如镞破大小腹，致肠突出者，看肠外衣膜穿破否？若膜穿者，肠必逐条而散也，则不治
；若
可治。不可伤其膜，宜敷收膜散，外盖玉红膏，冀其渐平。如肠出者，将温汤浴暖其肠，不
可伤犯。一人将醋和冷水，不令病者知觉，急 其面，其肠自收。用油线缝合，不可太深，
恐伤其肉。掺铁扇散，搽玉红膏，外盖长肉膏。又用布缠腰数转，须避风邪，切戒恼怒、高
声，恐有崩裂之患。初服舒肠活血汤，再服八珍汤，调理月余可愈。或阴囊皮破，肾子挂出
，用温汤挪上，油线缝合，搽玉红膏，又盖长肉膏，服调理之剂可愈。或皮不破而肾子入小
腹者，不治。
凡皮肉穿破之症，失血过多，营卫已虚，或被风邪袭入经络，渐传入里，寒热交作，口
噤切牙，角弓反张，口吐涎沫，身冷自汗，伤口反为底陷，其毒内攻，其危甚速。投万灵丹，或
大神效活络丹，以玉真散敷于患处，得脓 肿、身温有汗为效。若前症不退，伤口不高，乍
醒乍昏，时发时止，口噤不开，语声不出，终属死症。
夫接骨入骱者，所赖其手法也。两手安置其筋骨，仍复于旧位也。其伤有轻重，而手法
有所宜、失宜。其痊可之迟速及遗留之生理残障，皆关乎手法之所施也。人身有十二经，筋脉罗列，
必知其体，识其部位。机触于外，巧生于内，手随心转，法从手出。或拽之离而复合，或推
之就而复位。或正其斜，或完其阙。或骨有截断碎断斜断，骱
有全脱半脱，筋有弛纵卷挛，翻转离合，在其肉内，以手扪之，自悉其情。法之所施，不知
其苦，方为手法也。伤有关性命者，如七窍上通脑髓，膈近心君，四末受伤，痛苦入心。若
元气素壮，败血易消，刻期可愈。元气素弱，一旦被伤，势必难支，若手法再误，万难挽回
，尤当慎之。医者，心明手巧，知其病情，善用手法，治之多效。若草率不较，误入非浅。
虽笔之于书，乃活法多端，难以尽述。须得口传心授，临症多而活法变，庶无误耳。
如果箭头刺破大小腹部，导致肠子脱出，首先要观察肠子的外衣膜是否穿破？如果膜已破裂，肠管必然逐条散开，这就无法治疗；如果膜未破，则可以治疗。处理时不可损伤其膜，适宜敷用收膜散，外部覆盖玉红膏，希望它能逐渐平复。如果肠子脱出，应用温热的汤水清洗温暖肠管，不可使其受到损伤。曾有一例，有人将醋与冷水混合，不让病人察觉，急忙以此水喷洒病人的面部，受刺激后肠子自然回纳。随后用油线进行缝合，缝合深度不可过深，恐怕会伤及肌肉组织。之后撒上铁扇散，涂抹玉红膏，外部再覆盖长肉膏。另外用布带在腰部缠绕数圈，必须避开风邪，切忌恼怒和高声喊叫，恐怕有伤口崩裂的危险。初期服用舒肠活血汤，随后服用八珍汤，调理一个多月即可痊愈。或者阴囊皮肤破裂，睾丸脱出，用温水将其托回，用油线缝合，涂抹玉红膏，再覆盖长肉膏，服用调理药剂即可痊愈。或者皮肤未破而睾丸陷入小腹者，无法治疗。
凡是皮肉穿破的病症，若失血过多，营卫之气已经虚弱，又被风邪侵袭经络，逐渐传入体内，出现寒热交替发作、牙关紧闭、咬紧牙齿、角弓反张（身体向后弯曲如弓）、口吐涎沫、身体发冷且自汗、伤口反而凹陷的情况，这是毒气内攻，病情危急且发展迅速。应投用万灵丹，或大神效活络丹，并用玉真散敷于患处，等到出现脓液肿胀、身体变暖且有汗出，即为见效。如果前述症状不退，伤口不隆起，患者时而清醒时而昏迷，症状时发时止，牙关紧闭不开，不能说话，最终属于死症。
至于接骨复位，主要依赖手法操作。双手安置好筋骨，使其恢复到原来的位置。伤势有轻重之分，手法也有适宜与否的区别。痊愈的快慢以及遗留的生理残疾，都取决于手法的应用。人体有十二经脉，筋脉交错罗列，必须了解其形体，识别其部位。外部的触动引发内部的巧思，手随心意转动，技法从手中施展。有的通过牵引使其分离后再复合，有的通过推按使其就位并复位。有的矫正其倾斜，有的修补其缺损。如果骨头有截断、碎裂、斜断，关节有完全脱位或部分脱位，筋脉有松弛、卷曲、挛缩、翻转、离合等情况，存在于肌肉内部，用手触摸探查，自然能了解具体情况。手法的应用，要让患者不知痛苦，这才算是真正的手法。伤势关系到性命的情况，如七窍上通脑髓，膈部靠近心脏，四肢末端受伤，痛苦深入内心。如果元气素来强壮，败血容易消散，限期可以痊愈。如果元气素来虚弱，一旦受伤，势必难以支撑，如果手法再有误，就万难挽回，尤其应当谨慎。医生应当心明手巧，了解病情，善于运用手法，治疗大多有效。如果草率行事不加详察，错误就会很深。虽然记载在书中，但活法多种多样，难以全部叙述清楚。必须得到口传心授，临床经验丰富才能灵活变通，这样才不会有误。
If an arrowhead pierces the upper or lower abdomen, causing the intestines to protrude, one must first observe whether the outer membrane of the intestines is ruptured. If the membrane is ruptured, the intestinal loops will scatter strand by strand, and this condition is incurable; if the membrane is intact, it is treatable. Care must be taken not to damage the membrane. It is appropriate to apply Shoumo San (Membrane-Recovering Powder) and cover it externally with Yuhong Gao (Jade Red Ointment), hoping for gradual flattening. In cases where intestines are eviscerated, warm water should be used to bathe and warm the intestines without causing injury. There was a case where someone mixed vinegar with cold water, concealed this from the patient, and hastily splashed it on the patient's face, which caused the intestines to retract spontaneously due to the stimulus. The wound was then sutured using oiled thread; the suturing depth must not be too deep to avoid damaging the flesh. Tie Shan San (Iron Fan Powder) was sprinkled, Yuhong Gao (Jade Red Ointment) applied, and Changrou Gao (Flesh-Growing Ointment) covered externally. Additionally, several turns of cloth bandages were wrapped around the waist. Exposure to wind-cold pathogenic factors must be avoided, and anger or loud shouting must be strictly prohibited to prevent the risk of wound dehiscence. Initially, Shuchang Huoxue Tang (Intestine-Relaxing and Blood-Activating Decoction) was administered, followed by Bazhen Tang (Eight-Treasure Decoction). With调理 (conditioning/regulation) for over a month, recovery could be achieved. Alternatively, if the scrotal skin is ruptured and the testicles are exposed, they should be gently pushed back up using warm water, sutured with oiled thread, smeared with Yuhong Gao (Jade Red Ointment), covered with Changrou Gao (Flesh-Growing Ointment), and treated with conditioning agents for recovery. However, if the skin is intact but the testicles have retracted into the lower abdomen, the condition is incurable.
