Tooth From the Tiger’s Mouth Products are the most effective formulas for trauma and sports related injuries. These formulas have been carefully chosen by Tom Bisio, one of the leading experts in Chinese Sports Medicine and author of the popular book, A Tooth From the Tiger’s Mouth. The TTM line is based on traditional formulas used by generations of Chinese physicians, sports medicine doctors, martial arts practitioners, tui na experts, and bonesetters. These formulas have not only been used by Tom Bisio for the last 30 years in his own Sports Medicine Clinic, but by clinics all over the United States by hundreds of practitioners, on thousands of patients.
Kamwo has ensured that Tooth From the Tiger’s Mouth products are prepared in the traditional way maximizing each products effectiveness.
Master practitioners know that using the right formula at the right time is the key to clinical success. To ensure correct usage of our products, we have created a unique colored-coded system in accordance with the Three Stages of Injury and Healing. This system allows health professionals, trainers, athletes, and martial artists to quickly and accurately choose the correct product(s).
Learn more about the application, theory and treatment of sports medicine with Tom Bisio!
Each of the three stages of injury will be discussed in detail, using a multi-modality approach to treatment and healing that gets immediate and clinically effective results. Tom offers an in depth discussion on products from Tooth from the Tiger’s Mouth line, teaching you how to combine these therapies with acupuncture, tui na, gua sha and cupping. The emphasis of these classes is on the acquisition of clinical skills that can immediately be put into practice. Healthy Seminars is an online platform where acupuncturists and functional medicine practitioners can find a large selection of online continuing education courses and educational resources. Click the Earn CEU link below to be directed to Tom Bisio’s seminars.
Tooth From the Tiger’s Mouth Product Line & Three Stages of Injury
To make these products easy to use, we have color-coded and numbered the products according to the different stages of injury. Using the right product at the right time and in the right circumstances is the key achieving maximal clinical efficacy. This guide is designed to familiarize you with the stages of injury and the appropriate products for each stage.
This stage starts from the moment the injury occurs and usually lasts from 1-7 days. Stage 1 injuries are characterized by swelling, redness and pain, and possibly a local sensation of heat. In Western medicine this is called the “Inflammatory Stage.” If the trauma is minor, this stage may only last 2-3 days. If the injury is more severe, it may be a full week before swelling, redness and pain begin to subside.
This stage usually begins within a week after the initial injury and can last up to 3 weeks. The swelling and pain are reduced and much or all of the redness and heat (“inflammation”) may be gone. There is often stiffness due to spasms in tendons that have reflexively contracted in an attempt to protect the injured area by immobilizing it. In Stage 2, treatment can be more direct and aggressive.
This stage begins 3-4 weeks after the injury. Swelling and inflammation are usually gone, but stiffness, aching, pain and restricted motion may still be present. Wind, cold and damp may be present in the local area due to poor local circulation or deficiency of Qi and blood. Injuries to tendons and ligaments can take up to 6-8 weeks to heal completely, and in severe cases, it can take even longer. Improper treatment in the earlier stages of injury can extend this stage to months or even years. Additionally, constitutional factors may impede the healing process.
For more information about staging, a quick reference chart and treatment principles visit the TTM Booklet.
Commonly Asked Questions
How do I use a medicinal soak?
Place the flow-through bag containing the herbs bag in 2-3 gallons of liquid – if you are immersing the injured area (hand, foot, elbow) in the pot, you will need at least 2 gallons of water. Alternatively, for areas like the back, hip, knee, hamstrings, neck, or shoulder, one can soak a piece of flannel or a towel in the mixture, wring the cloth out and place it on the affected part as a compress. In this case, you may need 3 gallons of water. The first day you use the soak, bring the water to boil and then turn down the heat and simmer for 30-40 minutes. If possible, steam the affected part in the vapor as the mixture cools. Then immerse the affected part in the liquid and soak for 15-20 minutes. If you are soaking cloth or towels in the mixture to use as a compress; soak the cloth and then wring it out before placing it over the injured area. Meanwhile, put a second cloth in the mixture. As soon as the first cloth cools replace it and keep switching cloths for 1-15 minutes.
This mixture can be reused for up to 6 days. Simply save the liquid in the pot and reheat to the desired temperature on days 2 to 6. In order to increase the blood invigorating effect of a soak: Add 1 quart of alcohol (vodka or rice wine) after you have simmered the herbs for 30-40 minutes.
In order to increase the sinew relaxing and spasm releasing effect a soak: add 1 quart of white vinegar after you have simmered the herbs for 30-40 minutes.
