地龙散 治腰脊痛，或打扑损伤，从高坠下，留在太阳经中，令人腰脊或胫、 、臂、
腰中，痛不可忍。
地龙 官桂 苏木（各九分） 麻黄（七分） 黄柏 当归梢 甘草（各一钱半） 桃仁（九个）
上作一服。水二盅，煎至一盅，食前服。
戴复庵云∶癫扑伤疼，酒调琥珀散极佳。再有乌药顺气散，用以治之风腰疼尤宜。有
扑人，服药并熏洗、搽贴药皆不效自若，或教以用白芍药、赤芍药、威灵仙、乳香、没
药等分，为末。和匀酒调服，随即痛减其半。
或大便不通，按之痛甚，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。若腹痛按之不痛，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、芎、归补之。既下而发热，阴血伤
也，用四物、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，气血俱伤也，用八珍汤补之。既下而欲呕，胃气伤也，用六君、当归补之。既下而
泄泻，脾肾伤也，用六君，肉果、破故纸补之。若下后手足俱冷，昏愦出汗，阳气虚寒
也，急用参附汤。吐泻，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，虚极之坏症也，急投大剂参附汤，多有得生者。
有一患者，杖后，服四物，红花、桃仁、大黄等剂以逐瘀血，腹反痛，更服一剂，痛益
甚，按其腹不痛。薛曰∶此血虚也，故喜按而不痛，宜温补之剂，遂以归身、白术、参
、炙草，二剂痛即止。 有一患者，仲秋夜归坠马，腹内作痛，饮酒数杯，翌早大便
自下瘀血，即安。此元气充实，挟酒热而行散也。一男子，跌伤腹痛，作渴，食梨子二
枚益甚，大便不通，血欲逆上，用当归承气汤加桃仁，瘀血下而瘥。此因元气不足，瘀
血得寒而凝聚也。故产妇，金疮者，不宜食此。 一男子，孟秋坠梯，腹停瘀血，用大
黄等药，其血不下，反加胸膈胀痛，喘促短气。薛用肉桂，木香末各二钱，热酒调服，即
下黑血及前所服之药而苏。此因寒药凝滞而不行，故用辛温之剂散之。 陈侍御坠马腿
痛作呕，服下药一剂，胸腹胀痛，按之即止，惟倦怠少气。诊其脉微细而涩，予曰∶非瘀
血也，乃痛伤气血，复因药损脾气而然耳，投养脾胃，生气血之药而愈。
加味承气汤 治瘀血内停，胸腹胀痛，或大便不通等证。
大黄、朴硝（各二钱） 枳实 浓朴 当归 红花（各一钱） 甘草（五分）
用酒水各一盅，煎至一盅服。仍量虚实加减，病急不用甘草。
〔垣〕定痛乳香神应散 治从高坠下，疼痛不可忍，腹中疼痛。
乳香 没经 雄黑豆 桑白皮 独科栗子 当归（各一两） 破故纸（炒，二两） 水蛭（半两）
上为末。每服五钱，醋一盏，砂石器内煎至六分，入麝香少许，温服。
地龙散：治疗腰脊疼痛，或因跌打损伤，从高处坠落，瘀血滞留于太阳经中，导致腰部、脊柱或小腿、手臂、腰部中间部位疼痛剧烈，难以忍受。
药材：地龙、官桂、苏木（各九分）、麻黄（七分）、黄柏、当归梢、甘草（各一钱半）、桃仁（九个）。
以上药材作为一剂服用。加水两盅，煎煮至一盅，饭前服用。
戴复庵说：跌打损伤引起的疼痛，用酒调服琥珀散效果极佳。还有乌药顺气散，用来治疗风邪引起的腰痛尤为适宜。曾有一例被殴打的人，服药以及熏洗、外敷药物均无效，疼痛依旧。有人建议用白芍药、赤芍药、威灵仙、乳香、没药等量，研成粉末。混合均匀后用酒调服，随即疼痛减轻一半。
如果大便不通，按压时疼痛加剧，这是瘀血在体内，使用加味承气汤攻下。攻下后疼痛仍不止，按压依然疼痛，说明瘀血未尽，使用加味四物汤补益并活血行滞。如果腹痛但按压不痛，这是气血受损，使用四物汤加入人参、[原文缺字，推测为茯苓或类似补气药]、白术进行补益调和。如果攻下后胸胁反而疼痛，这是肝血受损，使用四君子汤加入川芎、当归进行补益。攻下后出现发热，这是阴血受损，使用四物汤加入人参、白术进行补益。攻下后出现恶寒，这是阳气受损，使用十全大补汤进行补益。攻下后既恶寒又发热，这是气血俱损，使用八珍汤进行补益。攻下后想呕吐，这是胃气受损，使用六君子汤加入当归进行补益。攻下后出现泄泻，这是脾肾受损，使用六君子汤加入肉果、破故纸进行补益。如果攻下后手足冰冷，神志昏沉出汗，这是阳气虚寒，急需使用参附汤。如果吐泻且手足冰冷，指甲发青，这是脾肾虚寒至极，急需使用大剂量参附汤。如果出现牙关紧闭、手撒不开、遗尿、痰多、嘴唇发青、身体寒冷，这是极度虚弱的危重证候，急需投以大剂量参附汤，大多能存活。
有一位患者，受杖刑后，服用四物汤、红花、桃仁、大黄等药剂以驱逐瘀血，腹部反而疼痛，再服一剂，疼痛更加剧烈，但按压腹部却不痛。薛己说：这是血虚，所以喜欢按压而不痛，应当使用温补药剂，于是用当归身、白术、人参、炙甘草，两剂后疼痛即止。
