伤损之症,若腹中作痛,按之痛甚者,瘀血在内也,用加味承气汤下之。下后按之仍痛者,瘀血未尽也,用加味四
物汤调之。按之不痛者,血气伤也,用四物加参、 、白术。下后发热,胸胁作痛者,肝血伤也,用四君加川芎、当归。
下后恶寒者,阳气虚也,用四君加炮干姜。下后发热者,阴血伤也,用四物加参、术、牡丹皮。下后寒热间作者,气血
俱伤也,用八珍汤加柴胡。欲呕作呕者,胃气伤也,用六君加当归、半夏。有因乘怒跳跃,而胸腹闷痛,喜手按摸者,
肝火伤脾也,用四君加柴胡、山栀;畏手按摸者,肝血内滞
也,用四物加桃仁、红花。胸胁作痛,饮食少思者,肝脾气伤也,用四君加柴胡、丹皮。若胸腹胀满,饮食不思者,脾
肝气滞也,用六君加柴胡、枳壳。切牙发搐者,肝盛脾虚也,用异功散加川芎、山栀、钩藤钩、天麻。若用风药,则阴
血益伤,肝火益盛;或饮糖酒,则肾水益虚,肝火愈炽。若用大黄等药,内伤阴络,反致下血,壮实者或成痼疾,虚弱
者多致不起。凡伤损之症,有瘀血停滞于内者,虽裸体亦以手护腹胁。盖畏物触之而痛也,世俗概以内伤阴虚腹痛,不
辨虚实,专用破血之剂以速其危,其得不死者,亦幸矣。
一小儿跌扑腹痛,作呕恶心,气口脉大,此饮食停滞也,用保和丸二服,吐出酸食,恶寒发热,倦怠不食,此脾胃
伤也,先用六君子汤,次用补中益气汤,间服而愈。
一小儿坠楼,良久方苏,呻吟不绝,自以手护其腹,此内伤瘀血停滞也,用当归导滞散二钱,熟酒调下,而呻吟顿
止,次用四物加柴胡、牡丹皮而安。
一小儿跌仆瘀血腹痛,用导滞散下之瘀血甚多,随作烦躁面赤,作渴欲饮,此血脱也,用独参汤而安,又用四君、
当归、黄 及五味异功散而愈。
一小儿因怒跳跃,胁胸作痛,或以为内伤瘀血,服大黄之药,纯下鲜血,其痛益甚,按之则痛止,此肝脾气血俱伤
也,用四君加芎、归,四剂而痛止;又以异功散加升麻、柴胡,而饮食进,元气渐复,病亦随愈。
一女子因怒捶胸,腹痛,经行如崩,作呕不食,面色青赤,两关脉大而虚,此肝经火动,脾经血伤也,用加味逍遥
散,二剂血止;次用异功散加柴胡、升麻而愈。后因复怒,腹痛作泻面青,此肝木乘脾也,用六君、柴胡、升麻而痊。
一小儿因跌伤臂出血,腹痛恶食呕吐,发搐切牙,此因惊骇停食,肝火内动,而侮于脾也,先用保和丸二服,呕吐
腹痛悉止;又用异功散加柴胡、山栀,发搐切牙亦愈;却用托里散,患处溃而悉痊。
一小儿跌仆发搐吞酸,腹痛恶心,寸口脉大,余谓此饮食内伤也。不信,服当归导滞散,连泻五次,目直切牙,手
足厥冷,此脾胃之气复伤,而木火内动也,用五味异功散加干姜一剂,稍缓又二剂,乃去干姜加柴胡,再服而痊愈。
一小儿跌仆,因服大黄之药,下血发热,腹痛呕吐,按其腹却不痛,用五味异功散加当归、升麻二剂,腹痛顿止,
又二剂而血止,又二剂而热止,又二剂而元气复。
没药丸 治打扑伤损作痛等症。筋骨疼痛,或气逆血滞,肚腹胸胁胀闷。
没药 乳香 川芎 川椒 芍药 当归 红花 桃仁 血竭(各一两) 自然铜(四钱,火 醋淬七次)
上为末,用黄蜡四两,熔化入前药,急搅匀,丸弹子大。每服一丸,酒一钟,煎化服。
撤消通气散 治打扑伤损及乳痈便毒初起,或气滞作痛尤效。
木香 茴香(炒) 青皮 穿山甲(酥炙) 陈皮 白芷 甘草 漏芦 贝母(各等分)
上为细末,每服一二钱,温酒调,徐徐服。
加味芎 汤 治打扑仆坠,筋骨疼痛,血瘀皮肤不破,入胃作呕,或为呕血。
芎 当归 百合(水浸半日) 白芍药(炒) 荆芥穗(各二钱)
上作二三剂,酒水煎服。
当归导滞散 治跌扑瘀血在内,胸腹胀满,或大便不通,作喘吐血。
大黄 当归(各等分)
上为末,每服一二钱,温酒调,徐徐服。
黑丸子(一名和血定痛丸) 治跌扑仆坠,筋骨疼痛,瘀血不散,壅肿作痛,或风寒所伤,肢体疼痛。若流注、
鹤膝风初起,服之自消。如溃而脓清发热者,与补气血之药自敛。(方见流注)
跌打损伤类病症,如果腹部疼痛,按压时疼痛加剧的,是瘀血在体内,用加味承气汤攻下。攻下之后按压仍然疼痛的,是瘀血没有排尽,用加味四物汤调理。按压时不痛的,是气血受损,用四物汤加入人参、茯苓、白术。攻下之后出现发热,胸胁部疼痛的,是肝血受损,用四君子汤加入川芎、当归。攻下之后出现恶寒的,是阳气虚弱,用四君子汤加入炮干姜。攻下之后发热的,是阴血受损,用四物汤加入人参、白术、牡丹皮。攻下之后寒热交替发作的,是气血都受损,用八珍汤加入柴胡。想要呕吐或已经呕吐的,是胃气受损,用六君子汤加入当归、半夏。有因为发怒跳跃,导致胸腹部闷痛,喜欢用手按压的,是肝火伤及脾脏,用四君子汤加入柴胡、山栀;害怕手按压的,是肝血在体内停滞,用四物汤加入桃仁、红花。胸胁部疼痛,饮食减少不想吃的,是肝脾气血受损,用四君子汤加入柴胡、丹皮。如果胸腹胀满,不想吃东西的,是脾肝气机阻滞,用六君子汤加入柴胡、枳壳。咬牙抽搐的,是肝气盛而脾虚,用异功散加入川芎、山栀、钩藤、天麻。如果使用祛风药,则阴血更加受损,肝火更加旺盛;如果饮用糖酒,则肾水更加亏虚,肝火更加炽烈。如果使用大黄等药物,会内伤阴络,反而导致便血,体质壮实的人可能形成顽固疾病,体质虚弱的人多会导致死亡。凡是跌打损伤的病症,有瘀血停滞在体内的,即使裸体也会用手护住腹部和胁部。这是因为害怕物体触碰而疼痛。世俗之人一概认为是内伤阴虚腹痛,不辨别虚实,专门使用破血的药剂来加速其危险,能够不死,也是侥幸了。
一个小孩跌扑后腹痛,恶心欲呕,气口脉大,这是饮食停滞,用保和丸服用两次,吐出酸腐食物后,出现恶寒发热、倦怠不想吃饭,这是脾胃受伤,先用六君子汤,再用补中益气汤,交替服用而痊愈。
