凡跌打损伤、坠堕之证,恶血留内,则不分何经,皆以肝为主。盖肝主血也,故败血凝滞,从其所属必
归于肝,其痛多在胁肋小腹者,皆肝经之道路也。若壅肿痛甚或发热自汗,皆宜斟酌虚实,然后用调血行经之
药。王好古云∶登高坠下撞打等伤,心腹胸中停积瘀血不散者,则以上、中、下三焦分别部位,以施药饵。瘀
在上部者,宜犀角地黄汤;瘀在中部者,宜桃仁承气汤;瘀在下部者,宜抵当汤之类。须于所用汤中加童便
好酒,同煎服之。虚人不可下者,宜四物汤加穿山甲。若瘀血已去,则以复元通气散加当归调之。《内经》云∶形
伤作痛,气伤作肿。又云∶先肿而后痛者,形伤气也;先痛而后肿者,气伤形也。凡打仆闪错,或恼怒气滞
血凝作痛,及元气素弱,或因叫号血气损伤,或过服克伐之剂,或外敷寒凉之药,致气血凝结者,俱宜用活血
顺气之剂。后列诸方,以备选用。
犀角地黄汤
犀角 生地黄(酒浸,另捣) 丹皮 白芍(各等分)
水煎服。
桃仁承气汤
大黄 芒硝 桃仁 桂枝 甘草
水煎服,以利为度。
抵当汤
水蛭 虻虫(去翅、足,各三十枚) 大黄(酒浸,三两) 桃仁(去皮、尖,三十枚)
水煎,去渣,取三升,温服一升,不下再服。
复元活血汤
柴胡(五钱) 当归 穿山甲(炮) 栝蒌根(各三钱) 甘草 红花(各二钱) 桃仁(去皮、尖,五十个)
大黄(酒浸,一两)
上将桃仁研烂,余药锉,如麻豆大,每服一两。水二盅,酒半盏,煎至七分,去渣,大温,食前服,以利为度。
巴戟汤
巴戟(去心) 大黄(各半两) 当归 地黄 芍药 川芎(各一两)
上为末,水煎服,以利为度。
破血消痛汤
羌活 防风 官桂(各一钱) 苏木(一钱半) 柴胡 连翘 当归梢(各二钱) 麝香(另研,少许)
水蛭(炒去烟尽,另研,二钱)
上为粗末,共一服,酒二大盏,水一盏,水蛭、麝香另研如泥,余药煎至一大盏,去火,稍热,调二味服之,
两服立愈。
清心药
牡丹皮 当归 川芎 赤芍药 生地黄 黄芩 黄连 连翘 栀子 桃仁 甘草(各等分)
上引用灯心草、薄荷煎,入童便和服。
止痛药
当归 牛膝 川芎 怀庆生地 赤芍药 白芷 羌活 独活 杜仲 续断(各一两) 肉桂 八角茴香
乳香 没药(各五钱) 南木香 丁皮 沉香 血竭(各二钱半)
上为末,老酒调用。
活血顺气何首乌散
何首乌(三钱) 当归 赤芍药 白芷 乌药 枳壳 防风 甘草 川芎 陈皮 香附 紫苏 羌活 独活
肉桂(各一钱)
上薄荷、生地黄煎,入酒和服。疼痛甚者,加乳香、没药。
调经散
川芎 当归 芍药 黄 (各一钱半) 青皮 乌药 陈皮 熟地黄 乳香(各一钱)
上作一服,水二盅,煎至一盅,不拘时服。
牡丹皮散
牡丹皮 当归 骨碎补 红花(酒浸) 续断 乳香 没药 桃仁 川芎 赤芍药 生地黄(各等分)
上水酒煎服,却用秫米饭热罨缚,冷又蒸热,换缚。
橘术四物汤
当归 川芎 白芍药 怀庆生地(各二钱) 陈皮 白术 红花(各一钱) 桃仁(十枚)
上生地黄煎服。骨节疼,加羌活、独活。痛不止,加乳香、没药。
当归补血汤
当归 川芎 白芍药 熟地黄 防风
连翘 羌活 独活 乳香 没药 白芷 续断 杜仲(各等分)
上生地黄煎,入童便和服,不可用酒。气虚,加人参、白术、黄 。
复元通气散
木香 茴香(炒) 青皮(去皮) 穿山甲(酥炙) 陈皮 白芷 甘草 漏芦 贝母(各等分)
上为末,每服一二钱,温酒调下。
凡是跌打损伤、高处坠落等病症,若体内有恶血(瘀血)滞留,无论涉及哪条经络,都以肝脏为主要调理对象。因为肝主藏血,所以败坏的血液凝滞,必然归属于肝经;疼痛多发生在胁肋和小腹部位,因为这些地方是肝经循行的道路。如果肿胀疼痛严重或伴有发热、自汗等症状,都应当仔细斟酌患者体质的虚实,然后使用调和血液、疏通经络的药物。王好古说:登高坠落、撞击殴打等外伤,导致心腹胸中积聚瘀血不散的,应根据上、中、下三焦的部位分别施药。瘀血在上部的,适宜用犀角地黄汤;瘀血在中部的,适宜用桃仁承气汤;瘀血在下部的,适宜用抵当汤之类的方剂。必须在所用的汤剂中加入童便(童子尿)和好酒,共同煎煮服用。体质虚弱不能耐受攻下法的患者,适宜用四物汤加穿山甲。如果瘀血已经去除,则用复元通气散加当归来调理。《内经》说:形体受伤会导致疼痛,气机受伤会导致肿胀。又说:先肿胀后疼痛的,是形体受伤影响了气机;先疼痛后肿胀的,是气机受伤影响了形体。凡是跌倒扑打、闪挫扭伤,或因恼怒导致气滞血凝作痛,以及元气素来虚弱,或因大声呼号导致气血损伤,或过服克伐正气的药物,或外敷寒凉药物,导致气血凝结的,都适宜使用活血顺气的方剂。后面列出各种方剂,以备选用。
