Functions
warms the channels and disperses cold unblocks painful obstruction and stops severe pain tonifies qi and secures the exterior relaxes spasm and moderates toxicity
Indications
Cold Bi (寒痹 / Painful Bi 痛痹) — invasion of cold into the channels and joints: severe, fixed, boring joint pain markedly worse for cold and relieved by warmth reduced range of movement in the affected joint absence of redness or heat in the joint
Contraindications
heat patterns of any kind heat bi (red, swollen, hot joints) pregnancy ⚠️ Raw (unprocessed) Chuan-wu must NEVER be used — processed (制川乌) form only ⚠️ Eighteen Incompatibilities (十八反): Chuan-wu must NOT be combined with Ban-xia, Gua-lou, Bei-mu, Bai-ji, or Bai-lian ⚠️ Must be prescribed and dosed only by a qualified practitioner
Notes
The classical formula for Cold Bi / Painful Bi: chosen when cold has invaded the channels and joints producing severe, fixed, boring pain that is strongly aggravated by cold and relieved by warmth, without any signs of heat or redness at the joint. Chuan-wu (processed aconite) is the chief herb, powerfully warming the channels and expelling cold to arrest pain; Ma-huang opens and unblocks the channels; Bai-shao and Gan-cao relax spasm, nourish the sinews, and help moderate Chuan-wu's toxicity; Huang-qi tonifies the qi and consolidates the exterior. ⚠️ SAFETY: Chuan-wu contains aconitine and is HIGHLY TOXIC. Only the properly processed (制) form is permissible. It must be decocted first and separately for 30–60 minutes or longer together with honey (白蜜), which moderates its toxicity and prolongs its analgesic action. Signs of aconitine toxicity (numbness of lips and extremities, palpitations, arrhythmia) require immediate medical attention. Preparation: Decoct Chuan-wu first with honey (白蜜) for at least 30–60 minutes before adding the remaining herbs; strain and drink warm. Modifications: Reduce Chuan-wu dose and extend decoction time if the patient is elderly or constitutionally weak; combine with channel-warming and blood-moving herbs (e.g., Dang-gui, Ji-xue-teng) when blood stasis accompanies the cold bi.
For education only — not medical advice. Consult a qualified practitioner.