Two Medical Cases of Lost-Soul Syndrome from Qing Dynasty Famous Doctor Xu Dashun's Huixi Medical Cases

Xu Dashun, courtesy name Lingtai, was a famous physician of the Qing dynasty—but he was more than merely a famous doctor. In Yuan Mei's words: The gentleman was born with exceptional endowment, surpassing others in intelligence and vigor. Whether star classics, geographic records, the Nine Palaces, music theory, or even wielding swords, snatching spears, deploying troops, and the methods of the states of Ying and Yue—none he did not thoroughly investigate—yet he excelled especially at medicine.

In youth he obtained the Tianxing Tu (Star Chart), Tianwen Zhi (Treatise on Astronomy), and Gui Liao Qiao (Ghost Gauge Apertures), mastering astronomical and stellar calculations. When young he read the Tao Te Ching and the Hundred Schools, writing annotations later collected into the Complete Library of the Four Treasuries. At twenty his father had him write a book on water conservancy, and he wrote the Book of Jiangnan Water Conservancy, becoming highly skilled in hydraulic works. Yet because he was physically weak from childhood, he began martial arts at twenty and achieved the ability to lift a three-hundred-jin stone, mastering spear and staff techniques. Later, because his brother fell ill and could not be cured, he self-taught Chinese medicine and became a famous doctor, leaving behind many classic works; the Yongzheng emperor twice summoned him to treat illness. In his spare time he wrote poetry, producing the collection Huixi Daoqing. His mother went blind in old age, so he hired opera troupes to sing; finding the singing inadequate, he researched himself and wrote A Treatise on Transmitting the Voice in Music Bureau—an important source for Chinese traditional performing arts to this day, of great value in vocal technique.

In short, a genius of a man, and extremely rigorous in scholarship. Xu Dashun's medical cases often contain experience summaries, and these experiences are very precious.

I. Zhang Zhenxi of Pinghu: a neighboring wall's house caught fire; startled by the blaze, several days later his illness flared up. No great chills or fever; vexed and stifled, not eating, lethargic and drowsy. When I examined him, he exchanged a few pleasantries, but his spirit did not connect. I said: This is the syndrome of lost soul—not only has wind-cold penetrated deeply, but the spirit-mind is also injured; it cannot quickly recover, nor should heavy prescriptions be used. Use a decoction to dispel the pathogen, and pills or powders to calm the spirit; only thus can there gradual recovery. It was then New Year's Eve; I prescribed half a month's medicine and returned. Not until the Lantern Festival did he know he was in his bedroom; asked about what had passed before, he remembered nothing. By the second month his body was already well. He came with his younger brother Yuanruo to thank me, waiting upon me in the mountains. He also said: Last night a lump rose at the back of my head, slightly painful. I looked, and was alarmed: this is a Jade Pillow abscess—a greatly dangerous syndrome. Lacking medicine here, I urgently went back with him, using both external raising and internal support, all methods together. His brother could not stay long and returned first. Next morning my son cried out in alarm: Master Zhang is dying. I rose and looked: his head had become as large as a bushel, lips over an inch thick, eyes only fine slits; from crown to shoulders thousands of pus blisters—yet his spirit was not confused, the toxin had not attacked the heart, and rescue was still possible. I urgently sent a boat to fetch his brother. First I poured in heart-protecting medicine so the toxin could not invade inward, then used decoctions to support it outward from within, and externally applied medicines to soften hardness, reduce swelling, draw out toxin and raise pus. In one day over a dou of toxin-water flowed out. By evening the swelling gradually subsided and the skin wrinkled. The next day his tongue could move, he could eat; it never became a full abscess, the sore being only the size of a cash coin, scabbing over in several days. When his brother arrived on hearing the news, he was eighty or ninety percent healed. Whenever pathogen remains with no exit, it must erupt as swelling and abscess—there are many such patients, but few doctors can treat them.

Translation: There was a certain Zhang Zhenxi of Pinghu. Because his neighbor's house caught fire, he was frightened; several days later the illness flared up. There were no major chills or fever, but he was vexed, had no appetite, always felt listless, and liked to doze. When I went to see him and exchanged a few pleasantries, the other party ignored me and seemed listless. I said: This is the lost-soul syndrome—because wind-cold has penetrated deeply, and the spirit-mind has also been injured. It was New Year's Eve, so I gave half a month's medicine and left. Later, not until the Lantern Festival did the patient begin to know he was in the bedroom; asked about what happened before, he completely remembered nothing. By the second month his body was already well.

When I went to see him I was greatly alarmed and said this was a Jade Pillow abscess—an extremely dangerous illness, and the place lacked medicine, so I went back with him, using all methods internal and external together. His brother could not stay long and left first. The next morning my child shouted at me that this man was about to die. I rose, went to look, and found his head had grown much larger, his lips over an inch thick, his eyes only a slit half open; from head to shoulders there were large numbers of pus blisters. Only his spirit was not yet confused, meaning the toxin had not attacked the heart and he could still be saved. So I quickly had someone go by boat to call his brother.

