Chapter Five. Herbs that expel Wind-Dampness
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1. What are the indications for herbs that expel Wind-Dampness?
Herbs that expel Wind-Dampness are used for treating Bi syndrome. ‘ Bi’ means ‘obstruction’. Bi syndrome is also translated as ‘Painful Obstruction syndrome’. This syndrome is caused by invasion of Wind, Dampness and Cold, which obstruct the meridians and cause pain in the muscles, tendons, bones and joints. Painful Obstruction syndrome can be divided into four types according to the exogenous pathogenic factors and the characteristics of the symptoms.
Wind Painful Obstruction syndrome
Wind Painful Obstruction syndrome is called ‘ Xing Bi’ in Chinese. ‘ Xing’ means ‘moving’ or ‘walking’. This syndrome is characterized by pain that migrates from joint to joint and from one place to another. The pain worsens during windy weather. Other symptoms and signs include tingling of the limbs, pain with a radiating nature, a normal tongue body with a white, thin coating and a moderate pulse. The pathogenic factors of Wind Painful Obstruction syndrome are Wind, Dampness and Cold, with Wind being the predominant factor. In clinical practice, it is often associated with diseases such as migraine, cervical or lumbar spondylosis, hyperosteogeny and rheumatic fever.
Cold Painful Obstruction syndrome
Cold Painful Obstruction syndrome is called ‘T ong Bi’. ‘T ong’ means ‘pain’ in Chinese. The syndrome is characterized by severe pain of a fixed, contracting or cramping nature. The pain worsens during winter or cold weather and is relieved by warmth. Other symptoms and signs include cold limbs and a preference for warmth, a purple or blue tongue body with a white, sticky or watery coating and a deep, wiry pulse. The pathogenic factors of this syndrome are Wind, Dampness and Cold, with Cold being the predominant factor. In clinical practice, it is often associated with diseases such as rheumatic fever, rheumatoid arthritis, osteoarthropathy and osteoporosis.
Damp Painful Obstruction syndrome
Damp Painful Obstruction syndrome is called ‘ Zhuo Bi’. ‘ Zhuo’ means ‘to wear’ and ‘to adhere’. The syndrome is characterized by a fixed, lingering pain and swelling of the joints or muscles associated with a heavy or numb sensation. The pain and swelling worsen during humid and cold weather. The other symptoms and signs are heaviness of the body, edema or difficult micturition, a light purple tongue body with a white, thick coating and a deep, moderate pulse. The pathogenic factors in this syndrome are Wind, Dampness and Cold, with Dampness being the predominant factor. In clinical practice, it can be seen in diseases such as chronic strain of the muscles or other soft tissues and various kinds of arthritis.
Hot Painful Obstruction syndrome
Hot Painful Obstruction syndrome is called ‘ Re Bi’. ‘ Re’ means ‘hotness’. It is characterized by painful and swollen joints with hot or burning sensations. The other symptoms and signs are fever, thirst, scanty urine, a red tongue body with a yellow coating and a rapid, slippery pulse. Hot Painful Obstruction syndrome is a development of the invasion of Wind, Dampness and Cold. First of all, when Wind, Dampness and Cold invade the body, they disturb the Qi movement and the Blood circulation. As the body puts up resistance in order to eliminate these pathogenic factors, Heat is produced in the process. Furthermore, Wind, Dampness and Cold can also turn into Heat if they are not eliminated in time and accumulate in certain meridians and joints. In clinical practice, this syndrome can be seen during the onset and active stage of rheumatic fever or rheumatoid arthritis, as well as frozen shoulder, tenovaginitis, bursal synovitis, pyogenic osteomyelitis and suppurative arthritis.
2. What are the characteristics of herbs that expel Wind-Dampness?
Herbs that expel Wind-Dampness are used for treating Bi syndrome. They are able to expel Wind, transform Dampness and warm the Interior. The characteristics of their properties and functions are as follows.
Pungent taste
Most of the herbs that expel Wind-Dampness are pungent. This gives the herbs the ability to expel Wind from the skin, muscles and bones. As Dampness is associated with Wind, when Wind is expelled by the pungent herbs then Dampness can be partially eliminated too. This function is called ‘wind disperses dampness’.
