PingLe Guo’s Orthopedic Manipulation and the Spirit of Great Physicians

The Guo School of Orthopedic Manipulation in Pingle has been passed down for more than 220 years. Through periods of social upheaval and transformation, it has evolved into an indispensable component of traditional Chinese medicine’s orthopedics and traumatology. Owing to its remarkable clinical efficacy and its lofty medical ethics and professional conduct, the school has earned a prestigious reputation throughout the Central Plains and far beyond China’s borders. Since its inception, the spirit of the Guo School of Orthopedic Manipulation in Pingle has been handed down from generation to generation within the family.

Tang Dynasty Sun Simiao wrote in “Qianjin Yifang for Emergency Preparedness”: “In all cases where a great physician treats illness, he must first calm the spirit and steady the will, free from desire and attachment, and begin by manifesting great—” With compassionate hearts, we vow to universally relieve the suffering of all sentient beings. Should anyone afflicted by illness or calamity come seeking help, we shall not inquire whether they are noble or humble, rich or poor… nor shall we shy away from danger. To be evil—enduring the rigors of day and night, the extremes of heat and cold, hunger, thirst, and exhaustion—yet dedicating oneself wholeheartedly to saving others, without any desire to perform feats or seek fame or recognition—only then can one truly be a great physician for all living beings; to act otherwise... “Then it is a colossal, sentient thief.”

The purity of “wholeheartedly serving patients”

For more than 220 years, the Guo School of Orthopedics in Pingle has upheld a steadfast, unwavering commitment to putting patients first—regardless of wealth or poverty, and undeterred by challenging circumstances. Their sole mission has always been to do their utmost in diagnosing and treating patients, with an unrelenting pursuit of ever-greater precision in their work.

Since Guo Xiangtai founded the PingLe Guo School of Orthopedics, a bamboo winnowing basket for collecting consultation fees was placed beneath the large locust tree in front of the family home. Whether it was pastries or simply cabbage and radishes, such offerings could be accepted as payment for medical services. From that time on, the Guo family adopted the familial ethos of “treating all patients—rich or poor—with equal respect,” a tradition that endured through five generations, most notably with Guo Canruo, and remained unchanged for over a century.

In the 1950s, the Luoyang Specialized Orthopedic Hospital was established, marking the transformation of the Pingle Guo School of Orthopedics from a family clinic into a specialized orthopedic hospital. With the introduction of X-ray technology into traditional Chinese medicine’s bone and injury specialties, Pingle Guo School physicians, determined to achieve more precise reductions and superior therapeutic outcomes, willingly subjected themselves to radiation exposure by performing manual reduction under fluoroscopic guidance—despite the grave risk of radiation-induced limb amputation, they never once regretted their commitment.

As Mr. Guo Weihua, the sixth-generation inheritor of the PingLe Guo School of Orthopedics, has taught his children: “First, you must never accept free meals; second, you must never accept gifts; and third, you must never leave your post to seek extra income.”

A posture of “being unbound by convention, daring to break barriers, and continuously innovating”

Throughout the generations, the inheritors of Pingle Guo’s Orthopedic Therapy have continuously refined its academic theory. Mr. Gao Yunfeng, the fifth-generation descendant, proposed the principle of syndrome differentiation and medication based on three stages; his successor, Guo Weihuai, the sixth-generation inheritor, put forward the “Three Principles and Four Methods” framework; building on this foundation, the seventh-generation heirs, Guo Yanjin and Guo Yanxing, expanded it into the “Seven Principles and Six Methods” as well as the “Pingle Guo’s Orthopedic Therapy Balance Theory”; and the eighth-generation inheritor, Guo Jiayi, integrated these established theories with the needs of modern diseases to develop the “Bone-Nourishing Theory.” It is precisely through the relentless exploration and innovation of successive generations that the theoretical foundation of Pingle Guo’s Orthopedic Therapy has remained vibrant and dynamic over more than 220 years.

The inheritors of the PingLe Guo School of Orthopedic Manipulation have not only excelled in academic innovation but have also, across generations, upheld the ethos of breaking with tradition and constantly forging ahead. The fourth-generation inheritor, Mr. Guo Pingsan, confronted the challenge posed by Western medicine without retreating into rigid adherence to the past; instead, he actively studied the distinctive strengths of Western medicine and integrated them with the family’s traditional therapeutic approach. The fifth-generation inheritor, Guo Canruo, when faced with the risk of the family’s medical knowledge being lost, boldly defied the customary practice of passing the art exclusively to male heirs and entrusted her expertise in orthopedic manipulation to her wife, Gao Yunfeng. Subsequently, Gao Yunfeng, despite formidable familial opposition, joined forces with her son, Guo Weihuai, to donate the family’s secret formulas to the state, establishing hospitals, schools, and research institutes, and admitting students from outside the family. In this way, the unique techniques of the PingLe Guo School of Orthopedic Manipulation ceased to be confined to family transmission alone; through hospitals and educational institutions, they were made accessible to a broader audience, benefiting countless patients. Since 1958, the PingLe Orthopedic College has enrolled five cohorts of students, who have since spread throughout the country, becoming key professionals and teaching leaders in their respective regions and emerging as leading experts and scholars in China’s traditional Chinese medicine community specializing in bone and injury disorders. Like Mr. Guo Pingsan, Gao Yunfeng adopted an open-minded attitude toward Western medicine; in 1965, she published an article in the Health News titled “Leveraging the Strengths of Western Medicine to Complement the Weaknesses of Traditional Chinese Medicine,” in which she vigorously studied and assimilated the distinctive features of Western medicine. Together with her disciples, she refined the family’s traditional reduction techniques and developed more scientifically sound and practical medical devices, such as the traction frame and positioning frame, thereby making these reduction methods more efficient, simpler, and safer.

