Journal of Traditional Chinese Medicine, June 2010, Vol. 30, No.

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Lecture
Bi Syndrome (Arthralgia Syndrome)
ZHANG En-qin ᓴᘽࢸ
Manager &Chief Dr of EVERWELL Chinese Medical Centre, London Clinic7, London, U.K

The word ‘Bi’ (⯍) in Chinese means an obstruction. 2. Internal factors - general weakness of the body as
Bi Syndrome refers the syndrome characterized by well as the defensive qi:1
the obstruction of qi and blood in the meridians due This condition may cause the weakened resistance to
to the invasion of external pathogenic wind, cold and pathogens, marked by dysfunction of skin and pores
dampness, manifested as soreness, pain, numbness, as well as defensive qi. As a result pathogenic wind,
heavy sensation, swelling of joints and limbs, lim- cold and dampness can easily invade the body
itation of movements and so on. causing Bi syndrome, this was described in the book
As joint pain is one of most common symptoms in Bi -Prescriptions for Succouring the Sickness / Ji Sheng
syndrome, so some western doctors and editors often Fang (⌢⫳ᮍ), by Dr YAN Hong-he, in 1253, which
translate Bi syndrome into ‘Arthralgia Syndrome’. stated that ‘it is because of weakness of the body with
poor function of defensive qi that invasion of
Clinically, Bi syndrome covers many different acute pathogenic wind, cold and dampness can result in Bi
or chronic diseases in Western medicine, such as syndrome’.
rheumatic diseases, rheumatoid arthritis, osteo-
Now we can see that the basic pathology of Bi
arthritis, fibrositis, lupus, gout, neuralgia and others.
syndrome is the obstruction of qi and blood in the
In TCM there are many effective therapies for Bi meridians, due to the invasion of pathogenic wind,
syndrome, including acupuncture, moxibustion and cold and dampness. According to TCM theory, if the
herbal medicines. meridians are open and the qi and blood are
Aetiology and Pathology circulating smoothly and normally, there will be no
pain; but if the meridians are obstructed and the flow
According to TCM theory and the author’s clinical
of qi and blood are blocked, pain will arise’.
experiences, Bi syndrome can be caused by either
external factors or internal factors. However, the constitution of the body differs from
person to person, for example, with people that live
1. External factors – the invasion of the muscles, in the same condition, some suffer from Bi syndrome,
joints and meridians by pathogenic wind, cold and while other will not be affected. After suffering Bi
dampness: syndrome, if a patient has excess yang by nature as
In Chapter 43 the Bi Syndrome of Su Wen (㋴䯂 Plain well as accumulated heat, the wind-cold-dampness
Questions), a part of The Yellow Emperor’s Canon of type of Bi syndrome may transfer into heat type of Bi
Internal Medicine (咘Ᏹ‫ݙ‬㒣, BC475-221), said that syndrome.
‘if pathogenic wind, cold and dampness invade the
Additionally, if pathogenic wind, cold and dampness
body together, it will lead to obstruction in the
stay in the meridians and cause an obstruction for a
meridians and Bi syndrome may take place’.
Clinically, we can also see that Bi syndrome is more
Correspondence to: Prof. ZHANG En-qin
common in the areas where the weather is cold, wet Email: prof.engincan@hotmail.co.uk
and windy. Tel: 44-7846193488
146 Journal of Traditional Chinese Medicine, June 2010, Vol. 30, No. 2

long time, the basic pathogenesis may change into tongue with ecchymosis, white or greasy fur, thready
blood stasis type of Bi syndrome. This is why and unsmooth pulse.
clinically we often see some long-term patients with 6. Heart Bi syndrome (ᖗ⯍ ): Palpitation, chest
Bi syndrome manifested as blood stasis type. stuffiness, pectoral pain, shortness of breath, even
bluish discoloration of face, lips and finger nail,
According to Chapter 43 the Bi Syndrome of Su Wen
cold limbs, dark red tongue with little coating, faint
of Yellow Emperor’s Canon of Internal Medicine the
or hesitant pulse. (Notes: This type is often seen in
Bi condition can also develop and turn into bone Bi,
the patents with mitral stenosis and mitral
tendon Bi, blood-vessel Bi, muscle Bi and skin Bi.
incompetence of rheumatic heart disease).
