脉
表脉浮而无力，太阳也。脉长有力，阳明也。脉浮而弦小者，少阳也。河间曰∶
太阳宜汗，阳明宜下，少阳宜和解。
病
《内经》曰∶风者，百病之始也。清净，则腠理闭拒。虽有大风苛毒，而弗能为害也。若夫破伤风证，
因事击破皮肉，往往视为寻常，殊不知风邪乘虚而客袭之。渐而变为恶候。又诸疮久不合口，风邪亦能内袭，
或用汤淋洗，或着艾焚灸，其汤火之毒瓦斯，亦与破伤风邪无异，其为证也。皆能传播经络，烧烁真气，
是以寒热间作，甚则口噤目斜，身体强直，如角弓反张之状，死在旦夕，诚可哀悯。
治
法当同伤寒处治，因其有在表、在里、半表半里三者之不同，故不离乎汗、下、和三法也。是故在表者
汗之，在里者下之，在半表半里之间者宜和解之，又不可过其法也。
方
如圣散
川乌 草乌（各三钱） 苍术 细辛 川芎 白芷 防风（各一钱）
上为末，每服五七分，酒调服，忌油腻晕腥面。如癫狗咬，
加两头尖、红娘子各一钱。中风身体麻木，或走痛，酒调下。风旋头晕，酒调下。头风，茶调下。偏头风，
口噙水，搐鼻。伤风，热茶调下，出汗。风牙虫痛，频擦患处，流涎。金疮血不止，干掺之。恶疮久不愈，
口噙水洗，绵拭干掺之。犬咬蛇伤，蝎螫口噙，盐水洗之，仍敷上。痈疽、 瘤、鱼睛、红丝、发背、
脑疽等疮发时，新汲水调涂纸封，再用酒调服。汤火伤皮，新汲水调，鸡翎刷上。杖疮有血，干敷之。瘰
口噙水洗，掺之。干湿疥疮，香油调搽。
定风散 治破伤风，及金刃伤，打扑伤损，并癫狗咬伤，能定痛生肌。
天南星（为防风所制，服之不麻） 防风（各等分）
上为细末，破伤风以药敷疮口，然后以温酒调一钱服，如牙关紧急，角弓发张，用药二钱，童便调下。
打伤欲死，但心头微温，以童便灌下二钱，并进二服。癫狗咬破，先噙将水洗净，用
绢试干，贴药，更不再发，无脓，大有功效。
一字散 治破伤风搐搦，角弓反张。
蜈蚣（去毒，炒一条） 全蝎（一对，炒，去毒并头足）
上为细末，如发时，用一字擦牙缝内，或吹鼻中。
脱凡散 治破伤风，五七日未愈，已至角弓反张，牙关紧急。
蝉蜕（去头足，土净，五钱）
上为末，用好酒一碗，煎滚，服之立苏。
退风散 治破伤风不省人事，角弓反张。
防风（一钱） 荆芥（五分） 薄荷（七分） 僵蚕（炒，五分） 天麻（酒洗，一钱）
白芷（一钱） 麻黄（一钱） 茯苓（一钱） 当归身（一钱） 甘草（炙，五分）
上锉一剂，生姜七片，煎服。
羌活防风汤 治破伤风，初传在表。
当归 川芎 白芍 防风 羌活 本 细辛 地榆 甘草（炙，各一钱）
上锉一剂，水煎热服。若大便闭，加大黄。热，加黄芩。
水调膏 治初破伤风，热红肿，风斜欲将传播经络而未入深者，用此。
杏仁（去皮，细研） 白面（各等分）
上和匀，用新汲水调如膏，敷患处，肿消热退。
灸法 治破伤风及犬伤，神效。
用核桃壳半个，填稠人粪满，仍用槐白皮，衬扣伤处，用艾灸
之。若遍身汗出，其人大困则愈。远年者，将伤处前灸之，亦己。
脉象
表证脉象浮而无力，属于太阳经病变。脉象长而有力，属于阳明经病变。脉象浮而弦小，属于少阳经病变。刘河间说：太阳病适宜用发汗法，阳明病适宜用攻下法，少阳病适宜用和解法。
病症
《黄帝内经》说：风邪是各种疾病的起始。如果人体处于清净状态，腠理（皮肤纹理及毛孔）就会闭合抵御外邪。即使有大风和剧毒，也不能造成伤害。至于破伤风这种病症，是因为外伤导致皮肉破损，人们往往把它看作寻常小事，却不知道风邪趁着虚弱侵袭体内。逐渐演变成危重证候。另外，各种疮疡长久不愈合，风邪也能向内侵袭。或者用热水淋洗，或者用艾火熏灸，这些汤水火热之毒气，与破伤风的风邪没有区别。它们所导致的证候，都能传播到经络，烧灼消耗真气，因此出现寒热交替发作，严重时牙关紧闭、口眼歪斜，身体强直，像角弓反张的样子，死亡就在旦夕之间，实在令人哀悯。
治法
治疗应当参照伤寒病的处理方法，因为病情有在表、在里、半表半里三种不同情况，所以离不开汗法、下法、和法这三种方法。所以在表的用汗法，在里的用下法，在半表半里之间的用和解法，但又不能过度使用这些方法。
