篇名：上编 外治法
分类：器具释义
属性：攀索者，以绳挂于高处，用两手攀之也。
按、方剂：
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篇名：上编 外治法
分类：头面部
属性：[1]颠者，头顶也。其骨男子三叉缝，女子十字缝。
[2]一名天灵盖，位居至高，内涵脑髓，如盖，以统全体者也。
[3]或磞撞损伤，如猝然而死，身体强硬，鼻口有出入声气，目闭，面如
土色，心口温热跳动者，此证可治。
[4]切不可撅拿，并扶起盘坐，盖恐惊乱之气上冲，或从伤处，或从七窍
走泄，必伤性命也。
[5]惟宜屈膝侧卧
<1>先将高醋调混元膏，敷于顶上，以定痛消肿，活血拔毒。
<2>再将草纸卷点着，令烟气熏其口鼻，再燃煤淬入醋内，使热气熏蒸
口鼻，如无煤之处，烧铁淬之亦可，以引五脏血脉，使之通和。
<3>待其口中呻吟有声，即以童便调八厘散温服，可以气转阳回。
<4>外用手法，推按心胸、两肋、腋下、腹上。
<5>并轻托内腕攒筋，频频揉摩，即掌后高骨，寸关尺诊脉处也。
[6]夫冲撞损伤，则筋脉强硬
<1>频频揉摩，则心血来复，命脉流通，即可回生。
<2>常服正骨紫金丹。
<3>复外用散瘀和伤汤，洗去前敷之混元膏，再换敷混元膏。
<4>服丸药后，或大便色黑干燥，此乃肠胃存有瘀血，或有耳聋者，俱
服加减苏子桃仁汤，以逐瘀血，健脾胃，养精神。
<5>兼用导气通瘀锭塞于耳中。
<6>饮食宜素粥汤饮，忌气怒油腻面食。卧处宜净室，勿令人喧乱。
[7]若伤重已死者
<1>用白布缠头，以木棍轻轻拍击足心，再提发令其直正，安定颈骨，
舒其筋络。
<2>外敷混元膏，内服紫金丹。
[8]若地车马损伤颠缝者，其邪坠而下，多在左，而少在右，因右手利便
而然也，其治法同磞撞诸伤。
[9]如顶骨塌陷，惊动脑髓，七窍出血，身挺僵厥，昏闷全无知觉者，不
治。
按、方剂：[1]混元膏
治打扑损伤，骨碎筋翻，瘀血凝聚，消青紫肿痛等证。
羚羊血五钱 没药五钱 漏芦三钱 红花三钱 大黄二钱 麝香三钱
升麻三钱 白芨五钱 生栀子二钱 甘草二钱 明雄黄五公
白敛三钱
共为细末，用高醋熬成膏，敷于顶上。
[2]八厘散
治跌打损伤，接骨散瘀。
苏木面一钱 半两钱一钱 自然铜（醋淬七次）三钱 乳香三钱
没药三钱 血竭三钱 麝香一分 红花一钱 丁香五分
番木鳖（油炸去毛）一钱
共为细末，黄酒温服，童便调亦可。
[3]正骨紫金丹
治跌打扑坠闪错损伤，并一切疼痛，瘀血凝聚。
丁香 木香 瓜儿血竭 儿茶 熟大黄 红花各一两 当归头 莲肉
白茯苓 白芍各二两 丹皮五钱 甘草三钱
共为细末，炼蜜为丸，每服三钱，童便调下，黄酒亦可。
[4]散瘀和伤汤
治一切磞撞损伤，瘀血积聚。
番木鳖（油炸去毛） 红花 生半夏各五钱 骨碎补 甘草各三钱
葱须一两
水五碗煎滚，入醋二两，再煎十数滚，熏洗患处，一日十数次。
[5]加减苏子桃仁汤
治瘀血内聚，心经瘀热，大肠不燥者。
苏子三钱 苏木（末）一钱 红花一钱 桃仁（炒） 麦冬 橘红
各三钱 赤芍 竹茹 当归（酒洗）各二钱
水三钟，煎一钟，渣二钟，煎八分，温服。
[6]导气通瘀锭
专治耳聋奇方。
用不去油巴豆一个，斑蝥三个，麝香少许，以葱涎蜂蜜和捻如麦粒形
，丝棉裹置耳中，响声如雷，勿得惊惧，待二十一日，耳中有脓水流
出，方可去锭，奇妙无比。
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上编 外治法 - 器具释义
攀索：是指用绳子悬挂在高处，双手抓住绳索进行牵引的动作。
上编 外治法 - 头面部
[1] “颠”指的是头顶部位。男性的头顶骨缝呈“三叉”形，女性的头顶骨缝呈“十字”形。
[2] 该部位又名“天灵盖”，位置最高，内部容纳脑髓，如同盖子一样统摄全身。
[3] 如果因碰撞导致损伤，出现突然昏死、身体僵硬、鼻口有呼吸气息声、眼睛闭合、面色如土、心窝处温热且跳动等症状者，此证可以治疗。
