金匮治马坠及一切筋骨损方
大黄(一两切浸成汤下) 绯帛(如手大烧灰) 乱发(如鸡子大烧灰) 炊单布(一尺烧灰)
败蒲(一把三寸) 桃仁(四十九个去皮尖熬) 甘草(如中指节炙锉)
上七味以童子小便量多少煎汤成纳酒一大盏次下大黄去滓分温三服先锉败蒲席半领煎汤
浴衣被处斯须通利数行痛楚立瘥
发明复元活血汤治从高堕下恶血留于胁下疼痛不可忍
柴胡(五钱) 当归(六钱) 甘草(二钱) 穿山甲(炮二钱) 大黄(酒浸一两) 桃仁(去
皮尖五十个) 红花 栝蒌根(各二钱)
上件桃仁研烂余药锉如麻豆大每服一两水二盏半酒半盏煎至七分去滓食前大温服以利为
度得
利后痛或不尽服乳香神应散灵枢云坠堕恶血留于胁下则伤肝肝胆之经行于胁下属厥阴少阳宜
以柴胡为引用为君以当归活血脉又急者痛也以甘草缓其急亦能生新血阳生阴长故也为臣穿山
甲栝蒌根桃仁红花破血润血为之佐大黄酒制以荡涤败血为之使
当归导气散治损伤瘀血大便不通红肿暗青疼痛昏闷蓄血内壅欲死
大黄(一两) 当归(三钱) 麝香(少许)
上三味除麝香另研外为极细末入麝香合匀每服三钱热酒一盏调下食前内瘀血去或骨节伤
折疼痛接骨紫金丹治之
三因鸡鸣散治从高坠下及木石所压凡是损伤瘀血凝滞疼痛欲死兼以此药推陈致新神效
大黄(一两酒浸) 杏仁(三七粒去皮尖)
上研细酒一碗煎至六分去滓鸡鸣时服至晚取下瘀血即愈若便觉气绝取药不及急掰开口以
热小便灌之
按以上四方虽皆荡逐恶血之药前三方所以治血在肝经血分者也后一方所以治血在肺经气
分者
也当以脉之浮沉表里别之又海藏云若登高坠下撞打及伤心腹胸中积血不散以上中下三焦部分
分之以易老犀角地黄汤桃仁承气抵当汤丸之类下之亦有以小便同煎治之者更有内加生地黄当
归煎服者亦有加大黄者惟智者能择之
《金匮要略》治疗马匹坠落及一切筋骨损伤的方剂：
大黄（一两，切片浸泡，煎汤服用）、绯帛（大小如手掌，烧成灰）、乱发（大小如鸡蛋，烧成灰）、炊单布（一尺长，烧成灰）、败蒲（一把，三寸长）、桃仁（四十九个，去皮尖，炒制）、甘草（如中指节大小，炙烤后锉碎）。
以上七味药，用童便（儿童尿液）根据病情轻重适量煎煮成汤，加入一大盏酒，再放入大黄，去渣，分三次温服。先锉碎半领败蒲席煎汤，沐浴或熏洗受伤部位，片刻之后大便通畅数次，疼痛立刻痊愈。
发明复元活血汤，治疗从高坠落导致恶血停留于胁下，疼痛难以忍受的情况：
柴胡（五钱）、当归（六钱）、甘草（二钱）、穿山甲（炮制，二钱）、大黄（酒浸，一两）、桃仁（去皮尖，五十个）、红花、栝蒌根（各二钱）。
上述药材中，将桃仁研烂，其余药物锉碎如麻豆大小。每次服用一两，加水两盏半、酒半盏，煎至七分，去渣，饭前大温服用，以大便通畅为度。
如果通利后疼痛仍未完全消除，可服用乳香神应散。《灵枢》说：“坠堕导致恶血留滞于胁下，则损伤肝脏。”肝胆的经脉行经胁部，属于厥阴和少阳经，适宜以柴胡作为引经药为君药；以当归活血脉；又因“急者痛也”，用甘草缓解紧急疼痛，也能生新血，“阳生阴长”，所以作为臣药；穿山甲、栝蒌根、桃仁、红花破血润血，作为佐药；大黄酒制以荡涤败血，作为使药。
当归导气散，治疗损伤瘀血导致大便不通、红肿暗青、疼痛昏闷、蓄血内壅欲死的情况：
大黄（一两）、当归（三钱）、麝香（少许）。
以上三味药，除麝香单独研磨外，其余研为极细末，加入麝香混合均匀。每次服用三钱，用热酒一盏调服，饭前服用。若体内瘀血排出，或者骨节损伤骨折疼痛，可用接骨紫金丹治疗。
《三因极一病证方论》鸡鸣散，治疗从高坠落及被木石压迫，凡是损伤导致瘀血凝滞、疼痛欲死的情况，兼以此药推陈致新，效果神奇：
大黄（一两，酒浸）、杏仁（三七粒，去皮尖）。
以上两味药研细，用一碗酒煎至六分，去渣，在鸡鸣时（清晨）服用。到晚上排出瘀血即愈。如果突然感觉气绝，来不及取药，急忙掰开嘴巴，用热小便灌入。
按语：以上四个方子虽然都是荡涤驱逐恶血的药物，但前三方是用来治疗血在肝经血分的病症，后一方是用来治疗血在肺经气分的病症。应当通过脉象的浮沉表里来辨别。另外，海藏（张元素）说：如果是登高坠落、撞打以及伤及心腹胸中积血不散，应根据上、中、下三焦的部位分别处理，使用易老（李东垣）犀角地黄汤、桃仁承气汤、抵当汤丸之类攻下。也有用小便同煎治疗的，更有加入生地黄、当归煎服的，也有加大黄的。只有明智的人才能选择使用。
The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) formula for treating horse falls and all kinds of bone and tendon injuries:
Da Huang (Rhei Radix et Rhizoma, 1 liang, sliced and soaked, decocted in water for oral administration), Fei Bo (Crimson silk, size of a palm, burnt to ash), Luan Fa (Tangle hair, size of an egg, burnt to ash), Chuan Dan Bu (Cooking cloth, 1 chi long, burnt to ash), Bai Pu (Decayed cattail, one bunch, 3 cun long), Tao Ren (Persicae Semen, 49 kernels, peeled skin and removed bitter apricot kernel, stir-fried), Gan Cao (Glycyrrhizae Radix et Rhizoma, size of a middle finger joint, honey-fried and chopped).
Take the above seven ingredients, add Tong Zi Xiao Bian (Child's urine) according to the severity of the condition, decoct into a soup, add one large cup of Jiu (Alcohol/Wine), then add Da Huang. Strain the dregs, divide into three doses, take warm. First, chop half a mat made of decaying cattail, decoct in water, and use the steam or liquid to bathe/wash the injured area. After a short while, if bowel movements become smooth several times, the pain will immediately subside.
Invention of Fu Yuan Huo Xue Tang (Revitalize Blood Decoction), treating severe pain in the hypochondrium caused by blood stasis (E Xue, evil blood) remaining after falling from a height:
Chai Hu (Bupleuri Radix, 5 qian), Dang Gui (Angelicae Sinensis Radix, 6 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 qian), Chuan Shan Jia (Manis Squama, processed, 2 qian), Da Huang (Rhei Radix et Rhizoma, soaked in wine, 1 liang), Tao Ren (Persicae Semen, 50 kernels, peeled and bitter kernel removed), Hong Hua (Carthami Flos), Gua Lou Gen (Trichosanthis Radix, each 2 qian).
Grind the Tao Ren until paste-like. Chop the remaining herbs to the size of hemp seeds. Take 1 liang per dose, with 2.5 cups of Shui (Water) and 0.5 cup of Jiu (Alcohol/Wine). Decoct until reduced to 70%. Strain the dregs. Take warm before meals. The dosage is adequate when bowel movement is promoted.