方剂
如圣散
川乌、草乌（各三钱）、苍术、细辛、川芎、白芷、防风（各一钱）
以上药物研成粉末，每次服用五七分，用酒调服，忌食油腻、晕腥面食。如果是疯狗咬伤，加两头尖、红娘子各一钱。中风导致身体麻木，或游走性疼痛，用酒调服。风旋头晕，用酒调服。头风头痛，用茶调服。偏头痛，口中含水，搐鼻给药。伤风，用热茶调服，以出汗为度。风虫牙痛，频繁擦拭患处，流涎。金创出血不止，干药粉撒敷。恶疮长久不愈，口中含水清洗后，用棉签擦干再撒药粉。犬咬蛇伤，蝎子蜇伤，口中含水清洗，再用盐水洗净，并敷上药物。痈疽、瘤、鱼睛、红丝、发背、脑疽等疮疡发作时，用新汲水调成糊状涂在纸上封贴，然后再用酒调服。汤火烫伤皮肤，用新汲水调药，用鸡毛刷涂抹。杖刑伤痕有血，干药粉敷贴。瘰疬，口中含水清洗后撒药。干湿疥疮，用香油调搽。
定风散 治疗破伤风，以及金属利器损伤、跌打损伤，还有疯狗咬伤，能止痛生肌。
天南星（被防风制约，服用后不麻舌）、防风（各等分）
以上研成细末，破伤风将药粉敷在疮口上，然后用温酒调服一钱。如果牙关紧急，角弓反张，用药二钱，用童子尿调服。
被打伤快要死了，只要心口还微温，用童子尿灌服二钱，并连续服用两剂。疯狗咬破伤口，先用清水洗净，用绢布擦干，贴上药粉，就不会再复发，如果没有化脓，效果很大。
一字散 治疗破伤风抽搐痉挛，角弓反张。
蜈蚣（去毒，炒一条）、全蝎（一对，炒，去毒并去掉头足）
以上研成细末，发病时，取“一字”量的药粉擦入牙缝内，或者吹入鼻中。
脱凡散 治疗破伤风，五七天未痊愈，已经发展到角弓反张，牙关紧闭。
蝉蜕（去掉头足，土炒干净，五钱）
以上研成粉末，用好酒一碗，煎煮至沸腾，服用后立即苏醒。
退风散 治疗破伤风神志不清，角弓反张。
防风（一钱）、荆芥（五分）、薄荷（七分）、僵蚕（炒，五分）、天麻（酒洗，一钱）、白芷（一钱）、麻黄（一钱）、茯苓（一钱）、当归身（一钱）、甘草（炙，五分）
以上锉碎为一剂，加生姜七片，煎服。
羌活防风汤 治疗破伤风，初起邪气在表。
当归、川芎、白芍、防风、羌活、藁本、细辛、地榆、甘草（炙，各一钱）
以上锉碎为一剂，用水煎煮热服。如果大便闭塞，加大黄。发热，加黄芩。
水调膏 治疗初起破伤风，红肿发热，风邪欲将传播经络但尚未深入者，用此方。
杏仁（去皮，细细研磨）、白面（各等分）
以上混合均匀，用新汲水调成膏状，敷在患处，肿胀消退，热势减退。
灸法 治疗破伤风及犬咬伤，神效。
用半个核桃壳，填满稠厚的人粪，仍然用槐树白皮衬垫扣在伤口处，用艾条艾灸它。如果全身出汗，病人感到极度困倦，就会痊愈。年代久远的旧伤，在伤口前方施灸，也能治愈。
Pulse Diagnosis
A superficial pulse that is floating and weak indicates a Taiyang (Greater Yang) syndrome. A long and forceful pulse indicates a Yangming (Yang Brightness) syndrome. A pulse that is floating, wiry, and small indicates a Shaoyang (Lesser Yang) syndrome. He-Jian stated: For Taiyang conditions, sweating (diaphoresis) is appropriate; for Yangming conditions, purgation (draining downward) is appropriate; for Shaoyang conditions, harmonization is appropriate.
