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Using Houpo (Magnoliae Officinalis Cortex) and Fangji (Stephaniae Tetrandrae Radix) as drugs to clear toxicity, because of their ability to move and disperse, they are often doubled in dosage. What benefit does this bring to Qi and Blood, yet one desires rapid ulceration, rapid healing, and rapid generation of flesh? No wonder patients suffer from irritability, thirst, and decreased appetite, leading to many deaths.

It is also said: In cases of traumatic injury, one should not lightly administer Wutou (Aconiti Lateralis Radix Preparata) or Fuzi (Aconiti Radix Preparata), as their nature and flavor are pungent and hot, fearing they will aid fire and exacerbate the condition. For those who habitually suffer from blood loss and deficiency, even in winter, they must absolutely not be used, because stasis gets further damaged by fire, Yin blood gets further consumed by fire, blood movement gets reckless by fire, and affected flesh gets further ruined by fire. However, if a person is habitually deficient and cold, or has Yang Qi collapse due to illness, this rule does not apply.

[Pain]
*Zhengti Leyao* states: Pain in the muscles is due to stagnation of Ying and Wei Qi; use Fuyuan Tongqi San. Pain in the tendons and bones is due to Liver and Kidney deficiency; use Liuwei Dihuang Wan. Pain with internal bleeding is due to Spleen and Stomach Qi deficiency; use Buzhong Yiqi Tang. Pain with external trauma bleeding is due to Spleen and Lung Qi deficiency; use Bazhen Tang. Generally, continuous lower bleeding indicates Spleen and Stomach Qi collapse; vomiting, diarrhea, and inability to eat indicate Spleen and Stomach Qi failure. If the Spleen and Stomach were nourished and tonified in advance, such disasters would not occur.

It is also said: If pain at the injury site persists for four or five days without reduction, or begins only after one or two days, it indicates impending suppuration; use Tuoli San. If pressing with a finger leaves an indentation that does not rebound, pus has formed; puncture and drain the pus, and the pain will cease naturally.

*Kefa Lianggui* states: In traumatic injuries, pain at the affected site is common. If pain results from excessive bleeding, it is due to Blood deficiency and flourishing Fire; use sweet-cold herbs to descend deficient Fire and sweet-warm herbs to nourish Spleen Qi. If pain results from excessive sweating, it is due to Liver Wood Fire flourishing; use pungent-cool herbs to clear Liver Fire and sweet-cold herbs to generate Liver Blood. If pain results from tendon and bone injury, treat by supporting righteousness and eliminating pathogens. If pain results from muscle injury, harmonize and tonify. If pain results from rebellious Qi and Blood, smooth and tonify. If pain results from Qi and Blood deficiency, warm and tonify. If pain is due to heat, clear it; if due to cold, warm it using Spleen-tonifying agents. If pain occurs during suppuration, use the method of supporting interior; if pain occurs after pus drainage, unblock the tendons.

[Tendon Spasm]
*Kefa Lianggui* states: In traumatic injuries, when large amounts of pus and blood are discharged, and accompanied by aversion to cold, fever, dry mouth, and thirst, Liver Blood will naturally become depleted. Treat with Shengyu Tang added with Chaihu (Bupleuri Radix), Mugua (Chaenomelis Fructus), Shanzhi (Gardeniae Fructus), Maidong (Ophiopogonis Radix), and Wuweizi (Schisandrae Chinensis Fructus). If treated as a Wind syndrome, the tendons will become drier and Blood more exhausted, making spasm impossible to relieve.

