Several Proven Prescriptions for TCM Treatment of White-Tiger Wind / Lijie Wind (Gout)
Baihu Feng (White-Tiger Wind) is a disease name in Chinese medicine, also known as Lijie Wind or gout. Zhang Zhongjing's Jingui Yaolue (Synopsis of Prescriptions of the Golden Chamber) in the Han dynasty already has a dedicated chapter, "On Stroke and Lijie Diseases: Pulse and Treatment." The main symptom is severe joint pain that prevents bending or extending the limbs. The ancients believed the disease was caused by "wind-cold-damp evils attacking the joints, with pain so severe it felt like a tiger biting," hence the name White-Tiger Wind or Lijie Wind.
The original text of the Jingui Yaolue states: "The cun-kou pulse is deep and weak; depth governs bone, weakness governs tendon; depth corresponds to kidney, weakness corresponds to liver. Sweating then entering water, as if water harms the heart. Lijie with yellow sweat oozing out—hence it is called lijie."
Volume 10 of the Shengji Zonglu describes lijie as follows: "Lijie Wind arises when qi and blood are weakened and invaded by wind and cold; qi and blood congeal and stagnate, failing to circulate through the joints, and the tendons lack nourishment. The righteous and evil struggle, and every joint traversed becomes painful—hence it is called Lijie Wind. Severe pain causes shortness of breath and sweating, and the limbs and joints cannot bend or extend."
The Zhubing Yuanhou Lun (On the Origins and Manifestations of Diseases) describes lijie as follows: "The presentation of Lijie Wind is shortness of breath, spontaneous sweating, pain in every joint that is unbearable, and inability to bend or extend. It arises from drinking wine, with the interstitial spaces opening and sweating into the wind. Some cases arise when qi and blood are deficient and wind evil is contracted. Wind traverses the joints and struggles with qi and blood, hence pain. When qi and blood are deficient, sweating occurs. When wind-cold binds the tendons, bending and extending become impossible—this is Lijie Wind."
From these records, the TCM condition of White-Tiger Wind (Lijie Wind) resembles gout, rheumatoid arthritis, and rheumatic arthritis in modern medicine, and is especially close to the clinical presentation of gout. Modern research shows gout is mainly caused by high uric acid; in addition, some diabetic patients and cancer patients after radiotherapy or chemotherapy may also develop gout symptoms.
There are many proven TCM prescriptions for White-Tiger Wind (Lijie Wind). The Jingui Yaolue treats it with Guizhi Shaoyao Zhimu Tang. The formula is: Guizhi (Cinnamon twig) 4 liang (12 g), Shaoyao 3 liang (using Baishao / white Paeonia, 9 g), Gancao (Licorice) 2 liang (6 g), Mahuang (Ephedra) 2 liang (6 g), Shengjiang (Fresh ginger) 5 liang (15 g), Baizhu (Atractylodes) 5 liang (15 g), Zhimu (Anemarrhena) 4 liang (12 g), Fangfeng (Saposhnikovia) 4 liang (12 g), Fuzi 2 pieces (processed; today use prepared Aconite 6-12 g). One Han-dynasty liang is roughly 15 g today, but in actual clinical use such large doses are not recommended. Using 30 g of Mahuang in this formula would easily cause a medical accident; for safety, converting one liang to 3 g is more appropriate.
The Zhubing Yuanhou Lun also has a prescription for Lijie Wind: Duhuo (Angelica pubescens), Qianghuo (Notopterygium), and Songshen (Pine node), in equal parts (10 g each), decocted in wine and taken. The Taiping Shenghui Fang records Dilong San for White-Tiger Wind with unbearable pain: Dilong powder (earthworm) 1 liang (30 g), good tea powder 1 liang (30 g), Baijiangcan (Stiff silkworm) 1 liang (30 g, slightly stir-fried). Grind the above into a fine powder; take 2 qian (6 g) each time, mixed with warm wine, at any time, three times daily. Note: modern gout treatment does not recommend decocting in wine; ginger-and-scallion water may be used instead.
Another empirical prescription for lijie comes from the mid-Qing dynasty. Its composition is: Niuxi (Achyranthes), Taoren (Peach kernel), Huangqin (Scutellaria), Baizhu (Atractylodes), and Danggui (Angelica), in equal parts, ground into a fine powder and taken with water. A renowned contemporary TCM physician, Professor Liu Duzhou, used an empirical formula for such cases: a combination of Shaoyao Gancao Tang and Lingyangjiao Gouteng Tang: Baishao (white Paeonia) 30 g, Gancao (Licorice) 15 g, Gouteng (Uncaria) 16 g, Lingyangjiao powder (antelope horn) 1.8 g (taken infused). Shaoyao Gancao Tang is also called Qi Zhang Tang (Wandering-Staff Decoction), a famous formula for spasmodic pain; Gouteng and Lingyangjiao extinguish wind and stop spasms. Professor Liu found that combining the two works even better clinically.
The above prescriptions may be selected as appropriate.