诸刺入肉系外伤，蝼蛄捣涂最为良，如刺已出仍作痛，再涂蝼蛄即无妨。
【注】诸刺入肉，外伤之证也。软浅者，以针拨出；硬深者，捣蝼蛄涂之，少时即出。
如刺已出，而仍作痛者，再以蝼蛄涂之即愈。
皮肉损破外伤风，初觉牙关噤不松，甚则角弓反张状，吐涎抽搐不时宁。四因动静
惊溃审，陷缩神昏不语凶。在表宜汗里宜下，半表半里以和平。
【注】此证由破伤皮肉，风邪袭入经络。初起先发寒热，牙关噤急，甚则身如角弓反
张之状，口吐涎沫，四肢抽搐，无有宁时，不省人事，伤口锈涩。然伤风有四∶因动受、静
受、惊受、疮溃后受，皆可伤风。动而受者，怒则气上，其人跳跃，皮肉触破，虽被风伤，
风入在表，因气血鼓旺，不致深入，属轻。静受者，起作和平之时，气不充鼓，偶被破伤，
风邪易于入里，属重。惊受者，惊则气陷，偶被伤破，风邪随气直陷入里，多致不救属逆。
若风邪传入阴经者，则身凉自汗，伤处反觉
平塌陷缩，其则神昏不语，嘬口舌短，其证贵乎早治，当分风邪在表、在里，或半表半
里，以施汗、下、和三法。如邪在表者，寒热拘急，口噤切牙，宜服千里奔散，或雄鼠
散汗之；次以蜈蚣星风散频服，追尽臭汗。如邪在里者，则惊而抽搐，脏腑秘涩，宜江鳔
丸下之。如邪在半表半里无汗者，宜羌麻汤主之。若头汗多出，而身无汗者，不可发汗，
宜榆丁散和之；若自汗不止，二便秘赤者，宜大芎黄汤主之。又有发表太过，脏腑虽和，自
汗不止者，宜防风当归散服之。发表之后，表热不止者，宜小芎黄汤服之。攻里之后，里
热不止，宜栝石汤服之。若伤时血出过多，不可再汗，宜当归地黄汤主之。至于生疮溃后
受风者，因生疮，溃而未合，失于调护，风邪乘虚侵入疮口，先从疮围起粟作痒，重则
牙紧，项软，下视，不宜发汗，误汗令人成痉，当以参归养荣汤加僵蚕主之，先固根本，
风邪自定。若手足战掉不已者，宜朱砂指甲散主之；若痰盛抽搐身凉者，宜黑花蛇散主
之。外治之法，遇初破之时，一二日间，当用灸法，令汗出其风邪方解。若日数已多，即
禁用灸法，宜羊尾油煮微熟，绢包乘热熨破处，数换，拔尽风邪，未尽者，次日再熨，兼
用漱口水洗之，日敷玉真散，至破口不锈生脓时，换贴生肌玉红膏，缓缓收敛。
【按】刘完素只论三阳汗、下、和三法，而不论三阴者，盖风邪传入阴经，其证已危，
如腹满自利，口燥咽干，舌卷囊缩等类，皆无可生之证，故置而不论也。
千里奔散
用行远路骡蹄心，阴阳瓦 存性，研细。每服三钱，热黄酒冲服。
【方歌】千里奔散破伤风，口噤拘急寒热攻，骡蹄火 存性研，每服三钱黄酒冲。
雄鼠散
活雄鼠一枚，用铁线缚绕，阴阳瓦 存性，研为细末。作一服，热黄酒调下。
【方歌】雄鼠破伤风居表，活鼠一枚铁线
绕，阴阳瓦 存性研，酒调尽服风邪了。
蜈蚣星风散
蜈蚣（二条） 江鳔（三钱） 南星 防风（各二钱五分）
共研细末，每用二钱，黄酒调服，一日二服。
【方歌】蜈蚣星风邪未散，搜风发汗去风源，南星江鳔防风末，酒服经络自通宣。
江鳔丸
天麻 雄黄（各一钱） 蜈蚣（二条） 江鳔 僵蚕（炒） 野鸽粪（炒，各五分）
共研细末，作两分，一分饭丸如梧桐子，朱砂为衣；一分加巴豆霜二分五厘，饭丸如
梧桐子大。每用朱砂药二十丸，加巴豆药一丸，二服加二丸，白滚水送下，至便利为度；
再服朱砂药，病愈即止。
