Differentiation of Internal and External Injuries

Inner and Outer Injury Differentiation is the core work of the Jin dynasty physician Li Gao (Dongyuan) on distinguishing internal injury from external contraction, developed through three volumes and twenty-six discourses centered on the question of how the clinical manifestations of internal injury and external contraction differ. The upper volume analyzes the differences between the two in terms of pulse signs, cold and heat, headache, oral and nasal breath, and related aspects. The middle volume focuses on injury from food, drink, and overexertion, and on overexertion depleting original qi. The lower volume discusses the principles for handling internal injury from food and drink and specific treatment methods. The value of this book lies not in an accumulation of formulas and drugs but in establishing an operational approach to differentiation: clinically, the symptoms of external contraction and internal injury are often confused, and misdifferentiation sends treatment in opposite directions. Li Gao takes deficiency and excess of original qi as the governing principle and separates "internal injury from overexertion" from the framework of externally contracted disease, exerting a profound influence on later generations of the spleen-earth supplementing school. It should be read as training material for the approach to disease differentiation, not as a quick-reference manual. It is suitable for readers with a foundation in Chinese medicine who are studying methods of pattern differentiation and for clinical practitioners to review and compare when encountering cases that "resemble external contraction but are not external contraction." The text follows the traditional medical discourse format and requires reading with annotated editions and basic knowledge.