经云。人有堕坠。恶血留内。腹中胀满。不得前后。先饮利药。金匮治马坠及一切筋骨损方。
大黄一两。另用酒一大盏浸。及桃仁、蒲黄、甘草、发灰。以童子小便煎成。纳大黄。去滓。分
温三服。先以败蒲席煎汤浴之。浴后服药。以衣被盖覆。斯须通利数行。痛楚立瘥。伤损气血凝
滞则肿。或紫或青。痛不可忍。宜活血行气。最忌恶血攻心与破伤二证。凡血上逆者。即以逐瘀
为急。口噤牙关紧。即是胃风。根据破伤治之。伤损着寒。痛不可忍。用葱杵烂炒热罨上。其痛立
止。冷则温之。恶血上攻。韭汁和童便饮半杯。即下。从高堕下。腹中瘀血满痛不得出。短气。
二便不通。千金桃仁汤。挫闪气血不顺。腰胁疼痛。或发寒热。香壳散加桃仁、苏木。胁痛。
加柴胡、川芎。跌扑闪挫。瘀结腹胁。大便不通。调营活络饮。跌扑损伤。瘀蓄大便不通。红肿
青紫。疼痛昏闷。内壅欲死者。当归导气散。跌扑闪挫。腰胁气滞。牵引掣痛。复元通气散。从
高坠下。恶血流于胁中。痛不可忍。复元活血汤。被打伤破。内有瘀血腹胀。蒲黄生者
筛取一升。当归、肉桂各二两。酒服方寸匙。日三服。丹方。治折臂断筋损骨。生地、大黄捣汁。
和酒服一月即接连。仍以滓炒热贴之。 虫擂酒服亦可。焙干为末。每服一钱。入麝少许。温酒
调服。接骨神效。跌折或金刃伤骨。用老鸦眼睛藤。和根叶细捣。封贴伤处。令患者痛饮至醉。
此续骨法也。若筋断取筋相对。用旋花根（即缠枝牡丹。）杵汁滴伤处。将渣封疮上。半月筋自
续。此续筋法也。又方。治筋绝取生蟹肉及黄。捣涂伤处。筋即续。亦治骨断。以蟹生捣和酒痛
饮。并以滓 。干即再涂。骨连筋续乃止。诸伤损瘀血凝聚。痛不可忍。以大黄一两切。杏仁三
十粒。研细。酒煎服。瘀血即下。若恐气绝。取药不及。先以热小便灌之。外用大黄末。姜汁调
涂。一夜青紫即变。瘀积日久。青黑痛极。以附子一枚 咀。猪脂煎数沸。去滓取脂。和醋涂之。
堕坠重伤。危在旦夕。用乌鸡连毛捣烂。和醋烘热。隔布熨之。甚则破牛马腹纳入。浸热血中救
之。金伤肠出。以猪脂抹手推入。急用桑皮线缝合。即以热鸡血涂之。次入烧人屎拌涂尤妙。从
高坠下。或行车走马。跌折筋骨。骨伤。自然铜散。筋伤。乳香定痛散。金刃出血不止者。紫金
丹敷之。跌扑致衄。或吐血不止。浓煎苏木汤去滓。煎小乌神汤。下黑神散。促筋脱骱。用槿树
皮捣烂。拌腊糟焙热涂扎。损伤一证。专从血论。但须分有瘀血停积与亡血过多之证。盖打扑堕
坠。皮不破而内损者。必有瘀血。若金刃伤皮出血。或致亡血过多。二者不可同法而治。有瘀血
者。宜攻利之。若亡血者。兼补调之。须察其所伤上下轻重浅深之异。经络气血多少之殊。惟宜
先逐瘀血。通经络。和血止痛。然后调气养血。补益胃气。无不效也。
〔诊〕金疮出血太多。其脉虚细小者生。数实而浮大者死。砍疮血不止。脉来或大或止者死。
细滑者生。从高颠仆。内有血。腹胀满。脉坚强者生。小弱者死。
《黄帝内经》说：人从高处坠落，恶血留滞体内，导致腹部胀满，大小便不通。治疗时应先服用通利大便的药物。《金匮要略》中记载了治疗马匹坠落及一切筋骨损伤的方剂。
大黄一两，单独用一大盏酒浸泡；另备桃仁、蒲黄、甘草、发灰。用童子小便煎煮上述药物至成汤剂，纳入大黄，滤去药渣，分三次温服。服药前先煎败蒲席汤洗浴身体，浴后服药，并用衣被覆盖身体保暖。不久就会多次排便通畅，疼痛立刻缓解。
跌打损伤导致气血凝滞则出现肿胀，颜色或紫或青，疼痛难以忍受。适宜采用活血行气的方法。最忌讳的是“恶血攻心”和“破伤风”这两种证候。凡是血液上逆的情况，应当以逐瘀为急务。若出现口噤、牙关紧闭，即是胃受风邪所致，应根据破伤风的治法进行治疗。
