夫破伤风者。有因卒暴伤损。风袭其间。传播经络。致使寒热更作。身体反张。口噤
不开
甚者邪气入脏。有因诸疮不瘥。荣卫虚弱。肌肉不生。疮眼不合。风邪亦能外入于疮。为
破伤风之候。有诸疮不瘥。举世皆言蕲艾为上。是谓热疮。而不知火热客毒。逐经诸变。不
可胜数。微则发热。甚则生风搐。或角弓反张。口噤目斜。亦有破伤风不灸而病者。因疮着
白痂。疮口闭塞。气壅于阳。故热易为郁结。热则生风也。古方药论甚少。以此疾与中风同
论。故不另立条目。惟河间论病同伤寒症治。通于表里。分别阴阳。有在表。有在里。有在
半表半里者。在表宜汗。在里宜下。在表里之间。宜和解。不可过其治也。故表脉浮而无力
者
太阳也。脉长而有力者阳明也。脉浮而弦小者少阳也。若明此三法。而施治不中者鲜矣。但
中风之人。尚可淹延岁月。而破伤风。始虽在表。随即转里。多致不救。大抵内气虚弱。而
有郁热者得之。若内气壮实。而无郁热者。虽伤而无害也。
一论破伤风。邪初在表者。急服此药以解之。稍迟则邪入于里。与此药不相合矣。
羌活防风汤
羌活 防风 本 川芎 白芍 当归 地榆 细辛 甘草（各一钱）
上剂。水煎。热服。
一论破伤风。在半表半里。急服此汤。稍缓邪入于里。不可用矣。
和解汤
羌活 防风 川芎 菊花 麻黄 石膏 前胡 黄芩 细辛 枳壳 白茯苓 蔓荆子
甘草（各五分） 薄荷 白芷（各二钱半）
上剂。水煎。热服。
一论破伤风。邪传入里。见舌强口噤。项背反张。筋惕搐搦。痰涎壅塞。胸腹满闷。便溺闭
赤。时或汗出。脉洪数而弦也。宜导之。
通里汤
川芎 羌活 黄芩 大黄（各二钱）
上锉。水煎温服。脏腑通和为贵。
一论风伤肾而腰痛者。或左右痛无常处。牵引两足。宜用五积散。加防风全蝎三个。（
方见中寒）
一论破伤风。及金刃伤。打扑伤损。并癫狗咬伤。定能定痛生肌。
五真散
天南星（为防风所制服之不麻） 防风
上各等分。为细末。破伤风以药敷口。然后以温酒调下一钱。如牙关紧急。角弓反张。
用药
二钱。童便调下。打伤欲死。但心头微温。以童便灌下二钱。并进二服。癫狗咬破。先口噙
药水洗净。用棉拭干贴药。更不再发。无脓。大效。
一治。破伤风。初觉有风。急取热粪堆内蛴螬虫二三个。用手捏住。待虫口中吐出水。
就
抹破处。身穿稍浓衣裳。待少时疮口觉麻。两胁微汗出。立效。如风紧急。速取此虫三五个
剪去尾。肚内黄水自出。涂疮口。再滴些少热酒饮之。汗出立效。烂草房上。亦有此虫。
一治破伤风五七日未愈。已至角弓反张。牙关紧急。服之神效。
蝉蜕（去头及足净五钱）
上为末。用好酒一碗煎滚。服之立苏。
一治破伤风。
夺命丹
川乌（火煨去黑皮一两） 雄黄（一钱）
上为末。葱汁为丸。如莲子大。每服一丸。用葱叶一片。将药裹内。火微烧。嚼烂。黄
酒下。衣盖汗出立愈。
灸法 治破伤风。及疯犬咬伤。（方见灸法）
一治破伤风牙关紧急。
立效散
雄黄 香白芷
上各等分。好酒煎服。如牙关紧者。灌之即活。
破伤风这一病症，有的是因为突然遭受外伤，风邪乘虚侵入其间，传播至经络，导致寒热交替发作，身体向后反张，口部紧闭无法张开。
严重的情况下，邪气深入脏腑；有的是因为各种疮疡久不愈合，营卫之气虚弱，肌肉不能生长，疮口无法闭合，风邪也能从外部侵入疮口，形成破伤风的证候。
对于各种疮疡久不愈合的情况，世人普遍推崇蕲艾（产于湖北蕲春的艾草）为上品，这被称为“热疮”，却不知火热之邪客居体内成为毒邪，随着经络传变产生的各种变化，数不胜数。轻微时表现为发热，严重时则引发风动抽搐，或者出现角弓反张、口噤目斜等症状。也有患破伤风并未进行艾灸治疗而发病的，这是因为疮面附着白色痂皮，导致疮口闭塞，阳气壅滞，因此热气容易郁结，热极而生风。