犀角地黄汤
犀角 生地黄(用酒浸泡,单独捣碎) 丹皮 白芍(各取等量)
用水煎煮服用。
桃仁承气汤
大黄 芒硝 桃仁 桂枝 甘草
用水煎煮服用,以大便通畅为度。
抵当汤
水蛭 虻虫(去掉翅膀和脚,各三十只) 大黄(用酒浸泡,三两) 桃仁(去掉皮和尖,三十个)
用水煎煮,去渣,取药液三升,温服一升,若未见效再服。
复元活血汤
柴胡(五钱) 当归 穿山甲(炮制) 栝蒌根(各三钱) 甘草 红花(各二钱) 桃仁(去掉皮和尖,五十个)
大黄(用酒浸泡,一两)
先将桃仁研烂,其余药材切碎,如麻豆大小,每次服用一两。用水两盅,酒半盏,煎至七分,去渣,大温,饭前服用,以大便通畅为度。
巴戟汤
巴戟天(去掉心) 大黄(各半两) 当归 地黄 芍药 川芎(各一两)
以上药材研为末,用水煎煮服用,以大便通畅为度。
破血消痛汤
羌活 防风 官桂(各一钱) 苏木(一钱半) 柴胡 连翘 当归梢(各二钱) 麝香(单独研磨,少许)
水蛭(炒至烟尽,单独研磨,二钱)
以上药材制成粗末,共为一服的量,用两大盏酒、一盏水,将水蛭和麝香另研成泥状,其余药材煎至一大盏,离火,稍热时,调入这两味药服用,服两次即可痊愈。
清心药
牡丹皮 当归 川芎 赤芍药 生地黄 黄芩 黄连 连翘 栀子 桃仁 甘草(各取等量)
以上药材引用灯心草、薄荷煎煮,加入童便混合服用。
止痛药
当归 牛膝 川芎 怀庆生地 赤芍药 白芷 羌活 独活 杜仲 续断(各一两) 肉桂 八角茴香
乳香 没药(各五钱) 南木香 丁皮 沉香 血竭(各二钱半)
以上药材研为末,用老酒调服。
活血顺气何首乌散
何首乌(三钱) 当归 赤芍药 白芷 乌药 枳壳 防风 甘草 川芎 陈皮 香附 紫苏 羌活 独活
肉桂(各一钱)
以上药材用薄荷、生地黄煎煮,加入酒混合服用。疼痛严重的,加乳香、没药。
调经散
川芎 当归 芍药 黄芪(各一钱半) 青皮 乌药 陈皮 熟地黄 乳香(各一钱)
以上药材作为一服的量,用水两盅,煎至一盅,不拘时间服用。
牡丹皮散
牡丹皮 当归 骨碎补 红花(用酒浸泡) 续断 乳香 没药 桃仁 川芎 赤芍药 生地黄(各取等量)
以上药材用水和酒煎煮服用,然后用秫米饭热敷包扎,冷了再蒸热,更换包扎。
橘术四物汤
当归 川芎 白芍药 怀庆生地(各二钱) 陈皮 白术 红花(各一钱) 桃仁(十个)
以上药材用生地黄煎煮服用。骨节疼痛的,加羌活、独活。疼痛不止的,加乳香、没药。
当归补血汤
当归 川芎 白芍药 熟地黄 防风
连翘 羌活 独活 乳香 没药 白芷 续断 杜仲(各取等量)
以上药材用生地黄煎煮,加入童便混合服用,不可用酒。气虚的,加人参、白术、黄芪。
复元通气散
木香 茴香(炒) 青皮(去皮) 穿山甲(用酥油炙烤) 陈皮 白芷 甘草 漏芦 贝母(各取等量)
以上药材研为末,每次服用一二钱,用温酒调服。
For all cases of falls, blows, and injuries from heights, if evil blood (stasis) remains within the body, regardless of which meridian is involved, the Liver is primarily targeted for treatment. This is because the Liver governs the storage of blood; therefore, when damaged blood stagnates, it inevitably returns to the Liver channel. Pain often occurs in the hypochondriac region and lower abdomen, as these are the pathways of the Liver meridian. If swelling and pain are severe or accompanied by fever and spontaneous sweating, one must carefully assess the deficiency or excess of the patient's constitution before administering herbs that harmonize blood and unblock meridians. Wang Haogu stated: For