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Pattern Names

Cold Bi • •

Classification
Category: Bio Med	Syndrome: Bi Syndrome

Symptoms
Tongue: thin white coat	Pulse: tight, wiry
Indications: local severe and fixed pain, better with heat, worse with cold, limited ROM, stiff joints, difficulty moving, no redness [41]
BioMed: Rheumatic arthritis, rheumatic fever, rheumatoid arthritis, gout, fibrosis, neuralgia *rheumatic arthritis is painful but there is no weakness, while rheumatoid causes both pain and weakness [41]

Treatment Principle

Dispel cold warm channels stop pain

Acupunture

REN4(raise clear Yang Qi), ST36(tonify deficiencies, muscle atrophy), BL23(Kidney deficiency, bones, joints), local points [41]

Herbs

Wu Tou Tang/Acojite (***dosage copied from from Maclean: Clinical Handbook of Internal Medicine) Zhi Chuan Wu Tou (aconite) 9-15g - WCD Bai Shao 6-9g - Huang Qi 12-18g Ma Huang 6-9g Zhi Gan Cao 6-9g (Feng Mi 60g) Other good herbs: Luo Si Teng (could sub for aconite) Ji Xue Teng Yan Hu Suo Alternate formula: Bai Shao Gan Cao Tang [41]

Notes

AKA "Painful Bi". Skin Bi: numbness, itching due to LU / Wei qi xu, Muscle Bi: due to blood xu from SP xu / digestive issues, no muscle tension or power, weak muscles (mu gua is great for muscle bi), Tendon Bi: tight tendons, tendonitis, restricted movement, tonify LV blood / move LV qi, Vessel Bi: involves blood stasis, may show visible veins, distended sublinguals, may have chest pain and palpitations, Bone Bi: KI & LV xu, chronic duration, Chronic Bi: prolonged cases [41]