《医宗金鉴》总论曰∶跌扑损伤,虽用手法调治,恐未尽得其宜,以致有治如未治之苦
未可云医理之周详也。爰因身体上下正侧之象,制器以正之,用辅手法之不逮,以冀分者
复合,欹者复正,高者就其下,陷者升其位。则危症可转于安,重伤可就于轻,再施以药饵
之功,更示以调养之善,则正骨之道全矣。
裹帘
《医宗金鉴》曰∶裹帘以白布为之,因患处不宜他器,只宜布缠,始为得法,故名裹帘
,其长短阔狭,量病势用之。
振梃
释义云∶凡头被伤而骨未碎、筋未断,虽瘀聚肿痛者,皆为可治。先以手法端提颈项筋
再用布缠头二、三层令紧,再以振挺轻轻拍击足心,令五脏之气,上下宣通,瘀血开散,则
奔心,亦不呕呃,而心神安矣。若已缠头,拍击足心,竟不觉疼,昏不知人,痰响如拽据,
身体僵硬,口溢涎沫,乃气血垂绝也,不治。
披肩
释义云∶凡两肩仆坠闪伤,其骨或断碎,或傍突,或斜努,或骨缝开错筋翻,法当令病
卧凳上,安合骨缝,揉按筋结,先以棉花贴身垫好,复以披肩夹住,肩之前后缚紧,再用
布在外缠裹毕,更用扶手板,长二尺余,宽三、四寸,两头穿绳,悬空挂起,令病者俯伏于
上,不使其肩骨下垂,过七日后开视之,如俱痊,可撤板不用,如尚未愈,则仍用之。若不
根据此治法,后必遗残患芦节。
耀山云∶用水竹半边,长短阔狭,以患处为则,削去棱角,嵌入肩内,其肩下腋肢,再
团一个,实其腋内,外以布带缚定系住,此治肩骨断碎之具,虽比板物较硬,然用之得法,
缚之妥贴,则无动移之患矣。
攀索
《医宗金鉴》曰∶攀索者,用绳挂于高处,以病患两手攀之也。
迭砖
释义云∶凡胸腹腋胁,跌打蹦撞垫努,以致胸陷而不直者,先令病患以两手攀绳,足踏
,将后腰拿住,各抽去砖一块,令病患直身挺胸,少倾,又各抽去砖一块,仍令直身挺胸,
如此者三,其足着地,使气舒瘀散,则陷者能起,曲者可直也。再将其胸以竹帘围裹,用宽
带八条紧紧缚之,勿令窒碍。但宜仰卧,不可俯卧侧卧,腰下以枕垫之,勿令左右移动。
通木
释义云∶凡脊背跌打损伤,膂骨开裂高起者,其人必伛偻难仰。法当令病者俯卧,再着
以两足踏其两肩。医者相其开裂高起之处,宜轻宜重,或端或拿,或按或揉,令其缝合,然
后用木根据前法逼之。
腰柱
释义云∶凡腰间闪挫岔气者,以常法治之。若腰节骨被伤错笋,膂肉破裂,筋斜伛偻者
醋调定痛散,敷于腰柱上,视患处将柱排列于脊骨两傍,务令端正,再用蕲艾做薄褥,复于
柱上,以御风寒,用宽长布带,绕向腹前,紧紧扎裹,内服药饵,调治自愈。
耀山曰∶医者,意也。尝考古人创论立方,虽有根据,以已意参之,总不出情理之中。
骨一道,用手法外,复用器具,盖有意会之处。阅《明史》内载,有谏臣某,因事迭奏忤上
,致延讯时,上令武士,用金瓜锤责其遍体,甚至肋骨击断其二;复令下狱,身加挺棍脚
,手铐刑具,严行监固。挺棍者,较人之长短,以木为之,上锁于颈,下链于踝,中系于手
而及于腰,使囚不能弯曲转侧活动。后上悟,怜其苦谏释之,肋骨俱已接续,未始非挺棍铐
之益也。挺棍与通木相似,械系与扎缚相同,击断者复接续,是以不医医之。今之用器具,
殆即此遗意欤。
竹帘
释义云∶凡肢体有断处,先用手法安置讫,然后用布缠之,复以竹帘围于布外,紧扎之
,使骨缝无参差走作之患,盖通用之物也。
杉篱
释义云∶凡用以围裹于竹帘之外,将所穿之绳结住,再于篱上加绳以缠之,取其坚劲挺
使骨缝无离绽脱走之患也。盖骨节转动之处与骨筋甚长之所,易于摇动,若仅用竹帘,恐挺
劲之力不足,故必加此以环抱之,则骨缝吻合坚牢矣。
陈远公曰∶有跌打骨折,必用杉木或杉板,将折骨凑合端正,以绳缚定,勿偏斜曲,再
扎,不可因疼痛心软,少致轻松,反为害事。后用内服药,如皮破血出,须用外治药,但骨
折而外边之皮不破,即不用外治之药,然内外夹攻,未尝不更佳耳。内治法宜活血去瘀为先
,血不活则瘀不去,瘀不去则骨不能接也。内治用接骨神丹煎服,外治贴全体神膏,再加末
药胜金丹,掺伤处为妙。每膏一张用末药三钱,掺膏上贴之。凡接骨不须二个,至重则用二
个。此绝奇绝异之方,倘未损伤,只贴膏药,不必用胜金丹掺药。内外治法三方,有不可形
容之妙,医者患者得以旦夕奏功,故特为表出,方出《冰鉴》。
谷兰云∶损伤固痛,因痛而以板木缚之则愈痛,愈痛而手软、心软,转致轻松,是痛其
反增其痛,迨至不可医药,悔何及哉!学人务熟习手法,临症时得自然之妙,自无手软、心
软之弊矣。
耀山云∶凡臂骨及小儿颈骨、腿骨、大手膊骨,截断折断、碎断斜断者,不必用大杉篱
用杉木皮尽可。将杉木皮削去粗皮,或三片或二片,如指面大,长短以患处为则。况杉木皮
