破伤亡血筋失养，微伤风入火之端，燥起白痂疮不肿，湿流污水紧牙关。
【注】破伤去血过多，筋失所养，经络空虚，风邪乘之为病，即经曰“风邪乘虚而
入”也，为风虚邪，宜桂枝汤合当归补血汤治之。夫伤重出血过多而病风者常也，然时
有微伤浅损，去血甚少，风邪乘之而病者，以其人素热，因风而然。即刘完素曰∶热甚风
搏并于经络也，为风火邪，宜防风通圣散加蝎尾治之。凡此证不论虚实，风毒内蕴不发
于外，疮口周遭燥起白痂，疮不甚肿，湿流污黑之水，牙关微紧，不似寻常活动，皆破
伤风之先兆也。
防风通圣散加蝎尾方 全蝎散 左龙丸 斑蝥大黄方
火盛通圣加蝎尾，风盛全蝎左龙丸，外因烧酒火罐法，犬风斑大酒同煎。
【注】破伤火盛者，多阳明证，用防风通圣散加蝎尾治之。风盛者，多太阳证，用全
蝎散，即生蝎尾七枚研末，热酒服之。服后不解，渐深入里，用左龙丸，即野鸽粪、江
鳔、僵蚕、雄黄、蜈蚣、天麻、朱砂、巴豆霜为丸也，方详在《丹溪心法》诸破伤风门
内。皆宜外用砂烧酒壶两个，盛多半壶烧酒，先以一壶上火令滚无声，倾酒即按在破伤疮
口，拔出污黑血水，满则自落。再以次壶仍按疮口，轮流提拔，以尽为度，其风立愈。犬
咬风毒入腹成痉风者，用斑蝥七枚，以糯米拌炒米黄，去米为末，生大黄末一钱合均，黄
酒一盏，煎至半盏，空心温服，取下毒物，弱者减半服之可也。
破伤风因失血过多导致筋脉失去濡养，或因轻微外伤致使风邪侵入而引发火热之端。若疮口干燥并出现白色痂皮且肿胀不明显，或渗出污浊污水且伴有牙关紧闭，均为破伤风的征象。
【注】破伤后出血过多，筋脉失去滋养，经络空虚，风邪乘虚而入致病，正如经典所言“风邪乘虚而入”，此属风虚邪气，适宜使用桂枝汤合当归补血汤进行治疗。通常情况下，重伤出血过多而继发风病是常态；然而有时仅有轻微浅表损伤，失血极少，却因患者素体蕴热，风邪乘之而发病，即刘完素所说：“热盛与风邪搏结于经络”，此属风火邪气，适宜使用防风通圣散加全蝎尾进行治疗。凡此类证候，无论虚实，若风毒内蕴而不发于外，表现为疮口周围干燥起白痂、疮面不甚红肿，或流出污黑液体、牙关微紧且活动不如常，皆是破伤风的前兆。
防风通圣散加蝎尾方、全蝎散、左龙丸、斑蝥大黄方。
火毒盛者用防风通圣散加蝎尾，风邪盛者用全蝎散或左龙丸，外治法可用烧酒配合火罐，犬咬致风毒入腹成痉者用斑蝥配大黄及黄酒同煎。
【注】破伤后火毒炽盛者，多表现为阳明经证，使用防风通圣散加全蝎尾治疗。风邪偏盛者，多表现为太阳经证，使用全蝎散，即将七枚生全蝎尾研成粉末，用热酒送服。若服药后病情未解，病邪渐深入体内，则使用左龙丸，该方由野鸽粪、江鳔（鱼鳔）、僵蚕、雄黄、蜈蚣、天麻、朱砂、巴豆霜制成丸剂，详细记载于《丹溪心法》的诸破伤风门中。这些情况均适宜外用两个砂制烧酒壶：装入大半壶烧酒，先将一个壶加热至沸腾无声，倒出酒后迅速按在破伤疮口上，拔出污黑血水，吸满后会自动脱落。再依次用另一个壶按在疮口上，轮流提拔，直到排尽为止，风邪即可立即痊愈。被狗咬伤导致风毒入腹形成痉风者，取七枚斑蝥，用糯米拌炒至米呈黄色，去掉米粒将斑蝥研末，加入一钱生大黄末混合均匀，用一盏黄酒煎至半盏，空腹温服，以排出毒物为宜，体质虚弱者减半服用即可。
Traumatic tetanus arises from blood loss leading to malnourishment of the sinews, or from minor wounds allowing wind pathogen invasion initiating fire. Dryness manifests as white crusts with minimal swelling, while dampness presents as flowing turbid water accompanied by trismus (lockjaw).
