伤损昏愦乃伤之至重,以致昏愦不知人事,宜急灌以独参汤。虽内有瘀血,断不可下,急用花蕊石散内化
之;盖恐下之,因泻而亡阴也。若元气虚甚者,尤不可下,亦用前散以化之。凡瘀血在内,大便不通,用大黄、
朴硝;血凝而不下者,须用木香、肉桂二三钱,以热酒调灌服之,血下乃生,怯弱之人,用硝、黄而必加木香、
肉桂同煎者,乃假其热以行其寒也。
花蕊石散
石硫黄(四两) 花蕊石(二两)
上二味合匀,用瓦罐一个,入药在内,封口,外用纸筋盐泥周遭固济,候泥干,安四方砖上,书八卦五行
字,用炭十斤笼叠周匝,自午时,从下着火渐渐上彻,直至经宿炭尽
火冷,又放经宿,罐冷取出研细,用绢罗罗过,瓷盒收贮。每服三钱,以童便调服。
伤损作呕,若因痛甚,或因克伐而伤胃者,宜四君子汤加当归、半夏、生姜;因忿怒而肝伤者,用小柴胡汤
加山栀、茯苓;因痰火盛者,用二陈汤加姜炒黄连、山栀;因胃气虚者,用补中益气汤加生姜、半夏;因出血过
多者,用六君子汤加当归。
四君子汤 补中益气汤(俱见伤损出血)
小柴胡汤 (方见瘀血泛注)
二陈汤 六君子汤(俱见胸腹痛闷)
伤损作渴,若因亡血过多者,用四物汤加人参、白术,如不应,用人参、黄 以补气,当归、熟地以补血,
或用八珍汤。若胃热伤津液者,用竹叶黄 汤;如胃虚津液不足,用补中益气汤;如胃火炽盛,用竹叶石膏汤;
若烦热作渴、小便淋涩,乃肾经虚热,非地黄丸不能救。
竹叶黄 汤
淡竹叶(二钱) 人参 黄 生地黄 当归 川芎 麦冬 芍药 甘草 石膏( ) 黄芩(炒) 半
夏(各一钱)
水煎服。
竹叶石膏汤
竹叶(三把) 石膏(一斤) 人参(三两) 甘草(炙,二两) 麦冬(一升) 半夏(半升) 粳米(半升)
引用生姜,水煎服。
四物汤 补中益气汤(俱见伤损出血)
八珍汤(方见瘀血泛注)
六味地黄丸(方见肌肉作痛)
Traumatic coma (loss of consciousness and mental confusion) is a condition of extreme severity, resulting in the patient being unconscious and unaware of their surroundings. It is imperative to immediately administer Dushen Tang (Single Ginseng Decoction). Although there is blood stasis internally, purgative methods must absolutely be avoided. Instead, Huarui Shi San (Huarui Stone Powder) should be urgently used to resolve the stasis; this is because purgation may lead to the exhaustion and loss of Yin fluids due to diarrhea. In cases where Yuan Qi (Original Qi) is severely deficient, purgatives are even more contraindicated, and the aforementioned powder should also be used to resolve the stasis. Whenever blood stasis remains inside causing constipation, Dahuang (Rhubarb Root and Rhizome) and Puxiao (Mirabilite) are used. If the blood is coagulated and fails to descend, Muxiang (Aucklandia Root) and Rougui (Cinnamon Bark), two or three qian, should be mixed with hot wine and administered orally. Life can only be preserved once the blood descends. For individuals with weak constitutions, when using Xiaoshi (Natrii Sulfas) and Dahuang, it is essential to add Muxiang and Rougui for simultaneous decoction; this utilizes their warming properties to facilitate the action of the cold-natured herbs.
