大熟地(七钱) 炙黄 白当归 焦术 生苡仁 净枣仁(各三钱) 川牛膝(二钱) 赤
芍白茯苓 木瓜(各一钱五分) 海防风(一钱) 川芎(八分) 加桂圆肉三个,水煎服
。
凡跌打损伤之症,不可概论也。青肿不痛,或肿不消退者,气血虚弱也,用十全大补汤
。若肿或作寒热者,血伤而肝火动也,用四物加山栀、柴胡。血出不止,或又发寒热者,用
四君子汤加川芎、当归、柴胡。寒热而痛甚者,欲溃脓也,用参 内补散。若脓出而痛甚者
,气虚也,用八珍汤。疮口赤肉突出者,血虚而肝火生风也,用柴胡栀子散。若脓不止,疮口
白肉突出者,气虚而有邪感也,用补中益气汤。若脓溃而痛,或溃而不敛者,皆脾胃虚也,
用六君子汤。苟徒知敷凉药而不溃不敛,所以致败症也。受伤若肠中作痛,按之不能宁者,
内有瘀血也,用承气汤下之。下后仍痛,瘀血犹未尽也,用加味四物汤调之。按之不痛,血
气伤也,用四物汤加参、 、白术。下后胸胁作痛,肝血伤也,四君子汤加川芎、当归。下
后发热,气血俱虚也,用八珍汤加当归、半夏。胸胁胀满,饮食不思者,肝脾气滞也,用六君子
汤加柴胡、枳壳。切牙发搐者,肝盛脾虚也,用蜈蚣散加川芎、山栀、钩藤、天麻。以上
须要谨慎,不可妄用也。各方载后。
大熟地(七钱) 炙黄芪 白当归 焦白术 生薏苡仁 净酸枣仁(各三钱) 川牛膝(二钱) 赤芍药 白茯苓 木瓜(各一钱五分) 海风藤(一钱) 川芎(八分) 加桂圆肉三个,水煎服。
凡是跌打损伤的病症,不可一概而论。如果局部青紫肿胀但不疼痛,或者肿胀不消退,这是气血虚弱所致,使用十全大补汤(一种具有益气补血、温阳固本功效的方剂)。如果肿胀伴有忽冷忽热的症状,这是血液受损导致肝火妄动,使用四物汤(由熟地黄、当归、白芍、川芎组成的补血基础方)加入山栀、柴胡。如果出血不止,或者又出现寒热症状,使用四君子汤(由人参、白术、茯苓、甘草组成的补气基础方)加入川芎、当归、柴胡。如果既有寒热症状且疼痛剧烈,这是脓液即将形成的征兆,使用参内补散(一种用于疮疡溃后气血不足、脓成不溃的方剂)。如果脓液排出但疼痛剧烈,这是气虚所致,使用八珍汤(由四君子汤和四物汤合方而成,气血双补)。如果疮口有红色肌肉突出,这是血虚导致肝火生风,使用柴胡栀子散。如果脓液淋漓不尽,疮口有白色肌肉突出,这是气虚并感受外邪,使用补中益气汤(具有补中益气、升阳举陷功效的方剂)。如果脓液溃破后疼痛,或者溃破后伤口不愈合收敛,这都是脾胃虚弱所致,使用六君子汤(在四君子汤基础上加入陈皮、半夏,增强健脾化痰功效)。如果只知道敷用凉性药物,反而导致脓液不形成或伤口不收敛,这就是导致败症的原因。受伤后如果肠中疼痛,按压时不能缓解,这是内有瘀血,使用承气汤(具有泻下攻积、清热润燥功效的方剂)通下。通下之后仍然疼痛,说明瘀血尚未排尽,使用加味四物汤调理。如果按压不痛,这是气血受损,使用四物汤加入人参、[原文缺字,推测为茯苓或类似药材]、白术。通下之后胸胁部位疼痛,这是肝血受损,使用四君子汤加入川芎、当归。通下之后发热,这是气血都虚弱,使用八珍汤加入当归、半夏。胸胁胀满,不想吃东西,这是肝脾气机阻滞,使用六君子汤加入柴胡、枳壳。如果出现咬牙抽搐的症状,这是肝气盛而脾虚,使用蜈蚣散加入川芎、山栀、钩藤、天麻。以上情况都需要谨慎处理,不可随意用药。各方剂的具体组成记载在后面。
Prepared Rehmanniae Radix (Radix Rehmanniae Praeparata) [7 qian], Roasted Astragali Radix (Radix Astragali Membranacei), White Angelicae Sinensis Radix (Radix Angelicae Sinensis), Charred Atractylodis Macrocephalae Rhizoma (Rhizoma Atractylodis Macrocephalae), Raw Coicis Semen (Semen Coicis), Clean Ziziphi Spinosae Semen (Semen Ziziphi Spinosae) [each 3 qian], Chuan Niu Xi (Radix Cyathulae Officinalis) [2 qian], Red Paeoniae Radix (Radix Paeoniae Rubra), White Poria (Poria), Quince (Fructus Chaenomelis) [each 1.5 qian], Hai Feng Teng (Caulis Sinomenii) [1 qian], Chuan Xiong (Rhizoma Chuanxiong) [8 fen], add three Longan Arillus (Arillus Longan), decoct in water and take orally.