跌打损伤感受寒邪，疼痛剧烈难忍，可用葱捣烂炒热外敷患处，疼痛立即停止。若属寒证则需温之。恶血上攻，饮用韭汁混合童子小便半杯，即可使瘀血下行。
从高坠落，腹中瘀血满痛且无法排出，伴有短气、二便不通，可用《千金方》中的桃仁汤。
因挫闪导致气血不顺，引起腰胁疼痛，或伴有寒热症状，可用香壳散加桃仁、苏木。
跌扑损伤，瘀血蓄积导致大便不通，局部红肿青紫，疼痛昏闷，内壅感强烈欲死者，可用当归导气散。
被打伤破皮，内有瘀血腹胀，可用生蒲黄一升（筛取），配当归、肉桂各二两，用酒送服方寸匙大小的量，每日三次。（此为丹方）
治疗骨折断筋损骨，将生地、大黄捣汁，和酒服用一个月即可接合，并将药渣炒热外贴患处。也可用土鳖虫擂碎后酒服，或焙干研末，每次服用一钱，加入少许麝香，温酒调服，接骨神效。
骨折或被金属利器伤骨，使用老鸦眼睛藤，连同根叶细捣，封贴伤处。令患者痛饮至醉，这是续骨的方法。
若筋断裂，取断端相对，用旋花根（即缠枝牡丹）杵汁滴在伤处，将药渣封在疮口上，半个月筋自然接续，这是续筋的方法。
又一方：治疗筋断绝，取生蟹肉及蟹黄，捣涂伤处，筋即可接续，也能治疗骨断。让患者生食螃蟹并和酒痛饮，并将药渣外敷，干了再涂，直到骨连筋续为止。
各种跌打损伤导致瘀血凝聚，疼痛剧烈难忍，可用大黄一两切片，杏仁三十粒，研细，酒煎服，瘀血即可排出。如果担心患者气绝，来不及取药，先用热的小便灌服。外用大黄末，姜汁调匀涂抹，一夜之间青紫色即可消退。
若瘀积日久，呈青黑色且疼痛极度剧烈，可用附子一枚切碎，用猪脂煎煮数沸，滤去药渣取脂，和醋涂抹患处。
坠落重伤，生命垂危，用乌鸡带毛捣烂，和醋加热，隔着布熨烫患处。情况严重者，剖开牛马腹部将患者纳入其中，浸在热血中抢救。
金属利器伤导致肠子流出，用手抹上猪脂将肠子推回，急用桑皮线缝合，随即涂上热鸡血，其次拌入烧过的人屎涂抹尤其妙。
从高坠落，或行车走马时跌折筋骨，骨伤用自然铜散，筋伤用乳香定痛散。
跌扑导致鼻衄，或吐血不止，浓煎苏木汤去渣，煎小乌神汤，送服黑神散。
损伤这一类病症，专门从血的角度论治。但必须区分是有瘀血停积还是亡血过多两种证候。一般来说，打扑坠落，皮肤未破而内部受损的，必然有瘀血；若是金属利器划伤皮肤出血，或导致失血过多，这两者不可用同样的方法治疗。有瘀血者，宜攻下通利；若亡血者，兼用补益调理。必须观察受伤部位的上下、轻重、浅深差异，以及经络气血多少的不同。只应当先驱逐瘀血，疏通经络，调和血液止痛，然后调理气养血，补益胃气，没有不有效的。
〔诊法〕金创出血太多，脉象虚细小者预后良好（生）；脉象数实而浮大者预后不良（死）。砍疮出血不止，脉象忽大忽止者死；脉象细滑者生。从高坠落，体内有瘀血，腹胀满，脉象坚强者生；脉象小弱者死。
The *Huangdi Neijing* states: When a person falls from a height, evil blood (stagnant blood) remains inside the body, causing abdominal distension and inability to pass stool or urine. Treatment should begin by administering purgative medicines. The *Jingui Yaolue* records a formula for treating injuries from horse falls and all kinds of bone and tendon damage.
