Called “B” (Blockage) Syndrome

Dr. Michael Tierra L.AC., O.M.D.

General treatment of arthritis, neuralgia: salt packs, potato juice, moxibustion, warm baths, massage, ginger oil, Chinese and pearl barley, papaya, wear corset to support the spine; herbs that are carminative, blood and qi moving and aromatic damp eliminating are used.

Avoid: vinegar and dried prunes


Wind in the joints: crackling sensation in the joints

Bupleurum and Cinnamon Twig Decoction

Wind in the extremities: numbness, headache, dizziness

Lindera Powder to Smooth the Flow of Qi

Wind-Damp: intense pain and severely restricted motion in the joints, particularly

those of the hands and feet

Aconite Decoction

Wind-Heat-Dampness: high fever, sweating, irritability, thirst, pain and swelling of the joints,

sensation of heaviness, reduced mobility, scanty dark urine; Pulse:

wiry, rapid; Tongue: white, red greasy , Grey or yellow greasy coat

White Tiger plus Cinnamon Twig Decoction

Wind-Cold-Damp: pain that increase with cold an diminishes with warmth, possibly

accompanied by a sensation of heaviness and numbness in the limbs

Fixed or migrating pain with reduced range of motion aggravated by

cold; Pulse: slow, possibly slippery; Tongue: thick or moist white coat

Remove Painful Obstruction Decoction from Medical Revelations

with Qi Deficiency: heaviness in body, stiffness in neck, shoulder and upper back,

numbness in extremities, difficulty moving; Pulse: moderate, Tongue:

white coat

Remove Painful Obstruction Decoction from Selected Formulas

with Heat from swollen and painful joints, especially of lower extremities, that are

constraint: warm to the touch and worsen at night, chills, absence of sweating,

weight loss, headache, Pulse: wiry and slippery, Tongue: white greasy


Cinnamon Twig, Peony and Anemarrhena Decoction

Blood and Qi Stagnation: shoulder pain, arm pain, lower back pain, leg pain or other chronic

aches and pains of the body with signs of blood stasis

Drive Out Blood Stasis from a Painful Body Decoction, Clematis and

Stephania Combination

Liver and Kidney Deficiency: fixed pain of lower back and lower extremities, weakness and

stiffness, an aversion to cold and attraction to warmth, shortness of

breath, palpitations, Pulse: thin, weak and slow; Tongue: pale with

white coat: Angelica Pubescens and Sanjisheng Decoction

Arthritis in General

Caused by Wind-Cold-Damp:

A) Migratoy: Cinnamon, Peony and anemarrhena

B) Painful: Decoction of Sichuan Aconite

Decoction of Prepared Aconite

C)Fixed: Chianghuo and Turmeric Combination (Chuan Pi Tang)

Caused by Wind-Heat-Damp:

White Tiger Decoction with Cinnamon

Phellodendron and Atractylodes (Powder of Two Effective Ingredients)

(red atractylodes is used – this is for lower body pain and swelling)

Chronic: Duhuo and Vaeicum Combination

Deforming Arthritis of Joints

Symptoms: water retention in joints, especially femur, knees and elbows (places in body of maximum stress), and then joint becomes deformed from degeneration. Initially it aches with exercise or lifting heavy weight but with no change in the skin or subdermal tissue at this stage. Then there is swelling and fluid around the joints (swelling of sinovial bursa occurs), followed by friction and cracking sounds. It is most common in women over 50 and in physiques which are challenged past their structural ability.

Formulas: Stephania and Astragalus

Atractylodes Combination

Cinnamon and Hoelen with Coix

Osteo-Arthritis (Spondylosis Deformans)

Symptoms: wasting disease with degeneration and deformation but no inflammation, aching upon awakening in morning, better with movement, aching in evening after activity, worsens with age, causes curving of spine

Formulas: Rehmannia Eight

Astragalus Combination

Rheumatoid Arthritis

Symptoms: Arthritis that is an autoimmune disease as well

Formulas: Pueraria Combination with Coix Combination

Major Siler Combination (Major Ledeborieles Combination)

Symptoms: chronic rheumatic pains

Formula: Ma Huang and Coix Combination


A) Trigeminal Neuralgia

Symptoms: pain anywhere from left or right lower eyelid down the cheeks and beneath the nose or even in upper jaw causing toothache, which sometimes results in mistaken tooth extraction as treatment