“Upholding orthodoxy while fostering innovation” is the duty and mission of the practitioners of the Pingle Guo School of Orthopedics. They have always taken the distinctive features of traditional Chinese medicine in bone and injury treatment as the foundation for innovation, steadfastly preserving the essence of TCM. The sixth-generation descendant, Guo Weihua, adheres to the principle of “prioritizing TCM over Western medicine and integrating the two,” continuously innovating and advancing upon traditional techniques. His groundbreaking work—“manual reduction combined with TCM–Western medicine integration for the treatment of chronic traumatic joint dislocations”—was awarded the National Major Scientific and Technological Achievement Prize in 1978.

Mr. Guo Weihuai, the sixth-generation descendant, founded the journal “Traditional Chinese Medicine Orthopedics” in 1989. Over its more than 30-year history, the journal has consistently adhered to its mission of highlighting the distinctive features of TCM orthopedics and traumatology, reflecting advances in academic research, and contributing to the modernization of this discipline.

The spirit of “remaining open, engaging in active exchanges, and making selfless contributions”

The inheritors of the Pingle Guo School of Orthopedics have always maintained an open and inclusive attitude. In the early years following the liberation of Luoyang, Mr. Gao Yunfeng, the fifth-generation descendant, publicly shared the family’s time-honored secret formulas, transforming what had long been a closely guarded, hereditary tradition into formally documented teachings and systematic instruction in specialized training programs. Over the past nearly seventy years, his disciples have spread across the country, passing on this legacy far and wide. To facilitate learning for future generations and benefit more patients, the inheritors of the Pingle Guo School published two seminal monographs in 1976 and 1995: “A Concise Guide to Orthopedic Manipulation” and “Pingle Orthopedic Techniques.” To provide students with a more comprehensive understanding of the theoretical foundations and clinical practices of the Pingle Guo School, Gao Yunfeng, together with his son Guo Weihuai, compiled the textbook “Lecture Notes on Pingle Orthopedic Science.” In 2019, the seventh-generation inheritors, Guo Yanjin and Guo Yanxing, along with the eighth-generation inheritors, Guo Jiayi and Guo Malong, once again synthesized and systematized the theoretical principles and technical methods of the Pingle Guo School, publishing the “Pingle Orthopedic Series.” This comprehensive series offers a thorough exposition of both the theoretical underpinnings and practical techniques of the Pingle Guo School, making it even easier for practitioners to master and apply these time-honored methods. Student Study of the Guo School of Orthopedics in Pingle.

Since the very inception of the Zhenggu Hospital, successive generations of inheritors of the Pingle Guo School of Orthopedics have actively participated in academic symposia and conferences, continuously studying the research findings and key techniques developed by leading experts and scholars, while also systematically disseminating the distinctive therapeutic methods of the Pingle Guo School. Beginning in 1986, the Pingle Guo School embarked on international academic exchanges, engaging with orthopedic and trauma specialists and academic organizations from numerous countries, including Russia, Italy, Germany, the United States, the United Kingdom, France, Japan, and others. In July 2019, Guo Yanxing, the seventh-generation inheritor, and Guo Jiayi, the eighth-generation inheritor, signed a framework cooperation agreement with the New Zealand Asian Book and Culture Center, under which they plan to establish a studio for the Pingle Guo School of Orthopedics—a national intangible cultural heritage—at the New Zealand Chinese Traditional Culture Experience Center in Auckland. The agreement further stipulates that experts from the school will be regularly dispatched to Auckland to promote and exchange knowledge of traditional Chinese medicine and culture.

Through the dedicated efforts of the seventh and eighth-generation inheritors of Pingle Guo’s Orthopedic Manipulation, by 2021 a total of 20 secondary workstations for Pingle Guo’s Orthopedic Manipulation had been established nationwide. By leveraging this workstation model, the distinctive diagnostic and therapeutic techniques of Pingle Guo’s Orthopedic Manipulation have been disseminated across the country, reaching frontier regions such as Xinjiang, Gansu, and Ningxia, as well as former revolutionary base areas, thereby benefiting local residents.

It is precisely because of this spirit, passed down through generations, that Pingle Guo’s Orthopedic Therapy has remained vibrant and resilient over the past 220-odd years, undiminished by the passage of time. Looking ahead, Pingle Guo’s Orthopedic Therapy will continue to uphold and advance this legacy: “to benefit humanity through Pingle Orthopedics, to ensure a steady stream of successors, to foster its prosperity and development, and to bring it to the world stage.”