Yaoshan says: The two elbows, two axillae, two thighs (Bi), and two popliteal fossae (Guo) of the human body are called the "Eight Emptinesses" (Ba Xu). *Neijing* states: These eight areas are all sites of joint mechanisms, where True Qi passes and Blood collaterals travel. Pathogenic Qi and evil blood cannot stay here; if they do, they damage the collaterals, causing joints and organs to lose flexibility, resulting in spasm. If there is dislocation or fracture, damaging both tendons and bones, surely evil blood and pathogenic Qi enter due to deficiency. One must examine the Zang-Fu, unblock the joints, and regulate Qi and Blood. Do not think that treating only the exterior ignores the interior. It is also said: When the Lung and Heart have pathogenic factors, their Qi stays in the elbows. Examining the Lung meridian, it travels from the chest to the Xiaobai acupoint in the elbow; the Heart meridian travels from the axilla to the Shaohai acupoint in the elbow. It is also said: When the Liver has pathogenic factors, its Qi flows into the axillae. Examining the Liver meridian, it spreads over the hypochondrium and travels through the Qimen acupoint in the axilla. It is also said: When the Spleen has pathogenic factors, its Qi stays in the thighs. Bi refers to the hip pivot; examining the Spleen meridian, it ascends along the medial thigh and knots at the Bi. It is also said: When the Kidney has pathogenic factors, its Qi stays in the popliteal fossae. Guo refers to the posterior bend of the knee; examining the Kidney meridian, it ascends and emerges above the medial malleolus. All these indicate diseases originating internally and manifesting externally. Once external trauma occurs, the five internal organs are connected. Understanding the Eight Emptinesses provides direction for medication. Chen Cangqi says: In deficiency and consumption syndromes,弊端 are myriad; one should adjust prescriptions according to the disease. For Lung Qi deficiency, add Tianmendong (Asparagi Radix), Mendumong (Ophiopogonis Radix), and Wuweizi (Schisandrae Chinensis Fructus); for Heart Qi deficiency, add Dangshen (Codonopsis Radix), Fushen (Poria with Hostwood), and Changpu (Acori Tatarinowii Rhizoma); for Liver Qi deficiency, add Tianma (Gastrodiae Rhizoma) and Chuanxiong (Ligustici Chuanxiong Rhizoma); for Spleen Qi deficiency, add Baizhu (Atractylodis Macrocephalae Rhizoma), Baishao (Paeoniae Radix Alba), and Yizhi (Alpiniae Oxyphyllae Fructus); for Kidney Qi deficiency, add Shudihuang (Rehmanniae Radix Preparata), Yuanzhi (Polygalae Radix), and Mudanpi (Moutan Cortex). These points must not be ignored.

Regarding the method of relaxing tendons, for post-traumatic tendon spasm and contraction preventing extension, use a large bamboo tube about one chi long, drill a hole at each end, tie a rope, hang it around the waist, sit down, and roll/crush it with the feet. Do not count the effort; prolonged use will be effective. *Yishuo* records: Someone fell from a horse and broke their shin, suffering from tendon spasm preventing walking. A Daoist taught them this method, and they recovered in a few days. *Jingyan Quan shu* says: Someone had spontaneous dislocation of limbs, held together only by skin, unable to move, named "Tendon Dissolution." Soak Huangbai (Phellodendri Chinensis Cortex) in wine overnight, dry and powder it, take 3 qian with wine; multiple doses bring stability.

[Bone Pain]
Yaoshan says: According to *Neijing*: Prolonged standing damages bones. Excessive consumption of sweet foods causes bone pain and hair loss. According to Xue's theory: For bone pain, take He Xue Ding Tong Wan. During the day, regulate with herbs that strengthen the Spleen and Stomach and generate Qi and Blood. If there is swelling, pain, and fever, absolutely do not take Qi-moving drugs. Use external scall moxibustion, and internally take Liujunzi Tang added with Huangqi (Astragali Radix), Chaihu (Bupleuri Radix), Jiegeng (Platycodonis Radix), Xuduan (Dipsaci Radix), and Gusuibu (Drynariae Rhizoma), or Buzhong Yiqi Tang added with Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Chinensis Fructus). When Qi and Blood harmonize, heat subsides naturally. *Jiuji Fang* treats whole-body bone pain by burning old straw sandals to ash, mixing with sesame oil, and applying to the painful area to stop pain immediately. However, external application is inferior to plasters; even severe bone pain can be alleviated.

[Damp-Phlegm]
*Kefa Lianggui* states: In traumatic injuries, if the lesion has healed but the leg hurts, it is because the injury was severe, pus and blood were excessive, and although the sore heals, Qi and Blood are still insufficient. Thus, damp-heat takes advantage of the deficiency to invade, causing pain. This is not a Wind syndrome, so use blood-nourishing and damp-resolving agents to stop pain.

