The Three Treasures Newsletters
SPRING 2002
BI SYNDROME
This newsletter looks in detail at "Bi" syndrome and the
Three Treasures remedies which treat it. "Bi", also called
"Painful Obstruction Syndrome" indicates pain, soreness,
or numbness of muscles, tendons and joints. It is probably the most
universal of all diseases affecting practically everyone at some
time or another of one's life in all parts of the globe.
"Bi", literally meaning "obstruction", can be
caused by one or a combination of the following:
| • |
invasion of external Wind |
| • |
invasion of external Cold |
| • |
invasion of external Dampness |
However, in prolonged cases of Painful Obstruction Syndrome other
pathological conditions may play a part in the development of the
disease. First of all, Wind, Cold and Damp will obstruct the circulation
of Qi, Blood and Body Fluids. After some time, Phlegm may develop.
Phlegm may lead to stasis of Blood. The stasis of Blood in the channels
further obstructs proper circulation and therefore is another cause
of pain. In many cases of chronic Bi syndrome, stasis of Blood is
a factor. For example, Cold and Dampness are frequent causes of
Painful Obstruction syndrome of the lower back. After repeated episodes
of invasion of the lower back by Cold and Dampness, the prolonged
retention of pathogenic factors may lead to chronic stasis of Blood
in the area. The ache then becomes more or less constant and more
severe. Stasis of Blood also causes pronounced stiffness due to
stagnant Blood not nourishing and moistening sinews.
Therefore, external Wind, Cold and Dampness may lead to:
| • |
Qi stagnation |
| • |
Blood stagnation |
| • |
Phlegm |
The above syndromes can (but do not always) occur against a background
of Deficiency of either Qi, Yin, Yang or Blood.
DIFFERENTIATION OF BI SYNDROME
Wind Painful Obstruction Syndrome (Wandering Bi): caused
by Wind and characterized by soreness and pain of muscles and joints,
limitation of movement, pain moving from joint to joint.
Damp Painful Obstruction Syndrome (Fixed Painful Bi): caused
by Dampness and characterized by pain, soreness and swelling in
muscles and joints with a feeling of heaviness and numbness of the
limbs, the pain being fixed in one place and aggravated by damp
weather.
Cold Painful Obstruction Syndrome (Aching Painful Bi): caused
by Cold and characterized by severe pain in a joint or muscle, limitation
of movement, usually unilateral.
Heat Painful Obstruction Syndrome (Febrile Bi): originates
from any of the previous 3 types when the pathogenic factor turns
into Heat in the Interior. There is usually an underlying Yin deficiency.
Characterized by pain and heat in the joints which feels hot to
touch, redness and swelling of the joints, limitation of movement
and severe pain.
Phlegm Painful Obstruction Syndrome (Bony Bi): Develops from
any of the previous four types and is only ever chronic. Characterized
by muscular atrophy, swelling and deformity of the bones in the
joints.
THE THREE TREASURES REMEDIES
As always, a remedy must be prescribed only after a thorough case
history has been taken, on the basis of the symptoms, pulse and
tongue.
Clear Channels
Pattern: Damp-Heat in the joints, Blood stasis
Action: Drain Dampness, expel Wind, clear Heat, benefit the
joints, invigorate Blood
Indications: sub-acute Painful Obstruction Syndrome from
Damp-Heat, painful, swollen, hot and red joints, rheumatoid arthritis,
gout
Tongue: Swollen with sticky-yellow coating
Pulse: Slippery, Rapid
Invigorate the Root
Pattern: Wind-Dampness in the channels, Spleen-Qi deficiency,
Blood deficiency, Kidney-Yang deficiency
Action: expel Wind and resolve Dampness from the channels,
tonify Kidney-Yang, tonify Spleen-Qi, nourish Blood
Indications: chronic Bi syndrome from Wind and Dampness in
the channels occurring against a background of Kidney-Yang deficiency,
Spleen-Qi deficiency and Blood deficiency. Chronic backache aggravated
by exposure to cold and dampness and alleviated by heat, pain in
the joints with no swelling or slight swelling knee-ache, dizziness,
tinnitus, tiredness
Tongue: Pale
Pulse: Deep, Weak
Benefit the Sinews
Pattern: Blood stasis, Phlegm and Dampness in the joints,
Kidney deficiency
Action: invigorate Blood, resolve Phlegm, expel Wind-Dampness,
dry Dampness
Indications: chronic Bi, chronic joint pain with swelling
of the joints and bone deformities, rigidity of joints
Tongue: Pale, red or purple, swollen, sticky coating
Pulse: Choppy or slightly Slippery
Brocade Sinews
Pattern: Chronic Wind-Damp Painful Obstruction (Bi) Syndrome
with Liver-Blood and/or Liver-Yin deficiency
Action: Nourish Liver-Blood and Liver-Yin, benefit sinews,
expel Wind-Dampness from the joints
Indications: Chronic soreness and slight swelling of the
joints, dizziness, numbness or tingling or limbs.
