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Bi Syndromes II

Key Symptoms:

  1. Soreness, pain, numbness and heavy sensations of the limbs and joints. Restriction of movement.
  2. In severe cases the soreness and pain are extreme and recur repeatedly accompanied by swelling of the joints and even deformity.
  3. It includes rheumatic arthritis (attacks larger joints), rheumatoid arthritis (attacks smaller joints), and others are commonly seen in the clinic.

Differential Diagnosis:

1) Wandering Bi (more wind than cold or damp)
Characterized by migrating pain and caused chiefly by pathogenic wind. Wandering pain in the joints, chills and fever.

Tongue: Normal body with thin white coat.
Pulse: Wiry

2) Painful Bi (more cold than wind or damp)
Characterized by sever pain and caused chiefly by pathogenic cold. Severe fixed stabbing pain in the joints. Pain is alleviated by warmth and aggravated by cold.

Tongue: Normal body with thin white coat
Pulse: Tight

3) Fixed Bi (more damp than wind or cold)
Characterized by marked soreness, numbness and heaviness. It is cause chiefly by pathogenic damp. Soreness and fixed pain in the joints, numbness or heavy sensation with possible swelling of the limbs. Fixed Bi is aggravated by damp weather.

Tongue: Normal body with white, greasy coat.
Pulse: Soft, slow

4) Heat Bi
Characterized by the manifestation of heat in the affected tissues. Also, sudden onset. Arthralgia with local redness, swelling and burning. Excruciating pain involving one or several joints accompanied with fever, sweating, and thirst.

Tongue: Normal body with yellow, greasy coat
Pulse: Slippery and rapid

Additionally, Bi syndromes may be classified according to their location. (The Bi of the Five Tissues)

Skin Bi
Numbness of the skin (sometimes with associated with a sensation of cold), neuritis of lateral cutaneous nerve of the thigh.

Muscle Bi
Soreness, numbness and pain of the muscles.

Tendon Bi
Soreness, pain, and stiffness of the tendons and muscles. i.e. Cervical Spondylopathy

Vessel Bi
Pain due to blockage of the vessels. i.e. Angina

Bone Bi
Soreness, heaviness and pain of joints which fail to perform their functions of lifting, extension and flexion. i.e. Cervical Spondylopathy

Etiology:

Dysfunction of the pores and weakness of Wei Qi or general weakness of the body with a deficiency of Yang Qi. Invasion of the meridians and collaterals by pathogenic wind, cold, and damp.

1) Wandering Bi
More Wind, than cold or damp.

2) Painful Bi More Cold, than wind or damp.

3) Fixed Bi
More Damp, than wind or cold.

4) Heat Bi
In the case of the body with constitutionally excessive Yang Qi, the addition of Pathogenic Wind, Damp and Cold will give rise to heat bi. Furthermore, long-standing wind, cold and damp Bi syndromes may turn into Heat Bi as the pathogenic factors in the meridians and collaterals are transformed into heat.

Treatment Principle:

Dispel wind, cold, damp. Clear heat. Soothe channels. Stop pain.

Point and Technique Prescription:

According to where the disease is manifesting, local, distal, and symptomatic points are selected and combined with Ashi points.

Shoulder pain: (Belongs to three Yang hand channels)

LI 15
SJ 14
SJ 10
LI 4 Yuan-source pt., so it assists to send Qi through Channels in shoulder.
SJ 5 San Jiao channel for Qi diseases, moves Qi through shoulder.
SI 3 Shu-stream (wood) for painful joints and sensations of heaviness.

Elbow joint pain: (Belongs to all six hand channels)

LI 11
Lu 5
SJ 10
SJ 5 Luo-connecting point, good to remove pathogens from SJ channel.
LI 4 Yuan-source pt. tonifies Qi in LI channel, which relieves stagnation.

Wrist pain: (Belongs mostly to the three hand Yang channels)

SJ 4
LI 5
Si 6 Xi-cleft, stops pain.
SJ 5 Removes Qi stagnation, San Jiao channel is for Qi diseases.

