典藏书目

In cases of lumbar bone fracture or dislocation, place a door panel on the ground with one end slightly elevated. Have the patient lie prone on it. The physician reaches up to hold the edge of the door panel, while three assistants pull downwards to extend the spine. Simultaneously, press on the injured area for three *shichen* (six hours). Then apply *Dingtong Gao* (Pain-Relieving Paste) and *Jiegu Gao* (Bone-Setting Paste). The patient should move their whole body throughout the night until the next day. If there is no pain at the joint after reduction, they may turn over left or right, but must still take blood-invigorating and stasis-resolving herbs.

For hip dislocations to the left or right, reduce the right hip by moving it leftward, and the left hip rightward. Use foot pressure to push the femoral head back into the acetabulum until aligned, then apply medication. If the hip is dislocated posteriorly (internally), have the patient sit with legs crossed, stabilize the shoulders, and use the physician's knee to push the femoral head forward into the socket. Severe pain initially is acceptable; once reduced and aligned, apply *Jiegu Gao* and *Dingtong Gao*. The patient should only lie supine and avoid turning over, as excessive movement may cause further injury.

For waist and leg injuries, always use wine to assist blood-invigorating and qi-unblocking formulas, and always add *Eucommiae Cortex* (Duzhong, 杜仲).

For hips dislocated superiorly from the buttocks, two or three people should grasp the leg and perform traction. Use foot pressure to push it back into place, then apply the aforementioned pastes. Dislocation into the groin area is difficult to treat.

Foot bone injuries are very difficult to reduce; treatment must be adapted to the specific situation and cannot rely on a single rigid method.

For fractures of both legs caused by falls or blows, manually reduce the bones and align them. Apply traction: seven parts force upward anteriorly, five parts downward posteriorly. Once stabilized, apply *Jiegu Gao* and *Dingtong Gao*. When applying splints, bind the middle section first, then the upper and lower sections, and finally add auxiliary splints externally. Swelling and pain are not concerning; change the dressing after five days.

To determine if a hip/knee dislocation is medial or lateral: if the knee does not adhere to the opposite limb, it is a lateral dislocation; reduce it by pushing inward from the outside. If the knee adheres and cannot abduct, it is a medial dislocation; reduce it by pushing outward from the inside. Adapt to circumstances.

For ankle dislocations, have the patient sit firmly. The physician steps on the thigh to leverage and manipulate, using both hands to press and rotate the joint two or three times. Then apply *Jiegu Gao*, *Dingtong Gao*, or *Lishang Gao* (Trauma-Healing Paste).

For knee fractures or severe contusions, manually reduce and align the bones, then apply the aforementioned pastes. Use mulberry bark (*Morus Albae Cortex*) as a splint, binding it in four segments.

If the patella is fractured or separated, secure it with a bamboo hoop, apply medicine, and bind with splints in four segments, keeping the knee extended. If swelling and pain occur, use a needle-knife to bleed, then apply paste and splints.

For injuries to the medial or lateral malleoli, or bilateral ankle sprains/fractures, use foot pressure to straighten and traction to align, then press flat and apply the aforementioned pastes.

If the patella is dislocated, do not extend it completely straight nor bend it fully. Complete extension hides the bony landmarks; complete flexion is also problematic. Maintain a semi-flexed position. Secure the patella with a bamboo hoop and tie it with rope.

For any joint fractures, dislocations, or subluxations of the elbows, arms, waist, or knees, manual reduction is required to restore normal anatomy. First, administer an analgesic herb mixture (Ma Yao) to eliminate pain perception before performing manual manipulation.