Library

In cases where the scrotum is torn off by external force, apply butter from a chicken egg (Jizi Huangyou) and thinly spread the fine hairs of Cibotium barometz (Jinmao Gouji) on top. Subsequently, apply a sealing paste (Fengkou Yao), followed by an external application of Sanxue Gao (Blood-Dispersing Ointment). Internally, decoct and administer Zhongye Jin Suo Chi (Mid-leaf Golden Lock Key) and Zijin Pi (Purple Gold Bark). Externally, wash with a decoction of Perilla Leaf (Zisu Ye). For swelling presenting as cyanotic, black, or purple discoloration in the scrotal region, apply Butou Gao (Flesh-Replenishing Ointment). Alternatively, mix Dingtong Gao (Pain-Calming Ointment) with small amounts of Chishao (Red Peony Root), Caowu (Aconitum Carmichaelii Deh.), Liangjiang (Galangal Rhizome), and Rougui (Cinnamon Bark), crush them together, and apply using crushed Chinese Leek Leaves (Jiu Ye); if leek leaves are unavailable, Scallion Leaves (Cong Ye) may be used. Concurrently, administer diuretic herbs to promote urination.

For women whose femur has dislocated and is lodged near the vulva, preventing walking, place a stool covered with cotton clothing. Have the patient lie supine on it. The physician should grasp the patient's foot and forcefully push it upwards towards the unaffected leg until the femur naturally reduces. Afterwards, apply Jiegu Gao (Bone-Joining Ointment) and Dingtong Gao. For injuries near the lower legs, hips, or scrotum, avoid using blood-invigorating purgatives; instead, use only topical applications to prevent blood stasis accumulation.

For severed tendons and damaged bones, first palpate the injury site to realign the bones and tendons. Apply Jiegu Gao or similar ointments and secure with primary (Zhengjia) and secondary (Fujia) splints. The primary splint consists of fir bark (Shanpi) stripped of its outer layer, cut to finger-width, placed along the muscle, with medicine applied on top. The secondary splint uses bamboo strips (Zhupian) stripped of their inner yellow layer, also finger-width, arranged sparsely for binding. If bones are shattered or fractured with skin/muscle damage, first fill the wound with Bujisan (Muscle-Replenishing Powder), then apply Sanxue Gao. For fractures, apply Jiegu Gao and splint. For open fractures (skin broken, bone exposed), apply Butou Gao. If the fracture is internal with skin/muscle rupture, add fresh urine (Tongbian) to blood-dispersing formulas for oral administration. If the bone is broken but the skin is intact, decoct trauma herbs in wine for oral consumption. For soft tissue injuries without fracture or skin breakage, apply Xiaozhong Gao (Swelling-Reducing Ointment) or Dingtong Gao. If skin is broken and joints are dislocated, and traction fails to reduce, press the skin/muscle 3 fen towards the adjacent area, make a small incision with a sharp knife, and manually reduce the bone without cutting flesh further. After reduction, apply Butou Gao. Leave wounds open around swollen areas and fill with Bujisan; if skin/muscle is intact, apply Jiegu Gao and Dingtong Gao. In cases of severe injury with bleeding, rapid manipulation is crucial. If shrapnel/bone fragments remain under the skin, apply Dingtong Gao and Jiegu Gao with splinting; severe trauma will cause necrosis, allowing fragments to expel naturally. Then apply Bujisan followed by Butou Gao. Assess bone alignment: depression suggests no major damage, while elevation indicates fracture. For fractures, reduce and align via traction, apply medicine, and splint firmly to prevent movement. For dislocations, maintain mobility through gentle bending exercises to prevent stiffness. For application, place Jiegu Gao or Dingtong Gao on banana leaves or paper over a board, then transfer to the injury site. If bone fragments remain, subsequent necrosis will expel them after applying Bujisan and Butou Gao. For severed skin/muscle, seal with Fengkou Yao, suture with thread, and externally apply Butou Gao and Sanxue Gao. For flat-area fractures/shatters with intact skin, use Jiegu Gao and Dingtong Gao with splinting. For joints (hands/feet flexion/extension), use silk bandages allowing periodic movement rather than rigid splints. For finger fractures, bind with ramie fiber; for leg fractures, use ramie rope bindings—warm in winter, cool in summer, lukewarm otherwise. During traction, ensure soft linen padding and apply force close to the injury site, not distal joints, adjusting for angular deformities. Manipulation must be swift and precise, requiring multiple assistants if necessary. For severed tendons, apply Liquidambar resin (Fengxiang) mixed with juice extracted from Boerhaavia diffusa (Jinfecao), followed by Lishang Gao (Trauma-Healing Ointment).