The diagnosis of traditional Chinese medicine does not rely entirely on instruments and equipment, but through the examination of various disease phenomena reflected in the external body, under the guidance of Chinese medicine theories, analysis, synthesis, comparison, and thinking, just like a detective follows clues to solve a case. We don't ask for 'seeing is believing', but reasoning according to a specific method to gain an understanding of the nature of disease. This specific method is the basic principle of TCM diagnosis, such as 'Outside the Outside and Inside', 'Seeing the Small Things', 'Changing with Constant Balance' and 'Knowing and Receiving by Cause'. In a nutshell, it is to infer the changes that are taking place between the internal organs and tissues of the body through the external conditions of the body; Through small changes, such as some changes in the ears, eyes, pulse, and tongue, understand the corresponding changes in the condition reflected by them; Through the comparison with the normal human body shape, color, and functional performance, it is measured whether the corresponding lesions have occurred and the condition of the lesions; Through the conditions, causes, and triggers of the disease, we can know what kind of external or internal stimuli the body has suffered and the lesions that occur.
Diagnosis is the basic method for doctors to examine patients and collect information about their conditions
Teacher Xie also said, "If you want to understand this, you must know the diagnosis and treatment methods of traditional Chinese medicine. He gently closed the book in his hand and said, "Xiao Wang, you must know that diagnosis is the basic method for doctors to diagnose patients and collect information about their conditions, and it is the cornerstone of traditional Chinese medicine diagnosis. ”
Xiao Wang nodded slightly, signaling that he was listening carefully.
Looking, smelling, asking, and cutting four diagnoses
Teacher Xie continued: "The diagnosis method mainly includes four diagnoses: looking, smelling, asking, and cutting. Visiting is a method of visually observing the patient's whole body and local changes, discharges, etc., in order to understand the condition. For example, pale complexion and yellow tongue coating may be a sign of some conditions. ”
The sixty-first difficulty of the "Book of Difficulties".
Said: The scriptures say, the god who knows by seeing, the saint who knows by hearing, the work that asks and knows, and the ingenuity that knows by cutting the pulse. What is it?
However, those who look at it will see its five colors to know its disease. Those who know it by hearing it will hear its five tones to distinguish it from their diseases. Ask those who know, ask them what they want, so as to know the origin of their disease. Those who know the pulse should diagnose their mouths and see their reality to know their diseases and where the diseases are. The scriptures say that what is known outside is called holy, and what is known inside is called God, and this is also said
The earliest use of the four-character joint name should be in the "Ancient and Modern Medical System": "Looking, hearing, asking, and cutting the four characters, honesty is the program of medicine." ”
Xiao Wang recorded this important information in a notebook.
Mr. Xie continued: "Olfactory diagnosis is a method to identify the changes in the patient's voice and smell through hearing and smell, so as to obtain information about the condition. For example, a person with a low, weak, coughing voice may be a sign of a respiratory problem. ”
Xiao Wang listened intently, and he could feel Mr. Xie's in-depth explanation of each diagnosis method.
Mr. Xie also said: "Consultation is a method of diagnosing the condition by purposefully asking patients or accompanying patients to understand the occurrence, development, diagnosis and treatment process, and current symptoms of the disease. During the consultation, the patient's words, expressions, and tone of voice should be considered to obtain more information. ”
Xiao Wang nodded, and he secretly made up his mind that he must use more consultation methods in future practice.
Finally, Mr. Xie mentioned: "Palpation is a method of touching, touching, pressing and pressing certain parts of the patient through the sense of touch of the hand to obtain information about the patient's condition. ”
Xiao Wang imagined how he would use the palpation method in the actual operation, and he couldn't help but feel a burst of excitement in his heart.
Teacher Xie looked at Xiao Wang and said with a smile: "The four diagnoses of looking, smelling, asking, and cutting are the methods for doctors to diagnose various symptoms of patients from different angles and different aspects, and they complement each other and cannot replace each other. Only by comprehensively using the four diagnoses can we explore the essence of the disease from the phenomenon and make a correct diagnosis of the disease. ”
Xiao Wang suddenly realized, he took out his notebook and carefully recorded these important knowledge points. Teacher Xie nodded with satisfaction when he saw his serious attitude.
"Xiao Wang, you have to remember that the medical information collected through the four clinics mainly includes symptoms, signs and medical history. Symptoms are pain or discomfort that the patient subjectively feels, such as chest tightness, headache, bloating, etc.; Signs are objectively detectable abnormalities, such as paleness, pale tongue, and thin pulse. In traditional Chinese medicine, signs and symptoms are collectively referred to as symptoms, or symptoms for short. Symptom is the phenomenon reflected by the disease, which is the main basis for judging the type of disease and distinguishing the syndrome. ”
What does the illness and syndrome of TCM mean?
