（破伤湿 破伤火附）
凡金疮跌扑，损破皮肉，及疮疡溃后，切忌当风用扇，若为风邪所乘，皆能传入经络，名破伤风。其
症寒热间作，牙关微紧。即宜威灵仙五钱，独头蒜一枚，同捣烂，热酒冲服，汗出愈。甚
则发痉，口噤项强，体直杀人。急用独圣散，苏木为末三钱，酒服立效。或用生蟾二两半，切剁如泥，入
花椒一两，同酒炒熟，再入酒二盏热服，少顷通身汗出，神效。其破伤重，亡血多，筋络失荣，贼风易袭，
经所谓风邪乘虚入之也，此为风虚邪。宜桂枝汤。合当归补血汤。若因营热煽风，疮势 肿，河间所谓热甚
风搏，并于经络也，此为风火邪。当归地黄汤。夫伤风法当疏表，然不宜峻用汗剂者。仲景谓疮家不可发汗，
汗之则变痉，故破伤症轻者，但用葱白香豉汤加白芷、当归、鲮鲤甲、麝香、蝎尾。症重者，亦用本方加防风、
远志、黄 、肉桂、犀角、鲮鲤甲。甚则用万灵丹煎葱豉汤下。若呕逆不食，系风引邪毒攻心，内用护心散，
外用葱熨法。大便不通，但用蜜煎导。症势稍退，即宜保元汤，仍加远志、肉桂、犀角、鲮鲤甲解散余毒。
如久不合口，疮毒内蕴，热甚生风，周遭起白痂，不甚肿，身发寒热，牙关微紧，急服玉真散，口噤者童便调
下，即用此散敷疮口。倘疮势红肿，用杏仁泥和白面，水调敷肿处，即消。如身冷牙噤，腰脊反张，四肢强直，
急服全蝎散，或大蜈蚣散。用小蜈蚣散擦牙，吐出痰涎，立苏。如服后不解，邪渐入里，发搐，目直视，二便
秘，用左龙丸。其背后搐者，太阳也，为在表。太阳经行身后，背后搐，如角弓反张。无汗，急汗之，防风汤、
九味羌活汤、小续命汤。汗过多，止之，防风当归散、白术防风汤。身前搐者，阳明也，为入里。阳明经行身
前，身前搐，如头低视下，手足牵引。急下之，先用小芎黄汤二服，后用大芎黄汤下之。两旁搐者，少阳也，
为半表半里。少阳经行身侧，两旁搐，如左右一目视，或左右一手一足搐。宜和之，小柴胡汤，或防风通圣散
加减。此河间法也。其但言三阳，不及三阴者，谓风邪传入三阴，其症必危。惟天灵盖 末一钱，鲮鲤甲半钱、
麝香一字，同研，煎葱白香豉汤送下。若少腹满自利，口燥咽干，舌卷囊缩，额上珠汗不流，肢体痛极，不
在伤处，终为死候。
凡通治破伤风，宜曹氏秘方∶荆芥，黄蜡，鱼鳔各五钱，艾叶三片，无灰酒一碗，重汤煮一炷香，热饮，
汗出愈。若发痉，宜蠲痉汤。病久衰弱，宜主调营。四物汤加防风、白芷、细辛。疮疡风邪攻注，身痛挛急，
羌活防风汤加地骨皮、荆芥穗。如破
伤肿，脓不透出。朱砂指甲散，酒调服。外用玉真散，姜汁调敷。又或用汤淋洗，湿气侵入，疮口流脓，
其人昏述沉重者，名破伤湿。先用除温汤，后用白术膏。若艾灸火烘，火气逼入，疮口肿赤，其人烦躁发热者，
名破伤火。小芎黄汤加薄荷、黑山栀、酒炒黄连。
《医鉴》曰∶诸疮欲变痉，宜急风散。发汗多成痉，宜防风当归散。亡血多成痉，宜当归地黄汤。
凡是金属利器造成的创伤或跌打损伤，导致皮肉破损，以及疮疡溃烂之后，切忌对着风口使用扇子扇风。如果此时被风邪侵袭，病邪都能传入经络，这种病症称为“破伤风”。
其症状表现为寒热交替发作，牙关微微发紧。此时应立即取威灵仙五钱、独头蒜一枚，一同捣烂，用热酒冲服，待出汗后即可痊愈。
病情严重者会出现痉挛、牙关紧闭、颈项强直、身体挺直甚至危及生命。此时急需使用独圣散，将苏木研成粉末三钱，用酒送服，立见成效。或者使用生蟾蜍二两半，切碎剁成泥状，加入花椒一两，同酒炒熟，再加入两盏酒热服，不久全身出汗，效果神奇。
对于破伤严重、失血过多、筋络失去濡养、贼风容易侵袭的情况，正如经典所说“风邪乘虚而入”，这属于“风虚邪”。适宜使用桂枝汤，合当归补血汤。
