Prescription
Main formula
Juan bi tang
Alternative formulas
Yi yi ren tang
Ma xing yi gan tang
Modifications
Patent remedies
Main points
Explanations
Alternative points
Modifications
Diagnosis
Principle of treatment
Herbal treatment
Fang feng tang
Explanations
Acupuncture treatment
Explanations
Diagnosis
Principle of treatment
Acupuncture treatment
Explanations
Herbal treatment
Downward Flow of Damp-Heat
Symptoms and signs
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Ankle pain
Remove Painful Obstruction Decoction. This formula, which dispels the Wind, eliminates the Cold, resolves the Damp, promotes the Qi and Blood circulation and relieves the pain, is indicated in ankle pain due to invasion of Wind, Cold and Damp with stagnation of Qi and Blood. Chuan Xiong Radix Ligustici Chuanxiong 10g, Hai Feng Teng Caulis Piperis Futokadsurae 10g, Du Huo Radix Angelicae Pubescentis 10g, Huai Niu Xi Radix Achyranthis Bidentatae 10g, and Sang Zhi Fructus Gardeniae 10g should be added to relieve the pain.
Coicis Decoction. This formula has a strong function which dispels the Wind, eliminates the Cold, resolves the Damp and relieves the pain, and is especially indicated in ankle pain due to invasion of Wind, Cold and Damp. Huai Niu Xi Radix Achyranthis Bidentatae 10g and Qin Jiao Radix Gentianae Macrophyllae 10g, etc., could be added to the prescription to relieve the pain.
Ephedra Apricot Kernel, Coicis and Licorice Decoction. This formula could be used to treat ankle pain in the early stage due to invasion of Wind, Cold and Damp, but only to eliminate Wind, Cold and Damp in general. To control the ankle pain some other herbs should be added to the prescription, such as Huai Niu Xi Radix Achyranthis Bidentatae 10g, Qin Jiao Radix Gentianae Macrophyllae 10g, Rou Gui Cortex Cinnamomi 6g, Cang Zhu Rhizoma Atractylodis 12g, Qiang Huo Rhizoma et Radix Notopterygii 12g, and and Du Huo Radix Angelicae Pubescentis 10g, etc.
1. If there is a fever and chills, add Fang Feng Radix Ledebouriellae Divaricatae 10g to relieve the External symptoms
2. If the ankle joints are swollen, add Han Fang Ji Radix Stephaniae Tetrandrae 10g to dispel the Damp, reduce the swelling and sedate the pain
3. If the ankle joint is swollen and red, add Zhi Mu Rhizoma Anemarrhenae 10g to clear the Heat and remove the obstruction from the collateral.
Jing Fang Bai Du Pian Schizonepeta and Ledebouriella Tablet to Overcome Pathogenic Influences.
Han Shi Bi Chong Ji Cold-Damp Bi Syndrome Infusion.
Tian Ma Qu Feng Bu Pian Gastrodia Dispel Wind Formula Tablet.
TE-5 Waiguan, LI-4 Hegu, BL-12 Fengmen, GB-40 Qiuxu, GB-41 Zulinqi, SP-6 Sanyinjiao, SP-10 Xuehai and some local Ah Shi points. Reducing method is used on these points. Moxibustion is used on some local points.
▪ TE-5, LI-4 and BL-12 dispel the External pathogenic Wind and relieve the External symptoms.
▪ Ah Shi points and GB-40 and GB-41 around the ankle joint are suitable for regulating the local circulation of Qi and Blood.
▪ There is a saying ‘the Wind will be dispelled automatically when the Blood flows smoothly’. SP-10 activates the circulation of Blood; SP-6 is the crossing point of the Kidney, Spleen, Liver channels, regulating the Blood and Qi, so these are useful for eliminating Wind.
Moxibustion warms the channels and collaterals, dispels the Cold and relieves the pain.
TE-4 Yangchi, LU-7 Lieque, SP-9 Yinlingquan, LR-3 Taichong and GB-34 Yanglingquan, etc.
