耀山曰∶伤科血病,四物(汤)为君,失亡补益,瘀滞攻行。盖闻内蓄不散,治分三部∶
犀角地黄(汤),中必桃仁承气(汤),瘀在下者,抵当(汤)通利。外感有邪,医随四季∶春用
五积(散)、香苏(饮)、夏以五苓(散)、香薷(饮),秋拟(藿香)正气(散),冬则双解(散)。且
如损伤发热,须别阴阳,阴虚者当归补血(汤),阳衰者(四)君子(汤)、(加)附(子)、(生)姜
。挟表体疼,虚实宜详,形实者疏风败毒(散),气弱者羌活乳香(汤)。初患之时,审症择方
,瘀凝昏愦者花蕊石(散),痰迷心闷者苏合香(丸),血瘀泛注者葱熨法,亡血过多者圣愈汤
,烦躁而不眠者加味归脾(汤),眩晕而呕胀者六君子汤。三、五日间,变症多端,喘咳者参
苏二味(参苏饮)、十味(参苏饮),口渴者竹叶石膏(汤)、(竹叶)黄 (汤),血热发躁仍用(
当归)补血(汤),气虚下陷(补中)益气(汤)升提,胃火作呕(加)栀芩清胃(散),寒凉克伐六
君(子汤)补脾。过此之后,更宜调理,呕吐黑汁兮百合(散加味)、芎归(汤),肝火炽盛兮(
加味)逍遥(散)加剂,血蕴内呕兮四物(汤加)柴(胡黄)芩,元气虚脱兮人参独(参汤)味。或
以筋骨作痛,肝肾之伤,六味地黄(丸);肌肉作痛,荣卫之滞,复元通气(散)。火盛而痛,
(小)柴胡(汤、加)栀(子、黄)连;湿痰为祟,二陈(汤)加味。头痛兮(当归)补血(汤)、安神
(汤)、(补中)益气(汤);胸痛兮四君(子汤)、四物(汤)、归脾(汤)。然腰痛者,瘀留血沥,
破血(散)、舒筋(散),虚者四物(汤),实者桃仁(承气汤)。而阴疼者,白津便淋,小柴胡(
汤)应;肝经郁火,加(山)、栀(黄)连、(生)军。即如胁肋胀疼,分其通塞,不通者瘀聚,
撤消活血(汤);便通者肝火,(小)柴胡(汤)、栀(子)、青(皮)。下后腹痛,察其阴阳,阳伤
者恶寒,十全(大)补(汤)济;阴伤者发热,四物(汤)、(加白)术、(人)参。若夫秘结者润肠
(丸)、导滞(汤),血虚便秘者玉烛(散)调和,作泻者清暑(益气汤)、清燥(汤),肾衰脾泄者
破故(纸)、肉果。青肿不溃皆虚弱,外熨内托;新肉不生因亏乏,峻加温补。至于破伤风分
表里,发痉又辨柔刚,柔饮白术(汤)而刚则葛根(汤),表服(羌活)防风(汤)而里用(大小)芎
黄(汤),羌麻(汤)疗表里之和剂,玉真(散)医是症之总方。始终秘诀,养血理伤。短句义难
尽悉,当于长篇究详。
伤损论曰∶去伤损必须求其源,看其病之轻重,审其损之浅深。凡人一身之间,自顶至
有斫伤、打伤、跌伤及诸刃伤者皆有之。凡此数证,各有其说,有当先表里而后服损药者,
为医者当循其理治之。然医者意也,不知意者,非良医也。或者禀性愚昧,不能观其证之轻
重,明其损之浅深,未经表里,先服损药,误人多矣。有因此痰涎上攻,有因此大小脏腑闭
结,差之毫厘,谬以千里。所谓医不三世,不服其药,信哉。
刘宗浓曰∶打扑金刃损伤,是不因气动而病生于外,外受有形之物所伤,乃血肉筋骨受
非如六淫七情为病,有在气、在血之分也。所以损伤一证,专从血论,但须分其有瘀血停积
或为亡血过多之症。盖打扑坠堕,皮不破而内损者,必有瘀血;若金刃伤皮出血,或致亡血
过多,二者不可同法而治。有瘀血者,宜攻利之,若亡血者,兼补而行之。又察其所伤,有
上下、轻重、浅深之异,经络气血多少之殊,唯宜先逐瘀血,通经络,和血止痛,然后调气
养血,补益胃气,无不效也。
《证治准绳》用药诀云∶凡树木压或自高处颠下者,此等伤皆惊动四肢五脏,必有恶血
,专怕恶心,先用清心药、打血药及通大小肠药次第服之,临服时加童子小便入药内立效。
如专用通利大小肠,恐作隘塞,利害之甚。要先清心而后通利,自然无昏闷烦躁,无恶血污
心等患,以次用止痛药服之即止,或二十五味药加减用之。
凡跌扑伤、刀石伤、诸般伤至重者,先服清心药,次服童子小便,再服去血药。或被伤
未结,打从疮口出者;或结在内,用药打入大肠,实时泻出者;或结在外,用药打散者;或
归上膈,打从口中吐出者;则用姜汤、灯心汤调二十五味药服之,薄荷汤亦可。
凡打扑伤损,折骨出臼者,便宜用何首乌散服之。若发热体实之人,用疏风败血散。若
寒体弱之人,用五积交加散。后用黄、白、红、黑四种末子及活血丹、补损丹等药调理。
凡折骨出臼者,不宜用下瘀血之药及通利大便之药,只宜疏风顺气,和血定痛,补损而
凡打扑砍磕,从高跌坠,瘀血攻心,不能言语者,用独圣散及破血药,下去瘀血,即能
言语,次宜临证详治之。
凡打扑跌堕,伤于胁下,瘀痛不可忍者,先用破血药及独圣散,次以复元活血汤调理。
凡打扑跌堕,损破皮肉,紫黑色者,先用破血药,次用独圣散,又次用清上瘀血汤、消
下破血汤。
凡打扑损伤,呕吐恶血汁者,先用独圣散,次用百合散,又次用生料四物汤加硬骨牛乳
根,加减调理。
凡打扑刀斧斫磕等伤,破皮损肉,血出去多,头目眩晕者,先用川当归、大川芎煎水服
用白芍药、熟地黄、续断、防风、荆芥、羌独活、南星煎水,加童便和服则可,不可用酒。
如血出少,内有瘀血者,以生料四物汤一半,独圣散一半,煎水服。未破皮肉者,加酒和服。
凡打扑刀斧斫磕,成破伤风,痛不可忍,牙关紧急,角弓反张者,用生南星、防风等分
为末,米泔调涂患处。又用热酒、童便各半调,连进三服即苏,次用疏风败毒散调治之。
凡刀斧斫磕伤,破阴囊皮者,先服独圣散,次服止痛药。内有瘀血者,用破血药。
凡刀斧伤破肚皮肠出者,先用清心药加童便和服,及用独圣散,次用止痛药。如血出过
先用当归、川芎,水煎服;次加白芍药、熟地黄、羌活、独活、防风、荆芥、白芷、续断,
水煎,调乳香、没药末和服之。
凡伤损药中,不可缺乳香、没药,此药极能散血止痛。
凡跌磕闪肭脱臼者,不可使用自然铜,久后方可用之。折骨者宜使用之,若不折骨不碎
不可用,修合诸损药皆要去之。用自然铜必用火炼,然新出火者,其火毒与金毒相煽,夹香
热药毒,虽有接骨之功,其燥散之祸甚于刀剑,戒之!