Further more as the five zang organs are connected
externally with their corresponding meridians and Bi Syndrome in Western Medicine
tissues, so pathogens linger in the meridians and In western medicine, many diseases may manifests as
tissues including bone, tendon, blood vessel, muscle ‘Bi (arthralgia) syndrome’, but mostly seen in the
and skin, they may gradually seep into the internal following diseases:
organs. For example, bone Bi may develop into
1. Rheumatism
kidney Bi; tendon Bi into liver Bi; blood vessel Bi
into heart Bi (clinically this is most common); muscle It generally occurs as delayed sequel to group A
Bi into spleen Bi; skin Bi into lung Bi and so on. haemolytic streptococcal infection. Rheumatism
involves the connective tissues in the heart, joints,
Differential Diagnosis skin and vessels. It commonly appears in young
Clinically, the author classify Bi syndrome into adults between the ages of 20–30 and manifests as
following 6 different types: migratory polyarthritis. The large joints of ext-
1. Wind Bi ( 亢 ⯍ wandering arthralgia 㸠 ⯍ ) remities are most frequently affected, marked by
syndrome: Wandering arthralgia without fixed loc- redness, swelling, heat sensation and pain of the
ation, accompanied with aversion to wind, white or joints during acute stage, some patients may also
greasy fur and floating pulse. have annular erythema, subcutaneous nodules, chorea
and other symptoms. Laboratory tests show elevated
2. Cold Bi (ᆦ⯍ painful arthralgia ⮯⯍) syndrome:
erythrocyte sedimentation rate (ESR), positive
Severe stabbing arthralgia with fixed location as well
C-reactive protein or increased white cell count etc.
as local cold sensation, alleviated by warmth,
Repeated reoccurrences may cause heart valvular
aggravated by cold, white fur and tight pulse.
diseases, such as mitral stenosis (marked by diastolic
3. Dampness Bi ( ⑓ ⯍ fixed arthralgi ⴔ ⯍ ) murmur) , mitral incompetence (systolic murmur),
syndrome: Soreness and fixed pain in the joints with etc.
local swelling and numbness, aggravated on cloudy
2. Rheumatoid arthritis
and rainy days, white and greasy fur, soft and slow
pulse. Its aetiology and pathogenesis have not been fully
known so far, but most scholars believe that it’s a
4. Heat Bi ( ⛁ ⯍ heat arthralgia) syndrome: kind of autoimmune disease with abnormity of
Arthralgia with local redness, swelling and burning humoral immunity and cellular immunity, man-
sensation, accompanied with fever, sweating and ifesting as symmetric polyarthritis mostly with small
thirst, yellow and greasy fur, slippery and rapid pulse. joints of hands, wrists, and feet involved. This is
5. Blood Stasis Bi ˄⯔㸔⯍˅syndrome: Long-term marked by pain, swelling and rigidity of joints
intermittent arthralgia with swelling, rigidity and usually aggravated in the morning and alleviated by
deformity of joints, numbness of limbs, purplish dim exertion. Laboratory tests show blood sedimentation
Journal of Traditional Chinese Medicine, June 2010, Vol. 30, No. 2 147

rate (ESR) increased, blood RF positive, etc. It does Method: Select 6–12 acupoints for each treatment
not cause heart valvular disease. according to the location of pain.
3. Osteoarthritis For wind Bi (wandering arthralgia) syndrome, heat Bi
It is also manifested as a type of Bi (arthralgia) (heat arthralgia) syndrome and blood stasis Bi
syndrome, caused by the breakdown and eventual syndrome, the reducing method is advisable.
loss of the cartilage of one or more joints. Before the
For cold Bi (painful arthralgia) syndrome and
age of 45, it occurs more in males; while after age 55,
dampness Bi (fixed arthralgia) syndrome, the needles
more in females. It commonly affects the hand, feet,
should be retained for 30 minutes and moxibustion is
spine and large weigh-bearing joints such as the hips
also recommended.
and knees, and manifests as joints pain and swelling,
finally leading to limitation of joint mobility. 2. Herbal Therapies
Therapeutic principle: dispersing pathogenic wind,
4. Fibrositis
cold, and dampness.