If pain persists after bowel movement, take Ru Xiang Shen Ying San (Frankincense Divine Response Powder). The *Ling Shu* (Spiritual Pivot) states: "Trauma causing E Xue (evil blood) to stagnate in the hypochondrium damages the Gan Zang (Liver)." The Gan and Dan meridians traverse the hypochondrium, belonging to the Jue Yin and Shao Yang channels. It is appropriate to use Chai Hu as the guiding herb and sovereign drug; Dang Gui to invigorate blood vessels; Gan Cao to relieve urgency and pain ("urgency causes pain") and generate new blood ("Yang generation leads to Yin growth"), serving as the minister drug; Chuan Shan Jia, Gua Lou Gen, Tao Ren, and Hong Hua to break blood stasis and moisten blood, serving as the assistant drugs; Da Huang processed with wine to sweep away败血 (decayed blood), serving as the envoy drug.
Dang Gui Dao Qi San (Angelica Guiding Qi Powder), treating injury-induced blood stasis causing constipation, redness, swelling, dark cyan discoloration, painful dizziness, internal accumulation of blood stasis leading to near-death state:
Da Huang (Rhei Radix et Rhizoma, 1 liang), Dang Gui (Angelicae Sinensis Radix, 3 qian), She Xiang (Moschus, a small amount).
Pulverize the three ingredients into an extremely fine powder, except for She Xiang which is ground separately. Mix thoroughly. Take 3 qian per dose, mixed with one cup of hot Jiu (Alcohol/Wine). Take before meals. If internal blood stasis is expelled, or for bone/joint fractures and pain, treat with Jie Gu Zi Jin Dan (Bone-Setting Purple Gold Pill).
San Yin Ji Yi Bing Zheng Fang Lun (Categories of Causes and Manifestations of Diseases) Ji Ming San (Rooster-Crow Decoction), treating falls from heights or crushing by wood/stone, where any injury causes blood stasis stagnation and excruciating pain nearing death. This medicine pushes out the old and generates the new with miraculous effect:
Da Huang (Rhei Radix et Rhizoma, 1 liang, soaked in wine), Xing Ren (Armeniacae Semen Amarum, 27-33 kernels, peeled and bitter kernel removed).
Grind finely. Decoct in one bowl of Jiu (Alcohol/Wine) until reduced to 60%. Strain. Take at Ji Ming time (early morning, around 3-5 AM). By evening, if E Xue (blood stasis) is discharged, recovery occurs. If sudden Qi Jue (collapse of vital energy/unconsciousness) occurs and there is no time to prepare the medicine, forcibly open the mouth and灌 (pour/inject) hot Xiao Bian (urine).
Commentary: Although the above four formulas are all medicines that sweep away and expel E Xue (evil blood/blood stasis), the first three treat blood stasis in the Gan Jing (Liver Meridian) and Xue Fen (Blood Level), while the latter treats blood stasis in the Fei Jing (Lung Meridian) and Qi Fen (Qi Level). One must distinguish them by pulse characteristics (floating/sinking, superficial/deep). Furthermore, Hai Zang (Zhang Yuansu) stated: For falls from heights, blows, and accumulated blood in the heart, abdomen, and chest that does not dissipate, one should differentiate by the Upper, Middle, and Lower Jiao (Triple Burner) regions and use formulas such as Xi Jiao Di Huang Tang (Rhino Horn and Rehmannia Decoction), Tao Ren Cheng Qi Tang (Persicae Seed and Magnolia Bark Decoction), or Di Dang Tang/Wan (Di Dang Decoction/Pill) to purge. Some are decocted with Xiao Bian (urine); some include Sheng Di Huang (Rehmanniae Radix) and Dang Gui (Angelicae Sinensis Radix); some add Da Huang (Rhei Radix et Rhizoma). Only the wise can choose appropriately.