凡堕伤内有瘀血者,腹胀满而痛,或胸胁满,宜用破血药、清心药以通利之,自然而愈
。痛不止者,用独圣散服之效验。如更不止者,用止痛药服之大效。
凡刀刃所伤,从高跌坠,皮肉破损,出血过多,此宜止痛兼补为先,宜当归补血汤。若
不破损者,宜作瘀血停积治之,先以独圣散,次以破血药,随证加减。续后痛不止者,用止
痛药调理。
凡损伤,妙在补气血,俗工不知,惟要速效,多用自然铜,恐成痼疾也。初伤只用苏木
,黄连降火,白术和中,童便煎服。在下者可下瘀血,但先须补托。在上者宜饮韭汁,或和
粥吃。切不可饮冷水,血见寒则凝,但一丝血入心即死。
凡老人堕马,腰痛不可转侧者,先用苏木、人参、黄 、川芎、当归、陈皮、甘草煎服
,次以前药调下红、黑、黄、白四末子及活血丹、补损丹调理。
凡杖打闪肭疼痛,皆滞血证,宜破血药下之。痛不可忍,则伤血故也,宜清心药。更不
止,用独圣散。
凡损伤,大小便不通,未可便服损药,盖损药性热,又用酒服,涩秘愈甚。看患人虚实
者用破血药加木通,尚未通,加芒硝;虚者以四物汤加枳壳、麻仁、桃仁滑肠之类;虚人不
可下者,四物汤加穿山甲。
凡服损药,不可吃冷物、鱼、牛肉,若吃牛肉,痛不可治,瘟猪肉、母猪肉尤不可吃,
凡损药内用酒者,不问红白,只忌灰酒,且重伤不可使用酒,恐反发气,或作腹胀胸满
,切记切记!
凡损药其性必热,能生气血以接骨也,更忌用火炙。如敷药不效,服药亦不效。
凡损伤不可服草药,服之所生之骨必大,不得入臼,要相兼君臣药服则可,加温补气血
药同煎更妙。
凡打伤在两胁、两胸、两肚、两肋,却用通气通血清心药。又看病患虚实不同,虚者通
药须兼补药放缓,且用贴药在前,通药在后。
凡用通药反不通者,后用顺气药,腹肚全无膨胀,服而得安,此为不干血作,乃是气闭
。如腹肚果有血作,一通便下,亦须以顺气兼之,庶胸膈肚腹不致紧闷,气顺后却用损药。
凡人醉卧跌床下,胛背疼痛,不可屈伸,用损药不效,服黑豆酒数日愈,豆能下气,所
凡小儿跌凳脚上,用萝卜子煎服愈,亦顺气也。
凡损伤,整时先用热酒磨草乌服一、二盏方整。整时气绝,用苏合香丸须苏;未苏以黑
豆、防风、甘草、黄连水煎冷服,或苡草擂水服,不可用盐解之。若吐,加生姜汁。
上皆专科用药之法,人有虚实,不可一律而施。即如末条,整时先服草乌酒,整而气绝
以苏合香丸走窜之剂,未苏,又以冷药灌之。若施之气虚之人,惨于加刃矣。惟薛氏法,量
证施治,专于内补,可以遵用,学人宜审焉。
耀山曰∶内治既明,外敷宜晰。皮开肉绽兮封口(药),血流不止兮止血(药)。脉筋断兮
香(散),骨 脱兮(跌打)膏药贴。万灵(膏)、接骨(膏),治骨节之碎折;消肿(膏)、抑阳(
散),治身体之肿凸。坚硬不消,须用回阳(膏);肌肉不生,还须太乙(膏)。若逢脑壳破损
,混元(膏)、定痛(膏);如遇眼目青肿,(生)地黄(散)可灭。颧腮损伤者含以荜茇(散),嘴
唇破碎者涂以截血(膏)。蒺藜固齿(散),疗跌磕之斗齿;鸡(子)皮含护,医咬割之断舌。鼻
伤者以塞鼻(丹),耳落者以耳缀(法)。咽喉自刎破,忙将线缝合;杂以鸡绒毛,外掸花乳石
(散)。腹破肠出者,缝以麻缕、桑皮;囊开丸脱者,贴以(喜子)壁钱、(金毛)狗脊。箭刺入
肉,鼠脑、(象)牙屑;破伤风患,葱熨(法)须热。杖疮臀黑,切忌寒凉敷 ;夹棒踵伤,法
要破瘀活血。百症千方,概难尽说;谬叙俚言数句,聊为初学子诀。
《证治准绳》云∶凡脑骨损伤,皮不破者,用退肿膏敷贴。若皮破肉损者。先用封口药
掸之,外以散血膏贴之。若皮破血流者,用止血药掸之。
凡面目伤青黑色,用一紫散敷,或紫金膏贴。伤重者,用补肉膏敷贴。
凡两鼻孔跌磕,伤开孔窍者,用封口药掸伤处,外以散血膏贴之退肿。
凡耳斫跌打落,或上脱下粘,或下脱上粘,内用封口药掸,外用退肿膏敷贴。
凡唇口,刀斧斫磕跌堕等伤,破皮伤肉者,先用桑白皮缝合,却以封口药涂敷;次以散
敷贴,牵住所封之药,不令开落。或用鸡子黄油涂,次以金毛狗脊毛,薄掸于外,仍以封口
药涂抹之,次日以茶清洗净,掸末药,一日换一次,至八日剪去线,又掸末药。
凡腮颊颧,刀斧斫磕,跌堕等伤,破皮肉者,用封口药填疮口,外以散血膏敷贴。或跌
磕损伤,未破皮肉者,用补肉膏敷贴。
凡戏耍误割断舌头,未全断者,用封口药敷,一日换二、三次,七、八日全安。
凡齿牙被人打跌砍磕落者,只用补肌散掸之。
凡牙断跌磕斫伤,牙齿未动者,用芙蓉膏末掸。如齿动者,用蒺藜根烧存性为末,常揩
搽之即牢。
凡割喉者,以丝线先缝内喉管,后缝外颈皮,用封口药涂敷,外以散血膏敷贴。
凡手指跌扑打碎者,用鸡子黄油润,次掸封口药末,外以散血膏敷贴。若咬伤者,用泽
兰散敷之。
凡胸脯骨有拳槌伤,外有肿,内有痛,外用定痛膏敷贴,内服破血利药。
凡肚皮裂开,用麻缕为线,或捶桑白皮为线,以花蕊石散敷线,须从里面缝,外面皮不
可缝,留以掸药,用封口药涂,或补肌散以鸡子清调敷。
凡阴囊被人扯脱者,用鸡子黄油涂,以金毛狗脊毛薄摊于上,次掸封口药,又用散血膏
凡阴囊处有青黑紫色肿者,用补肉膏敷贴,或用定痛膏加赤芍、草乌、良姜、肉桂各少
许打和,用韭汁捣烂,同药敷贴。如无韭汁,葱汁亦可。仍服利小便药。
凡骨碎断或未碎断但皮破肉损者,先用补肌散填满疮口,次用散血膏敷贴。如骨折者,
要接骨膏敷贴夹缚。或皮破骨断者,用补肉膏敷贴。
凡筋断者,用枫香以金沸草捣取汁调涂,次用理伤膏敷贴。
凡用夹,须摊药于纸上平,两头要带薄搭头,搭得不浓不碍肉。平坦者,无高低不均之
患。若四岸高低不均,此上便有空缺不着肉处,即生泡。切记之。
凡敷贴接骨等膏药,仍疼痛不止者,可加乳香、没药、枫香、白芷、肉桂、南星、独活
等味,各量加些于药中敷贴,其肉温暖,疼痛即住。如刀斧伤者,去肉桂、南星、独活。
凡刀斧伤者,看轻重用药。如轻者,只用补肌散掸;重者,宜用封口药掸,紧缚住;如
伤最重者,外用散血膏敷贴。
耀山说:治疗外伤科的血证疾病,以四物汤(补血调血的基础方)为主药,用于失血后的补益和瘀血阻滞的攻逐消散。大概听说体内蓄积的瘀血不散,治疗需分三个部位:瘀在中焦的,必用桃仁承气汤;瘀在下焦的,用抵当汤通利泻下。若是外感邪气,医生应根据四季变化用药:春季用五积散、香苏饮;夏季用五苓散、香薷饮;秋季用藿香正气散;冬季用双解散。
又如损伤后发热,必须辨别阴阳:阴虚者用当归补血汤;阳气衰微者用四君子汤,并加附子、生姜。兼有表证且身体疼痛的,要详细辨别虚实:形体壮实者用疏风败毒散;气虚体弱者用羌活乳香汤。在受伤初期,审察症状选择方剂:瘀血凝结导致神志昏沉者用花蕊石散;痰迷心窍导致胸闷者用苏合香丸;瘀血泛溢注散者用葱熨法;失血过多者用圣愈汤;烦躁不眠者用加味归脾汤;眩晕呕吐腹胀者用六君子汤。
