伤损之证,肌肉作痛者,乃荣卫气滞所致,宜用复元通气散;筋骨间作痛者,肝肾之气伤也,用六味地黄丸。
六味地黄丸
熟地黄(八两) 山萸肉(去核,四两) 怀山药(四两) 牡丹皮(三两) 泽泻(三两) 茯苓(三两)
共为末,炼蜜丸桐子大,空心,白汤服三钱。
复元通气散(方见伤损内证)
伤损之证,骨伤作痛者,乃伤之轻者也。若伤重,则或折、或碎,须用手法调治之,其法已详列前篇。此乃
磕蹦微伤,骨间作痛,肉色不变,宜外用葱熨法,内服没药丸,日间服地黄丸自愈矣。
没药丸
没药(去油) 乳香(去油) 川芎 川椒(去闭口及目) 芍药 当归(各半两) 自然铜(火 淬七次,二
钱半)
上为细末,用黄蜡二两熔化,入药末搅匀,丸弹子大,每服一丸,酒一盅化开,煎五分热服。
葱熨法(方见囟骨伤)
地黄丸(方见肌肉作痛)
伤损之证,胸腹痛闷者,多因跳跃捶胸,
闪挫举重,劳役恚怒所致。其胸腹喜手摸者,肝火伤脾也,用四君子汤加柴胡、山栀;如畏手摸者,肝经血滞
也,用四物汤加柴胡、山栀、桃仁、红花;若胸胁闷痛,发热晡热,肝经血伤也,用加味逍遥散;若胸胁闷痛,饮
食少思,肝脾气伤也,用四君子汤加芎、归、柴、栀、丹皮;若胸腹胀满,饮食少思,肝脾气滞也,用六君子
汤加柴胡、芎、归;若胸腹不利,食少无寐,脾气郁结也,用加味归脾汤;若痰气不利,脾肺气滞也,用二陈
汤加白术、芎、归、山栀、大麻、钩藤钩。如因过用风热之药,致肝血受伤,肝火益甚,或饮糖酒则肾水益虚,
脾火益炽,若用大黄、芍药内伤阴络,反致下血。少壮者,必成痼疾;老弱者,多致不起。
加味归脾汤
黑栀(一钱) 牡丹皮(一钱) 人参(一钱) 黄 (炙,一钱五分) 白术(炒,一钱五分) 茯神
(二钱) 枣仁(炒,一钱五分) 当归(一钱) 木香(五分) 远志(去心,八分) 圆肉(二钱) 甘
草(炙,五分)
引用姜、枣,水煎服。
二陈汤
陈皮(一钱五分) 半夏(制,二钱) 茯苓(二钱) 甘草(五分)
引用姜,水煎服。
六君子汤
即四君子汤加陈皮、半夏各一钱五分。
引用姜、枣,水煎服。
四君子汤 四物汤 加味逍遥汤(俱见伤损出血)
对于损伤病症,肌肉疼痛的,是由于营卫之气运行滞涩所致,适宜使用复元通气散;筋骨之间疼痛的,是肝肾之气受损的表现,应使用六味地黄丸。
六味地黄丸
熟地黄(八两) 山萸肉(去除果核,四两) 怀山药(四两) 牡丹皮(三两) 泽泻(三两) 茯苓(三两)
以上药物共同研磨成细末,用炼制的蜂蜜制成如梧桐子大小的药丸,空腹时,用白开水送服三钱。
复元通气散(方剂见前文“伤损内证”章节)
对于损伤病症,骨骼受伤引起疼痛的,属于伤势较轻的情况。如果伤势严重,则可能出现骨折或骨碎,必须采用手法进行调理治疗,具体方法已在前面篇章中详细列出。此处指的是轻微磕碰造成的损伤,骨骼间疼痛,但皮肤颜色没有变化,适宜外用葱熨法,内服没药丸,白天服用地黄丸即可自愈。
没药丸
没药(去除油脂) 乳香(去除油脂) 川芎 川椒(去除闭合的口及籽目) 芍药 当归(各半两) 自然铜(经火煅烧后淬水七次,二钱半)
以上药物研成细末,用黄蜡二两熔化,加入药末搅拌均匀,制成如弹子大小的药丸,每次服用一丸,用一杯酒化开,煎至五分热时温服。
葱熨法(方剂见前文“囟骨伤”章节)
地黄丸(方剂见前文“肌肉作痛”章节)
对于损伤病症,出现胸腹部胀闷疼痛的,多因跳跃、捶打胸部,或者闪挫、举重,以及劳累过度、愤怒情绪所致。如果胸腹部喜欢被手触摸按压的,是肝火损伤脾脏所致,使用四君子汤加柴胡、山栀;如果不喜欢被手触摸按压的,是肝经血液瘀滞所致,使用四物汤加柴胡、山栀、桃仁、红花;如果胸胁部胀闷疼痛,伴有发热和傍晚时分潮热,是肝经血液受损所致,使用加味逍遥散;如果胸胁部胀闷疼痛,饮食减少且食欲不振,是肝脾之气受损所致,使用四君子汤加川芎、当归、柴胡、山栀、牡丹皮;如果胸腹部胀满,饮食减少且食欲不振,是肝脾之气滞涩所致,使用六君子汤加柴胡、川芎、当归;如果胸腹部感觉不适,进食少且失眠,是脾气郁结所致,使用加味归脾汤;如果痰气运行不畅,脾肺之气滞涩,使用二陈汤加白术、川芎、当归、山栀、大麻、钩藤钩。如果是由于过度使用风热性质的药物,导致肝血受伤,肝火更加旺盛,或者饮用糖酒后肾水更加虚弱,脾火更加炽盛,此时若错误地使用大黄、芍药等治疗内伤阴络的药物,反而会导致下部出血。年轻力壮者,必定会形成顽固性疾病;年老体弱者,大多会导致死亡。