古代方书和药论中关于此病的记载很少，因为此疾与中风症状相似，所以一并论述，没有单独设立条目。只有刘河间在论述此病时，认为其症状与治疗同伤寒相似，通达表里，区分阴阳，有在表的，有在里的，有在半表半里的。在表的适宜用发汗法，在里的适宜用泻下法，在半表半里的适宜用和解法，不可过度治疗。
例如，脉象浮而无力的是太阳病（太阳经受邪所致的病证）；脉象长而有力的是阳明病（阳明经受邪所致的病证）；脉象浮而弦小的是少阳病（少阳经受邪所致的病证）。如果明了这三种治法，施治失误的情况就很少了。但是，患中风的人，病情尚可拖延岁月，而破伤风虽然起初在表，随即就会转入里证，大多导致无法救治。大抵是因为体内正气虚弱，且有郁热的人容易患上此病。如果体内正气壮实，且没有郁热的人，即使受伤也不会造成危害。
第一种论述：破伤风，邪气初在体表时，应立即服用此药以解除表邪。稍晚则邪气入里，与此药就不相合了。
羌活防风汤
羌活、防风、藁本、川芎、白芍、当归、地榆、细辛、甘草（各一钱）
以上药材为一剂，加水煎煮，趁热服用。
第二种论述：破伤风，邪气在半表半里之间，应立即服用此汤。稍缓则邪气入里，就不能再用了。
和解汤
羌活、防风、川芎、菊花、麻黄、石膏、前胡、黄芩、细辛、枳壳、白茯苓、蔓荆子、甘草（各五分）、薄荷、白芷（各二钱半）
以上药材为一剂，加水煎煮，趁热服用。
第三种论述：破伤风，邪气传入里证，见到舌体僵硬、口噤不开、项背反张、筋脉跳动抽搐、痰涎壅塞、胸腹满闷、大小便闭涩色赤、时而出汗，脉象洪数而弦。适宜用通里导下的方法。
通里汤
川芎、羌活、黄芩、大黄（各二钱）
以上药材切碎，加水煎煮，温服。以脏腑通畅调和为贵。
第四种论述：风邪损伤肾脏导致的腰痛，疼痛部位左右不定，牵引双腿，适宜使用五积散，加防风、全蝎三个。（方剂见“中寒”章节）
第五种论述：破伤风，以及金刃创伤、跌打损伤，还有疯狗咬伤，此方能定痛生肌。
五真散
天南星（被防风制服而不发麻者）、防风
以上各等分，研为细末。患破伤风者将药粉敷于伤口，然后用温酒调服一钱。如果是牙关紧急、角弓反张，用药二钱，用童便（小男孩的小便）调服。被打得快要死了，只要心头还微温，用童便灌服二钱，并连服两剂。疯狗咬破皮肤，先用口含药水洗净伤口，用棉布拭干后贴敷药物，以后就不再复发。如果没有化脓，效果极大。
第六种治疗方法：治疗破伤风，刚觉得有风邪侵袭，急忙取热粪堆里的蛴螬虫（金龟子幼虫）二三个，用手捏住，待虫口中吐出水来，就涂抹在破伤处。身穿稍厚的衣裳，过一会儿疮口感觉麻木，两胁微微出汗，立即见效。如果风邪紧急，迅速取此虫三五个，剪去尾部，肚内的黄水自然流出，涂在疮口上，再滴少许热酒饮用，出汗后立即见效。腐烂的草房顶上也有这种虫子。
第七种治疗方法：治疗破伤风五七日未愈，已经发展到角弓反张、牙关紧急，服用此方神效。
蝉蜕（去掉头和脚，净重五钱）
以上研为细末，用好酒一碗煎滚，服用后立即苏醒。
第八种治疗方法：治疗破伤风。
夺命丹
川乌（火煨去黑皮一两）、雄黄（一钱）
以上研为细末，用葱汁制成丸药，如莲子大小。每次服用一丸，用一片葱叶将药包裹在内，在火上微微烧焦，嚼烂后用黄酒送服。盖衣被使出汗，立即痊愈。
Wind-stroke due to broken skin (Po Shang Feng) is a condition caused by sudden trauma, where wind pathogen invades the wound and spreads through the meridians, causing alternating chills and fever, opisthotonos (body arching backward), and trismus (lockjaw).
