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1、InterrogationQu hongdaconceptionTo know the onset,development,treatment,present symptoms and other information of disease by questioning patient or accompanying peopleInternal classic Treatise on cold attackThousand worthy prescriptions for emergencepurposeTo know the hobby,custom of patientOnset de
2、velopment of diseaseJudge the cause and nature of diseaseData from all diagnostic methods should be taken into comprehensive consideration in order to avoid mistake in diagnosisMethod of interrogationSuitable environmentAsk the patient directly Questioning method in emergencyThe doctor should be ser
3、ious and patient,and be good at thinking and arousing patientsContent of interrogation1.General data:name,sex occupation,birth place,nationality,address,marriage state,24-solar terms of disease onset,visit data,admission data Examples:hepatic echinococcosis(包虫病)(pastoral area),rheumatism(风湿病),postpa
4、rtum disease(产后病)2.Life style and process(Diet,mental activity,regular daily life)3.Family history and anamnesis4.Chief complaint The symptoms the patient feels the most obvious and painfully and the main cause for visiting a doctor.symptoms+period5.History of disease 1)The cause of disease onsetcir
5、cumstance,time,symptoms,sudden or not,cause or predisposing cause,development and treatment 2)Present symptoms明代医学家张景岳十问歌：明代医学家张景岳十问歌：明代医学家张景岳十问歌：明代医学家张景岳十问歌：一问寒热二问汗，三问头身四问便，一问寒热二问汗，三问头身四问便，五问饮食六问胸，七聋八渴俱当辨，五问饮食六问胸，七聋八渴俱当辨，九问旧病十问因，再兼服药参机变，九问旧病十问因，再兼服药参机变，妇女尤必问经期，迟速闭崩皆可见，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
6、验。再添片语告儿科，天花麻疹全占验。Cold and fever Aversion to cold Intolerance of coldA.Chill and fever a.more chill than fever b.more fever than chill c.fever with aversion to coldB.the chill and fever seprately a.fever without chill sthenic fever,tidal fever,low grade fever b.intolerance of cold without feverC.Alt
7、ernate chill and fever a.shaoyang syndrome b.malariasweatingThe action of yang puts on yin makes the sweating.No sweating wind-cold in the exterior yin insufficiencySweating Normal sweating Abnormal sweatingAbnormality of sweating characterA.spontaneous sweatingB.Night sweatingC.profuse sweating hea
8、t or coldD.yellow sweating damp-heatE.fighting sweatingF.dying sweatingAbnormality on sweating locationA.hemihidrosis(半身汗)B.head sweatingC.Chest sweatingD.sweating in the palm and soleE.genital sweatingPainMechanism of pain:Stagnation or stasis Innutrition of bodyClassification of pain A.Character o
9、f pain B.Location of PainTo distinguish:heat cold excess deficiencypainCharacter of painExcess:sudden onset,severe and,incessant aggravated by pressing Causes:exogenous evils,qi stagnation,blood stasis,phlegm retention,parasitosis or food retentionDeficiency:occurs gradually,dull,paroxysmal,relieved
10、 by pressingA.Distending pain-qi stagnationB.Stabbing pain-blood stasisC.Colic pain(绞痛)-solid evils obstructionD.Retraction pain(掣痛)malnutrition of tendonsE.Scorching pain(灼痛)fire evilsF.Cold pain-yang deficiency,cold attackG.Hollow paindeficiency of essence or bloodH.Dull pain(钝痛)deficiency of pain
11、Location of painA.Headache excess deficiency Occiput radiating to nape-taiyang meridian forehead-yangming meridian bilateral sides-shaoyang meridian vertex-jueyin meridianappendixDizziness or vertigo:No phlegm no vertigo No deficiency no vertigo Excess-phlegm dampness Deficiency-qi and blood,Ascenda
12、nt hyperactivity of liver yang,kidney essenceB.General aching(pantalgia)wind-cold,wind-dampness pestilential toxin Insufficiency and disharmony of qi and bloodC.Chest pain lungphlegm-dampness,heat,abscess,yin deficiency heartqi deficiency and blood stasis,qi stagnation D.Hypochondriac pain blazing o
13、f liver fire shaoyang syndrome blood stasis from sprain or falling down damp-heat suspending fluid retentionE.stomachache stomach cold or heat liver qi stagnation blood stasis spleen yang deficiency spleen yin deficiency F.abdominal pain cold heat excess deficiency yangming fu syndrome deficient col
14、d of spleen blood stasis in lower jiao cold attack liver meridian parasitosis intestinal abcess G.lumbago kidney yin or yang deficiency blood stasis cold attackH.Pain of limbs(joints)wind,heat,cold,dampness 4.Diet and taste in mouth(饮食与 口味)A.Thirst and drinking(口渴与引水)B.Appetite and food intake(食欲与进食
