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1. When examining the pulse, first observe the Cun (inch), Guan (bar), and Chi (cubit) positions on the left hand. If the pulse is full and large (Hong Da), and the Taiyang region (temporal area), chest, hypochondrium, lower abdomen, and scrotum feel warm, it can be saved. If the pulses in both feet are palpable and strong, it is treatable; if there is pulsation under the ribs, it is also treatable.

2. If the Cun, Guan, and Chi positions on the right hand are fine, thin, deep, and slow, it indicates an external contraction. Chills, high fever, headache, and generalized body pain indicate external wind-cold invasion; avoiding wind is paramount. Avoid raw/cold foods, fresh fish, meat, and strong alcohol. For such conditions, apply external plasters and administer purgative medicines internally. If purgatives are used, after one day, it is best to only administer Shufeng San (Wind-Dispersing Powder) or Liqi San (Qi-Regulating Powder).

3. For falls or blows causing damage to the five Zang organs and loss of consciousness, blow Tongguan San (Pass-the-Gate Powder) into the nostrils. For males, use the left nostril; for females, the right. It is auspicious if the patient sneezes and expels phlegm.

4. For falls or blows causing lockjaw, rub with Frost Plum Meat (Shuangmei Rou) three to four times before applying medication.

5. For joint dislocations and bone fractures, first administer Jiegu San (Bone-Setting Powder), urgently apply external plasters, and then tightly bind with a board outside.

Striking upwards promotes smooth Qi flow; striking straight causes Qi obstruction; striking downwards reverses Qi flow. Among these, downward thrusts (Daocha Quan) are the most ferocious. All internal injuries fear reversed Qi from downward thrusts the most, as the harm is severe and should not be underestimated.

If there are many blood vessels visible on the whites of the eyes, there is also much internal blood stasis. Fixed gaze without spirit is difficult to treat. Pulling the nail bed of the middle finger: if it returns to normal upon release, it is treatable; if not, it is untreatable. Purple-black nails are untreatable. Retraction of the penis is untreatable. Observe toenails together with fingernails; foot sole injury with waxy yellow complexion is difficult to treat. If one or two of the "Five Extinction" signs (five critical prognostic indicators) are absent, treatment may still be possible.

When struck by fists: flat punches to the upper body are harmless; Sanjian punches are also harmless; Cuo punches are difficult to treat. There is also the Cha punch: straight thrusts might be treatable; upward thrusts may cause vomiting of blood, which has a chance of being treated; downward thrusts cause blood to sink and cannot be expelled, leading to certain death.

