HERB FORMULAS

JUAN BI TANG - 蠲痺湯 - REMOVE PAINFUL OBSTRUCTION DECOCTION

English: Remove Painful Obstruction Decoction
Also Known As:

HERBS AND ACTIONS

Pharmaceutical Latin
Pin Yin
Dosage
Actions
Rx. et Rz. Notopterygii Qiang Huo 3-10g Releases the Exterior, disperses Cold, expels Wind-Cold-Dampness, unblocks painful obstruction (Bi), alleviates pain, increases joint mobility and guides Qi to the Tai Yang and DU channels.
With Du Huo, relieves pain in the upper and lower parts of the body.
Rx. Angelica Pubescentis Du Huo 3-10g Releases the Exterior, dispels Wind-Cold-Dampness, opens the channels, vitalizes vessels and stops pain.
With Qiang Huo for joint pain and numbness.
Rx. Gentianae Macrophyllae Qin Jiao 3-10g Clears Heat, expels Wind-Dampness, relaxes the sinews, clears Deficiency Heat and resolves Dampness.
With Sang Zhi, and Hai Feng Teng, expels Wind-Dampness.
Ram. Mori Sang Zhi 9-30g Expels Wind, clears the channels, eases the joints, stops spasms and regulates water metabolism, especially useful for muscle spasms and painful obstruction of the upper extremities.
Caulis Piperis Kadsurae Hai Feng Teng 9-30g Expels Wind-Damp, clears the channels, disperses Cold, stops pain - good for immobile joints.
With Gui Zhi for pain, impaired joint movement and spasms of the sinews due to Wind-Damp Bi.
Rx. Angelica Sinensis Dang Gui 6-10g Nourishes Blood, invigorates and harmonizes Blood, disperses Cold and stops pain.
With Chuan Xiong, nourishes and invigorates Blood to subdue Wind and stop pain.
Rz. Chuanxiong Chuan Xiong 2-10g Activates Blood, regulates Qi, expels Wind-Cold and stops pain.
Olibanum Ru Xiang 2.5-7.5g Breaks up Blood Stagnation, invigorates the Blood, regulates Qi, relaxes the sinews, opens the channels, reduces swelling. and treats localized pain.
Rx. Aucklandiae Mu Xiang 2.5-10g Moves Qi, revives the Spleen, dispels Dampness, improves fluid metabolism and sedates pain.
Ram. Cinnamomi Gui Zhi 1.5-10g Releases External Wind-Cold from the muscle layer, harmonizes the Ying and Wei, warms the channels and collaterals, relieves pain, disperses Cold, unblocks Yang, transforms Qi, warms and facilitates the flow of Yang Qi in the chest and warms and facilitates the flow of Blood through the vessels.
(Cx. Cinnamomi) (Rou Gui) (3g) (Substitutes for Gui Zhi in severe cases.)
Rx. Glycyrrhizae Preparata Zhi Gan Cao 1.5-4.5g Moderates and harmonizes the harsh properties of the other herbs and prevents injury to normal Qi.

FORMULA ACTIONS

  • Removes Wind-Dampness
  • Disperses Cold
  • Eliminates Painful Obstruction
  • Circulates Qi and Blood
  • Stops pain

SYNDROMES

  • Wind-Cold-Damp Bi
  • Muscular atrophy due to Qi and Blood Stagnation

CLINICAL MANIFESTATIONS

  • Joint pain, especially in the wrist, ankle, knee and elbow
  • Muscle pain
  • There may be numbness and heaviness in the limbs
  • The pain is worse with Cold and better with warmth
  • The pain is aggravated by Wind
  • The pain aggravated by Dampness
  • The pain is stabbing
  • Muscle weakness
  • Difficult movement
  • Numbness of the muscles and skin
  • Hemiplegia, especially of the upper limbs
  • The pain alleviated by movement
  • Slight muscle edema
  • Heaviness of the joints
  • Cold joints
  • Aversion to Cold
  • The pain worse at night
  • Local inflammation
  • Migratory pain
  • Deviation of the eyes and mouth
  • Spasm of the limbs
  • T: Slightly purple or purple spots
  • C: Thick and white
  • P: Slippery or Slightly superficial or slightly rough or Slow and Soft or Wiry and tight or Floating and wiry

TREATS

CONTRAINDICATIONS AND HERB/DRUG INTERACTIONS

CONTRAINDICATIONS
  • Contraindicated for those with Damp-Heat in the channels.
HERB/DRUG INTERACTIONS

NOTES

  • Warms without drying.
  • Unblocks without causing damage.
  • Stronger Wind relieving and pathogen expelling action than Juan Bi Tang from Selected Formulas.