It is a chronic condition marked by stiffness and 1) Basic Herbal Recipe:
tenderness of muscles, tendons and joints, also
Modified Juan Pi Tang ( 㸆 ⯍ ∸ Decoction for
accompanied with restlessness, sleep-awakening
Treating Bi Syndrome) for Bi syndrome of cold, wind
feeling tired, fatigue, anxiety, depression, disturbance
and dampness types.
in bowel function. Its cause is not known yet.
Source: Yi Xue Xin Wu ( ए ᄺ ᖗ ᙳ Medical
TCM Treatments
Revelations), by Dr. CHEN Guo-peng, 1732.
1. Acupuncture and Moxibustion
Ingredients: Qianghuo ( 㕠⌏ Rhizoma seu Radix
Basic Acupoints:
Notopterygii) 10g, Duhuo ( ⣀ ⌏ Radix Angelica
Dazhui (GV 14), Hegu (LI 4), Quchi (LI 11), Jianyu Pubescentis) 10g, Guizhi (Ḗᵱ Ramulus Cinnamomi)
(LI 15), Waiguan (TE 5), Wangu (TE 4), Huantiao 10g, Qinjiao (⾺㡑 Radix Gentianae Mocrofhyllae)
(GB 30), Xuanzhong (GB 39), Jiaji (EX-BZ), 12g, Danggui (ᔧᔦ Radix angelicae sinensis) 10g,
Fengshi (GB 31), Yanglingquan (GB 34), Dubi (ST Chuanxiong (Ꮁ㡢 Rhizoma Ligustici Chuanxiong)
35), Kunlun (BL 60). Notes: you can choose local 10g, Haifengteng ( ⍋ 亢 㮸 Caulis Piperis Futo-
acupoints according to locations of Bi syndrome.
kadsurae) 30g, Jixueteng (叵㸔㮸 Caulis Spatholobi)
Supplementary Acupoints: 30g, Sangzhi (ḥᵱ Ramulus Mori) 30g.
For Wind Bi (wandering arthralgia) syndrome, add: Administration: All the above herbs should first be
Fengmen (BL 12), Xuehai (SP 10). soaked in a pot of water for 2 hours or more and then
For Cold Bi (painful arthralgia) syndrome, add: placed over a high fire until boiling. Then they are to
Weiyang (BL 39), Guanyuan (CV 4) be simmered over a low fire for 25–30 minutes.
For Dampness Bi (fixed arthralgia) syndrome, add: Finally, drain the herbal liquid from the boiled herbs
Fenglong (ST 40), Yinlingquan (SP 9) to obtain the decoction for oral use. Drink half in the
For Heat Bi (heat arthralgia) syndrome, add: Quchi morning and the other half in the evening.
(LI 11), Erjian (LI 2). For Wind Bi (wandering arthralgia) syndrome, add:
For Blood Stasis Bi syndrome, add: Xuehai (SP10), Weilingxian ( ࿕ ♉ ҭ Radix Clematidis) 12g,
Geshu (BL 17); Fangfeng (䰆亢 Radix Ledebouriellae) 10g.
For Heart Bi syndrome, add: Tongli (HT 5), Xinshu For Cold Bi (painful arthralgia) syndrome, add:
(BL 15). Baizhi ( ⱑ 㢋 Radix Angelicae Dahuricae) 12g,
148 Journal of Traditional Chinese Medicine, June 2010, Vol. 30, No. 2

Yuanhu (ᓊ㚵㋶ Rhizoma Corydalis) 9g. Indications: It can be used for Wind Bi ( 亢 ⯍
For Dampness Bi (fixed arthralgia) syndrome, add: wandering arthralgia 㸠 ⯍ ) syndrome; also for
exogenous wind-dampness syndrome marked by
Yiyiren (㭣㢵ҕ Semen Coicis) 30g, Cangzhu (㢡ᴃ
heaviness and pain of head, waist and back, or
Rhizoma atractylodis) 12g.
general pain of the body, with difficulty in turning
For Heat Bi (heat arthralgia) syndrome, add: round.
Rendongteng ( ᖡ ‫ ހ‬㮸 Caulis Lonicerae) 30g,
The author’s experience: Clinically the author use
Huangbai (咘ᶣ Cortex Phellodendri) 10g.
this recipe for rheumatic arthritis, common cold and
For Blood Stasis Bi syndrome, add: Ruxiang (ч佭 migraine of wind-damp type.