Da Huang (Rhubarb Root and Rhizome), 1 liang, soaked separately in one large cup of wine; along with Tao Ren (Peach Seed), Pu Huang (Typha Pollen), Gan Cao (Licorice Root), and Fa Hui (Ash of Human Hair). Decoct these ingredients using urine from an uncircumcised boy until reduced to a liquid. Add Da Huang, strain, and divide into three warm doses. Before taking the medicine, bathe in a decoction of decayed rush mats. After bathing, take the medicine, cover with blankets to keep warm. Soon, multiple bowel movements will occur, and pain will be relieved immediately.
Traumatic injury causing stagnation of Qi and blood leads to swelling, appearing purple or blue-black, with unbearable pain. It is appropriate to employ methods that invigorate blood and move Qi. One must strictly avoid two conditions: "evil blood attacking the heart" and "broken wind" (tetanus/lockjaw). In cases where blood rebels upward, expelling stasis is the urgent priority. If mouth lock and tight jaw occur, it indicates stomach wind; treat according to the protocol for broken wind.
If trauma is compounded by cold pathogen, causing unbearable pain, crush green onions, stir-fry until hot, and apply as a compress; pain stops immediately. For cold patterns, apply warmth. For evil blood attacking upward, drink half a cup of chive juice mixed with uncircumcised boy's urine to promote downward movement of stasis.
For falls from height causing fullness and pain in the abdomen due to stagnant blood, inability to expel it, shortness of breath, and obstruction of both bowels and bladder, use Tao Ren Tang (Peach Kernel Decoction) from *Qianjin Fang*.
For sprains and strains causing disordered Qi and blood, resulting in waist and hypochondriac pain, or accompanied by aversion to cold and fever, use Xiang Ke San (Aromatic Shell Powder) added with Tao Ren (Peach Seed) and Su Mu (Sappan Wood).
For hypochondriac pain, add Chai Hu (Bupleurum Root) and Chuan Xiong (Ligusticum Rhizome).
For traumatic injuries and sprains causing blood stasis accumulation in the abdomen and hypochondrium with constipation, use Tiao Ying Huo Luo Yin (Regulate Camp and Activate Collaterals Decoction).
For traumatic injuries where blood stasis accumulates causing constipation, local redness, swelling, cyanosis, severe pain, dizziness, and a sensation of internal blockage nearing death, use Dang Gui Dao Qi San (Angelica Guiding Qi Powder).
For sprains causing Qi stagnation in the waist and hypochondrium with radiating pulling pain, use Fu Yuan Tong Qi San (Restore Origin and Unblock Qi Powder).
For falls from height where evil blood flows into the hypochondrium causing unbearable pain, use Fu Yuan Huo Xue Tang (Restore Origin and Invigorate Blood Decoction).
For open wounds with internal blood stasis and abdominal distension, use raw Pu Huang (Typha Pollen), one sheng (sifted), combined with Dang Gui (Angelica Sinensis) and Rou Gui (Cinnamon Bark), each 2 liang. Take one cun chi (square inch spoonful) dose with wine, three times daily. (This is a folk prescription.)