如果是由于营分有热煽动内风，疮势肿胀，正如刘河间所说的“热甚风搏，并于经络”，这属于“风火邪”。适宜使用当归地黄汤。
治疗伤风原则上应当疏解表邪，但不宜峻猛使用发汗剂。张仲景曾说：“患有疮疡的人不可发汗，若强行发汗则会转变为痉病。”因此，破伤风症轻者，仅用葱白香豉汤加白芷、当归、鲮鲤甲、麝香、蝎尾。症重者，也使用本方加防风、远志、黄芪、肉桂、犀角、鲮鲤甲。病情极重者，则用万灵丹煎煮葱白香豉汤送服。
如果出现呕吐逆气、不能进食，这是风引邪毒攻心所致，内服护心散，外用葱熨法。大便不通，仅用蜜煎导法。
病情稍退后，即宜服用保元汤，仍加远志、肉桂、犀角、鲮鲤甲以解散余毒。
如伤口久久不合口，疮毒内蕴，热盛生风，周围起白色痂皮，肿胀不严重，身体出现寒热，牙关微紧，应紧急服用玉真散，牙关紧闭者用童便调服，并立即将此散敷于疮口。
倘若疮势红肿，用杏仁泥和面粉，用水调匀敷于肿胀处，即可消退。
如果身体冰冷、牙关紧闭、腰脊反张、四肢强直，应紧急服用全蝎散，或大蜈蚣散。用小蜈蚣散擦牙，吐出痰涎，患者立刻苏醒。
如果服药后症状未解，邪气逐渐入里，出现抽搐、两眼直视、大小便闭塞，使用左龙丸。
背部抽搐的，属于太阳经证，病位在表。太阳经行于身后，背部抽搐，如同角弓反张。无汗时，急当发汗，可用防风汤、九味羌活汤、小续命汤。若发汗过多，需止汗，可用防风当归散、白术防风汤。
身前抽搐的，属于阳明经证，病已入里。阳明经行于身前，身前抽搐，表现为头低视下，手足牵引。急当攻下，先用小芎黄汤服两次，后用大芎黄汤攻下。
两旁抽搐的，属于少阳经证，病在半表半里。少阳经行于身侧，两旁抽搐，表现为左右一眼注视，或左右一手一足抽搐。适宜和解，可用小柴胡汤，或防风通圣散加减。这是刘河间的治疗方法。
这里只提及三阳经，未提及三阴经，是因为风邪传入三阴经时，症状必定危重。此时唯有用天灵盖末一钱、鲮鲤甲半钱、麝香一字，一同研磨，煎煮葱白香豉汤送服。
如果出现小腹胀满、自利（腹泻）、口燥咽干、舌卷缩、囊缩、额头出汗如珠且凝滞不流、肢体剧痛，且疼痛不在受伤部位，最终均为死候。
凡通治破伤风，适宜使用曹氏秘方：荆芥、黄蜡、鱼鳔各五钱，艾叶三片，无灰酒一碗，隔水炖煮一炷香的时间，热饮，出汗即愈。
病程长久导致身体衰弱，适宜主要调理营血。使用四物汤加防风、白芷、细辛。
疮疡受风邪侵袭注注，身体疼痛挛急，使用羌活防风汤加地骨皮、荆芥穗。
如破伤肿胀，脓液无法透出，使用朱砂指甲散，酒调服。外用玉真散，姜汁调敷。
又或用汤药淋洗，湿气侵入，疮口流脓，其人昏沉沉重者，名为“破伤湿”。先用除温汤，后用白术膏。
(Attachment on Broken-Wind Dampness and Broken-Wind Fire)
In cases of metal weapon injuries or falls causing damage to the skin and flesh, as well as after the ulceration of sores, one must strictly avoid fanning oneself in the wind. If invaded by Wind pathogen at this time, the pathogen can transmit into the meridians, a condition named Broken-Wind (Po Shang Feng).
