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Traumatic tetanus arises from blood loss leading to malnourishment of the sinews, or from minor wounds allowing wind pathogen invasion initiating fire. Dryness manifests as white crusts with minimal swelling, while dampness presents as flowing turbid water accompanied by trismus (lockjaw).

[Note] Excessive bleeding after trauma causes the sinews to lose nourishment and the meridians to become empty, allowing wind pathogen to enter due to deficiency, as stated in the classics: "Wind pathogen enters when there is deficiency." This is considered a wind-deficiency pathogen, suitable for treatment with Guizhi Tang (Cinnamon Twig Decoction) combined with Danggui Buxue Tang (Astragalus and Angelica Decoction). Typically, contracting wind disease after severe injury with excessive bleeding is common; however, sometimes minor superficial injuries with minimal blood loss lead to disease because the individual has inherent heat, and wind pathogen exploits this condition. As Liu Wansu stated: "Excessive heat and wind pathogen bind together in the meridians," this is considered a wind-fire pathogen, suitable for treatment with Fangfeng Tongsheng San (Saposhnikia Decoction for Unblocking the Intestines and Stomach) added with Scorpion Tail (Quanxie Wei). For such conditions, regardless of excess or deficiency, if wind-toxin is retained internally without manifesting externally, characterized by dry white crusts around the wound, minimal swelling, flow of turbid black fluid, and slight stiffness of the jaw not moving normally, these are all precursors of traumatic tetanus.

Formulas include Fangfeng Tongsheng San with Scorpion Tail, Quanxie San (Scorpion Powder), Zuo Long Wan (Left Dragon Pill), and Banmao Dahuang Fang (Mustard Beetle and Rhubarb Formula).
For excessive fire, use Fangfeng Tongsheng San with Scorpion Tail; for excessive wind, use Quanxie San or Zuo Long Wan. External treatment involves using boiled wine with fire cups. For dog bite-induced wind-toxin entering the abdomen causing spasms, use Banmao (Mustard Beetle) with Dahuang (Rhubarb) decocted in yellow wine.

[Note] Traumatic tetanus with excessive fire often presents as Yangming meridian syndrome, treated with Fangfeng Tongsheng San added with Scorpion Tail. Cases with predominant wind often present as Taiyang meridian syndrome, treated with Quanxie San, which consists of seven raw Scorpion Tails ground into powder and taken with hot wine. If symptoms persist after administration and the pathogen penetrates deeper, use Zuo Long Wan, composed of Columba Fermentum (Wild Pigeon Droppings), Hicis Saccus (Fish Swim Bladder), Bombyx Batryticatus (Stiff Silkworm), Realgar, Centipede, Gastrodia Elata (Tianma), Cinnabar, and Crotonis Fructus Preparatum (Prepared Croton Seed) made into pills, detailed in *Danxi Xinfa* under the section on various traumatic tetanus cases. All these conditions are suitable for external treatment using two clay wine pots filled more than half full with distilled spirits. Heat one pot until boiling silently, pour out the wine, and immediately press the pot onto the traumatic wound to extract turbid black blood and fluid; it will fall off automatically when full. Then use the second pot in rotation until the extraction is complete, at which point the wind pathogen will be cured immediately. For dog bites where wind-toxin enters the abdomen causing spasms, take seven Banmao (Mylabris/Blister Beetles), stir-fry with glutinous rice until the rice turns yellow, remove the rice, grind the beetles into powder, mix with one qian of raw Dahuang (Rhubarb Root) powder, decoct in one cup of Huangjiu (Yellow Wine) until half remains, and take warm on an empty stomach to expel toxins. Reduce the dose by half for weak patients.