The human body’s “highway” typically refers to the circulatory system, which consists of the heart, blood vessels, and blood. It is responsible for delivering oxygen, nutrients, and hormones throughout the body while removing waste products and carbon dioxide.
A Story of Traffic Congestion
When we enjoy the abundant produce from all over the country, and when we appreciate the exotic cultures of other lands, the first thing we should be grateful for is transportation. It is only through convenient transportation that exchange and markets are made possible. A heavy snowfall before the 2008 Spring Festival disrupted the Beijing-Guangzhou Railway. The disruption of such a key transportation hub prevented many people from returning home for the holiday, and prices for daily necessities—such as vegetables, grain, and cooking oil—soared.
When we read these reports, aside from lamenting the ruthlessness of the snowstorm, we should also recognize the importance of transportation from another perspective. Without unimpeded transportation, our world would lose its connection to the outside; some goods would pile up and go to waste because they cannot be shipped out, while others would be in short supply because they cannot be brought in.
This is true from the perspective of broader social resources. Drawing on the principle of harmony between heaven and humanity, the same applies to our own bodies!
I. How to Lose a Beer Belly
Clinically, many patients come to me asking how to treat their beer bellies and protruding abdomens.
When taking their pulses, I find that their qi and blood are stagnant in the middle jiao. In addition to a distended abdomen, this manifests as a failure of clear yang to rise, leading to a foggy mind; and an inability of clear yang to nourish the limbs, resulting in aching, weak, and limp limbs. For such patients, while using purgative methods may provide temporary relief, it cannot lead to a complete cure. Why is this?
In fact, food consumed by the human body is first digested in the stomach, then processed in the small intestine to separate the clear from the turbid, and finally transported throughout the body via the spleen. During this process, if the spleen’s transport function is impaired—specifically, if its ability to distribute nutrients outward and upward is disrupted—the essence of food cannot be properly utilized. This is akin to a relay race: once the small intestine passes the baton, if the spleen fails to catch it, food will accumulate in the area between the small intestine and the spleen, naturally leading to a distended abdomen.
To understand this principle, simply imagine a snowstorm paralyzing the Beijing-Guangzhou Railway line. The treatment for this type of condition should not involve purgation but rather tonification.
Those practicing Western medicine might wonder: “The person is already so overweight, with so much excess fat—how can they possibly continue taking tonic herbs?”
Yes! Only by tonifying the spleen—restoring its transport and transformation functions—and delivering the accumulated essential nutrients to the limbs can the limbs regain strength. Only by transporting these essential nutrients to the head can a person maintain a clear mind and abundant energy.
Some may ask: If the essential nutrients from food accumulate in the middle jiao for a long time, won’t they turn into pathological byproducts?
Yes, that is indeed the case!
It’s like a traffic jam: if vegetables can’t be transported out and are left piled up at the production site for a long time, they will gradually rot. When spleen deficiency causes a decline in the spleen’s transport and transformation functions, the essence of food—after being absorbed by the small intestine—cannot be distributed throughout the body and remains stagnant in the middle jiao. Over time, it transforms into phlegm-dampness, which is different from the original essence of food. This is why patients with spleen deficiency are prone to producing phlegm.
Consequently, individuals with abdominal obesity (commonly known as a “beer belly”) will achieve better results if they combine spleen-nourishing and qi-tonifying treatments with phlegm-resolving herbs. When phlegm-dampness remains stagnant in the middle jiao for an extended period, it impedes the circulation of qi and blood, leading to a pathological mechanism characterized by qi stagnation and blood stasis. Therefore, the treatment of such patients also requires the appropriate combination of herbs that regulate qi and activate blood circulation.
With this analysis of the condition, the treatment approach becomes clearer.
Spleen deficiency leads to a decline in transport and transformation functions; the essential nutrients from food transmitted by the small intestine cannot be promptly distributed throughout the body, causing them to stagnate and transform into phlegm-dampness. Over time, the accumulation of phlegm-dampness further obstructs the circulation of qi and blood, and this obstruction, in turn, exacerbates the accumulation of phlegm-dampness. Spleen deficiency is the root cause of the condition, while the accumulation of phlegm-dampness is the manifestation of the disease!
For such patients, I typically use the following formula, which has proven to be very effective.
Astragalus, stir-fried Atractylodes macrocephala, stir-fried Atractylodes lancea, Poria, Hawthorn, Bitter Orange, Wood Fragrance, Salvia miltiorrhiza, Ligusticum chuanxiong, Sea Floatstone, and raw Licorice.
