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Zhenggushu – bone-setting

December 23, 2008

Exploring an Ancient Healing Art

The Medical Classic of the Yellow Emperor, the oldest existing classic of traditional Chinese medicine (TCM), wrote 2,000 years ago that the Chinese healers had mastered a magical bone-setting therapy through which the doctors could cure fractures with their bare hands.

This is Chinese Zhenggushu, or the healing art of bone-setting.

Before the introduction of Western medicine to China, folk bone-setters, both trained and untrained, have demonstrated that even in ancient times, people accomplished a scientific therapy that are applicable, relevant and innovative even in modern times.

The Miracle

Every day, Luoyang Orthopedics Hospital, the largest of its kind in China, receives patients from across China and the world. Most of them turn to the ancient TCM therapy for the management and treatment of fractures, which proves to be a cost-effective alternative for the costly, state-of-the-art techniques of surgical reduction, heavy casts and long periods of immobilization.

According to officially-set medical charges, with traditional bone-setting therapy the limb fractures may take six to 12 weeks to recover at the cost of no more than 800 Yuan (about $100). Western orthopedics surgery may cost 10,000 to 40,000 Yuan ($ 1,208-4,833), and the recovery period may last for several months.

This is what the ancient therapy has to offer: less pain, lower cost, and more effectiveness.

Ms. Zhang, a middle-aged Luoyang native, fell from her apartment and had her arm broken on Sept. 11, 2006. The following is a transcript excerpt of a documentary by state-owned China Central Television, which recorded the whole procedure Ms. Zhang received in Luoyang Orthopedics Hospital.

“When the doctor slightly shakes the patient’s arm, her shoulder bone is visibly dislocated and sounds of bone rubbing can be heard. This is the typical symptom of bone fracture. Doctor Zhang decides to operate bone-setting after the patient is applied anesthesia. In the mean time, two doctors were sitting in the X-ray room to observe the process.

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Doctor Zhang, with the help of two assistants, gently manipulates the angle of the fractured bone with his hands and then suddenly pushes the bone. In the X-ray room, it is clearly seen that the fragment has been relocated to its normal place, and this was done in a flash of push.

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Doctor Zhang then secures the patient’s arm with splints, bandages and slings instead of plaster of Paris. The reason is that the bone-setting didn’t cause open trauma to the patient and joints and veins inside the bone remain contact. The mild quiver of the splints will help the bone rejuvenate.”

How could the practitioner set the bone by just touching and feeling the patient’s skin and achieve such accuracy with simply a push? What are the tricks behind the ancient therapy?

A Time-honored Therapy

Description of orthopedic cases such as simple and compound fractures, dislocations and sprains have been found in The Rites of Zhou , one of three ancient ritual texts listed among the classics of Confucianism written more than 2,000 years ago. But the therapy of the time may sound rather brutal and primitive: The healer forcefully pressed the broken fragment back, and then fixed it with bamboo sticks.

In Qin and Han dynasties (221 BC-AD 24), the basic bone-setting theory and skill was developed. Over the history, practitioners enriched the therapy with their own experience during the treatment and more methods were added, leading to a complete and scientific system of orthopedic therapy.

In a medical book Golden Mirror of Medicine, complied by the Qing scholar Wu Qian, the bone-setting techniques were concluded as the following: The doctor shall first feel the trauma area with his hands to know which type of fracture the patient is suffering. For broken fractures, he shall reconnect the broken fragment with his hands, and/or medial apparatus; For dislocation, he shall hold the broken part level and relocate it by pushing towards the due angle with well-manipulated force; For caved-in fractures, he shall pull the fragment with his hands, strips, or medical apparatus with proper force; For sprains, manipulations and massage shall be applied; In case the joints have problem in restoring mobility, the doctor shall pinch the affected area and slowly press the bone back to its place. The broken bone shall be fixed with special splints, which were created by ancient Chinese and adopted in many other countries.

The Legend of a Medical Family

The Guo’s family, owner of the Luoyang Orthopedics Hospital, has carried the healing art for 200 years.

The origin of this family’s therapy is clouded with mystery. A widely-circulated legend has it that in the Jiaqing Period of Qing Dynasty (AD 1796-1820), the Guo’s ancestors, ordinary peasants in a small village of Pingle town, saved a beggar. To return their favor, the beggar left the family with a set of bone-setting books and secret medial prescriptions. From then on, the family offered free treatment to the village folks. The news was spread from mouth to mouth and many patients swarmed in for help. Since the 20th century, the bone-setting therapy of Guo’s family has become the most eminent school in China.