Its symptoms include alternating chills and fever, and slight tightness of the jaw. At this stage, immediately take five qian of Cistanche Herba (Weilingxian) and one bulb of Allium sativum L. var. angulosum (Dutousuan), pound them together until paste-like, mix with hot wine, and drink. Recovery occurs upon sweating.
In severe cases, spasms occur, the jaw is locked, the neck is stiff, the body becomes rigid, which can be fatal. Urgently use Du Sheng San: three qian of Sappan Wood Powder (Sumu), taken with wine for immediate effect. Alternatively, use two liang and a half of fresh Toad Venom (Sheng Chan), chopped into a paste, add one qian of Zanthoxylum Bungeanum (Huajiao), stir-fry with wine until cooked, then add two cups of wine and drink while hot. Shortly after, whole-body sweating occurs, yielding miraculous effects.
For severe broken-wound cases with significant blood loss, where tendons and collaterals lose nourishment and "Thieving Wind" easily attacks—as stated in classics, "Wind pathogen enters due to deficiency"—this is classified as Wind-Deficiency Pathogen. Guizhi Tang (Cinnamon Twig Decoction) combined with Danggui Buxue Tang (Angelica Sinensis Decoction for Replenishing Blood) is appropriate.
If caused by Heat in the Ying level stirring internal Wind, with swelling of the sore—as Liu Hejian described, "Intense Heat combats Wind, merging into the meridians"—this is classified as Wind-Fire Pathogen. Danggui Dihuang Tang (Angelica Sinensis and Rehmannia Decoction) is indicated.
Treatment for Wind injury should generally disperse the exterior, but harsh diaphoretic agents are inappropriate. Zhang Zhongjing stated, "Patients with sores should not be induced to sweat; doing so will transform the condition into Spasm." Therefore, for mild Broken-Wind cases, simply use Congbai Xiangchi Tang (Scallion and Fermented Soybean Decoction) added with Angelica Dahurica (Baizhi), Angelica Sinensis (Danggui), Pangolin Scales (Linglijia), Musk (Shexiang), and Scorpion Tail (Xiewei). For severe cases, use the same formula added with Saposhnikovia Divaricata (Fangfeng), Polygala Tenuifolia (Yuanzhi), Astragalus Membranaceus (Huangqi), Cinnamomum Cassia (Rougui), Rhinoceros Horn (Xijiao), and Pangolin Scales (Linglijia). In extreme cases, use Wan Ling Dan taken with a decoction of Scallion and Fermented Soybean.
If vomiting, regurgitation, and inability to eat occur, it is because Wind leads pathogenic toxins to attack the Heart. Internally use Huxin San (Heart-Protecting Powder); externally apply the Scallion Moxibustion method (Congyun Fa). For constipation, use Honey Suppository Method (Mijian Dao).
As the condition subsides, immediately use Baoyuan Tang (Preserve Origin Decoction), still adding Polygala Tenuifolia (Yuanzhi), Cinnamomum Cassia (Rougui), Rhinoceros Horn (Xijiao), and Pangolin Scales (Linglijia) to resolve residual toxins.
If the wound fails to close for a long time, with toxin accumulation internally, intense Heat generating Wind, white scabs forming around without significant swelling, accompanied by chills, fever, and slight jaw tightness, urgently administer Yuzhen San (Jade True Powder). For locked jaw, mix with child's urine and apply this powder to the wound.
If the sore is red and swollen, mix Almond Paste (Xingren Ni) with flour, dilute with water, and apply to the swollen area to reduce swelling.
If the body is cold, jaw is locked, back arches backward (opisthotonos), and limbs are rigid, urgently administer Quanxie San (Whole Scorpion Powder) or Da Wugong San (Large Centipede Powder). Rub teeth with Xiao Wugong San (Small Centipede Powder) to expel phlegm and saliva, leading to immediate recovery.
If symptoms persist after medication, and pathogens gradually enter the interior, causing convulsions, fixed gaze, and constipation/incontinence retention, use Zuolong Wan (Left Dragon Pill).
