《选粹》云∶大法固以血之或瘀或失,分虚实而为补泻,亦当看伤之轻重。轻者顿挫,
凝滞作痛,此当导气行血而已;若重者伤筋折骨,如欲接续,非数月不瘥;若气血内停,阻
塞真气不得行者必死,急泻其血,通其气,庶可施治。又云∶出血太多,头目昏眩,先用川
当归、大川芎,水煎服,次加白芍药、熟地黄、续断、防风、荆芥、羌独活、南星,煎加童
便,不可用酒。如血出少,内有瘀血,以生料四物汤一半,加独圣散水煎服。皮肉未破者,
煎成加酒服。
《可法良规》云∶凡伤损之症,若误饮凉水,瘀血凝滞,气道不通,或血上逆,多致不
若入于心即死,急饮童便热酒以和之。若患重而瘀血不易散者,更和以辛温之剂。睡卧要上
身垫高,不时唤醒,勿令熟睡,则血庶不上逆。故患重之人,多为逆血填塞胸间,或闭塞气
道咽喉口鼻不得出入而死。
《选粹》云∶损伤,寒凉之药一毫俱不可用,盖血见寒则凝,若冷冻饮料致血入心而死。惟
外伤者,当内外兼治。若外无所伤,内有死血,唯用苏木等治血之药,可下者下之,鸡鸣散
是也。
《可法良规》云∶凡损伤之症,外固不宜敷贴硝黄之类,恐济寒以益其伤。若人平素虚
虽在夏令,内服亦不宜用咸寒之品。盖胃气得寒而不生,运气得寒而不健,瘀血得寒而不能
行,腐肉得寒而不溃,新肉得寒而不生。若内有瘀血停滞,服以通之,不在此例。
《选粹》说:治疗的大法固然要根据血液是瘀滞还是流失,来区分虚证和实证,从而采用补法或泻法,但也应当观察损伤的轻重程度。轻度的损伤表现为筋骨挫伤,气血凝滞导致疼痛,这种情况只需疏导气机、运行血液即可;如果伤势严重,造成筋伤骨折,想要接合恢复,没有几个月是不能痊愈的;如果血液在体内停滞,阻塞真气使其无法运行,必然导致死亡,此时必须紧急泻除瘀血,通畅气机,这样才可以进行治疗。又说:如果出血过多,出现头晕目眩的症状,应先用川当归、大川芎,用水煎煮后服用,随后加入白芍药、熟地黄、续断、防风、荆芥、羌活、独活、天南星,煎煮时加入童子尿,不可使用酒。如果出血量少,但体内有瘀血,取生料四物汤的一半剂量,加入独圣散,用水煎煮后服用。如果是皮肉未破损的情况,煎好后加入酒服用。
《可法良规》说:凡是损伤类的病症,如果误饮凉水,会导致瘀血凝滞,气道不通畅,或者血液上逆,大多会导致死亡。如果血液进入心脏就会致死,此时应紧急饮用童子尿和热酒来调和它。如果病情严重且瘀血不易消散,应再配合辛温性质的药物。睡眠时要将上身垫高,不时唤醒患者,不要让他熟睡,这样血液才不容易上逆。所以重伤的人,往往因为逆行的血液填塞胸间,或者闭塞气道、咽喉、口鼻,导致气息无法出入而死亡。
《选粹》说:对于损伤,寒凉性质的药物一丝一毫都不可使用,因为血液遇到寒冷就会凝固,如果食用冷冻饮料导致血液进入心脏,就会致死。只有外伤者,才应当内外兼治。如果外部没有受伤,只是内部有死血(瘀血),只需用苏木等治疗血液的药物,可以攻下的就用攻下法,鸡鸣散就是这类方剂。
《可法良规》说:凡是损伤类的病症,外部本来就不宜敷贴硝石、大黄之类的药物,恐怕会借助寒性而加重损伤。如果病人平素体质虚弱,即使在夏季,内服也不宜使用咸寒性质的药物。因为胃气受到寒冷刺激就无法生成,运气(生理功能)受到寒冷刺激就不强健,瘀血受到寒冷刺激就不能运行,腐肉受到寒冷刺激就不会溃破,新肉受到寒冷刺激就不会生长。但是如果体内有瘀血停滞,服用通利药物的情况,不在此例。
*The Xuan Cui* states: The general principle of treatment is indeed to distinguish between deficiency and excess based on whether blood is stagnant or lost, thereby applying tonification or purgation methods. However, one must also assess the severity of the injury. In mild cases, there is sprain or contusion, with stagnation of qi and blood causing pain; in such instances, it suffices to guide the qi and promote blood circulation. In severe cases involving tendon injury and bone fracture, if union is desired, recovery will not occur without several months. If blood stagnates internally, blocking the true qi from circulating, death is inevitable; urgently purging the blood and unblocking the qi are necessary before treatment can proceed. It further states: If excessive bleeding leads to dizziness and vertigo of the head and eyes, first administer Chuan Dang Gui (Radix Angelicae Sinensis) and Da Chuan Xiong (Rhizoma Chuanxiong), decocted in water. Subsequently, add Bai Shao Yao (Radix Paeoniae Alba), Shu Di Huang (Radix Rehmanniae Preparata), Xu Duan (Radix Dipsaci), Fang Feng (Radix Saposhnikoviae), Jing Jie (Herba Schizonepetae), Qiang Huo (Rhizoma Notopterygii), Du Huo (Radix Angelicae Pubescentis), and Nan Xing (Rhizoma Arisaematis). Decoct with Tong Bian (Child's Urine); wine should not be used. If bleeding is scant but blood stasis exists internally, use half the dosage of Sheng Liao Si Wu Tang (Raw Material Four Substances Decoction), combined with Du Sheng San (Single Hero Powder), decocted in water and administered. For injuries where the skin and flesh remain intact, add wine to the decoction before administration.
*The Ke Fa Liang Gui* states: In all cases of trauma, if cold water is mistakenly ingested, blood stasis will stagnate, the qi mechanism will become obstructed, or blood may rebel upward, often leading to death. If blood enters the heart, death occurs immediately; urgently drinking Tong Bian (Child's Urine) mixed with hot wine can harmonize the condition. If the condition is severe and blood stasis is difficult to dissipate, combine with acrid-warm formulas. When sleeping, elevate the upper body with pillows, wake the patient frequently, and prevent deep sleep, so that rebellious blood is less likely to ascend. Thus, patients with severe injuries often die because rebellious blood fills the chest cavity, or blocks the qi mechanism at the throat, mouth, and nose, preventing respiration.
*The Xuan Cui* states: For trauma, absolutely no cold-cooling herbs should be used, for blood coagulates when exposed to cold; consuming frozen drinks can cause blood to enter the heart, resulting in death. Only in cases of external trauma should internal and external treatments be combined. If there is no external injury but only internal dead blood (blood stasis), use herbs that treat blood, such as Su Mu (Lignum Sappan), and apply purgation if appropriate; Ji Ming San (Crowing Rooster Powder) is an example of such a formula.
*The Ke Fa Liang Gui* states: In all trauma cases, external application of substances like Xiao Shi (Natrii Sulfas) and Da Huang (Radix et Rhizoma Rhei) is generally contraindicated, as their cold nature may exacerbate the injury. If the patient is constitutionally deficient, even in midsummer, internal administration of salty-cold substances should be avoided. This is because stomach qi fails to generate when chilled, physiological functions weaken under cold, blood stasis cannot circulate due to cold, necrotic tissue does not ulcerate due to cold, and new tissue fails to grow due to cold. However, this rule does not apply if internal blood stasis requires unblocking agents.