在三到五天之间,变症繁多:气喘咳嗽者用参苏饮(二味或十味方);口渴者用竹叶石膏汤或竹叶黄芩汤;血热烦躁仍用当归补血汤;气虚下陷者用补中益气汤升提;胃火作呕者用加味栀芩清胃散;寒凉药物克伐脾胃者用六君子汤补脾。过了这个阶段,更宜调理:呕吐黑汁者用加味百合散或芎归汤;肝火炽盛者用加味逍遥散加减;瘀血内蕴致呕者用四物汤加柴胡、黄芩;元气虚脱者用人参独参汤。
或者因筋骨作痛,属肝肾损伤,用六味地黄丸;肌肉作痛,属营卫滞涩,用复元通气散。火热旺盛而痛,用小柴胡汤加栀子、黄连;湿痰为患,用二陈汤加味。头痛者用当归补血汤、安神汤、补中益气汤;胸痛者用四君子汤、四物汤、归脾汤。然而腰痛者,是瘀血留滞,实证用破血散、舒筋散,虚证用四物汤,实证也可用桃仁承气汤。阴部疼痛伴小便白浊淋漓者,用小柴胡汤应对;肝经郁火者,加山栀、黄芩、黄连、生大黄。
就像胁肋胀痛,要分辨通畅与闭塞:不通畅的是瘀血聚集,用撤消活血汤;大便通畅的是肝火,用小柴胡汤加栀子、青皮。泻下后腹痛,要观察阴阳:阳伤者恶寒,用十全大补汤救治;阴伤者发热,用四物汤加白术、人参。如果是便秘,用润肠丸、导滞汤;血虚便秘者用玉烛散调和;腹泻者用清暑益气汤、清燥汤;肾衰脾泄者用破故纸、肉豆蔻。
青肿不溃烂都是虚弱所致,外用熨法,内用托毒法;新肉不生是因为亏乏,峻加温补。至于破伤风,要分表里,发痉又要辨柔刚:柔痉服白术汤,刚痉服葛根汤;表证服羌活防风汤,里证用川芎黄耆汤;羌麻汤是治疗表里兼顾的平和之剂,玉真散是治疗此症的总方。始终秘诀在于养血理伤。短句含义难以详尽,应在长篇中探究详情。
《伤损论》说:治疗损伤必须探求病因,看病的轻重,审察损伤的浅深。人身上下,从头顶到足底,凡是被砍伤、打伤、跌伤及各类刃器伤者都有发生。这些病症各有说法,有的应当先解表里而后服用治损药,作为医生应当遵循医理治疗。然而医者靠的是意会,不懂意会的不是良医。有些人禀性愚昧,不能观察证的轻重,不明损伤的浅深,未经解表里处理,先服治损药,误人很多。有人因此导致痰涎上攻,有人因此导致大小脏腑闭结,差之毫厘,谬以千里。所谓“医不三世,不服其药”,确实可信。
刘宗浓说:打扑金刃损伤,是不因气动而在外部产生的病,是外部受有形之物所伤,乃是血肉筋骨受到非自然伤害,不像六淫七情致病那样有在气、在血之分。所以损伤一证,专门从血论治,但须分清楚是有瘀血停积还是亡血过多的症状。大概打扑坠堕,皮不破而内部受损的,必有瘀血;若是金刃伤皮出血,或导致亡血过多,这两种情况不可用同样的方法治疗。有瘀血的,宜攻逐利下;若亡血的,兼用补益而行。又察其所伤,有上下、轻重、浅深之异,经络气血多少之殊,只宜先逐瘀血,通经络,和血止痛,然后调气养血,补益胃气,没有不有效的。
《证治准绳》用药诀说:凡是树木压伤或从高处颠落的,这种伤都会惊动四肢五脏,必有恶血,特别怕恶心,先用清心药、打血药及通大小肠药依次服用,临服时加入童子尿入药内立效。如果专用通利大小肠的药,恐怕造成隘塞,利害很大。要先清心而后通利,自然无昏闷烦躁,无恶血污心等患,依次用止痛药服用即止,或用二十五味药加减使用。
凡是跌扑伤、刀石伤、各种重伤,先服清心药,次服童子尿,再服去血药。如果被伤未结块,从疮口流出者;或结块在内,用药打入大肠,实时泻出者;或结块在外,用药打散者;或归上膈,从口中吐出者;则用姜汤、灯心汤调服二十五味药,薄荷汤亦可。
凡是打扑伤损,折骨出臼的,便宜用何首乌散服用。若发热体实之人,用疏风败血散。若寒体弱之人,用五积交加散。后用黄、白、红、黑四种末子及活血丹、补损丹等药调理。
凡是折骨出臼的,不宜用下瘀血之药及通利大便之药,只宜疏风顺气,和血定痛,补损而已。
凡是打扑砍磕,从高跌坠,瘀血攻心,不能言语的,用独圣散及破血药,下去瘀血,即能言语,其次宜临证详治。
凡是打扑跌堕,伤于胁下,瘀痛不可忍的,先用破血药及独圣散,次以复元活血汤调理。
凡是打扑跌堕,损破皮肉,呈紫黑色的,先用破血药,次用独圣散,又次用清上瘀血汤、消下破血汤。
凡是打扑损伤,呕吐恶血汁的,先用独圣散,次用百合散,又次用生料四物汤加硬骨牛乳根,加减调理。
凡是打扑刀斧斫磕等伤,破皮损肉,血出去多,头目眩晕的,先用川当归、大川芎煎水服用,另用白芍药、熟地黄、续断、防风、荆芥、羌活、独活、南星煎水,加童便和服则可,不可用酒。如血出少,内有瘀血的,以生料四物汤一半,独圣散一半,煎水服。未破皮肉的,加酒和服。
凡是打扑刀斧斫磕,成破伤风的,痛不可忍,牙关紧急,角弓反张的,用生南星、防风等分为末,米泔调涂患处。又用热酒、童便各半调,连进三服即苏,次用疏风败毒散调治之。
凡是刀斧斫磕伤,破阴囊皮的,先服独圣散,次服止痛药。内有瘀血的,用破血药。
凡是刀斧伤破肚皮肠出的,先用清心药加童便和服,及用独圣散,次用止痛药。如血出过多的,先用当归、川芎,水煎服;次加白芍药、熟地黄、羌活、独活、防风、荆芥、白芷、续断,水煎,调乳香、没药末和服之。
凡是跌磕闪肭脱臼的,不可使用自然铜,久后方可用之。折骨的宜使用之,若不折骨不碎不可用,修合诸损药皆要去之。用自然铜必用火炼,然新出火的,其火毒与金毒相煽,夹香热药毒,虽有接骨之功,其燥散之祸甚于刀剑,戒之!
凡是堕伤内有瘀血的,腹胀满而痛,或胸胁满,宜用破血药、清心药以通利之,自然而愈。痛不止的,用独圣散服之效验。如更不止的,用止痛药服之大效。
凡是刀刃所伤,从高跌坠,皮肉破损,出血过多的,此宜止痛兼补为先,宜当归补血汤。若不破损的,宜作瘀血停积治之,先以独圣散,次以破血药,随证加减。续后痛不止的,用止痛药调理。
凡是损伤,妙在补气血,俗工不知,惟要速效,多用自然铜,恐成痼疾也。初伤只用苏木,黄连降火,白术和中,童便煎服。在下者可下瘀血,但先须补托。在上者宜饮韭汁,或和粥吃。切不可饮冷水,血见寒则凝,但一丝血入心即死。
凡是老人堕马,腰痛不可转侧的,先用苏木、人参、黄芪、川芎、当归、陈皮、甘草煎服,次以前药调下红、黑、黄、白四末子及活血丹、补损丹调理。
凡是杖打闪肭疼痛,皆滞血证,宜破血药下之。痛不可忍,则伤血故也,宜清心药。更不止,用独圣散。
凡是损伤,大小便不通,未可便服损药,盖损药性热,又用酒服,涩秘愈甚。看患人虚实者用破血药加木通,尚未通,加芒硝;虚者以四物汤加枳壳、麻仁、桃仁滑肠之类;虚人不可下的,四物汤加穿山甲。
