Fang Xianzhi (February 1906-June 1968) was a native of Zhuji County, Zhejiang Province. He was the pioneer of Chinese orthopedics and the founder of Chinese orthopedic medicine.
He was a diligent student since his childhood and was admitted to Shanghai Hujiang University in 1925. In 1950, he was one of the first to join the anti-US medical team to aid North Korea and went to the front line to rescue the wounded. In order to cultivate orthopedic talents, in 1952, Fang Xianzhi and his peers jointly wrote to the Ministry of Health of the Central Government, applying for the establishment of orthopedic physicians' refresher courses, and in 1953, the Ministry of Health commissioned Fang Xianzhi to establish the National Orthopedic Physicians' Refresher Courses in Tianjin, and in 1957, Fang Xianzhi founded the Newsletter of Orthopaedic Refresher Courses, which was the first orthopaedic medical specialized magazine in China, and evolved into Chinese Journal of Orthopaedic Surgery, which promoted the promotion of the Chinese orthopaedic surgery.
The Chinese Journal of Orthopaedic Surgery has made outstanding contributions to the promotion of academic exchanges in orthopaedics and the promotion of advanced experience, and passed away on June 29, 1968, at the age of 62 years.
Fang Xianzhi made many contributions to orthopedic medical care. in 1951, he pioneered a new method of treating osteoarticular tuberculosis - osteoarticular tuberculosis foci clearance therapy. In addition, he classified orthopedics and established the modern orthopedic establishment; he classified bone tumors in a concise manner, which was known as the "way of classification"; he was the first to create the surgical treatment of "incision, repositioning and internal fixation" in China, which greatly increased the rate of healing of joint fracture and functional recovery; he repeatedly carried out the treatment of bone tumors, which was known as the "way of classification". He has repeatedly monitored the efficacy of treatment and promoted the combination of Chinese and Western medicine in fracture therapy.
Chinese name: Fang Xianzhi
Nationality: Chinese
Ethnicity: Han Chinese
Birthplace: Zhuji County, Zhejiang Province
Date of birth: February 24, 1906
Date of death: June 29, 1968
Occupation: Doctor
Graduated from Peking Union Medical College.
Major Achievements: First to develop "Osteoarticular Tuberculosis Focal Point Removal Therapy"
Representative Works: Orthopaedic Refresher Course Bulletin
Curriculum Vitae
Born in Zhuji County, Zhejiang Province, China, on February 24, 1906, he graduated from the Xiuzhou High School in Hangzhou, China, in 1925, and was a member of the Chinese Academy of Medicine (CAS).
Studied at the Biology Department of Shanghai Hujiang University from 1925 to 1928.
From 1928 to 1933, he studied at the Peking Union Medical College, and after graduation, he was awarded a doctorate degree in medicine from the State University of New York, USA.
From 1933 to 1940, he served as a resident, chief resident, attending physician, lecturer and professor at Peking Union Medical College.
In 1938, he went to the United States and studied at Boston University.
In July 1942, he founded Tianhe Hospital in Tianjin.
August 1944, founded Tianjin Orthopedic Hospital in Tianjin.
From 1952 to 1968, he was the director of the Department of Orthopedics of Tianjin People's Hospital and professor of Tianjin Medical College.
On June 29, 1968, he died of liver cancer in Tianjin.
Life Experience
Professor Fang Xianzhi, a pioneer of orthopedics in China and the founder of Tianjin Orthopedic Hospital, who was known as the "Sage of Bone", was born in Zhuji County, Zhejiang Province, China, on February 24, 1906, and was a diligent student since childhood. He studied at Xiuzhou Middle School in Hangzhou (now Jiaxing Xiuzhou Middle School), and in 1925, he entered Shanghai Hujiang University (now Shanghai University of Science and Technology) to study biology for 3 years, completing the pre-medical course, and in 1928, he entered the Peking Union Medical College (PUMC), which was China's top medical institution. At that time, Peking Union Medical College was the highest medical school in China, known for its high quality, not many students in each session, only 20 to 30 people, and the school system, together with the pre-medical program, lasted for 8 years. Students were strictly selected and had to have a solid foundation in biology, mathematics, physics, chemistry and English. After three years of premedical training and five years of rigorous training, Mr. Fong completed the entire basic medical and clinical curriculum with honors. After graduation, he served as a resident, chief resident, attending physician, and lecturer, and was highly respected and loved by physicians at all levels. 1938, he went to Boston University in the United States for further study, and returned to China to serve as a professor at the Union Medical College.