[4] 切不可强行扳扭颈部，也不可将患者扶起盘腿坐立，因为恐怕惊恐扰乱的气机向上冲逆，或者从伤口或七窍（眼、耳、鼻、口）泄漏，必然危及生命。
[5] 适宜让患者屈膝侧卧。
<1> 先用陈醋调和混元膏，敷在头顶，以止痛消肿，活血排毒。
<2> 再将草纸卷点燃，让烟气熏蒸患者的口鼻；随后将烧红的煤炭淬入醋中，利用热气熏蒸口鼻；如果没有煤炭，烧红铁器淬火亦可，目的是引导五脏血脉，使其通畅调和。
<3> 待患者口中发出呻吟声时，立即用童便（儿童尿液）调服八厘散，温服，可以使气机回转，阳气回复。
<4> 外用手法，推按心胸、两肋、腋下及腹部。
<5> 并轻轻托揉内腕部的攒筋（即手腕后方的高骨，寸、关、尺三部诊脉的位置），频繁揉摩。
[6] 对于冲撞损伤导致的筋脉僵硬：
<1> 频繁揉摩，可使心血恢复，命门脉搏流通，即可起死回生。
<2> 平时常服用正骨紫金丹。
<3> 另外外用散瘀和伤汤清洗，洗去之前敷的混元膏，再重新敷上混元膏。
<4> 服用丸药后，如果大便颜色黑且干燥，这是肠胃中有瘀血滞留；如果有耳聋症状，均服用加减苏子桃仁汤，以逐除瘀血，健运脾胃，滋养精神。
<5> 兼用导气通瘀锭塞入耳中。
<6> 饮食宜清淡的粥、汤、饮品，忌食生气动怒、油腻及面食。居住环境应保持洁净安静，不要让人喧哗扰乱。
[7] 如果伤势过重已经死亡者：
<1> 用白布缠绕头部，用木棍轻轻拍打足心，再提拉头发使其正直，安定颈骨，舒展筋络。
<2> 外敷混元膏，内服紫金丹。
[8] 如果是车马撞击导致头顶骨缝损伤，邪气下沉向下，多在左侧，少在右侧，这是因为右手便利所致，其治疗方法与碰撞各类损伤相同。
[9] 如果顶骨塌陷，惊动脑髓，七窍出血，身体挺硬僵直厥冷，昏迷闷绝完全无知觉者，无法治愈。
附方剂说明：
[1] 混元膏
主治：打扑损伤，骨折筋断，瘀血凝聚，消除青紫肿痛等症。
配方：羚羊血五钱，没药五钱，漏芦三钱，红花三钱，大黄二钱，麝香三钱，升麻三钱，白芨五钱，生栀子二钱，甘草二钱，明雄黄五钱，白敛三钱。
制法：共研为细末，用陈醋熬制成膏，敷于头顶。
[2] 八厘散
主治：跌打损伤，接骨散瘀。
配方：苏木面一钱，半两钱一钱，自然铜（醋淬七次）三钱，乳香三钱，没药三钱，血竭三钱，麝香一分，红花一钱，丁香五分，番木鳖（油炸去毛）一钱。
用法：共研为细末，用黄酒温服，也可用童便调服。
[3] 正骨紫金丹
主治：跌打坠闪错伤，以及一切疼痛，瘀血凝聚。
配方：丁香、木香、瓜儿血竭、儿茶、熟大黄、红花各一两；当归头、莲肉、白茯苓、白芍各二两；丹皮五钱；甘草三钱。
制法：共研为细末，炼蜜为丸，每次服用三钱，用童便送下，黄酒亦可。
[4] 散瘀和伤汤
主治：一切碰撞损伤，瘀血积聚。
配方：番木鳖（油炸去毛）、红花、生半夏各五钱；骨碎补、甘草各三钱；葱须一两。
用法：水五碗煎至沸腾，加入醋二两，再煎十余滚，熏洗患处，一日十数次。
[5] 加减苏子桃仁汤
主治：瘀血内聚，心经瘀热，大肠不燥者。
配方：苏子三钱，苏木（末）一钱，红花一钱，桃仁（炒）、麦冬、橘红各三钱，赤芍、竹茹、当归（酒洗）各二钱。
用法：水三钟，煎取一钟，药渣再加水二钟，煎取八分，温服。
[6] 导气通瘀锭
主治：专治耳聋的奇方。
配方：用不去油的巴豆一个，斑蝥三个，麝香少许，用葱汁和蜂蜜调和捻成麦粒形状，用丝棉包裹置于耳中。
效果：响声如雷，切勿惊慌恐惧，等待二十一天，耳中有脓液流出，方可取出药锭，疗效奇妙无比。
Upper Compilation: External Treatment Methods - Explanation of Instruments
Pansuo (Climbing Rope): Refers to the action of suspending a rope at a high place and grasping it with both hands for traction.