In cases of falls, blows, and injuries, one cannot generalize the treatment. If there is cyanosis and swelling without pain, or if the swelling does not subside, this indicates a deficiency of Qi and Blood; use Shiquan Dabu Decoction (Ten Agents Great Tonifying Decoction). If the swelling is accompanied by alternating chills and fever, this indicates that blood injury has stirred up Liver Fire; use Siwu Tang (Four Substances Decoction) with added Gardeniae Fructus (Fructus Gardeniae) and Bupleuri Radix (Radix Bupleuri). If bleeding persists or chills and fever recur, use Sijunzi Tang (Four Gentlemen Decoction) with added Chuan Xiong (Rhizoma Chuanxiong), Dang Gui (Radix Angelicae Sinensis), and Chai Hu (Radix Bupleuri). If there are chills and fever with severe pain, it suggests that pus is about to form; use Shenqi Neibu San (Ginseng Internal Tonification Powder). If pus discharges but pain remains severe, this indicates Qi deficiency; use Bazhen Tang (Eight Treasures Decoction). If red granulation tissue protrudes from the wound, this indicates Blood deficiency causing Liver Fire to generate Wind; use Chaihu Zhizi San (Bupleuri and Gardenia Powder). If pus discharge is continuous and white flesh protrudes from the wound, this indicates Qi deficiency with pathogenic invasion; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If pain occurs after pus rupture or if the wound fails to heal and close, this is due to Spleen and Stomach deficiency; use Liujunzi Tang (Six Gentlemen Decoction). Merely applying cooling herbs without allowing for suppuration or healing will lead to disastrous outcomes. If abdominal pain occurs after injury and pressing on the area does not relieve it, this indicates internal blood stasis; use Chengqi Tang (Order Downward Decoction) to purge. If pain persists after purging, the blood stasis is not yet fully resolved; use Jiawei Siwu Tang (Modified Four Substances Decoction) to regulate. If pressing causes no pain, this indicates injury to Qi and Blood; use Siwu Tang with added Ren Shen (Radix Ginseng), [missing character, likely Fu Ling/Poria], and Bai Zhu (Rhizoma Atractylodis Macrocephalae). If chest and hypochondriac pain occur after purging, this indicates Liver Blood injury; use Sijunzi Tang with added Chuan Xiong (Rhizoma Chuanxiong) and Dang Gui (Radix Angelicae Sinensis). If fever occurs after purging, this indicates dual deficiency of Qi and Blood; use Bazhen Tang with added Dang Gui (Radix Angelicae Sinensis) and Ban Xia (Rhizoma Pinelliae). If chest and hypochondriac distension/fullness occur with loss of appetite, this indicates stagnation of Liver and Spleen Qi; use Liujunzi Tang with added Chai Hu (Radix Bupleuri) and Zhi Ke (Fructus Aurantii). If teeth grinding and convulsions occur, this indicates excess Liver Qi and deficient Spleen; use Wugong San (Centipede Powder) with added Chuan Xiong (Rhizoma Chuanxiong), Gardeniae Fructus (Fructus Gardeniae), Uncariae Ramulus cum Uncis (Ramulus Uncariae cum Uncis), and Gastrodiae Rhizoma (Rhizoma Gastrodiae). The above conditions require caution; do not use medications recklessly. The specific formulas are listed below.