伤损胁肋胀痛之证，如大便通和，喘咳吐痰者，肝火侮肺也，用小柴胡汤加青皮、山栀清之；若胸腹胀痛，
大便不通，喘咳吐血者，乃瘀血停滞也，用当归导滞散通之。《内经》云∶肝藏血，脾统血，盖肝属木，木胜
侮土，其脾气必虚。宜先清肝养血，则瘀血
不致凝滞，次壮脾胃，则气血充盛。若行克伐，则虚者益虚，滞者益滞，祸不旋踵矣。
当归导滞散
川大黄（一两） 当归（二钱五分） 麝香（少许）
上三味，除麝香另研外，为极细末，后入麝香令匀，每服三钱，热酒一杯调下。
又方
川大黄 当归（各二两）
上共为细末，每服三钱，不拘时，温酒调服。
小柴胡汤 （方见瘀血泛注）
伤损腹痛之证，如大便不通，按之痛甚者，瘀血在内也，用加味承气汤下之；既下而痛不止，按之仍痛，瘀
血未尽也，用加味四物汤补而行之；若腹痛按之反不痛者，血气伤也，用四物汤加参、 、白术，补而和之；若
下而胸胁反痛，肝血伤也，用四君子汤加芎、归补之；既下而发热，阴血伤也，用四物汤加参术补之；既下而恶
寒，阳气伤也，用十全大补汤补之；既下而恶寒发热者，气血伤也，用八珍汤补之；下而欲呕者，胃气伤也，用
六君子汤加当归补之；下而泄泻者，脾肾伤也，用六君子汤加肉果、补骨脂补之；若下后手足俱冷，昏愦出汗，
阳气虚寒也，急用参附汤；若吐泻而手足俱冷，指甲青者，脾肾虚寒之甚也，急用大剂参附汤；口噤、手撒、遗
尿、痰盛、唇青体冷者，虚极之坏证也，急用大剂参附汤，多有得生者。
加味承气汤
大黄 朴硝（各二钱） 枳实 浓朴 当归 红花（各一钱） 甘草（五分）
水酒各半，煎服。
参附汤
人参（或五钱或一两） 制附子（或三钱或五钱）
引用姜，水煎服。
四君子汤 四物汤（俱见伤损出血）
六君子汤（方见胸腹痛闷）
八珍汤 十全大补汤（俱见瘀血泛注）
损伤导致胁肋部胀痛的症状，如果大便通畅调和，伴有气喘咳嗽、吐痰的，是肝火侵犯肺脏所致，使用小柴胡汤加入青皮、山栀来清泻；如果胸腹部胀满疼痛，大便不通畅，伴有气喘咳嗽、吐血的，这是瘀血停滞在体内，使用当归导滞散来通利消散。《内经》说：肝藏血，脾统血，大概因为肝属木，木气过盛会克制土（脾），脾气必然虚弱。应当先清泻肝火并滋养肝血，这样瘀血就不会凝滞，然后再强壮脾胃，使气血充盛。如果使用攻伐类药物，那么虚弱的会更虚，停滞的会更严重，灾祸很快就会降临。
当归导滞散
川大黄（一两） 当归（二钱五分） 麝香（少许）
以上三味药，除了麝香单独研磨外，其余研成极细粉末，然后加入麝香混合均匀，每次服用三钱，用一杯热酒调服。
又一方
川大黄 当归（各二两）
以上共同研成细末，每次服用三钱，不限时间，用温酒调服。
损伤导致腹痛的症状，如果大便不通畅，按压时疼痛剧烈的，是瘀血在体内，使用加味承气汤来攻下；已经攻下后疼痛仍不止，按压仍然痛，说明瘀血未尽，使用加味四物汤来补益并推动血行；如果腹痛按压时反而不痛，是气血受损，使用四物汤加入人参、[原文缺字，推测为茯苓或类似健脾药]、白术，进行补益调和；如果攻下后胸胁反而疼痛，是肝血受损，使用四君子汤加入川芎、当归来补益；已经攻下后出现发热，是阴血受损，使用四物汤加入人参、白术来补益；已经攻下后出现恶寒，是阳气受损，使用十全大补汤来补益；已经攻下后既恶寒又发热，是气血受损，使用八珍汤来补益；攻下后想要呕吐，是胃气受损，使用六君子汤加入当归来补益；攻下后出现泄泻，是脾肾受损，使用六君子汤加入肉果、补骨脂来补益；如果攻下后手脚都冷，神志昏沉迷糊且出汗，是阳气虚寒，紧急使用参附汤；如果呕吐泄泻且手脚都冷，指甲发青，是脾肾虚寒非常严重，紧急使用大剂量参附汤；牙关紧闭、手撒不开、遗尿、痰多、嘴唇发青身体冰冷，是极度虚弱的坏证，紧急使用大剂量参附汤，大多能存活。
加味承气汤
大黄 朴硝（各二钱） 枳实 浓朴 当归 红花（各一钱） 甘草（五分）
用水和酒各一半，煎煮后服用。
For symptoms of distending and painful swelling in the hypochondrium caused by trauma, if the stool is unobstructed and harmonious, accompanied by panting, coughing, and expectoration, it indicates Liver Fire invading the Lung (Zang organ). Use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with added Qing Pi (Green Tangerine Peel) and Shan Zhi (Gardenia Fruit) to clear the heat. If there is distension and pain in the chest and abdomen, unobstructed stool, accompanied by panting, coughing, and hemoptysis, this is due to Stasis of Blood stagnating internally. Use Dang Gui Dao Zhi San (Angelica Dahurica Stagnation-Resolving Powder) to promote circulation and resolve stasis. The *Nei Jing* states: "The Liver stores blood, and the Spleen controls blood." Since the Liver belongs to Wood, excessive Wood energy overacts on Earth (Spleen), causing Spleen Qi to be deficient. One should first clear the Liver and nourish Liver Blood so that blood stasis does not coagulate; subsequently, strengthen the Spleen and Stomach to ensure abundant Qi and Blood. If purgative or attacking methods are used, the deficient will become more deficient, and the stagnant will become more stagnant, bringing disaster swiftly.