In 1940, when the Pacific War broke out, Union Medical College was forced to close. Mr. Fang came to Tianjin with some of his old classmates and founded Tianhe Hospital (Tianjin Union Hospital), where he was in charge of general surgery and orthopedics. Later, due to the need for orthopedic patients, he set up the Tianjin Orthopedic Hospital under the sponsorship of the local gentry. Although these two hospitals were private and small in scale (the orthopedic hospital initially had only 10 beds), and the equipment was not complete, they basically followed the system of Concordia Hospital, and tried to be formalized in the writing of medical records, laboratory tests, surgical operations, and pre- and post-surgical treatments. Fang Xianzhi not only took on the heavy medical tasks himself, but also participated in some management and even laboratory work. Because of his excellent medical skills, in just a few years in tianjin is quite famous, the number of patients is increasing, the number of beds have also been expanded. The establishment of these two hospitals has enriched the medical power of Tianjin and solved many difficult and serious cases.
The Tianjin municipal government, in order to play the role of some medical experts, has been in the original hospital on the basis of enrichment and adjustment, the establishment of a number of specialized hospitals, such as Madaifu Hospital into the People's Hospital to orthopaedics and tumors as the focus. Fang Xian was employed as the director of orthopedic department of the hospital. Soon after the establishment of the hospital, orthopedics from scratch quickly developed into four wards with more than 100 beds. Such a large-scale specialized hospital was rare at that time. Mr. Fang was also appointed as a professor of the newly established Tianjin Medical College. After just a few years of preparation, the orthopedic department of Tianjin People's Hospital developed into a multi-specialty department, ranking among the top in the country and winning high praise.
Fang Xianzhi's hard work in running the school, with remarkable achievements, and outstanding results in medical care, was honored by the Ministry of Higher Education and the Ministry of Health, and in 1962, the State Science and Technology Commission of the People's Republic of China, led by Fang Xianzhi's major scientific research results of the treatment of bone fracture with the combination of traditional Chinese and Western medicines in Tianjin, which was appraised and highly evaluated.
Fang was persecuted during the Cultural Revolution, and on June 29, 1968, he died of liver cancer at the First Central Hospital of Tianjin at the age of 62. 10 years later, in the summer of 1978, a memorial service was held in the Martyrs' Mausoleum of Tianjin for Fang, with the attendance of about 600 representatives from all walks of life in Beijing and Tianjin and his former friends.
Medical technology
Noble medical style and exquisite medical technology
Fang Xianzhi was always diligent and responsible in medical treatment, and loved his profession for decades. He is always kind to his patients and treats them equally regardless of their status.
Fang Xian is very knowledgeable, in the case of sub-specialty is not fine, orthopedics has not been completely independent from the Department of Surgery, Fang Xian is not only engaged in their own orthopedic specialties have deep attainments, some related disciplines, such as general surgery, neurosurgery, urology, and thoracic surgery, etc., have a wealth of clinical experience, he is able to skillfully carry out the intestinal, gastric, renal, prostate, and even open thoracic surgery, you can say that the He can perform intestinal, gastric, renal, prostate and even open-heart surgeries. Mr. Fang also has a solid foundation in some basic medical disciplines, such as anatomy, physiology, biochemistry and pathology. His diagnosis of diseases does not rely solely on experience or laboratory reports, but on the basis of adequate and reliable materials, from which he analyzes, identifies and summarizes. For example, for bone tumors, he emphasized the combination of clinical symptoms, X-ray manifestations and pathological features. He often watched the pathological slides in person to understand the origin of tumor cells, their morphological characteristics and biological behavior, and then made correct judgment after repeated studies.
Fang Xianzhi examined each surgical patient in detail before surgery, considered whether he was suitable for surgery, then made a surgical plan, chose the best plan, and took corresponding measures according to the situation that might occur during the surgery, and made full preparations. Fang Xianzhi especially emphasized that a good surgeon cannot simply be a surgeon, but an internist who can hold a scalpel, that is to say, a surgeon needs to master two hands, not only to be able to open the knife, but also to deal with general internal medicine situations. Fang Xianzhi not only pays attention to the operation itself, but also attaches great importance to the treatment before and after the operation. Every patient is fully prepared before the operation, including talking with the patient and his family to make them understand the purpose of the operation and its prognosis, thus strengthening the patient's confidence. All the medical staff attending the surgery were explained in detail beforehand to obtain good cooperation.
