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
Arthritis/Neuralgia
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
coat
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
Neuralgia
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)
Guggula
Ma Huang and Coixyucca feverfew or Pueraria Combination for painful neck and shoulders
FORMULAS FOR BI SYNDROME
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.
Actions:
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
Modifications:
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).
14. CLEMATIS & STEPHANIA COMBINATION (SHU JING HUO XUE TANG)
(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
METHOD OF ADMINISTRATION
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
CLINICAL MANIFESTATION
Body aches due to exterior factors attacking a deficient body: severe muscle ache, painful joints, etc.
EXPLANATION
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
Constituents:
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.
Modifications:
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
Modifications:
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
Wind-cold-damp
A. Migratory Cinnamon, Peony and Anemarrhena
B. Painful Aconite Combination
C. Fixed Chiang huo and Turmeric Combination (Chuan Bi Tang)
Wind-Heat-Damp
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 MEDICINE
INVIGORATE THE BLOOD IN TREATING TRAUMA
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.
Modifications:
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.