Disease Pathogenesis
The *Neijing* (Inner Canon) states: Wind is the beginning of all diseases. If the body remains in a state of tranquility, the couli (pores and interstices) will close and resist external pathogens. Even with severe wind and toxic influences, they cannot cause harm. However, regarding Traumatic Wind (Po Shang Feng), which results from injuries that break the skin and flesh, people often regard it as trivial, not realizing that wind pathogens invade due to deficiency. It gradually develops into a malignant condition. Furthermore, if various sores fail to heal for a long time, wind pathogens can also invade internally. Using hot water irrigation or moxibustion introduces the toxicity of heat and fire, which is no different from traumatic wind pathogens. These conditions can spread through the meridians, burning and consuming true qi. Consequently, alternating chills and fever occur. In severe cases, trismus (lockjaw), facial deviation, and rigid body posture resembling opisthotonos (arched back like a bow) appear, leading to death within days or evenings. This is truly pitiable.
Treatment Principles
Treatment should follow the principles used for Cold Damage (Shang Han). Because the pathogen may be in the exterior, interior, or half-exterior half-interior, the methods of sweating, purging, and harmonizing are essential. Therefore, for exterior conditions, use sweating; for interior conditions, use purging; for half-exterior half-interior conditions, use harmonization. However, these methods must not be overused.
Formulas
Rusheng San (Like-Sage Powder)
Chuanwu (Aconiti Lateralis Radix Praeparata), Caowu (Aconiti Kusnezoffii Radix Praeparata) (each 3 qian); Cangzhu (Atractylodis Rhizoma); Xixin (Asari Radix et Rhizoma); Chuanxiong (Ligustici Chuanxiong Rhizoma); Baizhi (Angelicae Dahuricae Radix); Fangfeng (Saposhnikoviae Radix) (each 1 qian).
Grind the above into powder. Take 5-7 fen per dose, mixed with wine. Avoid greasy, fishy, and wheat products. For bites from mad dogs, add Liangtoujian (Gastrodiae Rhizoma) and Hongniangzi (Lytta) each 1 qian. For stroke causing numbness or wandering pain, take with wine. For dizziness caused by wind whirling, take with wine. For headache, take with tea. For hemicephalalgia, hold water in the mouth and insufflate into the nose. For common cold, take with hot tea to induce sweating. For dental pain caused by wind-worms, frequently rub the affected area to promote salivation. For uncontrolled bleeding from metal wounds, apply dry powder directly. For chronic malignant sores, rinse with water held in the mouth, wipe dry with cotton, and apply powder. For dog bites, snakebites, or scorpion stings, rinse with water held in the mouth, then wash with salt water, and apply the medicine. For carbuncles, ulcers, tumors, red thread disease, back abscesses, or brain abscesses during flare-ups, mix with fresh well-water, apply on paper as a poultice, and subsequently take with wine. For scalds or burns, mix with fresh well-water and brush onto the skin using a chicken feather. For bruising from beating with blood present, apply dry powder. For scrofula, rinse with water held in the mouth and apply powder. For wet or dry eczema, rub with sesame oil.