似竹样阁漏式,合于骨处极为妥贴。又杉木皮挖空,用纸粘裹,可缚手肘手腕,使其能转能
伸,能屈能曲,此夹扎中之活法也。又有竹蔑大片,再以纸包,或用三片、四片,看患处之
宽狭长短,定为法则。又有松木薄板,象今做糕匣者,用纸包裹,安于骨断之处,以棉带紧
扎甚妙。此皆常用验过之器具也。
抱膝
释义云∶膝盖骨复于楗 二骨之端,本活动物也。若有所伤,非骨体破碎,即离位而突
左右。虽用手法推入原位,但步履行止,必牵动于彼,故用抱膝以固之,庶免复离原位,而
遗跛足之患也。其法将抱膝四足插于膝盖两傍,以竹圈辖住膝盖,令其稳妥,不得移动,再
用白布宽带,紧紧缚之。
耀山云∶膝盖骨脆碎或跌碎者,常用纸竹毛篾缠绕一KT ,与膝盖大小相等,再加四绳缚
于KT 上,贴膏药后,即将篾KT 安上,四绳分前后缚之,较之竹圈,稍觉柔软矣。
又云∶以上器具,皆伤科必用之物,又增补试验各具,然未备也。有肩胛出臼,用布带
手上,系于柱间,在带上 者;有腿骨出 ,用阔带缚定腿足,将人抱住,以大 头吓者;
有用硬挺者;有用软骗者,种种器具,总不出缚缠夹扎挺托之法,复其原位,使勿游移活动
为得耳,要在人之活法变动也。
《选粹》云∶凡损伤平处,骨断骨碎,皮不破者,用接骨定痛等膏敷贴。若伤在手足曲
缩之处,要用包裹,可令时时转动。指骨碎者,只用麻片夹缚。腿上用麻绳扎缚。冬月热缚
,夏月凉缚,余月温缚。又云∶骨断皮破者,不可用酒煎药。或损在内而皮破者,可加童便
于破血药内和服。若骨断、皮不破者,可全用酒煎药。若只伤而骨不折、肉不破者,用消肿
膏或定痛膏。又云∶皮里有碎骨,只用定痛膏敷贴夹缚,如十分伤重,自然烂开其肉,碎骨
自出,然后用补肌散,外以补肉膏敷贴。又云∶夹缚处,须药水以时泡洗,春秋三日,夏二
日,冬四日,洗去旧药,须仔细勿惊动伤处,洗讫,仍用前药前膏敷缚。凡换药不可生换,
须用手巾打湿拓润,逐片取脱,随手荡洗换上,又不可停留一时刻,药膏必须预为摊就,随
手换上,此乃敷药之诀,如换膏药亦然。
《医宗金鉴》总论说:跌打损伤,虽然使用手法进行治疗,但恐怕未能完全得当,从而导致像没治一样的痛苦,这还不能说是医理周全。于是根据身体上下、正面侧面的形态,制作器具来矫正,用来辅助手法治疗的不足,希望断裂的能重新复合,歪斜的恢复端正,高的迁就低的,陷下的提升位置。这样危重的病症可以转为平安,重伤可以变为轻伤,再施以药物的功效,更展示调养的好处,那么正骨的方法就完备了。
裹帘
《医宗金鉴》说:裹帘是用白布制作的,因为患处不适合用其他器具,只适宜用布缠绕,这才符合方法,所以叫作裹帘,其长短宽窄,根据病情程度来决定使用。
振梃(一种拍打足心的工具)
释义说:凡是头部受到外伤而骨头未碎、筋脉未断,虽然有瘀血聚集肿痛的情况,都属于可治之症。先用手法端正提拉颈项部的筋脉,再用布将头缠两三层使其紧绷,然后用振梃轻轻拍击足心,使五脏之气上下宣通,瘀血开散,那么气血上冲心胸的症状就不会出现,也不会呕吐呃逆,心神就能安宁了。如果已经缠好头,拍击足心后,竟然感觉不到疼痛,昏迷不醒,喉间痰声如拽锯,身体僵硬,口吐涎沫,这是气血即将断绝的表现,属于不治之症。
披肩(一种固定肩部的夹板)
释义说:凡是双肩因跌倒坠落或闪挫受伤,骨头有的断裂破碎,有的旁突,有的斜努,或者骨缝错位、筋脉翻转,治疗方法应当让病人躺在凳子上,先合拢骨缝,揉按筋结,先在贴身处垫好棉花,再用披肩夹住,在肩的前后缚紧,最后在外面用布缠绕包裹完毕,再用扶手板,长二尺多,宽三、四寸,两头穿绳,悬空挂起,让病人俯伏在上面,不让肩骨下垂,过了七天后打开查看,如果都痊愈了,可以撤去木板不用;如果尚未痊愈,则继续使用。如果不按照此法治疗,后来必定遗留残废患难。
耀山说:用水竹劈成半边,长短宽窄,以患处为标准,削去棱角,嵌入肩部内部,在肩下腋肢处,再团一个东西,充实腋内,外面用布带缚定系住,这是治疗肩骨断裂破碎的器具,虽然比木板较硬,但如果使用方法得当,绑扎妥帖,就没有移动脱位的隐患了。
攀索
《医宗金鉴》说:攀索,是用绳子挂在高处,让病患双手攀握它。
迭砖
释义说:凡是胸腹腋胁部,因跌打蹦撞垫压努伤,导致胸部凹陷而不直的情况,先让病患双手攀绳,脚踏砖块,医者抓住其后腰,各抽去一块砖,让病患挺直身体挺胸,过了一会儿,又各抽去一块砖,仍让病患挺直身体挺胸,如此重复三次,直到脚着地,使气机舒畅瘀血消散,那么凹陷的就能抬起,弯曲的就能变直了。然后再将其胸部用竹帘围裹,用八条宽带紧紧缚住,不要令其阻碍呼吸。只宜仰卧,不可俯卧或侧卧,腰部下面用枕头垫高,不要让身体左右移动。
