Bi syndrome — fingers

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Textbook Prescriptions Pain — Upper Limb

Essentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.

Points

SI3 Houxi affected side

Small Intestine point on the ulnar border of the hand; frees the little-finger side
LI3 Sanjian affected side

Large Intestine point beside the second metacarpal head; frees the index-finger side
EX-UE9 Baxie four points on each affected hand

Extra points in the finger webs; open the joints of each finger directly

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

No cited needling data yet for EX-UE9. No flag here does not mean no risk.

Treatment Principle

Clear wind, cold and damp from the channels of the affected region so that qi and blood flow freely and the sinews loosen.

Indications

numbness and aching of the finger jointswandering bi: pain moving from joint to joint, chills and fever, thin sticky tongue coat, floating rapid pulsepainful bi: pain eased by warmth and worse for cold, no local inflammation, thin white coatfixed bi: fixed aching, heaviness and numbness of skin and muscle, flares in damp or overcast weather, white sticky coat, deep slow pulsefebrile bi: hot, red, swollen, tender joints with fever and thirst, yellow coat, slippery rapid pulse

Method

Treat the painful region with nearby and distal points on the yang channels that cross it, and match the technique to the type: needling alone for wandering (wind) bi; moxibustion first with needling in support for painful (cold) bi, using intradermal needles or moxa on ginger slices if the pain is severe; needles and moxa together, or the warming needle, for fixed (damp) bi; and needling with the reducing method for febrile (heat) bi.

⚠ Cautions

A hot, swollen joint with fever needs septic arthritis excluded, and in a young patient rheumatic fever with carditis, before acupuncture; gout and rheumatoid arthritis need medical management alongside it.

About

The book's regional prescription for bi when the fingers are numb and painful, for any of the four bi types.

Rationale

SI3 and LI3 treat the two borders of the hand on the yang channels that run to the fingers, while Baxie reaches between every pair of knuckles. Together they cover the small joints that the channel points alone would miss.

Clinical Notes

Whatever the region, the book adds GV14 when there is fever and BL11 when a joint has become deformed. It equates bi with rheumatic fever, rheumatic and rheumatoid arthritis, and gout.

Sources

Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Bi Syndromes (Painful Joints), p. 369–371.

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