Dr. Pu Fuzhou's Empirical Pain-Relieving Formula, Sansheng Qutong Fang
Dr. Pu Fuzhou had an empirical formula for rapid pain relief called 'Sansheng Qutong Fang' (Three-Raw Pain-Dispelling Formula). It consists of equal parts raw Wutou (Aconiti Radix; Caowu/Aconiti Kusnezoffii Radix may also be used), raw Tiannanxing (Arisaematis Rhizoma) and raw Baifuzi (Typhonii Rhizoma). Preparation: grind the three herbs into a fine powder. Take 30 g each time; take 7 stalks of scallion white (with rootlets), 15 g of fresh ginger, chop and pound them into a paste, mix with the herbal powder, wrap in soft cloth and steam. When using, apply the medicinal pack to the painful area. This formula dispels cold and relieves pain; its analgesic effect is good and rapid. However, all three herbs are highly toxic and may only be used externally; they must not be taken orally.
Dr. Pu Fuzhou's formula was originally for persistent migrainous headache unresponsive to other treatment, but in practice it also works for cancer pain and chronic bone and joint pain. Adding Chansu (Bufonis Venenum) 0.5 g and Bingpian (Borneolum) 6 g improves the relief of cancer pain and also reduces swelling. Dr. Pu's method is a bit laborious; once the patient has prepared the paste, he may buy empty plaster patches online, put the paste inside and apply the patch directly to the painful area.
Patients with sensitive skin may experience discomfort when using this formula. If a rash, itching or other adverse reaction appears, remove the patch promptly. If there is no discomfort, the plaster may be left on for a full day and night before changing.
The Wutou (Caowu), raw Tiannanxing and raw Baifuzi in this formula all belong to Chinese medicine's cold-dispersing and pain-relieving herbs. Wutou (Caowu) warms the meridians, disperses cold and relieves pain; the aconitine it contains excites the nerves, relieves spasms and stops pain--this is the analgesic mechanism. But aconitine is extremely toxic, and the lethal oral dose is very low. Tiannanxing and Baifuzi are both Araceae plants. Chinese medicine holds that Tiannanxing resolves phlegm, stops convulsions, reduces swelling and relieves pain, so it is often used for welling-abscesses and carbuncles with swelling and pain. Modern pharmacology confirms that Tiannanxing has expectorant, sedative, analgesic, anticonvulsant and anti-tumor effects. The mannitol in Tiannanxing also lowers intracranial pressure and relieves the headache and vomiting caused by raised intracranial pressure. Raw Tiannanxing works better than processed, but it is extremely toxic: 0.1 g is enough to be lethal. Baifuzi is the rhizome of Typhonium giganteum (Araceae); it has sedative, anti-inflammatory, antibacterial, analgesic and anti-tumor effects, and the raw herb is as toxic as Tiannanxing.
Therefore this three-herb formula must never be taken internally; even for external use it must be steamed to reduce toxicity. Tiannanxing and Baifuzi may blister the skin; if the patient develops blisters after use, it should not be used again.
The camphor phenol in Bingpian is a natural anesthetic, and Chansu also fights cancer and relieves pain, so I added Bingpian and Chansu to Dr. Pu's formula; the resulting combination relieves pain and reduces swelling even better. If the patient's skin is ordinarily sensitive, 10 g of Baiji (Bletillae Rhizoma) may be added to reduce skin irritation.
According to traditional Chinese medicine, Baiji and Chuanwu/Caowu are among the 'eighteen incompatibilities' and should not be used together. In fact, however, these so-called eighteen incompatible pairs are not reasonable. The ancients simply believed that white and black were opposite, and so listed many pale-colored or 'white'-named herbs as pharmacologically opposite to Aconitum. This view is unscientific. I have used Baiji together with Wutou without any adverse reaction.