【方歌】溃疡发痉类破伤，有汗为柔无汗刚，脓血出多成此证，
补正驱邪要审详。
【注】此类势类破伤风，牙紧体强，肢搐背反，有汗曰柔痉，
无汗曰刚痉，由溃疡亡血过多所致。治宜大补气血，以
十全大补汤加钩藤钩、栀子、天麻。服之不应者，服独
参汤；手足逆冷加桂、附，误作风痉，汗之则危。
方剂：十全大补汤、独参汤（俱见溃疡门）
【方歌】汤烫火烧皮烂疼，疱起挑破使毒轻，烦躁作呕防毒陷，
便秘神昏气喘凶。
【注】此证系好肉暴伤，汤烫火烧，皮肤疼痛，外起燎疱。即
将疱挑破，放出毒水使毒轻也。其证虽属外因，然形势
必分轻重，轻者施治，应手而愈；重者防火毒热气攻里
，令人烦躁，作呕便秘，甚则神昏闷绝。初伤用冷烧酒
一钟，于无意中望患者胸前一泼，被吃一惊，其气必一
吸一呵，则内之热毒，随呵而出矣。仍作烦闷者，以新
童便灌之。外初用清凉膏涂之，解毒止痛，不致臭烂，
次以罂粟膏涂之。痛止生脓时，换黄连膏贴之收敛。火
毒攻里者，宜四顺清凉饮服之，务令二便通利，则毒热
必解。初终禁用冷水、井泥浸塌伤处，恐热毒伏于内，
寒滞束于外，致令皮肉臭烂，神昏便秘，端肩气喘，多
致不救。外花炮火药烘燎者，治法同前。
方剂：婴粟膏
组成：婴粟花（十五朵，无花以壳代之）
香油四两，将婴粟炸枯，滤净，入白蜡三钱溶化尽
，倾入碗内，待将凝之时，下轻粉二钱，搅匀炖水中，
令冷取出。临用时，抿脚挑膏，手心中捺化，搽于伤处
，绵纸盖之，日换二次，其痛自止。次日用软帛挹净腐
皮，再搽之。
【方歌】婴粟膏医汤火烧，香油罂粟共煎熬，白蜡更兼真轻粉，
患上搽涂痛即消。
又方：清凉膏
组成：水泼开石灰末一升，加水四碗，搅浑澄清；取清汁一碗
，加香油一碗，以箸顺搅数百转，其稠粘如糊，用鸡翎
蘸扫伤处。
又方：黄连膏（见鼻部鼻疮）
四顺清凉膏（见面部痄腮）
[Prescription Verse] Spasms arising from ulcers resemble lockjaw (tetanus); with sweating it is termed soft spasm (Rou Jing), without sweating it is termed stiff spasm (Gang Jing). This condition arises from excessive loss of pus and blood. In treatment, tonifying the healthy qi and expelling pathogenic factors must be carefully examined.
[Annotation] This condition resembles lockjaw (tetanus), characterized by trismus (lockjaw), body rigidity, limb convulsions, and opisthotonos. With sweating, it is called soft spasm (Rou Jing); without sweating, it is called stiff spasm (Gang Jing). It is caused by excessive blood loss due to ulcers. The treatment should involve greatly tonifying Qi and Blood using Shiquan Dabu Tang (Ten Complete Tonifying Decoction) added with Gouteng Hook (Uncariae Ramulus cum Uncis), Gardeniae Fructus (Zhi Zi), and Gastrodiae Rhizoma (Tian Ma). If there is no response after taking this, take Danshen Tang (Single Ginseng Decoction); if the hands and feet are cold, add Cinnamon Twig (Guizhi) and Aconite Root (Fuzi). Do not mistakenly treat it as wind-induced spasm; applying diaphoresis (sweating method) would be dangerous.
[Prescription Verse] Scalds and burns cause skin erosion and pain; blisters should be pricked to relieve toxicity. Irritability and vomiting indicate a risk of toxin sinking inward; constipation, coma, and panting indicate a critical condition.
[Annotation] This condition results from sudden injury to healthy skin by scalds or fire, causing skin pain and external blistering. The blisters should be immediately pricked to drain toxic fluids, thereby reducing toxicity. Although this condition is caused by external factors, its severity must be distinguished. Mild cases respond quickly to treatment and heal; severe cases require preventing fire-toxic heat from attacking the interior, which causes irritability, vomiting, constipation, and even coma or suffocation. Upon initial injury, pour one cup of cold liquor onto the patient's chest unexpectedly to startle them. This startle will cause a reflex inhalation and exhalation, allowing internal heat-toxin to exit with the breath. If irritability persists, administer fresh child's urine (Tong Bian). Externally, apply Qingliang Ointment initially to detoxify and relieve pain, preventing foul rot; subsequently apply Ying Su Gao (Poppy Ointment). When pain ceases and suppuration begins, change to Huanglian Ointment for astringency. For fire-toxin attacking the interior, administer Sishun Qingliang Yin (Four-Obedience Cooling Clearing Drink), ensuring free passage of urine and feces so that toxic heat resolves. From beginning to end, strictly forbid immersing the injured area in cold water or well mud, lest heat-toxin become trapped internally while cold stagnation binds externally, leading to putrefaction of skin and flesh, coma, constipation, shoulder shrugging, and panting, often resulting in untreatable conditions. Burns from fireworks or gunpowder follow the same treatment.
Formula: Ying Su Gao (Poppy Ointment)
Composition: Poppy flowers (15 pieces; use pods if flowers are unavailable), Sesame Oil (4 liang). Fry the poppies until crisp, filter clean, add White Beeswax (3 qian) until melted, pour into a bowl. When nearly solidifying, add Calomel (Qing Fen, 2 qian), stir evenly, warm in water bath, cool, and remove. To use, rub a small amount between palms to melt, apply to the wound, cover with cotton paper, change twice daily; pain will cease naturally. The next day, gently wipe away necrotic skin with soft cloth and reapply.
[Prescription Verse] Ying Su Gao treats scalds and burns; sesame oil and poppy are boiled together, combined with white beeswax and pure calomel; applied to the affected area, pain vanishes instantly.
Another Formula: Qingliang Gao (Cooling Ointment)
Composition: Slake quicklime powder (1 sheng) with water (4 bowls), stir until turbid then let settle; take 1 bowl of clear supernatant, add 1 bowl of sesame oil, stir clockwise hundreds of times until thick and paste-like. Apply to the wound with a chicken feather.
Another Formula: Huanglian Gao (Coptis Ointment) (See Nasal Ulcers section)
Sishun Qingliang Gao (Four-Obedience Cooling Clearing Ointment) (See Mumps section)