篇名：上编 外治法
分类：胸背部
属性：[1]腰骨，即脊骨十四椎、十五椎、十六椎间骨也。
[2]若跌打损伤，瘀聚凝结，身必俯卧，若欲仰卧、侧卧皆不能也，疼痛
难忍，腰筋僵硬。
[3]宜用手法，将两旁脊筋，向内归附膂骨，治者立于高处，将病人两手
高举，则脊筋全舒，再令病人仰面昂胸，则膂骨正而患除矣。
内服补筋丸，外贴万灵膏，灸熨止痛散。
按、方剂：[1]止痛散
止痛消肿，活血通经，避风驱寒。
防风 荆芥 当归 蕲艾 牡丹皮 鹤虱 升麻各一钱 苦参
铁线透骨草 赤芍药各二钱 川椒三钱 甘草八分
共享末，装白布袋内，扎口煎滚熏洗。
[2]补筋丸：见□骨伤
[3]万灵膏：见囟骨伤
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篇名：上编 外治法
分类：四肢部
属性：[1]跟骨者，足后跟骨也。
[2]上承□、辅二骨之末，有大筋附之，俗名脚挛筋，其筋从跟骨过踝骨
，至腿肚里，上至腘中，过臀抵腰脊，至顶，自脑后向前至目眦，皆
此筋之所达也。
[3]若落马坠蹬等伤，以致跟骨拧转向前，足趾向后，即或骨未碎破，而
缝隙分离，自足至腰脊诸筋，皆失其常度，拳挛疼痛，宜拨转如旧，
药饵调治，皆同前法。
按、方剂：正骨紫金丹、混元膏、散瘀和伤汤、海桐皮汤、万灵膏诸药，皆内庭常用
经验之方，故以上诸证，多引用之。其或跌打损伤证中，而又兼他病者，
则不止此数药也，故采前人旧载诸方，集于末卷，以示证治之法，有不可
狭隘者焉。
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【上编 外治法 - 胸背部】
[1] 腰骨，是指第十四、十五、十六椎之间的骨骼。
[2] 如果是跌打损伤导致瘀血聚集凝结，患者身体必然只能俯卧，想要仰卧或侧卧都做不到，疼痛难以忍受，腰部筋脉僵硬。
[3] 适宜使用手法治疗，将两侧的脊筋向内归附于膂骨（脊柱旁的肌肉）。施术者站在高处，让病人双手高举，这样脊筋就能完全舒展；再让病人仰面挺胸，这样膂骨就能复位，病患即可消除。
内服补筋丸，外贴万灵膏，使用灸熨止痛散进行熏洗或热敷。
按语及方剂：
[1] 止痛散：具有止痛消肿、活血通经、避风驱寒的功效。
配方：防风、荆芥、当归、蕲艾、牡丹皮、鹤虱、升麻各一钱；苦参、铁线透骨草、赤芍药各二钱；川椒三钱；甘草八分。
用法：共研为细末，装入白布袋中，扎紧袋口，煮沸后先熏后洗患处。
[2] 补筋丸：参见“□骨伤”章节。
[3] 万灵膏：参见“囟骨伤”章节。
【上编 外治法 - 四肢部】
[1] 跟骨，即足部的后跟骨。
[2] 它上承托着□骨和辅骨（腓骨）的末端，有大筋附着其上，俗称脚挛筋。这条筋从跟骨经过踝骨，到达小腿肚内部，向上至腘窝（膝后弯曲处），穿过臀部抵住腰脊，直至头顶，再从脑后向前延伸至眼角内侧，都是这条筋所通达的范围。
[3] 如果是落马、坠蹬等外伤，导致跟骨扭转向前，足趾向后，即使骨头没有碎裂破损，但骨缝分离，从足部到腰脊的各条筋脉都会失去正常的状态，出现拳曲挛缩和疼痛。适宜将其拨转复位如初，药物调理治疗的方法都与前述方法相同。
按语：正骨紫金丹、混元膏、散瘀和伤汤、海桐皮汤、万灵膏等药物，都是内庭（宫廷太医院）常用的经验方剂，因此上述各种证候多引用这些方子。如果在跌打损伤证候中，又兼有其他疾病，则不止使用这几味药。所以采集前人记载的各方，汇集在本书末卷，以展示辨证治疗的法则，说明医学不可狭隘拘泥。
[Upper Compilation: External Treatment Methods - Chest and Back Region]
[1] The lumbar vertebrae refer to the bones between the 14th, 15th, and 16th thoracic vertebrae.