It is also said: When Kidney Water is sufficient, Liver Qi is abundant, and meridians are strong. Even with trauma, if Qi and Blood are not depleted, ulceration and healing occur on time, Qi does not rebel upward, and how can Phlegm-Saliva accumulate upward? If Kidney Qi becomes deficient, Water fails to generate Wood, Liver Qi surges and rebels downward, and Phlegm-Qi rises with it. This is not Wind-Phlegm, but Water overflowing to form Phlegm. Use Liuwei Dihuang Wan, or Liuwei Dihuang Tang added with Liver-clearing agents.

Yaoshan says: This type of pain is divided into Damp-Phlegm, Damp-Heat, Phlegm-Fire, and Phlegm-Qi syndromes. Essentially, Phlegm transforms from Dampness, which is predominant. Since Dampness affects the lower body first, lower-body herbs are mostly used.

[Headache]
*Kefa Lianggui* states: If the head/eyes are injured and suppurate, redness and swelling cause pain; once pus drains, pain stops. If headache comes and goes intermittently, it is Blood deficiency pain, not trauma. If headache is accompanied by vertigo, it is Fire, Phlegm, Qi deficiency, or Liver Wood hyperactivity; do not treat as Cold.

*Yixue Rumen* states: Blood deficiency headache attacks upward from the fish tail (the area behind the outer canthus near the hairline). Use Danggui Buxue Tang or Jiawei Siwu Tang. For combined Qi and Blood deficiency headache, Jiawei Tiaozhong Yiqi Tang or Anshen Tang are effective.

Li Dongyuan says: Phlegm-Jue headache presents with cyan-yellow cheeks upon onset, vertigo, reluctance to open eyes, reluctance to speak, heavy body, dizziness, and nausea. This is a combined Jueyin and Taiyin disease. Take Jufang Yuhu Wan and Banxia Baizhu Tianma Tang.

[Chest Pain]
*Danjī Xinfa* states: Heart pain with a choppy pulse indicates fixed blood (stasis). Also, pain worsened by drinking water indicates fixed blood; purge with Taoren Chengqi Tang. Also, if one usually likes hot drinks, causing fixed blood to remain in the stomach causing pain, purge with Taoren Chengqi Tang; mild cases use chive juice and Jiegeng (Platycodonis Radix).

Yaoshan says: According to Danxi, this is pain caused by blood stasis in the epigastrium. Traumatic injuries occasionally have blood remaining in the epigastrium, so this is cited for reference. However, if pain persists upon palpation, rely primarily on the choppy pulse.

*Yilin Jiyao*: Treats Qi-Blood heart pain with Moyao (Myrrhae Resina) powder, 2 qian, decocted with one cup of water and one cup of wine.

*Doumen Fang*: Treats unbearable Qi-Blood attacking the heart. Wash and cut Liaogen (Polygoni Multiflori Caulis), soak in wine, and drink.

[Hypochondriac Pain]
*Danjī Xinfa* states: Evil blood stagnating in the Liver, residing under the hypochondrium, causes pain that worsens upon pressure.

*Kefa Lianggui* states: Evil blood from beating, falling, or jumping should be drained via scarification rather than retained. The blood of the twelve meridians is generated by the Heart, stored in the Liver, and controlled by the Spleen. The lower abdomen and hypochondrium are locations of the Liver meridian. If evil blood accumulates and does not move, distension, pain, and spontaneous sweating will occur. The method should be to break and generate blood, clearing the Jueyin Liver meridian.

*Yixue Rumen* states: Blood stasis returns to the Liver meridian. Hypochondriac/axillary pain or afternoon onset: Xiao Chaihu Tang combined with Siwu Tang added with Taoren (Persicae Semen), Honghua (Carthami Flos), Ruxiang (Olibanum), and Moyao (Myrrhae Resina). If stool is hard and black, purge with Taoren Chengqi Tang.

*Xuanhui* states: For contusion-induced hypochondriac pain, blood returns to the Liver. Pohui Xiaotong Tang, Fuyuan Huoxue Tang, and Ruxiang Shenyingsan can be consulted.

