（附瘀血肿痛，筋伤壅肿。）
一妇人患臂腕肿大，已三月，手臂日细，肌瘦恶寒，食少短气，脉息细微，属形病俱虚也。遂投
补中益气加肉桂，引诸药以行至臂，再加贝母、香附以解久病之郁，间服和血定痛丸，以葱熨之，肿
消二三。因怒，患处仍胀，胸膈两胁微痛，以前汤更加木香、山栀、半夏、桔梗，服之少可。复因惊
不寐，少食盗汗，以归
脾汤加五味、麦冬，二十余剂而安。肿消三四，手臂渐肥，但经水过期而少，此心脾之血，尚未充足
而然也，乃用八珍加五味、麦冬、丹皮、远志、香附、贝母、桔梗，四十余剂，诸症悉愈。后因怒，
发热谵语，经水如涌，此怒动肝火，以小柴胡汤加生地二钱，一剂遂止。以四物加柴胡，调理而康。
州守陈克明子，闪右臂，腕肿痛，肉色不变，久服流气等药，加寒热少食，舌干作渴。曰∶伤损
等症，肿不消，色不变，此气虚而不能愈，当助脾胃，壮气血为主。如法治之，不二月，形气渐充，
肿渐消。半载，诸症悉退，体臂如常。
一小儿闪腿，腕壅肿，形气怯弱，欲治以补气血为主，佐以行散之剂。不信，乃内服流气饮，外
敷寒凉药，加寒热体倦。曰∶发寒热，脉息洪大，气血虚极也，治之无功。后肉溃，沥尽气血而亡。
一男子闪伤右腿，壅肿作痛，谓急砭去滞血，以补元气，庶无后患。不信，乃外敷大黄等药，内
服流气饮，后涌出秽脓碗许，其脓不止，乃复请治。视其腿细而脉大，作渴发热，辞不治，后果殁。
窗友王汝道，环跳穴处闪伤，瘀血肿痛，发热作渴，遂砭去瘀血。知其下焦素有虚火，用八珍加
知、柏、牛膝、骨碎补，四剂顿止。用十全大补，少加知、柏、麦冬、五味，三十余剂而愈。
李考功子十四岁，脚碗闪伤，肿而色夭，日出青脓少许，肝脉微涩，此肝经受伤，气血虚而不能
溃，难消之症，急止克伐之剂。不信，乃杂用流气等药，后果筋烂而死。（雄按∶此名蹬筋毒，溃后
最难收功。初起宜以烧酒于患处蘸拍数百下，后以韭菜杵烂罨之，日日如此，以散为度，甚效，且简
易也。若经外科，每致不救。）
（附注：瘀血导致的肿痛，以及筋脉损伤引起的肿胀。）
一位妇女患手臂和手腕肿大，病程已有三个月，手臂日渐变细，肌肉消瘦，怕冷，食欲减退，气短，脉搏细微，属于形体与病证俱虚的情况。于是投用补中益气汤加入肉桂，引导诸药到达手臂部位，再加入贝母、香附以解除久病产生的郁结，间歇服用和血定痛丸，并用葱白熨烫患处，肿胀消退了二三分。因为发怒，患处再次胀满，胸膈及两胁轻微疼痛，以前方剂为基础更加入木香、山栀、半夏、桔梗，服用后症状稍有好转。又因受惊导致失眠，食少盗汗，使用归脾汤加入五味子、麦冬，二十多剂后病情安定。肿胀消退了三四分，手臂逐渐丰满，但月经过期且量少，这是心脾之血尚未充足所致，于是使用八珍汤加入五味子、麦冬、丹皮、远志、香附、贝母、桔梗，四十多剂后，所有症状全部痊愈。后来因为发怒，出现发热、胡言乱语，月经量如涌出般多，这是愤怒引动肝火所致，用小柴胡汤加入二钱生地黄，一剂后出血即止。再用四物汤加入柴胡进行调理而康复。
州守陈克明的儿子，右臂扭伤，手腕肿痛，皮肤颜色没有改变，长期服用流气等药物，导致出现寒热往来、食欲减退、舌干口渴的症状。医生认为：损伤类病症，如果肿胀不消、颜色不变，这是气虚不能愈合，应当以扶助脾胃、壮大气血为主。按照这种方法治疗，不到两个月，形体和气机逐渐充盈，肿胀逐渐消退。半年后，所有症状全部退去，身体和手臂恢复正常。
一个小孩腿部扭伤，手腕处壅肿，形体和气机怯弱，想要以补益气血为主进行治疗，辅以行气散结的药物。家属不信，反而内服流气饮，外敷寒凉药物，导致出现寒热、身体疲倦的症状。医生认为：出现寒热，脉搏洪大，是气血极度虚弱，治疗难以奏效。后来肌肉溃烂，气血耗尽而死。
一个男子右腿扭伤，壅肿疼痛，医生建议立即用砭石刺破排出滞血，然后补益元气，这样才不会有后患。家属不信，反而外敷大黄等药物，内服流气饮，后来涌出约一碗的污秽脓液，脓液不止，于是再次请求治疗。医生查看其腿部肌肉萎缩而脉搏盛大，伴有口渴发热，推辞不治，后果然死亡。
窗友王汝道，环跳穴处扭伤，瘀血肿痛，发热口渴，于是用砭石去除瘀血。考虑到他下焦素有虚火，使用八珍汤加入知母、黄柏、牛膝、骨碎补，四剂后症状立刻停止。再用十全大补汤，少量加入知母、黄柏、麦冬、五味子，三十多剂后痊愈。
李考功的儿子十四岁，脚踝扭伤，肿胀且肤色晦暗，日出时流出少许青色脓液，肝脉微涩，这是肝经受伤，气血虚弱不能化脓溃破，属于难治之症，应立即停止使用攻伐类药物。家属不信，反而杂用流气等药物，后果筋烂而死。（徐灵胎按语：这称为蹬筋毒，溃破后最难收功。初起时宜用烧酒在患处蘸拍数百下，然后用韭菜捣烂敷盖，每天如此，以消散为度，效果很好，而且简单容易。如果交给外科医生处理，往往导致无法救治。）
(Note: Swelling and pain caused by blood stasis, and swelling caused by tendon injury.)