Fang Xianzhi always enters the operating room ahead of time for each surgery, and often personally directs the anesthesia, inserts the endotracheal tube, sets up the patient's position, and marks the location of the surgical incision in advance. During the operation, he was calm and relaxed, with clear anatomical hierarchy. Fang Xianzhi is meticulous in hemostasis and clear in the surgical field. His famous saying is "no bleeding, no advance", and he strives to minimize the damage to the patient during surgery. Fang Xianzhi never let go of any surgical details, from the beginning to the end of the operation, until the patient's wound is sutured and covered with a good dressing before leaving the operating room. After the operation, he often visits the patients, reminds the supervisor and subordinate doctors to pay attention to the possible situations after the operation, and especially emphasizes the postoperative functional exercise, and strives for an early recovery. The patient was able to return to work soon after his surgery.
Fang Xianzhi's technical excellence, never satisfied with the results achieved. He keeps up with the advanced pace of foreign technological development, absorbing, digesting and innovating. For the methods used in the past, he made long-term observation through a large number of cases, and once he found insufficiency or better methods from the literature, he would not hesitate to improve the old methods or introduce new methods. He has always been pragmatic in his work and never hid his shortcomings or even denied what he originally insisted to be correct. Although he did not understand the new methods proposed by others, he never rejected them, but observed them personally for a period of time, and once they were proved to be effective, he would actively support them and perfect them in terms of theory and technique. The application and promotion of combined Chinese and Western medicine in the treatment of bone fractures is a good example.
Fang Xianzhi often leads the physicians in the department to discuss the discharged cases and death cases, and constantly summarizes the experience. He never let go easily of the omission, misdiagnosis, and serious errors or accidents caused by improper treatment in his work. His conscientious style of taking things seriously not only educates those involved in the incident, but more importantly reminds everyone to pay attention to it and take it as a warning.
Cultivating talents
Fang Xianzhi always emphasized on cultivating talents. He placed special emphasis on basic kung fu training, such as writing medical records, formal physical examination and basic surgical operations. He also often used English terminology to improve physicians' foreign language skills. Every Sunday morning, he always participated in the routine examination with some experts***, and in the evening, he hosted the clinical pathology seminar with some experts***. At this time, the small Tianhe Hospital nursing school hall is always crowded with young and middle-aged medical personnel thirsty for knowledge.
The Chinese people **** and the early years of the founding of the country, major surgery is not divided into specialties, specializing in orthopaedics is very few, Fang Xianzhi y to develop China's orthopaedic specialty, must vigorously cultivate talents. 1953, Fang Xianzhi's positive suggestions and advocated the establishment of the Tianjin Medical College of orthopaedic surgeons training courses, teaching base in Tianjin People's Hospital. At the beginning of the opening, no matter manpower and material resources are seriously insufficient, and lack of experience in organizing advanced training courses. Fang Xianzhi fully mobilized the strength of orthopaedic community in Tianjin and opened the course as scheduled. The first few students were required to have at least 5 years of clinical experience, and many of them were attending physicians or above, and even director or associate professor level physicians. Fang Xianzhi from the development of teaching programs, curriculum design, until the specific arrangements are personally involved. He not only lectures and writes lecture notes. He also often listened to other people's lectures and made constructive comments. He personally reviewed and revised the lecture notes prepared by others and requested to add new contents every year. Mr. Fang adheres to the teaching method of linking theory to practice and learning while practicing. In addition to weekly teaching room visits and outpatient consultations, the courses are always arranged after 4:00 p.m., never affecting the work of outpatient clinics and wards. In addition to two weekly systematic lectures, but also arranged a clinical pathology seminar, by all levels of trainees and hospital physicians at all levels to take turns to speak, to be fully developed after free discussion, the pathologist announced biopsy or autopsy results, and finally by the Fang Xianzhi summary statement. It has been proved that this is a very lively and vivid teaching method, which helps to improve the ability of differential diagnosis of diseases.
Fang Xianzhi conducts weekly demonstration surgeries, explaining some common orthopedic surgeries from anesthesia, position, incision, exposure level to resection or fixation methods while operating. Afterwards, he organizes a detailed record of the operation and prints it into a book, making it a good practical teaching material.
After one year of intense and systematic study and serious, strict, rigorous and hard training, the students of the refresher course are greatly improved on the basis of the original step, more than able to master the general orthopedic specialty basic knowledge and technology, but also learn a set of pathological analysis and scientific research methods. There are many famous experts in China who graduated from Tianjin Orthopedic Doctors Training Course.
