Jin Gu Die Da Wan - 筋骨跌打丸 - Sinew and Bone Injury Pills

Source: Chinese Pharmacopoeia

Category: Formulas that Regulate Blood

Pattern: Blood Stasis due to injury of the Sinews and Bones

Key Symptoms: Pain of the Sinews and Bones due to injury

Ingredients

Hong Hua

160g

Liu Ji Nu

160g

Hu Po

40g

Wu Ming Yi

160g

(Pyrolusite)

Jiang Huang

80g

Gu Sui Bu

160g

E Zhu

160g

Wu Yao

160g

Wu Ling Zhi

80g

Zhi Ke

160g

Wu Jia Pi

160g

Hei Lao Hu

160g

(Kadsura coccinea)

40g

80g

80g

50g

Pinyin: Gui Zhi Chinese: 桂枝 Pharmaceutical: Ramulus Cinnamomi Taxonomy: Cinnamomum cassia English: Cinnamon Twig
Tastes: Pungent, sweet, warm Meridians Entered: Lung, Heart, Kidney, Liver
Actions & Indications: *Releases the Exterior, assists Yang, adjusts the Ying* and Wei and releases the muscle layer** Taiyang Wind Strike (Taiyang Zhongfeng, 太阳中风) - a weak person who catches cold easily with spontaneous sweating, aversion to drafts, fever and chills, nasal congestion, stiff and aching head and muscles Warms the channels and collaterals to relieve pain Wind-Cold-Damp Bi *Unblocks Yang* and transforms Qi and thin mucus Edema due to Cold-Phlegm or Yang Qi Deficiency with urinary dysfunction, dizziness and palpitations Assists Heart Yang and warms and facilitates the flow of Yang Qi in the chest** Palpitations due to Yang Obstruction in the chest due to Stagnation or Deficiency Listless chest Yang with upward movement of Phlegm and thin mucus and disorderly descent of Lung Qi with shortness of breath, chest and back pain and palpitations Heart and Spleen Yang Deficiency Warms and facilitates the flow of Qi through the channels and collaterals and Blood through the vessels Wind-Cold-Damp Bi Blood Stasis due to Cold, causing amenorrhea or dysmenorrhea with or without abdominal masses *Warms the Middle and directs Turbid Yin* downward** Middle Jiao Yang Deficiency Heart and Spleen Yang Deficiency (patient usually craves sweets) Aids fasting Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, make the body light, prevent forgetfulness, and render the face bright and efflorescent, thus forever looking charming, like a child's face. This may suggest it was part of supplementing the diet when engaging in an "avoiding grain" (Bigu 辟穀) fasting regime to cultivate life (Yangsheng 養生).
Standard Dosage: 3-10g in decoction for exterior conditions, or up to 15g for Bi Syndromes. Cautions: This herb induces heat, damages the yin and moves blood. It is prohibited for those with warm pathogens, yin deficiency with effulgent fire, or reckless movement of the blood due to heat in the blood. Use with caution in pregnant women.

San Qi

20g

Mo Yao

80g

Xiang Fu

160g

Mu Xiang

40g

Du Huo

80g

Zhi Zi

80g

Tao Ren

40g

Xu Duan

80g

Xi Xin

20g

Pinyin: Xi Xin Chinese: 细辛 Pharmaceutical: Herba cum Radix Asari Taxonomy: Asarum sieboldii English: Chinese Wild Ginger
Tastes: Pungent, warm, slightly toxic Meridians Entered: Lung, Kidney and Heart
Actions & Indications: Releases Exterior Wind and Cold As an adjunctive for any exterior Wind-Cold especially with Dampness in Lung or underlying Yang Deficiency Frequently used for Wind-Cold when the dominant symptoms are head and body aches Disperses Wind-Cold and Internal Cold and alleviates pain Pain due to Wind and/or Cold anywhere in the body, particularly headache, painful obstruction, abdominal pain or headache due to obstruction of Fluids and Blood by Cold, often with anhydrous Wind-Cold-Damp Bipain Warms the Lungs and transforms Phlegm and Thin Mucus (circulates water) Cough and Qi which surges upward and fullness in the chest in the chest with continuous cough from clumped Qi in the chest and diaphragm marked by copious, watery sputum due to Phlegm-Damp or Wind-Cold with congested fluids Disperses and unblocks the Qi of the nasal orifices (clears the orifices of the head) Nasal congestion Oral pathology Loss of consciousness Promotes healing of oral ulcerations Oral lesions or ulcerations Relieves toothache Toothache Aids fasting Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, make the body light and prolong life. This may suggest it was part of supplementing the diet when engaging in an "avoiding grain" (Bigu 辟穀) fasting regime to cultivate life (Yangsheng 養生).
Standard Dosage: 1-3g in decoction. Cautions: Traditionally contraindicated for headache due to hyperactivity of yang caused by yin deficiency and dry cough caused by lung dryness hurting yin. It is incompatible with Li Lu. While not prohibited in the UK, the RCHM has enacted a voluntary ban by use due to possible fears of aristolochic acid. It is usually substituted with Gui Pi (Cinnamon Bark), or Rou Gui, or Gui Zhi and Qiang Huo for channel problems, Zi Su Ye and Bai Qian for lung issues, Gao Ban and Bai Zhi for treating the head and Cong Bai and Bai Zhi for the sinuses.