Formulas: Pueraria Combination: Yang-firm first stage

Pueraria Combination with Atractylodes and Aconite Combination: Yang-firm

second stage

Cinnamon, Atractylodes and Aconite Combination: Surface weakness first stage

Hoelen Five Herbs

Cinnamon and Atractylodes Combination

Ma-Huang, Aconite and Asarum

Ophiopogon and Asarum Combination

B) Sciatica

Symptoms: pain in thigh down to lower extremities

Formulas: Licorice, Asarum and Rhubarb Combination

Tang Kuei, Evodia and Ginger Combination

Clematis and Stephania Combination

Persica and Rhubarb

Rehmannia Eight Formula

C) Intercostal Neuralgia

Symptoms: Chest pain

Formulas: Pinellia and Arisaema Combination

Ginseng and Ginger

Bupleurum and Gardenia

D) Brachial Neuralgia

Symptoms: upper arm pain

Formula: Siler and Platycodon

E) Other Neuralgia

Symptoms: chronic mild pain in legs, waist and back

Formula: Tang Kuei and Magnolia Formula

Symptoms: internal and external pain, muscular spasms, pain in arms and legs

Formula: Peony and Licorice Combination

Symptoms: chronic neuralgia and rheumatic pains

Formula: Ma Huang and Coix Combination

Other Formulas:

Flexibility Tonic (Shujin San)


Ma Huang and Coixyucca feverfew or Pueraria Combination for painful neck and shoulders


1. Stephania and Astragalus Combination (Fang Ji Huang Qi Tang

Astragalus (Huang Qi) 10-15 gms

Stephania (Fang Ji) 9-12 gms

Atractylodes alba (Bai Zhu) 6-9 gms

Fresh Ginger (Sheng Jiang) 1-3 gms

Baked Licorice (Gan Cao) 3-6 gms

Jujube dates (Da Zao) 3-5 pc.


1. diuretic, reduces edema

2. strengthens spleen, metabolism

3. dispels wind

Indications: for water and dampness accumulation with deficient exterior. Symptoms are spontaneous perspiration, intolerance of wind, heavy sensation of the body, dysuria, edema. Also used with Ledebouriella and Platycodon Combination (Fang Feng Tung Sheng San) for obesity.

Tongue: light color with white coat

Pulse: floating and feeble, soft or thready

Applications: cardiac and nephritic edema, fluid retention in the joints

Contraindications: when there is no edema


1. For heaviness in the lower back and feet add: Fuling, and Coix (Yi yi ren)

2. For abdominal distention add citrus peel (chen pi) and Bitter orange (zhi ke)

2. Atractylodes Combination (Yue bi jia zhu tang)

Ephedra (Ma huang ) 6-9 gms

Atractylodes (Bai zhu) 6-9 gms

Gypsum (shi gao) 20 gms

fresh ginger (sheng jiang0 9 gms

Licorice (gan cao) 6 gms

Fructus jujubae (da zao) 15 pcs

For wind edema, generalized edema, sore and heavy limbs, reduced urination, fever and chills, floating and slippery or deep pulse.

3. Cinnamon and Poria with Coix

Cinnamon twig (gui zhi) 6-9 gms

Poria (fu ling) 6-9

Moutan bark (Mu dan pi) 6-9

Persica seed (Tao ren) 6-9

Red peony (chi shao yao) 6-9

(The above is Cinnamon and Poria combination for blood and fluid stagnation)

Add: Coix (yi yi ren) 15-20 gms

Action: 1. remove blood and fluid stagnation

2. soften hard lumps

Indications: uterine fibroids, cysts, painful and difficult menstruation, retention of placenta, with Coix it can be used for deforming arthritis of the joints.

Applications of Cinnamon and Poria Combination: endometritis, adnexitis, hysteromyoma, ovarian cyst, infertility, post-partum bleeding, retention of the lochia, irregular menstruation.

4. Rehmannia Eight (Pa Wei Di Huang Wan) (also called jin gui shen qi wan)

Di Huang (Prepared rehmannia) 20 30 gms. Rehmannia glutinosa

Shan Zhu Yu (Cornus) 10 20 gms Cornus off.

Shan Yao (dioscorea) 10-15 gms. Dioscorea batata

Ze Xie (Alisma) 10-15 gms. Alisma Plantago

Fu Ling (Poria) 10-15 gms Poria cocos

Mu Dan Pi (Moutan peony) 10-15 gms Paeonia suffruticosa

Fu Zi (prepared aconite) 10-15 gms. Aconitum carmichaeli

Rou Gui (cinnamon bark) 6-9 gms. Cinnamomum cassia

Action: 1. To replenish kidney yang; 2. To warm the lower part of the body

5. Astragalus Combination (Huang qi jian zhong tang)

Astragalus (Huang Qi) 10-15 gms

Maltose (Yi tang) 20-30 gms

Cinnamon twigs (gui zhi) 6-9 gms

White peony (Bai shao yao) 10-15 gms

Baked licorice (gan cao) 3-6 gms

Fresh ginger (sheng jiang) 3-6 gms

Jujube dates (Da zao) 3-5 pcs

Action: 1. warm and tonify the spleen and stomach

2. replenish qi (spleen)

