【方歌】溃疡发痉类破伤，有汗为柔无汗刚，脓血出多成此证，
补正驱邪要审详。
【注】此类势类破伤风，牙紧体强，肢搐背反，有汗曰柔痉，
无汗曰刚痉，由溃疡亡血过多所致。治宜大补气血，以
十全大补汤加钩藤钩、栀子、天麻。服之不应者，服独
参汤；手足逆冷加桂、附，误作风痉，汗之则危。
方剂：十全大补汤、独参汤（俱见溃疡门）
【方歌】汤烫火烧皮烂疼，疱起挑破使毒轻，烦躁作呕防毒陷，
便秘神昏气喘凶。
【注】此证系好肉暴伤，汤烫火烧，皮肤疼痛，外起燎疱。即
将疱挑破，放出毒水使毒轻也。其证虽属外因，然形势
必分轻重，轻者施治，应手而愈；重者防火毒热气攻里
，令人烦躁，作呕便秘，甚则神昏闷绝。初伤用冷烧酒
一钟，于无意中望患者胸前一泼，被吃一惊，其气必一
吸一呵，则内之热毒，随呵而出矣。仍作烦闷者，以新
童便灌之。外初用清凉膏涂之，解毒止痛，不致臭烂，
次以罂粟膏涂之。痛止生脓时，换黄连膏贴之收敛。火
毒攻里者，宜四顺清凉饮服之，务令二便通利，则毒热
必解。初终禁用冷水、井泥浸塌伤处，恐热毒伏于内，
寒滞束于外，致令皮肉臭烂，神昏便秘，端肩气喘，多
致不救。外花炮火药烘燎者，治法同前。
方剂：婴粟膏
组成：婴粟花（十五朵，无花以壳代之）
香油四两，将婴粟炸枯，滤净，入白蜡三钱溶化尽
，倾入碗内，待将凝之时，下轻粉二钱，搅匀炖水中，
令冷取出。临用时，抿脚挑膏，手心中捺化，搽于伤处
，绵纸盖之，日换二次，其痛自止。次日用软帛挹净腐
皮，再搽之。
【方歌】婴粟膏医汤火烧，香油罂粟共煎熬，白蜡更兼真轻粉，
患上搽涂痛即消。
又方：清凉膏
组成：水泼开石灰末一升，加水四碗，搅浑澄清；取清汁一碗
，加香油一碗，以箸顺搅数百转，其稠粘如糊，用鸡翎
蘸扫伤处。
又方：黄连膏（见鼻部鼻疮）
四顺清凉膏（见面部痄腮）
【方歌】溃疡引发的痉挛症状类似破伤风，有汗出的称为柔痉，无汗出的称为刚痉，因脓血流失过多而形成此证，治疗时补益正气与驱除邪气都要仔细审察。
【注】此类病情类似于破伤风（一种由外伤感染引起的以肌肉强直性痉挛为特征的疾病），表现为牙关紧闭、身体强直、四肢抽搐、角弓反张，有汗出叫做柔痉（柔痉），无汗出叫做刚痉（刚痉），这是由于溃疡导致失血过多所引起。治疗应当大补气血，使用十全大补汤（一种具有温补气血功效的方剂）加入钩藤钩、栀子、天麻。服用后如果不见效，则服用独参汤（一种单味人参组成的补气方剂）；如果手足逆冷，则加入桂枝、附子，切忌误认为是风痉（由外感风邪引起的痉挛），若用发汗法治疗则会带来危险。
【方歌】被沸水烫伤或火烧导致皮肤破损疼痛，出现水泡需挑破以使毒邪减轻，若出现烦躁作呕要防止毒邪内陷，若出现便秘、神志昏迷、气喘则病情凶险。
【注】此证是由于健康皮肤突然受到损伤，被沸水烫或被火烧，导致皮肤疼痛，外部起燎疱。立即将水泡挑破，放出毒水以使毒邪减轻。虽然此证属于外因所致，但病情形势必须分轻重，轻者施治，能够应手而愈；重者要防止火毒热气攻入体内，使人烦躁、作呕、便秘，甚至神志昏迷、闷绝。初次受伤时，用一杯冷烧酒，在不经意间向患者胸前泼去，使其受惊，其气息必然一吸一呵，体内的热毒就会随着呵气排出。如果仍然感到烦闷，用新收集的童便（健康男童的小便）灌服。外用初用清凉膏涂抹，以解毒止痛，不致腐烂发臭，随后用罂粟膏涂抹。疼痛停止且开始生脓时，更换黄连膏贴敷以收敛伤口。火毒攻入体内的，宜服用四顺清凉饮（一种清热泻火的方剂），务必使大小便通畅，那么毒热必定解除。从开始到结束严禁用冷水、井泥浸泡塌陷伤处，恐怕热毒潜伏于内，寒凉凝滞束缚于外，导致皮肉腐烂发臭、神志昏迷、便秘、耸肩气喘，大多导致无法救治。被烟花火药烘烤燎伤的，治疗方法同上。
方剂：罂粟膏
组成：罂粟花（十五朵，无花时用壳代替）
香油四两，将罂粟炸至枯黄，过滤干净，加入白蜡三钱完全溶化，倒入碗内，待即将凝固时，加入轻粉二钱，搅拌均匀后在水中炖煮，令其冷却后取出。临用时，用手指蘸取药膏，在手心中揉化，涂抹于伤处，用绵纸覆盖，每日更换两次，疼痛自然停止。次日用软布擦净腐皮，再涂抹。
【方歌】罂粟膏治疗汤烫火烧，香油和罂粟共同煎熬，加上白蜡和真正的轻粉，涂抹在患处疼痛即刻消除。
又一方：清凉膏
组成：用水泼开石灰末一升，加水四碗，搅拌浑浊后澄清；取清汁一碗，加香油一碗，用筷子顺着搅拌数百转，其稠粘如糊状，用鸡毛蘸扫伤处。
又一方：黄连膏（见鼻部鼻疮章节）
四顺清凉膏（见面部痄腮章节）
[Prescription Verse] Spasms arising from ulcers resemble lockjaw (tetanus); with sweating it is termed soft spasm (Rou Jing), without sweating it is termed stiff spasm (Gang Jing). This condition arises from excessive loss of pus and blood. In treatment, tonifying the healthy qi and expelling pathogenic factors must be carefully examined.