通木
释义说:凡是脊背跌打损伤,膂骨开裂高起的,其人必然驼背难以仰身。治疗方法应当让病人俯卧,再让他的双脚踩在医生的两肩上。医生观察其开裂高起之处,决定轻还是重,是端提还是拿捏,是按压还是揉搓,令其缝合,然后用木具按照前面的方法逼迫复位。
腰柱
释义说:凡是腰部闪挫岔气的,用常规方法治疗。如果腰节骨被伤错位,肌肉破裂,筋脉斜曲驼背的,用醋调匀定痛散,敷在腰柱上,视患处将柱子排列在脊柱两旁,务必端正,再用蕲艾做成薄褥,覆盖在柱子上,以抵御风寒,用宽长的布带,绕向腹部前面,紧紧扎裹,内服药物,调理即可自愈。
耀山说:医者,靠的是意念。曾经考察古人创立理论制定方剂,虽然有依据,但加入自己的理解参酌,总不出情理之外。骨骼一道,除了用手法治疗外,又复用器具,大概有意会相通的地方。阅读《明史》记载,有位谏臣某,因事多次上奏触犯皇上,导致受审时,皇上命令武士,用金瓜锤责打他全身,甚至肋骨被打断两根;又下令入狱,身上加上挺棍脚镣,手戴铐具,严密监禁。挺棍,是根据人的长短,用木头制成,上面锁在脖子,下面链在脚踝,中间系在手并延伸到腰,使囚犯不能弯曲转侧活动。后来皇上醒悟,怜悯他苦苦劝谏而释放了他,肋骨都已经接续,未尝不是挺棍铐具的益处。挺棍与通木相似,械系与扎缚相同,被打断的又重新接续,这就是“不医而医”的道理。现在使用器具,大概就是这种遗意吧。
竹帘
释义说:凡是肢体有断裂处,先用手法安置完毕,然后用布缠绕,再以竹帘围在布的外面,紧扎,使骨缝没有参差不齐走动的隐患,这是通用的物品。
杉篱
释义说:凡是用来围裹在竹帘外面的,将所穿的绳结住,再在篱上加绳缠绕,取其坚固强劲,使骨缝没有离绽脱走的隐患。大概是骨节转动之处和筋骨很长的地方,容易摇动,如果仅用竹帘,恐怕强劲之力不足,所以必须加此物来环抱,那么骨缝吻合就坚牢了。
陈远公说:有跌打骨折,必须用杉木或杉板,将折骨凑合端正,用绳缚定,不要偏斜弯曲,再扎紧,不要因为疼痛心软,稍微导致轻松,反而成为害事。后用内服药,如果皮破血出,须用外治药,但是骨折而外面的皮不破,就不用外治的药,然而内外夹攻,未尝不是更好。内治法宜以活血去瘀为先,血不活则瘀不去,瘀不去则骨不能接也。内治用接骨神丹煎服,外治贴全体神膏,再加末药胜金丹,掺在伤处为妙。每张膏药用末药三钱,掺在膏上贴之。凡是接骨不需要两个,最重则用两个。这是绝奇绝异的方子,如果没有损伤,只贴膏药,不必用胜金丹掺药。内外治法三方,有不可形容的妙处,医者患者得以早晚见效,所以特别提出,方子出自《冰鉴》。
谷兰说:损伤固然疼痛,因为疼痛而以板木缚之则更痛,越痛而手软、心软,转而导致轻松,这是痛其反而增加其痛,等到不可医药的时候,后悔哪里来得及呢!学人务必熟习手法,临症时得到自然之妙,自然没有手软、心软的弊病了。
耀山说:凡是臂骨及小儿颈骨、腿骨、大手臂骨,截断折断、碎断斜断的,不必用大杉篱,用杉木皮完全可以。将杉木皮削去粗皮,或三片或两片,如指面大小,长短以患处为标准。况且杉木皮似竹子一样镂空式,贴合于骨处极为妥帖。又杉木皮挖空,用纸粘裹,可缚手肘手腕,使其能转能伸,能屈能曲,这是夹扎中的活法。又有竹篾大片,再用纸包,或用三片、四片,看患处的宽狭长短,定为法则。又有松木薄板,像现在做糕匣那样,用纸包裹,安于骨断之处,用棉带紧扎很妙。这些都是常用验证过的器具。
抱膝
释义说:膝盖骨复盖在股骨和胫骨两端,本是活动的物体。如果有伤,不是骨体破碎,就是离位而突出左右。虽然用手法推入原位,但步履行走停止,必牵动于此,所以用抱膝来固护它,以免再次脱离原位,而遗留跛足的祸患。其法是将抱膝的四足插入膝盖两旁,以竹圈辖住膝盖,令其稳妥,不得移动,再用白布宽带,紧紧缚住。
耀山说:膝盖骨脆碎或跌碎的,常用纸竹毛篾缠绕成一个框,与膝盖大小相等,再加四根绳缚于框上,贴膏药后,即将篾框安上,四根绳分前后缚住,比竹圈稍觉柔软了。
又说:以上器具,都是伤科必用的物品,又增补试验各种器具,然而还不完备。有肩胛骨脱臼,用布带套手上,系于柱间,在带上打结的;有腿骨脱臼,用宽带缚定腿足,将人抱住,以大锤头吓唬的;有用硬挺的;有用软骗的,种种器具,总不出缚缠夹扎挺托的方法,使其恢复原位,使其不要游移活动才算得当,关键在于人的灵活变动。
