典藏书目

In cases of falling from a height resulting in cervical dislocation, use a towel and a rope tied to a beam, hanging down. Use your hand to support and bind under the chin, securing it at the back of the head, and tie the ends tightly. Then take a clay jar, approximately 5-6 cun high, judge the depth of insertion, and adjust the height accordingly. Have the patient sit upright on the jar with legs extended and stable. The physician presses the injury flat and straight, distracts the patient by talking so they are unaware, and kicks away the jar with one foot. If the fracture is on the left, push it out from the left with the left hand; if on the right, push it out from the right with the right hand. Then apply Jiegu Gao (Bone-Setting Ointment) and Dingtong Gao (Pain-Calming Ointment). Another method involves having the patient lie on a bed, where an assistant compresses the head while another treads on both shoulders to reduce the dislocation.

For dislocations of the left or right shoulder blades due to falls, if the bone protrudes forward, tie the wrist with a towel in front of the chest; if it protrudes backward, tie the wrist behind the back. If displaced to the left, bend towards the right humerus; if to the right, bend towards the left humerus, allowing the bone to return to position. Check symmetry by touching the left temple to the right temple, and the right hairline to the left hairline. Then apply Dingtong Gao and Jiegu Gao.

For injuries to the Jianjing bone (GB21, Shoulder Well) and ribs, do not bind tightly; simply press them flat and apply Burou Gao (Flesh-Replenishing Ointment), Jiegu Gao, and Dingtong Gao. This applies similarly to two rib fractures.

For scapular dislocation, assess the reduction method: have the patient stand behind a chair, extending both hands to grip the armrests. Pad the axilla with soft clothing. One person holds steady, two persons perform traction, then release the wrists, flex them, and press flat. Apply Dingtong Gao and Jiegu Gao, and bind with silk.

The hand has four bones prone to fracture and six joints prone to dislocation. In arm dislocations, the proximal bone forms the glenoid cavity (mortise), and the distal bone forms the condyle (pestle). Surrounding tendons and vessels lock the joint. Dislocation may also damage these structures. Reduction requires straightening the arm. One person pulls while another stabilizes the bone segment to guide it back into the socket. Depending on the direction of displacement, use a bamboo splint on one side only, placed at the flexion/extension point. After administering medicine, do not keep the limb completely immobilized; periodically flex and extend it because this area has many tendons. Lack of movement after medication may lead to chronic stiffness and loss of mobility.

For superior scapular dislocation, whether the hand bone displaces downward or the trunk bone upward, and whether to the left or right: use a pestle and a low stool. Have the patient stand on the stool, supporting the pestle against the dislocated area. Adjust height as needed. One person holds the arm, removes the stool, another holds the pestle, and a third assists the patient to drop their body weight downwards, reducing the joint. This is highly effective. Alternatively, without a stool, place two small ladders facing each other, pass a wooden rod through them, hold the rod's edge over the displaced axillary joint, and let the patient drop from above to naturally reduce the joint.

For wrist bone dislocation causing straightening and pulling out: lift the wrist with the physician's hand, pad with the patient's own knee, and press the bone back into place from the neck/shoulder area using the physician's hand. Apply Dingtong Gao and Jiegu Gao. For wrist subluxation, whether superior or inferior, pull and extend, then stabilize manually before applying ointments and splints.

For finger bone dislocation: invert a round chair upwards, step on it with the physician's foot, place the patient's hand inside the inverted chair rim, correct the wrist curvature, insert a small book between upper and lower parts for stability, apply ointment, and bind with silk cloth, ensuring the palm faces up.

For palmar dislocation, do not pull. Support downwards with clothing, gently press and shake to align flatly, then apply ointment and splints with padding underneath.

If the hand bone displaces to the left, the physician uses the right hand to pull it in; if to the right, uses the left hand. Extend and retract, shaking two or three times, then apply Jiegu Gao and Dingtong Gao with splints.

Fractures of limbs on one side are treatable; bilateral fractures of hands and feet are generally untreatable.

For limb fractures, tighten the middle binding but leave the ends looser to allow blood circulation. If the fracture resembles a cut bamboo joint, tighten the ends and loosen the middle to gather blood at the fracture site.

For hand bindings, loosen the proximal end to disperse blood forward; for foot bindings, loosen the distal end to disperse blood downward.

For palmar dislocation facing down, turn the palm up. Gently manipulate the injured area, flex the palm outward to align flatly, apply ointment, and use splints: one long splint on the dorsal side, one short splint on the palmar side, one long splint along the little finger curve, and one short splint at the high bone near the thumb. Bind three times.

Differentiate forearm fractures: comminuted fractures have bone fragments, while clean breaks from falls do not. Both can be treated with Dingtong Gao and Jiegu Gao.

For crushed fingers from falls, knives, or axes, lubricate with egg yolk oil, apply sealing powder, cover with Sanxue Gao (Blood-Dispersing Ointment), and bind with silk. For bite wounds, apply Zelan San (Zelansan Powder). For fever and chills, apply Retre San (Heat-Relieving Powder) until symptoms subside.

For carpometacarpal dislocation where bones interlock or dislocate laterally beyond the clavicle/collarbone area: manipulate the collarbone area to guide the bone back medially if displaced laterally, or laterally if displaced medially, to achieve reduction. Pure traction may fail; incomplete reduction leads to chronic disability in 70-80% of cases. Apply Jiegu Gao and Dingtong Gao with splints.

Four fractured bones require firmer fixation with fir wood bark and bamboo splints. Six dislocated joints should only be wrapped with cloth/bandages, not rigid splints, to allow periodic movement and prevent stiffening.