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[Formula Song] Various cases of foreign bodies penetrating the flesh belong to external injuries. The most effective treatment is to crush and apply mole (Lougu) topically. If pain persists after the foreign body has been removed, applying mole again will alleviate the discomfort.

[Annotation] Foreign bodies penetrating the muscle constitute a category of external injury. For those that are soft and shallow, they can be extracted using a needle. For those that are hard and deep, crushed mole should be applied to the wound; the foreign body will be expelled shortly thereafter. If pain persists after extraction, reapplying mole will lead to recovery.

[Formula Song] Skin and flesh damage allowing wind pathogen to invade externally initially presents with trismus (lockjaw). Severe cases exhibit opisthotonos (arched back), salivation, and frequent convulsions without relief. One must carefully distinguish between four causes: movement, stillness, fright, and post-ulceration. Symptoms such as sinking, contraction, coma, and muteness indicate a poor prognosis. When the pathogen is in the Exterior, sweating method is indicated; when in the Interior, purgative method is indicated; when in the Half-Exterior Half-Interior, harmonizing method is indicated.

[Annotation] This condition arises from skin or flesh trauma where wind pathogen invades the meridians. Initially, there is chills and fever, followed by trismus. In severe cases, the body assumes an opisthotonos posture, with salivation, limb convulsions, loss of consciousness, and a rusty/stiff sensation at the wound site. There are four etiologies for traumatic tetanus: due to movement, stillness, fright, or ulceration.
1. Due to movement: Anger causes Qi to rise; jumping/activity leads to skin/flesh rupture. Wind remains in the Exterior because vigorous Qi prevents deep invasion; this is mild.
2. Due to stillness: Peaceful state with non-vigorous Qi allows wind to easily enter the Interior upon minor trauma; this is severe.
3. Due to fright: Fright causes Qi to sink; wind follows Qi directly into the Yin levels, often fatal; this is adverse.
4. If wind enters the Yin meridians: Body becomes cold with spontaneous sweating, wound appears flat/sunken, coma, muteness, lip curling, and tongue retraction. Early treatment is crucial. Differentiate whether wind is in the Exterior, Interior, or Half-Exterior/Half-Interior to apply sweating, purgative, or harmonizing methods respectively.
- Pathogen in Exterior: Chills, fever, stiffness, trismus. Use Qianli Bensan (Thousand-Mile Running Powder) or Xiongshu San (Male Rat Powder) to induce sweating. Follow with Wugong Xingfeng San (Centipede, Aconite, and Wind Powder) frequently to expel foul sweat.
- Pathogen in Interior: Fright with convulsions, constipation. Use Jiangbiao Wan (Fish Swim Bladder Pill) to purge.
- Pathogen in Half-Exterior/Half-Interior: No sweat, use Qiangma Tang (Notopterygium and Ephedra Decoction). Head sweat only, no body sweat: do not sweat; use Yuding San (Sanguisorba and Violet Powder) to harmonize. Spontaneous sweating with dry/red urine/stool: use Da Xionghuang Tang (Large Ligusticum and Rhubarb Decoction).
- Over-sweating leading to persistent sweating despite harmonized Zang-Fu: Use Fangfeng Danggui San (Saposhnikovia and Angelica Powder).
- Persistent exterior heat after sweating: Use Xiao Xionghuang Tang (Small Ligusticum and Scutellaria Decoction).
- Persistent interior heat after purging: Use Guashi Tang (Trichosanthes and Talcum Decoction).
- Excessive blood loss at injury: Do not sweat; use Danggui Dihuang Tang (Angelica and Rehmannia Decoction).

For wind invasion after ulceration: Unhealed ulcers allow wind to enter via deficiency. Initial symptoms include millet-like rash and itching around the wound. Severe cases show trismus, neck weakness, and downward gaze. Sweating is contraindicated as it may cause spasms. Use Shengui Yangrong Tang (Ginseng and Angelica Nourishing Nutrient Decoction) with Tan-She (Bombyx Batryticatus) to secure the root and settle wind. For persistent tremors: Zhusha Zhijia San (Cinnabar and Nail Powder). For phlegm, convulsions, and cold body: Hei Huashe San (Black Flower Snake Powder).