In severe cases, the pathogenic factor enters the Zang organs. It may also arise from chronic ulcers that fail to heal; when Ying and Wei (nutritive and defensive Qi) are deficient, muscle tissue fails to regenerate, and the wound remains open, allowing external wind pathogen to enter the ulcer, resulting in wind-stroke due to broken skin.
Regarding chronic ulcers, people generally regard Qiai (Mugwort from Qichun) as the best treatment, calling it "heat ulcer." However, they are unaware that heat-fire pathogens acting as toxins can cause numerous variations along the meridians. Mildly, it presents with fever; severely, it generates wind stirring and convulsions, or opisthotonos, trismus, and deviation of the eyes. There are also cases of wind-stroke due to broken skin occurring without moxibustion treatment. This happens because a white scab forms on the wound, closing the orifice, causing Yang Qi to stagnate. Consequently, heat easily becomes constrained; extreme heat generates wind.
Ancient formularies and materia medica contain few records of this disease because its symptoms resemble those of Wind-Stroke (Zhong Feng), so it is discussed together without a separate entry. Only Liu Hejian discussed this disease, stating that its symptoms and treatment are similar to Cold Damage (Shang Han), penetrating both exterior and interior, distinguishing Yin and Yang. If the pathogen is in the exterior, sweating is indicated; if in the interior, purgation is indicated; if in the half-exterior half-interior, harmonizing is indicated. Treatment should not be excessive. For instance, a floating but weak pulse indicates Taiyang disease (disease of the Taiyang channel); a long and forceful pulse indicates Yangming disease (disease of the Yangming channel); a floating, wiry, and small pulse indicates Shaoyang disease (disease of the Shaoyang channel). If these three methods are understood, therapeutic errors will be rare. However, patients with Wind-Stroke can survive for years, whereas wind-stroke due to broken skin, though initially in the exterior, quickly transitions to the interior, often leading to untreatable conditions. Generally, those with deficient internal Qi and constrained heat are susceptible. Those with robust internal Qi and no constrained heat will not suffer harm even if injured.
First discussion: When wind-stroke due to broken skin is in the early stage in the exterior, administer this prescription immediately to resolve the exterior. Delaying allows the pathogen to enter the interior, making this prescription ineffective.
Qianghuo Fangfeng Decoction (Notopterygium and Saposhnikovia Decoction)
Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Ben (Ligustici Chuanxiong Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Diyu (Sanguisorbae Radix), Xixin (Asari Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 qian).
Take one dose, decoct in water, and take hot.
Second discussion: When wind-stroke due to broken skin is in the half-exterior half-interior, administer this decoction immediately. Delaying allows the pathogen to enter the interior, rendering this prescription useless.
Hexie Tang (Harmonizing Decoction)
Qianghuo, Fangfeng, Chuanxiong, Juhua (Chrysanthemi Flos), Mahuang (Ephedrae Herba), Shigao (Gypsum Fibrosum), Qianhu (Peucedani Radix), Huangqin (Scutellariae Radix), Xixin, Zhike (Aurantii Fructus Immaturus), Baifuling (Poria), Manjingzi (Vittariae Spora), Gancao (each 5 fen), Bohe (Menthae Haplocalycis Herba), Baizhi (Angelicae Dahuricae Radix) (each 2.5 qian).