Among the herbs used to strengthen and tonify the spleen, Astragalus, Poria, Atractylodes macrocephala, and Hawthorn are indispensable. Astragalus (Huangqi) tonifies qi and strengthens the spleen; Atractylodes macrocephala (Bai Zhu) and Atractylodes lancea (Cang Zhu) dry dampness and strengthen the spleen; Poria (Fu Ling) strengthens the spleen and drains dampness; Wood Fragrance (Mu Xiang) awakens the spleen with its aromatic properties; Hawthorn (Shan Zha) strengthens the spleen, stimulates the appetite, eliminates food stagnation, and resolves blood stasis; Bitter Orange (Zhi Shi) descends qi and transforms phlegm; Salvia (Dan Shen) and Ligusticum (Chuan Xiong) activate blood circulation and resolve blood stasis; Sea Float Stone (Hai Fu Shi) dissolves stubborn phlegm and masses; Licorice (Gan Cao) harmonizes the properties of the
Some may ask: Since there are many herbs that tonify qi and strengthen the spleen, why choose Astragalus (Huangqi) over Codonopsis (Dangshen) or Ginseng (Renshen)? This is because Codonopsis and Ginseng have a nature that tends to be nourishing and heavy; taking them can easily aggravate phlegm-dampness, so they are not suitable for long-term use.
Drawing an analogy to traffic congestion, I have analyzed the treatment of patients with abdominal obesity. In fact, there are many clinical conditions caused by the stagnation of qi and blood circulation—we simply aren’t aware of them.
II. How to Treat Melasma
Many women frequently develop spots on their faces; their originally fair and rosy complexion turns yellowish-brown, naturally dampening their spirits. For those who value their appearance, this is undoubtedly a very serious issue.
When consulting Western doctors, they are often told there is no effective remedy and advised to see a TCM practitioner; when consulting TCM practitioners, the condition is usually dismissed with a simple diagnosis of “endocrine imbalance.” Treatment typically involves soothing the liver and relieving depression, nourishing the liver and kidneys, and tonifying qi and blood. While these methods work for some, they are ineffective for many others. How exactly should these women be treated? Do they truly suffer from “endocrine imbalance”?
The body’s endocrine hormones regulate all the internal organs and every part of the body. The onset of all diseases is related to the endocrine system—hypertension, diabetes, hyperthyroidism, and even chronic prostatitis are all linked to the endocrine system. Therefore, attributing the onset of melasma to “endocrine imbalance” seems inappropriate.
In fact, in the fundamental theories of Traditional Chinese Medicine, there is a saying that succinctly summarizes facial conditions: “The heart governs the blood vessels, and its radiance is reflected on the face.”
The term “radiance” here refers to luster and brilliance. Whether the heart’s vital energy is abundant or deficient is reflected on the face. This is because the face is extremely rich in blood vessels; the qi and blood from the body’s twelve meridians and 365 collateral vessels all ascend to the face and flow through the orifices.
When heart qi is vigorous and the blood vessels are well-nourished, the face appears rosy and radiant. When the heart lacks qi and blood, and blood stagnates in the vessels, spots and acne will form.
These principles can be difficult for non-medical professionals to grasp. I often explain to patients that when traffic in a city is congested, garbage accumulates in many places, and what we see are piles and piles of trash. Similarly, when blood circulation in the facial vessels is poor, “waste” accumulates on the face, forming dark spots.
Patients often ask, “Why is blood circulation in the face so poor?”
This is most closely related to the heart, because the heart governs the blood vessels! All the blood vessels in the body are connected to the heart. When the heart lacks sufficient qi and blood and is unable to propel the blood effectively, blockages naturally occur.
Once you understand these principles, discussing the treatment of melasma becomes much easier, as you’ll know exactly what’s going on. I’ve formulated a highly effective herbal combination that those suffering from melasma may find helpful.
30 grams of Astragalus, 15 grams of Angelica sinensis, 20 grams of Salvia miltiorrhiza, 15 grams of Cinnamomum cassia, 20 grams of Rehmannia glutinosa, 20 grams of Paeonia lactiflora, 10 grams of Ligusticum chuanxiong, 30 grams of rose petals, 8 grams of raw licorice.
The combination of Astragalus and Angelica sinensis forms the Angelica Blood-Nourishing Decoction, a classic formula for nourishing the blood.
