The Excellent Painkiller Formula "Zhitong Yao" (Analgesic Medicine)
In the "Surgery Volume" of the *Standards of Patterns and Treatment* (Zhengzhi Zhunsheng), there is a formula named "Zhitong Yao" (Painkilling Medicine). Its composition is: 30g each (1 liang) of Chinese angelica (Danggui), Achyranthes root (Niuxi), Sichuan lovage rhizome (Chuanxiong), unprocessed rehmannia root (Shengdihuang), red peony root (Chishao), angelica dahurica root (Baizhi), notopterygium root (Qianghuo), pubescent angelica root (Duhuo), eucommia bark (Duzhong), and teasel root (Xuduan); 15g each (5 qian) of cinnamon bark (Rougui), star anise (Bajiao Huixiang), frankincense (Ruxiang), and myrrh (Moyao); and 7.5g each (2.5 qian) of costus root (Nan Muxiang), clove bark (Dingxiang Shupi), eaglewood (Chenxiang), and dragon's blood resin (Xuejie).
Preparation: grind all the above into a fine powder. Take 9–15g (3–5 qian) each time, mixed with wine, twice daily. This formula has the effects of invigorating blood and moving qi, tonifying the kidney and strengthening sinews, expelling wind and dispersing cold, regulating qi, and stopping pain. It is mainly indicated for traumatic injuries, metal wounds, and various joint pains. It may also be used to treat cancer pain.
This formula is built on Siwu Tang (Chinese angelica, Sichuan lovage, rehmannia, red peony), augmented with wind-expelling painkilling herbs (Baizhi, Qianghuo, Duhuo), blood-invigorating painkillers (Ruxiang, Moyao, Xuejie), sinew-strengthening painkillers (Duzhong, Xuduan, Niuxi), qi-regulating painkillers (Bajiao Huixiang, Nan Muxiang, clove bark, Chenxiang), and cold-dispelling painkillers (Rougui). It is therefore a very comprehensive analgesic formula.
The formula's name directly states that its main function is pain relief. Although in ancient times it was an orthopedics/traumatology analgesic, by the logic of its composition it can be used to relieve chronic pain of various causes.
When cancer patients use it for cancer pain, remember: it must NOT be taken mixed with wine. Instead, it may be mixed with ginger-scallion water, because alcohol is a carcinogen and is very harmful to cancer patients. Many herbs in this formula have an abortifacient side effect, so pregnant women must not use it. Because this formula strongly invigorates blood, patients with bleeding tendencies must not use it either.
Frankincense, myrrh, and dragon's blood are all resinous drugs that strongly irritate the gastric mucosa; patients may experience stomach discomfort after taking it. Patients with existing gastric problems should control the dosage carefully and take it together with formulas such as Pingwei Pills.