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Bi Syndrome (Arthralgia Syndrome)
痹 症
Lectured by Prof Engin CAN/Enqin Zhang
Senior Consultant and Prof in Chinese Medicine
Chief Author of A Practical-English Library of TCM-14 Books
Manager and Chief Dr of EVERWELL Chinese Medical Centre
London Clinic 7, 36 Gerrard Street, W1D 5QA
(This handout is for year 4 of TCM students of Middlesex University)
E-mail: prof.engincan@hotmail.co.uk
Lecturing Date& Time: Thursday, 11/12/2008 at 1.30-4.30pm
Lecturing Address: Middlesex University Archway Campus, London, the U.K.
The word ‘Bi’痹 in Chinese means an obstruction or blockage. Bi Syndrome
refers to the syndrome characterized by the obstruction of qi and blood
in the meridians due to an invasion of external pathogenic wind, cold and
dampness, manifestedas soreness, pain, numbness, heavy sensation,
swelling of joints, limbs, limitation of movements and so on.
As joint pain is one of most common symptoms in Bi syndrome, so some
Western doctors and editors often translate Bi syndrome into ‘Arthralgia
Syndrome’.
Clinically, Bi syndrome covers many different conditions in Western
medicine, such as rheumatism, rheumatoid arthritis, osteoarthritis, fibrositis,
lupus, gout, neuralgia and others.
In TCM there are many effective therapies for Bi syndrome, including
acupuncture, moxibustion and herbal medicines.
Aetiology and Pathology
According to TCM theory and our clinical experiences, Bi syndrome
can be caused by either external factors or internal factors.
(1）External factors – the invasion of the muscles, joints and meridians
by pathogenic wind, cold and dampness. In Chapter 43 “The Bi
Syndrome in Plain Questions”素问, a part of “The Yellow Emperor’s
Canon of Internal Medicine” 黄帝内经 (BC475-221), Dr Qibai says that ‘if pathogenic wind, cold and dampness invade
the body together, it will lead to an obstruction in the meridians and Bi
syndrome may take place’. Clinically, we can also see
that Bi
syndrome is more common in the areas where the weather is
cold, wet and windy.
(2)Internal factors - general weakness of the body and the defensive qi:
This condition may cause the weakened resistance to pathogens, marked
by dysfunction of skin and pores. As a result pathogenic wind, cold a
nd dampness can easily invade the body causing
Bi syndrome.
This was described in a book “Prescriptions for Succouring
Sickness”济生方by Dr Yan Honghe in 1253, he states that ‘it is because
of weakness of the body with poor function of defensive qi that invasion
of pathogenic wind, cold and dampness can result in Bi syndrome’.
Now we can see that basic pathology of Bi syndrome is an
obstruction of qi and blood in the meridians, due to an invasion
of pathogenic wind, cold and dampness. According to TCM theory,
if the qi and blood in the meridian circulate smoothly, there will
be no pain; but if the meridian is obstructed and the flow of qi and blood
is blocked, pain will arise.
However, the constitution of the body differs from person to person, for
example, with people that live in the same area, some suffer from Bi
syndrome, while others are not affected. Additionally,
after suffering Bi syndrome, if the patient has excess yang or
accumulated heat in the body, wind-cold-dampness
type of Bi syndrome may transfer into heat type of Bi
syndrome.
Furthermore, if pathogenic wind, cold and dampness stay in the
meridians for a long time, the basic pathogenesis may change into
blood stasis type of Bi syndrome. This is why clinically we
often see
some long-term patients with Bi syndrome manifested as blood stasis type.
According to Chapter 43 Bi Syndrome in “Plain Questions”素问 of “Yellow Emperor’s Canon of Internal Medicine”黄帝内经 the Bi condition can also develop and turn into bone bi, tendon bi,
blood- vessel bi, muscle bi and skin Bi; as five zang-organs
are connected externally with their corresponding meridians
and tissues, so pathogens which linger in the meridians and
tissues including bone, tendon, blood vessel, muscle and skin
may gradually seep into the internal organs. For example, bone
bi may develop into kidney bi; tendon bi into liver bi; blood
vessel bi into heart bi ( most common); muscle bi into
spleen bi; skin bi into lung bi and so on.
Differential Diagnosis
Clinically, we often classify Bi syndrome into the following patterns:
1. Wind Bi 风痹 (wandering arthralgia行痹) syndrome: wandering arthralgia, accompanied with aversion to wind,
white or greasy fur and floating pulse.
