Wind Painful Obstruction syndrome is called ‘ Xing Bi’ in Chinese. ‘ Xing’ means ‘moving’ or ‘walking’. This syndrome is characterized by pain that migrates from joint to joint and from one place to another. The pain worsens during windy weather. Other symptoms and signs include tingling of the limbs, pain with a radiating nature, a normal tongue body with a white, thin coating and a moderate pulse. The pathogenic factors of Wind Painful Obstruction syndrome are Wind, Dampness and Cold, with Wind being the predominant factor. In clinical practice, it is often associated with diseases such as migraine, cervical or lumbar spondylosis, hyperosteogeny and rheumatic fever.

Cold Painful Obstruction syndrome is called ‘T ong Bi’. ‘T ong’ means ‘pain’ in Chinese. The syndrome is characterized by severe pain of a fixed, contracting or cramping nature. The pain worsens during winter or cold weather and is relieved by warmth. Other symptoms and signs include cold limbs and a preference for warmth, a purple or blue tongue body with a white, sticky or watery coating and a deep, wiry pulse. The pathogenic factors of this syndrome are Wind, Dampness and Cold, with Cold being the predominant factor. In clinical practice, it is often associated with diseases such as rheumatic fever, rheumatoid arthritis, osteoarthropathy and osteoporosis.

Damp Painful Obstruction syndrome is called ‘ Zhuo Bi’. ‘ Zhuo’ means ‘to wear’ and ‘to adhere’. The syndrome is characterized by a fixed, lingering pain and swelling of the joints or muscles associated with a heavy or numb sensation. The pain and swelling worsen during humid and cold weather. The other symptoms and signs are heaviness of the body, edema or difficult micturition, a light purple tongue body with a white, thick coating and a deep, moderate pulse. The pathogenic factors in this syndrome are Wind, Dampness and Cold, with Dampness being the predominant factor. In clinical practice, it can be seen in diseases such as chronic strain of the muscles or other soft tissues and various kinds of arthritis.

Hot Painful Obstruction syndrome is called ‘ Re Bi’. ‘ Re’ means ‘hotness’. It is characterized by painful and swollen joints with hot or burning sensations. The other symptoms and signs are fever, thirst, scanty urine, a red tongue body with a yellow coating and a rapid, slippery pulse. Hot Painful Obstruction syndrome is a development of the invasion of Wind, Dampness and Cold. First of all, when Wind, Dampness and Cold invade the body, they disturb the Qi movement and the Blood circulation. As the body puts up resistance in order to eliminate these pathogenic factors, Heat is produced in the process. Furthermore, Wind, Dampness and Cold can also turn into Heat if they are not eliminated in time and accumulate in certain meridians and joints. In clinical practice, this syndrome can be seen during the onset and active stage of rheumatic fever or rheumatoid arthritis, as well as frozen shoulder, tenovaginitis, bursal synovitis, pyogenic osteomyelitis and suppurative arthritis.

Most of the herbs that expel Wind-Dampness are pungent. This gives the herbs the ability to expel Wind from the skin, muscles and bones. As Dampness is associated with Wind, when Wind is expelled by the pungent herbs then Dampness can be partially eliminated too. This function is called ‘wind disperses dampness’.

Many of the herbs are pungent and warm in nature, and are especially suitable for conditions where Cold or Wind-Cold predominates in the disease. Because the pungent taste can expel Wind and scatter Cold and the warmth can warm the Interior, warm-pungent herbs can alleviate pain quickly. Warm-pungent herbs are also suitable for usage in the winter, in cold climates and by elderly people. Herbs with a pungent and warm nature include Qiang Huo ( Notopterygii rhizoma), Du Huo ( Angelicae pubescentis radix), Wei Ling Xian ( Clematidis radix), Wu Jia Pi ( Acanthopanacis cortex) and Qian Nian Jian ( Homalomenae rhizoma).

Some of the herbs are bitter and pungent, and are especially suitable for treating Damp Painful Obstruction syndrome because bitterness and pungency can dry Dampness and reduce swelling and heavy sensations in the limbs. If the herb is also warm, the ability to expel Wind and Dampness is even stronger. Herbs with these properties are Song Jie ( Pini nodi lignum), Qian Nian Jian, Hai Feng Teng ( Piperis caulis), Hai Tong Pi ( Erythrinae cortex) and Cang Zhu ( Atractylodis rhizoma).

Some substances are salty; they are especially suitable for disorders where Wind and Dampness are in the Interior of the body for a considerable time or when the bones are involved. The commonly used salty substances are Wu Shao She ( Zaocys), Bai Hua She ( Agkistrodon acutus)* and Wei Ling Xian. Sourness nourishes the Body Fluids and Yin and can therefore moderate cramps and relieve the pain of the tendons and muscles. Mu Gua ( Chaenomelis fructus) is often used for this purpose.

In Bi syndromes, especially in chronic cases, the bones and tendons are impaired. Herbs that enter the Kidney and Liver meridians are often chosen because the Kidney and Liver govern the bones and tendons. Commonly used substances are Hai Feng Teng, Luo Shi Teng ( Trachelospermi caulis), Qian Nian Jian, Bai Hua She and Wu Shao She. Herbs that enter the Bladder meridian are often used to activate the Qi and Yang and to expel exogenous pathogenic factors from the skin, subcutaneous region and muscles. This is because the Bladder meridian covers the back of the body, which is considered as the Yang side of the body and is the first to be attacked by pathogenic Wind and Cold. Herbs with such functions include Qiang Huo and Wei Ling Xian.

Substances that expel Wind-Dampness are not only used orally, but are also applied topically because local use may directly expel the exogenous pathogenic factors, activate the Qi and Blood circulation and ultimately break up the obstruction. The commonly used forms are herbal plasters, lotions and tinctures. In addition, herbal alcohol drink is also frequently used as part of the diet for patients who suffer from chronic Bi syndrome.