脚有六臼四折骨。凡脚板上KT 交处出臼,须用一人拽去自用手,摸其骨节或骨突,出
在内用手正从此骨头拽归外;或骨出向外,须用力拽归内则归窠。若只拽不用手整入窠内,
误人成痼疾也。宜接骨膏、定痛膏敷贴,夹缚四折骨,用正副夹缚束。六出臼,只宜以
布帛包缚,不可夹之。凡脚膝出臼,与手臂肘出臼同,或出内出外,只用一边夹缚定,此
处筋脉最多,时时要曲直不可定放,又恐再出窠,时时看顾,不可疏慢,宜接骨膏、定
痛膏敷贴夹缚。凡脚大腿根出臼,此处身上骨是臼,腿根是杵,或出前,或出后,须用
一人手把住患人身,一人拽脚用手尽力搦,归窠矣。或者锉开,又可用软绵绳从脚缚,倒
吊起,用手整骨节,从上坠下自然归窠,却用接骨膏、定痛膏敷贴夹缚。
凡锉脊骨,不可用手整顿,须用软绳,从脚吊起,坠下体直。其骨使自归窠,未直则
未归窠,须要待其骨直归窠,却用接骨膏,或定痛膏,或补肉膏敷,以桑皮一片,放在药
上,杉皮两三片,安在桑皮上,用软物缠夹定,莫令曲,用药治之。凡脚、手骨被压碎
者,须用麻药与服,或用刀刮开,甚者用剪刀剪去骨锋,便不冲破肉,或有粉碎者去其
骨,免脓血之祸,然后用大片桑皮,以补肉膏或定痛膏,糊在桑皮上,夹在骨肉上,莫
令差错,三日一洗,莫令臭秽,用药治之。又切不可轻易自恃有药,便割、便剪、便弄,须
要详细审视,当行则行,尤宜仔细。或头上有伤,或打破,或刀伤,或压碎骨,用药敷
贴缚之。凡敷缚之际,要于密屋无风之所,勿使风入疮口,恐成破伤风之患,切记切记。
脚部有六个关节窝和四块易折的骨头。凡是脚板上骨骼交汇之处出现脱臼,必须用一人拉住患肢,另一人用手触摸骨节或骨突,如果骨头向外侧脱出,就用手将其从外侧拉回内侧;或者骨头向内侧脱出,就用力将其拉回内侧,使其复位。如果只是拉扯而不用手进行整复归位,会导致误诊并使人留下顽固性疾病。适宜使用接骨膏、定痛膏敷贴,并用夹板固定四块易折的骨头,使用正副夹板束紧。对于六个关节窝的脱臼,只宜用布帛包裹束缚,不可使用夹板。凡是脚膝部脱臼,与手臂肘部脱臼相同,无论是向内还是向外脱出,只需在一边用夹板固定,此处筋脉最多,需要时常弯曲伸直,不可长期固定不动,又担心再次脱臼,要时时照看,不可疏忽大意,适宜使用接骨膏、定痛膏敷贴并夹缚。凡是脚大腿根部脱臼,此处的身体骨骼是关节窝,腿根是骨杵,或者是向前脱出,或者是向后脱出,必须用一人按住患者的身体,另一人拉住脚并用手尽力揉捏,使其复位。如果手法失败,也可以用软绵绳从脚部捆绑,倒吊起来,用手整理骨节,利用重力自然下垂复位,然后用接骨膏、定痛膏敷贴并夹缚。
凡是脊椎骨骨折,不可用手强行整顿,必须用软绳,从脚部吊起,使身体垂直下垂。让骨头自行复位,如果身体未变直则说明骨头未复位,必须等待骨头变直并复位后,再用接骨膏,或定痛膏,或补肉膏敷贴,取一片桑皮放在药上,两三片杉皮安在桑皮上,用柔软物品缠绕夹固定,不要让其弯曲,用药治疗。凡是手脚骨头被压碎的,必须服用麻药止痛,或者用刀刮开,严重的用剪刀剪去骨锋,以免刺破肌肉,如果有粉碎性骨折则去除碎骨,避免脓血之祸,然后用大片桑皮,涂上补肉膏或定痛膏,糊在桑皮上,夹在骨肉之间,不要弄错位置,三天清洗一次,不要让伤口发臭,用药治疗。又切不可轻易自恃有药,就随意切割、剪切、摆弄,必须详细审视,该手术则手术,尤其要仔细。或者头部有伤口,或被打碎,或刀伤,或压碎骨头,用药敷贴固定。凡是敷贴固定的时候,要在密闭无风的房间,不要让风进入疮口,恐怕造成破伤风的隐患,切记切记。
The foot has six acetabula (joint sockets) and four fragile bones. Whenever there is dislocation at the junction of bones on the sole of the foot, one person must pull the limb while another uses their hand to palpate the bone joints or prominences. If the bone is displaced outward, it should be pulled from the outside back to the inside; if displaced inward, it should be forcefully pulled back to the inside to restore it to its socket. If only traction is used without manual reduction into the socket, it may cause misdiagnosis and lead to chronic disability. It is advisable to apply Jiagu Gao (Bone-Setting Plaster) and Dingtong Gao (Pain-Calming Plaster), and to splint the four fragile bones using primary and secondary splints for binding. For dislocations of the six acetabula, only cloth wrapping and binding are suitable; splints should not be used. Dislocations of the ankle and knee are similar to those of the elbow in the arm; whether displaced inward or outward, fixation with a splint on one side is sufficient. This area contains numerous tendons and vessels, so the joint should be flexed and extended frequently rather than kept immobile, to prevent re-dislocation. Careful observation is required, and negligence must be avoided. Jiagu Gao and Dingtong Gao should be applied and splinted.