凡是服损药,不可吃冷物、鱼、牛肉,若吃牛肉,痛不可治,瘟猪肉、母猪肉尤不可吃。凡损药内用酒的,不问红白,只忌灰酒,且重伤不可使用酒,恐反发气,或作腹胀胸满,切记切记!
凡是损药其性必热,能生气血以接骨也,更忌用火炙。如敷药不效,服药亦不效。
凡是损伤不可服草药,服之所生之骨必大,不得入臼,要相兼君臣药服则可,加温补气血药同煎更妙。
凡是打伤在两胁、两胸、两肚、两肋,却用通气通血清心药。又看病患虚实不同,虚者通药须兼补药放缓,且用贴药在前,通药在后。
凡是用通药反不通的,后用顺气药,腹肚全无膨胀,服而得安,此为不干血作,乃是气闭。如腹肚果有血作,一通便下,亦须以顺气兼之,庶胸膈肚腹不致紧闷,气顺后却用损药。
凡人醉卧跌床下,胛背疼痛,不可屈伸,用损药不效,服黑豆酒数日愈,豆能下气,所...(原文此处似有缺漏,依文意推断为解释黑豆功效)
凡是损伤,整复时先用热酒磨草乌服一、二盏方整。整复时气绝,用苏合香丸须苏;未苏以黑豆、防风、甘草、黄连水煎冷服,或苡草擂水服,不可用盐解之。若吐,加生姜汁。
以上皆是专科用药之法,人有虚实,不可一律而施。即如末条,整复时先服草乌酒,整复而气绝以苏合香丸走窜之剂,未苏,又以冷药灌之。若施之气虚之人,惨于加刃矣。惟薛氏法,量证施治,专于内补,可以遵用,学人宜审焉。
耀山说:内治既明,外敷宜晰。皮开肉绽的封口药,血流不止的止血药。脉筋断的香散,骨脱的跌打膏药贴。万灵膏、接骨膏,治骨节之碎折;消肿膏、抑阳散,治身体之肿凸。坚硬不消,须用回阳膏;肌肉不生,还须太乙膏。若逢脑壳破损,混元膏、定痛膏;如遇眼目青肿,生地黄散可灭。颧腮损伤者含以荜茇散,嘴唇破碎者涂以截血膏。蒺藜固齿散,疗跌磕之斗齿;鸡子皮含护,医咬割之断舌。鼻伤者以塞鼻丹,耳落者以耳缀法。咽喉自刎破,忙将线缝合;杂以鸡绒毛,外掸花乳石散。腹破肠出者,缝以麻缕、桑皮;囊开丸脱者,贴以壁钱、狗脊。箭刺入肉,鼠脑、象牙屑;破伤风患,葱熨法须热。杖疮臀黑,切忌寒凉敷;夹棒踵伤,法要破瘀活血。百症千方,概难尽说;谬叙俚言数句,聊为初学子诀。
《证治准绳》说:凡是脑骨损伤,皮不破的,用退肿膏敷贴。若皮破肉损的,先用封口药掸之,外以散血膏贴之。若皮破血流的,用止血药掸之。
凡是面目伤青黑色的,用一紫散敷,或紫金膏贴。伤重的,用补肉膏敷贴。
凡是两鼻孔跌磕,伤开孔窍的,用封口药掸伤处,外以散血膏贴之退肿。
凡是耳斫跌打落,或上脱下粘,或下脱上粘,内用封口药掸,外用退肿膏敷贴。
凡是唇口,刀斧斫磕跌堕等伤,破皮伤肉的,先用桑白皮缝合,却以封口药涂敷;次以散敷贴,牵住所封之药,不令开落。或用鸡子黄油涂,次以金毛狗脊毛,薄掸于外,仍以封口药涂抹之,次日以茶清洗净,掸末药,一日换一次,至八日剪去线,又掸末药。
凡是腮颊颧,刀斧斫磕,跌堕等伤,破皮肉的,用封口药填疮口,外以散血膏敷贴。或跌磕损伤,未破皮肉的,用补肉膏敷贴。
凡是戏耍误割断舌头,未全断的,用封口药敷,一日换二、三次,七、八日全安。
凡是齿牙被人打跌砍磕落者的,只用补肌散掸之。
凡是牙断跌磕斫伤,牙齿未动的,用芙蓉膏末掸。如齿动的,用蒺藜根烧存性为末,常揩搽之即牢。
凡是割喉的,以丝线先缝内喉管,后缝外颈皮,用封口药涂敷,外以散血膏敷贴。
凡是手指跌扑打碎的,用鸡子黄油润,次掸封口药末,外以散血膏敷贴。若咬伤的,用泽兰散敷之。
凡是胸脯骨有拳槌伤的,外有肿,内有痛的,外用定痛膏敷贴,内服破血利药。
凡是肚皮裂开的,用麻缕为线,或捶桑白皮为线,以花蕊石散敷线,须从里面缝,外面皮不可缝,留以掸药,用封口药涂,或补肌散以鸡子清调敷。
凡是阴囊被人扯脱的,用鸡子黄油涂,以金毛狗脊毛薄摊于上,次掸封口药,又用散血膏...(原文此处似有缺漏,依文意推断为敷贴)
凡是阴囊处有青黑紫色肿的,用补肉膏敷贴,或用定痛膏加赤芍、草乌、良姜、肉桂各少许打和,用韭汁捣烂,同药敷贴。如无韭汁,葱汁亦可。仍服利小便药。
凡是骨碎断或未碎断但皮破肉损的,先用补肌散填满疮口,次用散血膏敷贴。如骨折的,要接骨膏敷贴夹缚。或皮破骨断的,用补肉膏敷贴。
凡是用夹,须摊药于纸上平,两头要带薄搭头,搭得不浓不碍肉。平坦者,无高低不均之患。若四岸高低不均,此上便有空缺不着肉处,即生泡。切记之。
凡是敷贴接骨等膏药,仍疼痛不止的,可加乳香、没药、枫香、白芷、肉桂、南星、独活等味,各量加些于药中敷贴,其肉温暖,疼痛即住。如刀斧伤者,去肉桂、南星、独活。
Yaoshan stated: For blood-related injuries in orthopedics, Siwu Tang (Four Substances Decoction) serves as the principal formula, used for tonification after hemorrhage and for resolving stasis. Generally, internal accumulation of unresolved stasis is treated according to three locations: for stasis in the middle jiao (Middle Burner), Taoren Chengqi Tang (Peach Kernel and Rhubarb Decoction) is essential; for stasis in the lower jiao (Lower Burner), Didang Tang (Definitely Break Through Decoction) is used to promote unblocking and purgation. If external pathogens are involved, physicians should adjust prescriptions according to the four seasons: in spring, Wuji San (Five Accumulations Powder) or Xiangsu Yin (Fragrant Perilla Drink); in summer, Wuling San (Five Ling Powder) or Xiangru Yin (Mosla Drink); in autumn, Huoxiang Zhengqi San (Agastache Powder to Rectify Qi); in winter, Shuangjie San (Double Resolution Powder).