【方歌】江鳔破伤风入里，惊兼抽搐下之宜，天麻蜈蚣僵鸽粪，雄黄巴霜丸朱衣。
羌麻汤
羌活 麻黄 川芎 防风 枳壳（麸炒） 白茯苓 石膏（ ） 黄芩 细辛 甘菊花 蔓
荆子 前胡 甘草（生，各七分） 白芷 薄荷（各五分）
生姜三片，水二盅，煎八分服。
【方歌】羌麻汤芎风枳壳，苓芷石膏芩薄荷，细辛菊蔓前甘草，发汗破伤风即瘥。
榆丁散
防风 地榆 紫花 地丁 马齿苋（各五钱）
共研细末，每服三钱，温米汤调下。
【方歌】榆丁破伤风为患，头汗身无不宜散，此药米汤服解和，防榆地丁马齿苋。
大芎黄汤
黄芩 羌活 大黄（各二钱） 川芎（一钱）
水煎服，以微利为度。
【方歌】大芎黄治破伤风，汗多便秘小水红，水煎黄芩与羌活，大黄切片共川芎。
防风当归散
防风 当归 川芎 生地（各二钱五分）
水煎服。
【方歌】防风当归表太过，脏腑虽调汗出多，只将四味水煎服，川芎生地共相和。
小芎黄汤
川芎（三钱） 黄芩（二钱） 甘草（生，五分）
水煎温服。
【方歌】小芎黄汤发散后，表热犹存用此医，芎芩甘草煎温服，退热除根神效奇。
栝石汤
栝萎仁（九钱） 滑石（一钱五分） 苍术（米泔水浸，炒） 南星 赤芍 陈皮
（各一钱） 白芷 黄柏 黄芩 黄连（各五分） 甘草（生，二分）
生姜三片，水三盅，煎一盅服之。
【方歌】栝石芍芷柏芩连，苍术南星陈草煎，医治破伤风下后，热犹不解服之痊。
当归地黄汤
当归 熟地 川芎 本 白芍（酒炒） 防风 白芷（各一钱） 细辛（五分）
水煎服。
【方歌】当归地黄芎 本，白芍防风芷细辛，破伤之时血出甚，服此滋荣风不侵。
参归养荣汤
人参 当归 川芎 白芍（酒炒） 熟地 白术（土炒） 白茯苓 陈皮（各一钱）
甘草（炙，五分）
生姜三片，红枣肉二枚，水煎服。
【方歌】参归养荣荣卫虚，溃疮失护风邪居，生姜三片二枚枣，八珍汤内入陈皮。
朱砂指甲散
人手足指甲（烧存性用，六钱） 朱砂 南星 独活（各二钱）
共研细末，每用四钱，热黄酒调下。
【方歌】朱砂指甲散神效，破伤风侵手足摇，每用四钱热酒服．南星独活指甲烧。
黑花蛇散
麻黄（炙，一两） 黑花蛇（即乌蛇，酒浸，六钱） 天麻 白附子 干姜 川芎
附子（制） 草乌（泡，去皮，各五钱） 蝎梢（二钱五分）
共研细末，每服一钱，热黄酒调下，日二服。
【方歌】黑花蛇散蝎麻黄，天麻白附子干
姜，川芎附子草乌泡，善却风痰医破伤。
玉真散
白芷 南星 白附子 天麻 羌活 防风（各一两）
共研细末，唾津调浓，敷伤处。如破伤风初起，角弓反张，牙关紧急，每用三钱，热
童便调服亦妙。
【方歌】玉真散芷共南星，白附天麻羌活风，破伤风袭传经络，热酒调服立奏功。
生肌玉红膏（见溃疡门）
Any thorn or splinter penetrating the flesh constitutes an external injury. Applying a paste of mole crickets (Loushu) is most effective. If pain persists after the thorn has been removed, reapplying the mole cricket paste will resolve the issue without harm.