2. Cold Bi 寒痹(painful arthralgia痛痹) syndrome: severe stabbing arthralgia with fixed location as well
as local cold sensation, alleviated by warmth, aggravated by cold, white
fur and tight pulse.
3. Dampness Bi湿痹 (fixed arthralgia着痹) syndrome: soreness and fixed pain in the joints with local swelling
and numbness, aggravated on cloudy and rainy days, white and greasy
fur, soft and slow pulse.
4. Heat Bi 热痹 (heat arthralgia)
syndrome: arthralgia with local redness,
swelling and burning sensation, accompanied with fever, sweating and thirst,
yellow and greasy fur, slippery and rapid pulse.
5. Blood Stasis Bi 瘀血痹
syndrome: long-term intermittent arthralgia with swelling, rigidity and
deformity of joints, numbness of limbs, purplish dim tongue with ecchymosis,
white or greasy fur, thready and unsmooth pulse.
6. Heart Bi syndrome心痹 syndrome: palpitation, chest stuffiness, pectoral pain, shortness of
breath, even bluish discoloration of face, lips and finger nail, cold limbs,
dark red tongue with little coating, faint or irregular pulse. This type can be
seen in cases with mitral stenosis(二尖瓣狭窄)and mitral incompetence
(二尖瓣 关闭不全).
Bi Syndrome in Western Medicine
In Western medicine, many diseases may be manifested as ‘Bi syndrome’,
but mostly can be seen in the following diseases:
1. Rheumatism
It generally occurs as delayed sequel to group A haemolytic streptococcal
infection. Rheumatism involves the connective tissues in the heart, joints,
skin, vessels and others. It commonly appears in young adults between
the ages of 20-30 and manifests as migratory polyarthritis. The large joints
of extremities are most frequently affected, marked by redness, swelling,
heat sensation and pain of the joints during acute stage, some patients
may
also have annular erythema, subcutaneous nodules, chorea and other symptoms.
Laboratory tests show elevated erythrocyte sedimentation rate (ESR),
positive C-reactive protein or increased white cell count etc. Repeated
reoccurrences may cause heart valvular diseases (such as mitral stenosis
and/or mitral incompetence) .
2. Rheumatoid arthritis
The aetiology and pathogenesis have not been fully known so far, but most
scholars believe that it’s a kind of autoimmune disease with abnormity of
humoral immunity and cellular immunity, manifesting as symmetric
polyarthritis mostly with small joints of hands, wrists, and feet involved.
This is marked by pain, swelling and rigidity of joints, usually aggravated in
morning and alleviated by exertion. Laboratory tests show blood sedimentation
(ESR increased, blood RF positive, etc. But it doesn’t cause heart
valvular disease.
3. Osteoarthritis:
It is also manifested as a type of Bi (arthralgia)syndrome,
marked by breakdown and eventual loss of cartilage in one
or more joints. Before the age of 45, it occurs more in males; while after
age 55, more in females. It commonly affects the hand, feet, spine and
large weigh-bearing joints such as the hips and knees, and manifests as
joints pain and swelling, finally leading to limitation of joint mobility.
3. Fibrositis:
It is a chronic condition marked by stiffness and tenderness of muscles,
tendons and joints, also accompanied with restlessness, sleep awakening
feeling tired, fatigue, anxiety, depression, disturbance in bowel function.
Its cause is not known yet.
TCM Treatments:
1. Acupuncture and Moxibustion
Basic Acupoints:
Dazhui (Du 14),
Hegu (LI 4)
Quchi (LI 11),
Jianyu (LI 15),
Waiguan (SJ 5),
Wangu (SI 4),
Huantiao (G 30),
Xuanzhong (G 39),
Jiaji (Extra15),
Fengshi (G 31),
Yanglingquan (G 34),
Dubi (S 35),
Kunlun (B 60)
Notes: you can choose local acupoints according to locations of Bi
syndrome.
Supplementary Acupoints:
For Wind Bi (wandering arthralgia) syndrome, add:
Fengmen (B 12), Xuehai (Sp10)
For Cold Bi (painful arthralgia) syndrome, add:
Weiyang (B 39), Guanyuan (Ren 4)
For Dampness Bi (fixed arthralgia) syndrome, add:
Fenglong (S 40), Yinlingquan (Sp 9)
For Heat Bi (heat arthralgia) syndrome, add:
Quchi (LI 11), Erjian (LI 2).