Resina Olibani) 10g, Moyao (≵㥃 Myrrha) 10g, b) Duhuo Jisheng Tang (⣀⌏ᆘ⫳∸ Decoction of
Dilong (ഄ啭 Lumbricus) 12g. Pubescent Angelica and Loranthus) for Cold Bi
For Heart Bi syndrome, add: Yuzhu (⥝ネ Rhizoma syndrome.
Polygonati Odorati) 21g, Tinglizhi (㩊㢜ᄤ Semen Source: Qianjin Yao Fang ( ग 䞥 㽕 ᮍ Thousand
Lepidii seu Descurainiae) 9g, Huangqi (咘㡾 Radix Ducat Formulae), by Dr SUN Si-miao in 652.
Astragali seu Hedysari) 30g, Dangshen (‫ܮ‬খ Radix Ingredients: Duhuo ( ⣀ ⌏ Radix Angelicae Pub-
Codonopsis) 15g. escentis) 9g, Xixin (㒚䕯 Herba cum Radice Asari)
2) The Original Herbal Prescriptions for Different 3g, Fangfeng (䰆亢 Radix Ledebouriellae Divaricatae)
6g, Qinjiao (⾺㡑 Radix Gentianae Mocrofhyllae) 6g,
Types of Bi Syndrome
Sangjisheng (ḥᆘ⫳ Ramulus Loranthi) 6g, Duzhong
a) Qianghuo Sheng Shi Tang (㕠⌏㚰⑓∸ Decoction (ᴰӆ Cortex Eucommiae Ulmoidis) 6g, Niuxi (⠯㝱
of Notopterygium for Dispersing Dampness) for Radix Achyranthis Bidentatae) 6g, Rougui (㙝Ḗ
Wind Bi syndrome. Cortex Cinnamomi Cassiae) 6g, Danggui ( ᔧ ᔦ
Source: Nei Wai Shang Bian Huo Lun (‫ݙ‬໪Ӹ䕼ᚥ Radix Angelicae Sinensis) 6g, Chuanxiong (Ꮁ㡢
Rhizoma Chuanxiong) 6g, Shengdihuang (⫳ഄ咘
䆎 Clarifying Doubts about Injury from Internal and
Radix Rehmanniae Glutin- osae˅6g, Baishao (ⱑ㡡
External Causes) by Dr LI Gao , in 1247.
Radix Paeoniae Alba) 6g, Renshen ( Ҏ খ Radix
Ingredients: Qianghuo ( 㕠⌏ Rhizoma seu Radix Ginseng) 6g, Fuling (㤃㢧 Sclerotium Poriae Cocos)
Notopterygii) 9g, Duhuo ( ⣀ ⌏ Radix Angelicae 6g, Zhigancao ( ♭ ⫬ 㤝 Radix Glycyrrhizae Pra-
Pubescentis) 9g, Gaoben (㮕ᴀ Rhizoma et Radix eparatae) 6g.
Liguistici) 4.5g, Fangfeng (䰆亢 Radix Ledebouri-
Administration: The source text advises to coarsely
ellae) 4.5g, Zhigancao (♭⫬㤝 Radix Glycyrrhizae grind the above ingredients. However, today the
Praeparatae) 4.5g, Chuanxiong ( Ꮁ 㡢 Rhizoma normal dosage of Sangjisheng is 15–30, the dosages
Ligustici Chuanxiong) 4.5g, Manjingzi ( 㫧 㤚 ᄤ of others except Xixin are about 9–12 g.
Fructus Viticis) 3g.
For preparing the decoction: All the above herbs
Administration: All the above herbs should first be should first be soaked in a pot of water for 2 hours or
soaked in a pot of water for 2 hours or more, and then more, and then placed over a high fire until boiling.
placed over a high fire until boiling. Then they are to Then they are to be simmered over a low fire for
be simmered over a low fire for 25–30 minutes. 25–30 minutes. Finally, strain the herbal liquid from
Finally, strain the herbal liquid from the boiled herbs the boiled herbs to obtain the decoction for oral use.
to obtain the decoction for oral use. Drink half in the Drink half in the morning and the other half in the
morning and the other half in the evening. evening.