External treatment: Within 1-2 days of injury, moxibustion is used to induce sweating and resolve wind. After several days, moxibustion is forbidden. Boil sheep tail fat until slightly cooked, wrap in silk, and apply hot compress to the wound repeatedly to extract wind. Rinse with mouthwash. Apply Yuzhen San (Jade True Powder) daily until the wound stops feeling rusty and pus forms, then switch to Shengji Yuhong Gao (Flesh-Generating Jade Red Ointment) for gradual healing.

Commentary: Liu Wansu discussed sweating, purging, and harmonizing for the Three Yang meridians but omitted the Three Yin meridians. This is because wind entering Yin meridians indicates critical illness (e.g., abdominal fullness, diarrhea, dry mouth/throat, curled tongue, contracted scrotum), which is incurable; thus, it was excluded.

Formula: Qianli Bensan (Thousand-Mile Running Powder)
Composition: Sole of mules used for long-distance travel, calcined in a yin-yang kiln until preserved nature, ground fine. Dosage: 3 qian, taken with hot yellow wine.

[Formula Song] Qianli Bensan treats traumatic tetanus, trismus, stiffness, chills, and fever. Calcined mule sole powder, three qian taken with yellow wine.

Another Formula: Xiongshu San (Male Rat Powder)
Composition: One live male rat, bound with iron wire, calcined in a yin-yang kiln until preserved nature, ground to fine powder. Dosage: One dose, mixed with hot yellow wine.

[Formula Song] Xiongshu San treats wind remaining in the Exterior. One live rat bound with wire, calcined and powdered, taken with wine to eliminate wind pathogen.

Another Formula: Wugong Xingfeng San (Centipede, Star Aconite, and Wind Powder)
Composition: Wugong (Centipede, 2 units), Jiangbiao (Fish Swim Bladder, 3 qian), Nanxing (Arisaema, 2.5 qian), Fangfeng (Saposhnikovia, 2.5 qian).
Grind to fine powder. Dosage: 2 qian, mixed with yellow wine, twice daily.

[Formula Song] Wugong Xingfeng San searches for wind and induces sweating to remove the source. Arisaema, Fish Swim Bladder, Saposhnikovia powder taken with wine unblocks meridians.

Another Formula: Jiangbiao Wan (Fish Swim Bladder Pill)
Composition: Tianma (Gastrodia, 1 qian), Xionghuang (Realgar, 1 qian), Wugong (Centipede, 2 units), Jiangbiao (Fish Swim Bladder), Jiangcan (Silkworm, fried, 0.5 qian), Yegefen (Wild Pigeon Droppings, fried, 0.5 qian).
Grind to fine powder. Divide into two parts. Part 1: Rice pills sized like paulownia seeds, coated with Zhusha (Cinnabar). Part 2: Add Badoushuang (Rhubarb Frost, 0.25 li), rice pills sized like paulownia seeds. Dosage: 20 pills of Part 1 plus 1 pill of Part 2, increasing by 2 pills per subsequent dose, taken with plain boiled water. Stop when bowels move freely, then resume Part 1 only. Discontinue when cured.

[Formula Song] Jiangbiao Wan treats wind entering the Interior with fright and convulsions, suitable for purging. Gastrodia, Centipede, Silkworm, Pigeon Droppings, Realgar, and Rhubarb Frost made into Cinnabar-coated pills.

Another Formula: Qiangma Tang (Notopterygium and Ephedra Decoction)
Composition: Qianghuo (Notopterygium, 0.7 qian), Mahuang (Ephedra, 0.7 qian), Chuanxiong (Ligusticum, 0.7 qian), Fangfeng (Saposhnikovia, 0.7 qian), Zhike (Bitter Orange, bran-fried, 0.7 qian), Baifuling (Poria, 0.7 qian), Shigao (Gypsum, calcined, 0.7 qian), Huangqin (Scutellaria, 0.7 qian), Xixin (Asarum, 0.7 qian), Ganjuhua (Chrysanthemum, 0.7 qian), Manjingzi (Vernonia, 0.7 qian), Qianhu (Peucedanum, 0.7 qian), Gancao (Licorice, raw, 0.7 qian), Baizhi (Angelica Dahurica, 0.5 qian), Bohe (Mint, 0.5 qian).
Add 3 slices of Shengjiang (Fresh Ginger). Water: 2 zhong. Decoct to 0.8 zhong.