[Abdominal Pain]
*Danjī Xinfa* states: Pain with a fixed location that does not move indicates fixed blood. Abdominal pain from beating/falling is blood stasis. Use Taoren Chengqi Tang added with Danggui (Angelicae Sinensis Radix), Sumu (Daemonorops Cabillus), and Honghua (Carthami Flos), decocted with child's urine and wine, and purged.

*Jiyan Liangfang* states: From the second to seventh month of pregnancy, sudden falls cause fetal agitation, lumbar/abdominal pain from trauma. If there is vaginal bleeding, the fetus rushes upward affecting the heart, causing shortness of breath and continuous bleeding. Use Dihuang (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), and Aiye (Artemisiae Argyi Folium), 2 liang each; Ejiao (Colla Corii Asini) and Chuanxiong (Ligustici Chuanxiong Rhizoma), 3 liang each. Decoct in 7 sheng of water to obtain 2.5 sheng, divide into three doses.

Danxi says: For women with fetal agitation due to sprains/contusions, abdominal pain, and metrorrhagia, use Bazhen Tang removing Dihuang, adding Chenpi (Citri Reticulatae Pericarpium), decoct in water, and take with Suisha (Amomi Fructus Rotundus) powder and fried-black Wulingzhi (Trogopterori Faeces).

*Zhimifang*: Treats traumatic fetal agitation, bleeding, and abdominal pain with Ejiao (Colla Corii Asini), Aiye (Artemisiae Argyi Folium), and Qinjiao (Gentianae Macrophyllae Radix) powdered equally. Take 5 qian, delivered with rice soup (100 grains). *Duanju Fang* is effective without Qinjiao. Also, for deficient persons, Siwu Tang added with Ejiao, Aiye, Huangqi (Astragali Radix), and Gancao (Glycyrrhizae Radix) works. Bamboo shoot juice with wine also treats fetal trauma pain: 2 he of green bamboo shoots, 1 sheng of good wine, boiled three times, taken in three doses brings relief. Another prescription: Zhuma Gen (Boehmeriae Niveae Radix), 2 liang; Silver vessel, 5 liang; decoct with half wine and half water, effective.

*Chanshu* states: Both fetal agitation and fetal leakage cause bleeding. Fetal agitation involves abdominal pain; fetal leakage does not. Fetal agitation requires Qi regulation; fetal leakage requires Heat clearing. Sudden falls damaging fetal Qi require Jiao'ai Antai San. If pregnant (around three months), due to anger or stumbling, causing fetal trauma, abdominal pain, and lumbar distension, use Antai Wanquan Shenyingsan.

*Tai Chan Xinfa* states: For pregnancy trauma, fetal agitation, abdominal pain, lumbar soreness, and bearing-down sensation, difficult to retain, use Foshou San. If the fetus is undamaged, taking it calms it; if damaged, it induces abortion. Physicians must examine carefully and apply flexible methods to save eight or nine out of ten.

*Yixue Rumen* states: Blood stasis abdominal pain has a fixed location, whether from trauma, menstruation, or postpartum, where lochia remains and stagnates. Use Siwu Tang removing Dihuang, added with Taoren (Persicae Semen), Dahuang (Rhei Radix et Rhizoma), and Honghua (Carthami Flos). Blood pain is regulated with Shixiao San.

Yaoshan says: Traumatic stasis abdominal pain requires purgation. However, complications arise after purgation, which is why Xue's discussion is detailed and accurate. For pregnant women with abdominal pain, fetal calming is essential; scholars must study this deeply.

[Lumbar Pain]
Xue says: The waist is the mansion of the Kidney. Although caused by sprain, it is actually due to Kidney meridian weakness. Use Duzhong (Eucommiae Cortex), Buguzhi (Psoraleae Fructus), Wuweizi (Schisandrae Chinensis Fructus), Shanzhuyu (Corni Fructus), Congrong (Cynomorii Herba), and Shanyao (Dioscoreae Rhizoma).