injuries such as falling from heights, being struck, or beaten, where stasis accumulates in the heart, abdomen, and chest without dissipating, medicines should be administered according to the upper, middle, and lower Jiao (San Jiao). For stasis in the upper part, Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) is suitable; for stasis in the middle part, Tao Ren Chengqi Tang (Peach Kernel and Rheum Decoction) is suitable; for stasis in the lower part, Didang Tang (Resolute Attack Decoction) or similar formulas are suitable. Tongbian (Child's Urine) and good wine should be added to the decoction for simultaneous boiling and administration. For patients with a deficient constitution who cannot tolerate purgation, Siwu Tang (Four Substances Decoction) plus Chanshanjia (Pangolin Scales) is suitable. Once the stasis has been eliminated, Fuyuan Tongqi San (Fu Yuan Qi-Regulating Powder) plus Danggui (Angelica Sinensis) should be used for regulation. The *Neijing* states: Injury to the form causes pain; injury to Qi causes swelling. It further states: Swelling preceding pain indicates injury to the form affecting Qi; pain preceding swelling indicates injury to Qi affecting the form. In cases of falls, blows, sprains, or twisting injuries, or pain caused by Qi stagnation and blood coagulation due to anger, as well as in cases of inherent weak Yuan Qi, injury to Qi and blood from shouting, overuse of harsh drugs, or external application of cold-cooling herbs leading to Qi and blood coagulation, formulas that invigorate blood and smooth Qi are appropriate. Various formulas are listed below for selection.
Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction)
Xijiao (Rhinoceros Horn), Shengdihuang (Raw Rehmanniae Radix, soaked in wine and pounded separately), Danpi (Moutan Cortex), Baishao (White Peony Root) in equal parts.
Decoct in water and take orally.