Furthermore, regarding fever following trauma, one must distinguish between yin and yang deficiency: for yin deficiency, Danggui Buxue Tang (Angelica Tonifying Blood Decoction) is used; for yang collapse, Sijunzi Tang (Four Gentlemen Decoction) with added Fuzi (Aconite Lateral Root) and Shengjiang (Fresh Ginger) is indicated. When accompanied by exterior symptoms and body pain, deficiency and excess must be carefully distinguished: for those with robust constitution, Shufeng Baidu San (Wind-Dispersing and Toxin-Vanquishing Powder) is used; for those with weak qi, Qianghuo Ruxiang Tang (Notopterygium and Frankincense Decoction) is prescribed. At the initial stage of injury, select formulas based on symptoms: for unconsciousness due to coagulated stasis, Huaruishi San (Flower Porphyry Stone Powder) is used; for chest tightness due to phlegm confusing the heart, Suhexiang Wan (Styrax Pill) is administered; for diffuse stasis infiltration, Congxi Fa (Scallion Moxibustion Method) is applied; for excessive blood loss, Shengyu Tang (Savior's Life Decoction) is used; for restlessness and insomnia, Jiawei Guipi Tang (Modified Heart-Spleen Tonifying Decoction) is indicated; for dizziness, vomiting, and abdominal distension, Liujunzi Tang (Six Gentlemen Decoction) is prescribed.
Between the third and fifth days, complications may arise: for wheezing and coughing, Shenru Erwei Tang (Ginseng and Perilla Two-Ingredient Decoction) or Shiwei Shenru Tang (Ten-Ingredient Ginseng and Perilla Decoction) are used; for thirst, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) or Zhuye Huangqin Tang (Bamboo Leaf and Scutellaria Decoction) are indicated; for heat in the blood causing agitation, Danggui Buxue Tang is still used; for sinking of qi deficiency, Buzhong Yiqi Tang (Center-Boosting and Qi-Generating Decoction) is used to raise; for stomach fire causing vomiting, Jiawei Zhiqin Qingwei San (Modified Gardenia and Scutellaria Stomach-Clearing Powder) is used; for spleen deficiency caused by cold-collapsing medicines, Liujunzi Tang is used to tonify the spleen. After this period, regulation is more important: for vomiting black fluid, Jiawei Baihe San (Modified Lily Bulb Powder) or Xionggui Tang (Ligusticum and Angelica Decoction) are used; for blazing liver fire, Jiawei Xiaoyao San (Modified Free Wanderer Powder) is added to; for internal blood stasis causing vomiting, Siwu Tang with Chaihu (Bupleurum Root) and Huangqin (Scutellaria Root) is used; for collapse of yuan qi (Original Qi), Renshen Dushen Tang (Single Ginseng Decoction) is used.