Upper Compilation: External Treatment Methods - Head and Face Region
[1] "Dian" refers to the vertex of the head. In males, the cranial suture at the vertex forms a "trident" shape, while in females, it forms a "cross" shape.
[2] This area is also known as Tianlinggai (Heavenly Skull Cap). It is located at the highest point, contains the brain marrow internally, and acts like a lid to govern the whole body.
[3] If injury occurs due to collision, resulting in sudden unconsciousness, body stiffness, audible breathing from nose and mouth, closed eyes, earth-colored complexion, warmth and pulsation at the heart region, this condition is treatable.
[4] One must absolutely avoid forcibly twisting the neck or helping the patient sit up in a cross-legged position. Doing so may cause Qi disturbed by shock to rush upward, or leak from the wound or the seven orifices (eyes, ears, nose, mouth), which would inevitably endanger life.
[5] The patient should be placed in a lateral recumbent position with knees flexed.
<1> First, mix Hunyuan Gao (Mixed Primordial Ointment) with aged vinegar and apply it to the vertex to relieve pain, reduce swelling, invigorate blood, and draw out toxins.
<2> Then, light a rolled paper straw and let the smoke fumigate the patient's nose and mouth. Subsequently, quench red-hot coal in vinegar and use the generated heat to fumigate the nose and mouth; if coal is unavailable, quenching red-hot iron works as well. The purpose is to guide the blood vessels of the five Zang organs to achieve patency and harmony.
<3> Once the patient emits groaning sounds from the mouth, immediately administer Bali San (Eight-Centigram Powder) mixed with Tongbian (Child's Urine) for warm ingestion. This can restore Qi circulation and Yang energy.
<4> Apply external manual therapy techniques to push and press the chest, heart region, hypochondrium, axillae, and abdomen.
<5> Gently support and rub the Zanjing tendon at the inner wrist (the prominent bone behind the palm, where the Cun, Guan, and Chi pulse positions are located), rubbing frequently.
[6] For stiffness of tendons and vessels caused by collision injuries:
<1> Frequent rubbing and massaging will restore Heart Blood and facilitate the flow of the Life Gate pulse, potentially restoring life.
<2> Regularly ingest Zhenggu Zijin Dan (Bone-Setting Purple Gold Pill).
<3> Additionally, externally wash with Sanyu He Shang Tang (Blood-Dispelling and Injury-Healing Decoction) to remove the previously applied Hunyuan Gao, then reapply Hunyuan Gao.
<4> After taking the pills, if stool becomes black and dry, it indicates retained blood stasis in the intestines and stomach; if deafness occurs, administer Jiajian Suzi Taoren Tang (Modified Perilla Seed and Peach Kernel Decoction) to expel blood stasis, strengthen the Spleen and Stomach, and nourish the Spirit.
<5> Simultaneously insert Daoqi Tongyu Ding (Qi-Guiding and Stasis-Unblocking Plug) into the ear.
<6> Diet should consist of plain porridge, soups, and drinks. Avoid anger-inducing foods, greasy items, and wheat products. The sleeping environment should be clean and quiet, free from noise and disturbance.
[7] In cases of severe injury where death has already occurred:
<1> Wrap the head with white cloth, gently strike the sole of the foot with a wooden stick, then pull the hair to straighten the body, stabilize the cervical vertebrae, and relax the meridians.
<2> Apply Hunyuan Gao externally and ingest Zijin Dan internally.
[8] For injuries to the vertex sutures caused by carriage or horse collisions, the pathogenic factor sinks downward, predominantly on the left side and less commonly on the right, due to the prevalence of right-handedness. The treatment method is the same as for other collision injuries.
[9] If the vertex bone is depressed, disturbing the brain marrow, with bleeding from the seven orifices, body rigid and stiff with cold厥 (Jue), coma, and complete loss of consciousness, the condition is incurable.
Appendix: Formulas
[1] Hunyuan Gao (Mixed Primordial Ointment)
Indications: Traumatic injuries, fractures, tendon ruptures, blood stasis accumulation, resolving cyanosis, purple discoloration, swelling, and pain.
