Library

Zhangchuang (Bruising Wounds from Caning) is a condition where, in severe cases, blood stasis is the primary pathology. For blood stasis located externally, superficial lesions are treated with Bian stone (stone lancet) pricking, deep lesions with needle puncture, internal ulcerations with incision and drainage, and necrotic tissue with debridement. For blood stasis located internally, it is appropriate to harmonize with herbs that invigorate blood and promote Qi circulation; in severe cases, purgatives or moving agents should be used to facilitate flow. This constitutes the method for treating blood coagulation. However, during the punishment, shouting injures Qi, enduring pain injures Blood, and grief/anger injures the Shen (Spirit). When both Qi and Blood as well as emotional states are damaged, deficiency is inevitable. If tonification is not employed, emaciation and debility will worsen daily. Furthermore, the Spleen governs muscles; if Spleen Qi is injured, appetite decreases; if blood vessels are damaged, muscles suffer. Therefore, immediately after injury, if one observes that deficiency predominates over stagnation, it is appropriate to use herbs such as Renshen (Ginseng Radix), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Shudihuang (Rehmanniae Radix Preparata), and Gancao (Glycyrrhizae Radix et Rhizoma) to specifically regulate Spleen Qi and support/tongue the Qi and Blood. Once the Spleen is robust, Yuan Qi (Original Qi) recovers daily, muscles regenerate naturally, and safety is assured. For injuries involving tendons and bones causing pain, Moyao Jiangsheng Dan (Myrrh Descending Sage Pill) is suitable. If trismus (lockjaw) or opisthotonos (backward arching of the back) occurs, Yuzhen San (Jade True Powder) is also effective. In summary, this condition requires first examining the presence or absence of blood stasis and the excess or deficiency of form and Qi, then treating accordingly based on judgment. For any treatment methods for various complications not fully detailed here, they should be cross-referenced with the section on falls and blows. The four external formulas for Zhangchuang are found in the External Medicine section.

Wen Yonghui, Minister of Justice, was caned for memorializing against the Emperor's southern tour. His blood stasis had dispersed, but necrotic flesh did not ulcerate/drain. Using Tuo Li (Support Interior) herbs, it slightly ulcerated with clear pus, indicating Qi and Blood deficiency. Without large doses of Renshen (Ginseng Radix) and Huangqi (Astragali Radix), tonification cannot occur. Minister Wen was also skilled in medicine and feared abdominal fullness. I insisted he take the medicine, after which his appetite slightly returned. Subsequently, I increased the dosage of strong tonics; his diet improved daily, the flesh ulcerated with thick pus, and he recovered. I also treated nine colleagues of Minister Wen, including Hanlin Academician Jiang. All were first treated to dissipate blood stasis, then gradually given Pai Nong Tuo Li (Drain Pus Support Interior) herbs, and all recovered.

Xia Feng, a native of Beijing, suffered from widespread ulceration of the buttocks and knees due to caning wounds, with pus and blood stasis retained. He frequently experienced delirium and confusion, caused by internal action of pus-toxin. Urgently applying opening/draining methods worsened his delirium, indicating deficiency. After one dose of Bazhen Tang (Eight Treasures Decoction), symptoms slightly improved. After several doses, dead flesh naturally sloughed off and was removed. He was instructed to wash the wound with Lie Ti Tang (Hunting Hoof Decoction), apply Shenxiao Danggui Gao (Miraculous Angelica Ointment), and take Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction). He recovered in two months. Had stronger blood-breaking agents been administered, it would have been critical. (Commentary by Xue Ji)