Zhu Weiju: The “Aconite Doctor” of Republican Shanghai Who Dared to Sign a Written Guarantee — The Story Behind Shanghan Zhinan (Hard Questions on Cold Damage)

💬 Note from Doctor Luo: When I was talking about cold damage and warm disease a couple of days ago, I mentioned an important figure — in Republican-era Shanghai there was a famous physician named Zhu Weiju, who proposed that external pathogens should be divided into “organic pathogens” and “inorganic pathogens.” Many friends have asked: who exactly was this Zhu Weiju? Today I’d like to talk about him. His standing was actually similar to Zhang Xichun’s — both were masters of integrating Chinese and Western medicine — it’s just that not many people know about him today.

I. From Shaoxing to Chengdu: An Inquisitive Child

Zhu Weiju was a native of Shaoxing, Zhejiang. His father died when he was young, and he was sent to live with his uncle’s family in Chengdu. What did his uncle do? He managed the salt administration — and as everyone knows, the salt business was extremely lucrative back then. His uncle later went into commerce and made a lot of money. The family’s library was exceptionally rich, and Zhu Weiju read widely as a child. He was a very clever boy.

💬 Note from Doctor Luo: His uncle also hired several famous Confucian scholars to tutor him, and brought in a Chinese medicine teacher as well. But as the lessons went on, the teachers found the boy hard to teach — the questions he asked were too far ahead of his time, and the teachers couldn’t answer them. In the end there was nothing to do but let him study the books on his own. And so he advanced, teaching himself as he went.

II. A Fire-Spirit Doctor Who Had Studied Western Medicine: Fu Zi Was His Favorite Herb

Later he entered Sichuan’s military medical school to study Western medicine, where he studied for two years. Then he had the opportunity to go to Japan with the school’s Japanese teachers, and after completing his studies he returned to Chengdu.

💬 Note from Doctor Luo: As everyone knows, Sichuan has a school of Chinese medicine called the Fire Spirit School (Huo Shen Pai), which is especially skilled at using fu zi (aconite). Living in Chengdu, Zhu Weiju absorbed this tradition and studied it, gradually forming his own academic style — a particular mastery of fu zi. This became his most distinctive trait.

III. The “Odd One Out” in Shanghai: The Whole Street Cleared Heat; He Insisted on Warming Yang

After practicing in Chengdu for a time, he moved to Shanghai. Shanghai is in the south of the Yangtze, and at the time the dominant tradition there was the Warm Disease School (Wen Bing Pai) — the view that external pathogens are chiefly warm and heat evil, so its practitioners were especially good at clearing heat, eliminating dampness, and cooling the blood. But when one school becomes too fashionable, it tends to go to extremes: without asking why, no matter what illness came in, everyone used cooling herbs to drive out the pathogen.

💬 Note from Doctor Luo: When Zhu Weiju first arrived in Shanghai, he didn’t rush into practice. Instead he went incognito, visiting one clinic after another to see how the doctors wrote their prescriptions. And the more he watched, the more disappointed he became: these famous physicians treated every patient by clearing heat, no matter what the disease was. Their diagnosis was indeed remarkably accurate — they could tell whether the disease was at the qi level or blood level, when a patient was in danger, even when a patient would die. They could read a disease like a book. But their treatment was useless — one wrong step led to another, the pathogen could never be driven out, and the patients were never cured. Watching this, he decided to go into practice himself.

He practiced with his own philosophy — because he had studied Western medicine, he combined the insights of both traditions.

IV. His “New Chinese Medicine” Theory: Organic Pathogens and Inorganic Pathogens

Zhu Weiju believed that when external pathogens invade, the six channels (liu jing) described in the Shang Han Lun (Treatise on Cold Damage) are all reactions of the body’s resistance to the pathogen.

What do external pathogens include? Organic pathogens and inorganic pathogens. The six excesses (liu yin) that traditional Chinese medicine spoke of — wind, cold, summer heat, dampness, dryness, fire — are the influences of the external environment on the body, and the most important thing among them is the body’s own response to that environment. For example, when you’re chilled by cold and your body shivers, we call that “cold” a pathogen — but actually it’s your own body’s reaction. That is an inorganic pathogen. And under the disturbance of the inorganic pathogen, organic pathogens — bacteria, viruses, those living organisms — enter your body, multiply, and work their way inward. When both kinds of pathogens have entered, the body puts up various states of resistance, and these states are the six channels.