Indications: for cold and deficient spleen and stomach, weak exterior defensive system. Symptoms include dyspnea, involuntary perspiration, abdominal pain caused by cold, pale face, fatigue. It can be used for weakness during convalescence, night sweats, delicate constitution in children, chronic otitis media, chronic ulceration, hemorrhoids, carbuncle, and gangrene.

Tongue: pale with white coat

Pulse: deep and slow

Differentiation: Another formula, Minor Cinnamon and Peony (Hsiao-Jian-zhong tang) is also used for mal-developed children in the absence of severe weakness.

For severe anemia and drastic pain in the lower abdomen of women use Dang Gui jian zhong tang).

6. Pueraria Combination (GE GEN TANG)

Ge Gen (pueraria) 6-9 gms Pueraria lobata

Ma Huang (ephedra) 6-9 gms Ephedra sinica

Gui Zhi (cinnamon twig) 6-9 gms

Bai Shao (white peony) 3 gms

Gan jiang (Ginger) 3 gms

Gan Cao (licorice) 3 gms

Da Zao (jujube) 3-5pc

Action: 1. to dispel exterior wind and cold, 2. To relieve muscle ache and stiffness of the neck. For common cold caused by wind and cold in the Tai yang channel. Fever, no perspiration, intolerance of wind, muscle ache of the neck, tenderness on the umbilicus.

Key Ideas: This formula is for individuals with acute upper respiratory ailments, including fevers whose constitution is neither too strong nor too weak. Pueraria is specifically and antispasmodic that releases muscular tension, the benefit of which is particularly noticed around the neck and shoulders. It is also very valuable for the stomach and intestines because it is a complex carbohydrate that breaks down into simpler sugars more slowly and therefore helps to overcome all conditions that have occurred as a result of any internal or external sympathetic nervous stimulation (yang). One such stimulation is a by-product of overconsumption of simple sugars from refined sugar and fruit. Pueraria or in Japanese, Kudzu, helps to overcome sweet cravings and the negative effects of sweets.

7. Coix Combination (I yi jen tang)

Coix (Yi yi ren) 15 gms

Ephedra (Na huang) 6-9

Angelica Sinensis (dang gui) 6-9

Atractylodes (Bai zhu) 6-9

Cinnamon twigs (gui zhi) 3-6

White peony (Bai shao) 3-6

Licorice (gan cao) 3

Poly-rheumatism, arthritis, tubercular arthritis, muscular rheumatism, beriberi, nephritis, pulmonary edema, and pleurisy.

For rheumatoid arthritis combine with Pueraria Combination

8. Hoelen Five Herbs formula (Wu Ling San)

Ze Xie (alisma) 9-12 gms. Alisma plantago

Fu Ling (Poria) 6-9 gms. Poria cocos

Zhu Ling (Polyporus) 6-9 gms. Polyporus umbellatus

Gui Zhi (Cinnamon twig) 6-9 gms. Cinnamomum cassia

Bai Zhu (atractylodes) 6-9 gms. atractylodes alba

Actions: 1. Diuretic, 2. Diaphoretic, 3. To strengthen the spleen by removing dampness.

9. Cinnamon and Atractylodes Combination

Cinnamon twig (Gui Zhi) 6-9 gms

White peony (Bai Shao) 6-9

Fresh ginger (sheng jiang) 3-6

Licorice (gan cao) 3

Jujube dates (da zao) 3-5 pcs

Atractylodes alba (Bai zhu) 6-9

Prepared aconite (Fu Zi) 3-6

For apoplexy, arthritis, arthralgia, neuralgia

10. Ma Huang, Aconite and Asarum combination (Mahuang, fuzi xi xin tang)

Ephedra (mahuang) 6-9 gms

Prepared aconite (fu zi) 3-6

Asarum (xi xin) 1-3 gms

Actions: 1. dispel exterior wind and cold (diaphoretic)

2. replenishes the yang

Indications: deficiency yang, with affections of wind and cold, high fever with severe cold intolerance, pale complexion, weakness of the hand and feet with associated coldness.