Pungent and warm
Many of the herbs are pungent and warm in nature, and are especially suitable for conditions where Cold or Wind-Cold predominates in the disease. Because the pungent taste can expel Wind and scatter Cold and the warmth can warm the Interior, warm-pungent herbs can alleviate pain quickly. Warm-pungent herbs are also suitable for usage in the winter, in cold climates and by elderly people. Herbs with a pungent and warm nature include Qiang Huo ( Notopterygii rhizoma), Du Huo ( Angelicae pubescentis radix), Wei Ling Xian ( Clematidis radix), Wu Jia Pi ( Acanthopanacis cortex) and Qian Nian Jian ( Homalomenae rhizoma).
Bitter, pungent and warm
Some of the herbs are bitter and pungent, and are especially suitable for treating Damp Painful Obstruction syndrome because bitterness and pungency can dry Dampness and reduce swelling and heavy sensations in the limbs. If the herb is also warm, the ability to expel Wind and Dampness is even stronger. Herbs with these properties are Song Jie ( Pini nodi lignum), Qian Nian Jian, Hai Feng Teng ( Piperis caulis), Hai Tong Pi ( Erythrinae cortex) and Cang Zhu ( Atractylodis rhizoma).
Salty or sour
Some substances are salty; they are especially suitable for disorders where Wind and Dampness are in the Interior of the body for a considerable time or when the bones are involved. The commonly used salty substances are Wu Shao She ( Zaocys), Bai Hua She ( Agkistrodon acutus)* and Wei Ling Xian. Sourness nourishes the Body Fluids and Yin and can therefore moderate cramps and relieve the pain of the tendons and muscles. Mu Gua ( Chaenomelis fructus) is often used for this purpose.
Entering the Kidney, Bladder and Liver meridians
In Bi syndromes, especially in chronic cases, the bones and tendons are impaired. Herbs that enter the Kidney and Liver meridians are often chosen because the Kidney and Liver govern the bones and tendons. Commonly used substances are Hai Feng Teng, Luo Shi Teng ( Trachelospermi caulis), Qian Nian Jian, Bai Hua She and Wu Shao She. Herbs that enter the Bladder meridian are often used to activate the Qi and Yang and to expel exogenous pathogenic factors from the skin, subcutaneous region and muscles. This is because the Bladder meridian covers the back of the body, which is considered as the Yang side of the body and is the first to be attacked by pathogenic Wind and Cold. Herbs with such functions include Qiang Huo and Wei Ling Xian.
More forms of administration
Substances that expel Wind-Dampness are not only used orally, but are also applied topically because local use may directly expel the exogenous pathogenic factors, activate the Qi and Blood circulation and ultimately break up the obstruction. The commonly used forms are herbal plasters, lotions and tinctures. In addition, herbal alcohol drink is also frequently used as part of the diet for patients who suffer from chronic Bi syndrome.
3. What are the commonly used methods and herbs for treating Bi syndrome?
Substances that expel Wind-Dampness are mainly pungent, warm and bitter, and enter the Liver, Spleen and Kidney meridians. Pungency has dispersing and moving properties, is able to disperse Wind-Dampness and Cold, and to activate the Qi movement and Blood circulation; bitterness can dry dampness; warmth can scatter Cold, warm the muscles and subcutaneous region and strengthen the function of the Defensive Qi. These substances are able to expel Wind, eliminate Dampness, scatter Cold, invigorate the collaterals, relax the tendons and alleviate pain. Some of the substances also have the function of tonifying the Kidney and Liver and strengthening the bones and tendons.
Substances that expel Wind-Dampness are mainly used for Bi syndromes. Since one or two exogenous pathogenic factors can be predominant in each condition, the symptoms can vary. It is very important to choose the proper herbs according to which of the four types of the Bi syndrome is present, the affected region, the duration of the disease and the constitution of the patient. The commonly used methods and herbs are as follows.
Expelling Wind
This method is mainly used for Wind Painful Obstruction syndrome, which is characterized by migrating pain. Pungent and warm herbs are often used, such as Fang Feng ( Saposhnikoviae radix), Qiang Huo ( Notopterygii rhizoma), Wei Ling Xian ( Clematidis radix), Hu Zhang ( Polygoni cuspidati rhizoma) and Wu Shao She ( Zaocys).
