详观病案，曾患两膝肿疼，愈而复发，膝踝趾骨皆 热肿
痛，连臀部亦肿，又兼目痛。此诚因心肝皆有郁热，而关节经络之间又有风湿热相并，阴塞血脉之流通，故作
肿疼也。后见有胡××、张××皆有答复，所论病因及治法又皆尽善尽美，似无庸再为拟议。然愚从前治此等
证，亦纯用中药，后阅东人医报见治急性偻麻质斯（即热性历节风），喜用西药阿斯匹林，载有历治诸案可考
验，后乃屡试其药，更以中药驾驭之，尤效验异常。在奉曾治一幼童得此证，已危至极点，奄奄一息，数日
未断，舁至院中亦治愈（详案在石膏解下）。由斯知西药之性近和平，试之果有效验，且洞悉其
原质者，固不妨与中药并用也。爰拟方于下，以备采择∶
阿斯匹林一瓦半，生怀山药一两，鲜茅根去净皮切碎二两，将山药茅根煎汤三茶杯，一日之间分三次
温服，每次送服阿斯匹林半瓦。若服一次周身得汗后，二次阿斯匹林可少用。至翌日三次皆宜少用。以一日
间三次所服之阿斯匹林有一次微似有汗即可，不可每次皆有汗也。如此服之，大约两旬即可愈矣。
详观病案，知系血海虚寒，其中气化不宣通也。夫血海者，冲脉也，居脐之两旁，微向下，男女皆有。
在女子则上承诸经之血，下应一月之信，有任脉以为之担任，带脉以为之约束。阳维、阴维、阳跷、阴跷，
为之拥护，督脉为之督摄，《内经》所谓女子二七，太冲脉盛，月事以时下者此也。有时其中气化虚损
或兼寒凉，其宣通主力微，遂至凝滞而作疼也。而诸脉之担任拥护、督摄者，亦遂连带而作疼也。斯当
温补其气化而宣通之，其疼自止。爰拟方于下∶
全当归（一两） 生乳香（一两） 生没药（一两） 小茴香（一两炒熟）
鱼鳔胶（一两猪脂炸脆） 川芎（五钱） 甘松（五钱，此药原香郁，若陈腐者不用亦可）
共为细末。每服二钱五分，用真鹿角胶钱半，煎汤送下，日服两次。
仔细查看病案，患者曾患有双膝肿胀疼痛，痊愈后复发，膝盖、脚踝和脚趾骨骼都出现热肿疼痛，臀部也连带肿胀，同时伴有眼睛疼痛。这确实是因为心和肝都有郁结的热邪，而在关节经络之间又有风、湿、热三种邪气结合，阴寒之邪阻塞了血脉的正常运行，从而导致了肿胀和疼痛。后来看到胡××、张××等人都有回复，他们讨论的病因及治疗方法都已经非常完美，似乎不需要我再提出新的建议。然而，我从前治疗这类病症时，完全使用中药，后来阅读日本医生的医报，发现他们治疗急性偻麻质斯（即热性历节风）时，喜欢使用西药阿斯匹林，记载的治疗案例可供验证。此后我便多次尝试这种药物，并用中药来配合驾驭它，效果尤其显著。在奉天（今沈阳）我曾治疗过一个患此病的幼童，病情危急到了极点，气息奄奄，几天没有断绝，抬到医院中也治好了（详细病例见《石膏解》篇下）。由此可知，西药的药性接近平和，试用果然有效，而且如果透彻了解其成分原理的人，确实不妨与中药一起使用。于是拟定方剂如下，以备参考选择：
阿斯匹林一瓦半，生怀山药一两，鲜茅根去掉皮切碎二两，将山药和茅根煎成三茶杯的药汤，一天之内分三次温服，每次送服阿斯匹林半瓦。如果服用一次后全身出汗，第二次的阿斯匹林可以少用一些。到了第二天，三次的阿斯匹林都应该少用。以一天内三次所服的阿斯匹林，只要有一次微微似有汗出即可，不可每次都让病人出汗。这样服药，大约二十天左右就可以痊愈了。
仔细查看病案，知道这是血海虚寒，其中的气化功能不能宣通所致。所谓血海，就是冲脉，位于肚脐两旁，略微向下，男女都有。在女子身上，它向上承接各条经脉的血液，向下对应每月的月经来潮，有任脉来承担其功能，带脉来约束它，阳维脉、阴维脉、阳跷脉、阴跷脉来拥护它，督脉来总督摄持它，《内经》所说的女子十四岁，太冲脉旺盛，月经按时来潮，指的就是这种情况。有时其中气化虚损或者兼受寒凉，其宣通的力量微弱，从而导致凝滞而引发疼痛。而那些负责承担、拥护、总督摄持的各条经脉，也会连带产生疼痛。这时应当温补其气化功能并使其宣通，疼痛自然停止。于是拟定方剂如下：
全当归（一两），生乳香（一两），生没药（一两），小茴香（一两炒熟），鱼鳔胶（一两用猪油炸脆），川芎（五钱），甘松（五钱，此药原本香气浓郁，如果是陈旧腐坏的则不用也可以）。
以上药材共同研成细末。每次服用二钱五分，用真鹿角胶半钱，煎汤送服，每天服用两次。
Carefully examining the medical record, the patient previously suffered from swelling and pain in both knees. After recovery, the condition recurred, with heat, swelling, and pain affecting the bones of the knees, ankles, and toes. The buttocks were also swollen, accompanied by eye pain. This is indeed caused by stagnant heat in the Heart and Liver, combined with Wind, Dampness, and Heat pathogens in the joints and meridians. The Yin pathogen obstructs the smooth flow of blood vessels, resulting in swelling and pain. Later, I saw responses from Hu XX and Zhang XX; their discussions on the etiology and treatment methods were perfect, seemingly leaving no need for further suggestions. However, in the past, when I treated such conditions, I used only Chinese herbs. Later, reading Japanese medical journals, I found that they preferred using Western medicine Aspirin to treat acute Rheumatoid Arthritis (i.e., Acute Hot Bi Syndrome), with numerous recorded cases available for verification. Thereafter, I frequently tested this drug, controlling it with Chinese herbs, which yielded exceptionally effective results. In Fengtian (now Shenyang), I once treated a young child suffering from this condition. The case was extremely critical, with the child barely breathing, yet survived for several days. After being brought to the hospital, the child was cured (see detailed case under "Explanation of Gypsum"). From this, I learned that the nature of Western medicine is relatively mild; trials proved effective. Moreover, those who thoroughly understand its chemical composition should not hesitate to use it in conjunction with Chinese herbs. Therefore, I propose the following prescription for reference:
Aspirin 1.5 grains, Raw Huai Yam (Dioscoreae Hypoglaucae Rhizoma) 1 liang, Fresh Imperata Root (Imperatae Rhizoma) peeled and chopped 2 liang. Decoct the Yam and Imperata Root in water to make three cups of decoction. Take warm throughout the day in three doses. Each time, take Aspirin 0.5 grain with the decoction. If sweating occurs over the whole body after the first dose, reduce the amount of Aspirin in the second dose. On the next day, reduce the Aspirin dosage for all three doses. Among the three daily doses of Aspirin, it is sufficient if there is slight sweating in just one instance; do not induce sweating every time. With this regimen, recovery can be expected in approximately twenty days.
Carefully examining the medical record, I know this is due to deficiency-cold in the Sea of Blood (Chong Mai), where the Qi transformation fails to circulate freely. The Sea of Blood refers to the Chong Mai (Penetrating Vessel), located on both sides of the umbilicus, slightly downward, present in both men and women. In women, it receives blood from all meridians above and corresponds to monthly menstruation below. It is supported by the Ren Mai (Conception Vessel) for its function, constrained by the Dai Mai (Girdle Vessel), protected by the Yang Wei Mai (Yang Linking Vessel), Yin Wei Mai (Yin Linking Vessel), Yang Qiao Mai (Yang Heel Vessel), and Yin Qiao Mai (Yin Heel Vessel), and supervised by the Du Mai (Governing Vessel). As stated in the *Neijing* (Inner Canon): "When a girl reaches fourteen, the Tai Chong Mai becomes abundant, and menstruation arrives on time." Sometimes, due to deficiency-cold in Qi transformation or exposure to cold, the power of circulation becomes weak, leading to stagnation and pain. Consequently, the meridians responsible for support, protection, and supervision also suffer连带 pain. At this point, one should tonify the Qi transformation with warmth and promote its free circulation; the pain will cease naturally. Therefore, I propose the following prescription:
Quan Dang Gui (Angelicae Sinensis Radix) 1 liang, Raw Ru Xiang (Olibanum) 1 liang, Raw Mo Yao (Myrrha) 1 liang, Xiao Hui Xiang (Foeniculi Fructus) stir-fried until cooked 1 liang, Yu Biao Jiao (Colla Bladderae Suillae) fried crisp in pig fat 1 liang, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 5 qian, Gan Song (Nardostachyos Radix et Rhizoma) 5 qian (this herb originally has a rich fragrance; if stale or rancid, it should not be used).
Grind all ingredients into fine powder. Take 2.5 qian per dose, delivered with a decoction made from Zhen Lu Jiao Jiao (Colla Cornus Cervi) 0.5 qian. Take twice daily.