一个小孩从楼上坠落,很久才苏醒,呻吟不停,自己用手护住腹部,这是内伤瘀血停滞,用当归导滞散二钱,用熟酒调服,呻吟立刻停止,接着用四物汤加入柴胡、牡丹皮而安定。
一个小孩跌打损伤后瘀血腹痛,用导滞散攻下排出很多瘀血,随后出现烦躁面红、口渴想喝水,这是血脱,用独参汤而安定,又用四君子汤、当归、黄芪以及五味异功散而痊愈。
一个小孩因发怒跳跃,胁部和胸部疼痛,有人以为是内伤瘀血,服用大黄类药物,纯下鲜血,疼痛更加严重,按压则疼痛停止,这是肝脾气血俱伤,用四君子汤加入川芎、当归,四剂后疼痛停止;又用异功散加入升麻、柴胡,饮食进益,元气逐渐恢复,病也随之痊愈。
一个女子因发怒捶打胸口,腹痛,月经如崩漏般大量出血,恶心不想进食,面色青赤,左右关脉大而虚,这是肝经火动,脾经血伤,用加味逍遥散,两剂后血止;接着用异功散加入柴胡、升麻而痊愈。后来再次发怒,腹痛腹泻面色青,这是肝木乘脾,用六君子汤、柴胡、升麻而痊愈。
一个小孩因跌伤手臂出血,腹痛恶食呕吐,抽搐咬牙,这是因为惊骇停食,肝火内动,而克制脾土,先用保和丸服用两次,呕吐腹痛全部停止;又用异功散加入柴胡、山栀,抽搐咬牙也好了;最后用托里散,患处溃烂后完全痊愈。
一个小孩跌仆后抽搐吞酸,腹痛恶心,寸口脉大,我认为这是饮食内伤。家属不信,服用当归导滞散,连续腹泻五次,眼睛直视、咬牙,手脚冰冷,这是脾胃之气再次受伤,而木火内动,用五味异功散加入干姜一剂,稍缓解后又两剂,然后去掉干姜加入柴胡,再服用而痊愈。
一个小孩跌仆,因服用大黄类药物,便血发热,腹痛呕吐,按压腹部却不痛,用五味异功散加入当归、升麻两剂,腹痛立刻停止,又两剂后血止,又两剂后热止,又两剂后元气恢复。
没药丸:治疗打扑伤损引起的疼痛等症状。筋骨疼痛,或者气逆血滞,肚腹胸胁胀闷。
药材:没药、乳香、川芎、川椒、芍药、当归、红花、桃仁、血竭(各一两);自然铜(四钱,火烧后醋淬七次)。
制法:以上研为细末,用黄蜡四两熔化,加入前药,急搅均匀,制成弹子大小的丸药。每次服用一丸,用一杯酒煎化服用。
撤消通气散:治疗打扑伤损及乳痈、便毒初起,如果是气滞作痛尤其有效。
药材:木香、茴香(炒)、青皮、穿山甲(酥炙)、陈皮、白芷、甘草、漏芦、贝母(各等分)。
制法:以上研为细末,每次服用一二钱,用温酒调服,慢慢服用。
加味芎 汤:治疗打扑仆坠,筋骨疼痛,皮肤未破但血瘀入胃引起呕吐,或者呕血。
药材:川芎、当归、百合(水浸泡半天)、白芍药(炒)、荆芥穗(各二钱)。
制法:以上作为二三剂的量,酒水同煎服用。
当归导滞散:治疗跌扑后瘀血在体内,胸腹胀满,或者大便不通,气喘吐血。
药材:大黄、当归(各等分)。
制法:以上研为细末,每次服用一二钱,用温酒调服,慢慢服用。
黑丸子(又名和血定痛丸):治疗跌扑仆坠,筋骨疼痛,瘀血不散,壅肿作痛,或者风寒所伤,肢体疼痛。如果是流注、鹤膝风初起,服用后可自行消散。如果溃烂且脓液清稀发热,配合补气血的药物可自行收敛。(方剂见“流注”条下)
Injuries and trauma syndromes: If there is abdominal pain that worsens upon pressure, it indicates blood stasis within; use Jiawei Chengqi Tang (Modified Doubling Decoction) to purge. After purging, if pain persists upon pressure, the blood stasis is not fully resolved; use Jiawei Siwu Tang (Modified Four Substances Decoction) to regulate. If there is no pain upon pressure, it indicates injury to Qi and Blood; use Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng), Fuling (Poria), and Baizhu (Atractylodes Macrocephala Rhizome). After purging, if fever occurs with chest and hypochondriac pain, it indicates injury to Liver Blood; use Sijunzi Tang (Four Gentlemen Decoction) added with Chuanxiong (Szechwan Lovage Rhizome) and Danggui (Angelica Sinensis Radix). After purging, if aversion to cold occurs, it indicates deficiency of Yang Qi; use Sijunzi Tang added with Paoganjiang (Prepared Dried Ginger). After purging, if fever occurs, it indicates injury to Yin Blood; use Siwu Tang added with Renshen, Baizhu, and Mudanpi (Tree Peony Bark). After purging, if alternating