What is Chinese medicine bonesetting?

Bone-setting, Chinese medicine refers to the treatment of fractures, dislocations and other diseases by pushing, dragging, pressing and pressing. As a specialty name, orthopedics is a specialty for diagnosing and treating injuries, and it is also one of the "thirteen branches" of ancient medicine, some of which are also called traumatology or orthopedics.

The object of bonesetting is mainly the damage of bones, joints and soft tissues caused by external forces, but it also includes visceral injuries caused by similar reasons. The word "Zheng" is used as a gerund here. In other words, it is a science and technology to correct limb deformation and recovery caused by bone and joint injury.

In the official medical system of the Yuan Dynasty, there was a "bonesetting golden carving department". For this reason, Wei Yilin, a medical expert specializing in bone setting in Yuan Dynasty, set up a special "Boning Golden Branch" in Volume 18 of "A Good Prescription for World Doctors" to discuss the pulse cause, syndrome differentiation and treatment of bone and joint injuries caused by golden blade. Jin Jian of Medical Sect: Essentials of Bone-Setting and Mind-Therapy points out: "Bone-setting today is also the evidence of traumatic injury in ancient times."

Treatment measures

compensation

Bone-setting is a kind of therapy that uses skilled manipulation to correctly reset the displaced fracture end and treat soft tissue injury. Therefore, in the implementation of manual reduction, first of all, we should do a good job in the examination and diagnosis of fractures. On this basis, hand rotation and fracture reduction can only be achieved through eye observation, hand touch and heart meeting.

Direct or indirect violence acts on limbs or trunk, resulting in local bone fracture. Because of the different stress, posture and muscle contraction, various types of fractures can be caused, and different types of fracture reduction techniques are also different. If the fracture is complete, the butt joint shall be closed; Depressed fracture, the trapped person is recovered by lifting and pushing; Comminuted fracture was reduced by pinching; Spiral crack, rotary extrusion connection; Protruding fracture, which is smoothed by expansion; The impaction fracture of coccyx was reduced by lifting hook and stretching and pressing; Fracture of green branch of humerus, such as medial and lateral condyle fracture, is reduced by friction and extrusion; If the fracture end is shortened due to overlapping displacement, it should be reset according to the principle of "separation first, separation later and recombination again". Gently press and massage the injured part before operation to relax the contracted muscles and relieve the pain, and then reset the overlapping broken ends by stretching and traction; Displaced to the opposite side can be reset by pushing; For the fracture of juxtaposition of two bones, the broken end was separated by the method of bone separation with buckle and extrusion, but the broken end was reduced by the method of clip and extrusion. In the process of bone setting, in addition to using appropriate and skilled techniques, the treatment must be timely, and the action should be bold, meticulous, accurate and agile. If you use too much force during the operation, you will be in danger of damaging bones and soft tissues; If the force is too small, the purpose of resetting cannot be achieved. During the operation, we should use hand skills correctly and strive to complete the repair at one time. Repeated surgery will not only damage the broken end of the fracture, but also adversely affect the healing and bring more pain to the patient. The earlier the operation, the better. Fracture of limbs should be carried out within half an hour after injury. At this time, the affected limb is numb, no serious edema has occurred, the tension of the affected area is small, and the pain is slight, which is the best rectification period. If the local swelling is severe or the skin is damaged, appropriate treatment is needed. After the swelling subsided, the skin healed and the muscle spasm was relieved, manual reduction was performed. However, it is necessary to prevent delayed treatment, so as not to artificially cause old fractures.

Fixed; unchangeable

The purpose of orthopedic fixation is to strengthen the effect and local relative stability after reduction, so as to accelerate the healing of fracture. A fixed range should be appropriate. Too big, it will affect the activity of the injured limb; Too small to achieve the purpose of fixation, if the injured limb is fixed for a long time, the blood circulation will be blocked, which will easily lead to muscle atrophy, joint stiffness, osteoporosis, delayed fracture healing and other adverse consequences. If it is a transverse fracture, it should be pushed along the central axis after reduction and fixation. If it is a lower limb bone, you can step on the ground besides pushing, so that you can measure whether it is correctly reset and whether it is conducive to connection. For the fracture that has not been reduced for the first time, or the fracture that has been displaced, the method of "moving by moving" can be adopted, and then the fracture can be corrected by reduction and fixation after stretching and shaking. Long bone fracture was fixed with three-point dressing. The effect of three-point compression is beneficial to the axial alignment of the fracture segment, which can not only make the fractured limb achieve anatomical reduction, but also solve the dysfunction of the injured limb caused by the contradiction between static and dynamic. The fracture ends were well butted and the limb function recovered. X-ray showed that the callus passed through the fracture line, which was basically blurred and could be fixed.

massage

Bone-setting massage is a unique therapy of Mongolian medicine. It is also one of the auxiliary treatment methods in orthopedics. Different massage techniques are used in different stages of fracture. There are:

Initial massage: within one week after the fracture, local soft tissues, blood vessels and lymphatic vessels were damaged to varying degrees, leading to symptoms such as hyperemia, Sheila fever, blood stasis, pain and swelling. In this regard, the method of removing blood stasis and reducing swelling should be adopted. That is, white wine is sprayed on the gap and upper section of the splint every day for friction; Massage on the mat; Rub the injured limb centripetally; The painful part should be pressed by kneading; The adjacent joints of the injured limb are squeezed and rubbed; In addition, the relevant acupoints are supplemented by friction. The above massage is helpful to improve blood circulation, promote metabolism and accelerate fracture healing.

