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Jiming San (from *San Yin Fang*). Used for injuries caused by metal blades or blows, where blood stasis accumulates, leading to severe restlessness and a sensation of impending death.

Dahuang (Rhubarb Radix et Rhizoma, steamed with wine, 5 qian) Dangguiwei (Angelicae Sinensis Radix Caudex, 3 qian) Taoren (Persicae Semen, 14 grains, ground)

Prepare as one dose. Decoct with wine and administer at the time of cockcrow. The patient will recover after passing bloody stool the next day. It is also excellent for treating fractures and traumatic injuries.

Zhu Danxi stated: Traumatic tetanus (Poshang Feng) often results in death and is the most acute condition. Initially, it arises from excessive bleeding, wind pathogen entering through the wound, or premature closure of the wound causing blood stasis to stagnate internally. Blood pathology belongs to Yin; although initially located in the exterior, it easily transmits to the Zang organs. Therefore, injuries caused by this wind pathogen are difficult to treat. Symptoms include fever, spontaneous sweating, trismus (lockjaw), and convulsions. The condition is extremely urgent and cannot be treated with ordinary medicines; it requires Quanxie (Scorpio) to open orifices and extinguish wind, combined with Fangfeng (Saposhnikoviae Radix) and other wind-dispelling herbs.

Feng Luzhan stated: For traumatic tetanus where the pathogenic factor is initially in the exterior, dispersing methods should be used, following the treatment principles for exterior syndromes in Cold Damage (Shanghan).

He further stated: There are four ominous signs in traumatic tetanus that indicate untreatability: first, the face and eyes appear dark blue/black; second, sweat beads on the forehead do not flow; third, the eyes become small and fixed/staring; fourth, the body sweats profusely like oil. (From *Jinang*)

Chen Shigong stated: Traumatic tetanus occurs when skin and flesh are damaged and subsequently invaded by external wind pathogens entering the meridians, gradually transmitting inward. Symptoms include alternating chills and fever, trismus, teeth grinding, opisthotonos (arched back), and foaming at the mouth. If the pathogen enters the Yin level, the body becomes cool with spontaneous sweating, and the injury site becomes flat and sunken as before, indicating that the toxin has retreated inward. One should use Wanling Dan to induce sweating, allowing the wind pathogen to exit outward, and then apply Yuzhen San to the affected area. Pus discharge indicates a favorable prognosis; if symptoms persist despite sweating, the outcome is fatal. (From *Waike Zhengzong*)

In cases where children or adults develop boils on the head, forehead, or temples, and after they rupture, the minor nature of the injury leads to neglect and refusal to apply plasters, external wind and water-dampness may invade. This causes swelling of the head and face, resembling traumatic tetanus. Internal administration of Jingjie, Fangfeng, Baizhi, Jiangcan, and Chantui to induce sweating is indicated. Externally, Hongshengdan should be used to draw out pus, covered with a plaster for recovery.

*Huichun Lu* states: For traumatic tetanus resulting from beatings, characterized by swollen and hot head and face, Jiwei Qianghuo Tang should be taken hot to induce sweating. Externally, grind Xingren (Apricot Seed) into a paste, mix with a little flour, and apply with fresh well-water to the wound; the swelling will subside.

Chen Shigong stated: In traumatic tetanus, if after sweating the trismus does not resolve, speech remains impossible, other symptoms persist, the injury site is not raised, the patient alternates between consciousness and coma, and symptoms come and go, the prognosis is fatal. (From *Waike Zhengzong*)