Journal of Traditional Chinese Medicine, June 2010, Vol. 30, No. 2 149

Indications: It can be used for Cold Bi (ᆦ⯍ painful Source: Wen Bing Tiao Bian (⯳⮙ᴵ䕼 Systematic
arthralgia ⮯⯍) syndrome, marked by heavy and Differentiation of Warm Disease) by Dr WU Ju-tong ,
painful sensation at fixed location in the back and in 1798.
lower extremities accompanied by weakness and Ingredients: Guangfangji ( ᑓ 䰆 Ꮕ Radix Ari-
stiffness, an aversion to cold and attraction to warmth, stolochiae Fangchi) 15g, Xingren (ᴣҕ Semen Pruni
palpitation, shortness of breath, or local paresthesia Armeniacae) 15g, Yiyiren (㭣㢵ҕ Semen Coicis
or numbness. Amarum) 15g, Cansha ( 㱩 ≭ Excrementum
The author’s experiences: The author usually use this Bombycis Mori ) 9g, Banxia (ञ໣ Rhizoma Pinelliae
recipe for chronic rheumatoid arthritis, osteoarthritis, Ternatae) 9g, Lianqiao ( 䖲 㖬 Fructus Forsythiae
lumbar spondylopathy, sciatica and sequelae of Suspensae) 9g, Zhizi ( ᷔ ᄤ Fructus Gardeniae
poliomyelitis of cold Bi type. Jasminoidis) 9g, Huashi ( ⒥ ⷇ Talcum) 15g,
c) Yiyiren Tang (㭣㢵ҕ∸ Coix Seed Decoction) Chixiaodou˄䌸ᇣ䈚 Semen Phaseoli Calcarati) 9g.
for Dampness Bi syndrome. Administration: Decoct the herbs for oral use.

Source: Ming Yi Zhi Zhang (ৡएᣛᥠ Displays of Indications: For Heat Bi ( ⛁ ⯍ heat arthralgia)
Enlightened Physicians) by Dr HUANG Fu-zhong, in syndrome, marked by heat and pain in the joints,
16th century. reduced mobility, fever and shaking chills, a
lustreless, yellow complexion, scanty urine, yellow
Ingredients: Mahuang (咏咘 Herba Ephedrae) 6g. and greasy fur of tongue.
Note: In the UK, it is not allowed, for Damp Bi, they
The author’s experiences: The author use the recipe
may use Mugua (᳼⪰ Fructus Chaenomelis) instead
acute rheumatic arthritis, infective arthritis and other
of Mahuang. Danggui ( ᔧ ᔦ Radix Angelicae
conditions marked by heat-damp Bi syndrome.
Sinensis) 9g, Cangzhu (㢡ᴃ Rhizoma Atractylodis)
9g, Yiyiren (㭣㢵ҕ Semen Coicis) 24g, Guizhi (Ḗᵱ e) Shu Feng Huo Xue Tang (⭣亢⌏㸔∸ Decoction
Ramulus Cinnamomi Cassiae) 6g, Baishao (ⱑ㡡 for Dispersing Wind and Promoting Blood
Radix Paeoniae Lactiflorae) 6g, Zhigancao (♭⫬㤝 Circulation) for Blood Stasis Bi syndrome.
Radix Glycyrrhizae Praeparatae) 3g. Source: Dong Yi Bao Jian (ϰएᅱ䡈 Precious Mirror
Administration: All the above herbs should first be of Oriental Medicine) by Dr XU Sun, a Korean, in
soaked in a pot of water for 2 hours or more, and then 1611.