After using the soak, dry the skin and keep it warm and away from cold or drafts. Cover the pot. The soak can be used once or twice a day for up to 7 days. Simply re-heat the liquid to a sufficiently warm temperature. There is no need to boil it again. As long as you keep the pot covered and re-heat the soak every day, the liquid will not get moldy.
Some people like to take out the flow-through bag containing the herbs after the cooking procedure. However I recommend leaving the bag in the pot as you soak because it increases the strength of the herbal mixture, Do not use soaks for the treatment of fractures.
How do I apply an ointment (Gao)?
A Gao is essentially a poultice. Apply a thick coat of the ointment (Gao) over the injured area. Cover with gauze and then apply an elastic bandage, so that the herbal material is pressed firmly against the skin. The bandage should be firmly in place so that the herbal material does not slip, but not so tight that circulation is restricted. Leave for 24- 48 hours, before removing.
Areas like the hamstring muscles, shoulder, or ribs can benefit greatly from a Gao, but they can be difficult to wrap so that the herbal material stays in place over the injured tissues. For these areas, apply a thinner layer of the ointment, almost as if you were painting on the mixture. Then cover with gauze squares and tape the edges down. On a large area, like the ribs or the hamstrings, use rolled gauze to cover the area
Why should I use Herbal Ice (San Huang San Gao) instead of applying ice?
Herbal Ice (San Huang San Gao) is the traditional Gao that martial artists have used for centuries for injuries like sprains that are red, hot, swollen and painful (“inflammation” in modern Western medicine). Herbal Ice is composed of cooling herbs that reduce heat while breaking up blood stasis and dispersing swelling. This is the start of restoring the free flow of blood and Qi. Herbal Ice is an important substitute for ice because ice can create further stasis by constricting blood vessels and congealing stagnant fluids. Many doctors and trainers have now realized that ice causes more problems than it solves.
Herbal Ice (San Huang San Gao) is also the first stage treatment of choice for severe contusions to the muscles, which present with extensive bruising and swelling. Herbal Ice should only be used until the initial heat and swelling (inflammation), are gone or significantly reduced. It is not for long-term use. Residual swelling can be addressed by other gao by liniments like Extra Strength Trauma Liniment, Dragon’s Blood Tendon Lotion, or second stage Gaos like Extra-Strength Gold Yellow Ointment (Jin Huang Gao), or Trauma Ointment Stage 2: (Die Da Gao Stage 2)
What is the difference between Herbal Ice and Stage 1 Trauma Ointment (Die Da Gao Yi Bu)?
Herbal Ice (San Huang San Gao) is more appropriate with soft tissue or bone injuries that are red, hot, swollen and painful. Herbal Ice reduces the swelling and cools the local area while dispersing local blood and fluid stasis. Stage 1 Trauma Ointment (Die Da Gao Yi Bu) focuses more on moving blood stasis and improving micro-circulation. It is more suitable when there is bruising and swelling, without the presence of heat (hot to the touch and red). Stage 1 Trauma Ointment contains many blood moving herbs whose warming nature is offset by a very large dosage of Da Huang (Rhubarb). Da Huang is cooling and moves blood stasis, making it very appropriate for a Stage 1 Injury.
What is the difference Stage 1 Trauma Ointment and Stage 2 Trauma Ointment?
Stage 1 Trauma Ointment (Die Da Gao Yi Bu) contains many blood moving herbs whose warming nature is offset by a very large dosage of Da Huang (Rhubarb). Da Huang is cooling and moves blood stasis, making it very appropriate for a Stage 1 Injury. In Stage 2, Trauma Ointment (Die Da Gao Er Bu), the dosage of Da Huang is significantly reduced, allowing the warming nature of the other herbs to more strongly warm the channels and collaterals and move blood stasis. These two formulas are an example of using the same formula for different situations with minimal modification.
When should I use Extra Strength Golden Ointment (Qiang Li Jin Huang Gao)?
Extra Strength Golden Ointment (Qiang Li Jin Huang Gao) is generally used for Stage 2 injuries. It is the treatment of choice for Stage 2 injuries accompanied by pockets of swelling or residual swelling. There may still be some heat in the local area but this is not the full-blown hot, red swelling of a Stage 1 injury, which calls for Herbal Ice (San Huang San). Extra Strength Golden Ointment contains cooing herbs that move stasis, like Huang Bai and Da Huang, but it also contains warming herbs that move fluid stasis and prevent the formation of phlegm in the network vessels: Cang Zhu, Bai Zhi, Tian Nan Xing, and Chen Pi. This also combination makes Extra Strength Golden Ointment ideal for sprains or fractures that occur in damp, hot weather, which can increase the tendency for damp and warmth to penetrate the local a and increase the swelling and stasis.
