扑损伤,或被伤入于肺者,纵未即死,二七难过。左胁下伤透内者。肠伤断一半可
医,全断者不可治。小腹下伤内者。证候繁多者。脉不实重者。老人左股压碎者。伤破阴子
者。血出尽者。肩内耳后伤透于内者。皆不必用药。
肚上被伤,肚皮俱破,肠出在外,只肠全断难医;伤破而不断者,皆可治疗。肠及肚皮
破者,用花乳石散敷在线,轻用手从上缝之,莫待粪出,清油捻活于入肚内。肚皮裂开者,
用麻缕为线,或捶桑白为线,亦用花乳石散敷在线,须用从里重缝,肚皮不可缝外重皮,留
外皮开,用药掺待生肉。
凡损若不折骨,不碎骨,则不可用自然铜,于药内除去,无痰诞,不用半夏。老人有伤
者骨脉冷,每用加当归川芎川乌木香丁香人参半夏,去白芍药生地黄,此亦是二十五味药内
加减,老人服丸,或邻脏腑者,不问老少,如有血并痰,从口中出者,用清心药,加丁皮川
芎半夏入二十五味内同服。或皮肤热者,加黄柏皮皂角半两,入二十五味药内同煎服。
扑损伤,骨肉疼痛,整顿不得,先用麻药服,待其不识痛处,方可下手。或服后麻
不倒,可加曼陀罗花及草乌五钱,用好酒调些少与服。若其人如酒醉,即不可加药。
被伤有老有幼,无力有血出甚者,此药逐时相度入用,不可过多。亦有重者,若见麻不
倒者,又旋添些,更未倒,又添酒调服少许,已倒便住药,切不可过多。
跌打损伤,或者伤势伤及肺部者,即使当时没有立即死亡,十四天后也难以存活。左侧胁下穿透性内伤者。肠道受伤断裂一半尚可医治,完全断裂者则无法治疗。小腹下部内部受伤者。症状表现繁杂者。脉象不实且重按无力者。老年人左侧大腿被压碎者。阴器破损者。血液流尽者。肩部内部及耳后穿透性内伤者。以上情况都不必用药。
腹部受到外伤,肚皮全部破裂,肠子脱出体外,只有肠道完全断裂难以医治;若是受伤破损但肠道未断者,都可以进行治疗。对于肠道和肚皮破裂的情况,使用花乳石散敷在线条上,轻轻用手从上方进行缝合,不要等到粪便流出,用清油捻润后将肠子送回腹腔内。肚皮裂开者,用麻线作为缝线,或者将桑白皮捶打成线状,也使用花乳石散敷在线条上,必须从里层重新缝合,肚皮的表皮不可重叠缝合,保留外皮敞开,用药粉掺撒等待肌肉生长愈合。
凡是损伤如果没有骨折、骨碎,就不应使用自然铜,需在药方中去除自然铜;如果没有痰涎,就不使用半夏。老年人有损伤时,骨脉寒冷,每剂药需加入当归、川芎、川乌、木香、丁香、人参、半夏,去掉白芍药和生地黄,这也是在二十五味药基础上的加减法。老年人服用丸剂,或者伤势邻近脏腑者,不论老少,如果有血液和痰涎从口中吐出,使用清心药,加入丁皮、川芎、半夏,与二十五味药同服。如果皮肤发热者,加入黄柏皮、皂角半两,与二十五味药同煎服用。
跌打损伤,骨肉疼痛,无法复位整理,先服用麻醉药物,待患者感觉不到疼痛时,才可以动手操作。如果服药后麻醉效果不明显,可以添加曼陀罗花及草乌五钱,用好酒调匀少量给患者服用。如果患者出现类似醉酒的状态,就不可再加药。受伤者有老有少,体弱或出血严重者,这种药要随时斟酌用量加入,不可过多。也有重伤者,如果见麻醉效果不明显,又临时添加一些,仍然没倒下,再添加用酒调服的少许,一旦患者倒下(失去知觉)就停止给药,切不可过量。
For traumatic injuries, or those where the lungs are injured, even if death does not occur immediately, it is difficult to survive after fourteen days. For penetrating internal injuries under the left hypochondrium. If the intestine is injured and half-severed, it can be treated; if completely severed, it is incurable. For internal injuries in the lower abdomen. For cases with numerous and complex symptoms. For cases where the pulse is not solid and heavy upon palpation. For elderly persons whose left thigh is crushed. For injuries breaking the external genitalia. For cases where blood is exhausted. For penetrating internal injuries inside the shoulder and behind the ear. In all these cases, medication is unnecessary.
If the abdomen is injured such that the abdominal wall is entirely broken and intestines protrude externally, only complete intestinal severance is difficult to treat; injuries that break but do not sever the intestines can all be treated. For ruptures of the intestines and abdominal wall, apply Huashu Shi San (Flower乳 Stone Powder) on the suture thread, gently suture from above using hands, without waiting for feces to emerge. Moisten the intestines with refined sesame oil and return them into the abdominal cavity. For cracked abdominal walls, use hemp thread as sutures, or pound mulberry white bark into thread form. Also apply Huashu Shi San on the thread. Sutures must be performed deeply from the inner layer. The outer skin of the abdominal wall should not be sutured over itself; leave the outer skin open and apply medicated powder to await flesh regeneration.
In cases of trauma without bone fracture or comminution, Ziran Tong (Fossilized Wood) should not be used and must be removed from the prescription. If there is no phlegm-rheum, Banxia (Pinelliae Rhizoma) is not needed. For elderly persons with injuries, the bone pulses are cold; each dose should include Danggui (Angelicae Sinensis Radix), Chuanxiong (Chuanxiong Rhizoma), Chuanwu (Aconiti Radix), Muxiang (Aucklandiae Radix), Dingxiang (Caryophylli Flos), Renshen (Ginseng Radix et Rhizoma), and Banxia (Pinelliae Rhizoma). Remove Baishao (Paeoniae Radix Alba) and Shengdihuang (Rehmanniae Radix). This is also a modification of the Ershiwuwei Yao (Twenty-Five Ingredients Formula). Elderly persons take pills. If the injury is adjacent to internal organs, regardless of age, if blood and phlegm are expelled from the mouth, use Qingxin Yao (Heart-Clearing Medicine) added with Dingpi (Citri Reticulatae Pericarpium Rubrum), Chuanxiong (Chuanxiong Rhizoma), and Banxia (Pinelliae Rhizoma), taken together with the Twenty-Five Ingredients Formula. If the skin is hot, add Huangbai Pi (Phellodendri Cortex) and Zaoguo (Gleditsiae Fructus) half liang, decocted together with the Twenty-Five Ingredients Formula.
For traumatic injuries causing pain in bones and muscles that cannot be realigned, first administer an anesthetic medicine. Only when the patient loses sensation of pain can manipulation begin. If the anesthesia is insufficient after administration, add 5 qian of Tuoluoluo Hua (Datura Flower) and Caowu (Aconiti Kusnezoffii Radix), mixed with good wine and given in small amounts. If the person appears intoxicated, do not add more medicine. For injured persons who are old or young, weak, or suffering severe bleeding, this medicine should be adjusted and administered according to the situation at each time; do not overdose. In severe cases, if anesthesia is insufficient, add more temporarily. If still not anesthetized, add a little more mixed with wine. Once the patient falls unconscious, stop the medicine immediately; do not overdose.