Convulsions of the back belong to the Taiyang channel, indicating the disease is in the Exterior. The Taiyang meridian runs along the posterior aspect; back convulsions resemble opisthotonos. With no sweating, urgently induce sweating using Fangfeng Tang (Saposhnikovia Decoction), Jiwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction), or Xiao Xuming Tang (Minor Continuation of Life Decoction). If sweating is excessive, stop it using Fangfeng Danggui San (Saposhnikovia and Angelica Powder) or Baizhu Fangfeng Tang (Atractylodes Macrocephala and Saposhnikovia Decoction).
Convulsions of the anterior body belong to the Yangming channel, indicating the disease has entered the Interior. The Yangming meridian runs along the anterior aspect; anterior convulsions present as head lowered looking down, with traction of hands and feet. Urgently purge using Xiaoxionghuang Tang (Minor Ligusticum and Rhubarb Decoction) twice, followed by Da Xionghuang Tang (Major Ligusticum and Rhubarb Decoction) to purge.
Convulsions of the lateral sides belong to the Shaoyang channel, indicating the disease is at the Half-Exterior Half-Interior level. The Shaoyang meridian runs along the lateral aspect; lateral convulsions present as one eye looking left or right, or one hand and foot convulsing on either side. Harmonize using Xiaochaihu Tang (Minor Bupleurum Decoction) or Fangfeng Tongsheng San (Saposhnikovia and Unblocking Success Powder) with modifications. This is Liu Hejian's method.
Only the Three Yang channels are mentioned, not the Three Yin channels, because when Wind pathogen transmits to the Three Yin channels, the condition is invariably critical. Only Tianlinggai Powder (Human Skull Cap Powder) one qian, Pangolin Scales (Linglijia) half a qian, and Musk (Shexiang) one zi, ground together and taken with a decoction of Scallion and Fermented Soybean, are suitable.
If lower abdominal fullness with spontaneous diarrhea, dry mouth and throat, curled tongue, retracted testicles, bead-like sweat on the forehead that does not flow, and extreme limb pain occur—where the pain is not at the injury site—it is ultimately a death omen.
For general treatment of Broken-Wind, Cao's Secret Formula is suitable: Schizonepeta Tenuifolia (Jingjie), Yellow Beeswax (Huangla), and Fish Bladder (Yubiao) each five qian, three pieces of Mugwort Leaf (Aiye), one bowl of unfiltered wine. Simmer over hot water for the duration of one incense stick, drink hot, and recover upon sweating.
If spasms occur, Juan Jing Tang (Spasm-Dispelling Decoction) is indicated.
For prolonged illness causing weakness, primarily regulate the Ying level using Siwu Tang (Four Substances Decoction) added with Saposhnikovia Divaricata (Fangfeng), Angelica Dahurica (Baizhi), and Asarum Sieboldii (Xixin).
For sores invaded by Wind pathogen causing body pain and cramping, use Qianghuo Fangfeng Tang (Notopterygium and Saposhnikovia Decoction) added with Cortex Lycii (Digupi) and Schizonepeta Spike (Jingjiesui).
For broken-wound swelling where pus cannot emerge, use Zhusha Zhijia San (Cinnabar and Nail Powder), mixed with wine. Externally apply Yuzhen San (Jade True Powder) mixed with Ginger Juice.
Alternatively, wash with decoction. If Dampness invades, the sore oozes pus, and the patient feels heavy and lethargic, it is named Broken-Wind Dampness (Po Shang Shi). First use Chuwen Tang (Remove Warmth Decoction), then use Baizhu Gao (Atractylodes Macrocephala Ointment).
If moxibustion or fire heating causes Fire Qi to penetrate, resulting in red and swollen sores with irritability and fever, it is named Broken-Wind Fire (Po Shang Huo). Use Xiaoxionghuang Tang (Minor Ligusticum and Rhubarb Decoction) added with Mentha Haplocalyx (Bohe), Gardenia Jasminoides (Heishanzhi), and Coptis Chinensis (Huanglian) fried with wine.
The *Yi Jian* states: For various sores about to transform into spasm, urgently use Feng San (Wind Powder). For spasm caused by excessive sweating, use Fangfeng Danggui San (Saposhnikovia and Angelica Powder). For spasm caused by excessive blood loss, use Danggui Dihuang Tang (Angelica Sinensis and Rehmannia Decoction).