Library

In cases of traumatic injury, falls, or bumps, the syndrome is specifically differentiated based on blood. If there is stagnant blood accumulation or excessive blood loss, treatment should be administered accordingly to avoid errors. For deficiency syndromes, tonification combined with promoting circulation is appropriate. One must also observe the differences in location (upper vs. lower), severity, and depth of the injury, as well as the variations in the quantity of Qi and Blood within the meridians. First, eliminate the stasis; then harmonize the Ying (Nutritive) level and relieve pain. This approach will invariably be effective. The *Neijing* states: "Injury to the form causes pain; injury to Qi causes swelling." It further says: "Swelling preceding pain indicates form injuring Qi; pain preceding swelling indicates Qi injuring form." In cases of contusions, sprains, or injuries caused by anger leading to Qi stagnation and blood coagulation resulting in swelling and pain, or injuries from shouting causing Qi and Blood damage, or overuse of purgative agents, or external application of cold-natured medicines leading to Qi and Blood coagulation, methods for invigorating blood and smoothing Qi are suitable. Miscellaneous trauma syndromes are not exhaustively listed here but are categorized and detailed subsequently for students to study diligently.

For traumatic injuries where evil blood remains internally, regardless of the meridian involved, the Liver is primarily addressed because the Liver stores blood, and damaged blood inevitably returns to the Liver. Pain located mainly in the hypochondrium and lower abdomen follows the pathway of the Liver Meridian. Treatment should focus on soothing the Liver, regulating blood, and unblocking the meridians. Wang Haogu stated: Injuries such as falling from heights, collisions, or blows cause stagnant blood in the heart, abdomen, and chest; or Qi and blood stasis attack each other, causing coma, alternating chills and fever, worse at night than during the day, with numerous variable symptoms. If physicians do not examine the root cause, palpate the pulse for deficiency or excess, distinguish between meridians and Zang-Fu organs, and prescribe medications recklessly, many will die unnecessarily. Therefore, in clinical practice, one must assess the pulse for deficiency/excess, evaluate the severity of symptoms, arrange herbs according to the principles of Sovereign, Minister, Assistant, and Courier, tailor treatment to the age and constitution (old/young, strong/weak), and differentiate lesion locations among the Upper, Middle, and Lower Jiao. If stasis is in the upper jiao accompanied by hematemesis, Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) is indicated; if in the middle jiao, Tao Ren Chengqi Tang (Peach Kernel and Rhubarb Decoction); if in the lower jiao, Didang Tang (Attack the Accumulation Decoction). For deficient patients, Sini Tang (Four Substances Decoction) should be added. Once the stasis dissipates, Fuyuan Tongqi San (Restore Origin and Unblock Qi Powder) can be used for regulation. If the injured area is cyanotic, swollen, firm, with severe pain limiting movement, and the pulse is choppy and sluggish, preventing Qi and stasis from rushing upward is crucial; Shenhua San (Ginseng and Astragalus Powder? Note: Text says Shen Huang San, likely a typo for Shen Mai San or similar, but translating literally as Ginseng and Astragalus Powder or keeping Pinyin) should be used to dispel stasis, along with Fuyuan Huoxue Tang (Restore Origin and Invigorate Blood Decoction). For injuries treated late, where damaged blood has hardened, Zijin Dan (Purple Gold Pill) should be taken to dispel stasis, followed by Qushang San (Remove Trauma Powder) for unblocking, until the discoloration fades, blood harmonizes, and pain ceases. In cases of trismus (lockjaw), Tongguan San (Open the Pass Powder) should be insufflated into the nose to induce sneezing, followed by Sanhuang Bao La Wan (Three Yellows Precious Wax Pill) or Duoming Dan (Life-Rescuing Pill). If the mouth is open and medication can be swallowed, the prognosis is treatable; if not, it is critical. Patients must avoid sitting or lying in damp, windy places, consuming raw/cold/hard foods, and taking cold-natured medicines, lest blood coagulate and remain difficult to resolve, causing lingering complications. When examining severe trauma, first loosen clothing, inspect the severity of the injury and whether vital points are affected, observe complexion, listen to voice, and palpate the pulse for deficiency/excess. A harmonious pulse across six positions indicates survival; discordant nine-pulse readings indicate death. If the testes are within the scrotum, the case is treatable; if they retract into the lower abdomen, it is untreatable. In cases of lockjaw, apply Kaiya San (Open Teeth Powder) urgently; if consciousness returns, Li Dong Wan (Li's Cave Pill) may be administered to potentially reverse the condition. Physicians must examine carefully and avoid negligence that could harm patients.