insufficient, turbid yin rising counterflow — yin cold dominates internally, and turbid yin (the cold-damp qi) moves upward, causing the headache. What to do? Warm the middle, tonify deficiency, direct the counterflow downward and resolve phlegm — Wu Zhu Yu Tang.

Prescription: Dang Shen 30 g, Wu Zhu Yu 9 g, Sheng Jiang 15 g, Da Zao 8 pieces. After four doses, the headache lessened and the clear-water spitting decreased; the urine became slightly copious and clear — this is cold descending and yang arising; the spleen and stomach have regained their transformation-and-transport function. Then the original formula was continued for several more doses, and all symptoms were cured — the headache completely resolved.

💬 Note from Doctor Luo: This case’s differentiation points: spitting clear saliva (the water is clear), chills all over (insufficient yang qi), pale tongue, headache worst at the vertex — based on these, we judge that the person has yin cold dominating internally, insufficient yang qi, and turbid yin rising counterflow, so we use Wu Zhu Yu Tang — with excellent results. Listen to a few cases and my differentiation analysis, and you will roughly know: what kind of situation might relate to Wu Zhu Yu Tang, and whether you can try it — sometimes the analysis alone lands the diagnosis.

Case three: antibiotics for skin sores produced all-night restlessness — “yin restlessness” cured in two doses

Now another case — Doctor Li Ying’s yin-restlessness case. Mr. Yao, 63, in the spring of the bing-yin year, developed sores on his hands and feet. He was hospitalized for a week, and the sores healed — but then he fell into the suffering of night insomnia.

💬 Note from Doctor Luo: Let us analyze the sequence of events: how were the sores treated? Probably antibiotics and the like. Most antibiotics are cold-natured; or perhaps he stayed in a Chinese medicine hospital and took cold-natured detoxifying herbs. The result? The sores healed, but it turned into night insomnia.

Sedatives and sleeping pills only made it worse. What kind of insomnia? Restless all night, unable to sleep — every night restless beyond endurance. Even injections of fast-acting sedatives made the night restlessness worse. How bad was it? Loud lamenting without end — every night restless and lamenting loudly, not falling asleep until dawn. Every single night.

💬 Note from Doctor Luo: I have seen patients like this too — at night restless and anxious beyond endurance, not knowing what to do, pacing and lamenting, finally dozing near dawn, then restless again at night. Such cases genuinely exist in real life; usually they cannot be cured — you must match the formula to the pattern. This patient had failed both Chinese and Western treatment.

After half a month, Doctor Li Ying was called in. Observing the patient: dull, dark complexion; cold hands and feet (shou zu ni leng); poor appetite — these are all Wu Zhu Yu Tang signs, a bit of a Lesser Yin presentation; speech normal, calm when sitting quietly during the day; stools slightly loose — also a sign of insufficient yang qi; tongue pale red, without coating; both pulses deep, slow and forceful.

💬 Note from Doctor Luo: Why is he so agitated at night? Because at night yin cold dominates internally — it flares up at night. This is the expression of extremely insufficient yang qi, yin cold prevailing fiercely. Differentiation: liver-kidney yang deficiency, middle yang not rising, turbid yin qi rising counterflow — this is called yin fan (yin restlessness), a deficiency-restlessness pattern.

Prescription: Wu Zhu Yu Tang — Wu Zhu Yu and Ren Shen 9 g each, Sheng Jiang 18 g, Da Zao 12 pieces, one dose, decocted in water. After taking it, the patient fell asleep peacefully that very night, unrousable when called — clearly the medicine had hit the disease mechanism. The original formula was continued for one more dose, and he was cured. A year later, follow-up: no relapse. Two doses solved the problem.

