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0Lecture
Bi Syndrome (Arthralgia Syndrome)
ZHANG En-qin ^S®
Manager &Chief Dr of EVERWELL Chinese Medical Centre, London Clinic7, London, U.K
The word 'Bi' (in Chinese means an obstruction. Bi Syndrome refers the syndrome characterized by the obstruction of qi and blood in the meridians due to the invasion of external pathogenic wind, cold and dampness, manifested as soreness, pain, numbness, heavy sensation, swelling of joints and 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 acute or chronic diseases in Western medicine, such as rheumatic diseases, rheumatoid arthritis, osteo-arthritis, 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 the author's 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 of Su Wen Plain Questions), a part of The Yellow Emperor's Canon of Internal Medicine BC475-221), said that
'if pathogenic wind, cold and dampness invade the body together, it will lead to 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 as well as the defensive qi :1
This condition may cause the weakened resistance to pathogens, marked by dysfunction of skin and pores as well as defensive qi. As a result pathogenic wind, cold and dampness can easily invade the body causing Bi syndrome, this was described in the book -Prescriptions for Succouring the Sickness / Ji Sheng Fang (i^^), by Dr YAN Hong-he, in 1253, which stated 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 the basic pathology of Bi syndrome is the obstruction of qi and blood in the meridians, due to the invasion of pathogenic wind, cold and dampness. According to TCM theory, if the meridians are open and the qi and blood are circulating smoothly and normally, there will be no pain; but if the meridians are obstructed and the flow of qi and blood are blocked, pain will arise'.
However, the constitution of the body differs from person to person, for example, with people that live in the same condition, some suffer from Bi syndrome, while other will not be affected. After suffering Bi syndrome, if a patient has excess yang by nature as well as accumulated heat, the wind-cold-dampness type of Bi syndrome may transfer into heat type of Bi syndrome.
Additionally, if pathogenic wind, cold and dampness stay in the meridians and cause an obstruction for a
Correspondence to: Prof. ZHANG En-qin Email: prof.engincan@hotmail.co .uk Tel: 44-7846193488
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 the Bi Syndrome of Su Wen of Yellow Emperor's Canon of Internal Medicine the Bi condition can also develop and turn into bone Bi, tendon Bi, blood-vessel Bi, muscle Bi and skin Bi. Further more as the five zang organs are connected externally with their corresponding meridians and tissues, so pathogens linger in the meridians and tissues including bone, tendon, blood vessel, muscle and skin, they 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 (clinically this is most common); muscle Bi into spleen Bi; skin Bi into lung Bi and so on.
Differential Diagnosis
Clinically, the author classify Bi syndrome into following 6 different types:
1. Wind Bi (wandering arthralgia syndrome: Wandering arthralgia without fixed location, accompanied with aversion to wind, white or greasy fur and floating pulse.
2. Cold Bi (M^ painful arthralgia M^) 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 (fixed arthralgi ^^) 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 (^ ^ 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 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 (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 hesitant pulse. (Notes: This type is often seen in the patents with mitral stenosis and mitral incompetence of rheumatic heart disease).
Bi Syndrome in Western Medicine
In western medicine, many diseases may manifests as 'Bi (arthralgia) syndrome', but mostly 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 and vessels. 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 (marked by diastolic murmur) , mitral incompetence (systolic murmur), etc.
2. Rheumatoid arthritis
Its 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 the morning and alleviated by exertion. Laboratory tests show blood sedimentation
rate (ESR) increased, blood RF positive, etc. It does not cause heart valvular disease.
3. Osteoarthritis
It is also manifested as a type of Bi (arthralgia) syndrome, caused by the breakdown and eventual loss of the cartilage of 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.
4. 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 (GV 14), Hegu (LI 4), Quchi (LI 11), Jianyu (LI 15), Waiguan (TE 5), Wangu (TE 4), Huantiao (GB 30), Xuanzhong (GB 39), Jiaji (EX-BZ), Fengshi (GB 31), Yanglingquan (GB 34), Dubi (ST 35), Kunlun (BL 60). Notes: you can choose local acupoints according to locations of Bi syndrome.
