Xu Zesan

01 · Lineage & Regional School

Xu Zesan, Male, Han, from Binzhoushizhanhua, Shandong, is a sixth-batch national representative bearer of TCM Bone-setting Therapy (Ⅸ-6). The tradition is documented in Binzhoushizhanhua, Shandong. Within the regional tradition and school record of TCM Bone-setting Therapy in Binzhoushizhanhua, Shandong: Xu's TCM bone setting is a traditional bone-setting medicine of the northern Shandong region, distributed mainly in the areas surrounding Binzhou, Shandong, and has now been transmitted to the sixth generation. Xu's TCM bone setting is a traditional bone-setting medicine of the northern Shandong region, distributed mainly in the areas surrounding Binzhou, Shandong, and has now been transmitted to the sixth generation. The terrain around Binzhou in northern Shandong is flat and crisscrossed by rivers and canals, and it has always been a place where farming and fishing were given equal weight; traumatic injuries from falls, sprains, and crushing were common, and the need for bone-injury treatment existed over a long period - this is precisely the regional basis that enabled the Xu family to accumulate clinical experience from generation to generation. Its transmission is mainly by hand-to-hand oral instruction and personal example within the family, with secret prescriptions and reduction manipulations coming from the same lineage, so people of other surnames could hardly imitate them.

02 · Mastery & Signature Works

The bearer record for Xu Zesan is anchored in the documented technical standards of TCM Bone-setting Therapy in Binzhoushizhanhua, Shandong. Within the documented technical tradition of TCM Bone-setting Therapy in Binzhoushizhanhua, Shandong: In long years of medical practice, the Xu family accumulated rich clinical experience and formed a unique theoretical system and complete principles and methods of treatment. Based on the clinical symptoms, the physician uses "the hand perceives and the mind comprehends" - touching the affected area carefully, first lightly and then heavily, from shallow to deep, from far to near, comparing the two ends - to learn the site and severity of the condition, diagnose the bone injury, and adopt different bone-setting methods according to the nature of the injury, achieving instant reduction for the patient through light, gentle, steady, and precise manipulation. Bone setting uses the bare-handed reduction method, with manipulations such as traction and pulling, flexion-extension and bending-back, rotation and twisting, lifting and pressing into place, criss-cross pinching, squeezing and separating bone fragments, lifting-pressing and end-pressing, and clamping and binding tightly. Soft-tissue sprains and contusions are generally treated with tuina and massage manipulation, in forms such as finger pressing, elbow pressing, flexion-extension, traction, leg lifting, and dorsiflexion of the foot; the manipulations number several dozen, including pushing, twining, rolling, kneading, rubbing, and scrubbing. The manipulations for ordering the limbs and sinews include separating sinews, ordering sinews, flicking sinews, plucking collaterals, rolling and rocking, raising and lowering, calming, cervical rotation, leg-lifting and waist-pressing, pressing, and stepping. Xu's TCM bone setting possesses a number of family secret prescriptions; internal prescriptions have a basic formula with modifications according to the presenting condition, and external remedies include "Dragon's Blood and Notoginseng Bone-Joining Plaster", which promotes bone healing, and "Chuanxiong Wind-Expelling Blood-Activating Plaster", which treats soft-tissue injuries, along with many other external plasters. The manufacturing process of the external plasters is unique, and the selection of medicaments is refined. The reduction manipulations and the craft of boiling plasters of Xu's TCM bone setting are currently transmitted mainly within the Xu family, through master-apprentice oral instruction and personal example. Xu's bone setting has a holistic outlook, advocating comprehensive examination, equal attention to sinews and bones, combined internal and external treatment, and the integration of injury-treatment manipulation, fixation methods, and medication. Its techniques are diverse and emphasize skill. In clinical application, it values the combination of light and heavy force, with light predominating; movements are simple and concise, using skill in place of force; treatment is varied according to the individual and based on pattern differentiation; movements are light, dexterous, and correct; key points are highlighted, with treatment applied to both near and far; force goes from light to heavy and from near to far; from the exterior to the interior, deep, penetrating, and substantial; emission and retraction are swift and appropriate, with force kept suitable. The unique therapeutic principles, prescription composition, pattern-based-treatment thinking, and efficacious family plaster formulas of Xu's bone-setting accord with the principles and methods of traditional Chinese medicine, and are an outstanding representative of the folk traditional medical cultural resources of northern Shandong. Xu's bone-setting therapy fully embodies the advantages of "simple, convenient, effective, and cheap" in Chinese medicine, lightens patients' economic burden, and has unique efficacy in the clinical treatment of osteoarticular injuries, back and leg pain, hyperosteogeny, and lumbar disc herniation, playing an important role in developing general health care and strengthening the people's constitution. Representative repertoire, works and technical entries recorded for the project include: "Palpation from light to heavy": Palpation runs light to heavy, shallow to deep, near to far, bracketing the injury between both hands. "Eight manual reductions without instruments": Traction, angulation, rotation, lifting, interlocking, splitting, pressing and binding, all performed without instruments. "Straightening sinew and limb": Dozens of sinew-straightening and rubbing methods are used, as long as they do not fight the immobilisation. "The dragon's-blood and notoginseng plaster": Two patented plasters, one for bone union and one for soft-tissue injury, anchor an otherwise flexible prescription system.

03 · Transmission & Safeguarding Status

In 2025, Xu Zesan was announced in the sixth batch of national representative bearers for TCM Bone-setting Therapy, with Binzhoushizhanhua, Shandong as the declared area. Within the documented safeguarding record of TCM Bone-setting Therapy in Binzhoushizhanhua, Shandong: The project was inscribed in the national inventory in 2021 (batch 5), with Binzhoushizhanhua, Shandong as its declared area, and Zhanhua Xuzesanzhenggu Hospital as its safeguarding unit. Since the project was inscribed in the national inventory, its declared area and safeguarding unit have carried out documentation, transmission and presentation within the national safeguarding framework. Together, the inventory record and the project archive form the public documentary basis for the bearer’s transmission practice.

04 · Associated Heritage Item Dossier

05 · Fellow National Bearers Lineage

National representative bearers recorded under the same item code, ordered from the first to the sixth batch. Batch order is not a teacher–student relationship.

06 · Archival Sources & Bibliography

1. Xuzesan (Binzhoushizhanhua, Shandong) · China ICH Official Project Archive
2. Xuzesan · China ICH Official Archive