Emergency Medication (Prescriptions for acupoint injuries mentioned in the previous chapter):
For injuries below the fontanelle and at the bilateral Taiyang acupoints, take Maxiong Wan. For unceasing bleeding, take Zijin Dan. For injuries to the laryngeal prominence (Jiehou), take Zijin Dan. For injuries to the Philtrum (Renzhong), take Maxiong Wan. For dizziness/heaviness from blows to both ears, or scalp wounds at the occiput, take Zijin Dan with wine-soaked child's urine, assisted by Shengjin San, followed by a decoction to conclude treatment. The throat has two tubes: the trachea is external, the esophagus is internal. Throat cuts caused by a right-handed knife are easier to treat; those by a left-handed knife are difficult. Esophageal rupture is untreatable. Tracheal rupture: first use anesthesia, sprinkle fine powder of Raw Pinellia Rhizome (Sheng Banxia), then apply downy hairs from human tail hair assisted by Ginseng root paste, suture the skin with mulberry bark thread (after applying anesthesia), and cover externally with Xuejie Gao (Dragon's Blood Plaster). If human hair is unavailable, reed flower tips may be used. For recovery, use Ganjie Tang, and optionally take Zijin Dan with wine, spoon by spoon. Do not tie sutures tightly to avoid further injury. For fractures of the three segments of the transverse bone in the chest, expect hemoptysis; take Zijin Dan with wine-soaked child's urine, assisted by Shengjin San, concluding with a decoction. Injuries to the heart pit cause lockjaw, cardiac closure, and inability to walk; take Duoming Dan. For breast injuries above or below, first take Duoming Dan, assisted by Mengchong San, concluding with a decoction using channel-guiding herbs. Use Bupleurum Root (Chaihu) for left/right chest, and Platycodon Root (Jiegeng) and Tangerine Peel (Qingpi) for the back. For severe cases with lockjaw, blow a small amount of Biqisan (Nose-Blowing Powder) into the nostrils via a reed tube (male left, female right); if no sneeze, blow the other nostril. If still no sneeze, dip a piece of rush pith in saliva to introduce medicine into the nose. Sneezing with expulsion of phlegm/blood is auspicious. Otherwise, it is a critical condition where medication is contraindicated. Left breast injury causes coughing; take Zijin Dan, assisted by Shengjin San, then Liuwei Dihuang Wan with antitussive herbs. [Text error "Men" likely refers to a specific trauma type] causes lockjaw, opisthotonos, and rigidity. If three of the Five Extinction signs are absent, Duoming Dan can be taken within seven days; after seven days, dosage must be carefully managed. If upper body Qi stagnation occurs, take Zijin Dan to purge blood, then use a decoction. Injury to the Sea of Blood (Xuehai) untreated leads to blood masses; use Pungent Niter (Puxiao) moxibustion/irrigation, avoid powders, drink one jar of Walnut Medicinal Wine, and apply Qianchui Gao externally to dissipate the mass. Take Duoming Dan first, then apply plaster, then Mengchong San until cured. Qi Gate injury causes Qi obstruction, resulting in opisthotonos, neck stiffness, and rigid body like a corpse. If untreated for more than three hours, or if rescue is delayed allowing Qi to descend and foul stool to pass, death is inevitable. Do not panic. Check respiration. If absent, it was likely a downward thrust injury. Quickly pull the hair, place the patient prone over your knee, massage and lightly tap the back to expel Qi, then medicate. For blows causing fainting, do NOT use diaphoretic (sweating) medicines. Use Zijin Dan for left-side injuries, Duoming Dan for right-side. Fever appearing 3-4 days later may require diaphoretics to disperse wind. For new injuries, after seven days when blood returns to its vessels, only take Qili San; use other medicines after seven days. For joint fractures, take Guapi San, apply HT Lu Gao, and perform manipulation over the plaster for natural bone setting. For injuries below the heart pit in the Small Intestine area, use Qi-moving medicines. First take Mengchong San 3-4 doses, then Qi-moving medicines. If intestines are not painful, Qi-moving medicines are unnecessary. Bladder injury causes urinary retention; use umbilical moxibustion to restore urination. If ineffective, the bladder is shattered and untreatable. Stomach/Digestive tract injuries are treated with purgative decoctions. Scrotal rupture: seal with Ginseng powder and apply green HT hair to heal. Alternatively, clamp with bamboo strips then suture. If clamping is inconvenient, suture directly and take Maxiong Wan. Leg injuries: apply Liangtoujian Gao. Waist/spine injuries: use bran manipulation method and take Lower Back Pain Formula. Kick to Haidi Acupoint causes blood rushing up, roaring in ears, chest oppression, and dizziness; first take Huxin Wan for pain. Though injured below, the pathology affects the upper body; use blood-invigorating decoction. For constipation, use umbilical irrigation. External Genital injury: treat similarly, but prevent upward migration by having someone lean against the back and pressing down from the lower abdomen with heels; avoid hot baths. Weili/Coccyx injury: take 7 qian of Plantago Seed powder mixed with rice soup, or use irrigation and diaphoretics. Abdominal blunt trauma: take Zijin Dan, then decoction with Yinchen (Artemisia Capillaris) etc., similar to jaundice formulas. Generally, upper body injuries focus on dispersing blood using Duoming Dan (three doses daily); if unable to swallow, use Dang Gui blood-invigorating medicines. Pediatric injuries prioritize purity/cleanliness. Elderly patients have weak constitution; reduce dosage. During medication, avoid pork, duck eggs, fresh chicken, mutton, seafood, dried bamboo shoots, noodles, vinegar, and mushrooms. Avoid wind, sexual abstinence, calm the mind, and remove worry. After three months, complications will likely be avoided. For chronic old injuries, take Mengchong San. For hematemesis, take Zijin Dan. For critical emergencies, Duoming Dan is superior. For releasing the exterior, Donggua San is best. There are thirteen standard formulas for regulation; following them ensures no errors.

There is another excellent formula, now passed down due to my old age. Observe my technique. Unscrupulous doctors, greedy for wealth, exploit patients' illnesses, turning non-critical cases into crises by using harsh purgatives to induce coma, thereby claiming credit for "inducing labor." For pregnant women regardless of gestational age, if fetal Qi is injured causing backache and abdominal pain, one dose brings relief. Even if threatened miscarriage with bleeding occurs in a critical state, one dose brings relief, and a second dose cures it. For term pregnancy with inflexible pubic symphysis causing difficult labor or life-threatening situations, one dose induces delivery, saving both mother and child. For breech presentation or failure to progress for 6-7 days, or dead fetus in utero in critical condition, one dose works immediately. This formula is effective in every case, truly miraculous. Seeing people suffer maternal and infant mortality due to lack of good strategies, I could not bear it. I secreted this formula to share with the world, hoping to save mothers and children permanently from this disaster. I urge colleagues to spread it widely so we may all reach longevity. It is my great fortune and the fortune of the world.

This was published and distributed by Zhao Yaoxian of Yaodu. Since verified formulas are rare, and this one is miraculous and crucial for childbirth, few would distribute it. Fearing it would be lost, I had it woodblock printed to disseminate it widely, preventing its obscurity. My deepest hope is that everyone is spared the calamity of difficult childbirth.