Supplementary Acupoints:
For Wind Bi (wandering arthralgia) syndrome, add: Fengmen (BL 12), Xuehai (SP 10).
For Cold Bi (painful arthralgia) syndrome, add: Weiyang (BL 39), Guanyuan (CV 4)
For Dampness Bi (fixed arthralgia) syndrome, add: Fenglong (ST 40), Yinlingquan (SP 9)
For Heat Bi (heat arthralgia) syndrome, add: Quchi (LI 11), Eijian (LI 2).
For Blood Stasis Bi syndrome, add: Xuehai (SP10), Geshu (BL 17);
For Heart Bi syndrome, add: Tongli (HT 5), Xinshu (BL 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 Therapies
Therapeutic principle: dispersing pathogenic wind, cold, and dampness.
1) Basic Herbal Recipe:
Modified Juan Pi Tang (M^ffi Decoction for Treating Bi Syndrome) for Bi syndrome of cold, wind and dampness types.
Source: Yi Xue Xin Wu ( H ^ to Medical Revelations), by Dr. CHEN Guo-peng, 1732.
Ingredients: Qianghuo (^^ Rhizoma seu Radix Notopterygii) 10g, Duhuo (^^ Radix Angelica Pubescentis) 10g, Guizhi Ramulus Cinnamomi) 10g, Qinjiao Radix Gentianae Mocrofhyllae) 12g, Danggui Radix angelicae sinensis) 10g,
Chuanxiong Rhizoma Ligustici Chuanxiong)
10g, Haifengteng (Caulis Piperis Futo-kadsurae) 30g, Jixueteng Caulis Spatholobi)
30g, Sangzhi Ramulus Mori) 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 ( ^ R ^ Radix Clematidis) 12g, Fangfeng (I^M Radix Ledebouriellae) 10g.
For Cold Bi (painful arthralgia) syndrome, add: Baizhi ( ^ ^ Radix Angelicae Dahuricae) 12g,
Yuanhu (M^MM Rhizoma Corydalis) 9g.
For Dampness Bi (fixed arthralgia) syndrome, add: Yiyiren Semen Coicis) 30g, Cangzhu
Rhizoma atractylodis) 12g.
For Heat Bi (heat arthralgia) syndrome, add: Rendongteng ( # 0 Caulis Lonicerae) 30g, Huangbai (^tt Cortex Phellodendri) 10g.
For Blood Stasis Bi syndrome, add: Ruxiang Resina Olibani) 10g, Moyao (S^ Myrrha) 10g, Dilong Lumbricus) 12g.
For Heart Bi syndrome, add: Yuzhu (S^ Rhizoma Polygonati Odorati) 21g, Tinglizhi (^W^ Semen Lepidii seu Descurainiae) 9g, Huangqi Radix Astragali seu Hedysari) 30g, Dangshen Radix Codonopsis) 15g.
2) The Original Herbal Prescriptions for Different Types of Bi Syndrome
a) Qianghuo Sheng Shi Tang (^^WMffi Decoction of Notopterygium for Dispersing Dampness) for Wind Bi syndrome.
Source: Nei Wai Shang Bian Huo Lun (^H^?^ Clarifying Doubts about Injury from Internal and External Causes) by Dr LI Gao , in 1247.
Ingredients: Qianghuo (^^ Rhizoma seu Radix Notopterygii) 9g, Duhuo (^^ Radix Angelicae Pubescentis) 9g, Gaoben (M^ Rhizoma et Radix Liguistici) 4.5g, Fangfeng (I^M Radix Ledebouri-ellae) 4.5g, Zhigancao Radix Glycyrrhizae
Praeparatae) 4.5g, Chuanxiong (jl| ^ Rhizoma Ligustici Chuanxiong) 4.5g, Manjingzi ( H ^ ^ Fructus Viticis) 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 ( wandering arthralgia ^T ^) syndrome; also for exogenous wind-dampness syndrome marked by heaviness and pain of head, waist and back, or general pain of the body, with difficulty in turning round.
