破伤风方论，已载杂病第五，此其似是而非者尔。
〔薛〕 大凡痈疽溃后筋縻肉烂，脓血大泄，阳随阴散，或筋脉拘急，恶寒惕搐，甚
者舌强口噤，项背反张，痰涎壅盛，便闭汗出，不时发热，此气血俱虚而传变。虽与破
伤风相类，而主治之法当大补气血。若果系风症，亦须以大补气血为本，而兼以治风之
药。设若不审是非而妄药之，则误矣。 司徒边华泉，肩患痈，溃而发热，目直或 ，殊
类中风，日晡热甚，脉益数，此足三阴气血亏损，虚火妄动。用参、 、归、术、炙草，
加酒炒黑黄柏、五味、麦门、肉桂，四剂而愈，又数剂而敛。 陆大行，背疮内溃，出
脓二碗许，用托里之剂痛止肿消，停药忽寒热作渴，头痛自汗，此元气虚而未能复也。用
十全大补加麦门、五味、肉桂二剂，益甚。诊其脉如故，此药力未及，仍用前药加附子一
钱，三剂诸症悉愈，乃去附子，加肉桂，数剂而敛。 一儒者患腿痈，深蓄于内，肉色
不变，久不穿溃，针出脓瘀五碗许，恶症骈臻，全类中风，此脾胃虚而变症也。用六君
子加当归、炮姜，及圣愈汤各四剂而安；又劳心不寐，用归脾汤而愈。 一儒者，伤寒
后患流注，肿痛潮热，用十宣散，败毒等剂，出稀脓五六碗许，发热、恶寒、烦躁、作渴，
殊类破伤风症而殁。 一男子背疮未痊，敛以膏药，剪孔贴之。患破伤风症而殁。此先
失于内补，外邪袭其虚耳。予见了此症，贴膏药剪孔，欲其通气而反患破作风；搽敛药
生肌，欲其收口而反助其余毒，以致殁者多矣，可不慎哉。
破伤风的方剂论述，已经记载在杂病第五卷中，这里讲述的是那些看似相似实则不同的情况。
〔薛己〕大凡痈疽溃烂之后，筋脉松弛、肌肉腐烂，脓血大量流失，阳气随着阴液耗散。或者出现筋脉拘挛紧急、怕冷、惊恐抽搐，严重的出现舌体僵硬、牙关紧闭、项背强直反张、痰涎壅盛、大便闭塞、出汗、不时发热，这是气血都虚弱导致的传变。虽然与破伤风症状相似，但主治方法应当以大补气血为主。如果确实是风邪致病，也必须以大补气血为根本，同时兼用治风的药物。假使不审察是非而胡乱用药，那就错了。
司徒边华泉，肩膀患痈，溃烂后发热，眼睛直视或斜视，非常像中风，下午申时（日晡）发热严重，脉搏更加数急，这是足三阴经气血亏损，虚火妄动。用人参、[此处原文缺字，据上下文推测可能为黄芪或类似补气药，但依规则不增添，故略过或视为缺失]、当归、白术、炙甘草，加上酒炒黑黄柏、五味子、麦门冬、肉桂，服用四剂痊愈，又服几剂伤口收敛。
陆大行，背部疮疡内溃，流出脓液约两碗，使用托里透脓的药剂后疼痛停止、肿胀消退，停药后忽然寒热发作、口渴、头痛、自汗，这是元气虚弱而不能恢复。使用十全大补汤加麦门冬、五味子、肉桂，服用两剂，病情反而加重。诊察他的脉搏如故，这是药力未达到病所，仍然用前面的药方加入一钱附子，服用三剂各种症状全部痊愈，然后去掉附子，加入肉桂，服用几剂伤口收敛。
一位儒生患腿部痈肿，深蓄于体内，皮肤颜色不变，长久不穿溃，针刺放出脓瘀血约五碗，恶症接踵而至，完全像中风，这是脾胃虚弱而发生的变症。使用六君子汤加当归、炮姜，以及圣愈汤各服用四剂而安定；后来又因劳心失眠，使用归脾汤而痊愈。
一位儒生，伤寒后患流注（一种漫无定处的脓肿），肿痛潮热，使用十宣散、败毒散等药剂，排出稀脓五六碗左右，出现发热、恶寒、烦躁、口渴，非常像破伤风症状而死亡。
一名男子背部疮疡未痊愈，用膏药覆盖，剪开孔洞贴敷。结果患上破伤风症状而死亡。这是先前失于内补正气，外邪乘虚侵袭所致。我见过这类病症，贴膏药剪孔，本想使其通气却反而患破伤风；搽抹生肌敛疮的药物，本想使其收口却反而助长余毒，导致死亡的很多，能不谨慎吗？
The discussion on formulas for treating tetanus (Pòshāngfēng) has already been recorded in Volume 5 of Miscellaneous Diseases; this section describes cases that appear similar but are fundamentally different.