💬 Note from Doctor Luo: He put it very vividly — the Tai Yang pattern is the body rousing itself to fight the pathogen; the Shao Yang pattern is when the energy for fighting is a little insufficient — like a battery that’s running low, the light flickers on and off, the body has power one moment and none the next, so the resistance comes and goes in waves; the Yang Ming pattern is resisting too hard — the body throws huge amounts of energy into the fight, high fever, an excited hyperactive state — like the excessive immune response we talked about a couple of days ago, the cytokine storm, which is when you want to suppress the reaction a little; the Tai Yin pattern is insufficient resistance, and the Shao Yin pattern is even more insufficient resistance — both occur when the body’s reserves were low to begin with or have been exhausted by illness, so it sinks into a low state; and the Jue Yin pattern is the body’s final rally — a turning point: either it conquers, or it fails. So the six-channel pattern differentiation is, throughout, the different states of the body’s resistance to pathogens.

He had no quarrel with Western medicine. When foreign doctors came to Shanghai, he even joined with two of them to open a Sino-Western clinic — three doctors, two Western and one Chinese, seeing patients together. In the Shanghai of that time, this was extremely fashionable.

V. The Case That Made Him Famous: Pediatric Master Xu Xiaopu’s Son and the Midnight Question, “When Did He Pass?”

When he first started practicing in Shanghai, people didn’t accept him, and he had few patients. But after several famous cases, his reputation soared. The most famous of them involved Shanghai’s great pediatric physician Xu Xiaopu.

💬 Note from Doctor Luo: Xu Xiaopu’s family had practiced pediatrics for generations — he was a bona fide pediatric master of the Warm Disease School, very famous in Shanghai. He had two sons, both of whom he later entrusted to Zhu Weiju to teach. One of them, Xu Zhongcai, later became a great pediatric physician in Shanghai in his own right, living until 2001.

The story goes that Xu Xiaopu’s son Xu Boyuan fell ill with severe febrile disease — a grave external-cold illness. The boy had already sunk into a coma: unconscious, twitching, raving nonsense — the classic presentation of clouded mind with delirious speech (shen hun zhan yu). At the time, many physicians were called in — Xu Xiaopu was himself a master, the “King of Pediatrics” of Shanghai, and many famous doctors were his friends — but every one of them prescribed cooling herbs: if he’s delirious, there must be heat, clear the heat! Not the slightest effect.

When the case turned critical, Zhu Weiju was summoned. Zhu Weiju took one look: you have to see what state this child is in — his upright qi (zheng qi) is insufficient; he lacks the strength to fight the pathogen. What he needs is to warm the yang, to rouse the body’s own qi so it can drive the disease out. The cooling herbs you’ve all been using are like giving the disease “ice support” — the more you use them, the weaker the upright qi becomes. So he prescribed warming herbs: ma huang (ephedra), fu zi (aconite), and gan jiang (dried ginger).

💬 Note from Doctor Luo: The other doctors were horrified — my heavens! The child is already unconscious, heat at its peak, and you prescribe herbs this hot? Even Xu Xiaopu didn’t dare give them to the child. Zhu Weiju asked: why is there still no effect? That’s wrong — you must not have given the medicine. When he saw the medicine really hadn’t been given, he grew impatient: fine, I’ll write you a guarantee! Zhu Weiju had a habit of writing guarantees: if I fail to cure him, smash my signboard, I take full responsibility — and I’ll give you a time limit, cured within a number of days. He said: just give him my formula, don’t delay, or it will be dangerous.

Xu Xiaopu had no choice but to steel himself and give the child the medicine. And while the child took it, Zhu Weiju personally supervised — and after it was done he still didn’t leave: “If I go, you might reduce the dose or stop giving it, so I’ll stay right here.” The two men sat together in the room.

In the middle of the night, a servant came rushing in panic to find Xu Xiaopu. Xu Xiaopu’s heart sank, and he asked one thing: “When did he pass?” — he assumed the child had given out; why else would the servant be so frantic? But the servant said: “The child is awake.” Half disbelieving, Xu Xiaopu rushed out — and sure enough, the child was awake, and even eating! Remarkable — Master Zhu was truly something!

