1. Major Events of Xu's Bonesetting In the 22nd year of Emperor Daoguang's reign in the Qing Dynasty (1842), Wang Yumei, the first-generation inheritor of Zhanhua Fushou Changquan and bonesetting art, became a disciple of Taoist Feng Xiuling from Mount Wutai. In 1924, Xu Chenglin, the fourth-generation inheritor of Zhanhua Fushou Changquan and bonesetting art, became a disciple of Zhao Fenglong. The following year, he began to "practice medicine in the village and never give up" and taught his sons Xu Shunsan and Xu Zesan, becoming the first person in the family to practice Xu's bonesetting. In 1969, Xu Chenglin, the first-generation inheritor of Xu's bonesetting, founded the Dongyang Brigade Orthopedic Medical Clinic. In 1986, Xu Chenglin, the first-generation inheritor of Xu's bonesetting, passed away. His sons Xu Shunsan and Xu Zesan inherited their father's business and opened their own clinics. Subsequently, Xu Zesan founded the "Zhanhua Xu Zesan Bonesetting Hospital". In 2004, Xu Zesan founded the Binzhou Xu's Orthopedic Research Institute. In February 2010, Xu Zesan compiled a medical monograph "Bone Protection and Health Preservation and Traditional Chinese Medicine Bone Correction" which was published by Science and Technology Press. In May 2013, Xu's Traditional Chinese Medicine Bone Correction was included in the list of the third batch of intangible cultural heritage projects in Binzhou City. In 2014, Zhanhua Xu Zesan Bone Correction Hospital was rated as a "Shandong Time-honored Brand" by the Shandong Provincial Department of Commerce. In 2014, Xu's Bone Correction Pharmacy "Xuejie Sanqi Bone Correction Paste" and "Chuanxiong Zhuifeng Huoxue Paste" obtained national invention patents. In 2015, Xu Zesan was identified as a municipal intangible cultural heritage inheritor; the main building of the Traditional Chinese Medicine Bone Correction and Traditional Chinese Medicine Health Preservation Research and Application Center was completed. In March 2016, Xu's Traditional Chinese Medicine Bone Correction was promoted and included in the name of the fourth batch of Shandong Province's intangible cultural heritage extension projects. 2. The Origin and Inheritance of Xu's Bone Correction Medical Skills The Xu's Bone Correction Technique in Dongyang Village, Zhanhua is one of the representatives of traditional Chinese medicine bone correction therapy in northern Shandong Province, and originated from the Taoist martial arts Fushou Changquan in the late Qing Dynasty. Feng Xiuling is the founder, the first generation inheritor is Wang Yumei, the second generation inheritor is Wang Tinghui, and the third generation inheritors are Wang Jisheng, Wang Zongzhou, and Zhao Fenglong (1883-1962). Zhao Fenglong was born in Yuejiatangfang, Dagao Town, and was a Taoist priest. He loved martial arts since childhood and studied under Wang Tinghui. Zhao Fenglong was proficient in martial arts, had superb bone-setting skills, was generous, willing to teach, and never conservative. In 1924, Xu Chenglin came to him to become his apprentice. Zhao Fenglong passed on all his life's learning to his beloved disciple Xu Chenglin. Xu Chenglin (1905-1986) practiced medicine all his life and became a well-known master of Chinese bone-setting, thus opening the history of Xu's Chinese bone-setting in Zhanhua. His wife Luo Wenying (1909-1985) systematically mastered the diagnosis and treatment skills of Xu's bone-setting through long-term exposure and dedicated study, and played an important role in promoting the inheritance and development of Xu's bone-setting medical skills. In 1986, Mr. Xu Chenglin passed away due to illness. The "Zhanhua County Chronicles" wrote a biography of him (see below). After Xu Chenglin's death, his sons Xu Shunsan and Xu Zesan followed his teachings and opened clinics or hospitals to carry forward their father's business. Zhanhua Xu's bone-setting skills have been passed down from generation to generation for three generations. Zhao Fenglong is respected as the master. The first generation inheritor is Xu Chenglin, the second generation inheritors are Xu Shunsan and Xu Zesan, and the third generation inheritors are Xu Changzhou, Xu Changjun, and Xu Changshan. Xu Changzhou, after graduating from medical school in 1991, followed his father Xu Shunsan to practice medicine. After his father passed away in 1996, he practiced medicine independently. Since 2007, he has served as the secretary of the Dongyang Village Party Branch. Xu Zesan, the founder of the Xu Zesan Orthopedic Hospital, has mastered and further developed the Xu family's traditional Chinese medicine bone-setting treatment techniques and prescriptions under the strict requirements and careful cultivation of his father. With his superb medical skills and noble medical ethics, he has carried forward the bone-setting business and become a famous bone-setting doctor. He was re-elected as a member of the fourth, fifth, sixth and seventh CPPCC of Zhanhua County. Xu Zesan inherited his father's medical practice in the 1980s and founded the Zhanhua Xu Zesan Orthopedic Hospital. In 2004, he founded the Binzhou Xu's Orthopedic Research Institute and served as the director of the hospital and the director of the institute. Later, the eldest son Xu Changjun and the second son Xu Changshan graduated from medical school, returned to the Orthopedic Hospital to inherit their ancestral business, and gradually grew into