[Annotation] This condition resembles lockjaw (tetanus), characterized by trismus (lockjaw), body rigidity, limb convulsions, and opisthotonos. With sweating, it is called soft spasm (Rou Jing); without sweating, it is called stiff spasm (Gang Jing). It is caused by excessive blood loss due to ulcers. The treatment should involve greatly tonifying Qi and Blood using Shiquan Dabu Tang (Ten Complete Tonifying Decoction) added with Gouteng Hook (Uncariae Ramulus cum Uncis), Gardeniae Fructus (Zhi Zi), and Gastrodiae Rhizoma (Tian Ma). If there is no response after taking this, take Danshen Tang (Single Ginseng Decoction); if the hands and feet are cold, add Cinnamon Twig (Guizhi) and Aconite Root (Fuzi). Do not mistakenly treat it as wind-induced spasm; applying diaphoresis (sweating method) would be dangerous.
[Prescription Verse] Scalds and burns cause skin erosion and pain; blisters should be pricked to relieve toxicity. Irritability and vomiting indicate a risk of toxin sinking inward; constipation, coma, and panting indicate a critical condition.
[Annotation] This condition results from sudden injury to healthy skin by scalds or fire, causing skin pain and external blistering. The blisters should be immediately pricked to drain toxic fluids, thereby reducing toxicity. Although this condition is caused by external factors, its severity must be distinguished. Mild cases respond quickly to treatment and heal; severe cases require preventing fire-toxic heat from attacking the interior, which causes irritability, vomiting, constipation, and even coma or suffocation. Upon initial injury, pour one cup of cold liquor onto the patient's chest unexpectedly to startle them. This startle will cause a reflex inhalation and exhalation, allowing internal heat-toxin to exit with the breath. If irritability persists, administer fresh child's urine (Tong Bian). Externally, apply Qingliang Ointment initially to detoxify and relieve pain, preventing foul rot; subsequently apply Ying Su Gao (Poppy Ointment). When pain ceases and suppuration begins, change to Huanglian Ointment for astringency. For fire-toxin attacking the interior, administer Sishun Qingliang Yin (Four-Obedience Cooling Clearing Drink), ensuring free passage of urine and feces so that toxic heat resolves. From beginning to end, strictly forbid immersing the injured area in cold water or well mud, lest heat-toxin become trapped internally while cold stagnation binds externally, leading to putrefaction of skin and flesh, coma, constipation, shoulder shrugging, and panting, often resulting in untreatable conditions. Burns from fireworks or gunpowder follow the same treatment.
Formula: Ying Su Gao (Poppy Ointment)
Composition: Poppy flowers (15 pieces; use pods if flowers are unavailable), Sesame Oil (4 liang). Fry the poppies until crisp, filter clean, add White Beeswax (3 qian) until melted, pour into a bowl. When nearly solidifying, add Calomel (Qing Fen, 2 qian), stir evenly, warm in water bath, cool, and remove. To use, rub a small amount between palms to melt, apply to the wound, cover with cotton paper, change twice daily; pain will cease naturally. The next day, gently wipe away necrotic skin with soft cloth and reapply.
[Prescription Verse] Ying Su Gao treats scalds and burns; sesame oil and poppy are boiled together, combined with white beeswax and pure calomel; applied to the affected area, pain vanishes instantly.
Another Formula: Qingliang Gao (Cooling Ointment)
Composition: Slake quicklime powder (1 sheng) with water (4 bowls), stir until turbid then let settle; take 1 bowl of clear supernatant, add 1 bowl of sesame oil, stir clockwise hundreds of times until thick and paste-like. Apply to the wound with a chicken feather.
Another Formula: Huanglian Gao (Coptis Ointment) (See Nasal Ulcers section)
Sishun Qingliang Gao (Four-Obedience Cooling Clearing Ointment) (See Mumps section)