Library

Chen Shigong stated: Generally, for metal weapon injuries with unceasing bleeding, if the patient is constitutionally weak, Qi tonification should be applied; if the patient has inherent heat, Blood nourishment should be applied; if caused by anger, Liver soothing should be performed; if accompanied by irritability, thirst, and confusion, Spleen Qi tonification should be used; if there are tendon spasms and convulsions, Liver Blood nourishment is required; if medication fails, Dihuang Tang (Rehmannia Decoction) should be used to nourish Kidney Water. Exposure to wind must be avoided, as well as taking hemostatic herbs that damage tendons. If the patient feels thirsty, they must endure it without drinking water; dry and fatty foods are suitable to quench thirst. Salty foods must strictly be avoided, as well as excessive consumption of fermented grain juice or thin porridge; violating these taboos will cause blood to surge and overflow, leading to death. Emotions such as joy, anger, worry, and sorrow, loud talking, wild laughter, excessive thinking, sexual exertion, irritability, overwork, sour and salty foods, pickled oils, and hot soups are all contraindicated, even after recovery. Liuyi San (Six-Ingredient Powder) and Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) can be taken to ensure safety. (From *Waike Zhengzong*)

Cheng Shanling stated: Cuts from blades or sharp porcelain fragments result only in broken skin and flowing blood if superficial; if deep, tendons may sever with uncontrollable bleeding. For broken skin, Fuyuan San (Fortune-Origin Powder) should be sprinkled to stop bleeding and relieve pain. For severed tendons, Tianxia Diyi Jinchuang Yao (Number One Metal Wound Medicine in the World) should be applied. If both bone and tendon are severed, the patient's complexion will likely be sallow; externally, wind and cold must be avoided, and internally, cold foods are contraindicated. In cases of excessive blood loss, Dushen Tang (Single Ginseng Decoction) or Bazhen Tang (Eight-Treasure Decoction) should be used for tonification; there are no other methods. (From *Yangyi Shifa*)

*Maijing* states: For metal wound injuries with excessive bleeding, a deficient and fine pulse indicates survival, while a rapid, full, and large pulse indicates death. For bleeding from metal wounds, a deep and small pulse indicates survival, while a floating and large pulse indicates death. For chopping wounds losing one or two *shi* (a unit of volume/weight indicating massive loss) of blood, a large pulse predicts death within twenty days.

For stabbing wounds with unceasing bleeding where the pulse ceases, or becomes large, death occurs within seven days; a slippery and fine pulse indicates survival. If the pulse does not correspond to the disease, death ensues.

*Bingyuan* states: For metal wounds with severed intestines, prognosis varies by depth. If only one end of the intestine is visible, it cannot be reconnected. If abdominal pain, shortness of breath, and inability to eat occur, death follows in one and a half days for large intestine severance, and three days for small intestine severance. If both ends are visible, immediate suturing is possible: first, suture the severed intestine with needle and thread according to method, then apply rooster comb blood to the junction to prevent gas leakage, and push it back inside. If the intestine is eviscerated but intact, wash it with barley gruel juice, soak it, and return it to the abdomen. Drink the clear gruel liquid gradually; after more than twenty days, consume soft rice porridge, and after one hundred days, resume normal porridge diet.

*Linghui Fang* states: Patients with metal wound blood loss suffer from extreme thirst but must endure it. They should eat dry food and consume fatty substances to quench thirst. Porridge drinks must be avoided to prevent fatal blood overflow. Anger, loud laughter, physical labor, and consumption of salty/sour foods, hot wine, and hot soups are contraindicated, as they cause wound pain to flare up, potentially leading to immediate death.

*Tai Ping Sheng Hui Fang* states: Metal wounds injuring the Tianchuang acupoint, eyebrow corners, back of the head, jumping vessels in the arms, inner thighs, upper and lower breasts, Xinjiuwei acupoint, small intestine, and Shu points of the Zang-Fu organs are fatal sites. Additionally, head trauma with brain matter extrusion, aphasia, upward staring eyes, bubbling sounds in the throat, salivation, and involuntary hand movements are untreatable.

*Jisheng Babui* states: For metal wound bleeding, a deficient and fine pulse is favorable, while a full and large pulse is dangerous.

It further states: Even if the injury is superficial, a weak and rapid vital pulse is concerning; if the injury is severe but the vital pulse is harmonious and slow, there is no cause for concern. In severe bleeding, the pulse should not be surging and large, but rather level, regular, and substantial.

It also states: If the abdomen is ruptured and intestines protrude, completely severed intestines are difficult to treat, but intact ones are curable. For ruptured intestines and abdominal wall, use hemp threads or mulberry bark fibers as sutures, coated with Huarui Shi San (Mineral Pyrite Powder), and suture from the inside. The intestine should be moistened with clarified oil to restore vitality before insertion into the abdomen, then the abdominal wall is sutured. Do not suture the outer redundant skin; leave it open, apply medicinal powder, and wait for tissue regeneration.

It further states: If the abdominal wall is broken and intestines and fat protrude, administer decoctions like Huoxue San (Blood-Invigorating Powder) or Foshou San (Buddha's Hand Powder) orally. The fat can be manually removed as it is non-vital tissue. Then, push the intestines back in and suture. Administer purgatives to prevent constipation.

*Zhengchuan* states: Generally, metal wounds, fractures, falls, and internal injuries invariably involve stagnant blood, which should first be expelled. If blood loss is excessive, the focus shifts to regulating and tonifying Qi and Blood. Huarui Shi San, Duoming San, Jiming San, Daozhi San, Posxue Xiaotong Tang (Blood-Breaking Pain-Relieving Decoction), and Fuyuan Huoxue Tang (Restoring Vitality Blood-Invigorating Decoction) are all selectable options.