凡至险之症,有气管全断者,不治;若稍连续者,可治。或气管捏扁,气塞不通,医将
二指拈正其管,用通关散吹鼻取嚏可也。或天柱骨断,额冷脉绝者死。或囟门骨破、髓出者不治
。若内膜不穿,髓不出者可治。或食饱受伤,及跌损五内者不治,若过得三日,可治。或耳
后寿台骨破,血流不止者难治。胸口大痛,青色裹心者死。两乳重伤痛极,呼吸不得者难治
。或肾囊皮破,肾子挂出者可治;肾子入小腹者不治。或腰眼重伤,内肾离位,或笑或哭者
立死。或胃肠受伤,吐粪或泄粪者立死。孕妇足踢小腹者难治。重伤后,气出不收,眼开者
,不治。口如鱼嘴,吹沫缠风者,不治。小腹重伤,不分阴阳者,难治。
或跨物失足,骑伤阳物,始而溺孔出血,继则玉茎肿胀,小便点滴不通,小腹坚实
者,死于七日内,不治。又有八忌∶一忌伤脑髓出;二忌伤臂中跳脉;三忌伤小腹膀胱;四
忌伤海底穴;五忌伤五内;六忌伤气海,咽喉痰声如锯物;七忌疼在不伤处,两目直视;八
忌血出不止,先赤后黑,肌肉腐烂,臭秽不堪。犯此八者,难治。凡斗殴时,向上打为顺气
,平打为塞气,倒插打为逆气。凡人血随气转,气顺则血顺,气逆则血逆,塞则气闭,逆则
上冲。是以伤有平塞顺逆之别,若治之不辨,危在须臾。又有五绝之论∶一看两眼白睛上红
筋多,则瘀血亦多,若直视无神,不治;二扳揿其指甲,血即还原者,可治,不还原者,不治;
三若脚趾与手指甲俱黑者,死;四阳物缩者,不治
;五脚底之色蜡黄者,难治。此五绝之症也。又有十不治之证∶颠扑损伤入于肺者,纵未即
死,二七难过;左胁下伤透至内者;肠伤断者;小腹下伤入内者;证候繁多者;伤破阴子者
;老人左股压碎者;血出尽者;肩内耳后伤透于内者;脉不实者。以上诸证,不必用药。
凡是极其危险的伤证,有气管完全断裂的,无法救治;如果气管只是部分相连,还可以治疗。或者气管被挤压变形,导致气息堵塞不通,医生可以用两根手指捏正气管,使用通关散吹入鼻腔引发喷嚏以通气即可。或者天柱骨(颈椎)断裂,额头发冷、脉搏消失的,死亡。或者囟门骨骼破碎、脑髓流出的,无法救治。如果颅内膜没有穿透,脑髓没有流出的,可以治疗。或者在吃饱饭后受伤,以及跌打损伤了五脏六腑的,无法救治;如果能挺过三天,就可以治疗。或者耳后乳突骨破损,血流不止的,难以治疗。胸口剧烈疼痛,面色青紫且中心发暗的,死亡。两乳受到重伤且疼痛极度剧烈,呼吸困难无法喘息的,难以治疗。或者阴囊皮肤破裂,睾丸脱出体外的,可以治疗;睾丸缩入小腹内的,无法救治。或者腰部两侧严重受伤,肾脏移位,或者因疼痛而笑或哭的,立即死亡。或者胃肠受伤,呕吐粪便或排泄粪便的,立即死亡。孕妇足部踢伤小腹部,难以治疗。重伤之后,元气外泄无法收敛,眼睛睁开的,无法救治。口唇张开像鱼嘴一样,口吐白沫并伴有抽搐痉挛的,无法救治。小腹部严重受伤,不分阴阳虚实属性的,难以治疗。
或者是骑跨物体失足,骑伤生殖器,起初尿道口出血,随后阴茎肿胀,小便点滴不通,小腹部坚硬的,七日内死亡,无法救治。又有八种禁忌症:一忌脑髓流出;二忌手臂中跳跃的动脉受损;三忌小腹部膀胱受伤;四忌会阴穴(海底穴)受伤;五忌五脏六腑受伤;六忌气海穴受伤,咽喉间痰声如拉锯般作响;七忌疼痛发生在未受伤的部位,且两眼直视无神;八忌出血不止,先鲜红后发黑,肌肉腐烂,气味恶臭不堪。触犯这八种情况的,难以治疗。凡是斗殴时,向上击打为顺气,平向击打为塞气,向下倒插击打为逆气。人的血液随着气血运行,气顺则血顺,气逆则血逆,气塞则气闭,气逆则向上冲撞。因此外伤有平、塞、顺、逆的区别,如果治疗时不加以辨别,危险就在顷刻之间。又有五种绝症的判断方法:一看双眼白睛上红色血丝多,说明瘀血也多,如果两眼直视无神,无法救治;二扳动按压其指甲,血色能迅速恢复红润的,可以治疗,不能恢复的,无法救治;三如果脚趾甲和手指甲都变黑的,死亡;四生殖器内缩的,无法救治;五脚底颜色呈蜡黄色的,难以治疗。这就是五种绝症。又有十种无法治疗的证候:头部颠扑损伤伤及肺部的,即使没有立即死亡,十四天内也难保性命;左胁下伤透至内部的;肠道断裂的;小腹部下方伤及内部的;证候繁杂众多的;阴器破损的;老年人左侧大腿被压碎的;血液流尽的;肩部和耳后伤透至内部的;脉象虚弱的。以上各种证候,不必用药治疗。
For extremely critical injuries, if the trachea is completely severed, it is untreatable; however, if there is partial continuity, it may be treatable. If the trachea is flattened and airway obstruction occurs, the physician can use two fingers to realign the tube and administer Tongguan San (Passing-Through Powder) into the nasal cavity to induce sneezing for ventilation. If the Tianzhu bone (cervical spine) is fractured, accompanied by a cold forehead and absent pulse, death ensues. If the fontanelle bone is broken with brain matter extrusion, it is untreatable; but if the inner membrane remains intact and no brain matter leaks out, it is treatable. Injuries sustained after a full meal, or falls damaging the Zang-Fu organs (internal organs), are generally untreatable; yet if the patient survives three days, treatment becomes possible. Fractures of the mastoid bone behind the ear with uncontrolled bleeding are difficult to treat. Severe chest pain with cyanosis spreading to the heart region indicates death. Severe trauma to both breasts with excruciating pain and respiratory distress is difficult to treat. Rupture of the scrotal skin with testicular prolapse is treatable; however, if the testicles retract into the lower abdomen, it is untreatable. Severe