*Xushi Baojian* states: Heavy lifting strain, or sprain/fall pain is also called Kidney Lumbar Pain. Use Duhuo Tang, Ruxiang Chentong Rushen San, Shujin San, and Li'an San. I note: *Zixū Maijue* states: Lumbar pain pulses are mostly deep and wiry; deep and solid indicates sprain. *Zhizhi* states: Blood dripping causes lumbar pain, turning like needle pricks. For blood stasis, use Pohui San'yu Tang; for stasis in Foot-Taiyang, Shaoyin, Shaoyang, use Chuanxiong Rougui Tang; for stasis in the lumbar spine, use Dilong San; for excess, use Taoren Chengqi Tang; for chronic cases, Siwu Tang added with Taoren (Persicae Semen), Sumu (Daemonorops Cabillus), wine, and Honghua (Carthami Flos).

[Genital Pain]
*Zhengzhuan·Maifa* states: Liver pulse is urgent on deep palpation and similarly on superficial palpation. If hypochondriac pain, Qi fullness, drawing pain to the lower abdomen, difficulty urinating, dizziness, headache, and lumbar/spine pain occur, it results from recent falling.

[Blue Swelling]
The Classics state: Qi moves/nourishes, Blood moistens. If trauma causes persistent swelling with dark color, it is Yuan Qi deficiency. Use Liujunzi Tang added with Danggui (Angelicae Sinensis Radix) to cultivate Spleen/Stomach Yuan Qi; then blue swelling disappears, stasis resolves, and pus/dirt exits naturally. If one takes harsh cooling agents, depleting Qi and Blood, swelling increases, color becomes bluer, and ulceration worsens.

The Classics state: The robust recover as Qi moves; the weak develop disease as Qi stagnates. If bones are set and joints reduced but swelling persists, it is due to weak Yuan Qi failing to move stasis. Only by tonifying, nourishing Yin, and assisting Yang can Qi move vigorously, dispersing blood stasis and reducing swelling/pain. If one uses Qi-moving and blood-breaking agents, Yuan Qi becomes weaker, Qi movement more stagnant. Diseases in bones/thighs or areas rarely reached by Qi/Blood are hardest to treat.

*Qixuan* formula: For blue swelling extending over the legs, mash fresh Sanqi (Notoginseng) stems/leaves and apply to the blue area; blood stasis dissipates miraculously. If no Sanqi, mashed white radish is also effective.

For traumatic shoulder dislocation with swelling/pain, *Defang Fang* uses raw Dihuang (Rehmanniae Radix) mashed, spread on oiled paper, sprinkled with Muxiang (Aucklandiae Radix) powder, covered with more Dihuang, applied to the site; pain stops by next day.

After trauma healing, for skin blue swelling, use very large eggplant seeds, slice one finger thick, bake on tile until dry, powder. Mix 2 qian with wine, take before bed; dissolves overnight without trace. This is from Shenghui Fang.

Feng Luzhan says: For falls/trauma, fractures/sprains, though external contact, internal injury inevitably occurs, causing Qi/Blood stagnation, red/swollen or blue, unceasing pain. Initially, use sweet-pungent-warm dispersants to move Qi and break stasis; pain retreats, swelling subsides. Examples include Duhuo (Angelicae Pubescentis Radix), Baizhu (Angelicae Dahuricae Radix), Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Moyao (Myrrhae Resina), ancient coins, Lu jiaohui (Cervi Cornus Degelatinati Colla), Chi Shao (Paeoniae Radix Rubra), Honghua (Carthami Flos). Decoct in water/wine, adding child's urine is excellent. After external trauma settles, continue regulating with herbs tonifying Qi, Blood, tendons, and bones.

Yaoshan says: Heard in the capital of a government clerk who fell while drunk, injuring head/face with purple/red/blue swelling, hindering appearance before superiors. Someone passed a method: soak cloth towel in water, apply hot to injury repeatedly, change when cool; swelling dissipates gradually, able to attend court next day. This is the Yanshou method, treating open wounds with unceasing bleeding.

[Difficulty Ulcerating]
*Kefa Lianggui* states: Generally, Spleen/Stomach govern muscles. Putrefaction and flesh generation depend entirely on Spleen/Stomach and abundant Qi/Blood. If physicians do not understand pathology and fail to tonify/support, some die with dead flesh unable to ulcerate; some die with dead flesh ulcerated but new flesh unable to grow; some die with dead flesh ulcerated and new flesh grown, but wound fails to close for a long time. These three cases result from failing to tonify in advance.

