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Injuries caused by being crushed by trees or falling from heights involve disturbance to the four limbs and five zang organs, inevitably resulting in internal accumulation of evil blood (stasis). The primary concern is nausea. One should first administer heart-clearing medicines, stasis-resolving hemostatic agents, and medications that unblock the large and small intestines in sequence. Adding urine from a healthy young boy (Tongzi Xiaobian) to the decoction before administration yields immediate results. Relying solely on purgatives for the intestines may cause severe obstruction; therefore, combining heart-clearing formulas with intestinal unblocking agents ensures smooth passage without distress or cardiac contamination by stasis. Subsequently, analgesics are administered to stop pain.

For severe injuries such as blunt trauma, knife wounds, or stone impacts, heart-clearing medicines should be taken first, followed by three doses of diuretics and stasis-resolving agents. If blood has not coagulated, it flows out through the wound; if coagulated internally, medication guides it into the large intestine for excretion. In cases where stasis has not yet accumulated due to beating, kicking, or crushing, medications disperse stasis in the limbs. Stasis located in the upper chest may be expectorated orally, while stasis in the middle chest is directed to the large intestine for excretion. After these emergency measures, analgesics derived from the "Twenty-Five Ingredients Formula" are used with modifications. All prescriptions follow the principle of "tang shi" (guiding herbs). Initially, only heart-clearing medicine is decocted and taken with a cup of child's urine for pain relief. For severe injuries, ginger soup or Juncus effusus (Dengxin Cao) soup is used to mix the Twenty-Five Ingredients Formula; mint soup is also acceptable. For knife injuries or damage to the five fu organs, complications like restlessness and hemorrhage must be prevented. Fractures are treated with ginger wine and bone-setting medicines applied externally. Comminuted fractures from heavy impact require the "tang shi" method combined with wine administration. Minor bruises respond quickly to the Twenty-Five Ingredients Formula mixed with ginger soup.

For fractures and dislocations, Heshaowu San (Polygonum multiflorum Powder) is appropriate. Patients with fever and robust constitution should use Shufeng Baidu San (Wind-Dispersing and Toxin-Vanquishing Powder). Those with chills and weak constitutions should use Wuji Jiajiao San (Five Accumulations Combined Powder), followed by tonics like Busun Dan (Damage-Replenishing Pill) and Huoxue Dan (Blood-Activating Pill). Fractures and dislocations should not be treated with strong purgatives or blood-draining herbs initially; instead, focus on dispersing wind, regulating qi, harmonizing blood, relieving pain, and replenishing deficiency. If stasis attacks the heart causing aphasia after a fall, Dusheng San (Sole Saint Powder) and blood-breaking herbs are used to expel stasis, restoring speech, followed by detailed clinical treatment. For painful bruising under the ribs, Dusheng San and blood-breaking herbs are used first, followed by Fuyuan Huoxue Tang (Restore Origin and Activate Blood Decoction). For purple-black skin lesions, use blood-breaking herbs, then Dusheng San, followed by Qing Shang Yuxue Tang (Clear Upper Stasis Decoction) and Xiao Xia Poxue Tang (Eliminate Lower Break-Stasis Decoction). For vomiting of dark blood, start with Dusheng San, then Baihe San (Lily Bulb Powder), and finally Shengliao Siwu Tang (Raw Material Four Substances Decoction) with Hard-bone Cow Milk Root.

For heavy bleeding causing dizziness after cuts or falls, decoct Chuan Danggui (Angelica sinensis) and Da Chuanxiong (Ligusticum chuanxiong). Add Baishao (White Peony), Shudihuang (Prepared Rehmannia), Xuduan (Dipsacus), Fangfeng (Saposhnikovia), Jingjie (Schizonepeta), Qianghuo (Notopterygium), Duohuo (Angelica pubescens), and Nanting (Arisaema). Mix with child's urine; do not use wine. If bleeding is light but stasis exists, mix half Shengliao Siwu Tang with half Dusheng San. For intact skin, add wine. For tetanus symptoms (lockjaw, opisthotonos) after cuts, grind Nanxing (Arisaema) and Fangfeng equally into powder, apply with rice wash water, or mix with hot wine and child's urine for oral administration. Follow with Shufeng Baidu San. For scrotal wounds, take Dusheng San, then analgesics; use blood-breaking herbs if old stasis is present. For evisceration, use heart-clearing medicine with child's urine and Dusheng San, followed by analgesics. For excessive bleeding, decoct Danggui and Chuanxiong, then add Baishao, Shudihuang, Qianghuo, Duohuo, Fangfeng, Jingjie, Baizhi (Angelica dahurica), and Xuduan. Mix with Rushxiang (Frankincense) and Moyao (Myrrh) powders. Rushxiang and Moyao are essential in injury medicines for their ability to dispel stasis and stop pain.