💬 Note from Doctor Luo: Then Zhu Weiju was asked to write another prescription, and within a few doses the child was saved. Xu Xiaopu mulled it over for days — the shock was too great: “I’m called a pediatric master. My family’s signboard has stood for generations. The ‘King of Pediatrics’ sign hangs over my door — and I couldn’t even cure my own child. Master Zhu cured him in a few doses. I have no face left to hang my sign!” He had the signboard taken down and carried to Zhu Weiju: “Master Zhu, your skill is far above mine. I no longer dare call myself a pediatric master. Let me be your disciple!” Zhu Weiju replied: “You and I are brothers — how could we become master and disciple? Tell you what — entrust your two sons to me, and I’ll teach them.”

And those two boys later both became great pediatric physicians. As for Xu Xiaopu and his sons, in their later prescriptions they always used the trio of gan jiang (dried ginger), xi xin (asarum), and wu wei zi (schisandra), and they too became skilled with fu zi — they had completely converted to Zhu’s school. Xu Xiaopu set aside his original doctrine, and their family clinic drew enormous numbers of patients, several hundred a day.

VI. Fighting Again in Shanghai: The Cigar-Smoking Famous Doctor Said Two Words: “Finished”

Zhu Weiju’s fame also had to do with his temper — he was a superb debater and loved to debate. His temper was somewhat fiery and impatient, and he could not tolerate a grain of sand in his eye.

💬 Note from Doctor Luo: Once someone invited him to see a patient — a family’s child was seriously ill, quite similar to Xu Xiaopu’s son, already nearly unconscious. Other doctors had failed, and Zhu Weiju prescribed warming-yang herbs and left. The family was rich, so they invited more physicians — including a famous Shanghai doctor who was very celebrated at the time. The famous doctor looked at the prescription: these herbs are far too hot! Acrid-drying medicinals — too hot, this can’t be cured; the child has been ruined by this treatment, he’ll surely die — and wrote “incurable” on the medical record. As it happened, the famous doctor finished his visit and came downstairs just as Zhu Weiju was going up. Zhu Weiju had just arrived in Shanghai and still needed to pay his respects to the local powers, so he was very courteous, greeting the man with a smile. But the famous doctor looked down on him — puffing his cigar, he turned his face away and said two words: “Finished.” — This one’s done for, ruined by that treatment.

When Zhu Weiju saw the record reading “acrid-drying medicinals used — incurable,” and recalled the sneer on that famous doctor’s face, he was disgusted. The family still wanted to use the famous doctor’s herbs, but Zhu Weiju said: “I practice with a signature habit — I write a guarantee: if I ruin the case, you may smash all three signboards of my clinic. If I neither cure nor worsen him, I’ll treat him for five days only; after five days with no change you’re free to call another doctor, no harm done. But if I cure him, you must write down the whole story and go tell it publicly.” The family said, fine, let’s try. Zhu Weiju used his warming-yang method and cured the child in a few days.

💬 Note from Doctor Luo: Once it was cured, Zhu Weiju said this isn’t over — that famous doctor insulted me in front of everyone and even wrote on the record that I’d ruined the case. That won’t do. You must take out a newspaper notice and tell the story! As it happened, a Chinese medicine convention was being held in Shanghai at the time — the Nationalist government was trying to abolish Chinese medicine, and the practitioners had united to protest. Zhu Weiju, with his impatient temperament, took the floor: “Is clinical effectiveness the first standard of Chinese medicine?” The chairman said, of course it is. “And a so-called famous doctor who fails at treatment, then slanders his colleagues and accuses them of harming patients — what should be done with him?” The chairman said: “He is a disgrace to Chinese medicine; he must be expelled!” Zhu Weiju then produced the medical record and all the evidence… The hall erupted — everyone normally protected each other’s face, and such a move was unbearable; the meeting broke up quickly. Later someone held a private banquet, a reconciliation dinner, to patch things up between them. Zhu Weiju had wanted to keep pressing, but in the end he let it go. After this affair he became extremely famous and influential in Shanghai.

