上 不与接骨同,全凭手法及身功。宜轻宜重为高手,兼吓兼骗是上工。法使骤然人不
觉,患如知也骨已拢。兹将手法为歌诀,一法能通万法通。
托下巴歌诀
头骨圆圆曰髑髅,下把骨脱两般求。单边为错双边落,上似弯环下似钩。两指口中齐重
捺,各腮颊外共轻揉。下巴往里徐徐托,托上还须用带兜。
提颈骨歌诀
人登高处忽逢惊,首必先坠颈骨顷。面仰难垂惟伸续,头低不起则端擎。腔中插入须提
拔,骨上歪斜要整平。再看有无他磕碰,临时斟酌度其情。
整背腰骨歌诀
脊背腰梁节节生,原无脱 亦无倾。腰因挫闪身难动,背或伛偻骨不平。大抵脊筋离出
位,至于骨缝裂开 。将筋按捺归原处,筋若宽舒病体轻。
上肩 歌诀
损伤肩膊手筋挛,骨 犹如杵臼然。若是肘尖弯在后,定当 骨耸于前。常医或使两人
拉,捷法只须独自掮。倘遇妇人难动手,骗中带吓秘家传。
托肘尖歌诀
臂膊之中曰肘尖,凸凹上下骨镶粘。直而不曲筋之病,屈若难伸骨有嫌。骨裂缝开翻托
好,筋横纵急搦安恬。仍当养息悬于项,屈曲时时疾不添。
挪手腕歌诀
腕似农车水骨联,仰翻俯复曲如旃。行车竭蹶应防复,走马驰驱或致颠。手必先迎筋反
错,掌如后贴骨开偏,轻轻搦骨归原处,骨若还原筋已痊。
上大腿 歌诀
环跳穴居跨骨前,中分杵臼似机旋。筋翻肿结脚跟HT ,骨错斜行腿足蹁。宣用手掎并脚
牮,或施布缚发绳悬。
推膝盖骨歌诀
膝骨形圆盖膝间,原系活动各筋扳。盖移腿上腰胯痛,骨走 中步履艰。若出外边筋肿
大,如离内侧 难弯。推筋捺骨归原位,抱膝相安何足患。
拽脚踝拐歌诀
足趾足跟踝相并,伤筋动骨致难行。脚尖向后应知挫,踝骨偏斜定是拧。骨突骨坳宜摸
悉,筋翻筋结要厘清。筋须揉拨又须拽,筋若调匀骨亦平。
耀山云∶骨 者,两骨相交活动之处也。如杵之臼,如户之枢,又如桔槔之有机。以筋
之,故能转运而不碍。若脱 者,筋必受伤,是以上 必先理其筋也。前接骨歌,系陈氏秘
,法赅而备,惟原稿韵脚未妥,稍为润色之,脱稿之后,复撰上 歌诀十首,未敢言工,聊
便诵记而已。接骨 之 字,音料,乃尻骨上有八孔,谓之八 。《叶氏医案》云∶接骨上
骱,骱音戛,小骨也,或有用作窍,用作 ,均未切当。薛氏《正体类要》有骨 接而复脱
之句,今仍借用之。
接骨与一般的骨折处理不同,完全依靠手法技巧以及施术者的身体功力。运用手法时轻重适宜才算高手,同时配合惊吓和欺骗手段的才是上等医生。手法施展得突然,让患者察觉不到,如果患者知道了,骨头就已经复位了。现将接骨的手法编成歌诀,掌握了一法就能通晓万法。
托下巴歌诀
头骨圆形称为髑髅,下颌骨脱位有两种情况需要区分。单侧错位为“错”,双侧脱落为“落”,上颌似弯环,下颌似钩状。用两指在口中同时用力下按,在两腮颊外侧共同轻柔揉捏。将下巴向内徐徐托起,托起后还需要用带子兜住固定。
提颈骨歌诀
人从高处坠落忽然受惊,头部必然先坠,颈椎骨发生倾斜。面部仰起难以垂下,只能伸展接续;头部低垂不起,则需要端正擎举。胸腔中插入支撑物必须提拔,骨骼歪斜的要整理平整。再看是否有其他磕碰伤,根据当时具体情况斟酌处理。
整背腰骨歌诀
脊背腰部的骨架节节相连,原本没有脱臼也没有倾倒。腰部因挫伤闪失导致身体难以活动,背部若佝偻则骨骼不平。大抵是脊筋脱离原位,至于骨缝裂开(此处原文有缺字,意指骨缝分离)。将筋按压捺回原处,筋若宽舒,病痛就轻了。
上肩胛歌诀
损伤肩膊导致手部筋脉挛急,肩关节犹如杵臼般结构。如果肘尖弯曲在后,定当肩胛骨耸立于前。普通医生或许会让两人拉扯,快捷的方法只需独自扛起。倘若遇到妇人难以动手操作,采用骗中带吓的秘传方法。
托肘尖歌诀
手臂中间称为肘尖,上下凸凹的骨头镶嵌粘合。伸直不能弯曲是筋的病,屈曲难以伸展是骨的嫌隙。骨裂缝开要翻托好,筋横纵急迫要握持安抚。之后仍应当休养并将手臂悬于颈部,屈曲时动作敏捷以免病情加重。
挪手腕歌诀
