据来案云云，臂疼当系因热。而愚再三思之，其原因断乎非热。或经络间因瘀生热，故乍服辛凉之品似
觉轻也。盖此证纯为经络之病，治之者宜以经络为重，而兼顾其脏腑，盖欲药力由脏腑而达经络也。西人治
急性关节疼痛，恒用阿斯匹林。然用其药宜用中药健运脾胃通行经络之品辅之。又细阅素服之方皆佳，所
以不见效者，大抵因少开痹通窃之药耳。今拟一方于下∶
于白术（此药药局中多用麸炒殊非所宜，当购生者自炒熟，其大小片分两次炒之轧细）取净末一两，乳香、
没药（二药须购生者轧成粗渣，隔纸在锅内烘融化，取出晾干轧细）各取净末四钱，朱血竭（此药未研时外皮作
黑色，若研之色若朱砂者方真）研细三钱，当归身（纸裹置炉旁候干轧细）净末七钱，细辛、香白
芷细末各钱半，冰片（用樟脑升成者，不必用梅片）、薄荷冰细末各三分，诸药和匀，贮瓶密封。每服一钱
半，络石藤（俗名爬山虎，能蔓延砖壁之上，其须自粘于壁上不落者方真）煎汤送服，日两次。方中之义∶以
白术健脾开痹为主（《神农本草经》谓白术逐风寒湿痹），佐以白芷去风，细辛去寒，当归、乳香、没药、血
竭以通气活血，冰片、薄荷冰以透窍即以通络。且脾主四肢，因其气化先行于右（右关候脾脉是明征），故
右臂尤为脾之所主。丁氏《化学本草》谓没药善养脾胃，其温通之性不但能治气血痹疼，更可佐白术以健补
脾胃，故于此证尤宜也。至阿斯匹林，初次宜服半瓦，以得微汗为度，以后每日服两次，撙节服之，不
必令其出汗，宜与自制末药相间服之，或先或后皆可（后接来函按法治愈）。
根据来信描述的症状，手臂疼痛似乎是由热邪引起的。但我反复思考后认为，其病因绝非热邪。可能是经络间因瘀血阻滞而生热，所以初次服用辛凉性质的药物时，感觉症状有所减轻。因为这个病症纯粹是经络的问题，治疗时应以调理经络为主，同时兼顾脏腑，目的是让药力能够由脏腑传导至经络。西方人治疗急性关节疼痛，常使用阿司匹林。然而使用这种西药时，应当配合使用中药中健运脾胃、通行经络的药物作为辅助。我又仔细查阅了他平时服用的方子，那些方子本身都不错，之所以不见效，大概是因为缺少了开通痹阻、疏通经络的药物。现在拟定一方如下：
取白术（此药在药房中多用麦麸炒制，这很不适宜，应当购买生品自己炒熟，将大小片分两次炒制后轧成细粉）净末一两；乳香、没药（这两味药须购买生品，轧成粗渣，隔纸在锅内烘融化，取出晾干后轧成细粉）各取净末四钱；朱砂色血竭（此药未研磨时外皮呈黑色，若研磨后颜色像朱砂那样才是真品）研细三钱；当归身（用纸包裹放在炉旁候干后轧成细粉）净末七钱；细辛、香白芷细末各一钱半；冰片（用樟脑升华制成的，不必用梅花片）、薄荷脑细末各三分。将上述药物混合均匀，装入瓶中密封保存。每次服用一钱半，用络石藤（俗名爬山虎，能蔓延在砖墙上，其须根能牢固粘附在墙上不脱落者才是真品）煎汤送服，每日两次。
本方的意义在于：以白术健脾、开通痹阻为主（《神农本草经》记载白术能祛除风寒湿痹），辅以白芷祛风，细辛散寒，当归、乳香、没药、血竭来通气活血，冰片和薄荷脑来透达孔窍即起到通络的作用。而且脾主四肢，因为人体的气化作用先行于右侧（右关脉候察脾脉，这是明显的证据），所以右臂更是脾所主管的部位。丁氏的《化学本草》记载没药善于滋养脾胃，其温通的性能不仅能治疗气血痹阻疼痛，更可辅助白术来健补脾胃，因此对于此证尤为适宜。至于阿司匹林，初次宜服用半瓦（剂量单位），以微微出汗为度，之后每日服用两次，节制服用，不必令其出汗，宜与自制的药粉交替服用，先服或后服都可以。（后来接到来信说按此法治愈了）。
According to the case description in your letter, the arm pain seems to be caused by Heat. However, after careful consideration, I firmly believe that the cause is definitely not Heat. It is likely that Heat arises from Blood stasis within the meridians; thus, taking acrid-cool herbs initially may seem to alleviate symptoms. Since this condition is purely a disease of the meridians, treatment should prioritize the meridians while simultaneously attending to the Zang-Fu organs, aiming to allow the medicinal power to travel from the Zang-Fu to the meridians. Western medicine often uses Aspirin for acute joint pain. However, when using this drug, it should be supplemented with Chinese herbs that strengthen and regulate the Spleen and Stomach and promote circulation through the meridians. Upon reviewing his usual prescriptions, they are all good; the reason for their ineffectiveness is likely the lack of herbs that open blockages and unblock the collaterals. I now propose the following prescription:
