Wind-damp–dispelling agents

Agents that primarily treat wind-damp impediment (bì) patterns and that are used in wind-relieving formulas and wind-dispelling dampness-overcoming formulas (a subcategory of dampness-dispelling formulas).

Wind-damp impediment patterns (more properly but less commonly wind-cold-damp impediment patterns) arise when wind, cold, and dampness combine and invade the body. The wind, cold, and dampness lodges in the channels, flesh, sinews, and joints, obstructing the qì and blood of the channels. This obstruction causes pain, aching, heaviness, numbness, and inhibited bending and stretching of the joints. In severe cases, there is enlargement and deformity of the joints. When wind-cold-damp lies depressed for a long time, it can transform into heat, giving rise to scorching hot red swollen joints. impediment corresponds in biomedicine to arthritis, sciatica, and other musculoskeletal diseases.

Note that wind-damp impediment is variously referred to as wind-cold-damp impediment, impediment patterns, or simply impediment. It should be distinguished from chest impediment and throat impediment, which are not caused by wind-cold-damp.

Wind-damp impediment patterns are differentiated into four basic types.

• Wind impediment (also called moving impediment) is associated with prevalence of wind evil and is characterized by wandering pain, i.e., pain that appears in different locations at different times.
• Cold impediment (also called painful impediment) is associated with prevalence of cold evil and is characterized by acute cold pain.
• Damp impediment (also called fixed impediment) is associated with prevalence of dampness and is characterized by heaviness of the limbs, numbness of the skin, and pain of fixed location that is triggered by yīn-type (dull wet) weather.
• Heat impediment is associated with heat as well as wind-cold-damp and is characterized by scorching hot red swollen joints and other heat signs.

Subcategories

Wind-damp–dispelling medicinals are divided into three categories.

• Wind-cold-damp–dispelling agents, which treat wind impediment, cold impediment, and damp impediment.
• Wind-damp-heat–dispelling agents, which treat heat impediment patterns arising when wind-cold-damp transforms into heat.
• Wind-damp–dispelling sinew-strengthening agents, used in the treatment of wind-damp impediment that has persisted for a long time and has caused debilitation of right qì.

Properties

Nature:Wind-damp–dispelling cold-dispersing medicinals are mostly warm. Wind-damp–dispelling heat-clearing medicinals are mostly cold. Wind-damp–dispelling sinew-bone–strengthening medicinals are generally warm. A few agents in all three subcategories are balanced.

Flavor:Wind-damp–dispelling medicinals dispel wind and dry dampness. Since acridity can dispel wind and bitterness can dry dampness, most of these agents are acrid and/or bitter. The sinew and bone strengthening medicinals are supplementing, hence some also have a sweet flavor.

Channel entry: All except fáng jǐ (Stephaniae Tetrandrae Radix) and wēi líng xiān (Clematidis Radix) enter the liver channel. Because the sinews are governed by the liver and the bones are governed by the kidney, the agents that strengthen sinews and bones all enter the liver and kidney channels.

Toxicity: Bái huā shé (Bungarus seu Agkistrodon) is toxic. When using fáng jǐ (Stephaniae Tetrandrae Radix), one must be sure that it has not been misidentified or substituted with guǎng fáng jǐ (Aristolochiae Fangchi Radix), which contains aristolochic acid and is toxic.

Bearing: Wind-damp–dispelling medicinals include upfloating and downsinking medicinals.

Actions And Indications

Wind-damp–dispelling medicinals can all dispel wind, cold, and/or dampness. They all provide relief from wind-damp impediment patterns.

According to Chinese medical theory, wind-damp impediment patterns are caused by wind, cold, and dampness combining and invading the channels. Thus, wind-damp impediment implies wind-cold-damp impediment, and wind-damp–dispelling medicinals are generally medicinals that eliminate wind-cold-damp in the treatment of impediment patterns. Wind-cold-damp can in time transform into heat or it can contend with internally brewing heat to give rise to impediment with heat signs.

Wind-damp–dispelling medicinals are divided into three classes:

• Wind-cold-damp–dispelling medicinals: These are mostly acrid, bitter, and warm, entering the spleen, liver, and kidney channels. Their acridity dispels wind; their bitterness dries dampness, and their warmth dispels cold. By entering the spleen channel, they dispel dampness; by entering the liver and kidney channels, they act on the sinews and bones. Wind-cold-damp–dispelling medicinals are used for impediment patterns characterized by prevalence of any of the three primary evils.
• Wind-damp-heat–dispelling medicinals: Wind-damp–dispelling medicinals that also clear damp-heat and disperse swelling or clear heat and resolve toxin treat heat impediment. They are also used to treat water swelling, jaundice, strangury, eczema, or itchy skin due to damp-heat, and may also be used for heat toxin sores and welling-abscesses.
• Wind-damp–dispelling sinew-bone–strengthening medicinals: Wind-damp–dispelling medicinals that have an additional action of strengthening sinews and bones are effective in the treatment of impediment patterns that have persisted for a long time, giving rise to weakness of the sinews and bones. Since the liver governs the sinews and the kidney governs the bones, these medicinals strengthen sinew and bone by supplementing the liver and kidney. They can therefore also be used for other patterns of insufficiency of the liver and kidney.