[Note] Various cases of thorns entering the flesh are classified as external injuries. For shallow and soft penetrations, use a needle to pick them out; for deep and hard ones, apply crushed mole crickets to the wound, and the thorn will be expelled shortly.
If pain remains after the thorn is removed, applying mole crickets again will lead to recovery.
When wind pathogen invades through damaged skin and flesh, initially the jaw becomes stiff and locked. In severe cases, the body arches backward like a bow (opisthotonos), with salivation and frequent convulsions. These four causes—movement, stillness, fright, and ulceration—must be carefully examined. If the wound collapses and shrinks, accompanied by coma and muteness, the prognosis is ominous. When the pathogen is in the Exterior, sweating is indicated; when in the Interior, purgation is indicated; when in the Half-Exterior Half-Interior, harmonizing is indicated.
[Note] This condition arises from wind pathogen invading the meridians following skin and flesh trauma. Initially, there is chills and fever, lockjaw, and in severe cases, the body assumes an opisthotonic posture, with salivation, limb convulsions that do not cease, unconsciousness, and a rough sensation at the wound site. However, wind injury has four categories: acquired during movement, during stillness, due to fright, or after ulceration.
Acquired during movement: Anger causes Qi to rise; jumping or vigorous motion breaks the skin. Although exposed to wind, the pathogen remains in the Exterior. Because Qi and Blood are vigorous and active, the pathogen does not penetrate deeply; this is a mild case.
Acquired during stillness: During periods of calm rest, Qi is not vigorously active. Accidental injury allows wind pathogen to easily enter the Interior; this is a severe case.
Acquired due to fright: Fright causes Qi to sink. Accidental injury allows wind pathogen to sink directly into the Interior along with the Qi, often leading to death; this is a adverse/rebellious case.
If the wind pathogen transmits to the Yin meridians, the body becomes cool with spontaneous sweating, and the wound appears flat and sunken. Subsequently, coma, muteness, lockjaw, and tongue retraction occur. Early treatment is crucial. One must differentiate whether the wind pathogen is in the Exterior, Interior, or Half-Exterior Half-Interior, and apply sweating, purgative, or harmonizing methods accordingly.
If the pathogen is in the Exterior, presenting with chills, fever, stiffness, lockjaw, and teeth grinding, Qianli Bensan (Thousand-Mile Sprint Powder) or Xiongshusan (Male Rat Powder) should be taken to induce sweating; subsequently, Wugong Xingfeng San (Centipede, Aconite, and Wind-Expelling Powder) should be taken frequently to expel foul sweat.
If the pathogen is in the Interior, presenting with fright, convulsions, and constipation, Jiangbiao Wan (Fish Maw Pill) should be used for purgation.
If the pathogen is in the Half-Exterior Half-Interior without sweating, Qiangma Tang (Notopterygium and Ephedra Decoction) is the primary formula.
If there is profuse head sweating but no body sweating, sweating therapy is contraindicated; Yuding San (Sanguisorba and Vinca Powder) should be used to harmonize. If spontaneous sweating persists with dry, red urine and stool, Daxionghuang Tang (Major Ligusticum and Rhubarb Decoction) is indicated.
If excessive exterior-releasing therapy was used, resulting in persistent spontaneous sweating despite harmonized Zang-Fu organs, Fangfeng Danggui San (Saposhnikovia and Angelica Powder) is indicated.
If exterior heat persists after releasing the exterior, Xiaoxionghuang Tang (Minor Ligusticum and Scutellaria Decoction) is indicated.
If interior heat persists after purging, Guashitang (Trichosanthes and Talc Decoction) is indicated.
If excessive blood loss occurred at the time of injury, further sweating is contraindicated; Danggui Dihuang Tang (Angelica and Rehmannia Decoction) is indicated.
