Library

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).