Academic contributions
Fang Xianzhi has made achievements in the treatment of osteoarticular tuberculosis, the treatment of bone fracture by combining traditional Chinese and Western medicine, and the classification of bone tumor. As early as 1947, Fang Xianzhi pioneered the method of removing tuberculosis foci on the basis of the application of recently introduced anti-tuberculosis drugs, and formulated a set of operating procedures from surgical approach, foci removal, bone grafting and fusion to post-operative plaster braking for the major joints of the whole body such as shoulders, elbows, hips, knees, and various parts of the spine. The main point is to remove the tuberculosis foci as thoroughly as possible on the basis of improving and strengthening the patient's general condition and systematically applying anti-tuberculosis drugs in combination. The so-called lesion removal refers to the removal of dead bones, abscesses, caseous material, resection of hypertrophied synovium and fibrotic fistulae, and chiseling of hardened bone cavity walls; and according to the patient's age, occupation and other circumstances, different measures are taken, such as simple resection, bone grafting and fusion of joints, etc.; spinal tuberculosis combined with spinal cord compression at the same time for decompression and fusion. Postoperatively, long-term anti-tuberculosis medication is continued, and nutrition and braking are strengthened. The advantage of this kind of surgery is that it makes the course of treatment much shorter, cures the disease itself, and maintains all or part of the function of the affected part. With the continuous improvement of surgical methods and techniques, the cure rate of large joints of the limbs and simple spinal tuberculosis reaches more than 95%; 90% of those with spinal tuberculosis combined with paraplegia have also been recovered.
The fracture of radius-ulnar bone of forearm is an example. In the past, western doctors believe that it is difficult to achieve a good reset of the double fracture of these two bones, and it is difficult to avoid displacement by using traditional Chinese medicine reset methods. Fang Xianzhi observed the role of the interosseous membrane connecting the radius and the ulna, and found that when the forearm was in the neutral (neither rotated forward nor backward) position, the bone gap was the widest, and the distance between the two bone stems was the farthest, the interosseous membrane was tense up and down uniformly, and the interosseous ridge of the flexor carpi ulnaris was confronted with each other. From this phenomenon he got the revelation that the radial-ulnar diaphysis is most stable after fracture if the interosseous membrane is intact and remains tense. When treating the double fracture of radial-ulnar bone of forearm, the first manipulation is done in the neutral position of forearm against traction, and then two bone-splitting pressure pads are placed between two bones on the dorsal side of forearm, plus four small splints on the palmar, dorsal, radial, and ulnar sides of forearm, which can make the interosseous membrane keep tense, and control the rotational displacement. Fang Xianzhi and others also designed a set of practice methods after forearm fracture according to the small cloud hand and big cloud hand movements in Taijiquan, so that the patient with forearm fracture can not only avoid forearm rotation, keep the fracture end stable, but also keep the shoulder and elbow joints active. After this kind of reconditioning and practicing gong, it makes the treatment of otherwise complicated fracture become simple and the success rate reaches 90%.
For humerus fracture, femur fracture, tibial fibula fracture and fracture of adjacent joints and other parts of the fracture, he followed the principles of "combination of motion and static", "tendon and bone" and other principles to establish their own treatment methods, forming a complete set of Chinese and Western medicine combination system. Bone Tumor Classification Classification of Bone TumorsThere are many types of bone tumors, and there have been various classification methods, but they are often cumbersome and difficult to be mastered by general clinicians. Fang Xianzhi classified them into two categories: primary and secondary. Primary tumors are divided into tumors of basic bone tissues (including bone, cartilage, periosteum, etc.) and tumors of accessory bone tissues (including blood vessels, spinal cord, bone marrow, etc.). Each type is divided into benign and malignant tumors. Secondary or metastatic bone tumors are malignant, including carcinomas and sarcomas. This classification is known as Fang's classification, which was once widely used in China in the 1950s and 1960s. With the progress of histochemical, immunological and ultrastructural studies of tumors, this classification is not perfect and fails to reflect the origin of the tumor tissue and its biological behavior. However, under the conditions at that time, this method was relatively concise and easy to grasp, and it played a role in guiding the treatment and estimating the prognosis.
Fang Xianzhi often put forward some new ideas or made some technical improvements in various branches of orthopedics. He was the first scholar to introduce lumbar intervertebral disc herniation surgery in China. As early as 1949, he published a paper on the subject in ChineseJournalofMedicine (English edition of Chinese Journal of Medical Sciences), in which he argued that the main pathology of lumbar intervertebral disc herniation is the rupture and protrusion of the annulus fibrosus, which leads to the compression of the lumbar nerve root, and that therefore the disease should be referred to as rupture of the annulus fibrosus of the lumbar intervertebral disc.
For rheumatoid arthritis, Fang Xianzhi had categorized it into peripheral, central, mixed, pediatric and osteitis. He regarded cases with thickening and hypertrophy of the Achilles nodes and significant bony hyperplasia of the Achilles tendon and metatarsal tendon membrane attachments as a type of rheumatoid arthritis. Although ankylosing spondylitis was separated out as a separate disease and was no longer categorized as a central type of rheumatoid arthritis, this classification was still of some significance at that time from the point of view of historical development.