Eliminating Dampness
This method is mainly used for Damp Painful Obstruction syndrome, which is characterized by heaviness and numbness of the limbs. The herbs that are used in this condition are Han Fang Ji ( Stephaniae tetrandrae radix), Mu Gua ( Chaenomelis fructus), Bi Xie ( Dioscoreae hypoglaucae rhizoma), Qin Jiao ( Gentianae macrophyllae radix), Cang Zhu ( Atractylodis rhizoma) and Hai Tong Pi ( Erythrinae cortex).
Scattering Cold and warming the Interior
This method is mainly used for Cold Painful Obstruction syndrome, which is characterized by severe, fixed, cramping pain which worsens in cold weather or in winter. Herbs that can be used in this condition are Fu Zi ( Aconiti radix lateralis preparata)*, Chuan Wu ( Aconiti carmichaeli radix)*, Cao Wu ( Aconiti kusnezoffii radix)*, Gui Zhi ( Cinnamomi cassiae ramulus) and Xi Xin ( Asari herba)*.
Clearing Heat and eliminating Wind-Dampness
This method is mainly used for Hot Painful Obstruction syndrome, which is characterized by swelling and red joints with warm or burning sensations. Herbs that can be used are Sang Zhi ( Mori ramulus), Luo Shi Teng ( Trachelospermi caulis), Xi Xian Cao ( Sigesbeckiae herba), Huang Bai ( Phellodendri cortex) and Yi Yi Ren ( Coicis semen).
Invigorating the Blood and promoting circulation
This method is mainly used for chronic Bi syndromes or Bi syndromes characterized by stubborn pain. Commonly used herbs are Dang Gui ( Angelicae sinensis radix), Chuan Xiong ( Chuanxiong rhizoma), Hong Hua ( Carthami flos) and Chuan Niu Xi ( Cyathulae radix).
Dispersing the Lung-Qi, regulating the Qi from the Bladder meridian and expelling exogenous pathogenic factors
This method is mainly used during the onset of Bi syndrome when the exogenous pathogenic factors are in the superficial layer of the body, especially the upper body. The symptoms are sudden onset of pain, swelling of joints, fever, chills and general pain. Commonly used herbs are Qiang Huo, Fang Feng, Gao Ben ( Ligustici sinensis radix), Ma Huang ( Ephedrae herba)* and Xing Ren ( Armeniacae semen).
Invigorating the tendons, opening the collaterals and nourishing the Blood
This method is mainly used for chronic Bi syndrome, where Wind, Dampness and Cold stay in the muscles and tendons for a long period of time, obstructing the Qi and Blood circulation in the collaterals. Patients complain of stiffness of the body, tingling sensations and numbness of the limbs. Herbs that can be used in this condition are Shen Jin Cao ( Lycopodii herba), Hai Feng Teng ( Piperis caulis), Sang Zhi, Di Long ( Pheretima), Dang Gui Wei ( Angelicae sinensis radix extremitas) and Bai Hua She ( Agkistrodon acutus)*.
Tonifying the Liver and Kidney, strengthening the tendons and bones
This method is mainly used for chronic Bi syndrome in elderly people and patients with a weak constitution. Patients complain of weakness and stiffness of the joints, especially in the waist and knees, and difficulty with walking. Herbs which can be used for these complaints are Sang Ji Sheng ( Taxilli herba), Qian Nian Jian ( Homalomenae rhizoma), Gou Ji ( Cibotii rhizoma)**, Xu Duan ( Dipsaci radix), Gu Sui Bu ( Drynariae rhizoma), Xian Mao ( Curculinginis rhizoma), Xian Ling Pi ( Epimedii herba) and Wu Jia Pi ( Acanthopanacis cortex).
In clinical practice, these methods are often used together. For instance, to treat Wind Painful Obstruction syndrome, methods that expel Wind, invigorate the Blood and nourish the Blood are often used together. To treat Damp Painful Obstruction syndrome, methods that expel Wind, eliminate Dampness, disperse the Lung-Qi and invigorate the sinews are often used together. To treat Cold Painful Obstruction syndrome, methods that scatter Cold, warm the Interior and promote Blood circulation are often used together. To treat chronic Bi syndrome, tonifying methods are often used together with methods for eliminating exogenous pathogenic factors.
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