有一位患者，仲秋之夜回家坠马，腹内作痛，饮酒数杯，第二天早上大便自行排出瘀血，随即安宁。这是因为元气充实，借助酒的热力使瘀血消散。
一名男子，跌伤后腹痛，口渴，吃两个梨子后症状加重，大便不通，血液欲逆上冲，使用当归承气汤加入桃仁，瘀血排出后痊愈。这是因为元气不足，瘀血因寒凉而凝聚。所以产妇和金创患者，不宜食用此类寒凉之物。
一名男子，孟秋时节从梯子上摔落，腹部停滞瘀血，使用大黄等药物，瘀血未下，反而增加胸膈胀痛，气喘短促。薛己用肉桂、木香末各二钱，热酒调服，随即排出黑血及之前所服的药，患者苏醒。这是因为寒凉药物凝滞导致气血不行，所以使用辛温药剂来发散。
陈侍御坠马后腿痛且呕吐，服用攻下药一剂后，胸腹胀痛，按压则痛止，唯独倦怠少气。诊察其脉象微细而涩，我说：这不是瘀血，而是疼痛损伤了气血，又因药物损伤脾气所致，投用调养脾胃、生气血的药剂而痊愈。
药材：大黄、朴硝（各二钱）、枳实、浓朴、当归、红花（各一钱）、甘草（五分）。
用水、酒各一盅，煎煮至一盅服用。仍需根据虚实情况加减，病情紧急时不用甘草。
〔李东垣〕定痛乳香神应散：治疗从高处坠落，疼痛剧烈难忍，腹中疼痛。
药材：乳香、没药、雄黑豆、桑白皮、独科栗子、当归（各一两）、破故纸（炒，二两）、水蛭（半两）。
以上研成粉末。每次服用五钱，醋一盏，在砂石器内煎至六分，加入少许麝香，温服。
Dilong San (Earthworm Powder): Treats pain in the waist and spine, or pain caused by falls and injuries. When falling from a height, blood stasis may remain in the Taiyang Meridian (Sun Yang Channel), causing unbearable pain in the waist, spine, calves, arms, or middle of the waist.
Ingredients: Earthworm (Di Long), Official Cinnamon Twig (Guan Gui), Sappanwood (Su Mu) (each 9 fen), Ephedra Herb (Ma Huang) (7 fen), Phellodendron Bark (Huang Bo), Radix Angelicae Sinensis Tip (Danggui Shao), Licorice Root (Gan Cao) (each 1 qian 5 fen), Peach Kernel (Tao Ren) (9 pieces).
Take as one dose. Add two cups of water, decoct to one cup, and take before meals.
Dai Fu'an stated: For pain due to falls and blows, taking Hupo San (Amber Powder) mixed with wine is excellent. Additionally, Wuyao Shunqi San (Aucklandia Decoction for Regulating Qi) is particularly suitable for treating wind-induced lower back pain. There was a case of a person beaten who found no relief from oral medications, fumigation, washing, or topical applications. Someone suggested using equal parts of White Peony Root (Baishao Yao), Red Peony Root (Chishao Yao), Spirit Flower Root (Weiling Xian), Frankincense (Ruxiang), and Myrrh (Moyao), grinding them into powder. Mixed evenly and taken with wine, the pain decreased by half immediately.