For Blood Stasis Bi syndrome, add:
Xuehai (Sp10), Geshu (B17);
For Heart Bi syndrome, add:
Tongli (H 5), Xinshu (B 15).
Method: Select 6-12 acupoints for each treatment according to the location of pain.
For wind Bi (wandering arthralgia) syndrome, heat bi (heat arthralgia)syndrome and blood stasis Bi syndrome, the reducing method is advisable.
For cold Bi (painful arthralgia) syndrome and dampness Bi (fixed arthralgia)syndrome, the needles should be retained for 30 minutes and moxibustion
is also recommended.
2. Herbal Therapy
Therapeutic principle: dispersing pathogenic wind, cold, and dampness.
1) Basic Herbal Formula:
Modified Juan Pi Tang/Decoction for Treating Bi Syndrome 蠲痹汤，for Bi syndrome of cold, wind and dampness types.
Source: Medical Revelations (Yi Xue Xin Wu) 医学心悟by Dr. Chen Guopeng, 1732
Ingredients:
Qianghuo (Rhizoma seu Radix Notopterygii) 羌活 10g
Duhuo (Radix Angelica Pubescentis) 独活 10g
Guizhi (Ramulus Cinnamomi) 桂枝10g
Qinjiao (Radix Gentianae Mocrofhyllae) 秦艽12g
Danggui (Radix angelicae sinensis) 当归10g
Chuanxiong (Rhizoma Ligustici Chuanxiong) 川芎10g
Haifengteng (Caulis Piperis Futokadsurae) 海风藤 30g
Jixueteng (Caulis Spatholobi) 鸡血藤30g
Sangzhi (Ramulus Mori) 桑枝30g
Administration: All the above herbs should first be soaked in a pot of water
for 2 hours or more and then placed over a high fire until boiling. Then they
are to be simmered over a low fire for 25-30 minutes. Finally, drain the
herbal liquid from the boiled herbs to obtain the decoction for oral use.
Drink half in the morning and the other half in the evening.
For Wind Bi (wandering arthralgia) syndrome, add:
Weilingxian (Radix Clematidis) 威灵仙12g,
Fangfeng (Radix Ledebouriellae) 防风10g
For Cold Bi (painful arthralgia) syndrome, add:
Baizhi (Radix Angelicae Dahuricae) 白 芷 12 g ,
Yuanhu (Rhizoma Corydalis) 延胡索 9 g.
For Dampness Bi (fixed arthralgia) syndrome, add:
Yiyiren (Semen Coicis) 薏苡仁30g,
Cangzhu (Rhizoma atractylodis) 苍术 12 g .
For Heat Bi (heat arthralgia) syndrome, add:
Rendongteng (Caulis Lonicerae) 忍冬藤30g,
Huangbai (Cortex Phellodendri) 黄柏 10g
For Blood Stasis Bi syndrome, add:
Ruxiang (Resina Olibani) 乳香10g,
Moyao (Myrrha) 没药10g,
Dilong (Lumbricus) 地龙12g
For Heart Bi syndrome, add:
Yuzhu (Rhizoma Polygonati Odorati) 玉 竹21g,
Tinglizhi (Semen Lepidii seu Descurainiae) 葶苈子 9g,
Huangqi (Radix Astragali seu Hedysari) 黄芪 30g,
Dangshen (Radix Codonopsis) 党参 15 g .
2) Original Herbal Formulae for Different Type of Bi Syndrome
(1) Qianghuo Sheng Shi Tang/Decoction of Notopterygium
for Dispersing Dampness 羌活胜湿汤，for Wind Bi syndrome.
Source: Nei Wai Shang Bian Huo Lun/Clarifying Doubts about Injury
from Internal and External Causes内外伤辨惑论, by Dr Li Gao , in 1247.
Ingredients:
Qianghuo （Rhizoma seu Radix Notopterygii 9g羌活
Duhuo (Radix Angelicae Pubescentis) 独活9g
Gaoben (Rhizoma et Liguistici) 藁本4.5g
Fangfeng (Radix Ledebouriellae) 防风4.5g
Zhigancao (Radix Glycyrrhizae Praeparatae) 炙甘草4.5g
Chuanxiong (Rhizoma Ligustici Chuanxiong) 川芎4.5g
Manjingzi (Fructus Viticis) 蔓荆子3g
Administration: All the above herbs should first be soaked in a pot of
water for 2 hours or more, and then placed over a high fire until boiling.
