Yibi Xiao: An External Swelling-Reducing and Pain-Relieving Formula
In Waike Zhengzhi Quansheng Ji, by the Qing-dynasty surgeon Wang Hongxu, there is an external swelling-reducing and pain-relieving formula called 'Yibi Xiao.' It consists of: Dahuang (Rhei Radix et Rhizoma) 60 g, Tenghuang (Gamboge) 30 g, Mingfan (alum) and Chansu (Bufonis Venenum) each 15 g, Shexiang (Moschus), Ruxiang (Olibanum) and Moyao (Myrrha) each 6 g. Grind all the herbs into a powder. Pound snails into a paste and mix with the herbal powder to form medicinal sticks. When using, grind a stick with vinegar into a juice, dip a new brush in it and paint a ring around the lesion; when dry, paint another ring, and repeat until the swelling or boil subsides.
Wang Hongxu's Yibi Xiao is rarely used today, but his family-ancestral Xihuang Wan and Xiaojin Wan remain famous anti-tumor, nodule-dissolving patent medicines. The Wang family practiced surgery for generations. In fact, the Yibi Xiao he left is also a very effective formula. The Tenghuang in it is quite toxic, but its swelling-reducing and pain-relieving effect is excellent, and modern pharmacology shows it inhibits tumors. So this empirical formula works well for red, swollen, hot and painfular unknown external toxins or tumor-caused swellings.
Alum relieves pain well. I have made external analgesics from Ku fan (dried alum), Pengsha (Borax) and Bingpian (Borneolum); the analgesic effect is satisfactory, and in some patients it outperforms oral morphine-class analgesics. The alum Wang Hongxu used is hydrated potassium aluminum sulfate, while Kufan is potassium aluminum sulfate, so their analgesic mechanism is the same.
Chansu, Shexiang, Ruxiang and Moyao are all commonly used swelling-reducing and pain-relieving herbs; modern pharmacology shows they also have anti-cancer and swelling-reducing effects. Hence this formula inhibits palpable surface tumors. This external method is safer than oral medicine. But some patients using Chansu-containing preparations may be irritated and the lesion may actually swell further; if that happens, stop immediately.
The Shexiang and Niuhuang in Yibi Xiao are expensive; today artificial musk and artificial cow-bezoar are usually substituted. Ruxiang and Moyao are resins that are hard to powder; after high-temperature vinegar quenching they are both more effective and easier to powder. When preparing the medicine, heat Ruxiang and Moyao, quench with vinegar, and then powder.
This formula must not be taken internally; pregnant women are forbidden to use it, and patients with bleeding tendencies must not take it. External use is fairly safe: apart from patients with sensitive skin who may develop allergic reactions, most patients have no significant adverse effects.