chills and fever occur, it indicates injury to both Qi and Blood; use Bazhen Tang (Eight Treasures Decoction) added with Chaihu (Bupleurum Root). If there is nausea or vomiting, it indicates injury to Stomach Qi; use Liujunzi Tang (Six Gentlemen Decoction) added with Danggui and Banxia (Pinellia Tuber). If due to jumping in anger, causing chest and abdominal distension and pain that prefers pressure, it indicates Liver Fire injuring the Spleen; use Sijunzi Tang added with Chaihu and Shanzhi (Gardenia Fruit). If it dislikes pressure, it indicates stagnation of Liver Blood internally; use Siwu Tang added with Taoren (Peach Seed) and Honghua (Carthamus Flower). If there is chest and hypochondriac pain with poor appetite, it indicates injury to Liver and Spleen Qi and Blood; use Sijunzi Tang added with Chaihu and Danpi (Moutan Cortex). If there is chest and abdominal fullness with loss of appetite, it indicates Qi stagnation in the Spleen and Liver; use Liujunzi Tang added with Chaihu and Zhike (Aurantii Fructus). If teeth grinding and convulsions occur, it indicates excess Liver and deficient Spleen; use Yigong San (Extraordinary Success Powder) added with Chuanxiong, Shanzhi, Goutenggou (Uncaria Ramulus cum Uncis), and Tianma (Gastrodia Rhizome). If wind-dispelling herbs are used, Yin Blood will be further injured and Liver Fire will intensify; if sugar wine is consumed, Kidney Water will be further depleted and Liver Fire will become more blazing. If Da Huang (Rhubarb Radix) and similar drugs are used, they may injure the Yin collaterals internally, leading to hematochezia; robust individuals may develop chronic diseases, while weak individuals often die. In all injury cases where blood stasis stagnates internally, patients protect their abdomen and flanks with their hands even when naked, fearing touch due to pain. Laypeople generally attribute this to internal injury with Yin deficiency abdominal pain without distinguishing deficiency from excess, exclusively using blood-breaking agents which accelerates danger; survival is merely fortunate.