injury to the lumbar region causing kidney displacement, especially if accompanied by involuntary laughter or crying due to pain, leads to immediate death. Injury to the stomach and intestines resulting in vomiting or defecating feces causes immediate death. A pregnant woman kicked in the lower abdomen presents a difficult prognosis. After severe trauma, if vital Qi escapes and cannot be retained, and the eyes remain open, it is untreatable. A mouth shaped like a fish's gaping jaws with foaming at the mouth and wind-stroke symptoms is untreatable. Severe lower abdominal trauma where Yin and Yang patterns are indistinguishable is difficult to treat.
Falling onto an object and injuring the genitalia initially presents with bleeding from the urethral meatus, followed by swelling of the penis and complete urinary retention with a firm lower abdomen; this results in death within seven days and is untreatable. There are also eight contraindications: 1. Extrusion of brain matter; 2. Injury to pulsating arteries in the arm; 3. Injury to the bladder in the lower abdomen; 4. Injury to the Haidi acupoint (perineum); 5. Injury to the Zang-Fu organs; 6. Injury to the Qihai acupoint (Sea of Qi) accompanied by rattling phlegm sounds in the throat like sawing wood; 7. Pain occurring in uninjured areas with fixed gaze; 8. Unstoppable bleeding that turns from red to black, with rotting flesh and unbearable foul odor. Cases involving these eight conditions are difficult to treat. In fights, upward strikes promote smooth Qi flow, horizontal strikes obstruct Qi, and downward thrusts cause rebellious Qi. Blood follows Qi; when Qi is smooth, blood flows smoothly; when Qi is rebellious, blood rebels; when Qi is obstructed, it closes; when rebellious, it rushes upward. Therefore, traumatic injuries are categorized as smooth, obstructed, or rebellious. Failure to distinguish these during treatment leads to imminent danger.
There are five signs of absolute despair: 1. Numerous red veins on the sclera indicate extensive blood stasis; if accompanied by fixed gaze and lack of spirit, it is untreatable. 2. Pressing the fingernails until blanching; if color returns immediately, it is treatable; if not, it is untreatable. 3. Blackening of toenails and fingernails indicates death. 4. Retraction of the penis is untreatable. 5. Waxy yellow discoloration of the soles of the feet is difficult to treat. These constitute the five signs of despair.
There are also ten untreatable conditions: Head trauma penetrating to the lungs, even if not immediately fatal, will likely result in death within fourteen days (two weeks); deep penetration of injury to the left hypochondrium; severed intestines; deep penetration of injury below the lower abdomen; complex and numerous syndromes; rupture of the external genitalia; crushed left thigh in the elderly; exhaustion of all blood; deep penetration of injury in the shoulder or behind the ear; and weak pulse. For the above conditions, medication is unnecessary.