Da Huang

160g

Pinyin: Da Huang Chinese: 大黄 Pharmaceutical: Radix et Rhizoma Rhei Taxonomy: Rheum palmatum English: Chinese Rhubarb Root
Tastes: Bitter, cold Meridians Entered: Large Intestine, Spleen, Stomach, Liver and Heart
Actions & Indications: Drains Heat and purges accumulations Intestinal Heat Excess, with high fever, profuse sweating, thirst, constipation, abdominal distention and pain, delirium, a yellow tongue coat and a full pulse Yang-Ming Fu Stage Qi Level Heat in the Intestines Drains Fire Fire from Excess with intense fever, sore throat, and painful eyes and constipation Fire toxin sores due to Xue Level Heat, especially with constipation Clears Heat, transforms Dampness and promotes urination Damp-Heat with oedema, jaundice, painful urinary dysfunction and acute, hot dysenteric disorders Drains Heat from the Blood Bloody stool either from hemorrhoids or Heat in the Intestines Chaotic movement of hot Blood with hemoptysis or epistaxis with constipation It can be powdered and administered orally for bleeding in the upper digestive tract Invigorates the Blood and dispels Blood Stasis Blood Stasis with amenorrhea, fixed abdominal masses or fixed pain Blood Stasis due to traumatic injury Intestinal abscess Clears Heat and reduces Fire toxicity Topically or internally for burns or skin lesions (Chuang Yung) due to Heat Clears Heat and eliminates Phlegm Chronic Accumulation of Phlegm-Heat with cough, dyspnea, mania, disorientation and other symptoms of Phlegm Misting the Heart
Standard Dosage: 10-15g in decoction. Excessive decoction will reduce the purgative action. Therefore it should be added at end to achieve this purpose and over-decocted to eliminate this action. Cautions: It should be used with caution in case of spleen and stomach deficiency for its bitter and cold property which is easily to damage stomach qi. It is contraindicated to women during pregnancy, menstruation or lactation for it has actions of activating blood and resolving stasis, and can make the purged substances follow lactating out.

Zi Ran Tong

80g

Dang Gui

40g

Pinyin: Dang Gui Chinese: 當歸 Pharmaceutical: Radix Angelicae sinensis Taxonomy: Angelica sinensis English: Chinese Angelica Root / Tang-Kuei / Dong Quai Root
Tastes: Sweet, Pungent, Warm Meridians Entered: Heart and Liver
Actions & Indications: Tonifies the Blood and regulates the menses Blood Deficiency, especially when affecting the Heart and Liver with pale, ashen complexion, lusterless nails, tinnitus, blurred vision and palpitations Blood Deficiency associated irregular menstruation, amenorrhea and dysmenorrhea Invigorates and harmonizes the Blood and disperses Cold (stops pain due to Blood Stasis) Blood Stasis causing abdominal pain and carbuncles and pain due to Blood Stasis from traumatic injury, especially when accompanied by Deficiency Cold Postpartum menstruation Pregnancy (use with caution) Blood Deficiency with chronic Wind-Damp-Bi Moistens the Intestines and unblocks the bowels Dry Intestines due to Blood Deficiency Reduces swelling, expels pus, generates flesh and alleviates pain Sores and abscess (Chuang Yung), internally and topically Stops coughing and treats dyspnea Used adjunctively for coughing Tonifies the Blood while suppressing Parasites Gu Sydnrome (Fruehauf, 1998) Chronic inflammatory disease (Fruehauf, 2015)
Standard Dosage: 6-12g in decoction. Cautions: It is contraindicated in cases of Damp-Heat stagnating in the Middle, Lung Heat with Phlegm Fire, and Yin deficiency with effulgent Yang because it is warm and sweet in properties. In addition, it should be used with caution in cases of loose stool because it can moisten intestines to smooth stool. Many sources recommend using caution, avoiding or only taking under guidance of a TCM physician during pregnancy as it can cause uterine contractions. However, there are no studies supporting this and the only scientific literature seems to suggest that Z-Ligustilide has anti-spasmodic activities that alleviate dysmenorrhoea by inhibiting uterine contractions (Du et al., 2006; Dietz et al., 2016). Caution is also advised in breast cancer patients due to its oestrogen stimulating activity. This based upon Lau et al (2005) who found it may stimulate breast cancer growth in vitro, however Yue et al, (2019) demonstrated that it is not that stimulatory in breast cancer both in vitro and in vivo through a series of tests, although they suggested it should still be used with caution in estrogen receptor-positive breast cancer. Conversely, a large population study in Taiwan by Wu et al (2014) found it reduced the subsequent risk of endometrial cancer in breast cancer survivors taking tamoxifen, especially in those of reproductive age.

Chi Shao

40g

San Leng

160g

Ru xiang

80g

Ze Lan

160g

Feng Mi

4500g

Preparation: Ground into powder and made into 1000 pills with honey weighing 7.6g each. One pill is taken twice per day.

Actions: Invigorates Blood, dissipate Blood stasis, disperses swelling and alleviates pain, promotes healing of Sinews and Bones.

Contraindications: Pregnant women and patients with abnormal liver and kidney function. Use with caution if the patient has allergies.

Research Links:

American Dragon

TCMWiki

Journal of Chinese Medicine

National Resource Centre for Chinese Materia Medica, China

TCM-ID Integrated Database, East China Normal University

TCM-ID Information Database, National University of Singapore

Pubmed

Science Direct

Google Scholar

Bai Du (Chinese)

A+ Medical Encyclopedia (Chinese)

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.

Herb Formulas Notebook

筋 骨 跌 打 丸  Jin Gu Die Da Wan

Sinew and Bone Injury Pills