A child suffered a fall with abdominal pain and nausea, with a large pulse at the Qikou position; this was food stagnation. Two doses of Baohe Wan (Preserve Harmony Pill) were administered, resulting in the vomiting of sour food. Subsequently, aversion to cold, fever, fatigue, and anorexia appeared, indicating Spleen and Stomach injury. Liu Junzi Tang (Six Gentlemen Decoction) was used first, followed by Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), administered alternately until recovery.
A child fell from a building and regained consciousness after a long time, groaning incessantly and protecting the abdomen with his hands; this indicated internal injury with blood stasis stagnation. Er qian (two mace) of Danggui Daozhi San (Angelica Guiding Stagnation Powder) was administered mixed with warm cooked wine, immediately stopping the groaning. Subsequently, Siwu Tang added with Chaihu and Mudanpi was used to stabilize the condition.
A child suffered trauma with abdominal pain due to blood stasis. After purging with Daozhi San, a large amount of dark blood was expelled, followed by irritability, red face, thirst, and desire to drink; this indicated blood depletion. Dushen Tang (Single Ginseng Decoction) stabilized the condition, followed by Sijunzi Tang, Danggui, Huangqi (Astragalus Membranaceus Radix), and Wuwei Yigong San (Five-Ingredient Extraordinary Success Powder) for complete recovery.
A child jumped in anger, experiencing pain in the hypochondrium and chest. Mistakenly treated as internal blood stasis with Da Huang, pure bright red blood was passed, worsening the pain, which ceased upon pressure. This indicated simultaneous injury to Liver and Spleen Qi and Blood. Sijunzi Tang added with Chuanxiong and Danggui was given for four doses, stopping the pain. Then, Yigong San added with Shengma (Cimicifugae Rhizoma) and Chaihu was used; appetite improved, Yuan Qi (Primal Qi) gradually recovered, and the disease healed.
A woman punched her chest in anger, suffering abdominal pain, menorrhagia like a flood, nausea, anorexia, green-red complexion, and large, empty pulses at both Guan positions. This indicated Liver Fire stirring and Spleen Blood injury. Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) stopped the bleeding in two doses. Subsequently, Yigong San added with Chaihu and Shengma cured the condition. Later, renewed anger caused abdominal pain, diarrhea, and blue complexion, indicating Liver Wood overacting on Spleen Earth. Liujunzi Tang, Chaihu, and Shengma cured it.