Xiao Wang walked into Mr. Xie's study with great interest, and this time he wanted to ask about the relationship between illness and syndrome in traditional Chinese medicine. He stood in front of Teacher Xie and bowed respectfully: "Master, I would like to ask you to explain what the illness and syndrome of Chinese medicine mean. ”
Teacher Xie smiled and nodded, and tapped his fingertips on the table: "Xiao Wang, illness is a summary of the characteristics and laws of the whole process of disease development. It contains the basic characteristics of the disease, the etiology, the pathogenesis process, the development law, etc. Disease diagnosis, also known as disease differentiation, is a diagnostic thinking process that comprehensively analyzes the data of the four diagnoses, makes a judgment on the type of disease, and determines the name of the disease under the guidance of the theory of traditional Chinese medicine. The name of a disease is a generalization and abstraction of the characteristics and laws of the whole process of a specific disease, that is, it is synonymous with the disease. ”
Xiao Wang listened intently, and at the same time quickly opened his notebook and recorded Teacher Xie's words.
Traditional Chinese medicine diagnosis, it is necessary to observe the pulse syndrome, know what is wrong, and treat it with the syndrome
Teacher Xie continued, "However, it should be noted that modern disease names do not correspond to TCM disease names one-to-one. Modern disease names may be included in the scope of TCM disease names, but the specific situation needs to be differentiated by TCM physicians in clinical practice. Look at the pulse evidence, know what is wrong, and follow the evidence. ”
Xiao Wang hurriedly nodded to show that he understood, and then plucked up the courage to ask again: "Master, you also mentioned the 'certificate' of traditional Chinese medicine, and I don't quite understand this concept yet. ”
Mr. Xie smiled and encouraged him: "Yes, syndrome is a unique concept of traditional Chinese medicine, which is a pathological summary of the etiology, pathology, location, and condition of a certain stage in the process of disease, reflecting the essence of pathological changes at a certain stage in the development of a disease. Syndrome differentiation is based on the guidance of traditional Chinese medicine theory, the analysis and synthesis of various clinical data collected by the four clinics to make judgments on the etiology, nature, location and struggle between evil and good at the current stage of the disease, and summarize it into the diagnostic thinking process of a certain syndrome. ”
Xiao Wang listened with relish, and he couldn't help but raise his hand to signal: "Master, are there many types of certificates?" ”
Teacher Xie nodded: "Yes, clinically, the same disease may manifest as different syndrome types, which is what we often call syndrome types. Each syndrome type has its own characteristics and rules, so for different patients, we need to treat them according to their specific conditions. ”
Xiao Wang comprehended, and at the same time opened the notebook again and carefully recorded Mr. Xie's words.
Mr. Xie also said: "TCM diagnostics is a theoretical, practical and scientific discipline. It requires not only mastery of basic theories, but also a wealth of practical skills to improve diagnostic skills. ”
Xiao Wang listened carefully, and he understood in his heart that in order to become an excellent TCM, he must start from the basic theory: "It turns out that TCM diagnostics is so important, and it is quite complicated to learn. ”
Mr. Xie continued, "First of all, you must be proficient in the basic theories of Chinese medicine. Only by having an in-depth understanding of the basic theories of Chinese medicine can we accurately identify diseases and distinguish syndromes in clinical practice. ”
Xiao Wang nodded, and he began to understand that learning Chinese medicine is not only about rote memorization, but also about understanding the principles behind it: "I want to study the basic theories of Chinese medicine carefully, so that I know what it is, and more importantly, why it is true." ”
Mr. Xie continued: "Secondly, we must continue to carry out clinical practice. TCM diagnostics needs to be continuously improved in practice, and only in clinical practice can the skills of diagnosis be truly mastered. ”
Xiao Wang was deeply touched after hearing this, and he was determined to participate more in clinical practice and continuously improve his diagnostic ability: "I want to participate more in clinical practice and constantly improve myself." ”
In conclusion, Mr. Xie emphasized: "We should also pay attention to cultivating the unique scientific thinking method of Chinese medicine. The theory of TCM is dominated by a holistic concept, which requires the cultivation of unique cognitive thinking and scientific thinking methods. ”
Xiao Wang listened with relish, and he understood in his heart that in order to become an excellent Chinese medicine practitioner, it is not only necessary to learn knowledge, but also to cultivate a unique way of thinking: "I will study hard, not only to master knowledge, but also to cultivate a unique way of thinking in Chinese medicine." ”