The author's experience: Clinically the author use this recipe for rheumatic arthritis, common cold and migraine of wind-damp type.
b) Duhuo Jisheng Tang (^^W^^ Decoction of Pubescent Angelica and Loranthus) for Cold Bi syndrome.
Source: Qianjin Yao Fang (^^^^ Thousand Ducat Formulae), by Dr SUN Si-miao in 652.
Ingredients: Duhuo (^^ Radix Angelicae Pubescentis) 9g, Xixin (M^ Herba cum Radice Asari) 3g, Fangfeng (I^M Radix Ledebouriellae Divaricatae) 6g, Qinjiao Radix Gentianae Mocrofhyllae) 6g, Sangjisheng Ramulus Loranthi) 6g, Duzhong
Cortex Eucommiae Ulmoidis) 6g, Niuxi Radix Achyranthis Bidentatae) 6g, Rougui (^ ^ Cortex Cinnamomi Cassiae) 6g, Danggui ( Radix Angelicae Sinensis) 6g, Chuanxiong (j 11 ^ Rhizoma Chuanxiong) 6g, Shengdihuang (^i&M Radix Rehmanniae Glutin- osae) 6g, Baishao ( Radix Paeoniae Alba) 6g, Renshen (A# Radix Ginseng) 6g, Fuling Sclerotium Poriae Cocos) 6g, Zhigancao (^^^ Radix Glycyrrhizae Praeparatae) 6g.
Administration: The source text advises to coarsely grind the above ingredients. However, today the normal dosage of Sangjisheng is 15-30, the dosages of others except Xixin are about 9-12 g.
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 painful arthralgia M^) 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.
The author's experiences: The author usually use this recipe for chronic rheumatoid arthritis, osteoarthritis, lumbar spondylopathy, sciatica and sequelae of poliomyelitis of cold Bi type.
c) Yiyiren Tang (^^-f^^ Coix Seed Decoction) for Dampness Bi syndrome.
Source: Ming Yi Zhi Zhang (^Efa^ Displays of Enlightened Physicians) by Dr HUANG Fu-zhong, in 16th century.
Ingredients: Mahuang Herba Ephedrae) 6g.
Note: In the UK, it is not allowed, for Damp Bi, they may use Mugua Fructus Chaenomelis) instead of Mahuang. Danggui (Radix Angelicae Sinensis) 9g, Cangzhu Rhizoma Atractylodis) 9g, Yiyiren Semen Coicis) 24g, Guizhi
Ramulus Cinnamomi Cassiae) 6g, Baishao (S ^ Radix Paeoniae Lactiflorae) 6g, Zhigancao Radix Glycyrrhizae Praeparatae) 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 fixed arthralgia ^'M) 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.
The author's experiences: The author use this recipe for rheumatic arthritis of dampness Bi type.
d) Xuan Bi Tang (m^^ Decoction for Relieving Bi Syndrome) for Heat Bi syndrome.
Source: Wen Bing Tiao Bian Systematic
Differentiation of Warm Disease) by Dr WU Ju-tong , in 1798.
Ingredients: Guangfangji ( ^ W 3 Radix Ari-stolochiae Fangchi) 15g, Xingren Semen Pruni Armeniacae) 15g, Yiyiren Semen Coicis
Amarum) 15g, Cansha ( S fà Excrementum Bombycis Mori ) 9g, Banxia (^M Rhizoma Pinelliae Ternatae) 9g, Lianqiao ( ^ M Fructus Forsythiae Suspensae) 9g, Zhizi ( M ^ Fructus Gardeniae Jasminoidis) 9g, Huashi ( ^ ^ Talcum) 15g, Chixiaodou (^'hs Semen Phaseoli Calcarati) 9g. Administration: Decoct the herbs for oral use.
Indications: For Heat Bi ( ^^ 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.
The author's experiences: The author use the recipe acute rheumatic arthritis, infective arthritis and other conditions marked by heat-damp Bi syndrome.
e) Shu Feng Huo Xue Tang (^M^^i^ Decoction for Dispersing Wind and Promoting Blood Circulation) for Blood Stasis Bi syndrome. Source: Dong Yi Bao Jian (^E^^ Precious Mirror of Oriental Medicine) by Dr XU Sun, a Korean, in 1611.