[Note] Excessive bleeding after trauma causes the sinews to lose nourishment and the meridians to become empty, allowing wind pathogen to enter due to deficiency, as stated in the classics: "Wind pathogen enters when there is deficiency." This is considered a wind-deficiency pathogen, suitable for treatment with Guizhi Tang (Cinnamon Twig Decoction) combined with Danggui Buxue Tang (Astragalus and Angelica Decoction). Typically, contracting wind disease after severe injury with excessive bleeding is common; however, sometimes minor superficial injuries with minimal blood loss lead to disease because the individual has inherent heat, and wind pathogen exploits this condition. As Liu Wansu stated: "Excessive heat and wind pathogen bind together in the meridians," this is considered a wind-fire pathogen, suitable for treatment with Fangfeng Tongsheng San (Saposhnikia Decoction for Unblocking the Intestines and Stomach) added with Scorpion Tail (Quanxie Wei). For such conditions, regardless of excess or deficiency, if wind-toxin is retained internally without manifesting externally, characterized by dry white crusts around the wound, minimal swelling, flow of turbid black fluid, and slight stiffness of the jaw not moving normally, these are all precursors of traumatic tetanus.
Formulas include Fangfeng Tongsheng San with Scorpion Tail, Quanxie San (Scorpion Powder), Zuo Long Wan (Left Dragon Pill), and Banmao Dahuang Fang (Mustard Beetle and Rhubarb Formula).
For excessive fire, use Fangfeng Tongsheng San with Scorpion Tail; for excessive wind, use Quanxie San or Zuo Long Wan. External treatment involves using boiled wine with fire cups. For dog bite-induced wind-toxin entering the abdomen causing spasms, use Banmao (Mustard Beetle) with Dahuang (Rhubarb) decocted in yellow wine.
[Note] Traumatic tetanus with excessive fire often presents as Yangming meridian syndrome, treated with Fangfeng Tongsheng San added with Scorpion Tail. Cases with predominant wind often present as Taiyang meridian syndrome, treated with Quanxie San, which consists of seven raw Scorpion Tails ground into powder and taken with hot wine. If symptoms persist after administration and the pathogen penetrates deeper, use Zuo Long Wan, composed of Columba Fermentum (Wild Pigeon Droppings), Hicis Saccus (Fish Swim Bladder), Bombyx Batryticatus (Stiff Silkworm), Realgar, Centipede, Gastrodia Elata (Tianma), Cinnabar, and Crotonis Fructus Preparatum (Prepared Croton Seed) made into pills, detailed in *Danxi Xinfa* under the section on various traumatic tetanus cases. All these conditions are suitable for external treatment using two clay wine pots filled more than half full with distilled spirits. Heat one pot until boiling silently, pour out the wine, and immediately press the pot onto the traumatic wound to extract turbid black blood and fluid; it will fall off automatically when full. Then use the second pot in rotation until the extraction is complete, at which point the wind pathogen will be cured immediately. For dog bites where wind-toxin enters the abdomen causing spasms, take seven Banmao (Mylabris/Blister Beetles), stir-fry with glutinous rice until the rice turns yellow, remove the rice, grind the beetles into powder, mix with one qian of raw Dahuang (Rhubarb Root) powder, decoct in one cup of Huangjiu (Yellow Wine) until half remains, and take warm on an empty stomach to expel toxins. Reduce the dose by half for weak patients.