Numbness or pain in the fingers: (Usually treated with three hand Yang)

Si 3 Shu-stream point for painful joints.
LI 3 Shu-stream point for painful joints.
Ba Xie (The eight evils-so named because of their ability to dispel Xie Qi)

Pain in the vertebral joints: (Vertebra belong to Du Mai)

Du 26 Sensitive points are good for moving Qi in the channel.
Du 12 Shen Zhu means "Body Support"
Du 3 Lumbar Yang Gate
Du 4 Ming Men

Pain in the hip joint: (Hip joint belongs to Foot Shao Yang-GB)

GB 30
GB 29
GB 39 Influential Point of the Marrow (think of hip is a big marrowed bone)
GB 34 Influential Point of the Tendon
Pain in the thigh region:
GB 31
UB 54 (Three cun lateral to the midline, at the level of fourth sacral foreman)
UB 36
GB 34

Pain in the knee joint:

GB 34 Local/and Inf. Point of Tendon
Sp 9 Local/and it clears damp (because it tonifies Spleen)
St 35
Xi Yan
St 34 Local/and Xi-cleft point for pain.
Sp 10 Sea of Blood

Pain and numbness in the leg:

UB 57
UB 58
GB 34 Influential Point of Tendon

Pain in the ankle:

UB 62 Yang Qiao Mai Master Point
Kid 6 Yin Qiao Mai Master Point
UB 60
GB 40
St 41

Numbness and pain in the toes:

Ba Feng (Great to disperse the 8 evil winds and other pathogens.)
Jing Well points of foot channels.

Wandering Bi: (Mostly wind)

UB 17 Influential point of the blood
Sp 10 Sea of Blood
GB 20 For wind ("Wind Pool")
Du 16 Also for wind ("Wind Palace")

Painful Bi: (Mostly Cold)

UB 23 Kidney Back-shu. Tonifying Kidney Yang disperses Cold
Du 4 Ming Men fire warms cold
Ren 4 Guan Yuan (Yuan-source qi point for dispersing cold)
Ren 8 Moxa only with ginger to warm the abdomen.

Fixed Bi: (Mostly Damp)

St 36 He-Sea Point (earth) for stomach. Strong tonification for Sp/St.
Sp 9 Tonifies Spleen dispels damp.
SI 3 Shu-stream point for painful joints.

Heat Bi:

Du 14 Crossing point of all six Yang Channels. Good to release heat.
LI 11 Yang Qi is prevalent in this point, hence a good point to reduce to remove XS heat.

Tendon Bi:

GB 34 Influential Point of Tendons

Bone Bi:

GB 39 Influential Point of Marrow, hence controls bone.
UB 11 Influential Point of Bone

Vessel Bi:Lu 9 Influential Point of Vessels
UB 17 Influential point of the Blood
Sp 10 Sea of Blood

Techniques:

Reduce for excess, tonify for deficiency syndromes.

Skin, wandering Bi:
Shallow Insertion.

Bone, tendon or vessel Bi: Deep insertion for a long time (at least a half hour)

Painful and Vessel Bi:
Moxibustion in addition to needling.

Fixed, muscle, or bone Bi:
Needling, moxibustion, and cupping.

Explanation:

The prescriptions are formulated by selection of the local and distal points on the meridians supplying the diseased areas with Qi and Xue.

UB 17 is the influential point of the blood Sp 10 is the Sea of Blood. Together, they have the function of activating and nourishing the blood. "Wind will be naturally eliminated if the blood circulates smoothly." GB 20 and Du 16 also dispel wind. UB 23, Du 4, Ren 4 and Ren 8 is a combination of back and front points that strengthen the Kidney fire and relieve the painful Bi.

Sp 9, St 36 are He-sea points. Sp 3 is the Yuan source and Shu Stream point of the Spleen channel. These points, together, strengthen the function of the spleen and stomach and eliminate damp to relieve the fixed Bi.

Du 14 is the crossing point for all the Yang channels. combines with LI 11, the can clear the heat for heat Bi.

The following points are used because they are influential points:

GB 34 Tendons
GB 39 Marrow
UB 11 Bone
Lu 9 Vessels
UB 17 Blood
Sp 10 Sea of Blood

Needling depth for Bi Syndromes' local points:

Superficial for Skin Bi.
Medium for Muscle Bi.
Deep for Bone Bi.

More from Dr. Ma at: Acuherbsonline.com


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