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1. Wash the injured area with decocted medicinal water; 2. Carefully examine the site of injury; 3. Perform traction (pulling and stretching); 4. Or forcefully push the dislocated bone back into position; 5. Press and correct until aligned; 6. Apply *Heilong San* (Black Dragon Powder, an external powder for unblocking meridians, reducing swelling, and relieving pain); 7. If the wound is open, fill the ulcer with *Fengliu San* (Wind-Flowing Powder, an external powder); 8. Secure with splints and bandages; 9. Administer internal medicine; 10. Wash again; 11. Apply *Heilong San* again; 12. If the wound is open, fill it with *Fengliu San* again; 13. Re-bandage with splints; 14. Continue treating with internal medicine as previously prescribed.

For crushed skull bones, gently flatten and align them by hand. If the skin is intact, apply *Heilong San*. If the skin is broken, fill the wound with *Fengliu San*, wrap with silk cloth, and keep away from wind and water to prevent tetanus (Po Shuang Feng). If water and wind pathogens enter the brain causing tetanus, headache will inevitably occur, and it becomes incurable. For wounds within the hair, the hair must be shaved off before applying medication.

Crushed skull bones are treatable if located on other parts of the skull. However, if located at the temporalis region (Taiyang acupoint), which is a vital area, it is absolutely incurable.

For scapular dislocation, assess how to reduce it. Use a chair to encircle the ribs, placing soft clothing and bedding over a bamboo mat. Have one person hold firmly while two persons perform traction. Then let the wrist hang naturally, and bind the flexed wrist with a silk cloth.

For rib fractures (Jin Jing Gu) below the ribs, do not use splints. Simply press flat to ensure alignment, apply *Heilong San*, and bind with silk cloth. The same applies to bilateral ribs.

For hip dislocation from the upper buttock, two or three people can stabilize the leg and perform traction, then use the foot to push it back into place. If the hip dislocates from the groin, reduction is not possible.

For hand or foot bone dislocations, observe the direction of displacement. If the bone dislocates to the left, pull and insert it to the right. If it dislocates to the right, pull and insert it to the left.

The long bones in hands and feet come in pairs. If one bone is fractured, it is treatable. If both bones are fractured, it is absolutely incurable. Severe injuries to hand or foot bones are also incurable.

For severe injuries, generally, traction and pressing correction are required first, or opening the skin followed by pressing correction, then applying patches, filling coatings, and splinting. Traction should be applied near the original fracture site, not far away on another bone segment.

When performing traction, first observe how the bones on either side have displaced. There is straight traction and oblique traction.

To identify the injury site, palpate the bones for alignment; misalignment will be visible.

For injuries on either side, observe the interosseous spaces and carefully knead and press. By estimating, one can see the general situation. The goal is to return the bone to its original position and make the skin adhere to the bone.

Traction may be performed by one, two, or three people, depending on difficulty.

If the skin is broken and the bone is severely displaced, unable to be reduced by traction or close approximation, leave a gap of one or two fen. Use a sharp knife to cut slightly to facilitate insertion. Do not cut muscle; the muscle will naturally necrose to allow insertion. After the bone is inserted, apply *Heilong San* around the four sides of the wound, leaving the ulcer open in the swollen area, and fill it separately with *Fengliu San*. The knife used must be very sharp; excavating knives or carving knives are suitable.

Pressing and correction should involve frequent rotation to maintain mobility.

For shattered or fractured bones, check if the local area is level. Generally, depressed bones indicate no fracture. Observe the bones from left and right. The injury site requires traction, pressing correction, and medicinal application. Splinting must be level and correct.

Swelling is caused by blood stasis. Soak and wash with hot medicinal water, then apply *Heilong San*.

For severe injuries, soak and wash with medicinal water before applying ointments. For mild injuries, apply ointments directly without washing.

