The Jin Kui Yao Lue states: Rheumatism is caused by the invasion of wind pathogen, which interacts with righteous qi to produce phlegm-dampness (dampness pathogen). In Huai'an weather, phlegm-dampness coagulates when it encounters cold pathogen. It departs from the muscles and causes pain, dissolves when it encounters hot blood, and the pain dissipates. The feeling of sorrow and sadness persists, moving around without a fixed location. Bi syndrome refers to the insufficiency of righteous qi in the human body, allowing external pathogens such as wind, cold, and dampness to invade, internally combined with phlegm, stasis, and heat-toxin, causing blockage in the meridians and impeding the smooth flow of qi and blood, resulting in pain, soreness, heaviness, numbness, swelling of joints, difficulty in flexion and extension, and even joint deformities that affect the internal organs, leading to paralysis and disability.
According to the cause, there are different types: Feng Bi (wind bi), where wind-cold-dampness invade together, manifesting as migratory pain in the limbs and muscles; Han Bi (cold bi), where cold predominates, causing severe pain in the limbs, joints, and muscles that improves with warmth; Shi Bi (dampness bi), where dampness predominates, causing swelling and heavy pain in the limbs, joints, and muscles; Re Bi (heat bi), characterized by redness, swelling, heat, and pain in the affected area; Zhou Bi (generalized bi), where pain is widespread throughout the body; Zhong Bi (recurrent bi), where pain comes and goes continuously.
According to the affected tissues, there are Pi Bi (skin bi), Rou Bi (flesh bi), Jin Bi (sinew bi), Mai Bi (vessel bi), and Gu Bi (bone bi). In Traditional Chinese Medicine, Bi syndrome refers to various types of rheumatic arthritis, suppurative arthritis, tuberculous arthritis, osteophytes, myofascial fibrosis, sciatica, periarthritis of the shoulder, ankylosing spondylitis, and vasculitis described in ancient medical literature.
Causes and Pathogenesis:
1. Deficiency of righteous qi: Insufficient qi, blood, essence, and fluids lead to weakened regulatory and defensive functions of the body, making it susceptible to external pathogens. This deficiency often results from improper living habits, excessive sexual activity, constitutional weakness, or prolonged overwork. When righteous qi is deficient, especially wei qi (defensive qi), the body becomes vulnerable to invasion by external pathogens, leading to obstruction in the meridians and impaired circulation of qi and blood, resulting in Bi syndrome.
2. Invasion by external pathogens: External pathogens include wind, cold, dampness, and heat. Wind alone cannot harm the body, but when combined with dampness, it easily invades the body. Common combinations include wind-cold-dampness and wind-dampness-heat. When righteous qi is weak, these pathogens can invade the skin and meridians, causing stagnation and blockage in the channels, leading to Bi syndrome.
3. Stagnation: Refers to blood stasis and phlegm凝聚. After trauma, changes in weather or exposure to cold-damp conditions can lead to symptoms of heaviness, stiffness, distension, numbness, and pain in the affected area. Treatment must involve promoting blood circulation and resolving stasis alongside expelling pathogens for satisfactory results.
Bi syndrome often presents with string-like pulses due to pain and wind, aligning with its pathogenesis. During treatment, it is important to expel pathogens, activate blood circulation, and nourish qi and blood, as they circulate in the meridians and are essential nutrients for the body. Prolonged illness often leads to qi and blood deficiency, exacerbated by the use of drying herbs for treating Bi syndrome. Therefore, treatment should focus on tonifying qi and strengthening the spleen, nourishing blood to facilitate smooth circulation and removal of pathogens. For yin-blood deficiency, nourishing yin and replenishing blood is crucial, using herbs that both expel pathogens and nourish blood.
Rheumatoid joint pain is one of the most common and feared chronic diseases among middle-aged and elderly people. Some elderly individuals express that any disease associated with "rheumatism" is difficult to treat. Orthopedic experts point out that what is commonly referred to as "rheumatism" pertains to pain symptoms related to wind, rain, dampness, and cold climatic changes, also known in Traditional Chinese Medicine as "wind evil, cold evil, dampness evil." From a Western medical perspective, "rheumatism" encompasses all joint and surrounding tissue lesions causing joint and muscle pain, including degenerative arthritis due to aging, autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, and metabolic disorders like gout.
Temperature and humidity influence serve as triggers rather than direct causes of rheumatism, with most cases attributed to aging and misuse. Degenerative arthritis typically affects specific weight-bearing joints, with milder symptoms compared to rheumatoid arthritis but still classified under "rheumatism."
Rheumatic diseases are a broad category of diseases primarily affecting muscles, bones, joints, and connective tissues, including autoimmune rheumatic diseases (like systemic lupus erythematosus and rheumatoid arthritis), degenerative rheumatic diseases (like osteoarthritis), and metabolic rheumatic diseases (like gout and osteoporosis).
"Wind" and "dampness" are not necessarily the primary culprits of rheumatic diseases. Although long-term exposure to cold and damp conditions may exacerbate joint pain, this is more of an allergic reaction to weather changes rather than a direct cause. Rheumatic diseases are complex, involving immune system dysfunction that can affect multiple systems and organs, leading to diverse clinical manifestations and making accurate diagnosis challenging.
Early and appropriate treatment is crucial to prevent irreversible joint damage and disability. With advancements in treatment options, many rheumatic diseases are no longer considered incurable. Patients should seek professional medical advice rather than relying on unverified treatments, focusing on maintaining overall health and managing symptoms effectively.
If experiencing persistent joint or muscle pain, fatigue, weight loss, or other systemic symptoms, it is important to consult a specialist for proper diagnosis and management. Early intervention can significantly improve outcomes and quality of life for individuals with rheumatic diseases.