Do not use bear bile or herbal leaves to treat a sprain

Some of the traditional treatments that are commonly used for a sprain include covering the affected area with heated herbal leaves, rubbing with tiger balm or Gac core alcohol and using bear bile.  However, many people have suffered serious consequences as a result of these treatments which can lead to joint stiffness, muscle wasting or disability.  In severe cases, surgery has even been necessary.

Wrong treatment - small lesions may still require surgery.
M.Sc. Nguyen Trung Dung, from the Department of Musculoskeletal - Hanoi Medical University (HMU) Hospital, reported that the hospital recently received a lot of patients with complications as a result of the wrong treatment for sprains.

One example is the case of Ms. N.T.H, 38 years old, from Bac Giang who fell down and sprained her arm. Although the injury was very painful, she did not go to the hospital but instead went to a traditional medicine doctor who treated her with herbal leaves.

She told the doctor at HMU that the herbal doctor heated up a leaf (so-called traditional medicine handed down from his ancestors) until it was on fire, then placed it over the inflamed area and covered it with a bandage.  She returned to see the traditional doctor every day for the herbal leaves to be replaced.
“At first the injured area was very hot when the doctor covered it with the leaves but then it became milder and felt less painful.  So I continued to return to him for his traditional treatment.  However, after 7 days of this treatment, I found the skin on the affected area had blistered and scalded so then I went to the hospital”, she said.

Doctors from the Department of Musculoskeletal – HMU Hospital diagnosed that Ms. N.T.H. had suffered complications leading to cellulitis of the area.  If she had continued with the herbal doctor’s treatment instead of going to the hospital in a timely manner she would definitely have suffered a fatal septicemia. 

It is worth mentioning that the incorrect treatment of Ms N.T.H. is not an isolated incident as traditional herbal treatments are very popular.  As well as using herbal leaves to cover wounds and injuries, many people use bear bile, wine of Gac fruit core and tiger balm to rub on injuries.  This treatment actually heats up the affected area and gives an initial pleasant feeling.  However, this does not cure the injury and can in fact increase the risk of ligament fibrosis causing tendon pain, stiffness, muscle wasting and the patient needing surgery to reshape the ligament.

Dr. Tran Van Phuc from Saint Paul Hospital (Hanoi) also shared this opinion.  He said that many people with minor injuries often did not seek treatment from a doctor but self-treated with bear bile or leaves of Crinum latifolium.  As a result of this treatment they inadvertently increase their vulnerability and cause a mild injury to become a major or chronic injury.

Another example is the case of a Grade 9 pupil who had to have surgery at Saint Paul hospital after a foot injury he received when playing football.  His family thought that it was only muscle trauma and instead of splinting it they took him to a traditional doctor for treatment.  This resulted in the injury becoming more serious which led to calcification of the ligament, destruction of a small bone and serious pain in his leg which stopped him from walking.  He then had to go to hospital to have surgery to repair the injury.

Bear bile and Gac core alcohol causes more bleeding
According to M.Sc. Dung, a sprain is a ligament injury of the joint and most likely to occur at wrist, ankle,  and shoulder or elbow joints. The injury can be minor, such as a slight muscle trauma or ligament stretch, or it can be more serious such as partially torn ligament which if not treated correctly can cause joint dislocation or in the worst situation if the ligament is entirely torn.

Patients will often see inflammation and livid skin on the sprained area which is a result of congestion caused by bleeding from blood vessels of the injured ligament. People often think that using heated leaves or rubbing bear bile or Gac core alcohol on the affected area will help the congestion and cure the pain.


Applying bear bile or heated materials to the affected area will increase bleeding and congestion, or may even cause muscle atrophy and stiffness which requires surgery to cure.

However, applying bear bile, medical alcohol or rubbing tiger balm onto the affected area is a serious mistake because using hot substances causes more bleeding and does not reduce the congestion.

The use of bear bile and other hot substances can in fact cause a more serious hematoma which may lead to necrosis, muscle atrophy and/or stiffness of the area in the long-term.  In many cases, patients do not splint the bone injury and the pain can become chronic. The only cure for this is surgery to reshape the new ligament.

Dr. Dung recommends that the most important treatment for a sprain is to fix the injured joint by splinting with a medical splint, elastic bandage or a plaster cast so that the ligaments have time to recover from the trauma.

Regarding folk remedies, herbalist Vu Quoc Trung, Director of Son Ha Private Medical Centre also confirmed that we should not use bear bile to cure a sprain.  Instead, we can use the leaves of some herbal trees such as Crinum latifolium, Pluchea indica or mugwort (Artemisia vulgaris).  To help cure the sprain the leaves should be pounded and boiled with a little water then when the mixture is cool it should be used to cover the affected area and reapplied once a day.  However, this remedy is suggested only for minor cases such as stretched ligaments.  In more serious cases such as torn ligaments or joint dislocations the patient should go to a specialized hospital for the best treatment.

By Hong Hai - Dantrinews

Translated by Nguyen Van Quan – Education officer on June 20th 2011; Edited by Kerry Henry on June 22, 2011,
Please note:  Translated by Education for Nature – Vietnam.  This translation is unofficial in nature.  The Vietnamese language version of this story can be obtained by contacting ENV.


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