To treat fractured arms, severed tendons, and damaged bones, crush Sheng Di Huang (Rehmannia Root) and Da Huang (Rhubarb Root) to extract juice, mix with wine, and drink for one month to achieve union. Apply the dregs heated externally. Alternatively, grind Eupolyphaga Steleophaga (Ground Beetle) with wine to drink, or dry, powder, and take one qian per dose with a little She Xiang (Musk) dissolved in warm wine; this is highly effective for bone setting.
For fractures or metal blade injuries to bones, use Lao Ya Yan Jing Teng (Smilax Rotundifolia Vine), finely crushed with roots and leaves, applied as a seal over the wound. Have the patient drink heavily until intoxicated; this is the method for reconnecting bones.
For severed tendons, align the ends, drip juice from Xuan Hua Gen (Dioscorea Hypoglauca Root, also known as Climbing Peony) onto the wound, and seal the sore with the dregs. Tendons will naturally reconnect in half a month; this is the method for reconnecting tendons.
Another prescription for severed tendons: take raw crab meat and roe, crush and apply to the wound; tendons will reconnect. This also treats bone fractures. Have the patient eat raw crab and drink wine heavily, applying the dregs externally until reapplication when dry, continuing until bone and tendon are united.
For various traumatic injuries causing凝聚 (coagulation) of blood stasis with unbearable pain, cut Da Huang (Rhubarb Root) 1 liang and Xing Ren (Apricot Seed) 30 grains, grind finely, decoct in wine, and drink to expel blood stasis. If fear of Qi collapse arises before medicine can be prepared, first灌 (irrigate) with hot urine. Externally, apply Da Huang powder mixed with ginger juice; cyanosis changes within one night.
For long-standing blood stasis presenting as dark blue-black with extreme pain, chop one Fu Zi (Aconite Lateral Root) and boil in pig lard for several boils. Strain and take the fat, mix with vinegar, and apply.
For severe falls endangering life, crush Wu Ji (Black-bone Chicken) with feathers, mix with vinegar, heat, and apply via cloth compression. In critical cases, open the belly of a cow or horse, place the patient inside, and rescue them by immersing them in the warm blood.
For metal blade injuries with eviscerated intestines, smear hands with pig lard, push intestines back in, suture urgently with mulberry root fiber thread, then apply hot chicken blood. Applying burned human feces mixed on top is particularly excellent.
For falls from height or accidents while riding leading to bone/tendon fractures: for bone injury, use Zi Ran Tong San (Natural Copper Powder); for tendon injury, use Ru Xiang Ding Tong San (Frankincense Pain-Relieving Powder). For unceasing bleeding from metal blades, apply Zi Jin Dan (Purple Gold Pill) externally.
For traumatic epistaxis or unceasing hematemesis, decoct Su Mu (Sappan Wood) strongly, strain, decoct Xiao Wu Shen Tang (Little Black God Decoction), and administer Hei Shen San (Black God Powder).
To reduce joint dislocations, crush Jin Pi (Hibiscus Tiliaceus Bark), mix with aged rice lees, heat, and apply/bind.
Injury syndromes are primarily discussed from the perspective of blood. One must distinguish between stagnation of blood stasis and excessive loss of blood. Generally, blunt trauma without skin breakage causes internal damage and必有 (must have) blood stasis. Conversely, metal blade injuries breaking skin and causing bleeding, or resulting in excessive blood loss, require different treatments. For blood stasis, employ purging and draining methods; for blood loss, combine tonification and regulation. Observe differences in location (upper/lower), severity, depth, and variations in meridian Qi and blood abundance. First, expel blood stasis, unblock collaterals, harmonize blood, and relieve pain. Then regulate Qi, nourish blood, and tonify Stomach Qi. There will be no failure.
[Diagnosis] For metal wound hemorrhage, if the pulse is deficient, fine, and small, prognosis is good (survival); if rapid, excess, floating, and large, prognosis is poor (death). For hacking wounds with unceasing bleeding, if the pulse fluctuates between large and absent, death ensues; if fine and slippery, survival occurs. For high falls with internal blood stasis and abdominal distension, if the pulse is firm and strong, survival occurs; if small and weak, death ensues.