Tongue: Pale and thin if there is Liver-Blood deficiency
or red and thin without coating if there is Liver-Yin deficiency
Pulse: Choppy or Fine, possibly only on the left side.
Nourish the Root and Clear Wind
Pattern: chronic Wind-Damp Painful Obstruction (Bi) Syndrome
occurring against a background of Kidney-Yin deficiency
Action: Nourish the kidneys and Liver, strengthen bones and
sinews, expel Wind-Dampness in the joints
Indications: lower backache, knee-ache, sciatica, ache in
joins
Tongue: Red without coating or with a rootless coating
Pulse: Weak on both rear positions or Floating-Empty
COMPARISON OF THE THREE TREASURES REMEDIES
TO TREAT BI SYNDROME
| |
Pathogenic Factors
|
Underlying Patterns
|
Indications
|
Acute or chronic
|
Remedy treats Ben or Biao?
|
| Nourish the Root and Clear Wind |
Wind
Dampness |
Kidney- (and Liver-) Yin deficiency |
Lower backache, knee ache, sciatica, ache
in joints |
Chronic |
Ben and Biao |
| Clear Channels |
Damp-Heat
Blood stasis |
Spleen-Qi deficiency
Liver-Blood deficiency |
Painful, swollen, hot and red joints |
Acute |
Biao only |
| Invigorate the Root |
Wind
Dampness |
Spleen-Qi deficiency
Blood deficiency
Kidney-Yang deficiency |
Chronic backache worse with cold and damp,
pain in the joints |
Non-allergic |
Ben and Biao |
| Benefit the Sinews |
Blood Stasis
Phlegm
Damp |
Kidney deficiency |
Swollen, painful joints, bone deformities,
rigidity of joints |
Allergic |
Mainly Biao |
| Brocade Sinews |
Wind Damp |
Liver-Blood deficiency
Liver-Yin deficiency |
Chronic soreness and slight swelling of
joints |
Non-allergic |
Ben and Biao |
|
CASE HISTORIES
Case History 1
A 52-year old woman had been suffering from rheumatoid arthritis
since the birth of her last child 17 years ago. Two months before
she came for treatment, she had had a bad flare up. Her wrists,
hands, knees, ankles and feet were extremely swollen and hot. She
had a severe restriction of movement. Her pulse was Slippery-Rapid
and her tongue was Red.
I diagnosed severe Damp-Heat in the joints with an underlying deficiency
of Liver-Blood and Yin. I prescribed 9 tablets of Clear Channels
a day to treat the Manifestation, and gave her acupuncture to treat
the underlying deficiency. After 3 months, the flare-up had subsided.
The joints were less swollen and hot and the patient’s mobility
was less restricted.
Case History 2
A 64-year old woman had been experiencing a lot of pain in the fingers
of both hands for the past year. On top of this, the fingers were
swollen and quite deformed. She also complained of frequent lower
backache and a weak feeling in her knees. She said she felt very
stiff on waking in the morning and this feeling eased off gradually
as the day went on but never quite left her. Her tongue was Pale
and partially Peeled and her pulse was slightly Floating-Empty.
The pain and deformity in her fingers and handsrobably began
as an invasion of Cold and Dampness but, over the year, turned
into stagnation of Phlegm. There is an underlying deficiency of
Blood (seen in the Pale tongue) and Yin (the tongue is partially
peeled and the pulse Floating-Empty). The back and knee problems
also point towards Kidney-Yin deficiency. I prescribed 6 Benefit
the Sinews a day and after six months the condition was ninety
percent better.
Case History 3
A 57-year-old woman had been suffering from chronic lower backache
for the past ten years. An MRI scan had shown a severe deterioration
of the intervertebral discs. Her backache was worse with exercise
and better with rest. She also complained of hot flushes and nightsweats.
Her tongue was slightly Red and completely without coating with
some cracks in the central area. Her pulse was Slippery, and Weak
on both Rear positions.
I diagnosed Kidney- and Liver-Yin deficiency and prescribed 6
tablets of Nourish the Root and Clear Wind a day. Given the severe
deterioration of the intervertebral discs, this backache could
not be cured completely but the continuous administration of the
above remedy greatly relieved the pain and allowed her to lead
a normal life.
Researched and edited by Rebecca Avern Lic.Ac, M.B.Ac.C
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