[Formula Song] Qiangma Tang contains Ligusticum, Saposhnikovia, Bitter Orange, Poria, Angelica Dahurica, Gypsum, Scutellaria, Mint, Asarum, Chrysanthemum, Vernonia, Peucedanum, Licorice. Induces sweating to cure traumatic tetanus.

Another Formula: Yuding San (Sanguisorba and Violet Powder)
Composition: Fangfeng (Saposhnikovia, 5 qian), Diyu (Sanguisorba, 5 qian), Zihuadiding (Viola, 5 qian), Machixian (Purslane, 5 qian).
Grind to fine powder. Dosage: 3 qian, mixed with warm rice soup.

[Formula Song] Yuding San treats traumatic tetanus with head sweat but no body sweat. Harmonizes when taken with rice soup. Ingredients: Saposhnikovia, Sanguisorba, Viola, Purslane.

Another Formula: Da Xionghuang Tang (Large Ligusticum and Rhubarb Decoction)
Composition: Huangqin (Scutellaria, 2 qian), Qianghuo (Notopterygium, 2 qian), Dahuang (Rhubarb, 2 qian), Chuanxiong (Ligusticum, 1 qian).
Decoct in water. Take until slight loose stool occurs.

[Formula Song] Da Xionghuang Tang treats traumatic tetanus with excessive sweating, constipation, and red urine. Decoct Scutellaria, Notopterygium, sliced Rhubarb, and Ligusticum together.

Another Formula: Fangfeng Danggui San (Saposhnikovia and Angelica Powder)
Composition: Fangfeng (Saposhnikovia, 2.5 qian), Danggui (Angelica Sinensis, 2.5 qian), Chuanxiong (Ligusticum, 2.5 qian), Shengdi (Rehmannia, 2.5 qian).
Decoct in water.

[Formula Song] Fangfeng Danggui San addresses excessive exterior release with harmonized Zang-Fu but persistent sweating. Decoct these four ingredients; Ligusticum and Rehmannia harmonize.

Another Formula: Xiao Xionghuang Tang (Small Ligusticum and Scutellaria Decoction)
Composition: Chuanxiong (Ligusticum, 3 qian), Huangqin (Scutellaria, 2 qian), Gancao (Licorice, raw, 0.5 qian).
Decoct in water, take warm.

[Formula Song] Xiao Xionghuang Tang is used after exterior release if exterior heat persists. Decoct Ligusticum, Scutellaria, and Licorice warm to clear heat and eradicate the root.

Another Formula: Guashi Tang (Trichosanthes and Talcum Decoction)
Composition: Gualouren (Trichosanthes Seed, 9 qian), Huashi (Talcum, 1.5 qian), Cangzhu (Atractylodes, soaked in rice water, fried, 1 qian), Nanxing (Arisaema, 1 qian), Chishao (Red Peony Root, 1 qian), Chenpi (Tangerine Peel, 1 qian), Baizhi (Angelica Dahurica, 0.5 qian), Huangbai (Phellodendron, 0.5 qian), Huangqin (Scutellaria, 0.5 qian), Huanglian (Coptis, 0.5 qian), Gancao (Licorice, raw, 0.2 fen).
Add 3 slices of Shengjiang (Fresh Ginger). Water: 3 zhong. Decoct to 1 zhong.

[Formula Song] Guashi Tang contains Peony, Angelica Dahurica, Phellodendron, Scutellaria, Coptis, Atractylodes, Arisaema, Tangerine Peel, Licorice. Taken after purging for traumatic tetanus if heat persists.