Ingredients: Antelope Horn Blood (Lingyang Xue) 5 qian, Myrrh (Moyao) 5 qian, Rhizoma Leuzeae (Loulu) 3 qian, Flos Carthami (Honghua) 3 qian, Radix Rhe Palmate (Dahuang) 2 qian, Moschus (Shexiang) 3 qian, Radix Cimicifugae (Shengma) 3 qian, Bulb Coeliae (Baiji) 5 qian, Fructus Gardeniae (Sheng Zhizi) 2 qian, Radix Glycyrrhizae (Gancao) 2 qian, Realgar (Xionghuang) 5 qian, Rhizoma Belamcandae (Bailian) 3 qian.
Preparation: Grind all ingredients into fine powder, boil with aged vinegar to form an ointment, and apply to the vertex.
[2] Bali San (Eight-Centigram Powder)
Indications: Falls and blows, setting bones, dispelling blood stasis.
Ingredients: Powdered Caulis Spatholobi (Sumu Mian) 1 qian, Semina Crotali Tigrini (Banliangqian) 1 qian, Pyritum (Ziran Tong, quenched in vinegar seven times) 3 qian, Olibanum (Ruxiang) 3 qian, Myrrh (Moyao) 3 qian, Draco Sanguis (Xuexie) 3 qian, Moschus (Shexiang) 1 fen, Flos Carthami (Honghua) 1 qian, Flos Caryophylli (Dingxiang) 5 fen, Semen Crotali Tigrini (Fanmubie, fried and de-haired) 1 qian.
Usage: Grind into fine powder, take warm with yellow wine, or mix with child's urine.
[3] Zhenggu Zijin Dan (Bone-Setting Purple Gold Pill)
Indications: Traumatic falls, sprains, dislocations, all types of pain, and blood stasis accumulation.
Ingredients: Flos Caryophylli (Dingxiang), Radix Aucklandiae (Muxiang), Draco Sanguis (Gu'er Xuexie), Cortex Camelliae (Ercha), Radix Rhe Palmate (Shu Dahuang), Flos Carthami (Honghua) each 1 liang; Radix Angelicae Sinensis (Danggui Tou), Semen Nelumbinis (Lianrou), Poria (Baifuling), Radix Paeoniae Alba (Baishao) each 2 liang; Cortex Moutan (Danpi) 5 qian; Radix Glycyrrhizae (Gancao) 3 qian.
Preparation: Grind into fine powder, mix with refined honey to make pills. Take 3 qian per dose, washed down with child's urine or yellow wine.
[4] Sanyu He Shang Tang (Blood-Dispelling and Injury-Healing Decoction)
Indications: All collision injuries, blood stasis accumulation.
Ingredients: Semen Crotali Tigrini (Fanmubie, fried and de-haired), Flos Carthami (Honghua), Rhizoma Pinelliae (Sheng Banxia) each 5 qian; Rhizoma Drynariae (Gusuibu), Radix Glycyrrhizae (Gancao) each 3 qian; Radix et Rhizoma Rhei (Congxu) 1 liang.
Usage: Decoct in 5 bowls of water until boiling, add 2 liang of vinegar, boil ten more times. Use the decoction to fumigate and wash the affected area, 10+ times daily.
[5] Jiajian Suzi Taoren Tang (Modified Perilla Seed and Peach Kernel Decoction)
Indications: Internal blood stasis accumulation, Heart Meridian blood-heat, non-dry Large Intestine.
Ingredients: Fructus Perillae (Suzi) 3 qian, Powdered Caulis Spatholobi (Sumu) 1 qian, Flos Carthami (Honghua) 1 qian, Semen Persicae (Taoren, stir-fried), Radix Ophiopogonis (Maidong), Exocarpium Citri Reticulatae (Juhong) each 3 qian; Radix Paeoniae Rubra (Chishao), Caulis Bambusae in Taenia (Zhuru), Radix Angelicae Sinensis (Danggui, wine-washed) each 2 qian.
Usage: Decoct in 3 zhong of water to obtain 1 zhong. Decoct the dregs again with 2 zhong of water to obtain 8 fen. Take warm.
[6] Daoqi Tongyu Ding (Qi-Guiding and Stasis-Unblocking Plug)
Indications: A miraculous formula specifically for deafness.
Ingredients: Semen Crotonis (Badou, unrefined/oil-containing) 1 seed, Mylabris (Banmao) 3 insects, Moschus (Shexiang) a small amount.
Preparation: Mix with juice of Allium fistulosum (Congxian) and honey, roll into the shape of a sesame seed, wrap in silk cotton, and insert into the ear.
Effect: Loud noise like thunder will occur; do not be frightened. Wait twenty-one days until pus flows from the ear, then remove the plug. The effect is extraordinary.