Take one dose, decoct in water, and take hot.
Third discussion: When wind-stroke due to broken skin transmits to the interior, presenting with tongue stiffness, trismus, opisthotonos, muscle twitching and convulsions, phlegm-saliva obstruction, chest and abdominal fullness, constipation and dark urine, occasional sweating, and a surging, rapid, and wiry pulse, guiding/purgation is indicated.
Tongli Tang (Unblocking Interior Decoction)
Chuanxiong, Qianghuo, Huangqin, Dahuang (Rhei Radix et Rhizoma) (each 2 qian).
Cut into pieces, decoct in water, and take warm. The priority is the smooth harmony of the Zang-Fu organs.
Fourth discussion: For lumbar pain caused by wind damaging the Kidney, where pain shifts between left and right and radiates to both legs, Wujisan (Five Accumulations Powder) is indicated, added with Fangfeng and Quanxie (Scorpio) (three units). (See formula under "Cold Damage").
Fifth discussion: For wind-stroke due to broken skin, as well as injuries from metal blades, bruises and fractures, and bites from mad dogs, this powder stabilizes pain and promotes tissue regeneration.
Wuzhen San (Five True Powders)
Tiannanxing (Arisaematis Rhizoma prepared with Fangfeng so it is non-numbing), Fangfeng.
Mix equal parts, grind into fine powder. For wind-stroke due to broken skin, apply the powder to the mouth/wound, then take 1 qian mixed with warm wine. If there is severe trismus or opisthotonos, use 2 qian mixed with Tongbian (child's urine). For severe beating injuries where the patient appears dead but the heart is still slightly warm, pour 2 qian mixed with Tongbian down the throat, and administer two doses. For mad dog bites, first rinse the wound with the medicine held in the mouth, dry with cotton, and apply the paste. It will not recur. If there is no suppuration, it is highly effective.
Sixth treatment: For wind-stroke due to broken skin, at the first sign of wind invasion, urgently take two or three Qilao (larvae of scarab beetles) from a hot manure pile. Hold them in hand until they exude fluid from their mouths, then smear this fluid on the wound. Wear thick clothing. After a short while, the wound will feel numb, and slight sweating will occur around the hypochondrium, bringing immediate relief. If the wind invasion is urgent, quickly take three to five larvae, cut off their tails, let the yellow fluid inside drain out, apply to the wound, and drink a little hot wine. Sweating brings immediate relief. These larvae can also be found on rotting thatched roofs.
Seventh treatment: For wind-stroke due to broken skin lasting five to seven days without cure, progressing to opisthotonos and severe trismus, this formula is miraculous.
Chantui (Cicada Slough) (heads and feet removed, net weight 5 qian).
Grind into powder, boil in one bowl of good wine, and drink. Consciousness returns immediately.
Eighth treatment: For wind-stroke due to broken skin.
Duoming Dan (Life-Rescuing Pill)
Chuanwu (Aconiti Radix Lateralis Preparata, fire-roasted to remove black skin, 1 liang), Xionghuang (Realgar, 1 qian).
Grind into powder, bind with Scallion Juice into pills the size of lotus seeds. Take one pill per dose. Wrap the pill in a piece of scallion leaf, roast lightly over fire, chew thoroughly, and swallow with yellow wine. Cover with blankets to induce sweating for immediate recovery.
Moxibustion Method: Treats wind-stroke due to broken skin and mad dog bites. (See formula under "Moxibustion Methods").
Ninth treatment: For wind-stroke due to broken skin with severe trismus.
Lixiao San (Instant Effect Powder)
Xionghuang, Xiangbaizhi (Angelicae Dahuricae Radix).
Mix equal parts, decoct in good wine, and take. If trismus is severe, pour the liquid into the mouth to revive the patient.