问诊.ppt

Chapter8,Inquiry闻诊,Doeswesternmedicinehaveinquiry?,Yes?No?,Inthissection,youarerequiredto,MasterthebasicwordsformingTCMphrasesassociatedwiththischapter.FigureoutthemeaningofTCMphrasesformedbythesewords.FormnewTCMphrasesusingthesebasicwords.Statethecontentsofinquiry,Inthissection,youarerequiredto,5.Inquiryaboutthepresentsymptomsandsigns6.Statetheconcept,mechanismandcommonpatternsassociatedwithColdwithfever,chillswithoutfever,feverwithoutchillsandalternatingchillsandfever.Highfever,tidalfever(afternoontidalfever,dampness-warmtidalfeverandyindeficiencytidalfever)andmildfever.Continuenextpage,Withandwithoutsweating(includingdifferenttypessweating).Differenttypesofpain.Vertigoanddizziness.Oppressioninthechest,palpitation,hypochondriacdistension,gastricstuffiness,abdominaldistension,numbness,paralysis,heavybody,vomiting,itching,tinnitus,Symptomsofsenseorgans.Sleepingdisorders.Thirst.Disordersoffoodintake.Defecationdisorder.Urineamountandurinationdisorder.,Whatshallweinquire?,Section1,InquiryaboutColdandHeat问寒热,NewTerms,PhrasesandExpressions,生词、短语和表达形式,Inquiryabout,(询)问inquiryaboutcoldandheat问寒热问汗inquiryaboutsweatingInquiryaboutpain问疼痛,十问歌：一问寒热二问汗，三问头身四问便，五问饮食六问胸，七聋八渴俱当辩，九问旧病十问因，再兼服药篸机变，妇女尤必问经期，迟速闭崩皆可见，再添片语告儿科，天花麻疹全占验,Aversion,恶(寒、热、风)aversiontocold恶寒恶热aversiontoheataversiontocoldwithfever恶寒发热；发热恶寒however,畏isusuallytranslatedintofearasin“fearofcold”;寒战isusuallytranslatedintoshivering,meaningviolentchillswithtrembling.,Without,不feverwithoutchills但热不寒但寒不热chillswithoutfever,Tidal,潮水的潮热tidalfeverafternoontidalfever午后潮热lateafternoontidalfever日晡潮热bone-steamingtidalfever骨蒸潮热,Mild,微微热mildfevermildaversiontocold微恶寒mildchill微寒mildthirst微渴,unsurfaced,不扬的unsurfacedfever身热不扬身热夜甚isusuallytranslatedintofeverworseningatnight.,vexingheat,烦热vexingheatinthechest,palmsandsoles五心烦热手足烦热vexingheatintheextremities手足心热isusuallytranslatedintoheatinthepalmsandsoles,Reversal,厥reversalcoldoftheextremities手足厥冷；厥冷；厥逆upperbodyreversalandlowerbody上厥下竭exhaustionexhaustion=竭lowerbodyreversalwithupperbodyveiling下厥上冒veil=面纱，用面纱遮盖,冒revertingyinheatreversalpattern厥阴热厥证Nextpage,Note,厥阴istranslatedasrevertingyin,晕厥meansfainting,and厥证meanssyncopesuchasfloppingsyncope(薄厥),visceralsyncope(脏厥),crapulentsyncope(食厥),heatsyncope(热厥),andphlegmsyncope(痰厥).,Alternate,交流、交换alternatingchillsandfever寒热往来,Text,TheConceptofColdandheat寒热的概念,Concept,Coldandheatrefertothepatientssubjectivefeelingofchillsandfever.InquiryaboutcoldandheatmeanstoaskthepatientaboutsensationsofheatandcoldInTCM,patterndiagnosisisbasedonpresentsymptomsandsigns,andtreatmentisbasedonpatterndifferentiation,Thefactorsaffectingcoldandfeverofthebody,Differenttypesofcoldand/orfever,coldwithfever1externalcontractionchillswithoutfever2internaldamageofbodyyangqifeverwithoutchills3exuberanceofyangordeficiencyofyinalternationofchillsandfever4,1coldwithfever恶寒发热2chillswithoutfever但寒不热3feverwithoutchills但热不寒4alternationofchillsandfever寒热往来,typesofcoldandfever,Typesofcoldwithfever,AversiontowindwithmildfeverMildcoldwithhighfeverSeverecoldwithmildfever,Theresultsofreactionofpathogenicfactorsandhealthyqi,Highfever,persistenthighfeverwithaversiontoheatbutnochillsusuallycausedbyinteriorinvasionofexteriorheat(mostlywind-heat)orexternallycontractedwind-coldenterstheinteriorandtransformsintoheatpertainingtointeriorexcessheatsyndrome,Tidalfever,Lateafternoontidalfeverheatinyangbrightnessmeridian,alsocalledyangbrightnesstidalfeverDampness-warmtidalfeverunsurfacedfeverYindeficiencytidalfeverafternoontidalfevernightfever,nightsweatingVexingheatinthechest,palmsandsoles;alsocalledfivecenterfeverandbone-steamingtidalfever,Alternatingchillsandfever,lesseryangdisease,ahalf-exteriorhalf-interiorpatternbrucella布鲁氏菌malaria疟疾；瘴气,Mildfever,Threetypesoffeverwithoutchillsandtheircauses,Twotypesofalternatingchillsandfeverandtheircommonlyseendiseases,ReviewofTerms,词汇复习,ReviewofTerms,feverwithoutchills但热不寒afternoontidalfever午后潮热unsurfacedfever身热不扬alternatingchillsandfever往来寒热reversalcoldoftheextremities手足厥冷；厥冷；厥逆vexingheatinthechest,palmsandsoles五心烦热,Section2,InquiryaboutPain问疼痛,NewTerms,PhrasesandExpressions,生词、短语、表达形式,Heavy,重heavyheadandlightfeet头重脚轻身重heavybodyHeavypain重痛,vision,视力dizzyvision目眩blurredvision目昏；视物模糊doublevision视岐；复视視岐,Scorch,烧焦、烤焦灼痛scorchingpain,Grip,抓、握绞痛grippingpain绞痛canalsobetranslatedintocolickypain.,Pull,拉、扯掣痛pullingpain,Dull,不明显隐痛dullpain,Scurry,乱串scurryingpain窜痛,Oppressive,压迫的闷痛oppressivepainWhile酸痛isusuallytranslatedintoachingpain.,ache,(轻微)痛，酸痛achingpain酸痛,wander,漫游wanderingpain游走痛,Paroxysmal,阵发性的阵发性痛paroxysmalpainparoxysmalcough发作性咳嗽,persistent,持续性的持续性痛persistentpainpersistentsweating汗不止,contracture,拘急contractureofthenapeandneck项背拘急contracturemeansabnormalshorteningofmuscletissue,renderingthemusclehighlyresistanttopassivestretching,whilespasmreferstoasudden,violent,involuntarymuscularcontraction.四肢拘急contractureofthelimbs,Spasm,拘挛、挛急musclespasm肌肉挛急,strangury,痛性尿淋沥strangurydisease淋病血淋bloodstranguryheatstrangury热淋,Text,TheConceptofPain疼痛的概念,Concept,Painisaverycommonsubjectivesymptomandinquiryaboutpainincludesinquiryaboutthelocationandnatureofthepain,Excessanddeficiencypain,“Stagnationleadstopain.”Sixexcess,qistagnation,bloodstasis,stagnationofphlegm,retainedfood,andwormaccumulationcanallcauseexcesspain,becausetheycancausestagnationtothemeridiansandvesselsandpreventqiandbloodfromnormalcirculation.DeficiencycanleadtopainDeficiencyofqi,bloodandyinessencecanalsocausepainbecausetheycannotnourishthebodyproperly.,Excessanddeficiencypain,severepain,constantpain,paininanewdisease,orppainwithrefusalofpressure,ismostlyexcessiveintermittentpain,mildpain,painwithpreferenceforpressure,orpaininchronicdiseaseisusuallydeficient,Thelocationofapain,Headachecanbecausedbyexteriorpathogens(sixexcesses)Phlegm,bloodstasis,andwormsinsufficiencyofqi,blood,essenceandmarrowdiseaseoflocalorgans(nose,ears,eyes,teeth)Liverdiseases,includingliveryanghyperactivity,liverfireflamingupwardandliverfireinvadingthehead,liveryindeficiencyChestpainheartandlungdisease,liverqiascendingcounterflowandfluidretentioninthechestandhypochondrium,Thelocationofapain,Hypochondriacpaindiseasesoftheliverandgallbladder,fluidretentionintheregion,orinjuryofthelocalbonesormusclesStomachpainfailureofthestomachtodownbearfoodandinhibitionofstomachqimovementBackpaininjuryoflocalsinewsLumbago.WeaknessandsorenessoftheloinsandkneeskidneydiseasesLimbpaingeneralizedpain,ReviewofTerms,词汇复习,ReviewofTerms,grippingpain绞痛scurryingpain窜痛achingpain酸痛wanderingpain游走痛paroxysmalcough阵发痛strangurydisease淋病,Section3,InquiryaboutotherConditions问其他情况,NewTerms,PhrasesandExpressions,生词、短语、表达形式,Ungratifying,不满意的、不高兴的ungratifyingdiarrhea泻下不爽,Undigested,未消化的undigestedfoodinstool完谷不化undigestedfooddiarrhea下利清谷；完谷下利Thesameasclear-fooddiarrhea.clear-fooddiarrhea=下利清谷；完谷下利,fifth-watch,五更五更泻fifth-watchdiarrheafifth-watchcough五更咳,soggy,湿透的，浸透的濡泄soggydiarrheasoggypulse濡脉,bound,结hardboundstool大便硬结stoolsometimessloppyandsometimesbound溏结不调boundpulse结脉,urination,排尿、小便incompleteurination余尿不尽difficultpainfulurination小便涩痛,incontinence,失禁fecalincontinence大便失禁urinaryincontinence小便失禁,turbid,浊turbidurine小便混浊；尿浊separationoftheclearandturbid泌别清浊deepturbidvoice语声重浊,drib,点滴的落下dribblingurination小便淋漓dribblingurinaryblock癃閉,emission,排放seminalemission遗精dreamemission梦遗,vaginaldischarge,阴道排泄物whitevaginaldischarge白带yellowvaginaldischarge黄带,Text,TheConceptofotherConditions其他情况的概念,InquiryaboutUrineandUrination,andStoolandDefecation,Diarrhea腹泻spleenyangqideficiency,kidneyyangdeficiency,coldorcold-dampnessinthegastrointestinaltract,dampness-heatinthegastrointestinaltract,andliverdepressionwithspleendeficiencyUndigestedfoodinthestool完谷不化spleenorkidneyyangdeficiency.脾Stoolsometimessloppyandsometimesbound溏结不调Ungratifyingdiarrhea泻下不爽Hematochezia便血spleenqideficiencyfailingtocontroltheblood,heatordampness-heataccumulationinthestomachorintestinedamagingtheircollaterals,orqistagnationandblo