Foreword: The basis of this article originally appeared in a past edition of the New Zealand Register of Acupuncturists Newsletter. This article is an educational article specifically for registered or licensed practitioners of traditional Chinese medicine and acupuncture. Patients seeking help with Chinese herbs for their injuries are advised to seek a qualified practitioner.
In New Zealand contact Acupuncture NZ. In Australia, contact the Australian Acupuncture and Chinese Medicine Association and in the United States contact the National Certification Commission of Acupuncture and Oriental Medicine.
TCM practitioners who did their acupuncture training in the west would find this knowledge useful in clinic for the treatment of injuries as the knowledge of die da was not commonly taught in the acupuncture training programs in Australia or New Zealand. Die Da actually is translated as Hit and Strike by Wiseman & Ye but perhaps a more easily understood translation would be traumatology or traumatologic as suggested by Vitalis Skiauteris.
There are many Chinese herbal medicines that can be used externally in the treatment of sprains, strains, swellings, torn tendons and ligaments and even broken bones. The use of external herbs is very safe; however caution still needs to taken in the case of pregnancy as some of the herbs have a strong blood moving action and susceptible patients with a history of miscarriage may need extra care.
Some Die Da specialist practitioners claim to have their own “secret formulas” passed down from their family or master but the reality is that many of the ingredients are commonly used by all. One secret that I would like pass on to you about Chinese medicine secrets is the biggest secret of all- is that there are no secrets! A good book for those interested readers is Secret Shaolin Formulae for the Treatment of External Injury translated by Zhang Ting-Liang and Bob Flaws available through Blue Poppy Press.
More experienced Die Da practitioners would have a number of specialist formulas and have them powdered and then stored in jars in their clinic. I find having a selection like this is good for chronic conditions especially when they have become complicated with bi syndrome and patients present with a variety of conditions.
For the acute sprain with swelling and pain though, as commonly seen in sports injuries, I still prefer the simple boil up of about six to ten Chinese herbs and instruct the patient to soak the injured foot or ankle in the warm liquid. Some of the medicines below actually have a cooling nature and thus help with the “heat” and inflammation seen in acute swellings. In my opinion, the cooling herbs do not cause stagnation or accumulation of cold and possible future complications as can happen when applying the traditional ice packs which are still commonly practiced with the modern bio medical sports medicine approach.
Acute swelling
Jing Jie 15g (Schizonpetae Herba) 荆 芥
Da Huang 15g (Rhei Radix et Rhizoma) 大 黄
Zhi Zi 15g (Gardenia Fructus) 枝 子
Huang Bai 15g (Phellodendri Cortex) 黄 白
Ze Lan 15g (Lycopi Herba) 泽 兰
The above 5 Chinese herbs when used externally can reduce swelling, stop pain and quicken the Blood.
If there is more severe blood stasis or you suspect the injury is severe enough to cause chronic blood stasis that may hinder the recovery time and possibly lead to the accumulation of pathogenic factors, it is suggested to add one or both of the blood quickening Chinese herbs below. In my opinion, blood stasis is always inevitable with any injury and I always prefer to add them.
Tao Ren 10g (Persia Semen) 桃 人
Hong Hua 5g (Carthami Flos) 红 花
If the pain from the trauma is severe select one or more of the following. They will also help with swelling and help prevent accumulation of pathogenic factors.
Yan Hu Suo 10g (Corydalis Rhizoma) 延 胡 索
Mo Yao 5-8 g (Myrrha) 没 药
Ru Xiang 5-8g (Olibanum) 乳 香
Lu Lu Tong 10g (Liquidambaris Fructus) 路 路 通
Su Mu 5-10g (Sappan Lignum) 苏 木
Most of these Chinese herbs suggested are for the treatment of simple acute swelling and pain after an injury. These herbs are easily obtained, relatively inexpensive and easily stored. None of them are rare, exotic or an endangered species. In the past I have accompanied patients to their Kung Fu tournaments and took with me a few packets already mixed and sealed in plastic bags with a portable cooker and pot. Injured sports persons and coaches alike are always amazed at the recovery and pain relief compared to the traditional ice treatments. Stocking up your clinic with a small collection of these herbs is an extremely effective way to enhance your results in the treatment of acute sprains. Remember too, that needling directly into any acute swelling is generally contraindicated and thus the application of herbs ideally suited.
Preparation and application is simple. Put one packet of the mixed herbs into a pot with 2-3 litres water and bring to the boil and then simmer for 10-20 minutes. As a general rule I add enough water so that the injured body part can be covered and cook until the water has become coloured . Pour the liquid into a foot basin and soak the foot or ankle until the water becomes cool. The herbs can be re used 2-3 times or until the liquid no longer becomes coloured after the cooking. You can also instruct the patient to put a tea towel in the warm water and wash the injured area. This is often suited to other body areas such as elbows and shoulders.
When buying herbs wholesale, they are usually sold in 1 kilogram packages but you have the option to order any formulas ready mixed into small packets ready to prescribe and sell to your patients. The dosages recommended above are general guidelines only and with the external application of Chinese herbs precaution still needs to be adhered to.
For more information on Chinese herbs for internal treatment of injuries please go to Overview of the Chinese medicine treatment of trauma by Greg Bantick.
