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Traumatic injuries and improper operations Traumatic injuries include gunshots, penetrating knife wounds, beating, falling, accidents,

scalds, burns, frostbite, muscular sprain caused by sudden or frequent lifting or carrying too-heavy loads, bites by animals or insects, and so on. Wounds and joint injuries Gunshots, incision by knives, beating, falling, accidents, etc., may directly result in muscular swelling, bleeding and haematoma, or joint dislocation or fracture involving the tendons, muscles and bones. There may also be damage to the internal Zang-Fu organs, and shock following on from sudden and severe pain. Burns, scalds and freezing conditions Scalds and burns may result from industrial chemicals, boiling water or oil, or fires. If only the superficial layer of the skin is affected then tissue damage may be confined to redness, swelling, heat and blisters, and pain may be moderate. However, if scalds or burns are severe, the tendons, deep muscles and even the bones can be damaged, resulting in severe pain. Frostbite may also cause damage of the skin, muscles and even tendons, leading to severe pain. This often occurs in locations where the winter temperatures are very low. Frostbite may affect only the limbs, or the body generally, often attacking those who tend to have deficiency of Yang Qi with poor Blood circulation. In consequence, the body is not sufficiently warmed and protected, and Qi and Blood stagnation develop, causing contraction of the Tendons, blood vessels and muscles, and pain develops.

Sprains Muscle contraction or sprain due to sudden or quite frequent lifting or carrying too-heavy loads is also a common cause of pain, especially in the limbs and lower back. It leads to disorder of Qi and Blood circulation, damage to the tendons and muscles, abnormal joint movement, and hence to an alteration in the bodys physical structure; this causes Qi and Blood stagnation, and pain follows. The longer stagnation of Qi and Blood persists, the more complications are seen. Improper operations Improper operations can be also causative factors in pain. In the West, operations are carried out in all hospital departments. Most of the time they have positive results, but sometimes the operation is a failure, or may even aggravate the problem. In any event, the operation often necessitates cutting through tissues, so almost inevitably there is some bleeding during and after the operation, and some blood may be left behind in the body, leading to the development of Blood stagnation. According to the TCM viewpoint, pain after an operation can be caused by: disturbance of the Qi and Blood circulation a deleterious effect on the physiological functions of the Zang-Fu organs damage to or even complete blockage of channel circulation the persistence of excessive amounts of blood

in the body from bleeding during and after the operation, which then becomes stagnant scar formation disturbance of the Mind.