excellent orthopedic doctors. Xu Changjun is a member of the 8th CPPCC of Zhanhua District. Since its establishment, the Zhanhua Xu Zesan Orthopedic Hospital has continued to grow and develop under the careful management and scientific operation of the Xu family father and son. As of 2015, the hospital has set up Chinese and Western medicine clinics, Chinese orthopedics, nursing department, radiology department, operating room, pharmaceutical factory and other departments, equipped with advanced medical equipment and instruments, 45 medical staff with college degree or above, receiving an average of more than 10,000 patients per year, performing more than 1,200 operations, and a patient recovery rate of 97%. It is a "designated hospital for new rural cooperative medical care" recognized by the national health administration department. In 2014, Zhanhua Xu Zesan Orthopedics Hospital was rated as a "Shandong time-honored brand" by the Shandong Provincial Department of Commerce. Xu Zesan compiled a medical monograph "Bone Care and Health Care and Chinese Orthopedics" based on his more than 30 years of medical experience, which was published by the Science and Technology Literature Press in February 2010. The book was prefaced by Xiao Qingbin, a Chinese medicine health expert and member of the National Public Security System Federation of Literature and Art. It consists of two parts: bone care and health care guide and Chinese orthopedics therapy, with a total of 9 chapters and 200,000 words. Experts believe that the book, firstly, contains comprehensive and rich traditional bone-setting knowledge, and is a must-have book for orthopedic medical personnel. It has the function of a textbook to improve the level of medical skills, and can play an important role in promoting traditional medicine and popularizing basic knowledge for the general public. Secondly, it is widely practical. In the real society, everyone talks about health preservation. The rich knowledge of bone protection and health preservation in the book will surely play an important role in accelerating the cultivation of reading bone protection and health preservation awareness, and improving the public's bone protection and health preservation ability and health level. Therefore, it has positive practical significance for serving the society and the public. In 2014, in order to adapt to the needs of the development of modern medicine, further inherit and promote Xu's bone-setting medical skills, and better play the role of traditional medicine in saving lives and serving the people, Xu Zesan, in conjunction with many well-known medical schools and national scientific research institutions, established a research and application center for Chinese bone-setting and Chinese health preservation in the west district of Zhanhua. The main building covering an area of more than 100 acres was completed in 2015. In the long-term medical practice, Xu's Chinese bone-setting in the Xu Zesan Orthopedic Hospital has accumulated rich experience and formed a unique theoretical system and complete treatment principles and methods. Diagnosis: timely diagnosis of patients with bone injuries based on clinical symptoms. Through inspection, touch, smell, palpation and other diagnostic methods, the displacement of fractures or the results of restoration can be diagnosed to know the location and severity of the disease. Different bone-setting methods can be adopted according to different injuries. Inspection is to observe with eyes, first to see the swelling, second to see the deformity, and third to see the pain. Palpation is to touch the injured part carefully with hands, first light and then heavy, from shallow to deep, from far to near, with both ends facing each other, to understand the location and process of bone injury. Palpation depends entirely on practice and experience. Orthopedic masters have reached the realm of "hand touch and heart understanding". For any bone injury, they can know the condition of the bone injury by touching it with their hands. Ostrichosis is performed at the same time as palpation, that is, listening to the friction sound of bones while palpation. Palpation: by taking the pulse, the state of the struggle between the positive and negative forces and the degree of blood stasis of the patient can be understood. After fully understanding the patient's condition through observation, touch, smell and palpation, one can "know the body shape and the parts of the bones. Once the case is diagnosed, the mechanism is touched from the outside, the skill is born from the inside, the hands follow the heart, and the method comes from the hands". The bone-setting technique is the manual restoration method, "look at the shape, follow the momentum, stretch the shortcomings, and correct the deviations". Based on the ancestral bone-setting method, through light, soft, steady and accurate techniques, using traction movements such as pulling, stretching, flexing, rotating and lifting, the patient can be instantly restored. The principle of reduction is "to close first, separate, and then close again". When setting bones, the movements must be skillful and flexible, with a combination of hardness and softness, and skillful force should be used to treat according to the symptoms, so that the broken bones can be tightly closed and connected stably. As the bone-setting secret says: "Look at the situation, slowly connect