If a Stage 2 injury manifests with more blood stasis, rather than fluid swelling, one could still use Extra Strength Golden Ointment, however, Stage 2 Trauma Ointment Die Da Gao Er Bu) might be a better choice.
What Liniment should I use for bruising?
Extra Strength Trauma Liniment (Qiang Li Die Da Jiu) is the single best liniment for bruises, contusions, bone bruises, and even fractures. Extra Strength Trauma Liniment is much stronger then the more basic Trauma Liniment featured in A Tooth From the Tiger’s Mouth. It is excellent for killing pain because of its ability to move stasis and course the channels and collaterals (meridians). Extra Strength Trauma Liniment also has a strong effect on local micro-circulation – it clears local stasis while simultaneously stopping micro-hemorrhaging.
How do I apply Extra Strength Trauma Liniment (Qiang Li Die Da Jiu)?
For Bruises: Put a small amount of Extra Strength Trauma Liniment in your palm and pat it gently into the injured area. This helps it penetrate. Then use your thumb or three fingers to massage sore spots and break up lumps or accumulations. Start lightly and gradually work the liniment in deeper as the pain subsides.
Muscle Pulls: Massage Extra Strength Trauma Liniment into knots in the muscle. Try to break up knots by following the direction of the muscle fibers (i.e. longitudinally). Be sure to massage the liniment into the muscle attachments. For example for a pulled hamstring, first, pat the liniment into the painful area. Then use the thumb or 3 fingers to massage in circles around the sore area. Use the thumb to break up knots by massaging upwards toward the head and downwards toward the feet, following the direction of the muscle fibers. Finally, massage the liniment deep into the crease below the buttocks, and the area behind the knee as the hamstrings have tendon attachments to the bone in both of these areas.
Sprains & Strains: Massage Extra-Strength Trauma Liniment gently into the injured area. If there is swelling, put some liniment on the tip of your thumb or fingertips. Start at the edge of the swelling and rub in small circles around the edge with your thumb or fingertips. Add a little more of the liniment to your fingertips and lighten your pressure as you move inward, slowly and gently working the liniment into the center of the swollen area. Apply more liniment to your fingertips and direct your circles outward from the center, gently pushing stagnant fluids and blood away from the swollen area so they can be re-absorbed. Swollen lumps: For lumps from trauma like an “egg” on the shin. Apply Extra-Strength Trauma Liniment and rub the lump flat. Continue to apply the liniment and rub in circles around the area in order to disperse stagnant fluids.
For Fractures: Gently apply Extra-Strength Trauma Liniment and rub lightly over the fracture. Or soak cotton balls or paper towels with the liniment and apply over the area and then cover with rolled gauze. Reapply several times a day as the liniment will evaporate.
Why is Extra Strength Trauma Liniment appropriate for all stages of injury?
Extra Strength Trauma Liniment (Qiang Li Die Da Jiu) is a very balanced yet strong formula that contains very warming herbs like Chuan Wu and Cao Wu, which are balanced by cooling herbs like the “Three Yellows”: Huang Qin, Huang Bai, and Da Huang. It is excellent for killing pain because of its ability to move stasis and course the channels and collaterals (meridians). Extra Strength Trauma Liniment also has a strong effect on local micro-circulation – it clears local stasis while simultaneously stopping micro-hemorrhaging. Therefore it can be used in all stages of injury where there are stasis and pain.
When should I use Dragon's Blood Tendon Lotion (Xue Jie Shu Jin Lu) and how do I apply it?
Dragon's Blood Tendon Lotion (Xue Jie Shu Jin Lu) is used for chronic injuries to tendons and ligaments. These kinds of injuries run the gamut from old sprains that are slow to heal, to recurring tendonitis. In comparison with Extra Strength Trauma Liniment, which contains a balanced mix of cooling and warming herbs that do not overheat an inflamed area, Dragon’s Blood Tendon Lotion contains many more warming herbs that act to stimulate local circulation. The inclusion of these warming herbs is very important in treating chronic tendon injuries like tennis elbow because, unlike muscles, tendons do not have an extensive direct supply of blood. That is why these kinds of injuries can be recalcitrant and slow to heal. Increasing local circulation also prevents cold and dampness from penetrating into the injured area.