placed over a high fire until boiling. Then they are to Ingredients: Danggui (ᔧᔦ Radix Angelicae Sinensis)
be simmered over a low fire for 25–30 minutes. 2.5g, Chuanxiong (Ꮁ㡢 Rhizoma Chuanxiong) 2.5g,
Finally, strain the herbal liquid from the boiled herbs Weilingxian (࿕♉ҭ Radix Clematidis ) 2.5g, Baizhi
to obtain the decoction for oral use. Drink half in the (ⱑ㢋 Radix Angelicae Dahuricae) 2.5g, Hanfangji
morning and the other half in the evening. ( ∝ 䰆 Ꮕ Radix Stephaniae Tetrandrae) 2.5g,
Huangbai ( 咘 ᶣ Cortex Phellodendri ) 2.5g,
Indications: It can be used for Dampness Bi (⑓⯍
Dannanxing (㚚 फ ᯳ Arisaemae cum Bile) 2.5g,
fixed arthralgia ⴔ⯍) syndrome, marked by swelling
Cangzhu ( 㢡 ᴃ Rhizoma Atractylodis ) 2.5g,
and pain in the joints (usually of the hands and feet),
Qianghuo (㕠⌏ Rhizoma seu Radix Notopterygii)
numbness, and difficulty in moving the joints, or
2.5g, Guizhi ( Ḗ ᵱ Ramulus Cinnamomi) 2.5g,
accompanied by fever.
Honghua (㑶㢅 Flos Carthami) 1g, Ganjiang (ᑆྰ
The author’s experiences: The author use this recipe Rhizoma Zingiberis) 1g.
for rheumatic arthritis of dampness Bi type.
Administration: Decoct above herbs to make
d) Xuan Bi Tang (ᅷ⯍∸ Decoction for Relieving decoction, drink the decoction, half in morning,
Bi Syndrome) for Heat Bi syndrome. another half in evening.
150 Journal of Traditional Chinese Medicine, June 2010, Vol. 30, No. 2

Indications: It can be used for Blood Stasis Bi (㸔⯍) Ingredients: Tianma ( ໽ 咏 Rhizoma Gastrodiae),
syndrome, marked by sharp pain in all the joints due Qianghuo (㕠⌏ Rhizoma seu Radix Notopterygii),
to Blood stasis caused by wind, dampness and Duhuo (⣀⌏ Radix Angelicae Pubescentis), Duzhong
phlegm. Notes: This is a Korean formula. The above (ᴰӆ Cortex Eucommiae), Huainiuxi (ᗔ⠯㝱 Radix
dosages are from Japanese sources. According to my Achyranthis Bidentatae), Bixie ( 㧚 㾷 Rhizoma
own experience, the dosage for each herb should be Dioscoreae Hypohlaucae), Danggui ( ᔧ ᔦ Radix
at 10g. Angelicae Sinensis), Shudihuang ( ❳ ഄ 咘 Reh-
manniae Praeparatae), Xuanshen (Radix Scrop-
f) Xin Bi Tang (ᖗ⯍∸ Decoction for Heart Bi
hulariae) ⥘খ.
Syndrome) for Heart Bi syndrome.
Indications: For Bi syndrome marked by Wind Bi
Source: The author’s experienced recipe.
type accompanied with deficiency of the kidney and
Ingredients: Danggui (ᔧᔦ Radix Angelicae Sinensis)
blood.
15g, Chuanxiong (Ꮁ㡢 Rhizoma Chuanxiong) 15g,
Chishao (䌸㡡 Radix Paeoniae Rubrae) 15g, Ruxiang Administrations: 12 pills each time, 2 times a day.
( ч 佭 Olibanum) 9g, Lulutong ( 䏃 䏃 䗮 Fructus b) Xiao Huo Luo Dan (ᇣ⌏㒰Ѝ Pill for activating
Liquidambaris) 15g, Qianghuo (㕠⌏ Rhizoma seu energy flow in the meridian and collaterals)
Radix Notopterygii) 9g, Sangjisheng (ḥᆘ⫳ Herba Ingredients: Zhichuanwu ( ࠊ Ꮁ Р Radix Aconiti
Taxilli Chinensis) 15g, Weilingxian (࿕♉ҭ Radix Praeparatae) 180g, Zhicaowu (ࠊ㤝Р Radix Kus-
Clematidis) 9g, Yuzhu (⥝ネ Rhizoma Polygonati nezoffii Praeparatae) 180g, Dilong (ഄ啭 Pheretima
Odorati) 21g, Tinglizi (㩊㢜ᄤ Semen Lepidii seu Aspergillum) 180g, Zhitiannanxing ( ࠊ ໽ फ ᯳
Descurainiae) 9g, Huangqi (咘㡾 Radix Astragali) Rhizoma Arisaematis Praeparatae) 180, Ruxiang (ч
15g. 佭 Olibanum) 66g, Moyao (≵㥃 Myrrha) 66g.