Tongue: pale and damp

Pulse: deep

Indications: common cold, influenza and neuralgia aggravated icy coldness

11. Ophiopiogon and Asarum Combination (Jing zang juan tung tang)

Angelica sinensis (Dang gui) 3-6

ligusticum (chuang xiong) 3-6

Angelica du huo (du huo) 3-6

Notopterygium (Chiang huo) 3-6

Angelica pubescens (Bai zhi) 3-6

Ledebouriella (Fang feng) 3-6

Atractylodes (Bai zhu) 3-6

Ophiopogon (Mai men dong) 3-6

Scutellaria (Huang qin) 3-9

Vitex (Mang Jing zi) 3

Chrysanthemum (Ju hua) 3

Asarum (xi xin) 3

licorice (gan cao) 3

fresh ginger (sheng jiang) 3

for all types of headaches, including chronic headache, trigeminal neuralgia, pain caused by maxillary cancer.

12. Licorice , asarum and rhubarb combination

13. Dang Gui, Evodia and Ginger Combination (Dang gui si ni jia wu zhu yu sheng jiang tang)

Angelica sinensis (Dang gui) 9-12 gms

Evodia (wu zhu yu) 3-6

Fresh ginger (sheng jiang) 3-6

Cinnamon twig (gui zhi) 9-12

white peony (bai shao) 10-15

asarum (xi xin) 3-6

akebia (mu tong) 6-9

baked licorice (gan cao) 3-6

jujube dates (da zao) 3-5 pcs

Action: 1. warm the channels and dispel cold

2. nourish the blood and vascular system

3. anti-emetic

Indications: vomiting, fluid retention, coldness caused by blood deficiency, cold hands and feet, anemia, fluid retention in the stomach, vertical headache, arthritis, hernia, frostbite, menstrual pain, thromboangiitis obliterans (Buerger’s disease), pain in the thighs down to the lower extremities (sciatica).


(Decoction to Dredge the Meridians & Vitalize Blood)

1. Radix Angelicae Sinensis (Dang Gui) 5g

2. Radix Paeoniae Alba (Bai Shao) 4g

3. Radix Rehmanniae (Shen Di Huang) 4g

4, Rhizoma Ligustici Wallichii (Chuan Xiong) 3g

5. Semen Persicae (Tao Ren) 4g

6. Poria Cocos (Fu Ling) 4g

7. Rhizoma Atractylodis (Cang Zhu) 4g

8 Pericarpium Citri Reticulatae (Chen Pi) 4g

9. Rz. et Rx. Notopterygii (Qiang Huo) 3g

10. Radix Angelicae (Bai Zhi) 3g

l1. Radix Clematidis (Wei Ling Xian) 4g

12. Radix Stephaniae Tetrandrae (Fan Ji) 3g

13. Radix Sileris (Fang Fenq) 3g

14. Radix Gentianae (Long Dan Cao) 3g

15. Radix Achyranthis Bidentatae (Niu Xi) 4g

16. Radix Glycyrrhizae (Gan Cao) 2g


This formula is taken in the form of warm decoction on an empty stomach. Decoct the above herbs with three pieces of Rhizoma Zingiberis Recens.

1. To dredge channels and collaterals

2. To activate blood stagnation

3. To dispel damp


Body aches due to exterior factors attacking a deficient body: severe muscle ache, painful joints, etc.


Patient indicated for this formula usually has various deficiencies, the most common being that of the channels and collaterals. This deficiency may be caused by over

consumption of alcohol, excessive sexual activity, internal injuries, or attack of exterior factors, with the first two causes being the most common. Since the channels and the collaterals are deficient, many exterior factors such as wind, coldness, heat, or dampness may invade with ease, causing body pain.

The first four herbs in this formula, Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix Rehmanniae, and Rhizoma Ligustici Wallichii tonify blood and activate blood circulation. Semen Persicae is used to break down any blood stagnation. Poria Cocos dispels damp through diuresis. Rhizoma Atractylodis dries up damp. Pericarpium Citri Reticulatae regulates Qi flow and dries up damp. Rz. et Rx. Notopterygii, Radix Angelicae, Radix Clematidis, Radix Stephaniae, and Radix Sileris activate Qi circulation, dispel wind and damp, and relieve pain. Radix Gentianae dispels heat and dampness. Radix Achyranthis Bidentatae activates blood circulation and tonifies the body. Radix Glycyrrhizae harmonizes all of the herbs.