it, so that the broken ones can be connected, the sunken ones can be raised, the broken ones can be completed, and the protruding ones can be flattened." For joint dislocation and fracture displacement, the main bone-setting methods used are traction and extension, flexion and extension, rotation and rotation, end-lifting and straightening, staggered kneading, clamping and bone separation, shaking and squeezing, swinging and touching, clamping and binding, etc. (1) Traction and extension. One of the basic methods for fracture and dislocation reduction, its main function is to correct the shortening and displacement of the affected limb and restore the length of the limb. Pull along the longitudinal axis of the bone to restore the bones that are in a dislocated state due to fracture or joint dislocation to their original position, and create conditions for the next step of straightening and end-lifting. During straightening and end-lifting, a certain amount of traction must be maintained until it is properly fixed before it can be released. This method is often used to separate and pull bones for limb fractures or joint dislocations. According to the principle of "separation before closing, separation and then closing", for fractures of two or more bones in parallel, the bones are separated first under traction, and then reduced to maintain normal spacing. When traction begins, the limb is kept in its original position. Along the longitudinal axis of the limb, the distal and proximal bone segments are used for countertraction, and then the direction of the limb is changed according to the bone setting steps, and the traction is continued. (2) Flexion and extension (angle folding). It is mainly used for fractures near the joints. The flexion and extension of the joints are used under traction to correct the displacement and deformity of the fracture. It is often used to correct transverse fractures in muscle-rich areas, or serrated fractures, overlapping displacements, and situations where traction alone cannot completely bridge the overlapping displacement. This method can regulate the soft tissues around the fracture, so that the twisted and bent muscles and tendons can stretch and open as the fracture is reduced. At the same time, rotation, flexion and extension, abduction, and adduction are used to correct the fracture segment because it has lost continuity and can therefore move. Under traction, the distal segment of the fracture is rotated or flexed and extended to make it consistent with the direction of the proximal fracture segment. That is, the distal end is used to the proximal end, and the distal and proximal ends of the fracture are restored to the normal axis. Only then can the angular deformity be corrected and the overlapping displacement can be easily overcome. (3) Rotation and rotation. Rotate the limb to correct the rotational deformity at both ends of the fracture, that is, use a technique that "goes in the opposite direction" of the rotational force to achieve the purpose of reduction. It is suitable for patients with long tube fractures of the limbs and rotational deformity. (4) End lifting and pressing (also known as end lifting, squeezing and pressing or lifting, pressing and end squeezing). Correct the angular deformity of the fracture and the large bone end, and restore it to its original position. It is mostly used for fractures with lateral displacement (lateral displacement can be divided into anterior-posterior displacement and medial displacement). After the overlap, rotation and angular displacement are corrected, the lateral displacement becomes the lateral displacement of the fracture. Lifting and pressing are mainly used, and end pressing techniques are used for medial and lateral displacement. (5) Interlocking and pinching. Use the thumb and other fingers to pinch the two ends of the fracture, and pinch them together in an interlocking manner according to the direction of the distal displacement. Use fingers to clamp with force. It is suitable for the reduction of bone fragments or epiphyseal separation after fracture, as well as joint dislocation. According to the fracture deformity, it is divided into two methods: abutment method and folding method. The contact method is to hold the two ends of the fracture with both hands, and the thumbs of both hands are placed on the top of the angular deformity of the fracture. Using the principle of zero pressure, the thumbs and the other four fingers apply force at the same time in opposite directions to correct the angular deformity. This method is suitable for fractures with mild angular deformity, such as simple forearm fractures. The folding method (or "reverse folding method") is to hold the two ends of the fracture with both hands, and use force to increase the angle of the broken ends, so that the bone cortex on the same side is close to each other, and use the apex of the angle as the support point to slowly and steadily fold back to make the broken ends fit together. This method can be used for lateral displacement of long bone fractures of the limbs with slight overlap, or separation due to angular deformity. It is generally less used. (6) Clamping and separating bones. Using the gap between two juxtaposed bones, with the help of finger force and object pressure, to maintain continuous tension in the bone gap tissue. It is one of the indispensable techniques for fractures of