[2] If caused by falls or blows leading to blood stasis accumulation and coagulation, the patient's body must lie prone; lying supine or on either side is impossible. The pain is unbearable, and the lumbar tendons are stiff.
[3] Manual therapy (Tuina) is suitable. The practitioner should guide the tendons on both sides of the spine back towards the *lǔ gǔ* (muscles alongside the spine). Standing at a higher elevation, the practitioner has the patient raise both hands high above their head, which fully relaxes the spinal tendons. Then, instruct the patient to arch their chest while lying on their back, thereby realigning the *lǔ gǔ* and eliminating the ailment.
Internally administer *Bujin Wan* (Tendon-Nourishing Pill); externally apply *Wanling Gao* (Ten Thousand Spirits Plaster); use *Zhitong San* (Pain-Relieving Powder) for moxibustion or hot compress therapy.
Notes and Formulas:
[1] *Zhitong San* (Pain-Relieving Powder): Functions to relieve pain and reduce swelling, invigorate blood and unblock meridians, dispel wind and drive out cold.
Ingredients: *Fangfeng* (Saposhnikoviae Radix), *Jingjie* (Schizonepetae Spica), *Danggui* (Angelicae Sinensis Radix), *Qiai* (Artemisiae Argyi Folium), *Mudanpi* (Moutan Cortex), *Sheshi* (Chrysanthemi Indici Flos), *Shengma* (Cimicifugae Rhizoma), each 1 qian; *Kushen* (Sophorae Flavescentis Radix), *Tiexiantougucao* (Euphorbiae Pekinensis Herba), *Chishao* (Paeoniae Radix Rubra), each 2 qian; *Chuanjiao* (Zanthoxyli Pericarpium) 3 qian; *Gancao* (Glycyrrhizae Radix et Rhizoma) 8 fen.
Usage: Grind all ingredients into fine powder, place in a white cloth bag, tie tightly, boil in water, and use the steam for fumigation followed by washing the affected area.
[2] *Bujin Wan* (Tendon-Nourishing Pill): See section on "□ Bone Injury".
[3] *Wanling Gao* (Ten Thousand Spirits Plaster): See section on "Fontanelle Injury".
[Upper Compilation: External Treatment Methods - Limbs Region]
[1] The calcaneus (heel bone) is the bone at the posterior aspect of the foot.
[2] It supports the distal ends of the □ bone and fibula (*fu gu*). A large tendon attaches to it, commonly known as the "leg cramping tendon." This tendon originates from the calcaneus, passes through the ankle bone, enters the calf muscle, ascends to the popliteal fossa (*guo*), crosses the buttocks to reach the lumbar spine, continues to the vertex of the head, then descends from the back of the head forward to the inner canthus of the eye. All these areas are within the pathway of this tendon.
[3] If injured by falling from a horse or stepping out of a stirrup, causing the calcaneus to twist anteriorly and the toes to point posteriorly, even if the bone is not fractured, the joint spaces may separate. Consequently, all tendons from the foot to the lumbar spine lose their normal tension, resulting in curling, spasms, and pain. It is appropriate to manually reduce the displacement to its original state. Pharmacological treatment follows the same methods described previously.
Notes: *Zhenggu Zijin Dan* (Bone-Setting Purple Gold Pill), *Hunyuan Gao* (Primordial Unity Plaster), *Sanyu He Shang Tang* (Blood-Dispelling and Injury-Healing Decoction), *Haitongpi Tang* (Trollius Bark Decoction), and *Wanling Gao* (Ten Thousand Spirits Plaster) are all empirical formulas commonly used in the Imperial Medical Court. Therefore, the aforementioned conditions frequently cite these prescriptions. However, if traumatic injuries are complicated by other diseases, more than just these few medicines are involved. Thus, various formulas recorded by predecessors have been collected in the final volume to demonstrate principles of syndrome differentiation and treatment, illustrating that medical practice should not be narrow or rigid.