15. Persica and Rhubarb Combination (Tao Ho Cheng Chi Tang)

Tao ren (persica seed) 6-9 gms Prunus persica

Gui Zhi (cinnamon) 3-6 gms Cinnamomum cassia

Da Huang (rhubarb) 6-9 gms Rheum palmatum

Mang Xiao (mirabilitum) 3-6 gms Mirabilite (sodium sulphate)

Gan Cao (baked licorice ) 3-6 gms Glycyrrhiza Uralensis

Actions: to eliminate heat and blood stasis in the lower warmer (especially the left)

16. Pinellia and Arisaema Combination (Jing zhi hua Tan tang)

Pinellia (Ban xia) 3-6

Poria (fuling) 6-9

Arisaema 3-6

Scutellaria (huang qin) 3-6

Citrus (cheng pi) 3-6

Notopterygium (chiang huo) 3

Angelica (du huo) 3

Brassica seeds 3

fresh ginger (sheng jiang) 3-6

licorice (gan cao) 3

Bamboo manna 3

for generalized pain, chest pain, should stiffness, stridor, cough and arthralgia.

17. Regulate the Middle Pill (Li Zhong Wan)

(from shang han lun)

Rhizoma Zingiberis Officinalis (gan jiang) 9g

Radix ginseng (Ren Shen) 9g

Rhizoma Atractylodis (Bai Zhu) 9g

Honey fried licorice (zhi gan cao) 9g

Preparation: grind the ingredients into a powder and make into pills with honey. The pills should equal from one to two tablespoons of the herb. Take 2 to 3 times daily in 9 gram doses. It can also be taken as a decoction. The pill is often taken with rice congee. Unless it is an acute case, codonopsis can be substituted for ginseng in two to three times dosage.

Actions: warms the middle or tonifies spleen and stomach yang to warm digestion.

Indications: diarrhea with watery stool, nausea and vomiting, no particular thirst, loss of appetite, abdominal pain, pale tongue with white coat and a deep, thin pulse.

When spleen yang is injured (middle warmer) the clear yang cannot ascend. This causes diarrhea with loose watery stool. When the stomach loses its ability to make the turbid yin descend, nausea and bomiting ensue.

This is a primary formula often with the addition of either or both cortex cinnamomi and radix aconitae.

Analysis of the formula: ginger is the chief herb while ginseng and atractylodes are the assistants. Prepared licorice augments the qi of the middle burner and harmonizes the actions of the other herbs.

18. Siler and Platycodon (Fang feng tung sheng san)

Ledebouriella (Fang Feng) 6-9

Schizonepeta (Jing jie) 6-9

Ephedra (Ma huang) 3-6

Platycodon (Jie geng) 6-9

Mentha (Bo he) 3-6

Forsythia (Lian qiao) 6-9

Scutellaria (Huang qin) 3-6

Gardenia fruit (Zhi zi) 3-6

Rhubarb (Da huang) 3-6

Gypsum (shi gao) 9-12

Mirabilitum (Mang Xiao) 3-6

Talcum (Hua shi) 9-12

Angelica sinensis (dang gui) 6-9

Ligusticum (chuan xiong) 3-6

Atractylodes (Bai zhu) 6-9

White peony (Bai shao) 6-9

Licorice (gan cao) 3-6

Fresh ginger (sheng jiang) 3-6

Action: eliminate intense heat and fire in the exterior and interior of the body.

Indication: For all excess conditions, high body temperature (wind heat), headache, sore throat, fullness in the chest, constipation, skin eruptions or ulcers, obesity (can be combined with Stephania and astragalus), hypertension.

Tongue: red with a yellow coat

Pulse: forceful and rapid

19. Major Ledebouriella Combination (da fang feng tang)

Ledebouriella (fang feng) 3 gms

Ligusticum (chuan xiong) 3 gms

Angelica sinensis (Dang gui) 3

Prepared Rehmannia (Shu di huang) 3

White Peony (Bai shao yao) 3

Astragalus (huang qi) 3

Eucommia (Du zhong) 3

White atractylodes (bai zhu) 3

Ginseng (ren shen) 1.5

Achryanthes (Niu xi) 1.5

Licorice (gan cao) 1.5

Jujube dates (Da zao) 3-5 pcs

Fresh ginger (sheng jiang) 1.5

Prepared aconite (Fu zi) 1

Indications: Arthritis caused by coldness, dispels wind, smoothes the flow of qi, invigorates the blood vessels, fortifies the sinews and bones and eliminates damp cold. It was originally prescribed for dysenteric wind where the legs become very painful after a dysenteric disorder and difficult to walk. It is prescribed for crane’s knee with atrophy above and below the knee.

20. Bupleurum and Cinnamon Combination (Chai hu gui zhi tang)

Bupleurum 15 gms, pinellia 12 gms, ginseng 6 gms, white peony 6 gms, scutellaria 6 gms, cinnamon twigs 6 gms, fresh ginger 3 gms, licorice 3 gms, jujube date 3-5pcs.