加味归脾汤
黑栀子(一钱) 牡丹皮(一钱) 人参(一钱) 黄芪(炙烤,一钱五分) 白术(炒制,一钱五分) 茯神(二钱) 酸枣仁(炒制,一钱五分) 当归(一钱) 木香(五分) 远志(去除心,八分) 桂圆肉(二钱) 甘草(炙烤,五分)
引用生姜、大枣作为药引,加水煎煮后服用。
二陈汤
陈皮(一钱五分) 半夏(炮制,二钱) 茯苓(二钱) 甘草(五分)
引用生姜作为药引,加水煎煮后服用。
For injury syndromes, pain in the muscles is caused by stagnation of Ying and Wei Qi (Nutritive and Defensive Qi), and Fuyuan Tongqi San should be used; pain between the sinews and bones indicates injury to the Qi of the Liver and Kidney, and Liuwei Dihuang Wan should be used.
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill)
Shu Dihuang (Prepared Rehmanniae Radix, 8 liang) Shanyurou (Corni Fructus, pitted, 4 liang) Huai Shanyao (Dioscoreae Rhizoma, 4 liang) Mudanpi (Moutan Cortex, 3 liang) Zexie (Alismatis Rhizoma, 3 liang) Fuling (Poria, 3 liang)
Grind all ingredients into fine powder, mix with refined honey to form pills the size of tung tree seeds. Take 3 qian orally on an empty stomach with warm water.
Fuyuan Tongqi San (See formula under "Internal Syndromes of Injury")
For injury syndromes, pain resulting from bone injury indicates a mild degree of trauma. If the injury is severe, involving fractures or comminuted fragments, manual reduction techniques are required, as detailed in previous chapters. This section refers to minor contusions causing pain within the bone interstices without discoloration of the skin. External application of Congyi Method (Scallion Moxibustion/Warming) is indicated, along with oral administration of Moyao Wan. Self-healing can be achieved by taking Dihuang Wan during the day.