MODIFICATIONS

For Wind predominant Bi: For Cold predominant Bi:
+ 10g Rx. Saposhnikoviae Fang Feng + Rx. Aconiti Lateralis Preparata Zhi Fu Zi
For Damp predominant Bi:
or
+ Rx. Aristolochiae Guang Fang Ji + Rx. Aconiti Preparata Zhi Chuan Wu
+ Rz. Atractylodis Cang Zhu + Rx. Aconiti Kusnezoffii Zhi Cao Wu
+ Sm. Coicis Yi Yi Ren + Rx. Ephedrae Ma Huang
or
 + Rx. Hb. cum Rx. Asari Xi Xin
+ Rx. Stephaniae Tetrandrae Han Fang Ji
+ Minor Invigorate the Channels Special Pill
Xiao Huo Luo Dan
+ Rz. Atractylodis Cang Zhu
or
+ Sm. Coicis Yi Yi Ren +6g Rx. Aconiti Lateralis Preparata Zhi Fu Zi
+ Faeces Bombycis Can Sha + 3g Rx. Aconiti Preparata Zhi Chuan Wu
or
For pain primarily in the lower limbs:
+ 6g Fr. Chaenomelis Mu Gua + Rx. Achyranthis Bidentatae Niu Xi
+ 10g Cx. Acanthopanacis Wu Jia Pi
or
or
 + Fr. Chaenomelis Mu Gua
+ Rx. Clematidis Wei Ling Xian
or
More Ram. Mori Sang Zhi + Fr. Tribuli Bai Ji Li
or
 + Rx. Achyranthis Bidentatae Niu Xi
+ Rx. Clematidis Wei Ling Xian + Fr. Chaenomelis Mu Gua
+ Rz. Curcumae Longae Jiang Huang + Rx. Dipsaci Xu Duan
For low back pain:
or
+ Cx. Eucommiae Du Zhong + Rx. Cyathulae Chuan Niu Xi
+ Rz. Cibotii Gou Ji
For fever:
For periarthritis of the shoulder:
 + Rz. Anemarrhenae Zhi Mu
+ Ram. Cinnamomi Gui Zhi + Rx. Scutellariae Huang Qin
+ Caulis Impatientis Tou Gu Cao + Flos Lonicerae Jin Yin Hua
For periarthritis of the right shoulder:
 + Fr. Forsythiae Lian Qiao
+ Ram. Cinnamomi Gui Zhi
For periarthritis of the left shoulder:
+ Caulis Impatientis Tou Gu Cao + Ram. Cinnamomi Gui Zhi
+ Four Gentlemen Decoction
Si Jun Zi Tang
+ Caulis Impatientis Tou Gu Cao
+ Four Substance Decoction
Si Wu Tang
For periarthritis of the shoulder with neck pain:
+ Ram. Cinnamomi Gui Zhi
For periarthritis of the shoulder with neck pain and temporal headaches:
+ Caulis Impatientis Tou Gu Cao
+ Kudzu Decoction
Ge Gen Tang
+ Ram. Cinnamomi Gui Zhi
+ Caulis Impatientis Tou Gu Cao
For periarthritis of the shoulder with numbness and weakness of the arms:
+ Minor Bupleurum Decoction
Xiao Chai Hu Tang
+ Ram. Cinnamomi Gui Zhi
For periarthritis of the shoulder with headaches:
+ Caulis Impatientis Tou Gu Cao + Ram. Cinnamomi Gui Zhi
+ Astragalus and Cinnamon Twig Five-Substance Decoction
Huang Qi Gui Zhi Wu Wu Tang
+ Caulis Impatientis Tou Gu Cao
+ Pinellia, Atractylodes Macrocephala and Gastrodia Decoction
Ban Xia Bai Zhu Tian Ma Tang
For hemilateral sweating:
- Rx. Angelicae Dahuricae Du Huo
For a frozen shoulder:
- Rx. Aucklandiae Mu Xiang
- Rx. Gentianae Macrophyllae Qin Jiao - Rx. Glycyrrhizae Gan Cao
