External Traumatic Injuries - Die Da Sun Shang

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Contents

Definition

External traumatic injuries are damages of the skin, muscles, sinews (tendons and ligaments), bones and internal organs by external factors and the consequence these damages bring to parts or the whole body.

Classifications

According to location of damages

  • External damages: skin, muscle, sinew and bone
  • Internal damages: Zang Fu and the functional disorders of Qi, Blood and Jingluo

According external forces and the course of injuries

  • Acute damages: sudden external force
  • Chronic damages: wear and tear

According to time lapsed

  • New damages
  • Old damages

According to the completeness of the skin at injured location

  • Open damages
  • Close damages

According to degree of damages

  • Slight damages
  • Severe damages

According to occupation

  • Daily life
  • Industrial
  • Agricultural
  • Transport
  • Sport

According to properties of injuring factors

  • Physical
  • Chemical
  • Biological

Causes

External

  • Direct violent forces: location of damage in direct contact with violent forces
  • Indirect violent forces: location of damage in a distance from contact points with violent forces
  • Muscles’ violent contractions: quadriceps femoris (patella), triceps and biceps brachii (humerus)
  • Repetitive forces: lumbar muscle strain, fatigue fracture of metatarsus
  • Six Exogenous Evils and evil Toxin: Wind, Cold and Dampness invasion after injuries. Evil Toxin invasion after injuries.

Internal

  • Age: femoral neck fracture, incomplete fracture, semi-dislocation of the radial head
  • Constitution: habitual dislocation of the jaw, elbow and patella; hip fracture (femoral neck and intertrochanter fracture) and wrist fracture (Colles’ fracture) after falling over
  • Anatomy: borders between compact bone and cancellous bone (distant end of the radius, 2-3 cm from the end- Colles’ fracture)
  • Occupation: construction workers, porters, athletes, kung-fu practitioners, deck workers etc.

Pathological Mechanisms

Shang Qi (Qi Injuries)

  • Qi Stagnation: local or general qi stagnation; pain is the major symptom; swelling is various and the pain is shifting within a wide area and there is no evident pressure pain point. Most common in chest and hypochondriac injuries.
  • Qi Arrest: sudden severe injuries; transient loss of consciousness. Common in head injuries.
  • Qi Deficiency: general or certain Zang Fu or tissue’s functional deficiency or decline; common in chronic injuries, recovery period after severe injuries, weak Constitution and aged patients.
  • Qi Collapse: mostly following sever blood loss. Seen in open injuries and head injuries. Note: internal injuries with bleeding (internal bleeding in liver, spleen, kidney, chest, pelvic cavity and femur or multiple fractures etc) can not be seen by the naked eye. Look for sign of internal bleedings.

Shang Xue (Blood Injuries)

  • Blood Stasis: general or local. More local then general. Pain is the major symptom. Swelling is evident and the pain is like stabbing and there are fixed pressure pain points. Mostly with bruises.
  • Bleedings: external bleeding and internal bleeding. See “Qi Collapse” above.
  • Blood Deficiency: blood loss, spleen functional deficiency (failing to produce), blood stasis not yet removed and now blood can not be generated; Liver and Kidney Essence exhaustion after bone and sinew injuries.
  • Blood Heat: Blood Stasis transforms into Heat or Liver Fire or evil Toxin invasion.

Shang Jin (Fluid Injuries)

  • Fluid and Blood: loss of blood causes fluid deficiency; Blood Stasis transforms into Heat and consumes fluid.
  • Fluid and Qi: Qi Collapse following fluid depletion; deficient qi fails to control fluid; Kidney Yang Deficiency causes transforming dysfunction (oedema and urination difficulties).

Zang Fu and Jingluo

Sinews and Bone

  • Shang Jin (Sinew Injuries)

Contracture and slackening, dislocation of joints, fractures, Liver, Blood

  • Shang Gu (Bone Injuries)

Treatments

Internal

External

  • Applications: creams, plasters, powders, pastes
  • Rubbing: lotions, creams, oils
  • Steam and wash
  • Heated herbs
  • Manipulations: Tuina

References

Articles

Books


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