VII. Disciple Chen Susheng and Shanghan Zhinan: A Qi Bo–Yellow Emperor Style Dialogue of Teacher and Student

Later, the arrival of one physician added a great deal of color to Zhu Weiju’s legacy — much of his writing was preserved by this man. Who? Chen Susheng.

💬 Note from Doctor Luo: Chen Susheng was also someone I encountered very early in my own study of Chinese medicine. He had studied under two teachers and was already somewhat known in Shanghai. But one event shook him deeply — a relative, an elder in his family, fell ill with an external febrile disease; Chen Susheng prescribed for him, but nothing worked, and the man died. He said the shock was enormous: staring wide-eyed, “How did I fail to cure him? My skill is inadequate — I still have much to learn!” So he went searching for famous doctors, and someone recommended Zhu Weiju: “This man is genuinely formidable. Go study with him.”

Chen Susheng called on Zhu Weiju, and the two talked at length. Chen Susheng was a very down-to-earth man — actually already a minor famous physician with ideas of his own — and during the conversation he often challenged and pushed back. But after Zhu Weiju explained things to him, he was convinced: this is a master! So he formally became Zhu Weiju’s disciple and studied under him from then on.

The dialogue between teacher and student — Chen Susheng asking, Zhu Weiju answering — became a book: the Shanghan Zhinan (Hard Questions on Cold Damage) that I have long recommended.

💬 Note from Doctor Luo: This book is beautifully written. It imitates the style of the dialogues between Qi Bo and the Yellow Emperor in the Huang Di Nei Jing (Yellow Emperor’s Inner Canon), and many of its ideas are actually very advanced. In the Republican era, Zhu Weiju already felt: there are many ideas in Western medicine that we should adopt, to look at Chinese medicine from new angles and develop it. He once wanted to take this book to a conference in Beijing to debate the Chinese medicine establishment, but because he died fairly young, that never took shape. His thinking was excellent — very embracing of Western medicine.

VIII. “The Older the Better” Harms Chinese Medicine: His View of Development

Zhu Weiju believed that Chinese medicine must develop — that its development is precisely the process of broadly absorbing knowledge from every direction. Chinese medicine is therefore a doctrine full of vitality.

💬 Note from Doctor Luo: Many people today hold views less progressive than those of the Republican era. There’s a trend now: the older the better — mention development and you’re called a fake practitioner; you must practice “ancient Chinese medicine,” “pure Chinese medicine.” I think these are ideas that harm Chinese medicine. When bacteria and viruses appeared, Western medicine went and studied them — why shouldn’t Chinese medicine study them too? Organic pathogens can be researched; once brought into the Chinese medicine framework, we can classify their characteristics. Why not? An ultrasound machine is just equipment — it doesn’t belong to either tradition. It’s a device developed by people studying mechanics; Western medicine can use it, so why can’t Chinese medicine? If a good thing is sitting there, and Western medicine is allowed to eat it, why can’t Chinese medicine? It is only a piece of equipment produced by scientific development. So we should also develop and learn from it — Zhu Weiju, in his era, already held this inclusive, open-minded, progressive vision for Chinese medicine: looking at Chinese medicine from another angle, trying to uncover the principles inside it. That is truly precious.

IX. Among the Circle of Famous Doctors: “Unimpeded Eloquence” — Lu Yuanlei, Qin Bowei, and Cheng Menxue

Did the Chinese medicine establishment of the day mock him? No — on the contrary, many Chinese physicians deeply admired Zhu Weiju.

💬 Note from Doctor Luo: For example, the famous Shanghai physician Lu Yuanlei — friends who love Chinese medicine will know that he was on brotherly terms with Zhang Xichun in the north, equals in rank — Lu Yuanlei said: “Men like Zhu Weiju have unimpeded eloquence; they are extraordinary debaters. I admire his learning — I feel ashamed to be his inferior.” Then there was Qin Bowei, who after Liberation was transferred to Beijing and became one of the founding elders of Beijing University of Chinese Medicine, one of the founders of the Beijing College of Chinese Medicine. Qin Bowei said: “When I’m with Zhu Weiju, all I can do is listen — I don’t even get a chance to open my mouth.” He was such a powerful talker, his theoretical ability so strong. And there was Cheng Menxue, also a famous physician, who was very close to Zhu Weiju; after work they’d sit and chat.

