Bi Tong Ling Tang

This is a contemporary Chinese formula created by Chen Xiang-jun from Feng-nan in Hebei province. Its Chinese name literally translates as Impediment Pain Cleverly Efficacious Decoction. Our version is a 9:1 extract.

RX:

Yi Yi Ren (Semen Coicis)
Qiang Huo (Radix Et Rhizoma Notopterygii)
Niu Xi (Radix Achyranthis Bidentatae)
Cang Zhu (Rhizoma Atractylodis)
Mu Gua (Fructus Chaenomelis)
Xiang Fu (Rhizoma Cyperi)
Wu Yao (Radix Linderae)
Han Fang Ji (Radix Stephaniae Tetrandrae)
Qin Jiao (Radix Gentianae Macrophyllae)
Dang Gui (Radix Angelicae Sinensis)
Ru Xiang (Olibanum)
Mo Yao (Myrrha)
Tao Ren (Semen Persicae)
Hong Hua (Flos Carthami)
Di Long (Pheretima)
Gui Zhi (Ramulus Cinnamomi)
Su Geng (Caulis Perillae)
Gan Cao (Radix Glycyrrhizae)

INDICATIONS:

This formula is for the treatment of chronic, enduring impediment pain due to a combination of wind, cold, damp evils and blood stasis having entered the network vessels. This pattern corresponds to certain presentations of osteoarthritis and rheumatoid arthritis.

SIGNS & SYMPTOMS OF BLOOD STASIS ENTERING THE NETWORK VESSELS:

• Fixed pain Pressure pain

• Enduring pain Pain which is worse at night

SIGNS & SYMPTOMS OF LIVER DEPRESSION QI STAGNATION:

• Irritability

• Frustration

• A bowstring pulse

COMBINATIONS:

If there is marked qi vacuity, combine with Si Jun Zi Wan (Four Gentlemen Pills) or Bu Zhong Yi Qi Wan (Supplement the Center & Boost the Qi Pills). If there is a concomitant qi and blood vacuity, combine with Ba Zhen Wan (Eight Pearls Pills). If there is concomitant kidney yang vacuity, combine with Shen Qi Wan (Kidney Qi Pills) or You Gui Wan (Restore the Right [Kidney] Pills).

FORMULA EXPLANATION:

Arthritis typically corresponds to impediment conditions (bi zheng) in Chinese medicine. According to the Nei Jing (Inner Classic): “ [When] the three qi of wind, cold, and dampness combine, they result in impediment.” However, Ye Tian-shi has also said that, “Enduring diseases enter the network vessels,” meaning that enduring diseases are usually complicated by blood stasis in the network vessel. While Yan De-xin has pointed out that, if there is chronic disease, there is liver depression whether that depression was part of the original cause of that disease. This is based on the fact that unfulfilled desires is the main cause of liver depression and a sick person has to have many unfulfilled desires. Therefore, unlike many impediment pain formulas, this formula not only dispels wind, eliminates dampness, and scatters cold, but also quickens the blood and frees the flow of the network vessels as well as courses the liver and rectifies the qi. Within it, Qiang Huo and Gui Zhi warm yang and free the flow of the vessels, scatter cold and diffuse impediment. Qin Jiao and Fang Ji dispel wind and eliminate dampness, relax the sinews and free the flow of the network vessels. Cang Zhu and Yi Yi Ren eliminate dampness by a combination of seeping and drying as well as free the flow of the network vessels. Dang Gui, Hong Hua, and Tao Ren quicken the blood and dispel stasis. Di Long, Mo Yao, and Ru Xiang quicken the blood, free the flow of the network vessels, and powerfully stop pain. Su Gen, Wu Yao, and Xiang Fu course the liver and rectify the qi. In particular, when Su Gen is combined with Xiang Fu, these two medicinals harmonize the liver and spleen. Additionally, Yi Yi Ren fortifies the spleen, Dang Gui nourishes the blood, and Wu Yao warms the kidneys. Niu Xi supplements the liver and kidneys and strengthens the sinews and bones, while Mu Gua transforms dampness and relieves cramping. According to Bensky et al., this medicinal is especially useful for a liver-spleen disharmony resulting in problems in the lower extremities. And finally, Gan Cao harmonizes all the other ingredients in the formula.

CHINESE CLINICAL RESEARCH:

In a trial involving 306 patients suffering from wind, cold, damp impediment pain, 81.4% were cured after a course of treatment with this formula and 14.4% registered at least some improvement. This resulting in a total amelioration rate of 95.8%.