手腕像农用车的水轮骨节相连,仰翻俯复弯曲如旃旗。行车受阻应防止复发,骑马奔驰可能导致颠仆。手必须先迎,筋反错,手掌如向后贴附则骨开偏,轻轻握持骨头归还原处,骨头若还原,筋也就痊愈了。
上大腿骨歌诀
环跳穴位于跨骨之前,中间分开如杵臼似机枢旋转。筋翻转肿胀结聚于脚跟,骨错位斜行导致腿足蜷曲。应当用手牵引腿部并用脚抵住,或者施加布带束缚发绳悬挂。
推膝盖骨歌诀
膝骨形状圆盖于膝间,原本是活动的各筋扳动。髌骨移向腿上则腰胯痛,骨头走偏则步履艰难。若髌骨脱出外边则筋肿大,如离内侧则难以弯曲。推动筋、按压骨归回原位,抱膝相安有什么可担忧的。
拽脚踝拐歌诀
足趾足跟踝部相连,伤筋动骨导致难以行走。脚尖向后应知道是挫伤,踝骨偏斜定是拧扭。骨突骨凹宜仔细摸查清楚,筋翻转筋结聚要厘清分辨。筋须揉拨又须拽拉,筋若调匀骨也就平了。
耀山云:骨骱者,是两骨相交活动的地方。如同杵之臼,如同门之枢,又如桔槔之有机。因为筋的约束,所以能转运而不碍事。若骨骱脱位,筋必受伤,所以上骱必先理顺其筋。前面的接骨歌,是陈氏的秘方,法度完备,只是原稿韵脚不妥,稍微润色了一下,脱稿之后,又撰写了上骱歌诀十首,不敢说精巧,姑且方便诵读记忆罢了。接骨骱的“骱”字,音料,乃尻骨上有八孔,谓之八骱。《叶氏医案》说:接骨上骱,骱音戛,小骨也,或者有用作窍,用作骱,都未切当。薛氏《正体类要》有骨骱接而复脱之句,现在仍借用之。
Bone setting differs from general fracture management, relying entirely on manual techniques and the practitioner's physical skill. Appropriately applying light and heavy pressure characterizes a master, while employing simultaneous intimidation and deception characterizes an elite physician. The technique should be executed suddenly so that the patient remains unaware; if the patient becomes aware, the bone has already been reduced. Herein are the manual techniques set forth in verse: mastering one method allows mastery of all methods.
Verse for Supporting the Mandible
The skull is round, called *dulu* (skull). Dislocation of the mandible presents in two forms: unilateral displacement is termed "cuo" (dislocation), bilateral dislocation is termed "luo" (falling/dropping). The maxilla resembles a curved ring, while the mandible resembles a hook. Use two fingers to press down simultaneously inside the mouth, while gently kneading both cheeks externally. Slowly support the mandible inward; after supporting, it must be secured with a bandage.