Alternatively, for bone and tendon pain due to liver and kidney injury, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) is used; for muscle pain due to nutritive and defensive stagnation, Fuyuan Tongqi San (Restoring Origin and Promoting Qi Circulation Powder) is used. For pain due to excessive fire, Xiao Chaihu Tang (Minor Bupleurum Decoction) with Zhizi (Gardenia Fruit) and Huanglian (Coptis Rhizome) is used; for malice caused by damp-phlegm, Erchen Tang (Two-Aged Decoction) with modifications is used. For headache, Danggui Buxue Tang, Anshen Tang (Calming Spirit Decoction), and Buzhong Yiqi Tang are used; for chest pain, Sijunzi Tang, Siwu Tang, and Guipi Tang are used. However, for lower back pain due to lingering blood stasis, PoXue San (Blood-Breaking Powder) and Shujin San (Tendon-Relaxing Powder) are used for excess patterns, while Siwu Tang is used for deficiency patterns; for excess patterns, Taoren Chengqi Tang may also be used. For yin pain with white turbid urine, Xiao Chaihu Tang is appropriate; for liver meridian stagnant fire, Shanzhizi (Gardenia Fruit), Huangqin, Huanglian, and Shengjun (Raw Rhubarb) are added.
Similarly, for distending pain in the hypochondrium, distinguish between obstruction and patency: if obstructed due to stasis aggregation, Chexiao Huoxue Tang (Remove Stasis and Invigorate Blood Decoction) is used; if patent, indicating liver fire, Xiao Chaihu Tang with Zhizi and Qingpi (Aged Tangerine Peel) is used. For abdominal pain after purgation, observe yin and yang: for yang injury with aversion to cold, Shiquan Dabu Tang (Complete Great Tonifying Decoction) is employed; for yin injury with fever, Siwu Tang with Baizhu (Atractylodes Macrocephala Rhizome) and Renshen (Ginseng Radix) is used. For constipation, Runchang Wan (Intestine-Moistening Pill) or Daozhi Tang (Guide Out Stagnation Decoction) are used; for blood-deficiency constipation, Yuzhu San (Jade Candle Powder) harmonizes; for diarrhea, Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) or Qingzao Tang (Clear Dryness Decoction) are used; for kidney failure and spleen diarrhea, Pogu Zhi (Psoralea Fruit) and Rouguou (Myristica Seed) are used.
For cyanosis without ulceration, which indicates weakness, use external warming and internal supporting methods; for failure of new flesh growth due to deficiency, strongly add warming and tonifying agents. Regarding wind from broken skin, differentiate exterior and interior; for spasms, distinguish between flexible and rigid types: drink Baizhu Tang (Atractylodes Macrocephala Decoction) for flexible spasms, and Gegen Tang (Kudzu Decoction) for rigid spasms; take Qianghuo Fangfeng Tang (Notopterygium and Saposhnikovia Decoction) for exterior conditions, and Xiaoxiong Huang Tang (Minor Ligusticum and Astragalus Decoction) for interior conditions; Qiangma Tang (Notopterygium and Ephedra Decoction) is a harmonizing agent for both exterior and interior, while Yuzhen San (Jade Truth Powder) is the general formula for this condition. The ultimate secret lies in nourishing blood and managing trauma. Short phrases cannot exhaustively explain these principles; detailed study of longer texts is required.
*Shangsun Lun* (Treatise on Trauma) states: Treating trauma requires seeking its source, observing the severity of the disease, and assessing the depth of the injury. From head to toe, any part of the body can suffer cuts, blows, falls, or blade wounds. Each of these conditions has specific treatments; some require resolving the exterior and interior before administering trauma-specific medicines. Physicians must follow these principles. However, medical practice relies on intuitive understanding; those lacking this insight are not good physicians. Some, being dull-witted, fail to observe the severity of symptoms or the depth of injury, administering trauma medicines before addressing the exterior-interior dynamics, leading to many errors. This may cause phlegm-saliva to rush upward or blockages in the zang-fu organs. A slight deviation leads to great error. As the saying goes, "If a physician does not practice for three generations, do not take their medicine," this is indeed true.
Liu Zongnong stated: Injuries from blows, falls, or metal blades are external diseases not caused by internal qi movement but by tangible external objects damaging flesh, blood, tendons, and bones. Unlike diseases caused by the six excesses (pathogenic factors) or seven emotions, which have distinctions between qi and blood levels, trauma specifically concerns blood. One must distinguish between stasis accumulation and excessive blood loss. Blows and falls where the skin remains intact but internal damage occurs inevitably involve stasis; whereas blade wounds causing bleeding or excessive blood loss represent different pathologies requiring different treatments. For stasis, purgative and resolving methods are suitable; for blood loss, tonification combined with resolution is necessary. Furthermore, injuries vary in location (upper/lower), severity, and depth, and differ in the abundance of qi and blood in various meridians. The priority is to first eliminate stasis, unblock meridians, harmonize blood, and stop pain, followed by regulating qi, nourishing blood, and tonifying stomach qi, ensuring efficacy.
*Zhengzhi Zhunsheng* (Standard for Diagnosis and Treatment) medication aphorism states: For injuries from tree crushing or falling from heights, these injuries disturb the four limbs and five zang organs, inevitably involving evil blood (stasis). Nausea is particularly feared. First administer heart-clearing medicines, blood-resolving medicines, and medicines to unblock the intestines and bladder in sequence. Add child's urine to the decoction just before administration for immediate effect. Using only intestinal/bladder-unblocking medicines may cause blockage, which is very harmful. Clear the heart first, then unblock, naturally avoiding drowsiness, irritability, and evil blood contaminating the heart. Then administer pain-relieving medicines to stop pain, or use modifications of the Twenty-Five Ingredient Medicine.
For severe falls, knife/stone injuries, or other heavy traumas, first take heart-clearing medicine, then child's urine, then blood-removing medicine. If the injury is not yet clotted and blood flows from the wound; or if clots are inside and expelled via the large intestine after medication; or if clots are outside and dispersed by medication; or if clots rise to the upper burner and are vomited out; then mix the Twenty-Five Ingredient Medicine with ginger water or Jiedixin (Centella Decoction), mint water is also acceptable.
For sprains and fractures/dislocations, Hetoushao San (Polygonum Multiflorum Powder) is conveniently used. For those with fever and robust constitution, Shufeng Baixue San (Wind-Dispersing and Blood-Resolving Powder) is used. For those with cold constitution and weakness, Wuji Jiaojia San (Five Accumulations Combined Powder) is used. Later, regulate with yellow, white, red, and black powders, Huoxue Dan (Invigorate Blood Pellet), and Busun Dan (Tonify Trauma Pellet).