For dislocation at the root of the thigh, the pelvic bone acts as the acetabulum, and the femoral head as the condyle. Whether displaced anteriorly or posteriorly, one person must hold the patient's body steady while another pulls the leg and manually manipulates it to achieve reduction. If manual reduction fails, soft cotton ropes can be tied around the foot, suspending the patient upside down. Manual adjustment of the joints combined with gravitational traction can naturally restore the bone to its socket. Subsequently, Jiagu Gao and Dingtong Gao should be applied and splinted.
For fractures of the vertebral column, manual manipulation is contraindicated. Instead, soft ropes should be used to suspend the patient by the feet, allowing the body to hang vertically. The bones will self-reduce. If the body is not straight, reduction has not occurred. One must wait until the spine is straight and the bones are reduced, then apply Jiagu Gao, Dingtong Gao, or Burou Gao (Flesh-Replenishing Plaster). Place a piece of mulberry bark on the medication, followed by two or three pieces of cedar bark on top of the mulberry bark. Bind tightly with soft materials to prevent curvature, and treat with medication. For crushed bones in the hands or feet caused by compression, administer Mayu (Anesthetic Medicine) orally, or use a knife to scrape away debris. In severe cases, bone fragments may be trimmed with scissors to prevent them from piercing the flesh. If comminuted, remove the bone fragments to avoid complications such as pus and blood loss. Then, apply large pieces of mulberry bark coated with Burou Gao or Dingtong Gao onto the bone and flesh interface, ensuring correct placement. Clean the wound every three days to prevent foul odor, and continue treatment with medication. Do not casually rely on the availability of medicines to perform unnecessary cutting, trimming, or manipulation. Detailed examination is essential; surgical intervention should only be performed when indicated, with utmost care. For injuries to the head, whether from blunt trauma, lacerations, or crushing fractures, apply medication and bandage. During application and bandaging, ensure the environment is enclosed and windless to prevent wind from entering the wound, which could lead to Tetanus (Po Shang Feng). Remember this well.