+ 12g Rx. Astragali Huang Qi
- Ram. Mori Sang Zhi + 9g Caulis Trachelospermi Luo Shi Teng
- Olibanum Ru Xiang
- Rx. Aucklandiae Mu Xiang + 6g Rz. Curcumae Longae Jiang Huang
- Ram. Cinnamomi Gui Zhi
+ 15g Rx. Astragali Huang Qi
For a frozen shoulder with restricted movement:
+ 9g Rz. Curcumae Longae Jiang Huang - Rx. Aucklandiae Mu Xiang
- Rx. Glycyrrhizae Gan Cao
+ 12g Rx. Paeoniae Alba Bai Shao + 12g Rx. Astragali Huang Qi
+ 9g Rx. Saposhnikoviae Fang Feng + 9g Caulis Trachelospermi Luo Shi Teng
+ 3g Rz. Zingiberis Recens Sheng Jiang
+ 6g Rz. Curcumae Longae Jiang Huang
+ 3g Rx. Aconiti Preparata Zhi Chuan Wu
+ 12g Hb. Pyrolae Lu Xian Cao
For a frozen shoulder with Kidney Deficiency and bone weakness:
 + 12g Hb. Lycopodii Shen Jin Cao
For a frozen shoulder with marked Qi and Blood Deficiency:
- Rx. Aucklandiae Mu Xiang
- Rx. Glycyrrhizae Gan Cao - Rx. Aucklandiae Mu Xiang
+ 12g Rx. Astragali Huang Qi - Rx. Glycyrrhizae Gan Cao
+ 9g Caulis Trachelospermi Luo Shi Teng - Rx. et Rz. Notopterygii Qiang Huo
- Caulis Piperis Kadsurae Hai Fen Teng
+ 6g Rz. Curcumae Longae Jiang Huang
+ 12g Rz. Drynariae Gu Sui Bu + 18g Rx. Astragali Huang Qi
+ 12g Rx. Dipsaci Xu Duan + 9g Caulis Trachelospermi Luo Shi Teng
For a frozen shoulder with Kidney Yin Deficiency:
+ 6g Rz. Curcumae Longae Jiang Huang
- Rx. Aucklandiae Mu Xiang
- Rx. Glycyrrhizae Gan Cao + 6g Rx. Paeoniae Alba Bai Shao
- Rx. et Rz. Notopterygii Qiang Huo + 6g Rx. Codonopsis Dang Shen
- Caulis Piperis Kadsurae Hai Fen Teng
For a frozen shoulder with Kidney Yang Deficiency:
+ 12g Rx. Astragali Huang Qi - Rx. Aucklandiae Mu Xiang
+ 9g Caulis Trachelospermi Luo Shi Teng - Rx. Glycyrrhizae Gan Cao
- Rx. et Rz. Notopterygii Qiang Huo
+ 6g Rz. Curcumae Longae Jiang Huang + 12g Rx. Astragali Huang Qi
+ 9g Caulis Trachelospermi Luo Shi Teng
+ 9g Rx. Achyranthis Bidentatae Niu Xi
+ 6g Rz. Curcumae Longae Jiang Huang
+ 9g Hb. Taxilli Sang Ji Sheng
+ 9g Plastrum Testudinis Gui Ban + 9g Cx. Eucommiae Du Zhong
+ 9g Rz. Cibotii Gou Ji
For a frozen shoulder in a menopausal patient:
 + 9g Cx. Acanthopanacis Wu Jia Pi
- Rx. Aucklandiae Mu Xiang
- Rx. Glycyrrhizae Gan Cao
For a frozen shoulder with Phlegm-Dampness:
- Rx. et Rz. Notopterygii Qiang Huo - Rx. Aucklandiae Mu Xiang
- Caulis Piperis Kadsurae Hai Fen Teng - Rx. Glycyrrhizae Gan Cao
+ 12g Rx. Astragali Huang Qi
+ 12g Rx. Astragali Huang Qi + 9g Caulis Trachelospermi Luo Shi Teng
+ 9g Caulis Trachelospermi Luo Shi Teng
+ 6g Rz. Curcumae Longae Jiang Huang