Administration: All the above herbs should first be Administration: Make the above herbs into pills, 3g
soaked in a pot of water for 2 hours or more, and then (8 pills ) each time, 1–2 times a day.
placed over a high fire until boiling. Then they are to Indications: It can be used for treating Bi syndrome
be simmered over a low fire for 25–30 minutes. of cold type or blood stasis type. It can be also used
Finally, strain the herbal liquid from the boiled herbs for infertile and dysmenorrhea. Notes: Zhichuanwu
to obtain the decoction for oral use. Drink half in the (ࠊᎱР Radix Aconiti Praeparatae) and Zhicaowu
morning and the other half in the evening. (ࠊ㤝Р Radix Kusnezoffii Praeparatae) are not
The author’s experiences: Since 1985, the author has allowed to use in the UK, because the ingredients
used this recipe for rheumatic heart disease of Heart Zhichuanwu and Zhicaowu. Zhichuanwu contain
Bi syndrome (mitral stenosis and mitral inc- Wutoujian (aconine) which is highly toxic. So if you
ompetence) marked by palpitation, chest stuffiness, make a decoction of the herbs in other countries
pectoral pain, shortness of breath, even bluish except the UK, both herbs must be boiled for more
discoloration of face, lips and finger nail, cold limbs, than one – two hours until no numbness of the mouth
dark red tongue with little coating, faint or hesitant and tongue is felt according to traditional processing
pulse. It is effective to relieve symptoms. method, because the long time boiling can change its
Wutoujian / aconine into Wutoucijia (sub-aconine)
3) Common Herbal Pills
which has just 1–2 % of Wutoujian’ toxin with the
a) Qu Feng Wan ( 偅 亢 Ќ Pills for Dispersing same efficacy. Additionally, when we meet patients
Wind) with aconite poisoning, we should give patient
Source: Asante Academy of Chinese Medicine, UK Atropine injection and other supporting therapies on
Journal of Traditional Chinese Medicine, June 2010, Vol. 30, No. 2 151

time to save our patients. Myalgia)

c) Mugua Wan (᳼⪰Ќ Chaenomeles Fruit Pill) Ingredients: Methyl Salicylate ( ∈ ᴼ 䝌 ⬆ 䝃
Metthylsalicylatum), Menthol (㭘㥋㛥 Borneolum),
Main ingredients: Mugua ( ᳼ ⪰ Fructus
Camphor (‫ބ‬⠛ Camphora), Lemongrass extract (㢌
Chaenomelis), Danggui ( ᔧ ᔦ Radix Angelicae
佭 ⍌ 㝣 Extractum Herbae Cymbopogonis), Bel-
Sinensis), Chuanxiong ( Ꮁ 㡢 Rhizoma Liguistici
ladonna liquid extract ( 乴 㣘 ⌕ ⍌ 㝣 Extractum
Chuanxiong), Baizhi ( ⱑ 㢋 Radix Angelicae
Belladonnae Liquidum).
Dahuricae), Weilingxian (࿕♉ҭ Radix Clematidis)
Gouji (⢫㛞 Rhizoma Cibotii ), Niuxi (⠯㝱 Radix Actions: Dispelling wind, cold and dampness and
Achyranthis Bidentatae), Haifengteng (⍋亢㮸 Coulis promoting blood circulation to relieve pains.
Piperis Kadsurae), Jixueteng ( 叵 㸔 㮸 Caulis Indications: Rheumatic arthritis, myalgia and sprain.
Spatholobi), Renshen (Ҏখ Radix Ginseng).
Administration: External use, plaster it on the
Administration: 8 pills each time, 2 times a day. affected area, and then change it within 6–12 hours.
