凡夹缚,夏二日、冬四五日解开,用温水洗去旧药,洗时不可惊动伤处,仍用黑龙散敷
平处骨碎皮不破,可用黑龙散贴敷夹缚,若曲折处其势不可夹缚,恐愈后不能伸曲,可用黑
龙散敷贴以便曲伸。凡跌破以末药敷口,又用伞纸包好,再用杉木皮缚定。凡夹缚,用杉木
皮如指阔,四边排匀,方用绳扎紧三五道,宜粗。如缚指须用苎麻,若杉木皮用尿浸过方用
凡脚膝盖骨乃另生者,如跌碎或跌出者,当用物做成一箍,如盖骨大盖在上面,以长带
缚定,外用护膝,又缚如日去之。
凡重伤必用药水洗过敷药,轻者不洗亦可。凡腹破肠出者,医得其法,一日不死,医者
麻油搽手,然后送肠纳入。倘若肠出外风吹而肠胀干不入,即将麻油搽肠滋润,又用一人托
住其肠,再用一人暗含冷水一口,当面一喷,其人必惊,而托肠之人要乘势将肠一推推入,
自然收好,即捻定伤口,用银丝或丝线缝口。先用止血散,后贴收口膏药,少顷腹内作响乃
肠复位。肠虽归复内中,伤否目力难知,即取火酒一小杯,令患者饮之,使人嗅其伤处,若
闻火酒气味,其伤不可治矣。线缝时不可露一毫针,孔如稍露亦不可治,慎之,凡头颅骨破
碎,虽白浆流出,不在太阳穴边可治,用上部末药倍加黄荆子,或有孔血出不止,先用血见
愁杵烂搽上,日换二次,孔小贴膏药,孔大则搽三日见红色,见红色加收口药,加在膏药上
贴之。
凡出血用桃花散,不止可用三七塞之,另围桃花散。凡骨碎筋断皮破,破处俱用桃花散
涂四边,缝好以黑龙散敷之。
凡打后作痛,宜用大黄五钱,桃仁三钱,杏仁三钱,归尾一钱,甘草梢五钱,酒煎空心
服。凡大小便不通,用通理汤或川芎苏木汤。
凡是进行夹板固定,夏季两天、冬季四五天之后解开,用温水洗去旧药。清洗时不可惊动受伤部位,仍然使用黑龙散敷贴。
如果是平坦处骨头碎裂但皮肤未破,可以使用黑龙散贴敷并加以夹板固定;如果是关节弯曲处,因势态无法夹板固定,恐怕愈合后不能屈伸,可用黑龙散敷贴以便于屈伸活动。
凡是皮肉破损出血的伤口,将药末敷在创口上,再用伞纸包裹好,最后用杉木皮绑扎固定。
凡是进行夹板固定,使用宽度如手指宽的杉木皮,四周排列均匀,然后用绳子紧紧扎住三到五道,宜粗。如果绑扎手指必须用苎麻,如果使用杉木皮则需用尿液浸泡过后再使用。
凡是脚膝盖骨,因为是另生的骨骼,如果跌碎或脱出,应当用物品做成一个箍,大小如同髌骨盖在上面,用长带绑扎固定,外用护膝,再像前一天那样处理。
凡是腹部破裂肠子流出的情况,医生掌握正确方法,一天之内不会死亡。医生先用麻油涂抹双手,然后将肠子送回体内。倘若肠子流出体外被风吹干膨胀无法纳入,就用麻油涂抹肠子使其滋润,又让一人托住肠子,另一人口含一口冷水,当面喷向患者,患者必定受惊,而托肠之人要趁势将肠子推入,自然就能收好,随即捏合伤口,用银丝或丝线缝合伤口。先使用止血散,然后贴上收口膏药,过了一会儿腹内发出声响,说明肠子已复位。肠子虽然回归体内,但是否受损肉眼难以判断,就取一小杯火酒,让患者饮用,让人嗅闻其受伤部位,如果闻到火酒的气味,说明伤势不可治愈。
凡是头颅骨破碎,虽然有白浆流出,只要不在太阳穴旁边就可以治疗,使用上部药末加倍加入黄荆子。如果有孔洞出血不止,先用血见愁捣烂涂在上面,每天更换两次,孔小则贴膏药,孔大则涂抹三天直到出现红色,见到红色后加上收口药,加在膏药上贴敷。
凡是出血,使用桃花散,如果不止血可用三七堵塞,周围再围上桃花散。
凡是骨头碎裂、筋断、皮破,破损处都用桃花散涂抹四边,缝好后以黑龙散敷之。
For all splinting (splint fixation), remove the splints after two days in summer and four to five days in winter. Wash off the old medicine with warm water. During washing, do not disturb the injured area. Continue to apply Heilong San (Black Dragon Powder) for dressing.