When there is ankle pain with involvement of different channels, corresponding points should be combined:
1. If there is ankle pain along the Bladder channel, add BL-60, BL-62 and BL-63 to harmonise the collateral and relieve the pain
2. If there is ankle pain along the Gallbladder channel, add GB-42 and GB-43 to promote the circulation of Qi and Blood and relieve the pain
3. If there is ankle pain along the Stomach channel, add ST-41, ST-42 and ST-43 to promote the circulation of Qi and Blood in the channel, relieve blockage and arrest the pain
4. If there is ankle pain along the Liver channel, add LR-3 and LR-4 to harmonise the collateral and relieve the pain
5. If there is ankle pain along the Kidney channel, add KI-3, KI-4 and KI-5 to promote the circulation of Qi and Blood and relieve the pain
6. If there is ankle pain along the Spleen channel, add SP-4 and SP-5 to harmonise the collateral and relieve the pain
7. Some corresponding points on the wrist should be used in order to increase the therapeutic effect
8. If there is a fever and chills, add GV-14, the meeting point for all the Yang channels, to dispel the Wind, relieve the External symptoms and reduce the fever
9. If the ankle joint is swollen, add SP-9, the Sea point of the Spleen channel, to remove the Damp and reduce the swelling
10. If there is redness, swelling and a sensation of heat in the ankle joint, add LI-11, the Sea point of the Large Intestine channel, and ST-44, the Spring point of the Stomach channel, to clear the Heat and reduce the swelling.
A 30-year-old man had been suffering from wandering ankle pain on both sides for a month. He always wore slippers at home in the winter. A month previously, he started to feel pain in his ankle joint, which got worse when exposed to a wind. The painful areas around the ankle always moved from one ankle to the other, but were mostly around the place where the Bladder channels pass through; he also had a thin white tongue coating and a superficial and tight pulse.
Ankle pain due to invasion of Wind-Cold.
Dispel Wind, expel Cold and relieve the pain.
Ledebouriella Decoction
Fang Feng Radix Ledebouriellae 10g
Ma Huang Herba Ephedrae 6g
Dang Gui Radix Angelicae Sinensis 10g
Qin Jiao Radix Gentianae Macrophyllae 10g
Rou Gui Cortex Cinnamomi 6g
Gan Cao Radix Glycyrrhizae 6g
Qing Feng Teng Caulis Sinomenii 20g.
▪ Fang Feng and Ma Huang dispel Wind and Cold and relieve External symptoms
▪ Qin Jiao and Rou Gui warm the channels and dispel Cold
▪ Dang Gui promotes the circulation of Blood and removes obstructions from the collateral
▪ Qing Feng Teng dispels Wind-Cold and relieves the ankle pain
▪ Gan Cao harmonises the actions of the other herbs in the prescription.
TE-5, LI-4, SP-10, SP-6, BL-60, BL-63, wrist point SI-4 and some local Ah Shi points. Reducing method was used on these points. Treatment was given once every day.
▪ TE-5 and LI-4 dispel External pathogenic Wind and relieve External symptoms
▪ SP-10, and SP-6, the crossing point of the three Yin channels of the foot, regulate the circulation of the Blood and relieve the pain
▪ The Ah Shi points, wrist point SI-4, BL-60 and BL-63 promote the circulation of Qi and Blood around the ankle joint, dispel Wind-Cold and relieve the pain.
After treatment for 2 weeks, the patient’s ankle pain disappeared.
A 46-year-old female had been suffering from rheumatoid arthritis for 4 years. The pain was mainly in the lower limbs, especially in her ankles. In the previous few weeks, her ankle pain had become worse, and caused her difficulty in walking and sleeping. She received some painkillers from her doctor, but they did not help much. There was swelling and a heavy sensation in the ankle joints, the pain worsened on overcast and rainy days, and was located at GB-40. Accompanying symptoms included a poor appetite and occasional loose stools, a white and greasy tongue coating and a soft and slippery pulse.
Ankle pain due to invasion of Wind-Cold-Damp with predominance of Damp, weakness of Spleen and Stomach.
Eliminate Damp, dispel Wind-Cold, activate the Spleen and Stomach and sedate the pain.
TE-6, ST-40, SP-6, SP-9, BL-12, BL-60, GB-34, GB-40 and corresponding wrist point TE-4. Reducing method is used on these points. Treatment was given once every day.
▪ TE-6 and BL-12 dispel External pathogenic Wind-Cold and eliminate External Damp
▪ ST-40, the Connecting point, SP-6, the crossing point of the three Yin channels of the foot, and SP-9, the Sea point, activate the Spleen and Stomach, and eliminate Damp in the body and channels so as to relieve the pain
▪ BL-60 dispels External pathogenic factors and relieves the ankle pain
▪ GB-34, the Gathering point for the tendons, GB-40, the Source point, and the corresponding wrist point TE-4, the Source point, eliminate Damp, regulate the circulation of Qi and Blood in the Gallbladder channel and relieve the ankle pain.
A prescription based on Yi Yi Ren Tang Coix Decoction and Shen Ling Bai Zhu San Panaxa–Poria–Atractylodis Powder was given to eliminate Wind-Cold-Damp in the channels and strengthen the Spleen and Stomach.
After four treatment sessions, her ankle pain had improved, and the swelling had subsided. After 10 treatments, the ankle pain was gone. The herbal treatment was continued for another month in order to regulate her Spleen and Stomach and eliminate Damp from the body.