Taoren Chengqi Tang (Peach Kernel and Rheum Decoction)
Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), Taoren (Persicae Semen), Guizhi (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma).
Decoct in water and take orally; stop when bowel movement is achieved.
Didang Tang (Resolute Attack Decoction)
Shuizhi (Hirudo), Mengchong (Bombyx Batryticatus, wings and legs removed, 30 each), Dahuang (Rhei Radix et Rhizoma, soaked in wine, 3 liang), Taoren (Persicae Semen, skin and tip removed, 30).
Decoct in water, remove dregs, obtain 3 sheng of liquid. Take 1 sheng warm; if ineffective, administer again.
Fuyuan Huoxue Tang (Fu Yuan Blood-Invigorating Decoction)
Chaihu (Bupleuri Radix, 5 qian), Danggui (Angelicae Sinensis Radix), Chanshanjia (Pangolini Squama, processed), Gualougen (Trichosanthis Radix, 3 qian each), Gancao (Glycyrrhizae Radix et Rhizoma), Honghua (Carthami Flos, 2 qian each), Taoren (Persicae Semen, skin and tip removed, 50), Dahuang (Rhei Radix et Rhizoma, soaked in wine, 1 liang).
First, pound Taoren until paste-like. Chop remaining herbs to the size of hemp seeds. Take 1 liang per dose. Add 2 zhong of water and half a zhan of wine. Decoct until 7/10 remains. Remove dregs. Take large warm dose before meals; stop when bowel movement is achieved.
Baji Tang (Morinda Decoction)
Baji (Morindae Officinalis Radix, core removed), Dahuang (Rhei Radix et Rhizoma, 0.5 liang each), Danggui (Angelicae Sinensis Radix), Dihuang (Rehmanniae Radix), Shaoyao (Paeoniae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma, 1 liang each).
Grind into powder. Decoct in water and take orally; stop when bowel movement is achieved.
Poxue Xiaotong Tang (Blood-Breaking Pain-Eliminating Decoction)
Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Guangui (Cinnamomi Cortex, 1 qian each), Sumu (Sappan Lignum, 1.5 qian), Chaihu (Bupleuri Radix), Lianqiao (Forsythiae Fructus), Dangguishao (Tip of Angelicae Sinensis Radix, 2 qian each), Shexiang (Moschus, ground separately, a small amount), Shuizhi (Hirudo, stir-fried until smoke ceases, ground separately, 2 qian).
Make coarse powder. One dose uses two large zhan of wine and one zhan of water. Grind Shuizhi and Shexiang into mud separately. Decoct other herbs until one zhan remains. Remove from fire. When slightly warm, mix in the two ground powders and take. Two doses lead to immediate cure.
Qingxin Yao (Heart-Clearing Medicine)
Mudanpi (Moutan Cortex), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chishaoyao (Red Peony Root), Shengdihuang (Raw Rehmanniae Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Lianqiao (Forsythiae Fructus), Zhizi (Gardeniae Fructus), Taoren (Persicae Semen), Gancao (Glycyrrhizae Radix et Rhizoma) in equal parts.
Decoct using Dengxincao (Junci Medulla) and Bohe (Menthae Haplocalycis Herba). Mix with Tongbian (Child's Urine) and take orally.
Zhitong Yao (Pain-Eliminating Medicine)
Danggui (Angelicae Sinensis Radix), Niuxi (Achyranthis Bidentatae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Huaqing Shengdi (Huaiqing Raw Rehmanniae Radix), Chishaoyao (Red Peony Root), Baizhi (Angelicae Dahuricae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Duohuo (Saussureae Radix), Duzhong (Eucommiae Cortex), Xuduan (Dipsaci Radix, 1 liang each), Rougui (Cinnamomi Cortex), Bajiao Huixiang (Illicii Fructus), Ruxiang (Olibanum), Moyao (Myrrha, 5 qian each), Nanmuxiang (Agarwood), Dingpi (Syzygdii Caryophylli Cortex), Chenxiang (Aquilariae Lignum Resinatum), Xuexie (Dracaenae Sangues, 2.5 qian each).