Ziran Tong (Pyritum) should not be used immediately for sprains or dislocations, only after some time; it is suitable for fractures. Do not use it for non-fractured bones. When preparing Ziran Tong, it must be calcined (fire-calcined). Freshly calcined Ziran Tong contains fire and metal toxins that interact with aromatic heat herbs; although it aids bone setting, its drying and scattering effects can be more harmful than knives. Avoid this! Abdominal distension and pain after falling indicate internal stasis; treat with blood-breaking, heart-clearing, and unblocking herbs. If pain persists, use Dusheng San, then analgesics.

For open wounds with heavy bleeding, prioritize pain relief and tonification using Danggui Buxue Tang (Angelica Tonify Qi Decoction). For closed injuries with stasis, use Dusheng San, then blood-breaking herbs, adjusting according to symptoms. If pain continues, use analgesics. For chest pain, use Kaixin Cao, Xuelifkai, and Sumu (Sappan Wood) decocted in wine with child's urine. Alternatively, use Sumu alone with wine and child's urine. For severe open wounds, apply Fengkou Yao (Sealing Wound Medicine) or Bujisan (Muscle-Replenishing Powder) to the center, and surround with Jiexue Gao (Blood-Stopping Paste) to prevent fresh blood flow—a secret technique. Injury treatment relies on tonifying qi and blood; laymen often overuse Ziran Tong for quick results, risking chronic disease. Initial treatment uses Sumu to activate blood, Huanglian (Coptis) to clear fire, Baizhu (Atractylodes) to harmonize the middle, and child's urine. Lower injuries may require purging stasis after initial tonification; upper injuries benefit from leek juice or congee. Never drink cold water, as cold causes blood to coagulate; even a trace entering the heart is fatal.

For elderly patients with lumbar pain after falling from horses, decoct Sumu, Renshen (Ginseng), Huangqi (Astragalus), Chuanxiong, Danggui, Chenpi (Tangerine Peel), and Gancao (Licorice). Then take Busun Dan and Huoxue Dan. Pain from beating or sprains indicates stagnant blood; use blood-breaking herbs. If unbearable, use heart-clearing medicine, then Dusheng San. For severed vessels spurting blood, apply sealing medicine and pressure, or Hemostatic Powder. For swelling, apply hot fried green onion. If urination/defecation is blocked, do not immediately use injury medicines, as they are hot and wine exacerbates constipation. For excess patterns, use blood-breaking herbs plus Mutong (Akebia) and Mangxiao (Mirabilite); for deficiency, use Siwu Tang with Zhike (Bitter Orange), Mahren (Hemp Seed), and Taoren (Peach Kernel) to lubricate the intestines. For very deficient patients unable to purge, add Chansanjia (Pangolin Scale) to Siwu Tang.

Avoid cold foods, especially fish and beef, which are very cold and worsen pain. Avoid diseased pork and sow pork. Herbal remedies for fractures may cause excessive bone growth preventing reduction; combine with sovereign-minister herbs and warm tonics. Injury medicines are hot to generate qi and blood for bone healing; avoid moxibustion. Freshly gathered herbs for poultices are superior to powdered ones. If herbs are unavailable, use sovereign-minister herbs for binding. Avoid ash wine; heavy injuries should not initially use wine as it raises qi causing distension. Once stable, use wine-water decoctions. For injuries to flanks/chest/abdomen, use qi-moving, blood-activating, and heart-clearing medicines. Adjust for deficiency by combining tonics with moving herbs. If moving herbs fail, use qi-regulating herbs to relieve distension. This indicates qi closure rather than blood stasis. If blood stasis is confirmed, move it and regulate qi to prevent tightness. Use injury medicines only after qi is smooth.

For drunk falls causing back pain, black bean wine cures mild injuries by directing qi downward. For children falling on corners, radish seeds decoction regulates qi. For reduction, do not wash the head with water to avoid tetanus; other areas can be washed with cooked oil and herbal water away from wind. Before reduction, drink hot wine with Caowu (Aconitum carmichaelii). If fainting occurs during reduction, administer Suhexiang Wan (Styrax Pill). If unconscious, give cold decoction of Black Bean, Fangfeng, Gancao, and Huanglian, or Yi Cao (Coix Seed) paste. Do not use salt. Add ginger juice if vomiting. These are specialized methods; adjust for patient constitution. The final method involves Caowu wine, then Suhexiang Wan, then cold medicine; applying this to qi-deficient patients is cruel. Only Xue’s method, focusing on internal tonification based on syndrome, is recommended. Refer to subsequent syndrome-specific treatments.