Angelica sinensis, Prepared Rehmannia, White Peony, and Chuanxiong make up the Four Substances Decoction, another classic formula for nourishing the blood.
Salvia miltiorrhiza nourishes and invigorates the blood; it is renowned for the saying, “A single dose of Salvia Decoction is as effective as the Four Substances Decoction.”
Cinnamon Twig warms and unblocks the blood vessels, promoting blood circulation.
Rose petals invigorate blood circulation and dispel blood stasis, while also soothing the liver and relieving depression. Not only do they invigorate blood circulation and eliminate dark spots, but they also regulate liver qi to treat rib and stomach pain caused by liver-stomach qi stagnation.
With a total of nine herbal ingredients, this formula effortlessly achieves the goals of tonifying qi, nourishing blood, and invigorating blood circulation to unblock the meridians. When the heart is abundant in qi and blood, and blood flows smoothly through the vessels, one naturally radiates vitality—and there is no need to worry about dark spots appearing on the face.
For those who find taking Chinese herbal decoctions too troublesome, you can purchase astragalus, salvia root, and rose petals—10 grams of each—and steep them as tea. Although this formula consists of only three ingredients, it still delivers the benefits of “tonifying qi and nourishing blood, as well as promoting blood circulation and unblocking the meridians”; it simply takes a bit longer to see results.
For women with facial spots, gently rub your face with your hands about 100 times each session, two or three times a day, until your face becomes red and warm. The principle is simple: rubbing the face promotes blood circulation; as metabolism improves, the spots will gradually fade.
III. How to Deal with Ascending Deficient Heat
In my clinic, I frequently encounter patients suffering from “internal heat,” manifesting as sores and boils. While antibiotics and heat-clearing, toxin-eliminating medications can be effective, some patients experience a recurrence shortly after stopping the medication. What is the reason for this?
In nature, fire is the phenomenon of light and heat emitted during the combustion of matter—it is a form of energy release. We frequently use fire in our daily lives, such as for cooking, lighting cigarettes, and grilling food. The essence of fire is a form of energy transformation. For example, when wood burns, carbon and oxygen molecules combine; after combustion, they transform into carbon dioxide while releasing energy in the form of fire. When the human body ingests carbohydrates, they are broken down internally, releasing energy to sustain vital bodily functions.
In everyday life, we often say, “I’m running a ‘fire.’” So, what exactly is this “fire” we’re referring to?
“Running a fire” refers to the abnormal distribution of nutrients within the body, where they accumulate in certain areas and are eventually released in specific forms; this manifestation of release is collectively referred to as “running a fire.”
In this sense, “fire” is the transformation of the body’s subtle essences—it is the result of the accumulation and waste of nutrients!
It’s like the traffic congestion we mentioned earlier: when the transportation of goods is obstructed, some areas experience accumulation and waste while others face shortages. This accumulation and waste is “excess heat”—or “excess syndrome”—while the shortages represent “deficiency syndrome.”
In summer, if watermelons are grown on a large scale across the country, it’s certainly a good thing that everyone can enjoy them. However, if there are so many watermelons that they cannot all be consumed and they eventually pile up and rot, this constitutes waste resulting from overproduction—which falls under “excess.” However, if the scale of cultivation is not excessive, but watermelons cannot be transported from their places of origin to other parts of the country due to poor transportation infrastructure—resulting in a surplus in the growing regions and a shortage in areas where they are not grown—then although the surplus in the growing regions may rot and be wasted, from a national perspective, this constitutes a “deficiency.”
“Internal heat” in the human body is also categorized as “excess” or “deficiency,” and understanding it this way makes it much easier to grasp.
If there is an excess of nutrients—for example, eating beef and lamb every day or consuming high-calorie foods—and the body cannot utilize these nutrients or store them quickly enough, they are ultimately released in the form of “internal heat.” This is known as “excess fire.” If, for some reason, the body’s nutrients cannot be utilized properly—resulting in deficiencies in some areas and accumulations in others—and are released in the form of “internal heat,” this is known as “deficiency fire.”
The pathogenesis of “excess fire” is straightforward: once the “fire” is released and these excess nutrients are eliminated, the body reestablishes a new balance, and the “internal heat” symptoms naturally subside. The pathogenesis of “deficient fire,” however, is more complex; without addressing the root cause, the condition will not improve. Below, we will analyze “internal heat” in the human body through the process of food metabolism.