For the common cold

One of the most frequently indicated formula useful for 100’s of conditions. This is because is harmonizes internal and external symptoms, cold and heat, excess and deficiency.

1. for the common cold, influenza, pneumonia, TB, and pleuritis

2. gastrointestinal problems, stomach, sour stomach, gastric and duodenal ulcers, inflammation of the large intestine, spleen imbalances, gallstones, hepatitis, jaundice, and gallbladder imbalances.

3. Chronic appendicitis, peritonitis, abdominal pain, abdominal distension and constipation.

4. Intercostal neuralgia, headache, arthralgia, nephritis, pyelitis, neurosis, nervous exhaustion, irritability, insomnia, female disorders, hysteria, epilepsy and cardiac disorders.

Abdominal indications are distention beneath the heart, periumbilical or lower abdominal pain and tenseness around the pubic bones.

21. Lindera Powder for Regulating Qi (Wu yao shun qi san)

Ref. Lindera Formula p. 409


Wu Yao (Lindera) 10-15 gm Lindera strychnifolia

Jiang Can (Stiff silkworm) 3-6 gm. Bombyx mori

Chuan Xiong (ligusticum) 6-9 gm Ligusticum wallichii

Bai Zhi (Angelica root) 6-9 gm. Angelica dahurica

Mahuang (Ephedra) 6-9 gm. Ephedra sinica

Jie Geng (Platycodon) 6-9 gm. Platycodon grandiflorum

Zhi Ke (Mature bitter orange) 3-6 gm. Citrus aurantium

Chen Pi (Citrus peel) 3-6 gm. Citrus reticulata

Gan Jiang (Dried Ginger) 3-6 gm. Zingiber officinale

Gan Cao (Licorice) 3-6 gm. Glycyrrhiza uralensis

Action: 1. To dispel wind by regulating the flow of Qi (external and internal)

2. To resolve stagnation Or phlegm.

Indications For a person with stroke or cerebral hemorrhage.

The symptoms are: muscle-ache, paralysis, hemiplegia,

trigeminal neuralgia or Bell’s palsy, difficulty of speech,

deviation of the eyes and mouth, dyspnea.

Pulse: full/firm

Applications Syncope, stroke, cerebral hemorrhage, hemiplegia, trigeminal neuralgia, Bell’s palsy.

22. Aconite Combination (Fu zi tang)

Prepared aconite (fu zi) 6-9 gms

white atractylodes (bai zhu) 9-12

Ginseng (ren shen) 3-6

Poria (fu ling) 9-12

White peony (Bai shao yao) 6-12

Action: 1. dispel cold and reinforce yang

2. dispel dampness and relieve pain

Indications: arthritis caused by cold and dampness with whole body muscle ache and soreness, intolerance of cold, cold hands and feet.

Tongue: white

Pulse: deep, slow or weak

23. White Tiger Decoction (Bai hu tang)

Shi gao (gypsum) 20-30 gms Calcium sulfate

Zhi Mu (anemarrhena) 9-12 gms Anemarrhena asphodeloides

Jing Mi (rice) 15-30 gms Oryza sativa

Gan Cao (baked licorice) 3-6 gms Glycyrrhiza uralensis

Action: 1. to eliminate heat in the chi (secondary defense) system and the yang ming channel; 2, To promote the secretion of body fluids. For high fever, children’s fever, meningitis, diabetes, gingivitis, encephalitis B.

For accompanying deficient chi add ginseng, for inflamed arthritis add cinnamon twig 3-6 gms

24. Remove Painful Obstruction (Juan bi tang)

Notopterygii (qiang huo) 3 gms

Angelica pubescens (du huo) 3

Gentianae qinjao (qin jiao) 3

Ramulus Mori (Sang ji) 9

Caulis piperis (hai feng tang) 9

Angelica sinensis (dang gui) 9

Ligusticum (chuan xiong) 2.1

gummi olibanum (ru xiang) 2.4

Saussuria root (mu xiang) 2.4

Cinnamon bark (rou gui) 1.5

Honey prepared licorice (zhi gan cao) 1.5

Today the dosage is increased 2-3 times and cinnamon twigs are substituted for cinnamon bark.

Action: removes wind-dampness and alleviates painful obstruction.

Indications: for Joint pain that is aggravated with cold and lessens with warmth, possibly with limb heaviness and numbness, a thick, white tongue coat and a slow, possibly slippery pulse. The numbness is caused by a combination of wind and dampness.

Used for Osteoarthritis, rheumatoid arthritis, gouty arthritis and bursitis.