Moyao Wan (Myrrh Pill)
Moyao (Commiphora Myrrha Resina, defatted) Ruxiang (Boswelliae Carri Resina, defatted) Chuanxiong (Ligustici Chuanxiong Rhizoma) Chuanjiao (Zanthoxyli Pericarpium, remove closed ends and seeds) Shaoyao (Paeoniae Radix Alba) Danggui (Angelicae Sinensis Radix) (each 0.5 liang) Ziran Tong (Pyritum, calcined seven times in water quenching, 2.5 qian)
Grind all ingredients into fine powder. Melt 2 liang of yellow beeswax, mix uniformly with the powder, and form pills the size of bullet seeds. Take one pill per dose, dissolve in one cup of wine, heat until lukewarm, and consume.
Congyi Method (See formula under "Fontanelle Injury")
Dihuang Wan (See formula under "Muscle Pain")
For injury syndromes presenting with chest and abdominal distension, fullness, and pain, the etiology is often due to jumping, chest beating, sprains, heavy lifting, overexertion, or anger. If the chest and abdomen prefer being touched or pressed, it indicates Liver Fire injuring the Spleen; use Sijunzi Tang plus Chaihu and Zhizi. If the chest and abdomen dislike being touched, it indicates Blood stasis in the Liver Meridian; use Siwu Tang plus Chaihu, Zhizi, Taoren, and Honghua. If there is distending pain in the chest and hypochondrium accompanied by fever and afternoon tidal fever, it indicates injury to the Blood of the Liver Meridian; use Jiawei Xiaoyao San. If there is distending pain in the chest and hypochondrium with reduced appetite, it indicates injury to the Qi of the Liver and Spleen; use Sijunzi Tang plus Chuanxiong, Danggui, Chaihu, Zhizi, and Mudanpi. If there is abdominal fullness and reduced appetite, it indicates Qi stagnation of the Liver and Spleen; use Liujunzi Tang plus Chaihu, Chuanxiong, and Danggui. If there is discomfort in the chest and abdomen, poor appetite, and insomnia, it indicates Spleen Qi depression; use Jiawei Guipi Tang. If there is phlegm-Qi obstruction and stagnation of Lung and Spleen Qi, use Erchen Tang plus Baizhu, Chuanxiong, Danggui, Zhizi, Dama, and Gouteng. If excessive use of wind-heat herbs injures Liver Blood and exacerbates Liver Fire, or if consumption of sugary alcohol depletes Kidney Water and intensifies Spleen Fire, using Dahuang or Shaoyao to treat internal injury to Yin collaterals may instead cause lower body bleeding. In young and robust individuals, this will likely become a chronic disease; in the elderly and weak, it may lead to death.
Jiawei Guipi Tang (Modified Guipi Decoction)
Heizhi (Gardeniae Fructus, charred, 1 qian) Mudanpi (Moutan Cortex, 1 qian) Renshen (Ginseng Radix, 1 qian) Huangqi (Astragali Radix, honey-fried, 1.5 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried, 1.5 qian) Fushen (Poria cum Radix, 2 qian) Zaoren (Ziziphi Spinosomi Semen, stir-fried, 1.5 qian) Danggui (Angelicae Sinensis Radix, 1 qian) Muxiang (Aucklandiae Radix, 0.5 qian) Yuanzhi (Polygalae Radix, core removed, 0.8 fen) Yuanyrou (Longan Arillus, 2 qian) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 fen)
Use fresh ginger and jujube as guides, decoct in water, and take orally.
Erchen Tang (Two-Aged Decoction)
Chenpi (Citri Reticulatae Pericarpium, 1.5 qian) Banxia (Pinelliae Rhizoma, processed, 2 qian) Fuling (Poria, 2 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 fen)
Use fresh ginger as a guide, decoct in water, and take orally.
Liujunzi Tang (Six-Gentlemen Decoction)
Identical to Sijunzi Tang plus Chenpi and Banxia, each 1.5 qian.
Use fresh ginger and jujube as guides, decoct in water, and take orally.
Sijunzi Tang, Siwu Tang, Jiawei Xiaoyao Tang (All see formulas under "Injury with Bleeding")