💬 Note from Doctor Luo: In the old days they said “Shang Han formulas do not go past three” — with Shang Han Lun formulas, basically you prescribe three doses; if the pattern matches, three doses will certainly improve it; if after three doses there is no change at all, or it worsens, stop immediately — Zhang Zhongjing’s formulas have this trait, and at that point you should reflect: maybe your differentiation is wrong. When the disease mechanism matches, results come very fast, especially for functional disorders — I basically find that one dose already brings obvious improvement. That is the precision of Zhang Zhongjing’s formulas.

Case four: Wang, who slept ten months of every year — ten years of excessive sleep, cured in 40-plus doses

Now an duo mei (excessive sleep) case, treated by the old master Doctor Liu Jingqi. Mr. Wang, male, 53, seen on November 4, 1983. Excessive sleep for ten years — he loved sleeping especially much. How did it start ten years ago? From chilling and anger: heart vexed to the point of wanting to die; dry retching, spitting phlegm drool (note: not vomiting food); chest oppression and headache, weakness and fatigue, drowsy all day, the sleepiness coming and going. In the last three or four years, he completely lost the ability to work.

What exactly were the symptoms? Every early winter he began sleeping all day long — wanting to sleep constantly. Wake him and he would wake, eat; after eating he would lie down again and sleep. Day after day in a daze, until the next summer, when he improved.

💬 Note from Doctor Luo: Everyone, such conditions really exist — some people get sick in summer, some in winter. Some illnesses have obvious periodicity; the discipline that studies this is called chronomedicine (time medicine). When I was a student I bought a book on chronomedicine and read about all kinds of Chinese and Western conditions — it left a deep imprint on me: we truly live between heaven and earth, and following the seasonal changes of yin and yang, our bodies have cyclical rhythms; illness is often related to this. For example, some diseases attack at night — night attacks mean insufficient yang qi: within a day, yang qi is strong in the daytime and weak at night; in a person with very weak yang, when night comes and yang qi is stored away, yin cold becomes especially strong and the illness easily flares. Within a year? Summer yang is strong, winter yang is hidden — so you see, he fell ill every early winter, sleeping from then on, waking to eat and use the toilet, then lying down again in a daze.

Locally he took Ping Wei San (Calm Stomach Powder), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction) and Er Shen Tang variations — over a hundred doses, no effect. He still had: vexation, headache, nausea — see, these match Lesser Yin disease, do they not? Nausea and vomiting, headache, vexation — all of them match; whole-body weakness, unable to walk, needing help to get in and out of a car. Urination and stool normal, tongue coating thin and white, tongue not red, pulse deep and moderate.

💬 Note from Doctor Luo: Based on the symptoms: worse in winter — not the picture of abundant yang with heat, but a picture of depression and low function: fatigue and drowsiness, no strength, pale tongue. These case records do not say much more, but actually his hands and feet should have been cold too — it should have been jue ni (counterflow cold). This is a classic Lesser Yin disease — all the Lesser Yin symptoms are present. Differentiation: yang qi insufficient; we need to warm the liver, warm the stomach and tonify deficiency — from the angle of warming the liver, this is essentially Lesser Yin disease.

Prescription: Wu Zhu Yu 18 g, Sheng Jiang 18 g, Dang Shen 18 g, Da Zao 6 pieces, six doses. At the follow-up, he had continued the original formula at home for 40-plus doses — in the past month, his sleep returned to normal, the vexation, nausea and headache all disappeared, and he could do ordinary physical labor; the pulse was still deep and moderate, not fully recovered.

💬 Note from Doctor Luo: One more word here: generally after treating Lesser Yin disease, aftercare is crucial — restrain sexual activity, rest well, and do not stay up late consuming yourself; then take kidney-tonifying, kidney-and-heart-nourishing medicines over the long term. Mostly it is kidney qi insufficiency — tonify the kidney and regulate gradually, a little at a time. The Shang Han Lun teaches the treatment of external-contraction disease; for the aftercare part, works like the Jin Gui Yao Lue (Essential Prescriptions of the Golden Coffer) lay out many ideas for internal-damage illness. A person cannot cover everything in exhaustive detail, so we must draw inferences — the relationship between daily constitutional care and external-contraction illness — and in that way your understanding deepens.