A child injured his arm with bleeding, suffering abdominal pain, aversion to food, vomiting, convulsions, and teeth grinding. This was due to fright and food stagnation, with internal Liver Fire moving and insulting the Spleen. Two doses of Baohe Wan stopped vomiting and abdominal pain. Yigong San added with Chaihu and Shanzhi cured the convulsions and teeth grinding. Finally, Tuoli San (Support Interior Powder) was used; the wound ulcerated and healed completely.
A child fell, developed convulsions, acid regurgitation, abdominal pain, and nausea, with a large pulse at the Cun position. I diagnosed this as internal dietary injury. The family disagreed and administered Danggui Daozhi San, causing five episodes of diarrhea. The child then presented with staring eyes, teeth grinding, and cold extremities, indicating repeated injury to Spleen and Stomach Qi with internal movement of Wood and Fire. Wuwei Yigong San added with Ganjiang (Dried Ginger) was given for one dose, providing slight relief; two more doses followed. Ganjiang was then removed and Chaihu added; subsequent administration led to complete recovery.
A child fell and, due to taking Da Huang, experienced hematochezia, fever, abdominal pain, and vomiting. However, the abdomen was non-tender upon pressure. Wuwei Yigong San added with Danggui and Shengma was given for two doses, immediately stopping abdominal pain. Two more doses stopped the bleeding, two more stopped the fever, and two more restored Yuan Qi.
Moyao Wan (Myrrh Pill): Treats pain from blows and injuries. Indications include bone and tendon pain, rebellious Qi and stagnant Blood, and abdominal/chest/hypochondriac distension.
Ingredients: Moyao (Myrrha), Xiangru (Olibanum), Chuanxiong, Chuanjiao (Sichuan Pepper), Shaoyao (Peony Root), Danggui, Honghua, Taoren, Xuexie (Dragon's Blood) (1 liang each); Ziran Tong (Natural Pyrite) (4 qian, calcined seven times in vinegar).
Preparation: Grind into powder. Melt 4 liang of yellow beeswax, mix with the powder, stir vigorously, and form pills the size of bullet seeds. Take one pill per dose, dissolved in one cup of wine.
Chexiao Tongqi San (Remove Obstruction and Promote Qi Powder): Treats initial stages of blows/injuries, breast abscesses, and perianal abscesses. Particularly effective for pain due to Qi stagnation.
Ingredients: Muxiang (Costus Root), Huixiang (Fennel Fruit, stir-fried), Qingpi (Green Tangerine Peel), Chuanshanjia (Pangolin Scale, fried in butter), Chenpi (Tangerine Peel), Baizhi (Angelica Dahurica Root), Gancao (Licorice Root), Loulu (Rhaponticum Rhizome), Beimu (Fritillaria Bulb) (equal parts).
Preparation: Grind into fine powder. Take 1-2 qian per dose, mixed with warm wine, taken slowly.
Jiawei Xiong Tang (Modified Ligusticum Decoction): Treats falls and blows causing bone/tendon pain, blood stasis in skin not broken but entering the stomach causing vomiting or hematemesis.
Ingredients: Xiong (Ligusticum Chuanxiong Rhizome), Danggui, Baihe (Lily Bulb, soaked in water for half a day), Baishaoyao (White Peony Root, stir-fried), Jingjie Sui (Schizonepeta Spike) (2 qian each).
Preparation: Prepare as two to three doses, decocted in a mixture of wine and water.
Danggui Daozhi San (Angelica Guiding Stagnation Powder): Treats internal blood stasis from falls/blows, chest/abdominal fullness, constipation, asthma, or hemoptysis.
Ingredients: Da Huang (Rhubarb Radix), Danggui (equal parts).
Preparation: Grind into powder. Take 1-2 qian per dose, mixed with warm wine, taken slowly.
Hei Wan (Black Pill), also known as Hehexue Ding Tong Wan (Harmonize Blood and Stop Pain Pill): Treats falls/blows causing bone/tendon pain, unresolved blood stasis, swelling/pain, or limb pain from Wind-Cold. Effective for early-stage Liuzhu (Flowing Abscess) and Hexixi Feng (Crane Knee Wind), causing spontaneous resolution. For ulcerated cases with clear pus and fever, combine with Qi and Blood tonics to promote healing. (Formula see entry under "Liuzhu").