For any injuries involving rupture of skin and flesh, excessive blood loss leads to deficiency of Ying (Nutrient Qi) and Wei (Defensive Qi). If invaded by Wind-Cold pathogens entering the meridians and gradually transmitting inward, symptoms such as alternating chills and fever, trismus (lockjaw), teeth grinding, opisthotonos (body bent backward like a bow), foaming at the mouth, cold body with spontaneous sweating, and sunken wounds may occur. This indicates internal attack by toxins, a critical condition with rapid deterioration. Wanling Dan (Ten-Thousand Spirits Pill) or Dashenxiao Huoluo Dan (Great Divine Efficacy Meridian-Activating Pill) should be administered, and Yuzhen San (Jade True Powder) applied topically to the affected area. Effectiveness is indicated by suppuration/swelling, warming of the body, and sweating. If previous symptoms persist, wounds do not elevate, consciousness fluctuates between wakefulness and coma, symptoms come and go intermittently, trismus remains unrelieved, and speech is lost, the prognosis is ultimately fatal.
Regarding bone setting and joint reduction, reliance is placed on manual techniques. Both hands position the tendons and bones, restoring them to their original alignment. Injuries vary in severity, and manual techniques must be appropriate or inappropriate. The speed of recovery and any resulting physical disabilities depend entirely on the application of these techniques. The human body has twelve primary meridians, with tendons and vessels interlaced; one must understand their structure and identify their locations. External stimulation generates internal skill; the hand follows the mind, and methods emerge from the hand. Techniques include pulling to separate and then recombine, pushing to align and reduce displacement, correcting obliquity, or repairing defects. If bones are fractured, comminuted, or obliquely broken, joints are fully or partially dislocated, or tendons are lax, curled, contracted, flipped, or displaced within the muscle tissue, palpation with the hands reveals the specific situation. A proper manual technique should be applied such that the patient feels no pain; this constitutes true manual therapy. Injuries affecting vital life functions, such as those where the seven orifices connect to the brain marrow, the diaphragm is near the Heart (the sovereign organ), or the four extremities are injured causing pain to penetrate the heart, require extreme caution. If the Yuan Qi (Original Qi) is inherently strong, blood stasis dissipates easily, and healing occurs within a set period. If Yuan Qi is inherently weak, once injured, support is difficult to maintain; if manual techniques are also erroneous, recovery is nearly impossible, so utmost prudence is required. Physicians must be mentally clear and dexterous, understand the disease condition, and skillfully apply manual techniques for effective treatment. Hasty actions without careful consideration lead to deep errors. Although recorded in books, there are numerous flexible methods that cannot be fully described. One must receive oral transmission and mental instruction; only through extensive clinical experience can methods be adapted flexibly, ensuring no mistakes.