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(Emergently administer Liushen San [Sulfur and Musk Powder])
Realgar (Qihuang, Sulfur) (1 qian), Musk (Shexiang) (1 fen). Grind these two ingredients together into a powder. The patient should take 1 fen per dose. After taking the medicine, lie on a quilt. Have four people pull the quilt to roll the patient left and right continuously, without allowing rest. This will surely cause the expulsion of foul matter. Then administer Mengchong San (Manshield Powder), and various injuries can be resolved.

(For treating urinary retention)
Place 1 qian 1 fen of Musk (Shexiang) at the site, then cover it with refined salt (Feiyan) to a thickness resembling a copper coin. Apply moxibustion (Jiufa) three times or for the duration of three incense sticks over the salt. Urination will immediately resume. Remove the Musk once urination is established, and the person will feel refreshed. For traumatic injuries, use fetal bones from cattle, horses, pigs, or sheep that have not yet been born; burning the skin and hair to ash for later use is optimal. "Red Lead" (Hongqian) is originally difficult to obtain; if using the first menstrual blood of an virgin girl, there will inevitably be clots or blood strips two to three cun long. This blood is named Red Lead. Its use in trauma is infallible. This blood contains the vital energy of the parents, hence its scarcity.
Fractures of the Tianzhu bone (Axis vertebra/C2) are incurable. If the cranial bone is shattered, gently press it flat. If the skin is intact, apply Heilong San (Black Dragon Powder); if the skin is broken, fill the wound with Taohua San (Peach Blossom Powder), bandage well, and avoid wind. If the wound extends into the hairline, cut the hair, apply internal medication, and it will heal spontaneously. For shattered fontanelles, apply Zhixue San (Hemostatic Powder) externally and administer upper-body powdered medicines internally. Injuries to both eyes are treatable. Injuries behind the ears are incurable. Eyes open with unrestrained exhalation are incurable. Conditions resembling "fish mouth" with wind entrapment are incurable. Injuries to the throat from food stagnation are incurable. If the Qi pathway of the throat is injured, urgently have one person support the head and compress the trachea, tightening it to prevent air escape. Use a large silver needle threaded with silver wire, connecting segments about one cun apart. Apply pounded Banxia (Pinellia Rhizome) powder as a poultice, changing twice daily. After three days, apply a plaster, and administer upper-body decoctions internally for spontaneous recovery.
For shoulder joint dislocation, first assess the method of reduction. Use a chair to encircle the costal region, pad well with soft clothes and cotton quilts. Have one person hold steady while two persons perform traction on the wrist. Flex the wrist and bind it with silk cloth. If the clavicle is fractured, one end will likely be elevated and uneven. Treatment: first apply a plaster, then layer several sheets of oiled paper as padding, followed by a splint board. Bind tightly under the axilla with long straps before administering Jiegu Dan (Bone-Setting Pill).
Injuries to the Jingjing bone (likely referring to ribs or specific thoracic structures) under the costal margin cannot be bound with splints; they must be pressed flat first, then treated with Heilong San. The same applies to bilateral rib fractures. Fractures of the spinal column (Jiaji area) are incurable.
For shoulder-arm dislocation, have the patient sit low. Cross arms to embrace knees. Use the knee leverage to firmly push, causing the arm to extend forward; gently release to reduce it back to position. Then administer Jiegu Dan and apply plasters.
For wrist dislocation, the physician uses the left hand to suppress and support the palm of the injured arm, while the right hand grasps the distal segment near the joint. Hold firmly, preventing retraction, and pull forcefully to reduce it. Then administer Jiegu Dan and apply plasters.
For other hand bone dislocations, observe the direction of displacement: if displaced left, pull to the right to reduce; if displaced right, pull to the left.
For severed fingers, align them properly, then apply Shengji San (Flesh-Regenerating Powder) onto a plaster for application.
Tight pain in the chest/heart region with redness wrapping the heart is incurable. Cyanosis at the center of the chest is incurable. Breast injuries in men are treatable; breast injuries in women are incurable. Lower back injuries accompanied by involuntary laughter are incurable.
If the abdomen is ruptured with intestines eviscerated and dried/swollen by wind, unable to be reduced: the physician first applies sesame oil to lubricate the intestines. One person supports the intestine while another secretly holds cold water in their mouth and sprays it on the patient's face. The shock causes the patient to contract, allowing the physician to push the intestine back in. Immediately after reduction, pinch the anal sphincter shut and suture with silver wire, ensuring no needle holes remain. First apply two liang of hemostatic herbal medicine, then a plaster.
To determine if the intestine is perforated: vision is insufficient. Have the patient drink a small cup of distilled spirits. After drinking, a physician sniffs the wound. No alcohol scent indicates treatability; presence of alcohol scent indicates incurability.
