(A) the position according to the diagnosis
Before the diagnosis of Chinese medicine, one must first select a well-positioned body, and then fully expose the part to be examined. Depending on the purpose of the examination and the location of the examination, the general patient may take a seat or a supine position.
1. Sitting position: The patient takes a seat and the doctor can sit or stand with the patient. The doctor uses the left hand to help the body slightly and touch the right hand to press a certain part of the patient. Sitting position is mostly used for skin, hand, foot, and chest points.
2. Recumbent position: The patient must take a supine position or a lateral position. The body is relaxed, his legs are naturally straightened, and his arms are placed beside him. The doctor stands on the right side of the patient and cuts the patient's thorax and abdomen with his right hand or both hands. In the case of intra-abdominal masses or abdominal muscle tension, the patient may be allowed to bend his knees, relax his abdominal muscles, or take a deep breath so that he can press the hand. The supine position is used for chest and abdomen.
(B) the method of diagnosis
According to the method of diagnosis, there are four methods: touch, touch, press, and click.
1. Touch method: is to gently touch the patient's local skin with the fingers or palms to understand the skin's cool, moistening and other conditions, used to determine whether the disease is exogenous or internal injuries, whether sweating, and Yang Qi Yin Jin's profit and loss, more for the amount of Examination of the skin of the Ministry, limbs and chest and abdomen.
2. Touching method: It is to search for a part with a little force to find out the local feeling, whether there is pain and the shape, size, etc. of the mass, in order to identify the disease position and its actual condition, mostly for the chest and abdomen, acupoints, swelling and other parts .
3. According to the law: press the heavy hand or search for local, to understand whether the deep tenderness or mass, shape, texture, size, activity level, degree of swelling, nature, etc., in order to distinguish between the actual situation of dirty organs and evil, For chest and abdomen tumors.
The difference between the above three methods is that the strength of the difference is different and the depth of the difference is different. Touching force is light, diagnosed in the skin; touch method force slightly heavier, up to the muscle layer; according to the law of the most serious, diagnosed in the bones or deep abdominal cavity. The clinical operation can be comprehensively used. The first is to touch first, and then press it, from light to heavy, from shallow to deep, first to far and near, and then to the clinic. That is to say, "Re-arrangement of Popular Febrile Diseases," said: "The diagnosis should be massaged several times, either light or heavy, or hit or suppressed, and the chest and abdomen must be checked for softness, refused to press or not, and the coldness of the chest and abdomen should be examined. Heat, burning hands or not, in order to determine the cold and heat of their illness and reality. "And said:" Light hand follow, from the chest and under the umbilicus, know the skin moist, you can identify cold and heat; middle hand to find, ask the pain No pain, to detect the presence of evil; heavy hand push, check whether it is hard or not, but also asked whether it hurts, in order to distinguish the actual situation of dirty organs, deposition of what."
4.å© : : : : : : : : : : : : : : : åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ åˆ. That is to say, "Su asked to be true," the so-called "there are sounds, drums are like drums." The slamming method has two methods: direct slamming and indirect slamming.
(1) Direct slap method: The doctor directly slams the body surface with his finger or palm. For example, a direct palpation may be performed on the abdomen of a bulging patient, and if the pimple is a drum, the drum is an air drum; The doctor can also put both hands on the symmetry part of the patient's abdomen, slamming the abdominal wall with one hand. If the contralateral palm has a vibration wave, it is the performance of the abdomen.
(2) Indirect tapping: There are two methods of operation. Firstly, “Fist of the fistsâ€: The doctor puts his left palm on the body surface of the bedding, and the right hand holds an empty fist and attacks the back of his left hand. He asks the patient about the feeling of being attacked and whether there is local pain. To speculate on the location and extent of lesions. If there is a percussion pain at the waist, it is mainly related to kidney disease, in addition to consideration of possible local bone diseases. Second, "referring to the sniping method": The doctor's left middle finger refers to the second knuckle (as the board finger) close to the body part of the body, and the right middle finger (as the hammer) slams the left middle finger and must be flexible when attacking. Short, flexible. Such as the determination of the heart of the patient, the boundary of the liver, the examination of the pathological changes of the lungs, and the like.
(III) Precautions for admission
1. The light source should be appropriate, and the side light is helpful for observing some changes in the diagnosis.
2. You must choose the appropriate posture and method according to the different parts of the disease.
3. Doctors should behave steadily and generously, be serious about their attitudes, be gentle and soft, and avoid sudden violence or cold hands.
4. Pay attention to the patient's active cooperation so that the patient can accurately reflect the feeling of the patient's position.
5. Be careful to observe the patient's expression changes while checking to understand the exact location and extent of the pain.
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