If the bone is fractured on a flat surface but the skin is intact, Heilong San (Black Dragon Powder) can be applied and splinted. If the injury is at a joint or curved area where splinting is impossible due to the position, fearing that flexion and extension will be impaired after healing, apply Heilong San (Black Dragon Powder) for dressing to facilitate movement.
For any wound with broken skin and bleeding, apply the powdered medicine directly into the wound, wrap it well with umbrella paper (a type of protective paper), and then bind it firmly with fir bark.
For all splinting, use fir bark strips as wide as a finger, arrange them evenly around the limb, and then tie them tightly with rope for three to five turns; the rope should be thick. For binding fingers, ramie fiber must be used. If fir bark is used, it must be soaked in urine before application.
The patella (kneecap) is an independent bone. If it is crushed or dislocated by a fall, make a ring-like support from suitable material, sized to cover the patella, secure it with long straps, apply a knee protector externally, and bandage as previously described.
For severe injuries, wash the area with medicinal water before applying medicine; for minor injuries, washing may be omitted.
In cases of abdominal rupture with evisceration (protrusion of intestines), if the physician follows the correct method, death can be avoided within one day. The physician should first rub hands with sesame oil, then gently return the intestines into the abdominal cavity. If the protruded intestines have dried and swollen due to wind exposure and cannot be inserted, apply sesame oil to moisten the intestines. Have one person support the intestines while another person secretly holds a mouthful of cold water and suddenly sprays it onto the patient's face. The patient will startle, and the person supporting the intestines should take advantage of this moment to push the intestines back in, allowing them to settle naturally. Immediately pinch the wound edges together and suture using silver wire or silk thread. First apply Zhixue San (Stop Bleeding Powder), then paste a wound-healing plaster. After a short while, if bowel sounds are heard internally, it indicates the intestines have returned to their proper position. Although the intestines have returned inside, it is difficult to determine internal damage visually. Take a small cup of liquor (huojiu), have the patient drink it, and then smell the injured area. If the smell of liquor is detected coming from the wound, the injury is incurable.
During suturing, ensure no needle holes are exposed; even slightly exposed holes render the injury incurable. Exercise extreme caution.
For skull fractures with leakage of white fluid, treatment is possible provided the injury is not near the temporal region (Taiyang acupoint). Use upper-body powdered medicine with added Huangjingzi (Celtis sinensis seeds). If there is a hole with unceasing bleeding, first pound Xuejianchou (Ageratum conyzoides) into a paste and apply it, changing twice daily. For small holes, apply a plaster; for large holes, apply for three days until redness appears. Once redness appears, add wound-healing medicine to the plaster and apply.
For bleeding, use Taohua San (Peach Blossom Powder). If bleeding does not stop, pack the wound with Sanqi (Notoginseng Radix) and surround it with Taohua San.
For fractures, tendon ruptures, and broken skin, apply Taohua San (Peach Blossom Powder) to the edges of the wound. After suturing, apply Heilong San (Black Dragon Powder).
For pain after trauma, decoct Dahuang (Rhubarb Root and Rhizome) 5 qian, Taoren (Peach Seed) 3 qian, Xingren (Apricot Seed) 3 qian, Guiwei (Angelica Sinensis Tail) 1 qian, and Gancao Shao (Licorice Tip) 5 qian in wine. Take on an empty stomach.
For constipation (obstruction of both urination and defecation), use Tongli Tang (Unblocking Decoction) or Chuanxiong Sumu Tang (Ligusticum and Sappanwood Decoction).