Regarding wind invasion after ulceration of sores: Due to open, unhealed wounds and lack of care, wind pathogen enters the void of the wound. It first presents as millet-like papules and itching around the wound margin. In severe cases, lockjaw and neck weakness occur. Sweating is contraindicated; mistaken sweating leads to spasms. Shengu Yangrong Tang (Ginseng and Angelica Nourishing Ying Decoction) plus Cantharis (Stiff Silkworm) should be used to strengthen the root, causing the wind pathogen to subside naturally.
If tremors of the hands and feet persist, Zhusha Zhijia San (Cinnabar and Nail Powder) is indicated. If there is abundant phlegm, convulsions, and cool body temperature, Heihuashe San (Black Flower Snake Powder) is indicated.
For external treatment: Within one or two days of initial injury, moxibustion should be applied to induce sweating and resolve the wind pathogen. If many days have passed, moxibustion is strictly prohibited. Boiled sheep tail fat (slightly cooked), wrapped in silk, should be applied hot to the injured area, replaced multiple times, to extract the wind pathogen. If not fully extracted, repeat the next day. Wash with mouthwash. Apply Yuzhen San (True Jade Powder) daily until the wound ceases to feel rough and pus forms. Then switch to Shengji Yuhong Gao (Flesh-Regenerating Jade Red Ointment) for gradual healing.
[Commentary] Liu Wansu only discussed the sweating, purgative, and harmonizing methods for the Three Yang meridians, omitting the Three Yin meridians. This is likely because when wind pathogen transmits to the Yin meridians, the condition is critical. Symptoms such as abdominal fullness, spontaneous diarrhea, dry mouth and throat, tongue retraction, and testicular retraction indicate a lack of vital signs, hence they were omitted.
Qianli Bensan (Thousand-Mile Sprint Powder)
Use the heart of the hoof of a mule that travels long distances. Calcine it on a Yin-Yang tile until it retains its nature (charred outside, raw inside). Grind into fine powder. Take 3 qian per dose, washed down with hot yellow wine.
[Formula Song] Qianli Bensan treats broken-wind, with lockjaw, stiffness, chills, and fever attacking; Calcined mule hoof ground fine, take 3 qian washed down with yellow wine.
Xiongshusan (Male Rat Powder)
One live male rat. Bind it tightly with iron wire. Calcine it on a Yin-Yang tile until it retains its nature. Grind into fine powder. This constitutes one dose. Mix with hot yellow wine and take.
[Formula Song] Xiongshu treats broken-wind located in the Exterior; One live rat bound with iron wire; Calcined on Yin-Yang tile, mixed with wine to expel wind pathogen completely.
Wugong Xingfeng San (Centipede, Aconite, and Wind-Expelling Powder)
Wugong (Centipede, 2 pieces) Jiangbiao (Fish Maw, 3 qian) Nanxing (Arisaema, 2.5 qian) Fangfeng (Saposhnikovia, 2.5 qian)
Grind all into fine powder. Take 2 qian per dose, mixed with yellow wine. Take twice daily.
[Formula Song] Wugong Xingfeng San searches for wind pathogen before it scatters; Expels wind and induces sweating to remove the source; Arisaema, Fish Maw, and Saposhnikovia powder; Taken with wine, meridians become clear and smooth.
Jiangbiao Wan (Fish Maw Pill)
Tianma (Gastrodia, 1 qian) Xionghuang (Realgar, 1 qian) Wugong (Centipede, 2 pieces) Jiangbiao (Fish Maw) Jiangcan (Silkworm, stir-fried, 0.5 qian) Yegefen (Wild Pigeon Droppings, stir-fried, 0.5 qian)
Grind into fine powder. Divide into two portions. One portion is made into pills the size of paulownia seeds using rice paste, coated with Zhusha (Cinnabar). The other portion is added with Badou Frost (Croton Seed Frost, 0.25 qian) and made into pills the size of paulownia seeds. Take 20 Cinnabar-coated pills plus 1 Croton pill per dose. Increase by 1 Croton pill for subsequent doses. Swallow with plain boiled water. Continue until bowel movements are free. Then resume taking only the Cinnabar pills. Stop when the disease is cured.