Take one tael of pure powder of Atractylodis Rhizoma (Bai Zhu) (This herb is often bran-fried in pharmacies, which is inappropriate; purchase raw material and fry it yourself until cooked. Fry large and small slices separately twice, then grind into fine powder); four qian of pure powder of Frankincense (Ruxiang) and Myrrh (Moyao) (These two herbs must be purchased raw, ground into coarse dregs, melted over paper in a pot, taken out, dried, and then ground into fine powder); three qian of fine powder of Dragon's Blood (Xue Jie) (The true product has a black outer skin before grinding; if the color resembles Cinnabar after grinding, it is authentic); seven qian of pure powder of Angelicae Sinensis Radix (Dang Gui Shen) (wrapped in paper, placed near the stove to dry, then ground into fine powder); one qian and half a qian each of Asarum (Xi Xin) and Angelicae Dahuricae Radix (Xiang Bai Zhi) fine powder; three fen each of Borneolum Syntheticum (Bing Pian) (synthesized from Camphora Resina, do not use Mei Pian) and Menthae Haplocalycis Herba (Bo He Bing) fine powder. Mix all drugs evenly, store in a bottle, and seal tightly. Take 1.5 qian per dose, delivered with decoction of Trachelospermi Caulis (Luo Shi Teng) (commonly known as creeping fig, true product is that which spreads on brick walls and whose roots adhere firmly without falling off). Take twice daily.
The rationale of this formula is as follows: Atractylodis Rhizoma (Bai Zhu) serves as the main ingredient to strengthen the Spleen and open Bi syndrome (as stated in *Shennong Bencao Jing*, Atractylodis Rhizoma expels Wind-Cold-Dampness Bi). It is assisted by Angelicae Dahuricae Radix (Xiang Bai Zhi) to dispel Wind, Asarum (Xi Xin) to dispel Cold, Angelicae Sinensis Radix (Dang Gui), Frankincense (Ruxiang), Myrrh (Moyao), and Dragon's Blood (Xue Jie) to promote Qi circulation and invigorate Blood, and Borneolum Syntheticum (Bing Pian) and Menthae Haplocalycis Herba (Bo He Bing) to penetrate orifices and thereby unblock the collaterals. Moreover, the Spleen governs the four limbs. Since the body's Qi transformation proceeds first on the right side (the right Guan pulse position monitors the Spleen pulse, which is clear evidence), the right arm is particularly governed by the Spleen. Ding's *Huaxue Bencao* states that Myrrh (Moyao) is excellent at nourishing the Spleen and Stomach. Its warming and unblocking nature not only treats Bi pain due to Qi and Blood stagnation but also assists Atractylodis Rhizoma (Bai Zhu) in strengthening and tonifying the Spleen and Stomach, making it especially suitable for this condition. Regarding Aspirin, the initial dose should be half grain, stopping when slight sweating occurs. Thereafter, take twice daily, regulating the dosage, without inducing sweating. It should be taken alternately with the homemade powder, either before or after (subsequently, a letter was received stating cure according to this method).