+ 6g Rz. Curcumae Longae Jiang Huang
+ 9g Rz. Arisaematis Preparatum Zhi Tian Nan Xing
+ 9g Cx. Phellodendri Huang Bai
+ 9g Rz. Anemarrhenae Zhi Mu +9g Poria Fu Ling
+3g Rz. Curculiginis Xian Mao
For a frozen shoulder with severe Blood Stasis:
+ 3g Hb. Epimedii Yin Yang Huo - Rx. Aucklandiae Mu Xiang
For a frozen shoulder with Liver Qi Stagnation:
 - Rx. Glycyrrhizae Gan Cao
- Rx. Aucklandiae Mu Xiang + 12g Rx. Astragali Huang Qi
- Rx. Glycyrrhizae Gan Cao + 9g Caulis Trachelospermi Luo Shi Teng
+ 12g Rx. Astragali Huang Qi
+ 9g Caulis Trachelospermi Luo Shi Teng + 6g Rz. Curcumae Longae Jiang Huang
+ 6g Rz. Curcumae Longae Jiang Huang +15g Caulis Spatholobi Ji Xue Teng
+ 6g Myrrh Mo Yao
+ 9g Fr. Toosendan Chuan Lian Zi
For shoulder pain:
+ 9g Rz. Cyperi Xiang Fu - Cx. Eucommiae Du Zhong
+6g Rx. Bupleuri Chai Hu - Caulis Piperis Kadsurae Hai Feng Teng
For shoulder pain with a heavy sensation in the shoulder:
- Olibanum Ru Xiang
- Cx. Eucommiae Du Zhong + 10g Rz. Atractylodis Cang Zhu
- Caulis Piperis Kadsurae Hai Feng Teng
For shoulder pain with an aversion to Cold:
- Cx. Eucommiae Du Zhong
- Olibanum Ru Xiang - Caulis Piperis Kadsurae Hai Feng Teng
+ 10g Rz. Atractylodis Cang Zhu
+ 10g Rz. Curcumae Longae Jiang Huang - Olibanum Ru Xiang
+ 10g Rz. Atractylodis Cang Zhu
+ 20g Caulis Sinomenii Qing Feng Teng + 6g Rx. Aconiti Lateralis Preparata Zhi Fu Zi
For shoulder pain with a swollen shoulder:
- Cx. Eucommiae Du Zhong + 3g Hb. et Rx. Hb. cum Rx. Asari Xi Xin
- Caulis Piperis Kadsurae Hai Feng Teng
For piriformis syndrome:
+ 12g Cx. Eucommiae Du Zhong
- Olibanum Ru Xiang + 9g Rx. Cyathulae Chuan Niu Xi
+ 10g Rz. Atractylodis Cang Zhu
For piriformis syndrome with severe Cold in the affected area:
+ 20g Rz. Smilacis Glabrae Tu Fu Ling
+ 12g Cx. Eucommiae Du Zhong
+ 10g Rz. Pinelliae Preparatum Zhi Ban Xia + 9g Rx. Cyathulae Chuan Niu Xi
+ 9g Rx. Aconiti Lateralis Preparata Zhi Fu Zi
For piriformis syndrome with restricted movement of the lower limbs:
+ 9g Hb. Ephedrae Ma Huang
+ 12g Cx. Eucommiae Du Zhong
For piriformis syndrome with Qi Deficiency:
+ 9g Rx. Cyathulae Chuan Niu Xi + 12g Cx. Eucommiae Du Zhong
+ 12g Cx. Erythrinae Hai Tong Pi + 9g Rx. Cyathulae Chuan Niu Xi
+ 121g Hb. Siegesbeckiae Xi Xian Cao + 15g Rx. Astragali Huang Qi
+ 12g Rx. Codonopsis Dang Shen
For piriformis syndrome with Blood Deficiency:
For piriformis syndrome with Liver Blood and Kidney Yang Deficiency:
+ 12g Cx. Eucommiae Du Zhong
+ 9g Rx. Cyathulae Chuan Niu Xi + 12g Cx. Eucommiae Du Zhong