15、)C.Abnormal taste in mouth(异常口味)A.Thirst and drinkinga.No thirst(口不渴)b.Thirst with profuse drinking and urine(伴多汗)consumptive thirst disease lung stomach heat,kidney yin deficiencyc.Thirst but little drinking(少饮)yin deficiencydamp-heatfluid-retention blood stasisB.Appetite and food intake食欲与进食To dis
16、tinguish the yin or yang constitution of bodya.Poor appetite(食欲差)spleen deficiency/dampness/qi stagnation/food injury/pregnancyb.over eating but still feeling hungry(多食易饥)stomach fire/strong stomach and weak spleenc.Hunger without appetite(饥不欲食)stomach yin deficiency d.food addiction(偏嗜)parasitosis/
17、pregnancy/Symptoms relieved after food taking-deficiencySymptoms aggravated after food taking-excess (食后痛减,食后加重)Food drunk(食醉)-spleen deficiencyTo know the developing tendency of diseaseC.Taste in the mouthMorbid taste in the mouth(口味异常)Tastelessness(口淡)deficiency of spleen and stomachSweet taste(口甜
18、)-damp-heat in middle jiaoSour taste(口酸)heat accumulation in liver and stomachBitter taste(口苦)gallbladder heat syndromeSalty taste(口咸)kidney disease5.Defecation and urination二便Defecation is related to large intestine/lung/spleen/liver/kidneyUrination is related to bladder/kidney/lung/liverTo know th
19、e nature of disease and the funtion of visceraA.defecation(大便)a.stool form(便形):dry stool and dark color-heat in large intestine extremely dry stoolblood or body fluid deficiency loose bowel-deficient cold in spleen hard stool first&loose then-dampness/deficiency alternate dry and loose-stagnation of
20、 liver qi undigested food in stool-kidney yang deficiency food retention/damp-heat in large intestineb.Frequency of defecation(大便次数)constipation(便秘):excessive heat/cold accumulation/yin or qi blood deficiency diarrhea(腹泻):spleen deficiency/declining of life gate/fire/food retention/damp-heatc.color
21、of stool(便色):dark yellow stagnated heat in intestine black-far blood red-near blood red and white-dampness in large intestine grayish white-jaundance of damp heatd.feeling of defecation(便感)hot and burning sensation-damp heat unsmooth defecation-liver qi stagnation tenesmus(里急后重)dampheat fecal incont
22、inence(大便失禁)-deficiency of spleen and kidneyUrination(小便)Related to body fluid/lung/spleen/kidney4-6 times a day1500-2000 ml a dayReflect the condition of body fluid/visceraUrination(小便)a.amount of urine(尿量)Excessive urine(多尿):kidney yang deficiency consumptive thirst(消渴)kidney yin deficiency Scanty
23、 urine(少尿):heat/sweating/vomiting /Diarrhea /deficiency b.frequency of urination Frequent urination(尿频)kidney yang deficiency damp heat in lower jiao dysuria and anuria(癃闭):excess and deficiencyc.color of urine(尿色)normal-light yellow and tranparent yellow-heat,dampheat(jaundice 黄疸)clear-deficiency c
24、old red-collateral impairmentFeeling of urination urethral pain(尿痛)enuresis(遗尿)dripping(淋沥不尽)incontinence(失禁)6.sleepNormal -hiding of yang and flourish of yin (阳潜阴盛则寐)a.Insomnia(失眠)1.Disharmony between the heart and kidney (心肾不交)2.Deficiency of heart and spleen(心脾两虚)3.Gallbladder stagnation and phle
25、gm disturbing (胆郁痰扰)4.Food retention(食积)b.Sleepiness(嗜睡)1.damp-phlegm encumbering in spleen (痰湿困脾)2.spleen qi deficiency(脾气虚)食醉 3.deficiency of heart and kidney 4.heat in pericardium(热入心包)7.Women diseaseA.menstruation(月经)5-712-2007.03.12 24-30 B.vaginal discharge(白带)C.pregnancy(怀孕)D.symptoms after d
26、elivery(产后症状)A.menstruation(月经)a.Irregular menstruation(月经不调)preceded menstruation delayed menstruationb.Dysmenorrhea(痛经)前 中 后c.Amenorrhea and scanty menses(闭经)congenital(先天的)postnatal(后天的)Metrorrhagia and metrostaxis(崩漏)B.vaginal discharge(白带)Odorless white mucusnormal(正常)White vaginal discharge(色白
27、)Yellow vaginal discharge(色黄)Red vaginal discharge(色红)C.pregnancy(怀孕)Morning sickness(恶阻)Perturbation of fetus(胎动不安)Leakage of fetus(漏胎)Pregnant edema(子肿)D.symptoms after delivery(产后症状)Lochiorrhea(产后恶漏)Postpartum fever(产后发热)8.Disease in childrenThe condition after birth(出生后情况)Vaccination/infectious
28、disease(免疫和传染病)The special causes of children disease (小儿特殊情况)What is the aim of interrogation?symptomsTcm procedure of diagnosisEight principle Syndrome differentiationYin and yangExterior-interiorExcessive deficiencyCold-heatVisceral,Meridian,Three-jiaoWei-qi-ying-xueEtiological,Qi-blood andBody fluid