For fractures and dislocations, avoid purgative stasis-resolving medicines and bowel-unblocking medicines; instead, use wind-dispersing and qi-smoothing agents to harmonize blood, stabilize pain, and tonify trauma.
For blows, cuts, or falls from height causing stasis attacking the heart and inability to speak, use Dusheng San (Single Miracle Powder) and blood-breaking medicines to expel stasis, restoring speech, followed by detailed clinical treatment.
For falls injuring the hypochondrium with unbearable stasis pain, first use blood-breaking medicines and Dusheng San, then regulate with Fuyuan Huoxue Tang (Restoring Origin and Invigorating Blood Decoction).
For falls damaging skin and flesh turning purple-black, first use blood-breaking medicines, then Dusheng San, followed by Qing Shang Yuxue Tang (Clear Upper Stasis-Decaying Blood Decoction) and Xiao Xia PoXue Tang (Eliminate Lower Blood-Breaking Decoction).
For trauma with vomiting of foul blood, first use Dusheng San, then Baihe San (Lily Bulb Powder), then Shengliao Siwu Tang (Raw Material Four Substances Decoction) with Yinggu Niurugen (Hard Bone Cow Milk Root), adjusted as needed.
For cuts/axe wounds with extensive bleeding and dizziness, first take Chuan Danggui (Angelica Sinensis) and Da Chuanxiong (Ligusticum Chuanxiong) decoction. Separately decoct Baishao (White Peony Root), Shudi (Prepared Rehmannia Root), Xuanduan (Drynaria Rhizome), Fangfeng (Saposhnikovia Root), Jingjie (Schizonepeta Spike), Qianghuo (Notopterygium Rhizome), Duhuo (Angelica Pubescens Root), and Nanxing (Arisaema Rhizome), mix with child's urine for drinking; do not use alcohol. If bleeding is minimal with internal stasis, mix half Shengliao Siwu Tang and half Dusheng San, decoct and drink. For intact skin, add alcohol.
For traumatic wind (tetanus) from cuts/axes with unbearable pain, locked jaw, and opisthotonos, mix equal parts Sheng Nanxing (Raw Arisaema) and Fangfeng into powder, apply with rice wash water. Also mix hot wine and child's urine equally, take three doses to revive, then treat with Shufeng Baidu San.
For scrotal skin wounds from axes/cuts, first take Dusheng San, then pain-relieving medicine. For internal stasis, use blood-breaking medicine.
For abdominal wall rupture with evisceration, first take heart-clearing medicine mixed with child's urine, and Dusheng San, then pain-relieving medicine. For excessive bleeding, first decoct Danggui and Chuanxiong in water; then add Baishao, Shudi, Qianghuo, Duhuo, Fangfeng, Jingjie, Baizhi (Angelica Dahurica Root), and Xuanduan, decoct, and mix with Rumxiang (Frankincense) and Moyao (Myrrh) powder.
In all trauma medicines, Rumxiang and Moyao are indispensable as they effectively resolve blood and stop pain.
For dislocations, avoid Ziran Tong (Pyritum) initially; it can be used later. It is suitable for fractures but not for non-fractured dislocations; remove it when compounding trauma medicines. When using Ziran Tong, it must be calcined. Freshly calcined stone contains fire toxicity and metal toxicity, which, combined with aromatic-hot drugs, causes dryness and dispersion worse than swords/knives despite its bone-setting benefits. Beware!
For internal stasis from falls causing abdominal distension/pain or chest/hypochondriac fullness, use blood-breaking and heart-clearing medicines to unblock, leading to natural recovery. If pain persists, Dusheng San is effective. If still persistent, pain-relieving medicines are highly effective.
For blade wounds or falls with skin/flesh damage and excessive bleeding, prioritize pain relief and tonification with Danggui Buxue Tang. For intact skin, treat as stasis accumulation: first Dusheng San, then blood-breaking medicines, adjusted by syndrome. If pain persists later, use pain-relieving medicines.
The essence of trauma treatment lies in tonifying qi and blood. Quacks seek quick effects using much Ziran Tong, risking chronic illness. Initial trauma uses Musong (Sappan Wood), Huanglian (Scutellaria) to clear fire, Baizhu to harmonize the middle, decocted with child's urine. For lower injuries, purge stasis but first support tonically. For upper injuries, drink leek juice or eat with porridge. Never drink cold water; blood congeals in cold, and even a drop entering the heart causes death.
For elderly people falling from horses with immobile lower back pain, first decoct Musong, Renshen, Huangqi (Astragalus Root), Chuanxiong, Danggui, Chenpi (Aged Tangerine Peel), and Gancao (Licorice Root). Later, mix with the four colored powders, Huoxue Dan, and Busun Dan.
For stick strikes and sprains causing pain, these are stagnant blood syndromes; use blood-breaking medicines. Unbearable pain indicates blood injury; use heart-clearing medicines. If persistent, use Dusheng San.
For trauma with urinary/fecal retention, do not immediately take trauma medicines as they are hot and often taken with wine, worsening constipation. For excess patterns, add Mutong (Akebia Stem) to blood-breaking medicines; if no effect, add Mangxiao (Mirabilite). For deficiency patterns, use Siwu Tang with Zhike (Aurantii Fructus), Maren (Hemp Seed), and Taoren (Peach Kernel) to lubricate intestines. For frail patients who cannot tolerate purgation, use Siwu Tang with Chuanshanjia (Pangolin Scale).
When taking trauma medicines, avoid cold foods, fish, and beef. Beef makes pain untreatable; diseased pork and sow's meat are especially forbidden. Avoid ash wine regardless of type. Severe trauma should not use wine as it may aggravate qi or cause abdominal/chest distension. Remember this!
Trauma medicines are inherently hot to generate qi/blood for bone setting; avoid roasting. If topical application fails, oral medication will also fail.
Do not use wild herbs for trauma; they cause excessive bone growth preventing joint reduction. Combine with sovereign-minister herbs; adding warming/tonifying qi-blood herbs for decoction is better.
For injuries to hypochondrium, chest, abdomen, or ribs, use qi-unblocking, blood-harmonizing, and heart-clearing medicines. Adjust for deficiency/excess: for deficiency, combine unblocking with tonifying slowly, applying topicals first, then oral unblocking agents.
If unblocking medicines fail, use qi-smoothing agents. If abdomen is not distended and patient feels safe, it is qi closure, not blood stasis. If blood stasis is present, unblocking works, but combine with qi-smoothing to prevent chest/abdominal tightness. After qi smooths, use trauma medicines.
For drunk falls causing shoulder/back pain unable to bend/extend, if trauma medicines fail, drink black bean wine for several days; beans descend qi.
For children falling on feet, decoct Luobozhong (Radish Seed) to cure; this also smooths qi.
For trauma reduction, first take Caowu (Aconitum Carmichaelii Lateral Root) ground in hot wine, 1-2 cups. If unconscious during reduction, use Suhexiang Wan to revive; if not revived, decoct Black Bean, Fangfeng, Gancao, and Huanglian in water, cool and drink, or grind Yicao (Plantago Seed) with water. Do not use salt to dissolve. If vomiting, add Shengjiang (Fresh Ginger) juice.