+ 12g Rx, Paeoniae Alba Bai Shao + 9g Rx. Cyathulae Chuan Niu Xi
+ 12g Rx. Rehmanniae Preparata Shu Di Huang + 9g Cx. Acanthopanacis Wu Jia Pi
For piriformis syndrome with Liver Blood and Kidney Yin Deficiency:
 + 9g Hb. Epimedii Yin Yang Huo
+ 9g Rx. Morindae Officinalis Ba Ji Tian
- Rx. Cyathulae Chuan Niu Xi
+ 12g Cx. Eucommiae Du Zhong
For pain primarily in the upper limbs:
+ 9g Rx. Cyathulae Chuan Niu Xi + Rx. Clematidis Wei Ling Xian
+ 12g Hb. Taxilli Sang Ji Sheng + more Ram. Mori Sang Zhi
+ 12g Rx. Achyranthis Bidentatae Niu Xi
For temporomandibular joint syndrome (TMJ):
- Caulis Piperis Kadsurae Hai Feng Teng
+ 12g Rx. Rehmanniae Preparata Shu Di Huang
- Rx. Aucklandiae Mu Xiang
For rheumatic fever:
 + 9g Rx. Angelicae Dahuricae Bai Zhi
- Olibanum Ru Xiang
- Rx. Aucklandiae Mu Xiang + 9g Rx. et Rz. Ligustici Gao Ben
- Rx. Glycyrrhizae Preparata Zhi Gan Cao
For rheumatic fever with Wind predominant:
- Olibanum Ru Xiang
+ 30g Caulis Spatholobi Ji Xue Teng - Rx. Aucklandiae Mu Xiang
For rheumatic fever with Cold predominant:
 - Rx. Glycyrrhizae Preparata Zhi Gan Cao
- Olibanum Ru Xiang
- Rx. Aucklandiae Mu Xiang + 30g Caulis Spatholobi Ji Xue Teng
- Rx. Glycyrrhizae Preparata Zhi Gan Cao + 12g Rx. Clematidis Wei Ling Xian
+ 10g Rx. Saposhnikoviae Fang Feng
+ 30g Caulis Spatholobi Ji Xue Teng
+ 3g Rx. Aconiti Lateralis Preparata Zhi Fu Zi
For rheumatic fever with Damp predominant:
- Olibanum Ru Xiang
+ + 3g Rx. Aconiti Kusnezoffii Preparata Zhi Cao Wu - Rx. Aucklandiae Mu Xiang
- Rx. Glycyrrhizae Preparata Zhi Gan Cao
+ 6g Rx. Glycyrrhizae Gan Cao
For rheumatic fever with chorea:
 + 30g Caulis Spatholobi Ji Xue Teng
- Olibanum Ru Xiang + 30g Sm. Coicis Yi Yi Ren
- Rx. Aucklandiae Mu Xiang + 12g Rz. Atractylodis Cang Zhu
- Rx. Glycyrrhizae Preparata Zhi Gan Cao
For chronic rheumatic fever with repeated attacks:
+ 30g Caulis Spatholobi Ji Xue Teng - Rx. Aucklandiae Mu Xiang
+ 12g Rx. Paeoniae Alba Bai Shao - Rx. Glycyrrhizae Preparata Zhi Gan Cao
+ 12g Rx. Achyranthis Bidentatae Niu Xi + 30g Caulis Spatholobi Ji Xue Teng
+ 10g Myrrh Mo Yao
+ 10g Rz. Gastrodiae Tian Ma + 12g Pheretima Di Long
+ 20g Ram. cum Uncis Uncariae Gou Teng + 6g Scorpio Quan Xie
For rheumatic fever with Qi, Blood, Liver and Kidney Deficiency:
   
    - Olibanum Ru Xiang
    - Rx. Aucklandiae Mu Xiang
    - Rx. Glycyrrhizae Preparata Zhi Gan Cao
   
    + 30g Caulis Spatholobi Ji Xue Teng
    + 15g Rx. Astragali Huang Qi
    + 12g Rx. Codonopsis Dang Shen
    + 12g Cx. Eucommiae Du Zhong
    + 15g Hb. Taxilli Sang Ji Sheng