X. The Underground Party in His Clinic

Zhu Weiju’s clinic flourished — two Western doctors and one Chinese doctor, very fashionable in Shanghai at the time. And before Liberation, his clinic was also a meeting place for underground Communist Party members.

💬 Note from Doctor Luo: This is something most people don’t know. I have a good friend who always told me that a relative of his was a famous Chinese physician in Shanghai. For years I had no idea who he meant. Eventually I asked him: what was your relative’s name? He said: Zhu Weiju. My heavens! That’s a famous physician — a truly great one! He told me Zhu Weiju leaned strongly toward the Communist Party, and that many underground party members’ activities were arranged with Zhu Weiju’s help — he let them secretly meet at his home. His daughter is now very old, in her nineties, living in a nursing home. My friend said if you want to interview her, hurry — that was several years ago; I’ve been busy ever since and never made it.

XI. His Later Years: Laryngeal Cancer and a Fiery Temper

So how did Zhu Weiju die? Laryngeal cancer — he passed away before reaching seventy.

💬 Note from Doctor Luo: I think this had something to do with his fiery temperament. In those years in Shanghai he was constantly at war with the Warm Disease School; the establishment wouldn’t accept him, and he overreacted — often angry — and in the end he developed laryngeal cancer. Before he died, he traveled the whole country, visiting old friends and relatives, and then he passed away — a great pity. Had he lived longer, I believe he would have written many more books. A person’s character often determines what disease he finally gets and what problems finally come — this is fate, and it is tied to character.

XII. Legacy: Chen Susheng’s Triumph in Xinjiang, and Yan Dexin Transcribing His Prescriptions

Zhu Weiju passed all his learning to his disciple Chen Susheng. Chen Susheng’s later fate was turbulent — during the Cultural Revolution he was sent down to Xinjiang.

💬 Note from Doctor Luo: This Elder Chen was truly remarkable. Not long after I began studying Chinese medicine I was reading Chen Susheng’s books — in Xinjiang he encountered an enormous number of patients, because he was working at the grassroots level. So Chen Susheng’s learning was formed in Shanghai, tempered in Xinjiang — refined in Xinjiang — and reached its full maturity in Xinjiang. He eventually became a great physician of a generation.

In those Shanghai days there were many others who transcribed prescriptions under Zhu Weiju — for example, National TCM Master Yan Dexin. When he was young, Yan Dexin transcribed prescriptions under Zhu Weiju, absorbing all the useful parts of his academic thought; later he studied the doctrines of every other school as well, and ultimately became a master of his generation, with students everywhere in Shanghai. The influence of Zhu Weiju’s thought can still be seen around Shanghai today — many doctors in the Shanghai area are skilled with fu zi, and that all traces back to him.

💬 Note from Doctor Luo: Why have I told Zhu Weiju’s story today? In the Republican era, in the north there was Zhang Xichun, who began integrating Chinese and Western medicine, trying to bring in Western knowledge to develop Chinese medicine; in the south there were physicians like Zhu Weiju — somewhat later than Zhang Xichun, but with similar ideas: also hoping Chinese medicine would develop, hoping for the integration of Chinese and Western medicine, for the good of Chinese medicine. This kind of inclusive, enlightened, open-minded vision — I think it is wonderful. Today Zhu Weiju’s doctrines have not been fully carried forward, but his doctrines made an excellent beginning — if everyone would study his thought carefully, research on cold damage and on external febrile disease would gain enormously, and rise to another level.

💬 Note from Doctor Luo: Because I read Zhu Weiju’s books early in my study of Chinese medicine, I got rid of the “is my cold wind-cold or wind-heat?” confusion very early on — which kind of cold do I actually have? That confusion left me long ago, and I benefited greatly. That’s why I recommend him today. Another time, when the opportunity comes, I’ll tell more stories of the great physicians of Chinese medicine.

This article is compiled from Doctor Luo Dalun’s storytelling on the physician Zhu Weiju. Zhu Weiju (1884–1951), a native of Shaoxing, Zhejiang, was a great Republican-era Shanghai physician, author of Shanghan Zhinan (Hard Questions on Cold Damage, question-and-answer dialogues with his disciple Chen Susheng, published in 1947).