Dingfeng San (Wind-Calming Powder)
Treats traumatic wind, metal injuries, contusions, and mad dog bites; relieves pain and promotes tissue regeneration.
Tiannanxing (Arisaematis Rhizoma) (processed with Fangfeng to reduce numbing effect), Fangfeng (Saposhnikoviae Radix) (equal parts).
Grind into fine powder. For traumatic wind, apply powder to the wound, then take 1 qian mixed with warm wine. If there is severe trismus or opisthotonos, take 2 qian mixed with urine from a young boy. For severe contusions where the patient appears dead but the heart region remains slightly warm, administer 2 qian mixed with urine from a young boy, continuing for two doses. For open mad dog bites, first rinse with water, dry with silk, and apply the powder to prevent recurrence. If no pus forms, the efficacy is significant.
Yizi San (One-Character Powder)
Treats traumatic wind with spasms and opisthotonos.
Wugong (Centipedae Corpus) (remove toxicity, stir-fry one piece); Quanxie (Scorpio) (one pair, stir-fry, remove toxicity, head, and feet).
Grind into fine powder. During an attack, apply an amount equivalent to "one character" (approx. 0.5-1g) to rub between the teeth or insufflate into the nose.
Tuofan San (Mortal-Shedding Powder)
Treats traumatic wind that has persisted for five to seven days without recovery, progressing to opisthotonos and trismus.
Chantui (Cicadae Periostracum) (remove head and feet, earth-fry, 5 qian).
Grind into powder. Decoct in one bowl of good wine until boiling, then drink to restore consciousness immediately.
Tuifeng San (Wind-Retreating Powder)
Treats traumatic wind with loss of consciousness and opisthotonos.
Fangfeng (Saposhnikoviae Radix) (1 qian); Jingjie (Schizonepetae Spica) (0.5 qian); Bohe (Menthae Haplocalycis Herba) (0.7 qian); Jiangcan (Bombyx Batryticatus) (stir-fried, 0.5 qian); Tianma (Gastrodiae Rhizoma) (wine-washed, 1 qian); Baizhi (Angelicae Dahuricae Radix) (1 qian); Mahuang (Ephedrae Herba) (1 qian); Fuling (Poria) (1 qian); Dangguishen (Angelicae Sinensis Radix) (1 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (honey-fried, 0.5 qian).
Cut into pieces for one dose. Decoct with seven slices of fresh ginger and take orally.
Qianghuo Fangfeng Tang (Notopterygium and Saposhnikovia Decoction)
Treats traumatic wind in its initial stage when the pathogen is in the exterior.
Danggui (Angelicae Sinensis Radix); Chuanxiong (Ligustici Chuanxiong Rhizoma); Baishao (Paeoniae Radix Alba); Fangfeng (Saposhnikoviae Radix); Qianghuo (Notopterygii Rhizoma et Radix); Bencao (Ligustici Wallichii Rhizoma); Xixin (Asari Radix et Rhizoma); Diyu (Sanguisorbae Radix); Gancao (Glycyrrhizae Radix et Rhizoma) (honey-fried, each 1 qian).
Cut into pieces for one dose. Decoct in water and take hot. If constipation is present, add Dahuang (Rhei Radix et Rhizoma). If fever is present, add Huangqin (Scutellariae Radix).
Shuitiao Gao (Water-Mixed Paste)
Treats early-stage traumatic wind with redness, swelling, and heat, where wind is about to spread through meridians but has not yet penetrated deeply.
Xingren (Armeniacae Semen Amarum) (peeled and finely ground); Baifan (Tritici Farina) (equal parts).
Mix evenly. Add fresh well-water to form a paste. Apply to the affected area to reduce swelling and clear heat.
Moxibustion Method
Treats traumatic wind and dog bites with miraculous efficacy.
Take half a walnut shell, fill it densely with thick human feces, line it with inner bark of the locust tree (Huai Bai Pi), and place it over the wound. Perform moxibustion on it. If the whole body sweats and the patient feels extreme fatigue, recovery will occur. For old, chronic injuries, perform moxibustion anterior to the wound site, which will also lead to cure.