《病源论》云∶若中于腹,则气激,则肠随疮孔出也。
又云∶肠但出不断者,当作大麦粥,取汁持洗肠,以水渍纳之,当作研米粥饮之。二十
余日,稍作强糜食之,百日后可进饭耳。
《短剧方》金疮肠胃脱出欲令入法∶
取人粪干末,以粉肠上,即入。(《集验方》同之。)
《删繁方》治金疮肠出方∶
取桑皮线缝肠皮,用蒲黄粉之。
《刘涓子方》金疮中腹肠出不能纳方∶
小麦五升,水九升,煮取四升,去滓,以绵度(漉欤)之,使极冷,旁人含逊肠上自入。
又云∶金疮肠出,欲入之磁石散方∶
磁石(三两) 硝石(三两)
凡二物,下筛,白饮服方寸匕,日五夜再,二日入。
《葛氏方》肠出欲燥,而草土着肠者方∶作薄大麦粥,使才暖,以泼之,以新汲冷水
之,肠则还入,草土辈当KT 。《玉》∶从圣的反,又子陆反,畏敬也。《礼记》∶KT 然避
席是也,在皮外也。
《病源论》云∶夫金疮肠断者,视病深浅各有死生。肠一头见者,不可连也。若腹痛、
短气、不得饮食者,大肠一日半死,小肠三日死。肠两头见者,可连续之。先以针缕如法,
连续断肠,便取鸡血涂其际,勿令泄,即推纳之。
《葛氏方》若肠已断者方∶
以桑皮细线缝合,鸡热血涂之,乃令入。
《诸病源候论》说:如果腹部受到创伤,气机就会激荡,导致肠子随着伤口孔洞脱出。
又说:肠子虽然脱出但没有断裂的,应当煮大麦粥,取汁液用来清洗肠子,用水浸泡后将其纳入体内,并让患者饮用研碎的米粥。二十多天后,逐渐进食较稠厚的糜粥,一百天之后才可以进食米饭。
《短剧方》中关于金疮肠胃脱出欲使其回纳的方法:
取干燥的人粪粉末,撒在肠子上,随即将其纳入。(《集验方》与此相同。)
《删繁方》治疗金疮肠子脱出的方剂:
取桑皮线缝合肠壁,用蒲黄粉撒在上面。
《刘涓子方》中金疮伤及腹部、肠子脱出无法纳入的方剂:
小麦五升,水九升,煮至剩余四升,滤去渣滓,用绵布过滤,使药液极冷,由旁人含住药液喷洒在肠上,肠子自然回纳。
又说:金疮肠子脱出,想要将其纳入的磁石散方剂:
磁石(三两) 硝石(三两)
将这两味药捣筛成细粉,用白饮送服一方寸匕的药粉,白天服五次,晚上服两次,两天后肠子即可回纳。
《葛氏方》中肠子脱出欲使其干燥,且有草土粘附在肠上的方剂:
制作稀薄的大麦粥,使其温度适宜微暖,泼洒在肠上,再用新汲的冷水冲洗,肠子就会回纳,草土等物应当会自行脱落。《玉篇》解释:“KT”字读作“从圣的反切”,又读作“子陆的反切”,意为敬畏。《礼记》中说:“KT然避席”就是指这种情况,指附着在皮肤或肠子外表的东西。
《诸病源候论》说:凡是金疮导致肠子断裂的,根据病情深浅不同,生死预后也各异。如果肠子只有一端露出,则无法连接。如果出现腹痛、气短、不能饮食的症状,大肠损伤者一天半内死亡,小肠损伤者三天内死亡。如果肠子两端都露出,则可以连接。先用针线按照规范方法,将断裂的肠子连续缝合,然后取鸡血涂抹在接口处,防止泄漏,随即推纳入体内。
The *Zhu Bing Yuan Hou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases) states: If the abdomen is injured, the Qi will be agitated, causing the intestines to protrude through the wound.
It further states: For intestines that have protruded but are not severed, one should prepare millet porridge, take its juice to wash the intestines, soak them with water, and reduce them into the body. The patient should drink rice gruel. After more than twenty days, gradually consume thicker gruel. After one hundred days, regular rice can be eaten.
In the *Duan Ju Fang* (Short Formulas), the method for reducing protruding viscera in metallic wounds is as follows:
Take dried human feces powder, sprinkle it on the intestines, and immediately reduce them. (This is consistent with the *Ji Yan Fang*.)
In the *Shan Fan Fang* (Eliminating Complexity Formulas), the formula for treating protruding intestines in metallic wounds:
Use mulberry bark thread to suture the intestinal wall, and apply Polygoni Orientalis Pollen (Puhuang, 蒲黄) powder.
In the *Liu Juanzi Fang*, the formula for metallic wounds injuring the abdomen with protruding intestines that cannot be reduced:
Five sheng of wheat, nine sheng of water; boil until four sheng remain. Remove the dregs, filter through cotton cloth, and cool the liquid thoroughly. An assistant should hold the cold liquid in their mouth and spray it onto the intestines, causing them to reduce naturally.
It also states: For metallic wounds with protruding intestines, the Magnetite Powder (Cishi San, 磁石散) to facilitate reduction:
Magnetite (Ci Shi, 磁石) (3 liang)
Niter (Xiao Shi, 硝石) (3 liang)
Sift these two ingredients together. Take one cun bi (a square-inch measure) with white drink (gruel). Administer five times during the day and twice at night. The intestines will reduce within two days.
In the *Ge Shi Fang*, the formula for protruding intestines that are drying out and adhering to grass or soil:
Prepare thin millet porridge, keep it slightly warm, and pour it over the intestines. Then rinse with fresh cold well water. The intestines will reduce, and the grass and soil should detach. In the *Yu Pian*, "KT" is pronounced with the reverse cut of "Cong Sheng," and also with the reverse cut of "Zi Lu," meaning awe or respect. In the *Li Ji* (Book of Rites), "KT ran bi xi" refers to this situation, indicating something attached to the exterior surface.
The *Zhu Bing Yuan Hou Lun* states: Regarding metallic wounds where the intestines are severed, prognosis varies by depth. If only one end of the intestine is visible, connection is impossible. If accompanied by abdominal pain, shortness of breath, and inability to eat, death occurs within one and a half days for large intestine injuries, and within three days for small intestine injuries. If both ends of the intestine are visible, they can be connected. First, use needle and thread according to proper technique to suture the severed ends. Then apply chicken blood to the junction to prevent leakage, and push the intestines back into the body.
In the *Ge Shi Fang*, the formula for already severed intestines:
Suture with fine mulberry bark thread, apply hot chicken blood, and then reduce them into the body.