[Xue Ji] Generally, after the ulceration of carbuncles and sores (Yongju), the sinews become lax and the flesh rots, with a massive discharge of pus and blood. Yang Qi dissipates along with the loss of Yin fluids. This may present as spasms and stiffness of the sinews and vessels, aversion to cold, and fearful tremors or convulsions. In severe cases, it manifests as a stiff tongue, locked jaw, opisthotonos (hyperextension of the neck and back), excessive phlegm and saliva, constipation, sweating, and intermittent fever. These are transformations resulting from deficiency of both Qi and Blood. Although these symptoms resemble tetanus, the primary treatment method should be to greatly tonify Qi and Blood. If it is indeed a wind-pathogen condition, one must still take tonifying Qi and Blood as the root, while simultaneously using herbs that treat wind. If one fails to discern the truth and falsehood and prescribes medication recklessly, it will be an error.
Bian Huaquan, a Grand Secretary, suffered from a carbuncle on his shoulder. After it ulcerated, he developed fever, fixed gaze, or strabismus, closely resembling stroke (Zhongfeng). His fever was severe during the Shen hour (3-5 PM), and his pulse became increasingly rapid. This indicated a deficiency of Qi and Blood in the three Yin meridians of the foot, with deficient fire moving recklessly. He was treated with Ginseng Radix (Renshen), [missing character in source], Angelicae Sinensis Radix (Danggui), Atractylodis Macrocephalae Rhizoma (Baizhu), and Glycyrrhizae Radix et Rhizoma Preparata (Zhi Cao), added with alcohol-fried and charred Phellodendri Cortex (Huangbai), Schisandrae Fructus (Wuweizi), Ophiopogonis Radix (Maimendong), and Cinnamomi Ramulus (Rougui). After four doses, he recovered; after several more doses, the wound healed.
Lu Daxing suffered from an internal ulceration of a back sore, discharging approximately two bowls of pus. After using a formula to support the interior and expel toxins, the pain stopped and swelling subsided. Upon stopping the medication, chills, fever, thirst, headache, and spontaneous sweating suddenly appeared. This indicated that Yuan Qi (Original Qi) was deficient and unable to recover. He was treated with Shiquan Dabu Decoction (Ten Significant Tonification Decoction) added with Ophiopogonis Radix (Maimendong), Schisandrae Fructus (Wuweizi), and Cinnamomi Ramulus (Rougui). After two doses, his condition worsened. Palpating his pulse remained unchanged; this indicated the medicinal force had not yet reached the disease site. The previous prescription was used again with one qian of Aconiti Lateralis Radix Praeparata (Fuzi) added. After three doses, all symptoms resolved. Fuzi was then removed, and Cinnamomi Ramulus (Rougui) was added. After several doses, the wound healed.
A scholar suffered from a leg carbuncle, which accumulated deeply internally without changing the skin color, failing to ulcerate for a long time. Needling released approximately five bowls of pus and blood stasis. Malignant symptoms followed closely, completely resembling stroke. This was a transformation due to Spleen and Stomach deficiency. He was treated with Liujunzi Decoction (Six Gentlemen Decoction) added with Angelicae Sinensis Radix (Danggui) and Zingiberis Rhizoma Preparatum (Paojiang), as well as Shengyu Decoction (Holy to Save Life Decoction), each for four doses, leading to stabilization. Later, due to mental exertion and insomnia, he was treated with Guipi Decoction (Restore the Spleen Decoction) and recovered.
Another scholar, after suffering from Cold Damage (Shanghan), developed liuzhu (a type of wandering abscess), presenting with swelling, pain, and tidal fever. He was treated with Shixuan San (Ten Acupoints Powder) and Baidu San (Defeat Toxin Powder) and other formulas, discharging about five to six bowls of thin pus. He subsequently developed fever, aversion to cold, irritability, and thirst. His condition closely resembled tetanus, and he died.
A man’s back sore had not fully healed. It was covered with a plaster, with a hole cut out for application. He subsequently contracted tetanus and died. This was because internal tonification was neglected initially, allowing external pathogens to attack the deficiency. I have seen such cases where cutting holes in plasters was intended to allow ventilation but instead led to tetanus; applying healing ointments intended to close the wound instead aided the residual toxin, leading to death in many instances. Can one not be cautious?