《选粹》说:凡是损伤平处,骨断骨碎,皮不破的,用接骨定痛等膏敷贴。如果伤在手足曲缩之处,要用包裹,可令时时转动。指骨碎的,只用麻片夹缚。腿上用麻绳扎缚。冬月热缚,夏月凉缚,其余月份温缚。又说:骨断皮破的,不可用酒煎药。或者损在内而皮破的,可加童便于破血药内和服。如果骨断、皮不破的,可全用酒煎药。如果只伤而骨不折、肉不破的,用消肿膏或定痛膏。又说:皮里有碎骨,只用定痛膏敷贴夹缚,如果十分伤重,自然烂开其肉,碎骨自出,然后用补肌散,外以补肉膏敷贴。又说:夹缚处,须药水按时泡洗,春秋三日,夏二日,冬四日,洗去旧药,须仔细勿惊动伤处,洗毕,仍用前药前膏敷缚。凡换药不可生换,须用手巾打湿拓润,逐片取脱,随手荡洗换上,又不可停留一时刻,药膏必须预为摊就,随手换上,这是敷药的秘诀,如换膏药亦然。
General Discussion in *Yizong Jinjian* states: For falls and blows causing injury, although manual manipulation is used for treatment, it is feared that the appropriateness may not be fully achieved, leading to the suffering of being treated as if untreated. This cannot be said to reflect a thorough understanding of medical principles. Therefore, based on the morphology of the body's upper and lower parts and its anterior and posterior aspects, devices are manufactured to correct deformities, assisting where manual manipulation falls short, with the hope that separated parts will rejoin, crooked parts will become straight, high parts will be lowered to match low ones, and depressed parts will be elevated to their proper position. In this way, critical conditions can turn into safety, severe injuries can become mild. Furthermore, by applying the efficacy of medicinal herbs and demonstrating proper recuperation methods, the art of bone setting becomes complete.
Wrapping Curtain (Guolian)
*Yizong Jinjian* states: The Wrapping Curtain is made of white cloth. Because other devices are unsuitable for the injured area, only wrapping with cloth is appropriate, hence the name "Wrapping Curtain." Its length, width, and narrowness are determined according to the severity of the condition.
Vibrating Mallet (Zhenting)
The Explanation states: Whenever the head suffers trauma but the bone is not shattered and the tendons are not severed, even if there is blood stasis accumulation with swelling and pain, it is considered treatable. First, use manual manipulation to align and lift the tendons of the neck. Then, wrap the head tightly with two or