Outline:
Traumatic fever mainly refers to the elevated body temperature due to accumulation of blood stasis or invasion of pathogenic poison. The fever may be caused by accumulation of blood flowing out of the ruptured vessels after trauma, which is called blood stasis fever. Or it may be caused by infection of pathogenic poison on the basis of open injury or hematoma, which is called pathogenic poison fever. In a few cases, there occurs deficiency of yin blood due to massive bleeding. Consequently, yin fails to restrict yang and then yang gets hyperactive relatively, resulting in fever, which is called blood deficiency fever.

Major points for diagnosis  
1. Most of the patients have a traumatic history.
 
2. The body temperature is higher than 37.5℃. Blood stasis fever often occurs one day after the trauma, usually between 380C to 390C, and there is no chills but hematoma; pathogenic poison fever is often a hyperpyrexia with accompanying chill and aversion to cold, and infectious focus of pathogenic poison; blood deficiency fever has a history of massive bleeding, the fever often occurs in the afternoon, generally not higher than 38.5℃, and is commonly accompanied by such blood deficiency symptoms as dizziness and vertigo.
 
3. The patient with infection of pathogenic poison has leukocytosis.


Treatment  
Herbal therapy
Internal treatment based on syndrome different iat ion

(1) Syndrome of blood stasis
Main symptoms and signs:
Fever (38℃ to 39℃ ) occurring one day after the trauma, no chills, hematoma in traumatic part, dysphoria, insomnia, poor appetite, thirst, and bitter taste in the mouth, red tongue with ecchymoses and white-thick or yellow-greasy coating, stringy and rapid pulse, with traumatic history of sprain and contusion.
 
Therapeutic methods: Removing stasis and promoting blood flow.

Recipe and herbs:
Modified No. 1 Zhishang Decoction. Specifically, Danggui (Radix Angelicae Sinensis )10 g, Chishaoyao (Radix Paeniae Rubrae)10 g, Honghua ( Flos Carthmi )10 g, Shengdihuang ( Radix Rehmanniae )10 g, Ruxiang ( Gummi Olibanwm )10 g, Taoren ( Semen Persicae)10 g, Zhechong ( Eupolyphaga seu Steleophaga )10 g, Mudanpi ( Cortex Mountan Radicis)12 g, Zhizi (Fructus Gardeniae)10 g, Huangbai (Cortex Phellodendri)10 g, Fangfeng (Radix Ledebouriellae Divaricatae)10 g and Gancao (Radix Glycyrrhizae )3 g.
 
(2) Syndrome of pathogenic poison

Main symptoms and signs:
High fever with accompanying chill and intolerance of cold, lassitude of limbs, local redness, swelling, heat and pain, thirst with a desire for cold drink, scanty and dark urine, red tongue with yellow coating, slippery and rapid pulse.

Therapeutic method:
Clearing away heat and poison.

Recipe and herbs:
Modified Wuwei Xiaodu Decoction and Huanglian Jiedu Decoction. Specifically, Jinyinhua (Flos Lonicerae )15 g, Yejuhua ( Flos Chrysanthemi Indici )15 g, Pugongying ( Herba Taraxaci )15 g, Zihuadiding ( Herba Violae Yedoensitis )15 g, Zibeitiankui (Herba Semiaquilegiae )15 g, Huanglian ( Rhizoma Coptidis )5 g, Huangqin ( Radix Scutellariae )10 g, Huangbai (Cortex Phellodendri)10 g, Chishaoyao (Radix Paeniae Rubrae)10 g, Danggui ( Radix Angelicae Sinensis )10 g and Gancao ( Radix Glycyrrhizae )3g.

(3) Syndrome of blood deficiency
Main symptoms and signs:
Fever not more than38.5℃ in the afternoon, dizziness, vertigo, blurring vision, numbness of limbs, lassitude, lustreless complexion, pale tongue, feeble-thready or hollow pulse.
 
Therapeutic methods:
Nourishing and replenishing blood.

Recipe and herbs:
Modified Siwu Decoction. Specifically, Danggui (Radix Angelicae Sinensis)10 g, Shudihuang ( Radix Rehmanniae Praeparata ) 12 g,Baishaoyao ( Radix Paeoniae Alba )10 g, Chuanxiong (Rhizoma Ligustici Chuanxiong)10 g, Huangqi (Radix Astragali seu Hedysari )12 g, Jixueteng ( Caulis Spatholobi)10 g, Ajiao (Colla CoriiAsini) (to be taken after dissolved by hot decoction)10g, Chenpi (Pericarpium Citri Reticulatae )10 g, Gancao ( Radix Glycyrrhizae)5 g, Shengjiang ( Rhizoma Zingiberis Recens ) 3 pieces and Dazao (Fructus Ziziphi Jujubae ) 2 pieces.

Internal traumatic syndrome:
For the syndrome of blood stasis, the injured part may be topically treated with Xiaoyu Zhitong Paste or Sanse Application. For the syndrome of pathogenic poison, Shuangbai Powder may be topically used at its early stage.