Ingredients: Danggui Radix Angelicae Sinensis) 2.5g, Chuanxiong Rhizoma Chuanxiong) 2.5g, Weilingxian Radix Clematidis ) 2.5g, Baizhi
Radix Angelicae Dahuricae) 2.5g, Hanfangji ( S W 3 Radix Stephaniae Tetrandrae) 2.5g, Huangbai ( M tt Cortex Phellodendri ) 2.5g, Dannanxing (IS^M Arisaemae cum Bile) 2.5g, Cangzhu ( ^ ^ Rhizoma Atractylodis ) 2.5g, Qianghuo Rhizoma seu Radix Notopterygii)
2.5g, Guizhi ( Ramulus Cinnamomi) 2.5g,
Honghua (^X^ Flos Carthami) 1g, Ganjiang Rhizoma Zingiberis) 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 syndrome, marked by sharp pain in all the joints due to Blood stasis caused by wind, dampness and phlegm. Notes: This is a Korean formula. The above dosages are from Japanese sources. According to my own experience, the dosage for each herb should be at 10g.
f) Xin Bi Tang Decoction for Heart Bi
Syndrome) for Heart Bi syndrome. Source: The author's experienced recipe.
Ingredients: Danggui Radix Angelicae Sinensis) 15g, Chuanxiong Rhizoma Chuanxiong) 15g,
Chishao Radix Paeoniae Rubrae) 15g, Ruxiang (?L# Olibanum) 9g, Lulutong (Fructus Liquidambaris) 15g, Qianghuo Rhizoma seu
Radix Notopterygii) 9g, Sangjisheng Herba
Taxilli Chinensis) 15g, Weilingxian Radix
Clematidis) 9g, Yuzhu Rhizoma Polygonati
Odorati) 21g, Tinglizi (^W^ Semen Lepidii seu Descurainiae) 9g, Huangqi Radix Astragali)
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.
The author's experiences: Since 1985, the author has used this recipe for rheumatic heart disease of Heart Bi syndrome (mitral stenosis and mitral incompetence) marked by 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 hesitant pulse. It is effective to relieve symptoms.
3) Common Herbal Pills
a) Qu Feng Wan (1KA Pills for Dispersing Wind)
Source: Asante Academy of Chinese Medicine, UK
Ingredients: Tianma (^ft Rhizoma Gastrodiae), Qianghuo Rhizoma seu Radix Notopterygii),
Duhuo Radix Angelicae Pubescentis), Duzhong Cortex Eucommiae), Huainiuxi Radix
Achyranthis Bidentatae), Bixie (¥ M Rhizoma Dioscoreae Hypohlaucae), Danggui (Radix Angelicae Sinensis), Shudihuang (^ № M Reh-manniae Praeparatae), Xuanshen (Radix Scrop-hulariae)
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. b) Xiao Huo Luo Dan (V^/^^Pill for activating energy flow in the meridian and collaterals)
Ingredients: Zhichuanwu (Radix Aconiti Praeparatae) 180g, Zhicaowu Radix Kus-
nezoffii Praeparatae) 180g, Dilong Pheretima
Aspergillum) 180g, Zhitiannanxing ( ® A ^ M Rhizoma Arisaematis Praeparatae) 180, Ruxiang (^L # Olibanum) 66g, Moyao (S^ Myrrha) 66g.
Administration: Make the above herbs into pills, 3g (8 pills ) each time, 1-2 times a day.