Remove splints every two to three days in summer and every three to five days in winter. Soak the bound area in hot medicinal water to remove old medicine. During washing, do not disturb the injury site. Reapply *Heilong San* and re-splint. This is only for severe injuries.

For broken skin, fill with *Fengliu San* and apply more ointment. For intact skin, apply *Heilong San*. Must splint with cedar bark.

Use soft materials, such as silk cloth, for padding during traction and pressing.

If there are bone fragments under the skin, apply only *Heilong San*. Later, the skin and flesh will naturally necrose, and the fragments will spontaneously expel, leading to healing.

For broken bones or severed tendons with open wounds, fill and coat with *Fengliu San*. Suture the skin with needle and thread, then apply *Heilong San* around the four sides.

Splinting uses several pieces of cedar bark, tightly wrapped around, leaving one seam. Bind three times tightly.

For flat areas with shattered bones, wrap with skin pieces to allow flexion and extension. For finger bone fractures, use ramie fiber for splinting. For legs, use ramie rope splints, about the thickness of a string of coins.

For applying patches, take a board, place skin paper or oil paper on it, mix *Heilong San* with water, spread evenly, roll it up, and apply to the injury site.

For using cedar bark, soak slices about the size of a finger, arrange them sparsely around the circumference, and bind tightly with small rope three times. Change once every three days. Wash and reapply medicine as before.

For binding curved areas like wrists, ankles, or fingers, which require movement, apply medicine and wrap with silk cloth. Move frequently later. Flexion allows extension, and extension allows flexion. Alternating flexion and extension frequently is necessary.

Injuries initially cause numbness without pain. Traction, pressing, and even cutting the skin cause no pain. Pain occurs after two or three days.

Injuries can be managed within one month; after that, it is too late.

Do not consume herbal medicines for injuries, as this prevents bones from returning to their original state.

For falls and injuries with dirty blood in the intestines and stomach, first administer blood-dispersing medicines, such as *Siwu Tang* (Four Substances Decoction).

If there is urinary or fecal retention due to injury, do not immediately administer trauma medicines, as they often contain wine and are hot in nature. First administer *Siwu Tang*, assess the condition, then administer *Dacheng Tang* (Great Success Decoction) with *Mutong* (Akebia Caulis). If retention persists, add *Piaoxiao* (Mirabilite). Once urination and defecation resume, then administer trauma medicines.

For severe injuries, administer Qi-regulating medicines, such as *Yunqi San* (Qi-Balancing Powder), before trauma medicines.

General body pain without obvious cause is Wind Injury. Take Wind-Injury medicines, such as *Paifeng Tang* (Wind-Expelling Decoction). When taking trauma medicines, avoid cold foods. Fish and beef are extremely cold and should be avoided. Eating beef makes pain incurable.

Trauma medicines are inherently hot to generate Blood and Qi for bone knitting.

Medicines can be taken with red wine, clear wine, or raw wine.

Medicine preparation should be done in March and April. Do not prepare large quantities; especially in May. Store powders and make pills as needed.

Store pill and powder medicines in jars inside cabinets, dried by fire.

Moxibustion for injuries renders medical treatment ineffective and renders medicines useless.

Among all medicines, *Xiaohong Wan* (Little Red Pill) and *Dahuoxue Dan* (Great Blood-Activating Pellet) are most precious because they contain *Ruxiang* (Frankincense) and *Moyao* (Myrrh). *Fengxiang* (Styrax) can replace one-third of *Ruxiang*. *Xuejie* (Dragon's Blood) is hard to obtain; it can be omitted in *Dahuoxue Dan*, but having it is better.

Formulations must include *Ruxiang* and *Moyao*. If *Moyao* is unavailable, substitute with *Fanjiangzhen* (Sappan Wood from abroad). If *Xuejie* is unavailable, use this substitute.

Herbs vary between imported (Waidao) and local (Dangtu). For example, local *Danggui* differs from Sichuan *Danggui*. Pills can use local *Danggui* and local herbs. Powders must use imported herbs.