In traditional Chinese medicine, the condition that is congruent with arthritis is called "Bi syndrome." Bi syndrome manifests as pain, soreness, or numbness of muscles, tendons and joints, and is the result of the body being "invaded" by the external climatological factors of Wind, Cold, Heat, and/or Dampness. The symptoms manifested by the individual depend on which external pathogenic factor is strongest.

The four main patterns of Bi syndrome are differentiated below, and the leading herbs that are used to treat each pattern are listed.

>Wind Pattern. Exposure to wind, especially when one is unprotected and exposed to the wind for a long time, is an important cause of the Wind pattern of arthritis. Any Wind pattern is characterized by movement of symptoms from place to place. In the case of Wind Bi, there is joint soreness and pain which moves from joint to joint. Movement of joints is limited, and there is often fever, as well as an aversion to wind, or windy weather. A thin white tongue coating and a floating pulse are signs that help Chinese medicine practitioners diagnose Wind Bi. Leading herbs for this pattern include ledebouriella (Fang Feng), and ephedra (Ma Huang).

>Cold Pattern. The Cold pattern of arthritis (Cold Bi) is characterized by severe pain in a joint or muscle. This pain has a fixed location, rather than moving about (as in Wind Bi). The pain is relieved by applying warmth to the affected area, but increases with exposure to cold. Movement of joints is limited. A thin white tongue coating, combined with a wiry and tight pulse are signs of Cold Bi. Leading herbs for this pattern include aconite (Wu Tou), and ephedra (Ma Huang).

>Damp Pattern. The Damp pattern of arthritis (Damp Bi) is characterized by pain, soreness and swelling in muscles and joints, with a feeling of heaviness and numbness in the limbs. The pain has a fixed location and is aggravated by damp weather. A white, sticky tongue coating and a soggy, slow pulse are signs of Damp Bi. Leading herbs for this pattern include coix (Yi Yi Ren), and lancea atractylodes (Cang Zhu).

>Heat Pattern. The Heat pattern of arthritis (Hot Bi) can develop from any of the above three patterns. It is characterized by severe pain and hot-red-swollen joints. The pain is generally relieved by applying cold to the joints. Other symptoms include fever, thirst, anxiety, and an aversion to wind. A yellow, dry tongue coating and slippery, rapid pulse are seen with Hot Bi. Leading herbs for this pattern include anemarrhena (Zhi Mu), gypsum (Shi Gao), and cinnamon (Gui Zhi).

In the West, anti-inflammatory drugs are commonly prescribed for arthritis. In the East, acupuncture and Chinese herbal medicine, with their thousand-year-old history, are the major health care modalities used to fight joint and musculo-skeletal disorders including arthritis. These ancient therapies are still used because they are empirically effective, and have stood the test of time. Now they are standing to meet the tests of Western medicine.