three layers of cloth. Next, gently tap the soles of the feet with the Vibrating Mallet to promote the free flow of Qi among the Five Viscera (Zang-organs), disperse the blood stasis, prevent Qi from rushing to the Heart (Benxin), avoid vomiting or hiccups, and calm the Spirit (Shen). However, if after wrapping the head and tapping the soles, the patient feels no pain, falls into unconsciousness, produces rattling phlegm sounds like sawing wood, exhibits body rigidity, and foams at the mouth, this indicates that Qi and Blood are on the verge of exhaustion; such cases are untreatable.
Shoulder Cape (Pijian)
The Explanation states: Whenever both shoulders suffer sprain or fall injuries, where bones may be fractured, displaced laterally, protruding obliquely, or where bone joints are misaligned and tendons are flipped, the method requires the patient to lie on a bench. First, realign the bone joints and massage the tendon knots. Place cotton padding close to the skin, then secure the shoulder with the Shoulder Cape, binding it tightly front and back. Finally, wrap the outside with cloth. Use an armrest board, slightly over two chi long and three to four cun wide, with ropes threaded through both ends, suspended in the air. Have the patient lie prone on it to prevent the shoulder bones from sagging. After seven days, inspect the area. If healed, remove the board; if not, continue using it. Failure to follow this treatment will inevitably lead to permanent disability.
Yaoshan states: Use half-split water bamboo, sized to the injured area, with sharp edges removed, and insert it into the shoulder. Under the shoulder and armpit, place another padded object to fill the axilla. Secure externally with cloth bands. This device treats shattered shoulder bones. Although harder than wooden boards, if used correctly and bound securely, there is no risk of displacement.
