This formula was first recorded in ‘All Diseases Return to Spring’ (wan bing hui chun) by Gong Ting-xian (a.k.a. Gong Yun-lin), 1587. ‘Return to Spring’ (hui chun) is a poetic expression, still in use today, denoting the restoration of health after an illness ‐ the state of ill health being like the season of Winter. In addition to being a distinguished physician, Gong was renowned for his mastery of tui-na, hence his interest in musculoskeletal disorders, for which this formula was designed.

The name of the formula is literally: ‘Unblock the Channels and activate the Blood formula’. This refers to the focus of this formula’s action on activating the Blood and dispelling stasis, in addition to dispelling Wind-Cold Damp. This makes it a powerful and relatively rapid acting treatment for various forms of severe arthralgia.

The formula’s therapeutic actions are based on the theory that Blood deficiency predisposes to invasion by Wind, and that pathogenic Wind causes injury to the Blood, setting up a ‘vicious cycle’. In addition, the invading Wind generally carries other exogenous pathogens with it, i.e. Cold-Damp. As a consequence of the invasion of the Channels-collaterals, tendons and muscles by Wind, Cold and Damp, the movement of the Qi and Blood becomes obstructed. This manifests in severe localised pain. In order to effectively treat such conditions, Blood nourishing herbs need to be included ‐ along with the herbs that dispel static Blood ‐ in order to protect the Blood from the harsh dispersing action of these herbs (i.e. to harmonise the Blood). Moreover, Blood nourishing herbs help to regenerate the health Qi to prevent further invasion and promote the expulsion of the pathogens. Thus, the formula is built on a base of Dang-gui Four Combination (si wu tang), to which are added groups of herbs to dispel Wind-Damp as well as to activate the Blood and dispel stasis. These actions are supported by herbs that dispel Interior Damp and those that harmonise the Spleen and Stomach.

The major herbs in this formula, such as Clematis root (wei ling xian) and Stephania root (han fang ji) have demonstrated anti-inflammatory, antispasmodic and analgesic actions and have a long history of traditional use in the treatment of inflammatory conditons of the joints.

TCM ACTIONS
Activates the Blood and dispels stasis, dispels Wind-Damp to unblock the Channels and alleviate pain.

TCM SYNDROMES

• Wind-Damp Bi
• Blood stasis

INDICATIONS
Osteoarthritis ‐ acute exacerbations, active rheumatoid arthritis, acute muscular sprain, lumbodynia, sciatica.

SIGNS & SYMPTOMS
(Key clinical features in bold)

• Arthralgia (i.e. joint pain)
• Myalgia (i.e. muscle pain)
• Reduced mobility
• Joint swelling
• Paresthesia (i.e. tingling, prickling) or numbness
• Tongue may be dark or with purple spots
• Pulse may be wiry or uneven