丹溪曰∶破伤风症多死，最急症也。始因出血过多，或风从疮口而入，或疮早闭
合，瘀血停滞于内，血受病而属阴，始虽在表，随易传脏，故此风所伤，极多难治。其
症身热自汗，口噤搐搦，势急非常药可治，故丹溪曰∶非全蝎不开，兼以防风风药。凡
破伤风邪，初受在表者，宜用发散，同伤寒表治法，用防风、羌、独、芎、归、麻黄、
南星、白芷、全蝎、赤芍、细辛、 本、蔓荆、天麻、半夏、陈皮之类，随候加减。半
表半里者，宜用和解药，如发散不解，邪传入里，脏腑闭塞。惊而发搐，宜用天麻、蜈
蚣、雄黄、僵蚕、巴霜、朱砂、南星、全蝎之类为丸。或用羌、防、芎、归、赤芍，黄
芩、大黄之类，煎服下之，若病日久，气血渐虚，邪气入胃者，宜养气血为主，兼以风
药，如当归、地黄、芎、芍、防风、白芷之类；如伤骨疼痛者加乳香。
四恶症不可治，一头目青黑，二额上汗珠不流，三眼小目瞪，四身汗如油。
治破伤风，止血定疼。
苍术（六两） 川乌头（泡，去皮，四两） 防风 草乌头（泡，去皮） 细辛（二两五钱）
天麻 川芎 两头尖（泡，去皮，四两） 白芷（各一两五钱） 蝎梢（微炒） 雄黄
乳香（各五钱） 为末。每服一钱，酒调下。
一方
治破伤风，用全蝎十个，为末，酒调，一日三次服之。
Danxi stated: Wind-stroke due to broken skin (Pòshāngfēng) often results in death and is the most urgent condition. Initially, it arises from excessive bleeding, wind pathogen entering through the wound, or premature closure of the wound causing blood stasis within. Since blood pathology belongs to Yin, although the pathogen starts at the exterior, it easily transmits to the Zang-Fu organs. Therefore, injuries caused by this wind are extremely difficult to treat. Symptoms include fever, spontaneous sweating, trismus (lockjaw), and convulsions. The condition is so acute that ordinary medicines cannot cure it. Thus, Danxi said: Only Quanjie (Whole Scorpion) can open the meridians, combined with Fangfeng (Saposhnikovia Root) and other wind-dispelling herbs. For wind pathogen affecting broken skin initially located at the exterior, dispersing methods should be used, similar to treating exterior syndromes in Cold Damage (Shānghán). Formulas may include Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Mahuang (Ephedrae Herba), Banxia (Pinelliae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Quanjie (Whole Scorpion), Chishao (Paeoniae Radix Rubra), Xixin (Asari Radix et Rhizoma), Gaoben (Ligustici Wallichii Rhizoma et Radix), Manjingzi (Vittagiae Fructus), Tianma (Gastrodiae Rhizoma), Banxia (Pinelliae Rhizoma), and Chenpi (Citri Reticulatae Pericarpium), adjusted according to symptoms. For half-exterior half-interior stages, harmonizing formulas are appropriate. If dispersing fails and the pathogen transmits inward, causing Zang-Fu obstruction, and fright induces convulsions, one may use pills made of Tianma (Gastrodiae Rhizoma), Wugong (Scorpio), Xionghuang (Realgar), Jiangcan (Bombyx Batryticatus), Bafang (Crotonis Fructus Preparatum), Zhusha (Cinnabaris), Banxia (Pinelliae Rhizoma), and Quanjie (Whole Scorpion). Alternatively, decoctions of Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikovia Root), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Chishao (Paeoniae Radix Rubra), Huangqin (Scutellariae Radix), and Dahuang (Rhei Radix et Rhizoma) can be taken to purge. If the disease has persisted for a long time, Qi and Blood become deficient, and the pathogen enters the Stomach, treatment should primarily nourish Qi and Blood, supplemented by wind-dispelling herbs such as Danggui (Angelicae Sinensis Radix), Dihuang (Rehmanniae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix), Fangfeng (Saposhnikovia Root), and Baizhi (Angelicae Dahuricae Radix); if bone injury causes pain, add Ruxiang (Olibanum).
Four ominous signs indicate incurability: 1. Blue-black discoloration of the head and eyes; 2. Sweat beads on the forehead that do not flow; 3. Small, staring eyes; 4. Sweating like oil.
To treat wind-stroke due to broken skin, stop bleeding and relieve pain.
Cangzhu (Atractylodis Rhizoma, 6 liang), Chuanwutou (Prepared Aconiti Radix, peeled, 4 liang), Fangfeng (Saposhnikovia Root), Caowutou (Prepared Aconiti Kusnezoffii Radix, peeled), Xixin (Asari Radix et Rhizoma, 2.5 liang), Tianma (Gastrodiae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Liangtoujian (Dichroae Radix, peeled, 4 liang), Baizhi (Angelicae Dahuricae Radix, each 1.5 liang), Xieshao (Scorpion Tail, lightly stir-fried), Xionghuang (Realgar), Ruxiang (Olibanum, each 5 qian). Grind into powder. Take 1 qian per dose, mixed with wine.
Another prescription:
For wind-stroke due to broken skin, use 10 Quanjie (Whole Scorpions), grind into powder, mix with wine, and take three times daily.