The Magical Plaster

The therapy had been kept secret and passed down from father to son within the family until early 1900s when Guo Canruo, the fifth-generation practitioner, with no hope of surviving a serous liver disease, found his son too young to carry on the skill and therefore left the secrets to his wife, Gao Yunfeng.

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Gao Yunfeng

Among the treasured secrets Gao received, the prescription of medicated plasters was especially valuable. The TCM holds that, the bone-setting manipulation only solves the problem of bone replacement. The recovery shall also be solidified with traditional medicine, and in particular, the medicated plasters.

After the founding of the People’s Republic of China in 1949, Gao decided to unveil the secret prescription to the public. Today, in the Luoyang Orthopedics Hospital, the medicated plasters are still applied.



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The prescription says that, dozens of herbal medicines shall be grounded into yellow powders and mixed with red vermilion powders; boil a pot of sesame oil and pour the powders into it when the temperature is around 300 degrees celsius; stir the powders and heat them for 10 hours so that the medicines will be fully mixed and melt into thick liquid; pour cold water into the pot to cool down the liquid which will then sent to the workshop, reheated and applied to coarse cloth; a medicated plaster is finished.

But the therapy experienced a major setback in the 1960s when the whole country was thrown into a cultural revolution in which the ancient heritages were deemed as harmful feudalist influence. Gao, a doctor who had cured numerous patients, was tortured to death.

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The 8th generation practitioner is teaching the manipulation methods to the students.

Struggling to Survive

The family’s therapy, however, managed to survive the turbulence. But with the introduction of the X-ray machine, the traditional healing methods looked not that magical and its accuracy and unknown effects were questioned.

In face with the challenge of Western medicine, will traditional bone-setting lose its reason to exist?



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The doctors operated the therapy by exposing their hands under X-rays and replacing the bones with the guidance of images.

The practitioners refused to give up the time-honored therapy without a fight. They decided to operate the therapy by exposing their hands under X-rays and replacing the bones with the guidance of images. They believed this was the most direct way to improve the accuracy and effect of the ancient therapy. To protect the doctors from strong radiation, the hospital offered special lead gloves to them. But the doctors, who knew better than others about the harm, refused to wear the gloves because they also knew that the therapy relied heavily on their hands’ feelings.

The accuracy of the ancient therapy was greatly improved, and in some cases, better than the surgery. But the cost was high.

Twenty years later, the doctors, who had saved numerous patients, fell to the victim of radiation themselves. Seven elderly doctors fell sick. Among them, three doctors underwent amputation, and one has passed away. Fu Guanrui, a retired doctor suffered serious radioactive skin cancer, and had his middle finger amputated in 1998. In 2006, he had radiation-caused cataract and had artificial crystalline lens planted.

Today, with advanced protective equipment, the physicians don’t need to work under X-rays. They just need to check the result of the therapy from X-ray images. The ancient therapy has survived and turned a new page with the help of modern medical technology.

In 2006 the hospital, in cooperation with the Robert Research Institute of Beijing University of Astronautics and Aeronautics, developed a bone-setting robot. Doctors could control the robot via computer and guide its operation on the patient. The robot has done more than 100 animal experiments in Beijing and now is entering the clinic period. At first some patients refused to be treated by a robot. A young man from Ruyang County who had his calf broken was the first human patient the robot received and the result was satisfying.

The hospital plans to cooperate with the institute again and develop a second generation robot who will hopefully give full play to the ancient orthopedic therapy.

The Future

Low costs with good results are a double-edged sword. It has offered cost-effective treatments for many people who couldn’t afford the surgery in big hospitals while, at the same time, offered little benefit for the TCM practitioners. Since the 1990s, many TCM hospitals closed the special section of bone-setting for economic concerns. And the remaining hospitals, including the Luoyang Orthopedics Hospital are struggling to carry on.

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Guo Weihuai

Guo Weihuai, who was too young to inherit the therapy from his father Guo Canruo more than half a century ago, is now an old doctor. In 1998, he won the Norman Bethune Medal, the highest medical award in China. Though he can’t speak due to Parkinson’s syndrome, the man will go to the hospital every day in company with his daughter, who is also an expert bone-setter.

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Guo Zongzheng

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Guo Zongzheng

Mr. Guo Zongzheng is another member of the family. At the age of 94, he goes to the family ancestor’s former residence every day and treat patient as his ancestors did 200 years ago. The doctor is now compiling his clinical notes and plans to write a book about what he has learned in his life.

Guo’s family is still optimistic about their future. Their bone-setting art is now applying for National Intangible Cultural Heritage status.

By Cindy Xu

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