Dragon’s Blood Tendon Lotion should not be used when there are residual heat and redness (“inflammation”). In cases of tendonitis, it is not uncommon for there to be residual inflammation which can flare up if direct heat or warming liniments are applied. So how do you know if there is residual inflammation? If heat makes your injury feel better it is probably safe to use Dragon’s Blood Tendon Lotion. If you are still not sure, apply Dragon’s Blood Tendon Lotion twice a day for 1 or 2 days. If pain worsens switch to Trauma Liniment.
To apply, put a small amount of Dragon’s Blood Tendon Lotion on the ball of your thumb or on the pads of 2 or 3 fingers. Massage the liniment gently into the injured area. Pressure should be deep enough to penetrate, but not so deep as to be painful. Make small circles with your thumb or fingers in order to work the liniment into the injured tissues. Continue to rub the liniment into the area for several minutes adding more to your fingers as needed. For an injury like shin splints, where small micro-tears in the muscle are pulling the muscle away from the bone, massage in circles gently toward the bone using Dragon’s Blood Tendon Lotion.
Can I apply a medicinal soaks to a fracture?
No. In sinew injuries, herbal soaks are very important to relax sinews and break up accumulations of congealed blood. However, with fractures, soaks can actually be detrimental. Many of the blood dispersing, spasm relaxing soaks used in Stage 2 and Stage 3 injuries can actually slow bone healing because they have a dispersing, spreading effect on the Qi and blood, whereas herbs formulas that help heal broken bones have a consolidating, action that concentrates the Qi and blood. After the bones have knit, soaks can be used in order to improve circulation, dispel cold, or relax spasmed tissues.
Which products are appropriate for loose joints or overstretched ligaments?
Overstretched ligaments respond well to Bone-Sinew Gao (Gu Ji Wai Shang Xiao Tong Gao), which helps tighten and strengthen the ligaments. Bone –Sinew Gao is even more effective if used in conjunction with an internal formula like Stage 3 Bone Knitting Pill (Jie Gu Wan San Bu) This pill moves stasis and tonifies the liver and kidney to strengthen the sinews and bones. Bone Knitting Pill – Stage 3 contains many herbs that specifically speed bone knitting and strengthen the ligaments and tendons. It is based on an ancient Shaolin formula that was tested for centuries by martial artists.
In cases of constitutionally loose joint, or repeated dislocations which have led to joint instability, one should start with Stage 3 Bone Knitting Pill for one to two weeks and then switch to Strengthen Sinew Pills (Bu Jin Wan), which can safely be taken for a month or more.
What products are appropriate for Rheumatoid Arthritis?
Tiger's Invigorate Collateral Liniment (Hu Biao Huo Luo You) is specifically designed for wind-cold, damp that is lodged in the joints, causing stiffness and pain – Bi Syndrome. This formula includes vine medicinals that are traditionally used for joint pain because they open the channels and collaterals, free restrictions in the sinews, and dispel wind and dampness. The additions of herbs like Fang Feng and Gou Teng, which track down and dispel wind, increase its effectiveness with Bi Syndrome Tiger's Invigorate Collateral Liniment is energetically balanced with warming and cooling herbs, making it suitable for both warm and cold Bi (obstruction) Syndrome conditions.
Which internal formulas are used for fractures?
For Stage 1 Fractures (0-7 days, or even 0-14 days), the key is to dispel stasis. Unresolved stasis is one of the main causes of delayed bone healing. The herbal treatment of choice is the Blood Stasis Trauma Pill (Huo Xue Die Da Wan). In the Stage 2 Fracture Healing, Stage 2 Bone Knitting Pill (Jie Gu Wan Er Bu) is more appropriate because it continues to move stasis, but also adds a few tonic herbs that help to heal and strengthen bone and sinew.
If there is deficient Qi, with danger of wind, cold and damp penetration into the inured area, the Bonesetter’s Special Pill (Zheng Gu Zi Jin Dan) might be more appropriate at this stage. In Stage 3 Fracture Healing, the most appropriate formula is Stage 3 Bone Knitting Pill (Jie Gu Wan San Bu)). Stage 3 Bone Knitting Pill contains many herbs that significantly speed up bone knitting and strengthen the ligaments and tendons. It is based on an ancient Shaolin formula that was tested for centuries by martial artists. However, if there is still a lot of unresolved stasis in Stage 3, one should start with Blood Stasis Trauma Pill (Huo Xue Die Da Wan) for 5-7 days and then switch to Stage 3 Bone Knitting Pill (Jie Gu Wan San Bu). .