Indication: For Bi syndrome marked by numb limbs,
Caution: It should be used with care to pregnant
pantalgia, debility of loins and legs, dysbasia , etc.
d) Er Miao Wan (Ѡ཭Ќ Two Wonderful Ingredients women; but not to the patients with adhesive plaster
Pill) allergy and local ulceration.
b) Gou Pi Gao (⢫Ⲃ㝣 Dog-skin Plaster)
Ingredients: Huangbai (咘ᶣ Cortex Phellodendri),
Cangzhu (㢡ᴃ Rhizoma Atractylodis) Main Ingredients: ngpi ( 䴦 Ⲃ Pericarpium Citri
Reticulatae Viride), ngxiang (ϕ佭 Flos Caryophylli),
Indications: For Bi syndrome of damp-heat type.
uanxiong (Ꮁ㡢 Rhizoma Chuanxiong), nggui (ᔧᔦ
Administration: 8 pills each time, 3 times a day. Radix Angelicae Sinensis), Qianghuo (㕠⌏ Rhizoma
e) Shu Jin Jian Yao Wan (㟦ㄟ ‫ع‬㝄 Ќ Pill for seu Radix Notopterygii), Dafengzi (໻ᵿᄤ Semen
Relieving Rigidity of Muscle and Tendon and Chaulmoograe), Tianma (໽咏 Rhizoma Gastrodiae),
Strengthening Loins) Duzhong (ᴰӆ Cortex Eucommiae).

Ingredients: Jinyingzi ( 䞥   ᄤ Fructus Rosae Actions: Expelling wind and dispersing cold, relaxing
Laevigatae), Jixueteng (叵㸔㮸 Caulis Spatholobi), muscle and tendons, promoting blood circulation
Qianjinba (ग᭸ᢨ Radix Flemingiae Philippiensis) and alleviating pain.
Heilaohu 咥 㗕 㰢 ( Radix Kadsurae Coccineae), Indications: Bi syndrome due to wind, cold and
Fengmi ( ዄ 㳰 Mel), Ruxiang ( ч 佭 Olibanum), dampness, pain of loins and lower extremities,
Niudali ( ⠯ ໻ ࡯ Radix Millettiae Speciosae ), numbness of limbs and trunk, traumatic injuries. It
Sangjisheng (ḥᆘ⫳ Herba Taxilli), Tusizi (㦳ϱᄤ can be used to treat rheumatalgia, neuralgia, and
Semen Cuscutae), Nuzhengzi ( ཇ 䋲 ᄤ Fructus redness, swelling and pain caused by sprain, etc.
Ligustri Lucidi), Yanhusuo ( ᓊ 㚵 ㋶ Rhizoma
Administration: Warm it soft and then apply it to the
Corydalis), Liangmianzhen ( ϸ 䴶 䩜 Radix
affected areasˈ change it every 6–12 hours.
Zanthoxyli).
Indications: for Bi syndrome. Life Style and Diet Advice

Administrations: 12 pills each time, 2 times a day. 1. Living Environment: The ancient Chinese
‘Fengshui’ method is the theory and art which studies
4) External Treatment how to establish an ideal environment beneficial to
a) Shang Shi Zhi Tong Gao (Ӹ⑓ℶ⮯㝣 Adhesive prolonging life as well as preventing and treating
Plaster for Relieving Sprain, Rheumatalgia and diseases including Bi syndrome. It is the com-
152 Journal of Traditional Chinese Medicine, June 2010, Vol. 30, No. 2

prehensive theory of ancient architectural planning physical exercise, such as Taiji and Qi Gong. Taiji is
and design integrating geography, ecology, arch- more of a slow type of exercise type, very useful to
itecture, ethics and aesthetics etc. According to patients with Bi syndrome. While Qi Gong is a kind
Fengshui, people should live at a place with clear and of exercise for self-developing Qi Energy (including
plentiful water source, fresh air, sufficient sunlight, natural body’s defensive qi).
good vegetation as well as quiet, secluded and References
beautiful landscape. Because wind, cold and dam-
1. Zhu M. The Medical Classic of the Yellow Emperor
pness are the main factors to cause Bi syndrome, we
(English edition). Foreign Language Press; 2001, 2005.
should suggest patients with Bi syndrome to live in 2. Dan Bensky, Randall Barolet. Chinese Herbal Medicine
the environment which is full sunlight, less wind, Formulae & Strategies. Eastland Press, U.S.A; 1990.
cold and dampness. 3. Zhang EQ. A Practical English-Chinese Library of TCM.
2. Physical Exercises: TCM has many type of Shanghai TCM University Press; 1990: 4.