When the body encounters obstacles in the digestion and absorption of ingested food in the gastrointestinal tract—preventing it from being converted into components the body can utilize—food accumulates in the intestines, leading to symptoms of “fire,” primarily manifested as dry, hard stools and fever. At this point, the body as a whole is deficient in energy, because the intestines are unable to properly digest and absorb the food.
Although the body can digest and absorb ingested food, it may be unable to convert the nutrients during the absorption process. For example, patients with spleen and kidney yang deficiency have significantly impaired transport of the essence of food; they cannot “transform the coarse into the refined.” Since the body cannot utilize these “substandard” substances, they accumulate internally and lead to “internal heat.” Take diabetes as another example: insufficient insulin secretion by the pancreas reduces the body’s ability to utilize sugar, causing sugar to remain in the bloodstream. When these substances accumulate in various organs and tissues, they easily transform into “internal heat,” resulting in symptoms of “internal heat.”
Even when the zang-fu organs are capable of “transforming the coarse into the refined,” if their transport function is impaired, energy cannot be delivered promptly throughout the body and instead accumulates locally, leading to “internal heat.” This localized energy surplus is commonly seen in surgical conditions such as boils and erysipelas.
In cases where the transport function is intact but the zang-fu organs themselves are diseased, they are unable to utilize the delivered nutrients; these accumulate within the affected organ, ultimately resulting in “internal heat.” For example, in patients with liver qi stagnation, nutrients accumulate in the liver; they cannot be utilized nor transported to other parts of the body. Over time, this accumulation leads to fatty liver, which may eventually progress to cirrhosis. Symptoms such as restlessness and irritability exhibited by the patient are also manifestations of “internal heat.”
In the four situations described above, the cause of “excess heat” is dysfunction of the zang-fu organs, obstruction of the circulation of qi and blood in the body, impaired energy utilization, and abnormal accumulation—all of which manifest as “excess heat.” Additionally, aside from inherent imbalances within the zang-fu organs, the invasion of external pathogens may also lead to diminished organ function, resulting in impaired utilization of nutrients and, consequently, “excess heat”—which is precisely what is meant by “an excess of qi becomes fire.”
With this understanding, discussing specific treatment methods for “excess heat” becomes straightforward.
Excess Fire
The treatment for pure “excess fire” involves methods such as clearing heat and detoxifying, as well as promoting bowel movements to expel heat. For example, taking medications such as Sanhuang Tablets, Niuhuang Detoxification Tablets, or Huanglian Shangqing Tablets—selecting the appropriate medication based on the location of the “fire”—can yield excellent results. At the same time, dietary control is essential to limit the intake of high-calorie foods.
Deficient Fire
The term “deficient” here refers to the person as a whole: while some parts of the body experience “fire,” others are deficient.
① Deficient fire caused by impaired nutrient absorption. In children, “ganji” (chronic malnutrition) results from long-term food stagnation in the intestines, leading to poor absorption and ultimately malnutrition of the five zang organs and six fu organs, with symptoms of deficiency. In such children, because intestinal stagnation generates “fire,” their appetite is actually good; however, the more they eat, the worse the food stagnation becomes, and the poorer their absorption. Therefore, improving intestinal function, regulating the spleen and stomach, and allowing the body to recover naturally is the key to addressing “internal heat” caused by these symptoms.
② Deficient heat caused by impaired transformation and transport of nutrients. In diabetic patients, appetite is generally good and the intestines can absorb nutrients, but the middle jiao experiences an impairment in the transformation of food’s essence—that is, a dysfunction in the “fermentation” (沤) described in the phrase “the middle jiao is like fermentation” (中焦如沤). The spleen cannot “ferment” the nutrients transported from the intestines, nor can it “transform the coarse into the refined.” The “fermentation” process is, in fact, the process by which kidney yang warms the spleen earth and the spleen earth ascends clear yang. If the “fermentation” process is not properly addressed, what the spleen transmits upward to the lungs will consist of turbid essences rather than clear yang. Since the lungs cannot utilize these turbid essences, they instead stagnate there, leading to manifestations of upper-jiao fire—known as “upper consumption” (shang xiao). When these turbid essences are transported outward to the skin, they can easily cause intractable skin lesions; when transported to other zang-fu organs, they can damage those organs because they cannot be properly utilized.