Small intestine injuries, regardless of Yin/Yang classification, are incurable. Abdominal pain from trauma is treatable. Small intestine injury without stomach involvement is treatable. Pregnancy with lower abdominal injury involving the fetus is incurable. Lower abdominal injury with fecal vomiting is incurable. Testicular injury extending into the lower abdomen is incurable. Hip bone protruding from the groin is irreducible.
For leg fractures or dislocated joints with unequal length preventing reduction: use a small copper saw to trim evenly, then insert and apply a plaster. Administer Jiegu Dan daily. In summer, use clear tea water to keep clean and prevent odor. If the tibia/fibula is displaced inward, it is difficult to treat; use manual manipulation to reduce it to the original position, apply a plaster, and administer powdered medicines.
For hand/foot injuries where bones are dislocated: if only one of the two parallel bones (e.g., radius/ulna or tibia/fibula) is fractured, it is treatable; if both are fractured simultaneously, it is incurable.
The patella (kneecap) is an independent bone. If skin is broken and it dislocates: fashion a square hoop from bamboo strips, secure the patella with long bands, apply external knee guards, and administer Jiegu Dan internally. Remove the hoop upon healing.
For trauma causing urinary/fecal retention: do not use Jiegu Dan initially. Bone-setting medicines are generally drying and hot; mixing with wine exacerbates this heat, rendering them ineffective. First administer TONGLI Tang (Promoting Unobstructed Decoction) to resolve retention, then administer Jiegu Dan.
Trauma occurring after a full meal, or being beaten, if the patient survives three days, is treatable. Trauma with loss of pain sensation and absence of tremors/shivering is incurable. Falling from a height with loud screaming and sweat like oil is incurable.
For bone fragments protruding through flesh: use sharp instruments to trim both ends. Apply Bali Bao (Eight-Coin Treasure), file off sharp edges, press inwards, apply plaster, and wrap with multiple layers of bamboo leaves according to protocol. Then administer Jiegu Dan.
For traumatic swelling where the patient refuses examination or hardness obscures bone fragmentation: the physician gently palpates the swollen area. If crepitus (bone sound) is heard, administer anesthesia first. Incise to drain blood, apply hemostatic herbs, use "No. 7 Anesthetic" to numb the flesh, extract bone fragments, set remaining bones, and apply plaster. Wrap with oiled paper and tie securely. Serve light saline soup; upon waking, administer Jiegu Dan.
For hand bone comminution with intact skin: apply Wulong San (Black Unicorn Powder) and splint. Generally, at flexion points, if splinting prevents future movement, simply apply Heilong San, wrap well, and allow natural flexion/extension.
For severe bone comminution or fracture: assess local alignment. Generally, if the main bone shaft is intact, examine laterally for damage sites. First reduce and press straight, apply plaster, and splint. For severe injuries, manually reduce or distract to correct alignment. First fill the interior with Taohua San, surround with Heilong San, then splint.
During traction, observe how the surrounding bones displace. Traction can be direct or oblique, performed close to the injury site (2-3 fen away), avoiding displacement of other parts. On the second segment bone, judge the ease of traction.
For splinting: soak fir bark in urine, cut to finger-width, arrange evenly on four sides, and bind with hemp rope 2-3 times (use ramie for fingers). In summer, remove splints after two days; in winter, after 4-5 days. After 14 days (two sevens), wash with water to remove old medicine. Do not disturb the injury site during washing. Reapply Heilong San and resplint.
For falls or swelling due to blood stasis: wash with hot medicinal decoction, apply Heilong San externally.
For occasional sprains/strains: administer middle-body powdered medicines internally and apply plasters. For severe cases, add Jiegu San.
For severe injuries: wash with medicinal decoction, then apply topical medicine. Mild injuries need not be washed.
For splinting: use a piece of fir wood board. Spread Heilong San mixed with ginger juice on oiled paper, place over the injury site, and splint.
If bones are not comminuted: apply plaster only. Administer upper, middle, and lower body powdered medicines twice daily.
For bleeding: apply Taohua San. If bleeding persists, pack the wound with Sanqi (Notoginseng Radix), surrounded by Taohua San.
Blood stasis injuries strictly forbid cloth bandaging. As blood dries, it may adhere to the cloth, making dressing changes difficult. Oiled umbrella paper is preferable.
In rural areas lacking herbs/plasters, for fractures: temporarily mash glutinous rice with medicinal wine, ginger, and scallions. Wrap in hot cloth heated by an ironing board. Internally consume aged wine to prevent blood coagulation, then seek proper treatment.
Take trauma medicines while warm. Avoid cold water and cold foods when taking trauma medicines.
Trauma medicine preparations are unsuitable for mixing in May-June (lunar calendar) due to risk of spoilage. Store trauma medicines in porcelain bottles for best preservation.