juxtaposed bones and multi-segment fractures. It is used to correct fractures of two bones in parallel positions, such as double fractures of the ulna and radius, fractures and dislocations of the tibia and fibula, metacarpal bones and phalanges (or metatarsal toes), as well as lateral displacement of long tube fractures of the limbs without overlap. It can also be used to correct patellar fracture displacement. The displacement is aligned by squeezing. There are two types of squeezing and longitudinal squeezing. When resetting bones, the thumbs and index, middle and ring fingers of both hands can be used to squeeze or pinch the gap between the two bones from the palm side of the fracture to make the interosseous membrane tense, and the fracture ends that are close together will separate. The proximal and distal fracture segments are relatively stable, and the parallel double fractures can be relocated together like a single fracture. (7) Shaking and squeezing. After the fracture has been basically relocated, use both hands to tightly pinch the fracture site and tremble slightly and quickly to further correct the residual displacement and angular deformity; after the splint is fixed, use the base of the palm to gently tap the extremity along the longitudinal axis of the bone to make the fracture ends fit more tightly. (8) Swinging and touching. Used for transverse and serrated fractures. After the above-mentioned techniques, the fracture can be basically reduced, but there may still be a gap between the ends of a transverse or serrated fracture. At this time, the rocking technique and the touching technique can be used to ensure that the fracture is tightly incarcerated. (9) Clamping and tight clamping. Small splint fixation is suitable for correcting residual displacement deformity of fractures. It is not only a supplement to bone-setting techniques, but also has the function of fixation. In specific applications, tight clamping is not a single technique, but a comprehensive application of various techniques. Massage reduction techniques Massage reduction focuses on the treatment of soft tissue sprains and contusions and bone and joint dislocations. Commonly used techniques are divided into two categories: massage techniques and bone-setting reduction techniques. (1) Massage techniques. Massage techniques are generally used to treat soft tissue sprains and contusions, including pinching, flicking, pressing, pressing, kneading, tapping, pushing, loosening, shaking, pulling, moving, and rotating. There are thumb kneading, palm root kneading, tiger's mouth kneading, finger pressing, elbow pressing, lifting and pinching, plucking, flexion and extension traction, pulling, leg lifting, and dorsiflexion of the foot. This type of manipulation is the basic manipulation of other types of manipulations, and is specifically used in the clinical operation of various types of manipulations. Limb and tendon manipulations include tendon separation (pressing and kneading horizontally on deep pain points or tendon knots, not using force when moving up, and using force when moving down), tendon adjustment (pressing and moving slowly along the tendons), tendon stretching (lifting and stretching the tendons), collateral pulling (pulling left and right), rolling (rotational movement), lifting and lowering (flexion and extension movement), and calming (after performing other manipulations, fix the injured part in a posture that is conducive to its functional recovery and wait for a while). After fracture reduction, use the thumb and index finger to gently push up and down along the bone to adjust the soft tissue around the fracture, so that the twisted muscles and tendons can stretch and open as the fracture is reduced, which is especially important for fractures near the joints. The manipulation should be gentle during the operation, and the tendons should be pulled from top to bottom along the bones according to the direction of the muscles and tendons. This method is also suitable for muscle spasm pain, twisting and stiffness caused by acute and chronic manipulation of soft tissues in various parts of the body, or joint dysfunction caused by adhesion and hard contraction. It has the effects of raising and lowering qi and blood, stretching tendons and veins, and calming and relieving pain. (2) Bone setting and reduction techniques. There are cervical vertebrae shaking method, leg lifting and waist pressing method, pressing method, and stepping method. This type of technique is mainly suitable for cervical and lumbar injuries. For diseases such as lumbar disc herniation, facet joint disorder, synovial incarceration, secondary scoliosis, cervical subluxation, pubic symphysis separation, etc., the manipulation is used to relax the muscles, relieve spasms, and repair the fiber ring. Through multiple steps such as reduction, fixation, external application of plasters, and splint fixation, the patient's acetabulum, tendons, etc. are restored to their original positions, the pain is relieved, and then through functional exercise, the patient is gradually cured. Prescription drugs are mainly used for external plasters to treat bone injuries and bone diseases. Strictly follow the ancestral prescriptions and adopt different Chinese medicine treatment methods for different parts and symptoms, which significantly relieves the pain, shortens the treatment period, and has significant clinical