Then they are to be simmered over a low fire for 25-30 minutes. Finally,
strain the herbal liquid from the boiled herbs to obtain the decoction
for oral use. Drink half in the morning and the other half in the evening.
Indications: It can be used for Wind Bi 风痹 (wandering arthralgia行痹syndrome; also for exogenous wind-dampness syndrome marked
by heavy sensation and pain of head and back, or general pain of the
body, with difficulty in turning round.
My own experience: Clinically I use this recipe for rheumatic arthritis,
common cold and migraine marked by wind-damp type.
(2) Duhuo Jisheng Tang /Decoction of Pubescent Angelica
and Loranthus 独活寄生汤 – for Cold Bi syndrome.
Source: Qianjin Yao Fang / Thousand Ducat Formulae 千金要方
by Dr Sun Simiao in 652.
Ingredients
Duhuo (Radix Angelicae Pubescentis) 独活9g
Xixin (Herba cum Radice Asari) 细辛3g
Fangfeng (Radix Ledebouriellae Divaricatae) 防风6g
Qinjiao (Radix Gentianae Qinjiao) 秦艽6g
Sangjisheng (Ramulus Sangjisheng) 桑寄生6g
Duzhong (Cortex Eucommiae Ulmoidis) 杜仲6g
Niuxi (Radix Achyranthis Bidentatae) 牛膝6g
Rougui (Cortex Cinnamomi Cassiae) 肉桂6g
Danggui (Radix Angelicae Sinensis) 当归 6g
Chuanxiong (Radix Liguistici Chuanxiong) 川芎6g
Shengdihuang（Radix Rehmanniae Glutinosae）生地黄6g
Baishao (Radix Paeoniae Lactiflorae) 白芍 6g
Renshen (Radix Ginseng) 人参6 g
Fuling (Sclerotium Poriae Cocos) 6g
Zhigancao (Radix Glycyrrhizae Praeparatae) 炙甘草6g
Administration: The source text advises to coarsely grind the above
ingredients. However, today the normal dosage of Sangjisheng is
15-20g, the dosages of others except Xixin are about 9-12g.
For preparing the decoction: All the above herbs should first be
soaked in a pot of water for 2 hours or more, and then placed over a high
fire until boiling. Then they are to be simmered over a low fire for 25-30
minutes. Finally, strain the herbal liquid from the boiled herbs to obtain
the decoction for oral use. Drink half in the morning and the other half in
the evening.
Indications: It can be used for Cold Bi 寒痹 (painful arthralgia痛痹) syndrome, marked by heavy and painful sensation at fixed
location in the back and lower extremities accompanied by
weakness and stiffness , an aversion to cold and attraction
to warmth, palpitation, shortness of breath, or local
paresthesia or numbness.
My own experiences: I usually use this recipe for chronic
rheumatoid arthritis, osteoarthritis, lumbar spondylopathy,
sciatica and sequelae of poliomyelitis of cold bi type.
(3) Yiyiren Tang /Coix Seed Decoction 薏苡仁 汤,for Dampness Bi syndrome.
Source: Ming Yi Zhi Zhang / Displays of Enlightened Physicians 名医指掌by Dr Huang Fuzhong , in 16th century.
Ingredients:
Mahuang (Herba Ephedra) 麻黄6g
Note: In the UK, Mahuang is not allowed to be used, for Damp
Bi, we may use Mugua (Fructus Chaenomelis) 木瓜 instead of Mahuang 麻 黄
Danggui (Radix Angelicae Sinensis) 当归9 g
Cangzhu (Rhizoma Atractylodis) 苍术9g
Yiyiren (Semen Coicis) 薏苡仁 24 g
Guizhi (Ramulus Cinnamomi Cassiae) 桂枝6g
Baishao (Radix Paeoniae Lactiflorae) 白芍6g
Zhigancao (Radix Glycyrrhizae Praeparatae) 甘草3g
Administration: All the above herbs should first be soaked in a pot of
water for 2 hours or more, and then placed over a high fire until boiling.
Then they are to be simmered over a low fire for 25-30 minutes. Finally, strain the herbal liquid from the boiled herbs to obtain
the decoction for oral use. Drink half in the morning and the other half in the
evening.
Indications: It can be used for Dampness Bi湿痹 (fixed arthralgia着痹)syndrome, marked by swelling and pain in the joints (usually of the hands
and feet), numbness, and difficulty in moving the joints, or accompanied
by fever.