Doctor Luo’s closing note: Wu Zhu Yu Tang — kidney yang is the root; warm it all the way through

That is where we leave Wu Zhu Yu Tang today. Having seen these cases, everyone should understand: when you meet these symptoms, they may be related to the Wu Zhu Yu Tang pattern.

💬 Note from Doctor Luo: Wu Zhu Yu Tang does not only treat Lesser Yin disease — anything related to Jue Yin or Yang Ming is possible. But what is the main disease mechanism? Kidney yang insufficiency, which leads to liver yang insufficiency and spleen yang insufficiency — kidney yang is the root of the deficiency. When liver yang is insufficient, turbid yin rises counterflow — the liver’s yin qi rushes upward — producing a pattern of qi rushing upward: headache, vomiting drool and phlegm (because it is cold, what comes up is drool, not food), inability to eat, and very pronounced restlessness — some people’s restlessness is especially typical when their limbs are ice-cold. This restlessness often leads to emotional problems, because it involves the liver — and it is often worse at night, often worse in winter.

Dear friends, draw inferences from one case — your understanding of the relationships among our organs, and between the human body and the weather and seasons of the world, will deepen slowly. Listen a little every day; while hearing the stories, learn about your body’s problems — and slowly, you may grasp some knowledge. No rush — none of you are here to become doctors; you are here to understand your bodies better and take better care of them. Tomorrow we will continue with Doctor Xu Shuwei’s stories of treating illness with the formulas of the Shang Han Lun. Dear friends, see you tomorrow.

Compiled from Doctor Luo Dalun’s case-study lecture on the Wu Zhu Yu Tang (Evodia Decoction) patterns of Zhang Zhongjing’s Shang Han Lun (Treatise on Cold Damage); the cases come from the Shang Han Lun (Lesser Yin and Reverting Yin chapters).

What to take away

1. Lesser Yin disease is the innermost, most critical stage of external contraction — a state of depressed body function, no strength to resist, cold all over, yang qi insufficient and yin cold dominating internally. Zhang Zhongjing described a “state,” not an organ — but the six channels can be linked to zang-fu and channel differentiation.
2. People with weak kidney qi — especially weak kidney yang — live in a “Lesser Yin state” every day: faint-thin pulse, “dan yu mei” (constant desire to sleep). When they catch external pathogens, they quickly fall into full Lesser Yin disease.
3. Modern life consumes kidney qi in countless hidden ways: heavy desire, staying up late, and even scrolling short-video platforms full of dancing girls silently drains it — the ancients’ warnings still matter.
4. Wu Zhu Yu Tang (Evodia Decoction) is just four herbs: Wu Zhu Yu (evodia fruit) as the main force, Ren Shen (ginseng) to tonify upright qi, Sheng Jiang (fresh ginger) to warm the body, and Da Zao (jujube dates) to harmonize the spleen and stomach.
5. The differentiation key: vomiting clear water (not food), ice-cold hands and feet, restlessness — especially at night and in winter — and a pale (not red) tongue. If the restlessness comes at night, always ask yourself: could this be a Wu Zhu Yu Tang pattern?
6. Headache by channel: forehead = Yang Ming (stomach); both sides = Shao Yang (liver-gallbladder); back of head = Tai Yang (surface cold); vertex (crown) = Jue Yin — vertex headache plus clear-water spitting plus chills points straight to Wu Zhu Yu Tang.
7. “Shang Han formulas do not go past three”: if three doses bring no change (or worsen the condition), stop and reconsider the differentiation; when the pattern matches, one dose often brings obvious improvement — as in Doctor Li Ying’s “yin restlessness” case, cured in two doses.
8. After recovery, aftercare is crucial: restrain sexual activity, rest well, and take kidney-tonifying, kidney-nourishing medicines over the long term — the root of the whole pattern is kidney yang.