Mid-term massage: After preliminary comprehensive treatment, the fracture site is basically stable, the tendons and veins are stretched, and the swelling and pain are relieved. According to the theory of "kidney storing essence, essence producing marrow, marrow nourishing bone" and "liver producing blood, blood nourishing tendons", the main treatment principles in this period should be tonifying kidney, benefiting liver and strengthening bone. Therefore, acupoints such as liver, spleen, heart, kidney and lung should be selected for massage. Spray white wine first, shake or rub with your thumb; Push or massage upward along the spine with your palm; Or lateral rubbing to further improve blood circulation and accelerate fracture healing.

After massage: After one and two treatments, callus basically formed and the fracture healed completely. However, due to internal injuries and long-term bed rest, it often leads to three imbalances, weakness of qi and blood, joint stagnation, muscle atrophy and so on. At this time, in addition to continuing the mid-term massage, we should also spray white wine on the stomach, large intestine, bladder and other related acupuncture points, and apply methods such as kneading, shaking and pushing; Massage and rubbing parts; Knead, knead, knead the muscles of the affected limb; Knead, shake and spread the affected limb joints; For the affected limb (toe), traction method is used. Through the above massage, the injured limbs can have smooth qi and blood, strong bones and muscles, and recover their functions.

Massage method: from light to heavy, the range is slightly wider, and the operation should be detailed. For thin people, the technique should be light and slow; Strong people are heavier and faster. But care must be taken to keep the affected part stable. The massage method of spraying wine is based on "blood is nourished by food essence;" Blood is pneumatic. " It can not only prevent thermal invagination and tendon tightening, but also accelerate fracture healing and limb function recovery.

medicine

Refers to oral medication. According to the different stages and symptoms of fracture, the principle of medication is the same as massage, which is divided into three stages: initial stage, middle stage and late stage.

Initial stage: excessive blood heat, aversion to blood stasis, and obvious swelling and pain in the affected area. Commonly used prescriptions are: Qizhen Powder, Qixiong Pill, Borneol Seventeen Powder, Borneol Twenty-five Powder, Heiyunxiang Sini Decoction, etc. If accompanied by chest and abdomen burning, trembling, Chen Xiang Bawei Decoction, Ruyi Zhibao Pill and other prescriptions can be selected. Cough and expectoration are not good, so you can use Shashen Siwei Decoction or Sanqi to disperse the poison. If you have urinary incontinence, you can vote for the traditional prescription of orthopedics-eat an egg yolk; People with dry stools can take sesame single bead soup, or add a small amount of walnut kernel and honey for oral administration; Local fever should be coated with tortoise blood.

Mid-term: We can choose Liuwei Tongqiao Powder, Bawei Zhusha Powder, Sanwei Ochre Powder, Liuwei Concha Haliotidis Powder, Liuwei Eucommia Powder, Erwu Jiegu Powder and other drugs with the functions of expelling jaundice, reducing fever, strengthening tendons and bones.

In the later stage, it is advisable to take drugs that can strengthen muscles and bones, inhibit body growth and moisten rigidity, such as Jianwei Pomegranate Five-flavor Powder, Twenty-five-flavor Daji Powder, Sean Thirty-five-flavor Powder and Mercury Eighteen-flavor Powder. The affected area, especially the joints, can be soaked with drugs or rubbed with drugs. Generally, equal parts of liquor, vinegar and water are decocted and soaked in water, or soaked in green salt hot water, or decocted and soaked in three kinds of medicinal liquor: cypress, sandalwood and Artemisia.

For open fractures, debridement, reduction and medication should be performed first, and the wound should be sutured. In addition to using anti-adhesion drugs and heat-clearing drugs to prevent infection, we should also consider using drugs with myogenic effect to promote wound healing. For example, Pearl Five-flavor Powder, Musk Seventeen-flavor Powder are applied externally to wounds, and Honghua Eight-flavor Powder is taken orally, which has the functions of promoting blood circulation, stopping bleeding and promoting granulation. For white vein injury, thirteen fragrant Dapeng golden wing pills, fragrant roe dung or musk, sheep dung and white wine can be used for external application.