For wind predominant add Ledebouriella (fang feng)

For cold add Prepared aconite (fuzi)

For damp predominant add stephania, atractylodes cang zhu, coix

For pain especially in the upper extremities add clematis (wei ling tang)

For lower extremity pain add achryanthes and chaenomeles.

25. Cinnamon Twig, Peony and Anemarrhena Combination (Gui zhi shao yao zhi mu tang)

Cinnamon twig (gui zhi) 12gms

Ephedra (Ma huang) 6

Prepared aconite (fuzi) 6

Anemarrhena (zhi mu) 12

White peony (Bai shao) 9

Atractylodes alba (Bai zhu) 15

Ledebouriella (Fang feng) 12

Raw ginger (sheng jiang) 15

Licorice (gan cao) 6

Actions: unblocks the flow of yang qi, promotes movement (removes painful obstruction), dispels wind, and overcomes dampness.

Indications: For painful, inflamed and swollen joints (especially in the lower extremities) that are warm to touch, worsen at night, reduced range of motion in the affected joints, chills, absence of sweating, weight loss, headache, dizziness. It can be used for rheumatoid arthritis, connective tissue disorders, and gouty arthritis.

Tongue: white, greasy

Pulse: wiry and slippery

Distinguish this formula from White Tiger Decoction with Cinnamon which is for a more generalized feverish condition. This formula is for more localized inflammations.


For severe pain with restricted movement and that responds to warmth add ephedra 6gms and 6-9 gms of prepared aconite.

For heavy sensation throughout the body increase the dose of atractylodes

For symptoms that are worse at night substitute red peony (chi shao) for white peony (bai shao)

For pronounced heat in the joints increase White peony, anemarrhena and add Ramulus Mori (mulberry twigs) and Ramulus lonicera (honeysuckle stems)

For qi and Yin deficiency add unprepared rehmannia (sheng qi huang) and achryanthes (niuxi)

26. Drive Out Stasis from a Painful Body (Shen tong zhu yu tang)

Gentiana qinjao (qinjao) 3 gms

Ligusticum (chuan xiong) 6

Persica semen (tao ren) 9

Flos carthami (hong hua) 9

Licorice (gan cao) 6

Notopterygii (Chiang huo) 3

Myrrha (mo yao) 6

Angelica sinensis (dang gui) 9

Excrementum trogopteri (Ling zhi) 6

Cyperus (xiang fu) 3

Cyathulae (chuan nu xi) 9

Lumbricus (di long) 6

Actions: invigorates the blood, removes qi stagnation, opens the channels, relieves painful obstruction. It is used for shoulder and arm pain, lower back pain, leg pain and other aches and pains of the body with signs of blood stasis.

27. Angelica pubescens and Sangjisheng Combination (Du huo ji sheng tang)

Angelica pubescens (du huo) 9 gms

Asarum (Xi xin) 6

Ledebouriella (fang feng) 6

Gentiana (qin jiao) 6

Loranthes (sangjisheng) 15-30

Eucommia (du zhong) 6

Achryanthes (Niu xi) 6

Cinnamon bark (Rou gui) 6

Angelica sinensis (dang gui) 6

Ligusticum (chuan xiong) 6

Unprepared rehmannia (sheng di huang) 6

White peony (Bai shao) 6

Ginseng (ren shen) 6

Poria (fuling) 6

Prepared licorice (zhi gan cao) 6

Dipsacus (xu duan) is often substituted for Loranthes, codonopsis is often substituted for ginseng with twice the dosage.

Actions: expels wind and dampness, disperses painful obstruction and tonifies deficiency.

Indications: heavy and painful sensations at fixed areas of the lower back and lower extremities with accompanying weakness and stiffness, an aversion to cold and attraction to warmth, palpitations, shortness of breath, pale tongue with a white coat, a thin, weak and slow pulse. There may also be numbness. It can be used for Osteoarthritis, rheumatoid arthritis, chronic lower back pain, sciatica, sequelae of poliomyelitis.

Modifications: For severe pain add prepared aconite (fu zi); for blood stagnation add persica seeds and carthamus flowers

Phellodendron and Atractylodes Combination (Er miao San)

Phellodendron (Huang bai) 6-9 gms

Atractylodes Cang Zhu 9-12

Action: eliminates heat and dampness

Indications: for lower back pain caused by damp heat and inflammation, painful knees, low back, eczema, leucorrhea, urine is yellow and short, tinea pedis, gonorrhea.

Tongue: yellow and greasy

Pulse: soft and rapid


To strengthen the liver and kidney add achryanthes

To eliminate dampness add achryanthes and coix

To treat tinea pedis add coix, chaenomeles and areca seed

For leucorrhea add Euryale seed, ailanthus bark, and ginkgo seed.