Grind into powder. Take with old wine.
Huoxue Shunqi Heshouwu San (Blood-Invigorating and Qi-Smoothing Polygonum Multiflorum Powder)
Heshouwu (Polygoni Multiflori Radix, 3 qian), Danggui (Angelicae Sinensis Radix), Chishaoyao (Red Peony Root), Baizhi (Angelicae Dahuricae Radix), Wuyao (Litseae Fructus), Zhiqiao (Aurantii Fructus), Fangfeng (Saposhnikoviae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Xiangfu (Cyperi Rhizoma), Zisu (Perillae Folium), Qianghuo (Notopterygii Rhizoma et Radix), Duohuo (Saussureae Radix), Rougui (Cinnamomi Cortex, 1 qian each).
Decoct using Bohe (Menthae Haplocalycis Herba) and Shengdihuang (Raw Rehmanniae Radix). Mix with wine and take orally. For severe pain, add Ruxiang (Olibanum) and Moyao (Myrrha).
Tiaojing San (Menstruation-Regulating Powder)
Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), Huangqi (Astragali Radix, 1.5 qian each), Qingpi (Aurantii Fructus Immaturus), Wuyao (Litseae Fructus), Chenpi (Citri Reticulatae Pericarpium), Shudihuang (Prepared Rehmanniae Radix), Ruxiang (Olibanum, 1 qian each).
One dose. Decoct in 2 zhong of water until 1 zhong remains. Take at any time.
Mudanpi San (Moutan Powder)
Mudanpi (Moutan Cortex), Danggui (Angelicae Sinensis Radix), Gusuibu (Drynariae Rhizoma), Honghua (Carthami Flos, soaked in wine), Xuduan (Dipsaci Radix), Ruxiang (Olibanum), Moyao (Myrrha), Taoren (Persicae Semen), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chishaoyao (Red Peony Root), Shengdihuang (Raw Rehmanniae Radix) in equal parts.
Decoct in water and wine. Apply hot Shumi rice compress to the area. When cool, reheat and replace compress.
Juzhu Siwu Tang (Orange and Atractylodes Four Substances Decoction)
Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishaoyao (White Peony Root), Huaqing Shengdi (Huaiqing Raw Rehmanniae Radix, 2 qian each), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Honghua (Carthami Flos, 1 qian each), Taoren (Persicae Semen, 10).
Decoct using Shengdihuang (Raw Rehmanniae Radix) and take orally. For joint pain, add Qianghuo (Notopterygii Rhizoma et Radix) and Duohuo (Saussureae Radix). For persistent pain, add Ruxiang (Olibanum) and Moyao (Myrrha).
Danggui Buxue Tang (Angelica Tonifying Qi Decoction)
Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishaoyao (White Peony Root), Shudihuang (Prepared Rehmanniae Radix), Fangfeng (Saposhnikoviae Radix).
Lianqiao (Forsythiae Fructus), Qianghuo (Notopterygii Rhizoma et Radix), Duohuo (Saussureae Radix), Ruxiang (Olibanum), Moyao (Myrrha), Baizhi (Angelicae Dahuricae Radix), Xuduan (Dipsaci Radix), Duzhong (Eucommiae Cortex) in equal parts.
Decoct using Shengdihuang (Raw Rehmanniae Radix). Mix with Tongbian (Child's Urine) and take orally. Do not use wine. For Qi deficiency, add Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), and Huangqi (Astragali Radix).
Fuyuan Tongqi San (Fu Yuan Qi-Unblocking Powder)
Muxiang (Aucklandiae Radix), Huixiang (Foeniculi Fructus, stir-fried), Qingpi (Aurantii Fructus Immaturus, peel removed), Chanshanjia (Pangolini Squama, fried with butter), Chenpi (Citri Reticulatae Pericarpium), Baizhi (Angelicae Dahuricae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Loulu (Euphorbiae Humifusae Radix), Beimu (Fritillariae Thunbergii Bulbus) in equal parts.
Grind into powder. Take 1-2 qian per dose, mixed with warm wine.