Huarui Shi San (Huarui Stone Powder)
Shi Liuhuang (Pyrite, four liang) Huarui Shi (Huarui Stone, two liang)
Mix the above two ingredients evenly. Place them in one clay pot, seal the mouth, and reinforce the exterior with paper fibers and salt mud around the perimeter. Wait for the mud to dry, place the pot on a square brick, inscribe the Eight Trigrams and Five Elements characters, cover it completely with ten jin of charcoal, ignite from below at Wu hour (11:00 AM–1:00 PM), and gradually burn upwards until the charcoal is exhausted after one night. After the fire cools, leave it for another night. Once the pot is cool, remove it, grind into fine powder, sieve through silk gauze, and store in a porcelain box. Take three qian per dose, mixed with Tongbian (Child's Urine).
Traumatic vomiting caused by severe pain or by excessive harsh treatments damaging the Stomach Qi should be treated with Sijunzi Tang (Four Gentlemen Decoction) added with Danggui (Angelica Sinensis), Banxia (Pinellia Tuber), and Shengjiang (Fresh Ginger). Vomiting caused by anger injuring the Liver should be treated with Xiaochaihu Tang (Minor Bupleurum Decoction) added with Shanzhi (Gardenia Fruit) and Fuling (Poria); vomiting caused by abundant Phlegm-Fire should be treated with Erchen Tang (Two Aged Ingredients Decoction) added with Jiangchao Huanglian (Ginger-fried Coptis Rhizome) and Shanzhi; vomiting caused by deficiency of Stomach Qi should be treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shengjiang and Banxia; vomiting caused by excessive bleeding should be treated with Liu Junzi Tang (Six Gentlemen Decoction) added with Danggui.
Sijunzi Tang (Four Gentlemen Decoction) Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (Both see Traumatic Bleeding section)
Xiaochaihu Tang (Minor Bupleurum Decoction) (Formula see Blood Stasis General Notes section)
Erchen Tang (Two Aged Ingredients Decoction) Liu Junzi Tang (Six Gentlemen Decoction) (Both see Chest and Abdominal Pain and Distension section)
Traumatic thirst caused by excessive blood loss should be treated with Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng Root) and Baizhu (Atractylodes Macrocephala Rhizome). If ineffective, use Renshen and Huangqi (Astragalus Root) to tonify Qi, and Danggui and Shudihuang (Prepared Rehmannia Root) to tonify Blood, or use Bazhen Tang (Eight Treasures Decoction). Thirst caused by Stomach Heat damaging Body Fluids should be treated with Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction - *Note: Text says "Zhuye Huang [missing character] Tang", context implies heat-clearing formula like Zhu Ye Shi Gao Tang*); thirst caused by Stomach deficiency leading to insufficient Body Fluids should be treated with Buzhong Yiqi Tang; thirst caused by blazing Stomach Fire should be treated with Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction); thirst accompanied by irritability, heat, and dysuria (scanty, painful urination) indicates Deficient Heat in the Kidney Meridian, which cannot be cured without Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia).
Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction - *Textual variant*)
Danzhuye (Light Bamboo Leaves, two qian) Renshen (Ginseng Root) Huangqi (Astragalus Root) Shengdihuang (Rehmannia Root) Danggui (Angelica Sinensis) Chuanxiong (Ligusticum Rhizome) Maidong (Ophiopogon Tuber) Shaoyao (Peony Root) Gancao (Licorice Root) Shigao (Gypsum Fibrosum) Huangqin (Scutellaria Root, stir-fried) Banxia (Pinellia Tuber) (Each one qian)
Decoct in water and take orally.
Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction)
Zhuye (Bamboo Leaves, three handfuls) Shigao (Gypsum Fibrosum, one jin) Renshen (Ginseng Root, three liang) Gancao (Licorice Root, honey-fried, two liang) Maidong (Ophiopogon Tuber, one sheng) Banxia (Pinellia Tuber, half sheng) Jingsmi (Glutinous Rice, half sheng)
Add Shengjiang (Fresh Ginger) as a reference, decoct in water, and take orally.
Siwu Tang (Four Substances Decoction) Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (Both see Traumatic Bleeding section)
Bazhen Tang (Eight Treasures Decoction) (Formula see Blood Stasis General Notes section)
Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) (Formula see Muscle Pain section)