My own experience: I use this recipe for rheumatic arthritis
of dampness Bi type.
(4) Xuan Bi Tang /Decoction for Relieving Bi Syndrome宣痹汤，for Heat Bi syndrome.
Source: Wen Bing Tiao Bian / Systematic Differentiation of
Warm Disease 瘟病条辨， by Dr Wu Jutong , in 1798.
Ingredients:
Guangfangji (Radix Aristolochiae Fangchi) 广防己15g
Xingren （Semen Pruni Armeniacae ） 杏仁15g
Yiyiren (Semen Coicis Lachryma-jobi ) 薏苡仁15g
Cansha (Excrementum Bombycis Mori ) 蚕沙9g
Banxia (Rhizoma Pinelliae Ternatae) 半夏9g
Lianqiao (Fructus Forsythiae Suspensae) 连翘9g
Zhizi (Fructus Gardeniae Jasminoidis) 栀子9g
Huashi (Talcum) 滑石15g
Chixiaodou（Semen Phaseoli Calcarati) 赤小豆9g
Administration: Decoct the herbs for oral use.
Indications: For Heat Bi 热痹 (heat arthralgia)syndrome, marked
by heat and pain in the joints, reduced mobility, fever and shaking chills,
a lustreless, yellow complexion, scanty urine, yellow and greasy fur of tongue.
My own experience: I use the recipe acute rheumatic arthritis,
infective arthritis and other conditions marked by heat-damp Bi syndrome.
(5) Shu Feng Huo Xue Tang /Decoction for Dispersing Wind
and Promoting Blood Circulation 疏风活血汤，for blood stasis Bi syndrome.
Source: Dong Yi Bao Jian /Precious Mirror of Oriental
Medicine东医宝鉴by Dr Xu Sun, a Korean, in 1611.
Ingredients:
Danggui (Radix Angelicae Sinensis) 当归2.5g
Chuanxiong (Radix Ligustici Chuanxiong) 川芎2.5g
Weilingxian (Radix Clematidis ) 威灵仙2.5g
Baizhi (Radix Angelicae Dahuricae) 白芷2.5g
Hanfangji (Radix Stephaniae Tetrandrae) 汉防己2.5g
Huangbai (Cortex Phellodendri ) 黄柏 2.5g
Dannanxing (Pulvis Arisaemae cum Felle Bovis) 胆南星2.5g
Cangzhu (Rhizoma Atractylodis ) 苍术2.5g
Qianghuo (Radix et Rhizoma Notopterygii) 羌活2.5g
Guizhi (Ramulus Cinnamomi Cassiae) 桂枝2.5g
Honghua (Flos Carthami Tinctorii) 红花1g
Ganjiang (Rhizoma Zingiberis Officinalis) 干姜1g
Administration: Decoct above herbs to make decoction, drink
the decoction, half in morning, another half in evening.
Indications: It can be used for blood stasis Bi 血痹syndrome,
marked by sharp pain in all the joints due to blood stasis
caused by wind, dampness and phlegm.
Notes: This formula was created by a Korean doctor. The above
dosages are from Japanese
sources. According to my own experience,
the dosage for each herb should be 10g.
(6) Xin Bi Tang /Decoction for Heart Bi Syndrome 心痹汤,for Heart Bi syndrome.
Source: My own experienced recipe.
Ingredients:
Danggui (Radix Angelicae Sinensis) 当归15g
Chuanxiong (Radix Ligustici Chuanxiong) 川芎15g
Chishao (Radix Paeoniae Rubrae) 赤芍15g
Ruxiang （Gummi Olibanum ）乳香9
Lulutong (Fructus Liquidambaris) 路路通15g
Qianghuo (Radix et Rhizoma Notopterygii) 羌活9g
Sangjisheng (Ramulus Sangjisheng) 桑寄生15g
Weilingxian (Radix Clematidis) 威灵仙9g
Yuzhu (Rhizoma Polygonati Odorati) 玉竹21g
Tinglizi (Semen Lepidii seu Descurainiae) 葶苈子9g
Administration: All the above herbs should first be soaked in a pot of water
for 2 hours or more, and then placed over a high fire until boiling. Then they
are to be simmered over a low fire for 25-30 minutes. Finally, strain the herbal
liquid from the boiled herbs to obtain the decoction for oral use. Drink half in
the
morning and the other half in the evening.