Some practitioners use rhubarb to treat diabetic peripheral neuropathy because it eliminates accumulated turbid essence. With this understanding, it becomes clear that not only rhubarb but also many other herbs that clear fire and eliminate toxins are effective against diabetic peripheral neuropathy!
However, to restore the “fermentation” function of the middle jiao, one must first restore the function of the spleen, and the restoration of spleen function relies on kidney yang. When treating patients in the early stages of diabetes, I often prescribe Gui Fu Di Huang Wan; as the condition worsens, I use Zhen Wu Tang to warm the kidneys and strengthen the spleen, thereby restoring the “fermentation” function of the middle jiao. At the same time, I add raw gypsum to clear stomach fire. When stomach fire is not excessive, patients will not experience frequent hunger or overeat; as the intake of food essence decreases, the spleen’s “fermentation” function in the middle jiao is strengthened, naturally reducing turbid essence in the body and restoring blood sugar to normal levels.
③ “Deficient fire” caused by impaired nutrient transport. In surgical cases, the formation of boils and abscesses stems from circulatory disorders, which lead to abnormal local nutrient transport. Nutrients accumulate and trigger the condition; while it may appear to be “excessive internal heat,” the root cause actually lies in this transport impairment. For such conditions, promoting blood circulation and resolving stasis is an effective approach; once the transport issue is resolved and nutrients no longer accumulate, the condition naturally resolves. For patients with chronic conditions, I often prescribe tonic herbs to replenish deficient energy, which accelerates recovery. The ancient formula Hai Fu San (equal parts of frankincense and myrrh), hailed as the “miracle elixir for reviving and saving lives in surgical cases,” operates on this principle, as Astragalus (Huang Qi) helps expel toxins from the body.
④ “Deficient Fire” caused by impaired utilization of nutrients. For patients with liver qi stagnation, merely clearing and purging liver fire is like skimming the foam off boiling water—it addresses the symptoms but does not resolve the root cause. The fundamental treatment lies in regulating the liver and harmonizing qi to maintain a calm state of mind. When liver qi flows smoothly, the body’s qi and blood circulation becomes unobstructed, preventing stagnation, and liver fire naturally subsides.
⑤ “Internal heat” caused by an invasion of external pathogens. In patients with wind-heat colds, the wind-heat pathogen lodges in the lungs, impairing their dispersing function. This leads to stagnation of qi and blood within the lungs, causing symptoms of “internal heat” such as a swollen and sore throat. Treatment does not involve “clearing internal heat”; rather, it simply requires addressing the wind-heat pathogen by dispelling wind and resolving the exterior, and regulating the flow of qi, which will yield effective results.
Once you understand these principles, you’ll realize that “internal heat” doesn’t necessarily require “heat-clearing” herbs. Sometimes, promoting blood circulation and resolving stasis can clear heat; sometimes, soothing the liver and regulating qi can clear heat; sometimes, nourishing yin and blood can clear heat; and sometimes, using pungent-cool herbs to resolve exterior pathogens can treat “internal heat,” and so on.
To treat a disease, one must address its root cause! What is the root cause? It is the underlying factor that led to the disease, not the disease itself.
The story of traffic congestion reminds me of patients with spleen deficiency and impaired transport, dampness obstructing the middle jiao, and epigastric and abdominal distension; it reminds me of patients with stagnation of qi and blood in the face, resulting in skin patches; and it also reminds me of patients who exhibit various “excess heat” symptoms due to impaired qi circulation within the body. In fact, all of these stem from the same issue: a problem with the channels.
When the channels are obstructed, one side may present with a deficiency pattern while the other presents with an excess pattern;
When the channels are obstructed, one side may present with a cold pattern while the other presents with a heat pattern;
When the channels are obstructed, one side may present with a yang pattern while the other presents with a yin pattern.
Urban traffic is like the city’s blood vessels; if the blood vessels are blocked and stagnation persists over the long term, the city becomes like a pool of stagnant water.
The body’s blood vessels are much like urban traffic. When we see the many problems caused by traffic congestion, we should naturally realize that when the body’s blood vessels are obstructed, the body becomes a stagnant pool of water.
If we recognize the importance of smooth blood flow in the body, we will gain a profound understanding of the treatment of many diseases. By promoting the circulation of cold and heat within the body, fostering the balance between deficiency and excess, and facilitating the transformation of yin and yang—transforming a stagnant pool into a pool of living water—what problem could possibly remain unsolved?
