杖疮一证，凡其甚者，必以瘀血为患。血瘀在外者，浅则砭之，深则刺之，内溃者开之
，腐肉者取之。血瘀在内者，宜以活血流气之药和之，甚者利之行之，此治血凝之法也。然
其受刑之时，号叫则伤气，忍痛则伤血，悲愤则伤志，血气情志俱伤，虚所必至，若不培补
，则羸困日甚矣。况脾主肌肉，脾气受伤，则饮食必减，血脉损坏，则肌肉俱病。故凡即伤
之后，但察其虚多滞少者，则宜以参、 、归、术、熟地、甘草之属，专理脾气，以托气血
。脾健则元气日复，肌肉自生，可保无虞矣。其有伤筋骨而作痛者，宜没药降圣丹治之。若
牙关紧急，或腰背反张者，以玉真散治之并效。总之，此证宜先察其有瘀无瘀，及形气虚实
，酌而治之。凡诸变证治法，有未尽者，宜与前跌打损伤条，互参通用。外杖疮四方，见外
科方中。
文刑部用晦伏阙谏南巡受杖，瘀血已散，坏肉不溃，用托里之药稍溃而脓清，此气血虚也
，非大剂参 不能补。文君亦善医，以为恐腹满。予强之，而饮食稍思。遂加大补剂，饮食
日进，肉溃脓稠而愈。又治江翰林诸公与文同事者九人，皆先散其瘀血，渐用排脓托里之药
俱愈。
夏凤北京人，因杖疮臀膝通溃，脓瘀未出，时发昏愦，此脓毒内作而然也。急与开之，
昏愦愈甚，此虚也。以八珍汤一服少可，数服死肉自腐，顿取之。令用猎蹄汤洗净，以神效
当归膏涂贴，再以十全大补汤，两月而愈。若更投破血之剂则危矣。（薛按）
杖疮这一病证，凡是严重的，必然以瘀血为患。瘀血在体表的，浅表的可采用砭石刺破排脓，深部的可采用针刺引流，内部溃烂的需切开排脓，有腐肉的需清除腐肉。瘀血在体内的，宜用活血行气的药物调和，严重的需用通利攻下的药物疏导运行，这是治疗血凝的方法。然而受刑之时，呼号叫喊会耗伤气机，强忍疼痛会损伤血液，悲伤愤怒会挫伤意志，气血与情志均受损伤，虚弱是必然的结果，如果不进行培补，身体就会日益消瘦困顿。况且脾主肌肉，脾气受伤，则饮食必然减少，血脉损坏，则肌肉都会生病。所以凡是刚受杖责之后，只要观察其虚证多于实证（滞证）的情况，就适宜用人参、黄芪、当归、白术、熟地黄、甘草这类药物，专门调理脾气，以托举气血。脾气健运则元气每日恢复，肌肉自然生长，就可以保证没有危险了。其中有损伤筋骨而作痛的，适宜用没药降圣丹治疗。如果出现牙关紧闭，或者腰背向后反张的情况，用玉真散治疗也有效。总之，此证应当先察明是否有瘀血，以及形体和元气的虚实情况，斟酌后进行治疗。凡是各种变证的治法，如果有未详尽的，适宜与前文跌打损伤条目相互参照通用。外用治疗杖疮的四个方剂，见外科方中。
文部尚书用晦因在宫门前上书谏阻皇帝南巡而受杖刑，瘀血已经消散，但坏死的肌肉不溃烂排脓，使用托里透脓的药物后稍微溃破且脓液清稀，这是气血虚弱的表现，不用大剂量的人参、黄芪不能补益。文尚书也精通医术，担心腹部胀满。我强行让他服药，于是饮食稍有思虑。随后加大补剂的用量，饮食日渐增加，肌肉溃破脓液变稠厚而痊愈。我又治疗了江翰林等与文尚书共事的九人，都是先用药物消散瘀血，逐渐使用排脓托里的药物，都痊愈了。
夏凤是北京人，因为杖疮导致臀部膝盖全部溃烂，脓血未能排出，时常发生神志昏乱，这是脓毒内侵所致。急忙给他用开泄排毒的方法，神志昏乱反而加重，这是虚证的表现。服用八珍汤一次后症状稍有好转，连续服用几次后死肉自然腐烂，立刻去除。令他使用猎蹄汤清洗伤口，涂抹神效当归膏贴敷，再服用十全大补汤，两个月后痊愈。如果再用破血攻伐的药物就危险了。（薛己按语）
Zhangchuang (Bruising Wounds from Caning) is a condition where, in severe cases, blood stasis is the primary pathology. For blood stasis located externally, superficial lesions are treated with Bian stone (stone lancet) pricking, deep lesions with needle puncture, internal ulcerations with incision and drainage, and necrotic tissue with debridement. For blood stasis located internally, it is appropriate to harmonize with herbs that invigorate blood and promote Qi circulation; in severe cases, purgatives or moving agents should be used to facilitate flow. This constitutes the method for treating blood coagulation. However, during the punishment, shouting injures Qi, enduring pain injures Blood, and grief/anger injures the Shen (Spirit). When both Qi and Blood as well as emotional states are damaged, deficiency is inevitable. If tonification is not employed, emaciation and debility will worsen daily. Furthermore, the Spleen governs muscles; if Spleen Qi is injured, appetite decreases; if blood vessels are damaged, muscles suffer. Therefore, immediately after injury, if one observes that deficiency predominates over stagnation, it is appropriate to use herbs such as Renshen (Ginseng Radix), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Shudihuang (Rehmanniae Radix Preparata), and Gancao (Glycyrrhizae Radix et Rhizoma) to specifically regulate Spleen Qi and support/tongue the Qi and Blood. Once the Spleen is robust, Yuan Qi (Original Qi) recovers daily, muscles regenerate naturally, and safety is assured. For injuries involving tendons and bones causing pain, Moyao Jiangsheng Dan (Myrrh Descending Sage Pill) is suitable. If trismus (lockjaw) or opisthotonos (backward arching of the back) occurs, Yuzhen San (Jade True Powder) is also effective. In summary, this condition requires first examining the presence or absence of blood stasis and the excess or deficiency of form and Qi, then treating accordingly based on judgment. For any treatment methods for various complications not fully detailed here, they should be cross-referenced with the section on falls and blows. The four external formulas for Zhangchuang are found in the External Medicine section.
Wen Yonghui, Minister of Justice, was caned for memorializing against the Emperor's southern tour. His blood stasis had dispersed, but necrotic flesh did not ulcerate/drain. Using Tuo Li (Support Interior) herbs, it slightly ulcerated with clear pus, indicating Qi and Blood deficiency. Without large doses of Renshen (Ginseng Radix) and Huangqi (Astragali Radix), tonification cannot occur. Minister Wen was also skilled in medicine and feared abdominal fullness. I insisted he take the medicine, after which his appetite slightly returned. Subsequently, I increased the dosage of strong tonics; his diet improved daily, the flesh ulcerated with thick pus, and he recovered. I also treated nine colleagues of Minister Wen, including Hanlin Academician Jiang. All were first treated to dissipate blood stasis, then gradually given Pai Nong Tuo Li (Drain Pus Support Interior) herbs, and all recovered.
Xia Feng, a native of Beijing, suffered from widespread ulceration of the buttocks and knees due to caning wounds, with pus and blood stasis retained. He frequently experienced delirium and confusion, caused by internal action of pus-toxin. Urgently applying opening/draining methods worsened his delirium, indicating deficiency. After one dose of Bazhen Tang (Eight Treasures Decoction), symptoms slightly improved. After several doses, dead flesh naturally sloughed off and was removed. He was instructed to wash the wound with Lie Ti Tang (Hunting Hoof Decoction), apply Shenxiao Danggui Gao (Miraculous Angelica Ointment), and take Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction). He recovered in two months. Had stronger blood-breaking agents been administered, it would have been critical. (Commentary by Xue Ji)