[Failure to Close]
*Kefa Lianggui* states: Generally, in trauma syndromes, if there is no internal stasis, one should tonify the Spleen. When Spleen Qi is tonified, injured flesh heals itself, ulcers naturally, new flesh grows easily, and wounds close. Thus, "Strong Spleen means flesh grows." Absolutely avoid biased use of cold/harsh agents that damage Yuan Qi, leading to failure in generating flesh and closing wounds. Even with tonification, slow action is insufficient.

Yaoshan says: If mistakenly taking Qi-moving drugs causing chest oppression, shortness of breath, poor appetite, fatigue, dark lesion color, and thin pus, use Liujunzi Tang added with Jiegeng (Platycodonis Radix). If mistakenly taking blood-draining drugs causing diarrhea and dark lesion color, use Shiquan Dabu Tang doubling Rougui (Cinnamomi Cortex), Maidong (Ophiopogonis Radix), and Wuweizi (Schisandrae Chinensis Fructus). If mistakenly taking cold/harsh drugs causing lesion swelling/pain and chest/abdominal fullness, internally take Liujunzi Tang added with Muxiang (Aucklandiae Radix) and Danggui (Angelicae Sinensis Radix), externally apply Huiyang Gao. If lesion has blood stasis, mistakenly not scarified, causing deep accumulation and irritability/heat, urgently scarify to remove stasis. If bone is broken but tendon connects, and cutting is delayed, invading healthy flesh, it is untreatable. If mistakenly contracting Wind pathogen causing lesion itching, use Wind-dispelling and detoxifying agents. If putrefied but painless, black but not shedding, strongly tonify Yuan Qi to preserve life. This is another method for treating trauma swelling and ulceration.

[Developing Spasm]
*Kefa Lianggui* states: After trauma with open flesh or punctured swelling, if there is fever/aversion to cold, dry mouth/thirst, palpitations, insomnia/jerking, locked jaw, red eyes/headache, spontaneous/night sweats, chattering teeth, shortness of breath/panting, urinary incontinence/limb flaccidity, fever with large pulse (empty on pressure), fever preferring no clothes/desiring water, or aversion to cold with floating/large pulse (fine/deep on heavy pressure), feeling cold despite thick clothes—this is Qi/Blood combined with deficiency. Urgently tonify with Renshen (Ginseng Radix), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma). If ineffective, quickly add Fuzi (Aconiti Radix Preparata); delay is fatal. Or cold extremities, abdominal pain, diarrhea/borborygmus, inability to eat, hiccups/vomiting—this is Cold pathogen invading deficiency. Treatment is same as above. If sweating without aversion to cold, or no sweating with aversion to cold, locked jaw/cold feet, opisthotonos/back arching, stiff neck—this is Qi/Blood deficiency causing spasm. Treatment is same as above, with minor additions based on symptoms. Many spasm cases fail due to mistaken use of Wind drugs. If truly Broken-Wind syndrome, it is also due to Yuan Qi depletion and external pathogen invading deficiency. Strong tonification to secure the root is best. Reckless use of Wind drugs brings disaster instantly; physicians must observe carefully.

Yaoshan says: Spasm (Jing) is rigid, straight, non-flexible tendons. Cramp disease (Chi) is locked jaw and opisthotonos. Chi and Jing are collectively called Broken-Wind.

*Zhengzhuan* states: Broken-Wind initially results from broken skin/flesh, treated casually, unaware that Wind pathogen invades deficiency, becoming malignant. Symptoms include alternating chills/fever, severe locked jaw/deviated eyes, body rigidity like opisthotonos, death imminent. *Huichun* states: Chi disease is difficult to treat. Falls/bruises with unhealed wounds exposed to Wind also cause Chi, named Broken-Wind. Floating/weak pulse indicates Taiyang; Long/strong pulse indicates Yangming; Floating/Wiry-small pulse indicates Shaoyang. *Bencao Gangmu* states: Initially feel wound swelling with white crust, body chills/fever; urgently use Yuzhen San, mixed with ginger juice and wine, apply residue to wound. If locked jaw, mix with child's urine. He Jian states: Back spasms indicate Taiyang; body...