General Treatment Guidelines for Arthritis


A. Migratory Cinnamon, Peony and Anemarrhena

B. Painful Aconite Combination

C. Fixed Chiang huo and Turmeric Combination (Chuan Bi Tang)


White Tiger Decoction with Cinnamon Twigs

Phellodendron and Atractylodes Combination

Chronic Angelica pubescens and Sangjisheng Combination (Du huo ji sheng tang)

General formulas for treating pain



Trauma Pill (Die da wan)

Source: Collection of Chinese herbal Prepared Medicines

Radix Angelicae Sinensis (dang gui) 30g

Radix ligustici chuanxiong (chuang xiong) 30g

Gummi olibanum (mu xiang) 60g

Myrrha (mo yao) 30g

Sanguis Draconis (xui jie) 30g

Eupolyphaga seu opisthoplatia (tu bie chong) 30g

Herba ephedra (ma huang) 60g

Pyritum (zi ran tong) 30g

Preparation: Grind into a powder and form into pills with honey. Take one or two 3g pills twice daily with wine or warm water.

Actions: invigorates the blood, transforms blood stasis, harmonizes the nutritive qi, reduces swelling, and alleviates pain.

Indications: Traumatic injury such as sprain with bruising, swelling, and distended ache and pain at a fixed location.

This formula can be used to treat traumatic injury from falls, fractures, blows, contusions and strains.

Modification: for more severe symptoms add semen strychnotis (Ma qian zi) and Secretio Moschus (she xiang).

Contraindicated during pregnancy.

Fantastically Effective Pill to Invigorate the Collaterals (huo luo xiao ling dan)

Source: Records of Heart-felt Experiences in Medicine with Reference to the West (Yi Xue zhong zhong can xi lu)

Radix Angelicae Sinensis (dang gui) 15g

Radix Salviae Miltiorrhizae (dan shen) 15g

Gummi Olibanum (ru xiang) 15g

Myrrha (mo yao) 15g

Preparation: Decoction or the ingredients can be ground into a powder and divided into four equal doses and taken with warm wine.

Actions: invigorates the blood, dispels blood stasis, unblocks the collaterals, and alleviates pain.

Indications: can be used for various pains throughout the body including heart pain, stomach, abdomen, back, leg, arm, bruising and swelling due to traumatic injury, rheumatic pain, fixed abdominal masses, internal or external ulceration, a dark tongue and a wiry pulse.

One of the virtues of this formula is that it lends itself to a variety of modifications according to the location of the pain. It can be used for ectopic pregnancy, angina pectoris, cerebral thrombosis, sciatica, pelvic inflammatory diseases, arthritis, and traumatic injury.

Contraindicated during pregnancy.


1. For lower extremities pain add angelica pubescentis (du huo) and Radix achryanthis (niu xi)

2. For upper extremity pain add Rhizoma et Radix notopterygii (qiang huo), Rhizoma curcumae longae (jiang huang) and Fructus forsythiae (lian qiao).

3. For abdominal pain in women and abdominal masses such as fibroids, add Semen persicae (tao ren) and Excrementum Trogopteri pteromi (wu ling zi).

4. For red, swollen, hot and painful ulcerations, add Flos lonicerae (jin yin hua), Fructus forsythiae (lian qiao) and Radix anemarrhenae (zhi mu).

5. For deep-rooted yin-type ulcerations, add cortex cinnamomi cassiae (rou gui) and Colla cornu cervi (lu jiao jiao.

6. For non-healing ulcerations, add Radix astragali (huang qi), Radix anemarrhenae (zhi mu0 and Radix glycyrrhizae (gan cao).

7. For abscesses of the internal organs, add Radix notoginseng (san qi) and Fructus arctii (niu bang zi).

Shu Jin San (Planetary Formula’s Flexibility Tonic)

Angelica sinensis (Dang gui) 100 grams

Ligusticum (chuang xiong) 100 grams

Achryanthes (Niuxi) 120 gms

Lycii berries (Gou gi zi) 80 gms

Gambir (gouteng) 100 gms

Ledebouriella (fang feng 80 gms

Chaenemeles (mu gua) 120 gms

Tian qi ginseng (Sangzhi) 100 gms

Notopterygium (chiang huo) 80 gms

Grind to a fine powder

It soothes the muscles and tendons, improves blood circulation. tonic for liver and kidneys, It is used for all kinds of arthritis, pain of the lower back and legs, numbness and dyskinesia.

Dose: 9 grams each time. Take 2 times daily until there is improvement.

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