Verse for Lifting the Cervical Vertebrae
When falling from a height and suddenly startled, the head drops first, causing cervical vertebrae to tilt. If the face looks up and cannot lower, extension is required; if the head hangs low and cannot lift, elevation is needed. Insert supports into the thoracic cavity to lift, and straighten any tilted bones. Check for other contusions or impacts, and adjust treatment according to the specific circumstances at hand.
Verse for Correcting the Dorsal and Lumbar Spine
The spinal column consists of connected segments, originally without dislocation or tilting. Waist injuries from sprains make movement difficult; dorsal curvature indicates uneven bones. Generally, spinal tendons have displaced from their positions, and bone fissures may have opened. Press and knead the tendons back to their original positions; if the tendons relax, the condition lightens.
Verse for Reducing the Shoulder Joint
Injury to the shoulder and arm causes tendon spasms in the hand. The shoulder joint structure resembles a pestle and mortar. If the elbow tip bends backward, the scapula likely protrudes forward. Ordinary physicians might use two people to pull, but the swift method requires only one person to carry/support. If treating a woman where direct handling is difficult, use secret family methods involving deception mixed with intimidation.
Verse for Supporting the Elbow Tip
The middle of the arm is called the "zhoujian" (elbow tip), where convex and concave bones fit together. Straightness without flexion indicates a tendon pathology; inability to extend suggests a bone issue. If bone fissures exist, perform reduction carefully; if tendons are tense horizontally or vertically, grasp and soothe them. Subsequently, rest and suspend the arm at the neck; move the joints frequently to prevent stiffness.
Verse for Adjusting the Wrist
The wrist joints connect like the water wheel of farm equipment, capable of supination and pronation with flexion. Prevent recurrence when movement is obstructed, as riding may cause jarring. The hand must meet resistance; reversed tendons and posteriorly adhered palms indicate bone deviation. Gently grasp the bone to return it to place; once the bone is reduced, the tendon heals.
Verse for Reducing the Femur
The Huantiao point lies anterior to the hip bone. The joint separates medially like a pestle and mortar rotating on a pivot. Tendon reversal and swelling cluster at the heel; bone misalignment causes leg curling. Use hands to pull the leg and feet to brace, or apply cloth bindings and rope suspension.
Verse for Pushing the Patella
The patella is round and covers the knee, originally allowing movement via various tendons. If the patella shifts upward, waist and hip pain occur; if the bone deviates, walking becomes difficult. If dislocated laterally, tendons swell; if dislocated medially, bending is difficult. Push the tendons and press the bone back to their original positions; hugging the knee ensures peace, what is there to worry about?
Verse for Pulling the Ankle
Toes, heels, and ankles are connected; tendon and bone injuries hinder walking. Toes pointing backward indicate sprain; ankle deviation indicates twisting. Palpate bony prominences and depressions thoroughly; clarify tendon reversals and knots. Knead, pluck, and pull the tendons; if tendons are regulated, bones will level out.
Yao Shan said: "Guojia" (bone joint) refers to the site where two bones intersect and move, like a pestle in a mortar, like a door hinge, or like the mechanism of a counterpoise lever. Because of the tendons' constraint, it can rotate freely without obstruction. If the joint dislocates, the tendons must be injured; therefore, reducing the joint requires first regulating the tendons. The preceding bone-setting verse is a secret formula from the Chen family, comprehensive in method, though the original rhyme scheme was imperfect, so it was slightly polished. After completing this, I wrote ten verses on upper limb joint reduction. I dare not claim proficiency, but merely wish to facilitate memorization. The character "jia" in "jiegu jia" (setting bone joints) is pronounced "liao". It refers to the eight holes on the sacrum, called "ba jia" (eight joints). *Ye Shi Yi An* states: "Setting bone jia," where "jia" is pronounced "jia", meaning small bone. Some use it for "qiao" (aperture) or "jia", neither being precise. Xue Shi's *Zhengti Lei Yao* contains the phrase "bone joint reduced then dislocated again"; thus, I still borrow this term.