efficacy. Xu's orthopedics has a variety of self-made prescriptions, among which "Xuejie Sanqi Bonesetting Paste" and "Chuanxiong Zhuifeng Huoxue Paste" both obtained national invention patents in 2014. Five Main Characteristics of Xu's Bonesetting Medical Skills In the course of more than 100 years of inheritance and development, Xu's bonesetting has formed a complete set of systematic theoretical systems and diagnosis and treatment methods through the unremitting exploration of Chinese medicine bone injury theory and the continuous accumulation of clinical experience by several generations of inheritors. Its treatment principles of overall dialectical treatment, equal emphasis on tendons and bones, and internal and external treatment, as well as the unique treatment techniques combined with special medicines, have distinct "Xu's bonesetting" characteristics. Dialectical diagnosis doctors must "feel it in the flesh and know its condition by touching it with their hands." Before and after fracture reduction, timely diagnosis of bone injury patients should be made according to clinical symptoms. Carefully touch the affected area, first lightly and then heavily, from shallow to deep, from far to near, with both ends facing each other, and diagnose the fracture displacement or the result of the reduction through observation, touch, smell, palpation and other diagnostic methods, so as to know the location and severity of the disease, and adopt different bone-setting methods according to different injuries. Bone-setting techniques are mainly traction and extension, rotation and rotation, end-lifting and pressing, staggered kneading, clamping and squeezing, flexion and extension, folding and top-down, shaking and squeezing, swinging and bumping, clamping and binding, and there are many kinds of them. Pulling, stretching, pressing and straightening, lifting, pressing and squeezing require skills, "the mechanism touches the outside, the skill is born from the inside, the hand moves with the heart, and the method comes from the hand", "to close first separate, separate and then close together, the sunken ones rise again, and the protruding ones are flattened". In clinical application, emphasis is placed on the combination of light and heavy, with lightness as the main focus; the movements are simple, skill replaces force; hardness and softness complement each other, and softness overcomes hardness; the overall concept is comprehensive and thorough. Differentiate treatment according to individual needs, treat symptoms according to syndrome, be light and flexible, perform correct actions, highlight key points, apply treatment both near and far, from light to heavy, from near to far, from the surface to the inside, penetrate deeply and solidly, send and receive quickly and properly, and use appropriate strength. Special medicines for drug treatment have important functions such as reducing swelling and relieving pain, protecting the skin, and enhancing fixation. They have significant effects on patients with clinically healed fractures but limited joint movement, muscle stiffness, and tendon adhesions. When using external plasters to treat bone injuries, the right medicine should be used for different parts, different symptoms, and different treatment stages. Different dosage forms of plasters should be used. For example, for patients with femoral neck, scaphoid, ankle talus and other injuries that are difficult to heal, special prescriptions are used to promote local blood circulation and enhance blood oxygen supply, which can achieve healing effects in a short period of time; for patients with delayed fracture healing caused by various surgeries, external plasters and internal prescriptions are used to accelerate fracture healing; for various bone infections (osteomyelitis), Chinese medicine is used for dialectical treatment, and Chinese medicine prescriptions are used to treat them completely, clearing the poison, regenerating muscles and closing the wound, with good results. The fixation of instruments adopts a combination of dynamic and static, internal and external treatment methods, emphasizing the combination of manual treatment and self-exercise, and the combination of splint fixation and functional exercise. Patients are required to follow the doctor's advice and cooperate with physical function exercises in a targeted manner, so as to achieve the purpose of strengthening physical fitness, accelerating recovery, consolidating therapeutic effects and preventing recurrence. For patients with fractures and dislocations, combined external fixation is performed, and splints, bandages, pressure pads and other instruments must be "made according to the shape" to ensure the effective fixation of fractures and dislocations and the recovery of functions as soon as possible. 6. The important value of Xu's bone-setting skills and historical inheritance value. Xu's bone-setting skills are an important part of traditional Chinese medicine, with profound cultural heritage. After more than a hundred years of inheritance and development, it has formed a unique theoretical system and a complete set of supporting medical plans and technical techniques, and has accumulated rich practical experience. It is a fruitful achievement of Chinese orthopedics and has a very important historical inheritance value in promoting and facilitating the development of traditional Chinese bone-setting skills.