If there is constipation and severe pain upon palpation, this indicates internal blood stasis; use Jiawei Chengqi Tang (Modified Da Cheng Qi Decoction) to purge it. If pain persists after purging and remains tender to touch, the blood stasis is not yet exhausted; use Jiawei Siwu Tang (Modified Four Substances Decoction) to tonify and promote blood circulation. If abdominal pain is present but not painful upon palpation, this indicates injury to blood and qi; use Siwu Tang (Four Substances Decoction) added with Ginseng [text missing], Atractylodes Macrocephala Rhizome (Baizhu) to tonify and harmonize. If chest and hypochondriac pain appears after purging, this indicates injury to Liver Blood; use Sijunzi Tang (Four Gentlemen Decoction) added with Ligusticum Chuanxiong Rhizome (Xiong) and Angelica Sinensis (Gui) to tonify. If fever occurs after purging, this indicates injury to Yin Blood; use Siwu Tang added with Ginseng and Atractylodes Macrocephala Rhizome to tonify. If chills occur after purging, this indicates injury to Yang Qi; use Shiquan Dabu Tang (Ten Significant Tonifying Decoction) to tonify. If both chills and fever occur after purging, this indicates injury to both Qi and Blood; use Bazhen Tang (Eight Treasures Decoction) to tonify. If nausea follows purging, this indicates injury to Stomach Qi; use Liujunzi Tang (Six Gentlemen Decoction) added with Angelica Sinensis to tonify. If diarrhea follows purging, this indicates injury to Spleen and Kidney; use Liujunzi Tang added with Nutmeg (Rouguo) and Psoralea Fruit (Poguzhi) to tonify. If cold hands and feet, confusion, and sweating occur after purging, this indicates deficiency-cold of Yang Qi; urgently use Shenfu Tang (Ginseng and Aconite Decoction). If vomiting, diarrhea, cold extremities, and cyanotic fingernails occur, this indicates extreme deficiency-cold of Spleen and Kidney; urgently use a large dose of Shenfu Tang. If jaw stiffness, limp hands, urinary incontinence, profuse phlegm, cyanotic lips, and cold body occur, this is a critical condition of extreme deficiency; urgently administer a large dose of Shenfu Tang, with many patients surviving.
One patient, after receiving corporal punishment with a stick, took Siwu Tang, Safflower (Honghua), Peach Kernel, and Rhubarb to expel blood stasis, but abdominal pain worsened. After another dose, pain intensified, yet palpation of the abdomen revealed no tenderness. Xue Ji said: This is Blood Deficiency, hence the preference for pressure without pain. It should be treated with warming and tonifying agents. He prescribed Radix Angelicae Sinensis Body (Guishen), Atractylodes Macrocephala Rhizome, Ginseng, and Honey-fried Licorice. After two doses, the pain ceased.
Another patient fell from a horse on an autumn night, suffering abdominal pain. After drinking several cups of wine, he passed blood clots in his stool the next morning and felt relieved. This was because his Yuan Qi (Original Qi) was sufficient, and the heat of the wine helped dissipate the stasis.
A man suffered abdominal pain after a fall, accompanied by thirst. Eating two pears worsened the condition, leading to constipation and a sensation of blood rushing upward. He was treated with Danggui Chengqi Tang (Angelica Chengqi Decoction) added with Peach Kernel. After the expulsion of blood stasis, he recovered. This occurred because his Yuan Qi was insufficient, allowing the blood stasis to coagulate due to cold. Therefore, postpartum women and those with metal wounds should avoid such cold foods.
A man fell from a ladder in early autumn, resulting in abdominal blood stasis. Treatment with Rhubarb failed to move the blood and instead exacerbated chest and diaphragmatic distension, pain, and shortness of breath. Xue Ji prescribed Cinnamon Bark (Rougui) and Costus Root Powder (Muxiang) each at 2 qian, mixed with hot wine. The patient subsequently passed black blood and vomited the previously ingested medicines, regaining consciousness. This happened because cold medicines caused stagnation; thus, acrid-warm agents were used to disperse it.
Attendant Chen fell from a horse, suffering leg pain and vomiting. After one dose of purgatives, he experienced chest and abdominal distension and pain, which ceased upon palpation, leaving only fatigue and shortness of breath. His pulse was fine, thin, and choppy. I said: This is not blood stasis, but rather Qi and Blood injured by pain, further damaged by the purgative affecting Spleen Qi. He was treated with herbs to nourish the Spleen and Stomach and generate Qi and Blood, resulting in recovery.
Jiawei Chengqi Tang (Modified Da Cheng Qi Decoction): Treats symptoms such as internal retention of blood stasis, chest and abdominal distension and pain, or constipation.
Ingredients: Rhubarb (Dahuang), Mirabilite (Puxiao) (each 2 qian), Immature Bitter Orange (Zhishi), Magnolia Bark (Nongpu), Angelica Sinensis (Danggui), Safflower (Honghua) (each 1 qian), Licorice Root (Gancao) (0.5 qian).
Decoct with one cup of water and one cup of wine until one cup remains. Adjust dosage according to deficiency or excess; omit Licorice in urgent cases.
[Huan/Li Dongyuan] Dingtong Ruxiang Shenyingsan (Pain-Relieving Frankincense Divine Response Powder): Treats unbearable pain from falls and abdominal pain.
Ingredients: Frankincense (Ruxiang), Myrrh (Mojing - likely typo for Moyao), Male Black Soybean (Xiongheidou), Mulberry Root Bark (Sangbaipi), Du Ke Li Zi (likely a specific local herb or typo), Angelica Sinensis (Danggui) (each 1 liang), Psoralea Fruit (Poguzhi) (stir-fried, 2 liang), Leech (Shuizhi) (0.5 liang).
Grind into powder. Take 5 qian per dose, decoct with one cup of vinegar in a stone pot until reduced to 60%, add a small amount of Moschus (Shexiang), and take warm.