Do Gao, soaks and liniments cause skin rashes?
In general, skin reactions are rare with these products. Some people have sensitive skin. Ointments like Gao soaks and liniments, particularly those that contain warming herbs, can irritate the skin, causing an itch or a rash. This happens most commonly with the Bone-Sinew Gao (Gu Ji Wai Shang Xiao Tong Gao), or the Warming Soak (Wen Jing Huo Luo Jin Ji). Fair-skinned people seem particularly susceptible to this. If you do get a rash, simply remove the plaster or poultice and air out the skin. Never use Gao together with heating pads or other heat sources. This combination can overheat the area and cause a burn. Some liniments may be used with wet heat or a heat lamp. If you have just had a heating pad on the injured area or just been in a sauna or jacuzzi, let the skin cool before applying a Gao or liniment.
If you have sensitive skin, it can be useful to do a skin test – before using the product, apply a little bit of the product to a small area of the skin and see if it reacts.
Bone-Sinew Ointment Gao can cause a rash and itching, even in those with skin that is not sensitive. This is annoying but does not detract from the therapeutic action of the Gao. Washing the area carefully after removing the Gao and applying a moisturizer. Usually, this is sufficient to resolve any rash or itching.
How long should I leave a Gao (ointment/poultice) on the injured area?
Generally 24-48 hours. In an acute stage of injury, it is better to remove the poultice after 24 hours to see if the signs and symptoms (swelling, amount of heat, bruising, etc.) have changed and the situation now requires a different Gao. In more chronic cases like weak and overstretched ligaments, or damaged cartilage that is in the 3rd Stage, one can leave the Gao in place for as long as 72 hours.
Can the Blood Stasis Trauma Pill (Huo Xie Die Da Wan) be used as a substitute for the Traditional Die Da Wan?
Yes. Although the Traditional Die Da Wan contains Ma Huang, which strongly moves stasis in the superficial layers of the body, Blood Stasis Trauma Pill (Huo Xue Die Da Wan) is an equally, and often more effective formula, used by generations of martial arts practitioners for sprains, strains, and broken bones. Blood Stasis Trauma Pill is a very balanced and comprehensive formula that includes Sheng Di Huang and Qing Pi, a classic combination that keeps blood from accumulating. Wei Ling Xian opens all 12 vessels and the Luo's vessels and dispels wind. Fang Feng also dispels wind, and in this formula is used to prevent a movement toward Bi syndrome. Blood moving herbs like Mo Yao, Ru Xing, Dan Shen, Ze Lan, and Tu Bie Chong move and crack blood stasis. Zi Ran Tong dispels blood stasis, relieves pain and promotes healing of bones and sinews Gui Sui Bu (“Mender of Shattered Bones”) helps to heal injured sinew and bones.
About Tom Bisio
Tom Bisio has taught martial arts since 1979 and he is a licensed practitioner of acupuncture and traditional Chinese medicine. From 1990 to 2015, Tom headed a busy clinic in New York City, specializing in trauma, Chinese sports medicine, and orthopedic conditions, where a steady stream of apprentices and observers came to learn Chinese medicine.
Today, Tom teaches Traditional Tui Na, Chinese Sports Medicine and other aspects of Chinese medicine in North America and Europe through his Practical Chinese Medicine seminars. He is the founder and the creator of Zang Fu Tui Na, a unique method of manually regulating the internal organs. More recently, Tom collaborated with Kamwo Meridian Herbs to create a product line for sports injuries and trauma that is effective and easy to use.
Tom is also the founder of Internal Arts International (IAI). This organization teaches and promotes the Chinese Internal Arts of Ba Gua Zhang and Xing Yi Quan and their connections to both Chinese medicine and the healing arts. This includes online learning programs in Qi Gong, Ba Gua Zhang, and Chinese Medicine.
Tom is the author of the popular book, A Tooth From the Tiger’s Mouth: How to Treat Your Injuries with Powerful Healing Secrets of the Great Chinese Warriors (Simon and Schuster), and a companion volume, A Pearl form the Dragon’s Neck: Secret Revival Methods & Vital Points for Injury, Healing And Health from the Great Martial Arts Masters. Tom is the co-author of Zheng Gu Tui Na: A Chinese Medical Massage Textbook, and he has written and collaborated on more than fifteen books on Ba Gua Zhang, Xing Yi, Quan Nei Gong, Qin Na, and Daoist Meditation.