Another Formula: Danggui Dihuang Tang (Angelica and Rehmannia Decoction)
Composition: Danggui (Angelica Sinensis, 1 qian), Shudi (Prepared Rehmannia, 1 qian), Chuanxiong (Ligusticum, 1 qian), Gaoben (Ligusticum Wallichii, 1 qian), Baishao (White Peony Root, wine-fried, 1 qian), Fangfeng (Saposhnikovia, 1 qian), Baizhi (Angelica Dahurica, 1 qian), Xixin (Asarum, 0.5 qian).
Decoct in water.

[Formula Song] Danggui Dihuang Tang contains Ligusticum, Ligusticum Wallichii, White Peony, Saposhnikovia, Angelica Dahurica, Asarum. Used when significant blood loss occurred at injury to nourish nutrients and prevent wind invasion.

Another Formula: Shengui Yangrong Tang (Ginseng and Angelica Nourishing Nutrient Decoction)
Composition: Renshen (Ginseng, 1 qian), Danggui (Angelica Sinensis, 1 qian), Chuanxiong (Ligusticum, 1 qian), Baishao (White Peony Root, wine-fried, 1 qian), Shudi (Prepared Rehmannia, 1 qian), Baizhu (Atractylodes Macrocephala, earth-fried, 1 qian), Baifuling (Poria, 1 qian), Chenpi (Tangerine Peel, 1 qian), Gancao (Licorice, honey-fried, 0.5 qian).
Add 3 slices of Shengjiang (Fresh Ginger) and 2 pieces of Hongzao (Jujube flesh). Decoct in water.

[Formula Song] Shengui Yangrong Tang treats deficient Ying and Wei, wind residing due to unprotected ulcers. Fresh Ginger and Jujube added to Bazhen Tang with Tangerine Peel.

Another Formula: Zhusha Zhijia San (Cinnabar and Nail Powder)
Composition: Human hand/foot nails (calcined until preserved nature, 6 qian), Zhusha (Cinnabar, 2 qian), Nanxing (Arisaema, 2 qian), Duhuo (Angelica Pubescens, 2 qian).
Grind to fine powder. Dosage: 4 qian, mixed with hot yellow wine.

[Formula Song] Zhusha Zhijia San is highly effective for traumatic tetanus causing limb tremors. Take 4 qian with hot wine. Arisaema, Angelica Pubescens, and calcined nails.

Another Formula: Hei Huashe San (Black Flower Snake Powder)
Composition: Mahuang (Ephedra, roasted, 1 liang), Hei Huashe (Black Flower Snake/Wagler's Pit Viper, wine-soaked, 6 qian), Tianma (Gastrodia, 5 qian), Baifuzi (Typhonium, 5 qian), Ganjiang (Dried Ginger, 5 qian), Chuanxiong (Ligusticum, 5 qian), Fuzi (Aconite, processed, 5 qian), Caowu (Aconitum Kusnezoffii, soaked, peeled, 5 qian), Xieshao (Scorpion tip, 2.5 qian).
Grind to fine powder. Dosage: 1 qian, mixed with hot yellow wine, twice daily.

[Formula Song] Hei Huashe Scab contains Scorpion tip, Ephedra, Gastrodia, Typhonium, Dried Ginger, Ligusticum, Processed Aconite, Soaked Aconitum Kusnezoffii. Excellent for dispelling wind-phlegm and treating traumatic tetanus.

Another Formula: Yuzhen San (Jade True Powder)
Composition: Baizhi (Angelica Dahurica, 1 liang), Nanxing (Arisaema, 1 liang), Baifuzi (Typhonium, 1 liang), Tianma (Gastrodia, 1 liang), Qianghuo (Notopterygium, 1 liang), Fangfeng (Saposhnikovia, 1 liang).
Grind to fine powder. Mix with saliva to form a thick paste and apply to the wound. For early-stage traumatic tetanus with opisthotonos and severe trismus, take 3 qian mixed with hot child's urine.

[Formula Song] Yuzhen Powder contains Angelica Dahurica and Arisaema, Typhonium, Gastrodia, Notopterygium, Saposhnikovia. Wind pathogen invading meridians is instantly resolved when taken with hot wine.

Another Formula: Shengji Yuhong Gao (Flesh-Generating Jade Red Ointment) (See Ulcer Section)