[Formula Song] Jiangbiao Wan treats broken-wind entering the Interior; Indicated for fright and convulsions requiring purgation; Gastrodia, Centipede, Silkworm, and Pigeon droppings; Realgar and Croton frost pills coated with Cinnabar.
Qiangma Tang (Notopterygium and Ephedra Decoction)
Qianghuo (Notopterygium) Mahuang (Ephedra) Chuanxiong (Ligusticum) Fangfeng (Saposhnikovia) Zhike (Bitter Orange, bran-fried) Baifuling (Poria) Shigao (Gypsum) Huangqin (Scutellaria) Xixin (Asarum) Ganjuhua (Chrysanthemum) Manjingzi (Vitex) Qianhu (Peucedanum) Gancao (Licorice, raw, 0.7 qian each) Baizhi (Angelica Dahurica) Bohe (Mint, 0.5 qian each)
Add 3 slices of fresh ginger. Add 2 bowls of water. Decoct to 0.8 bowl. Take warm.
[Formula Song] Qiangma Tang contains Ligusticum, Saposhnikovia, and Bitter Orange; Poria, Angelica Dahurica, Gypsum, Scutellaria, and Mint; Asarum, Chrysanthemum, Vitex, Peucedanum, Licorice; Induces sweating, broken-wind heals quickly.
Yuding San (Sanguisorba and Vinca Powder)
Fangfeng (Saposhnikovia) Diyü (Sanguisorba) Zihua Diding (Vinca Major, 5 qian each) Machixian (Purslane, 5 qian)
Grind into fine powder. Take 3 qian per dose, mixed with warm rice soup.
[Formula Song] Yuding San treats broken-wind afflictions; Head sweating with no body sweating requires harmonizing; This medicine taken with rice soup resolves and harmonizes; Saposhnikovia, Sanguisorba, Vinca, and Purslane.
Daxionghuang Tang (Major Ligusticum and Rhubarb Decoction)
Huangqin (Scutellaria) Qianghuo (Notopterygium) Dahuang (Rhubarb, 2 qian each) Chuanxiong (Ligusticum, 1 qian)
Decoct in water and take. Stop when slight laxation occurs.
[Formula Song] Daxionghuang Tang treats broken-wind; With profuse sweating, constipation, and red urine; Decoct Scutellaria and Notopterygium in water; Slice Rhubarb and combine with Ligusticum.
Fangfeng Danggui San (Saposhnikovia and Angelica Powder)
Fangfeng (Saposhnikovia) Danggui (Angelica Sinensis) Chuanxiong (Ligusticum) Shengdi (Rehmannia, 2.5 qian each)
Decoct in water and take.
[Formula Song] Fangfeng Danggui San treats excessive exterior release; Although Zang-Fu are regulated, sweating is profuse; Decoct these four herbs in water; Ligusticum and Rehmannia harmonize together.
Xiaoxionghuang Tang (Minor Ligusticum and Scutellaria Decoction)
Chuanxiong (Ligusticum, 3 qian) Huangqin (Scutellaria, 2 qian) Gancao (Licorice, raw, 0.5 qian)
Decoct in water and take warm.
[Formula Song] After Xiaoxionghuang Tang releases the exterior, if exterior heat remains, use this medicine; Decoct Ligusticum, Scutellaria, and Licorice warm; Clears heat and removes root, miraculous effect.
Guashitang (Trichosanthes and Talc Decoction)
Gualouren (Trichosanthes Seed, 9 qian) Huashi (Talc, 1.5 qian) Cangzhu (Atractylodes, soaked in rice water, stir-fried) Nanxing (Arisaema) Chishao (Red Peony) Chenpi (Tangerine Peel, 1 qian each) Baizhi (Angelica Dahurica) Huangbai (Phellodendron) Huangqin (Scutellaria) Huanglian (Coptis, 0.5 qian each) Gancao (Licorice, raw, 0.2 qian)
Add 3 slices of fresh ginger. Add 3 bowls of water. Decoct to 1 bowl. Take.