Climbing Rope (Pansuo)
*Yizong Jinjian* states: The Climbing Rope involves hanging a rope from a high place for the patient to grasp with both hands.
Stacked Bricks (Diezhuan)
The Explanation states: For chest, abdomen, axilla, and hypochondriac injuries caused by falls, blows, or compression resulting in a depressed and straightened chest, first have the patient grasp a rope with both hands and stand on bricks. The physician holds the patient's lower back. Remove one brick from each side, instructing the patient to straighten their body and extend their chest. After a moment, remove another brick from each side, again instructing the patient to straighten and extend. Repeat this three times until the feet touch the ground. This allows Qi to flow freely and stasis to dissipate, raising the depression and straightening the curvature. Afterwards, wrap the chest with a bamboo curtain and bind tightly with eight wide belts to ensure breathing is not obstructed. The patient should only lie supine, not prone or lateral. Place a pillow under the waist to prevent left-right movement.
Through Wood (Tongmu)
The Explanation states: For spinal injuries from falls and blows where the dorsal bone is cracked and elevated, the patient will likely suffer from kyphosis and difficulty extending backward. The method requires the patient to lie prone. The physician places their shoulders under the patient's feet. Observing the cracked and elevated area, the physician determines whether to apply light or heavy pressure, lifting, grasping, pressing, or kneading to realign the fracture. Then, use a wooden device to force alignment according to previous methods.
Waist Pillar (Yaozhu)
The Explanation states: For lumbar sprains and Qi stagnation, use standard treatments. If the lumbar vertebrae are injured and misaligned, muscles are ruptured, and tendons are slanted causing kyphosis, mix Dingtong San (Pain-Relieving Powder) with vinegar, apply it to the Waist Pillar. Arrange the pillars alongside the spine according to the injury site, ensuring they are upright. Cover the pillars with a thin mat made of Qiai (Ai Ye, Mugwort Herb) to protect against wind and cold. Bind tightly with a long wide belt around the abdomen. Administer internal medicine for self-healing.
Yaoshan states: Medicine relies on intent. Examining how ancient masters established theories and formulas, although based on evidence, incorporating personal insight always remains within reason. Bone setting, besides manual therapy, utilizes devices, implying a conceptual connection. Reading the *History of Ming*, it records an censor who offended the Emperor through repeated memorials. During interrogation, the Emperor ordered warriors to beat him with golden melon hammers, breaking two ribs. He was then imprisoned, subjected to the "Tinggun" (a wooden torture device), shackles, and strict confinement. The Tinggun was made of wood, sized to the person, locked at the neck, chained at the ankles, and tied at the hands and waist, preventing bending or turning. Later, the Emperor realized his error, released the censor out of pity for his loyal remonstrance, and found his broken ribs had already united. This was not without benefit from the Tinggun and shackles. The Tinggun resembles Tongmu; shackling resembles binding. Broken bones reunited implies "healing without medicine." The current use of devices likely stems from this legacy.
Bamboo Curtain (Zhulian)
The Explanation states: For limb fractures, after manual reduction, wrap with cloth, then encircle with a bamboo curtain outside the cloth and bind tightly. This prevents bone fragments from shifting or displacing. It is a general-purpose item.
Fir Fence (Shali)
The Explanation states: Used to wrap around the bamboo curtain, securing the ropes, and adding more ropes around the fence to provide firmness and strength, preventing bone joints from separating or sliding. Areas of joint movement or long tendons are prone to shaking. Using only a bamboo curtain may lack sufficient rigidity, so adding this fence to encircle the area ensures firm union of the bone joints.
Chen Yuan Gong states: For fractures from falls and blows, use fir wood or fir boards to align the broken bones properly, bind them with ropes to prevent tilting or bending, and tighten securely. Do not loosen due to sympathy for pain, as this causes harm. Subsequently, use internal medicines. If the skin is broken and bleeding, external treatments are necessary. If the skin is intact despite the fracture, external treatment may be omitted, but combining internal and external treatments is superior. Internal treatment prioritizes invigorating blood and removing stasis; if blood does not circulate, stasis remains, and bones cannot unite. Internally, administer Jiegu Shendan (Bone-Connecting Divine Elixir) decoction. Externally, apply Quantisheng Gao (Whole-Body Divine Plaster), supplemented with Shengjindan (Gold-Surpassing Golden Pill) powder sprinkled on the wound. Use three qian of powder per plaster sheet. Usually, one application suffices; for severe cases, use two. This is an extraordinary formula. If there is no injury, simply applying the plaster without the powder is unnecessary. These three methods of internal and external treatment possess indescribable efficacy, allowing rapid results for both doctor and patient. Hence, they are highlighted here. The formula originates from *Bingjian*.