My own experience: Since 1985, I have used this formula for rheumatic heart
disease (mitral stenosis and/or mitral incompetence)marked by heart Bi
syndrome manifested as palpitation, chest stuffiness, pectoral pain, shortness of
breath, even bluish discoloration of face, lips and finger nail, cold limbs, dark
red tongue with little coating, faint or irregular pulse. It is effective to relieve
symptoms.
3) Common Herbal Pills
(1) Qu Feng Wan/Pills for Dispersing Wind驱风丸
Ingredients:
Tianma (Gastrodiae) 天麻
Qianghuo (Rhizoma seu Radix Notopterygii) 羌活
Duhuo (Radix Angelicae Pubescentis) 独活
Duzhong (Cortex Eucommiae) 杜仲
Huainiuxi (Radix Achyranthis Bidentatae 怀牛膝
Bixie (Rhizoma Dioscoreae Hypohlaucae萆解
Danggui (Radix Angelicae Sinensis) 当归
Shudihuang (Rehmanniae Praeparatae) 熟地黄
Xuanshen (Radix Scrophulariae) 玄参
Indications: For Bi syndrome marked by Wind Bi type accompanied with deficiency
of the kidney and blood.
Administrations: 12 pills each time, 2 times a day.
(2) Xiao Huo Luo Dan/ Pill for Activating Energy Flow in the Meridian and
Collaterals) 小活络丹
Ingredients of the Original Formula:
Zhichuanwu (Radix Aconiti Praeparatae) 制川乌180g
Zhicaowu (Radix Kusnezoffii Praeparatae) 制草乌 180g
Dilong (Lumbricus) 地龙 180g
Zhitiannanxing (Rhizoma Arisaematis) 制天南星 180g
Ruxiang (Resina Olibani) 乳香66g
Moyao (Myrrha) 没药66g
Administration: Make the above herbs into pills, 8 pills each time,
1-2 times a day.
Indications: This can be used for treating Bi syndrome of cold type
or blood stasis type. It can be also used for infertile and
dysmenorrhea.
Notes: This original formula can not be found in the UK, because
the ingredients Zhichuanwu and Zhicaowu which contain Wutoujian
(aconine)are highly toxic. If you make a decoction of the formula, it is
needed to be boiled for one –two hours, as the long time boiling can
change its Wutoujian/aconine into Wutoucijia (sub-aconine) which
has just 1-2 %of Wutoujian’s toxin with the same efficacy. Additionally,
when we meet patients with aconite poisoning, we should give patient
Atropine injection and other supporting therapies
on time to save our patients.
Today in the UK, we can find Xiao Huoluo Dan with a new formula
without any toxin, consisting of following ingredients:
Dihuang ( Radix Rehmannia) 地黄
Danggui ( Radix Angelica Sinensis) 当归
Ruxiang (Resina Olibani) 乳香
Moyao (Myrrha) 没药
(3) Mugua Wan/ Chaenomeles Fruit Pill 木瓜丸
Main ingredients:
Mugua (Fructus Chaenomelis) 木瓜
Danggui (Radix Angelicae Sinensis) 当归
Chuanxiong (Rhizoma Liguistici Chuanxiong) 川芎
Baizhi (Radix Angelicae Dahuricae) 白芷
Weilingxian ( Radix Clematidis) 威灵仙
Gouji (Rhizoma Cibotii ) 狗脊
Niuxi (Radix Achyranthis Bidentatae) 牛膝
Haifengteng ( Coulis Piperis Futokadsurae) 海风藤
Jixueteng (Caulis Spatholobi) 鸡血藤
Renshen (Radix Ginseng) 人参
Administration: 8 pills each time, 2 times a day.
Indication: For Bi syndrome marked by numb limbs, pantalgia,
debility of loins and legs, dysbasia, etc.
(4) Er Miao Wan / Two Wonderful Ingredients Pill 二妙丸
Ingredients:
Huangbai (Cortex Phellodendri) 黄柏
Cangzhu (Rhizoma Atractylodis) 苍术
Indications: For Bi syndrome of damp-heat type.
Administration: 8 pills each time, 3 times a day.