Dang Gui Dao Zhi San
Chuan Da Huang (Rhei Radix et Rhizoma, 1 liang)
Dang Gui (Angelicae Sinensis Radix, 2 qian 5 fen)
She Xiang (Musk, a small amount)
Grind the three ingredients into an extremely fine powder, except for She Xiang which is ground separately. Mix the She Xiang evenly into the powder. Take 3 qian per dose, mixed with one cup of hot wine.
Another Prescription
Chuan Da Huang (Rhei Radix et Rhizoma)
Dang Gui (Angelicae Sinensis Radix)
(Each 2 liang)
Grind together into a fine powder. Take 3 qian per dose at any time, mixed with warm wine.
Xiao Chai Hu Tang (See Minor Bupleurum Decoction under General Notes on Blood Stasis)
For abdominal pain caused by trauma, if the stool is unobstructed and pressing causes severe pain, it indicates internal blood stasis. Use Jia Wei Cheng Qi Tang (Modified Doubling Down Decoction) to purge. If pain persists after purging and tenderness remains upon pressure, the blood stasis is not yet exhausted. Use Jia Wei Si Wu Tang (Modified Four Substances Decoction) to tonify and promote circulation. If abdominal pain feels less tender upon pressure, it indicates injury to Qi and Blood. Use Si Wu Tang (Four Substances Decoction) with added Ren Shen (Ginseng Root), [missing character in original text], and Bai Zhu (Atractylodis Macrocephalae Rhizoma) to tonify and harmonize. If chest and hypochondriac pain appears after purging, it indicates injury to Liver Blood. Use Si Jun Zi Tang (Four Gentlemen Decoction) with added Chuan Xiong (Ligusticum Chuanxiong Rhizome) and Dang Gui (Angelicae Sinensis Radix) to tonify. If fever occurs after purging, it indicates injury to Yin Blood. Use Si Wu Tang (Four Substances Decoction) with added Ren Shen (Ginseng Root) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) to tonify. If aversion to cold occurs after purging, it indicates injury to Yang Qi. Use Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) to tonify. If both aversion to cold and fever occur after purging, it indicates injury to Qi and Blood. Use Ba Zhen Tang (Eight Treasures Decoction) to tonify. If nausea arises after purging, it indicates injury to Stomach Qi. Use Liu Jun Zi Tang (Six Gentlemen Decoction) with added Dang Gui (Angelicae Sinensis Radix) to tonify. If diarrhea occurs after purging, it indicates injury to Spleen and Kidney. Use Liu Jun Zi Tang (Six Gentlemen Decoction) with added Rou Guo (Nutmeg) and Bu Gu Zhi (Psoraleae Fructus) to tonify. If both hands and feet become cold, consciousness becomes clouded, and sweating occurs after purging, it indicates deficiency-cold of Yang Qi. Urgently use Shen Fu Tang (Ginseng and Aconite Decoction). If vomiting and diarrhea occur with cold hands and feet and cyanotic fingernails, it indicates extreme deficiency-cold of Spleen and Kidney. Urgently use a large dose of Shen Fu Tang (Ginseng and Aconite Decoction). If lockjaw, flaccid hands, urinary incontinence, profuse phlegm, cyanotic lips, and cold body occur, it is a critical condition of extreme deficiency. Urgently use a large dose of Shen Fu Tang (Ginseng and Aconite Decoction); many patients survive.
Jia Wei Cheng Qi Tang (Modified Doubling Down Decoction)
Da Huang (Rhei Radix et Rhizoma)
Po Xiao (Natrii Sulfas, Each 2 qian)
Zhi Shi (Immature Bitter Orange)
Nong Po (Magnoliae Officinalis Cortex)
Dang Gui (Angelicae Sinensis Radix)
Hong Hua (Carthami Flos)
(Geach 1 qian)
Gan Cao (Licorice Root, 5 fen)
Decoct with half water and half wine, then take orally.
Shen Fu Tang (Ginseng and Aconite Decoction)
Ren Shen (Panax Ginseng Radix, either 5 qian or 1 liang)
Zhi Fu Zi (Prepared Aconiti Lateralis Radix, either 3 qian or 5 qian)
Use fresh ginger as a guide, decoct with water, and take orally.
Si Jun Zi Tang (Four Gentlemen Decoction) and Si Wu Tang (Four Substances Decoction) (See both under Traumatic Hemorrhage)
Liu Jun Zi Tang (Six Gentlemen Decoction) (See prescription under Chest and Abdominal Distension and Pain)
Ba Zhen Tang (Eight Treasures Decoction) and Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) (See both under General Notes on Blood Stasis)