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In cases of injury characterized by swelling and pain, the pain is caused by the coagulation and stagnation of blood stasis. If there is distension with a heavy, bearing-down sensation, discoloration appearing blue or black, and in severe cases, fever, thirst, and sweating, this indicates obstruction and stagnation of the meridians and damage to Yin blood. Treatment should first involve pricking to release evil blood (stagnant blood) to unblock the obstruction, followed by regulation using Siwu Tang (Four Substances Decoction).

If pain following an injury is due to Blood deficiency, symptoms include fever, thirst, irritability, chest oppression, dizziness, and worsening in the late afternoon (Shi hour, 3-5 PM). This constitutes a syndrome of Yin deficiency with internal heat. Treatment is appropriate with Bazhen Tang (Eight Treasures Decoction) added with Mudanpi (Moutan Cortex), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Rougui (Cinnamomi Cortex), and Gusuibu (Drynariae Rhizoma).

If vomiting of black blood occurs after injury, it initially results from trauma causing damaged blood to flow into the stomach cavity. The blood appears black like bean juice and is expelled through vomiting. For patients with robust constitution and Qi, Baihe San (Lily Powder) is used; for those with deficient constitution and Qi, Jiawei Xiong Gui Tang (Modified Chuanxiong and Angelica Decoction) is indicated.

Baihe San Composition: Chuanxiong (Ligusticum Chuanxiong Rhizome), Chi Shaoyao (Paeoniae Radix Rubra), Danggui (Angelicae Sinensis Radix), Baihe (Lilii Bulbus), Shengdihuang (Rehmanniae Radix), Cebaiye (Platycladi Cacumen), Jingjie (Schizonepetae Herba), Xijiao (Rhinocerotis Cornu - *Note: Substitute with legal alternatives in modern practice*), Mudanpi (Moutan Cortex), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), Yujin (Curcumae Radix), Dahuang (Rhei Radix et Rhizoma) (each 1 qian/3g). Decoct in water, mix with Tongbian (urine of a healthy young boy) and take orally.

Jiawei Xiong Gui Tang Composition: Chuanxiong (Ligusticum Chuanxiong Rhizome), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baihe (Lilii Bulbus, soaked in water for one day), Jingjie (Schizonepetae Herba) (each 1 qian/3g). Decoct with 1.5 cups of water and 0.5 cup of wine until 0.8 cup remains. Take at any time.

Regarding fever following injury: If caused by excessive blood loss, resulting in a pulse that is surging yet empty upon light pressure and completely imperceptible upon deep pressure, this is Fever due to Blood Deficiency, treated with Danggui Buxue Tang (Angelica Tonifying the Blood Decoction). If the pulse is deep, minute, and weak upon pressure, this is Fever due to Excess Yin (Cold), treated with Sijunzi Tang (Four Gentlemen Decoction) added with Paojiang (Prepared Ginger) and Fuzi (Aconiti Lateralis Radix Praeparata). If fever is accompanied by restlessness, muscle twitching, and fasciculations, this indicates Loss of Blood (severe hemorrhage), treated with Shengyu Tang (Savior the Life Decoction). If fever is accompanied by incessant sweating, this indicates Blood Collapse (Qi collapsing with Blood), treated with Dushen Tang (Single Ginseng Decoction). In cases of Blood Collapse, if the pulse is solid/excess, prognosis is difficult; if the pulse is fine/small, prognosis is favorable.

Danggui Buxue Tang Composition: Huangqi (Astragali Radix, roasted/honey-fried, 1 liang/30g), Danggui (Angelicae Sinensis Radix, 3 qian/9g). Decoct in water and take orally.

Shengyu Tang Composition: Renshen (Ginseng Radix), Chuanxiong (Ligusticum Chuanxiong Rhizome), Danggui (Angelicae Sinensis Radix), Shudihuang (Rehmanniae Radix Preparata), Shengdihuang (Rehmanniae Radix), Huangqi (Astragali Radix, roasted/honey-fried) (equal parts). Decoct in water and take orally.

Sijunzi Tang (Four Gentlemen Decoction) and Dushen Tang (Single Ginseng Decoction) (See "Hemorrhage from Injury" section for formulas).