(5) Shu Jin Jian Yao Wan / Pill for Relieving Rigidity of Muscle
and Tendon and Strengthening Loins) 舒筋健腰丸
Ingredients:
Jinyingzi (Fructus Rosae Laevigatae 金樱子
Jixueteng (Caulis Spatholobi) 鸡血藤
Qianjinba (Radix Flemingiae Philippiensis) 千斤拔
Heilaohu ( Radix Kadsurae Coccineae) 黑老虎
Fengmi ( Mel ) 峰蜜
Ruxiang (Resina Olibani) 乳香
Niudali (Radix Millettiae Speciosae ) 牛大力
Sangjisheng (Herba Taxilli) 桑寄生
Tusizi (Semen Cuscutae) 菟丝子
Nuzhengzi (Fructus Ligustri Lucidi ) 女 贞子
Yanhusuo (Rhizoma Corydalis) 延胡索
Liangmianzhen (Radix Zanthoxyli) 两面针
Indications: for Bi syndrome.
Administrations: 8 pills each time, 3 times a day.
4) External Treatment
（1） Shang Shi Zhi Tong Gao /Adhesive Plaster for Relieving
Sprain , Rheumatalgia and Myalgia 伤湿止痛 膏
Ingredients:
Herbal extract compound liquid for alleviating pain due to dampness,
wind and cold 伤湿止痛流浸膏;
Methyl Salicylate ( Metthylsalicylatum )水杨酸甲酯
Borneol ( Borneolum ) 薄荷脑
Camphor (Camphora )冰片
Lemongrass extract ( Extractum Herbae Cymbopogonis) 芸香浸膏
Belladonna liquid extract (Extractum Belladonnae Liquidum) 颠茄流浸膏
Actions: Dispelling wind, cold and dampness and promoting blood
circulation to relieve pains.
Indications: Rheumatic arthritis, myalgia and sprain.
Administration: External use, plaster it on the affected area,
and then change it within 6 hours.
Caution: It should be used with care to pregnant women; but not
to the patients with adhesive
plaster allergy and local ulceration.
（2） Gou Pi Gao/ Dog-skin Plaster 狗皮膏
Main Ingredients
Qingpi (Pericarpium Citri Reticulatae Viride) 青皮
Dingxiang (Flos Caryophylli) 丁香
Chuanxiong (Rhizoma Liguistici Chuanxiong) 川芎
Danggui (Radix Angelicae Sinensis) 当归
Qianghuo (Rhizoma seu Radix Notopterygii) 羌活
Dafengzi (Semen Chaulmoograe) 大枫子
Tianma (Rhizoma Gastrodiae ) 天麻
Duzhong (Cortex Eucommiae) 杜仲
Actions: Expelling wind and dispersing cold, relaxing muscle and
tendons, promoting blood circulation and alleviating pain.
Indications: Bi syndrome due to wind, cold and dampness, pain of
loins and lower extremities, numbness of limbs and trunk, traumatic
injuries. It can be used to treat rheumatalgia, neuralgia,
and redness, swelling and pain caused by sprain, etc.
Administration: Warm it soft and then apply it to the affected areas， change it every 6 hours.
Life Style and Diet Advice
1) Living Environment: The ancient Chinese ‘Fengshui’ method is the theory and art which
studies how to establish an ideal environment beneficial to prolonging life as well as
preventing and treating diseases including Bi syndrome. It is the comprehensive theory
of ancient architectural planning and design integrating geography, ecology, architecture,
ethics and aesthetics etc. According to Fengshui, people should live at a place with
clear and plentiful water source, fresh air, sufficient sunlight, good vegetation as well as
quiet, secluded and beautiful landscape. Because wind, cold and dampness are the main
factorsto cause Bi syndrome, we should suggest patients with Bi syndrome to live in the
environment which is full sunlight, less wind, cold and dampness.
2) Physical Exercises: TCM has many type of physical exercise, such as Taiji and Qi Gong.
Taiji is more slow type of exercise, very useful to patients with Bi syndrome. While Qi
Gongis a kind of exercise for self-developing Qi / Energy (including natural body’s
defensive qi).We can suggest patients to attend such courses and practice one of them.
References:
1. The Medical Classic of the Yellow Empero
(English edition), Translated by
Dr Ming Zhu, published by Foreign Language Press, in 2001, 2005.
2. Chinese Herbal Medicine Formulae &Strategies, by Dr Dan Bensky& Dr.
Randall Barolet, published by Eastland Press, U.S.A in 1990.
3. A Practical English-Chinese Library of TCM, by Prof Enqin Zhang
(Engin CAN, published by Shanghai TCM University Press in April, 1990;
March, 1999.
Notes: For more information, please ring me on 07846193488; or Google- Enqin Zhang
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