Gulan states: Injury causes pain. Binding with boards and wood due to pain increases pain. Increased pain leads to laxity in hands and heart, resulting in loosening. This exacerbates the pain. When treatment becomes impossible, regret comes too late. Students must master manual techniques to achieve natural efficacy during clinical practice, avoiding laxity.
Yaoshan states: For fractures of the arm, child's neck, leg, or upper arm, whether cut, broken, shattered, or oblique, large fir fences are not necessary; fir bark suffices. Remove the rough bark from the fir bark, using two or three pieces, sized like a finger nail, with length determined by the injury site. Fir bark has a hollow structure similar to bamboo, fitting the bone perfectly. Hollowed fir bark wrapped in paper can be used for elbows and wrists, allowing rotation, extension, flexion, and bending—this is the flexible method of splinting. Large bamboo strips wrapped in paper, or three to four pieces sized to the injury, are also effective. Thin pine boards, like those used for cake boxes, wrapped in paper and placed at the fracture site, tightly bound with cotton bands, are also excellent. These are all commonly used and verified devices.
Knee Hug (Baoxi)
The Explanation states: The patella covers the ends of the femur and tibia and is naturally mobile. If injured, the bone may shatter or dislocate laterally. Even after manual reduction to the original position, walking or stopping will pull on it. Therefore, use the Knee Hug to stabilize it, preventing re-dislocation and subsequent lameness. Insert the four legs of the Knee Hug beside the knee, secure the knee with a bamboo hoop to ensure stability, and bind tightly with a wide white cloth belt.
Yaoshan states: For brittle or shattered patellae, wrap paper, bamboo, and hair strips into a frame equal in size to the knee. Attach four ropes to the frame. After applying plaster, place the strip frame over the knee and bind with the four ropes front and back. This is softer than a bamboo hoop.
Furthermore, the above devices are essential for orthopedics, yet additional experimental devices exist, though still incomplete. For shoulder dislocations, use cloth bands around the arms tied between pillars. For leg dislocations, bind the leg and foot with wide belts, hold the person, and use a large hammer head to intimidate/reduce. Some use hard supports; some use soft padding. All devices essentially rely on binding, wrapping, splinting, supporting, and holding to restore position and prevent movement. The key lies in the practitioner's flexibility.
*Xuanhui* states: For flat-surface injuries with fractures or comminution but intact skin, apply Jiegu Dingtong Gao (Bone-Setting and Pain-Relieving Plaster). For injuries in flexor areas of hands and feet, use wrapping that allows frequent movement. For crushed finger bones, use hemp片 (hemp slices) for splinting. For legs, use hemp rope binding. Apply hot bindings in winter, cool in summer, and warm in other months. If the bone is broken and skin is lacerated, do not decoct medicine with alcohol. If internal damage exists with skin laceration, add fresh urine (Tongbian, Child's Urine) to blood-breaking medicines for oral administration. If the bone is broken but skin is intact, decoct medicine entirely with alcohol. For soft tissue injuries without bone fracture or muscle rupture, use Xiaozhong Gao (Swelling-Reducing Plaster) or Dingtong Gao. If small bone fragments remain under the skin, apply Dingtong Gao and splint. If the injury is severe enough to cause necrosis and spontaneous expulsion of fragments, apply Bujisan (Muscle-Nourishing Powder) and cover with Burou Gao (Flesh-Replenishing Plaster). Soak splints in medicinal water regularly: every three days in spring/autumn, two days in summer, four days in winter. Wash off old medication carefully without disturbing the injury site, then reapply the same medicine and plaster. When changing dressings, do not peel dry gauze directly. Moisten with a wet towel, peel off layer by layer, wash immediately, and reapply. Do not delay; prepare plasters in advance for immediate application. This is the secret of dressing changes, applicable to plaster replacement as well.