These are specialized methods; patients vary in deficiency/excess, so uniform application is wrong. As in the last case, using Caowu wine for reduction, Suhexiang Wan for unconsciousness, and cold medicine if not revived, could be fatal for qi-deficient patients. Only Xue's method, treating based on syndrome and focusing on internal tonification, is advisable. Students should examine this carefully.
Yaoshan stated: Once internal treatment is clear, external applications should be distinct. For split skin and flesh, use Fengkou Yao (Sealing Wound Medicine); for continuous bleeding, use Zhixue Yao (Stop Bleeding Medicine). For severed vessels/tendons, use Xiang San (Fragrant Powder); for dislocated bones, apply Dieda Gao (Trauma Plaster). Wanling Gao (Myriad Spirits Plaster) and Jiegu Gao (Bone-Setting Plaster) treat shattered joints; Xiaozhong Gao (Swelling-Reducing Plaster) and Yiyang San (Yang-Inhibiting Powder) treat body swelling/protrusions. For induration not resolving, use Huyang Gao (Restore Yang Plaster); for lack of muscle growth, use Taiyi Gao (Supreme One Plaster). For skull fractures, use Hunyuan Gao (Primordial Unity Plaster) and Dingtong Gao (Pain-Stabilizing Plaster); for eye bruising, use Shengdihuang San (Raw Rehmannia Powder). For cheek injuries, hold Biba San (Piper Longum Powder); for lip tears, apply Jiexue Gao (Blood-Stopping Plaster). Jili Guchi San (Tribulus Tooth-Strengthening Powder) treats knocked-out teeth; Ji Zi Pi (Chicken Egg Skin) protects bitten/severed tongues. For nasal injuries, use Sibi Dan (Nasal Stuffing Elixir); for ear amputation, use Erzui Fa (Ear Attachment Method). For self-inflicted throat cuts, suture quickly; mix chicken down feathers externally with Huashi Shi San (Orpiment Powder). For abdominal rupture with evisceration, suture with hemp thread/mulberry bark; for scrotal opening/testicle prolapse, apply Bizhi Qian (Wall Spider Web) and Jinmao Gouji (Golden-haired Dog Spine Fur). For arrow splinters, use Mouse Brain and Elephant Ivory Dust; for tetanus, hot Congxi Fa (Scallion Moxibustion) is required. For whip marks on buttocks, strictly avoid cold compresses; for crush injuries to heels, use blood-breaking and invigorating methods. Hundreds of symptoms and thousands of formulas are hard to list; these colloquial phrases serve as basic guidelines for beginners.
*Zhengzhi Zhunsheng* states: For skull bone injuries with intact skin, apply Tuizhong Gao (Swelling-Reducing Plaster). For broken skin/flesh, first dust Fengkou Yao (Sealing Wound Medicine), then apply Sanxue Gao (Blood-Resolving Plaster). For broken skin with bleeding, dust Zhixue Yao (Stop Bleeding Medicine).
For blue/black facial injuries, apply Yizi San (One Purple Powder) or Zijin Gao (Purple Gold Plaster). For severe injuries, apply Burou Gao (Flesh-Tonifying Plaster).
For nose injuries from falls breaking nostrils, dust Fengkou Yao on the wound, apply Sanxue Gao externally to reduce swelling.
For ears cut or beaten off, whether detached upwards/downwards or attached downwards/upwards, internally dust Fengkou Yao, externally apply Tuizhong Gao.
For lip/mouth injuries from cuts/falls breaking skin/flesh, first suture with Sangbaipi (Mulberry Bark), apply Fengkou Yao; then apply powder, securing the sealed medicine to prevent opening. Alternatively, apply Ji Zi You Huang (Chicken Egg Yolk Oil), dust Jinmao Gouji Mao (Golden-haired Dog Spine Fur) thinly externally, reapply Fengkou Yao. Next day, clean with tea, dust powder, change once daily. On the eighth day, cut threads, dust powder again.
For cheek/jaw injuries from cuts/falls breaking skin/flesh, fill wound with Fengkou Yao, apply Sanxue Gao externally. For contusions without broken skin, apply Burou Gao.
For accidental tongue severance (not complete), apply Fengkou Yao, change 2-3 times daily; fully healed in 7-8 days.
For teeth knocked out by blows/cuts, dust Buchi San (Muscle-Replenishing Powder).
For broken teeth not loose, dust Furong Gao Mo (Hibiscus Plaster Powder). For loose teeth, burn Jili Gen (Tribulus Root) to char, powder, and rub frequently to secure.
For throat cutting, suture inner trachea first with silk thread, then outer neck skin, apply Fengkou Yao, cover with Sanxue Gao.
For crushed fingers, moisten with Chicken Egg Yolk Oil, dust Fengkou Yao powder, cover with Sanxue Gao. For bites, apply Zelan San (Eupatorium Powder).
For chest bone bruises with external swelling and internal pain, apply Dingtong Gao externally, take blood-breaking/diuretic medicines internally.
For abdominal splits, use hemp thread or pounded mulberry bark as suture, dust Huaruishi San on thread. Suture from inside; do not suture outside skin, leave space to dust medicine. Apply Fengkou Yao or Buchi San mixed with egg white.
For torn scrotum, apply Chicken Egg Yolk Oil, spread Jinmao Gouji Mao thinly on top, dust Fengkou Yao, then apply Sanxue Gao.
For scrotal bruising/swelling, apply Burou Gao, or mix Dingtong Gao with Chi Shao (Red Peony Root), Caowu, Liangjiang (Galangal), and Rougui (Cinnamon Bark), mash with Leek Juice, apply. If no leek juice, scallion juice works. Also take diuretic medicines.
For shattered or broken bones with skin/flesh damage, first fill wound with Buchi San, apply Sanxue Gao. For fractures, apply Jiegu Gao and bandage. For broken skin with bone fracture, apply Burou Gao.
For severed tendons, mix Fengxiang (Benzoin) with Jinfei Cao (Boil-down Grass) juice, apply, then cover with Lishang Gao (Injury-Healing Plaster).
When applying splints, spread medicine evenly on paper, ensure thin overlaps at ends that do not press too thickly on flesh. Flat application prevents uneven pressure blisters. If edges are uneven, gaps occur causing blisters. Remember this!
For bone-setting plasters causing persistent pain, add Rumxiang, Moyao, Fengxiang, Baizhi, Rougui, Nanxing, Duhuo in measured amounts. Warmth stops pain. For axe/cut wounds, remove Rougui, Nanxing, Duhuo.
For axe/cut wounds, dose by severity. Mild: dust Buchi San. Severe: dust Fengkou Yao, bind tightly. Very severe: apply Sanxue Gao externally.