篇名：上编 外治法
分类：胸背部
属性：[1]凫骨者，即胸下之边肋也。
[2]上下二条，易被损伤，左右皆然。自此以上，有肘臂护之，难以着伤
。在下近腹者，用手提之易治，盖其肋近边，可以着手，则断肋能复
其位也。
[3]其人必低头伛腰，痛苦呻吟，惟侧卧不能仰卧，若立起，五内皆痛，
或头迷神昏，饮食少进：
<1>宜内服正骨紫金丹。
<2>洗以八仙逍遥汤。
<3>贴万灵膏及散瘀等药可愈。
[4]若在上之第二肋，或有断裂垫伤，塌陷不起，因位居膈上，难以入手
，虽强为之，亦难完好。其所伤之血留于膈上，若不随药性开行，必
结成包囊，其包轻者系黄水，硬者系血块，则成痼疾矣。
按、方剂：[1]正骨紫金丹：见颠顶骨伤
[2]八仙逍遥汤：见玉梁骨伤
[3]万灵膏：见囟骨伤
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属性：[1]今之正骨科，即古跌打损伤之证也。专从血论，须先辨或有瘀血停积
，或为亡血过多，然后施以内治之法，庶不有误也。
[2]夫皮不破而内损者，多有瘀血；破肉伤□，每致亡血过多。二者治法
不同。
<1>有瘀血者，宜攻利之。
<2>亡血者，宜补而行之。
<3>但出血不多，亦无瘀血者，以外治之法治之。
[3]更察其所伤，上下轻重浅深之异，经络气血多少之殊，必先逐去瘀血
，和荣止痛，然后调养气血，自无不效。
[4]若夫损伤杂证，论中不及备载者，俱分门晰类，详列于后，学者宜尽
心焉。
按、方剂：
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Upper Compilation: External Treatment Methods
Classification: Chest and Back Region
Attributes: [1] Fugu (Web-bone), referring to the marginal ribs at the lower edge of the chest.
[2] The upper and lower two ribs are prone to injury, on both left and right sides. Above these ribs, they are protected by the elbows and arms, making direct injury difficult.
For those located lower, near the abdomen, they can be treated by lifting with the hand, as these ribs are close to the body's periphery, allowing access; thus, fractured ribs can be reduced to their proper position.
[3] The patient will inevitably bow their head and stoop their waist, groaning in pain, able only to lie on their side and unable to lie supine. If they stand up, pain is felt throughout the internal organs (Zang-Fu).
Alternatively, there may be dizziness, confusion of spirit, and reduced intake of food and drink:
<1> Internal administration of Zhenggu Zijian Dan (Bone-Setting Purple-Gold Pill) is suitable.
<2> Wash the area with Baxian Xiaoyao Tang (Eight Immortals Free-and-Easy Decoction).
<3> Application of Wanling Gao (Myriad Spirits Plaster) and blood-dispersing medications can lead to recovery.
[4] If the second rib above is fractured or injured by contusion, causing depression without elevation, because it is located above the diaphragm, it is difficult to manipulate.
Even if forced, complete restoration is hard to achieve. The injured blood remaining above the diaphragm, if not dispersed by the medicinal properties, will inevitably form a capsule.
Mild cases involve yellow fluid (effusion), while severe cases involve blood clots, resulting in chronic, stubborn diseases.
Commentary & Formulas: [1] Zhenggu Zijian Dan: See section on Head/Crown Bone Injury.
[2] Baxian Xiaoyao Tang: See section on Yuliang Bone Injury.
[3] Wanling Gao: See section on Fontanelle Bone Injury.
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Attributes: [1] Modern Orthopedics corresponds to ancient treatments for falls, blows, and injuries. It focuses specifically on "Blood." One must first distinguish whether there is stagnant blood accumulation or excessive blood loss, before applying internal treatment methods, to avoid errors.
[2] Injuries where the skin is intact but internal damage exists often involve blood stasis; injuries where flesh and skin are broken often result in excessive blood loss. The treatment principles for these two conditions differ.
<1> For blood stasis, purgative and resolving methods are appropriate.
<2> For blood loss, tonifying and promoting circulation methods are appropriate.
<3> However, if bleeding is minimal and there is no blood stasis, external treatment methods should be used.
[3] Furthermore, observe the differences in location, severity, depth, and the variations in the quantity of Qi and Blood in the meridians. First, eliminate blood stasis, harmonize Ying and Wei (Nutritive and Defensive levels) to relieve pain, and then nourish Qi and Blood. Effectiveness is assured.
[4] Regarding miscellaneous injury syndromes not fully covered in this treatise, they are categorized and detailed subsequently. Students should study them diligently.
Commentary & Formulas:
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