Wind-damp–dispelling medicinals have other actions besides addressing wind-cold-damp invading the channels.

Relieving pain: While all wind-damp–dispelling medicinals have some pain-relieving action, some are particularly effective. Some are effective not only for impediment pain, but also for toothache and pain due to external injury.

Soothing the sinews and quickening the network vessels: Some wind-damp–dispelling medicinals treat hypertonicity of the joints preventing normal bending and stretching, as well as the numbness manifesting in impediment patterns. They can also be used for similar conditions unassociated with impediment, such as leg cramps, hypertonicity of the nape and other parts of the body, as well as the sequelae of wind stroke (numbness, hemiplegia, deviated eyes and mouth, etc.)

The action of treating impediment patterns is referred to by different terms: dispelling wind and overcoming dampness, alleviating impediment, diffusing impediment, and eliminating impediment. The term soothing the sinews is found in medicinals that relax tension in the sinews in the treatment of hypertonicity of the sinews and joints causing inhibited bending and stretching. The term quickening the network vessels means to free the vessels and network vessels to treat hemiplegia or to relieve tingling and numbness in the skin. This is also called freeing the network vessels. Soothing the sinews and freeing the network vessels are interrelated actions, so they are usually referred to together.

Combinations

Prevalence of wind, cold, dampness, or heat, and presence of insufficiency of the liver and kidney.

Prevalence of wind: For wind impediment (moving impediment) characterized by wandering pain, select wind-damp–dispelling medicinals that have a powerful wind-dispelling action and combine them with wind-dispelling pain-relieving medicinals. This approach is often used to treat initial-stage impediment when there are exterior signs.

Prevalence of cold: For cold impediment (painful impediment), which is characterized by acute pain in the joints, select wind-damp–dispelling medicinals with a powerful cold-dispersing action and combine them with agents that warm the channels and relieve pain.

Prevalence of dampness: For damp impediment (fixed impediment), which is characterized by aching pain, heaviness of the limbs, and numbness of the skin, choose wind-damp–dispelling medicinals with a powerful dampness-eliminating action and combine them with agents that disinhibit water and percolate dampness and agents the fortify the spleen and dry dampness.

Prevalence of heat: For heat impediment, characterized by painful red swollen joints, choose cold-cool wind-damp–dispelling medicinals and combine them with agents that clear heat.

Insufficiency of the liver and kidney: When there is insufficiency of the liver and kidney, characterized by limp wilting sinews and bones, select wind-damp–dispelling medicinals that strengthen the sinews and bones. Combine these with medicinals that supplement the liver and kidney.

To treat wind, first treat the blood: impediment patterns usually involve evil qì obstructing the flow of qì and blood. Because of this, wind-damp–dispelling medicinals are very often combined with blood-quickening stasis–transforming medicinals. This is a practical expression of the principle, To treat wind, first treat the blood.

Method Of Use And Warnings

Avoid damage to yīn-blood: Except for the subcategory of wind-damp-heat–dispelling agents, wind-damp–dispelling medicinals are mostly warm and dry, and hence easily damage yīn-blood. For this reason, use them with care in yīn vacuity and blood depletion. If necessary, combine them with medicinals that supplement essence and blood.

Choose the right preparation form: Impediment patterns require medication over a long period of time. To save the trouble of brewing up decoctions, they are usually administered in pill form or as medicinal liquors. Medicinal liquors, which are made by steeping medicinals in strong liquor such as sorghum liquor, are particularly suitable, because alcohol has the action of warming and freeing the vessels and effectively extracts the active ingredients. It also dispels wind, cold, and dampness, as well as quickening the blood and relieving pain. However, it should be noted that medicinal liquors are inappropriate for patients suffering from peptic ulcers or for alcoholics. Nowadays, new preparation forms such as capsules, lozenges, and liquid preparations widen the choice considerably.

Toxicity: Bái huā shé (Bungarus seu Agkistrodon) is toxic. It should be used with care in high fever or yīn-blood vacuity engendering wind.