Indications: It can be used for treating Bi syndrome of cold type or blood stasis type. It can be also used for infertile and dysmenorrhea. Notes: Zhichuanwu (Wl^ Radix Aconiti Praeparatae) and Zhicaowu (Radix Kusnezoffii Praeparatae) are not allowed to use in the UK, because the ingredients Zhichuanwu and Zhicaowu. Zhichuanwu contain Wutoujian (aconine) which is highly toxic. So if you make a decoction of the herbs in other countries except the UK, both herbs must be boiled for more than one - two hours until no numbness of the mouth and tongue is felt according to traditional processing method, because the long time boiling can change its Wutoujian / aconine into Wutoucijia (sub-aconine) which has just 1-2 % of Wutoujian' 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.
c) Mugua Wan (^ЖА Chaenomeles Fruit Pill)
Main ingredients: Mugua ( ^ Ж Fructus Chaenomelis), Danggui ( ^ fi Radix Angelicae Sinensis), Chuanxiong ( j 11 ~Ц Rhizoma Liguistici Chuanxiong), Baizhi ( Ö î Radix Angelicae Dahuricae), Weilingxian Radix Clematidis)
Gouji (ЩЩ Rhizoma Cibotii ), Niuxi (^Ш Radix Achyranthis Bidentatae), Haifengteng (ШМ0 Coulis Piperis Kadsurae), Jixueteng ( ^Ü Caulis Spatholobi), Renshen (À# Radix Ginseng).
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.
d) Er Miao Wan (—^A Two Wonderful Ingredients Pill)
Ingredients: Huangbai (ЙЙ Cortex Phellodendri), Cangzhu Rhizoma Atractylodis)
Indications: For Bi syndrome of damp-heat type.
Administration: 8 pills each time, 3 times a day.
e) Shu Jin Jian Yao Wan (Pill for Relieving Rigidity of Muscle and Tendon and Strengthening Loins)
Ingredients: Jinyingzi ( â S i Fructus Rosae Laevigatae), Jixueteng Caulis Spatholobi),
Qianjinba (^^Ш Radix Flemingiae Philippiensis) Heilaohu Radix Kadsurae Coccineae),
Fengmi ( Mel), Ruxiang ( ?L# Olibanum), Niudali ( ^ ^ Л Radix Millettiae Speciosae ), Sangjisheng (ШШ^ Herba Taxilli), Tusizi (Ш^^ Semen Cuscutae), Nuzhengzi ( ^ ^ T Fructus Ligustri Lucidi), Yanhusuo ( Ш Щ Ш Rhizoma Corydalis), Liangmianzhen ( M ffi If Radix Zanthoxyli).
Indications: for Bi syndrome. Administrations: 12 pills each time, 2 times a day. 4) External Treatment
a) Shang Shi Zhi Tong Gao Adhesive
Plaster for Relieving Sprain, Rheumatalgia and
Myalgia)
Ingredients: Methyl Salicylate ( 7K % M ¥ Ih Metthylsalicylatum), Menthol (^^fla Borneolum), Camphor Camphora), Lemongrass extract (^ § # Extractum Herbae Cymbopogonis), Belladonna liquid extract ( II ^ ^ # Extractum Belladonnae Liquidum).
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 6-12 hours.
Caution: It should be used with care to pregnant women; but not to the patients with adhesive plaster allergy and local ulceration. b) Gou Pi Gao Dog-skin Plaster)
Main Ingredients: ngpi ( W ^ Pericarpium Citri Reticulatae Viride), ngxiang (T^ Flos Caryophylli), uanxiong Rhizoma Chuanxiong), nggui
Radix Angelicae Sinensis), Qianghuo Rhizoma seu Radix Notopterygii), Dafengzi (^MT Semen Chaulmoograe), Tianma Rhizoma Gastrodiae), Duzhong Cortex Eucommiae).
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 6-12 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 com-
prehensive 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 factors to 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 of a slow type of exercise type, very useful to patients with Bi syndrome. While Qi Gong is a kind of exercise for self-developing Qi Energy (including natural body's defensive qi).
References
1. Zhu M. The Medical Classic of the Yellow Emperor (English edition). Foreign Language Press; 2001, 2005.
2. Dan Bensky, Randall Barolet. Chinese Herbal Medicine Formulae & Strategies. Eastland Press, U.S.A; 1990.
3. Zhang EQ. A Practical English-Chinese Library of TCM. Shanghai TCM University Press; 1990: 4.