Diligent in writing
Fang Xianzhi published 85 papers in his lifetime, either alone or with his participation, mainly on the treatment of bone fractures, osteoarticular tuberculosis, and bone tumors. As early as 1936-1941, Fang published articles on gastroenterology, tetanus, and other general surgery and fracture treatment in Chinese Journal of Medicine (《中华医学杂志英文版》). Fang Xianzhi's monographs include Removal of Bone and Joint Tuberculosis Foci and Combined Treatment of Fractures with Chinese and Western Medicine, published by the People's Health Publishing House in 1956 and 1966, respectively. He also participated in the preparation of the chapter on sports medicine in Surgery, edited by Huang Jiaqi.
In September 1963, Fang Xianzhi attended the 20th Annual International Congress of Surgery in Rome, Italy, as a member of the Chinese Medical Delegation, where he read two academic papers in English, "Osteoarticular Tuberculosis Focal Removal Therapy" and "Combined Treatment of Fractures of the Forearm by Traditional Chinese and Western Medicines", which introduced the latest achievements of orthopedic surgery in China. In 1964, Mr. Fang Xianzhi attended the first Asia-Africa Medical Conference held in Cairo, Egypt, which was also a great success.
Fang Xianzhi, in order to promote orthopaedic academic exchanges and promote advanced experience, founded the Orthopaedic Refresher Course Newsletter in 1957, which was renamed Tianjin Medical Journal of Orthopaedics in 1961, and was the only orthopaedic academic publication in China at that time.
After the founding of the Society of Orthopaedic Surgery of the Chinese Medical Association (CMA) in 1981, CMA was entrusted to Tianjin with the task of organizing Chinese Journal of Orthopaedic Surgery, which is a bi-monthly journal with a circulation of more than 20,000 copies per issue.
Major works
1 Fang Xianzhi, Guo Juling, Zhou Yingqing. Fibrous ring rupture of lumbar intervertebral disc (with clinical case report of 47 cases). Journal of Surgery, 1952, 1:20.
2Fang Xianzhi, Tao黼, Guo Juling. Removal therapy of osteoarticular tuberculosis foci. Chinese Journal of Surgery, 1957, 5:90.
3 Fang Xianzhi, et al. Fractures of the bone. Newsletter of the orthopedic training class of Tianjin Medical College, 1957, 8:115.
4Fang Xianzhi, et al. Analysis of 659 cases of fractures and dislocations. The newsletter of the orthopedic training class of Tianjin Medical College, 1958, 2:16.
5Fang Xianzhi, et al. Achievements of orthopedics in Hebei Province in the past ten years. Tianjin Medical Journal, 1959, 1(4): 278.
6 Fang Xianzhi. Clinical study of osteoarticular tuberculosis--a paper to celebrate the 10th anniversary of the founding of the People's Republic of China. Chinese Journal of Surgery, 1959, 7: 985.
7Fang Xianzhi, Shang Tianyu, Wu Zhiqing, et al. Prevention and treatment of severe ischemic contracture of the forearm. Chinese Journal of Surgery, 1960, 8: 264.
8 Fang Xianzhi. View and application of "local external fixation" for external fractures. Tianjin medicine, 1961, 3: 171.
9 Fang Xianzhi. How to deal with fresh fractures. Tianjin medicine orthopedics supplement, 1962, 6:1.
10 Fang Xianzhi. Principles and theoretical basis for the treatment of fractures. Tianjin medicine journal, 1962, 4:125.
11 Fang Xianzhi. Summary of the academic discussion of the symposium on orthopedics of Chinese and Western medicine. Tianjin medical college orthopedics training class newsletter, 1962, 6:251.
12 Fang Xianzhi. How to deal with fresh patella fracture. Tianjin medicine journal of orthopedics supplement, 1963, 7 (1): 1.
13 Fang Xianzhi, Gu Yunwu, Shang Tianyu, Chinese and western medicine combined treatment of double fracture of the forearm. Chinese Journal of Surgery, 1964(Suppl):126.
14 Fang Xianzhi, et al. Treatment of osteoarticular tuberculosis foci. Beijing: People's Health Publishing House, 1956.
15Fang Xianzhi. In: Huang Jiayi, ed. Surgery. Beijing: People's Health Publishing House, 1963.
16Fang Xianzhi, et al. Combination of Chinese and Western medicine in the treatment of bone fracture. Beijing: People's Health Publishing House, 1966.
16 Fang Xianzhi, et al.