[Formula Song] Trichosanthes, Peony, Angelica Dahurica, Phellodendron, Scutellaria, Coptis; Atractylodes, Arisaema, Tangerine Peel, Licorice decocted; After purgation for broken-wind, if heat persists, take this to recover.
Danggui Dihuang Tang (Angelica and Rehmannia Decoction)
Danggui (Angelica Sinensis) Shudi (Prepared Rehmannia) Chuanxiong (Ligusticum) Gaoben (Ligusticum Wallichii) Baishao (White Peony, wine-fried) Fangfeng (Saposhnikovia) Baizhi (Angelica Dahurica, 1 qian each) Xixin (Asarum, 0.5 qian)
Decoct in water and take.
[Formula Song] Angelica, Rehmannia, Ligusticum, and Gaoben; White Peony, Saposhnikovia, Angelica Dahurica, and Asarum; When broken-wound causes heavy blood loss; Take this to nourish Ying and prevent wind invasion.
Shengu Yangrong Tang (Ginseng and Angelica Nourishing Ying Decoction)
Renshen (Ginseng) Danggui (Angelica Sinensis) Chuanxiong (Ligusticum) Baishao (White Peony, wine-fried) Shudi (Prepared Rehmannia) Baizhu (Atractylodes Macrocephala, soil-fried) Baifuling (Poria) Chenpi (Tangerine Peel, 1 qian each) Gancao (Licorice, honey-fried, 0.5 qian)
Add 3 slices of fresh ginger and 2 dates (pitted). Decoct in water and take.
[Formula Song] Shengu Yangrong Tang tonifies deficient Ying and Wei; Open ulcers neglected allow wind pathogen to reside; 3 slices ginger and 2 dates; Add Tangerine Peel to Eight Treasures Decoction.
Zhusha Zhijia San (Cinnabar and Nail Powder)
Human hand/foot nails (calcined to retain nature, 6 qian) Zhusha (Cinnabar) Nanxing (Arisaema) Duhuo (Angelica Pubescens, 2 qian each)
Grind into fine powder. Take 4 qian per dose, mixed with hot yellow wine.
[Formula Song] Zhusha Zhijia San is miraculous; Broken-wind invasion causes hand and foot tremors; Take 4 qian with hot wine; Arisaema, Angelica Pubescens, and calcined nails.
Heihuashe San (Black Flower Snake Powder)
Mahuang (Ephedra, processed, 1 liang) Heihuashe (Black Flower Snake/Wagler's Pit Viper, wine-soaked, 6 qian) Tianma (Gastrodia) Baifuzi (Typhonium) Ganjiang (Dried Ginger) Chuanxiong (Ligusticum) Fuzi (Aconite, processed) Caowu (Aconitum Carmichaelii, soaked, peeled, 5 qian each) Xieshao (Scorpion Tail, 2.5 qian)
Grind into fine powder. Take 1 qian per dose, mixed with hot yellow wine. Take twice daily.
[Formula Song] Heihuashe San contains Scorpion, Ephedra, Gastrodia, Typhonium, Dried Ginger; Ligusticum, Aconite, and soaked Carmichael Aconite; Excellent for dispelling wind-phlegm and treating broken-wind.
Yuzhen San (True Jade Powder)
Baizhi (Angelica Dahurica) Nanxing (Arisaema) Baifuzi (Typhonium) Tianma (Gastrodia) Qianghuo (Notopterygium) Fangfeng (Saposhnikovia, 1 liang each)
Grind into fine powder. Mix with saliva to form a thick paste and apply to the wound. If used for early-stage broken-wind with opisthotonos and lockjaw, take 3 qian mixed with hot child's urine; this is also excellent.
[Formula Song] Yuzhen San contains Angelica Dahurica and Arisaema; Typhonium, Gastrodia, Notopterygium, and Saposhnikovia; Wind pathogen invading and transmitting through meridians; Mixed with hot wine, it works immediately.
Shengji Yuhong Gao (Flesh-Regenerating Jade Red Ointment) (See Ulcer Section)