First I poured in some heart-protecting medicine so the toxin would not攻 inside; then I used decoctions to support it outward from within, and externally applied medicines to soften hardness, reduce swelling, draw out toxin, and raise pus. In one day a large amount of toxin-water—nearly half a dou—flowed out. By evening the swelling began to subside and the skin wrinkled. By the next day his tongue could turn, his mouth could move, he could eat; it never became a full abscess, and the sore was only the size of a copper cash, scabbing over in a few days. When his brother arrived on hearing the news, he was eighty or ninety percent healed.

Therefore, whenever a pathogen has no way out, it will inevitably erupt as swelling and abscess. There are many such patients, and few doctors who can treat them.

II. The wife of Wu Yuntai of Yangzhou suffered from xiao syndrome (wasting/thirst): day and night she ate dozens of bowls of congee, with rebellious qi and blazing fire, unable to sleep all night. I diagnosed her: all six pulses were fine and rapid, out of order, and her spirit was not clear and bright. I said: This resembles an possessing-spirit pulse; there must be another cause. Her family did not believe. Suddenly one day a maidservant rose in the morning to wait upon her, saw a woman in fine makeup sitting upright on the bed, thought it was the madam, looked carefully and found no one—and so told her. The madam said: This woman often sleeps inside my bed; because of this I cannot sleep, and am vexed and thirsty, wanting to drink. My medicine had not been very effective. One night about half past, the patient cried out: Quickly invite Third Master; on no account open the door—if the door opens my soul will surely walk out. Third Master was her younger brother, Tang Huisheng. The bedroom was far away and her voice could not be heard; the maid privately opened the door to invite him, and the soul at once followed out, wandering through halls, corridors, and places she had never normally trodden. Meeting Tang Huisheng hurrying over, the soul firmly grasped his queue and returned to the room. Seeing her own body lying on the bed, Huisheng stroked her, and the soul reattached to the body. Asked about all she had witnessed, none was wrong. Carefully examining the woman she had seen, it turned out to be the fiancée Yuntai had been betrothed to—she died before the marriage could take place. At death she had told her parents that Wu Lang would surely rise to rank and office; if I die you must implore him to offer me blood-sacrifice and bury me in the ancestral tomb. After Yuntai took office he had no time to attend to it, hence the haunting. Yuntai said to me: You said something was haunting; examining it, it has indeed proven true—you are truly a divine man. How shall we appease her? I said: A ghost, once it has a place to return to, will not become a malign spirit. You should receive the coffin, inter it in the tomb, establish a spirit tablet, and sacrifice to her. Yuntai followed my words, and then the medicine took effect, and the root of the illness was forever eradicated.

Translation: The wife of Wu Yuntai of Yangzhou suffered from upper-xiao syndrome—eating voraciously, easily hungry, consuming dozens of bowls of congee morning and night—with rebellious qi and blazing fire, unable to sleep all night. I examined her and found all six pulses rather abnormal and her spirit not quite clear. I said: This very much resembles a possessing-spirit pulse; there must be another cause. Her family did not believe.

Suddenly one day, when a maidservant rose in the morning and went to await Madam Yuntai's orders, she saw a woman in beautiful clothing sitting upright; she thought it was the madam, but on looking carefully it vanished—so she told the madam. And Madam Wu said: This woman often sleeps in my bed; because of this I cannot sleep, so I am vexed and thirsty and want to drink.

(A middle section is omitted: the household, seeing this situation, again sought medicine from Xu Dashun.)

After taking my medicine, no clear effect was seen. One night the patient suddenly shouted: Quickly invite Third Master; on no account open the door—open the door and my soul will surely run out. (Third Master was her younger brother Tang Huisheng.)

Because the bedroom was large, shouts could not be heard, so the maidservant opened the door herself—and out went Madam Yuntai's soul, wandering through halls, corridors, and places she did not usually go. Later meeting Tang Huisheng arriving, she grabbed his queue and would not let go. When they returned to the room and saw her own body lying on the bed, and the Third Master touched her, her soul returned to her body.

Later, everything Madam Wu said she had seen checked out one by one. Careful investigation revealed that it was the woman Wu Yuntai had been betrothed to with formal gifts—she simply died before the marriage could take place. Before dying, this woman told her parents that Wu Yuntai would surely become an official in the future; if I die you must be sure to sacrifice to me, and bury me in the ancestral tomb.

And after Wu Yuntai became an official he was always busy and had no time to handle this matter—so it became a haunting.

Wu Yuntai said to me: You said something was haunting—and it has actually proven true. You are truly a divine man. I answered: Because after a person dies, if descendants sacrifice to them, the ghost has somewhere to return and will not become a malign spirit. You should arrange a coffin, make a grave, establish a tablet for her, and sacrifice.

Wu Yuntai did as I said, and then his wife's medicine took effect, and the root of the illness was completely eradicated.