A woman suffered from swelling of the arm and wrist for three months. Her arm became progressively thinner, with emaciated muscles, aversion to cold, poor appetite, shortness of breath, and a fine and minute pulse. This was diagnosed as deficiency in both form (body constitution) and disease. Therefore, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was administered with added Rougui (Cinnamon Bark), to guide the herbs to the arm. Beimu (Fritillaria Bulb) and Xiangfu (Cyperus Rhizome) were added to resolve the stagnation from chronic illness. HeXue Dingtong Wan (Blood-Regulating and Pain-Relieving Pill) was taken intermittently, and the affected area was moxibustion-warmed with scallions. The swelling subsided by two or three parts. Due to anger, the affected area swelled again, with mild pain in the chest, diaphragm, and hypochondrium. The previous prescription was modified by adding Muxiang (Aucklandia Root), Shanzhi (Gardenia Fruit), Banxia (Pinellia Tuber), and Jiegeng (Platycodon Root). After taking it, symptoms improved slightly. Subsequently, due to fright causing insomnia, poor appetite, and night sweats, Guipi Tang (Restore the Spleen Decoction) was administered with added Wuweizi (Schisandra Berry) and Maidong (Ophiopogon Tuber). After more than twenty doses, she stabilized. The swelling subsided by three or four parts, and her arm gradually regained flesh. However, her menstruation was delayed and scanty, indicating that the blood of the Heart and Spleen was still insufficient. Thus, Bazhen Tang (Eight-Treasure Decoction) was used with added Wuweizi, Maidong, Danpi (Moutan Cortex), Yuanzhi (Polygala Root), Xiangfu, Beimu, and Jiegeng. After more than forty doses, all symptoms resolved. Later, due to anger, she experienced fever and delirium, with profuse menstrual bleeding. This was attributed to anger stirring Liver Fire. Xiaochaihu Tang (Minor Bupleurum Decoction) was administered with added 2 qian of Shengdi Huang (Rehmannia Root). The bleeding stopped after one dose. Siwu Tang (Four-Substance Decoction) with Chaihu (Bupleurum Root) was then used for regulation, leading to recovery.
The son of Prefect Chen Keming sprained his right arm, resulting in wrist swelling and pain, with unchanged skin color. Having long taken Liqi-type medicines, he developed alternating chills and fever, poor appetite, dry tongue, and thirst. It was stated: In trauma cases, if swelling does not subside and color remains unchanged, it is due to Qi deficiency preventing healing. Treatment should focus on strengthening the Spleen and Stomach and augmenting Qi and Blood. Following this method, within less than two months, his physical condition and Qi gradually filled out, and swelling subsided. After half a year, all symptoms disappeared, and his body and arm returned to normal.
A child sprained his leg, resulting in wrist swelling, with weak physical constitution and Qi. The intention was to treat primarily by tonifying Qi and Blood, assisted by agents promoting circulation and dispersion. The family did not believe this, instead administering Liqi Yin (Flowing Qi Drink) internally and applying cold-natured herbs externally. This led to chills, fever, and fatigue. It was stated: Chills and fever with a flooding pulse indicate extreme deficiency of Qi and Blood; treatment will be ineffective. Later, the flesh ulcerated, and upon exhaustion of Qi and Blood, he died.
A man sprained his right leg, resulting in swelling and pain. It was advised to immediately use bian stone (stone needle) therapy to drain stagnant blood, followed by tonifying Original Qi to prevent future complications. The family did not believe this, instead applying Dahuang (Rhubarb Root) externally and taking Liqi Yin internally. Later, about a bowl of foul pus gushed out, continuing incessantly. They sought treatment again. Examination revealed a thin leg with a large pulse, accompanied by thirst and fever. The physician declined treatment, and the patient subsequently died.
Wang Ruda, a friend from the window seat, sprained the Huantiao (GB30) acupoint area, suffering from blood stasis, swelling, pain, fever, and thirst. Bian stone therapy was used to remove the blood stasis. Knowing he had latent deficient fire in the Lower Jiao, Bazhen Tang was administered with Zhimu (Anemarrhena Rhizome), Huangbai (Phellodendron Bark), Niuxi (Achyranthes Root), and Gusuibu (Drynaria Rhizome). Symptoms ceased abruptly after four doses. Shiquan Dabu Tang (Complete Great Tonifying Decoction) with small amounts of Zhimu, Huangbai, Maidong, and Wuweizi was then used. After more than thirty doses, he recovered.
The son of Vice Minister Li, aged fourteen, sprained his ankle. There was swelling with dull complexion, and a small amount of greenish pus exuded at sunrise. The Liver pulse was slightly choppy. This indicated injury to the Liver Meridian, where Qi and Blood deficiency prevented suppuration and resolution, making it a difficult-to-treat condition. Aggressive draining and purging agents should have been stopped immediately. The family did not believe this, instead using various Liqi-type medicines. Consequently, the tendons rotted, and he died. (Xu Lingtai’s note: This is called Dengjin Du (Tendon-Kicking Poison). After ulceration, it is extremely difficult to achieve healing. At the onset, it is advisable to dip burning wine into the affected area and pat hundreds of times, then apply mashed leek leaves as a compress, daily until resolution. This is very effective, simple, and easy. If treated by surgeons, it often leads to untreatable conditions.)