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5.5 Inquiring of ears and eyes课程教案、知识点、字幕

同学们好

我们继续来学习中医问诊之问耳目

我们知道 耳目为人体的感觉器官

他们都与内脏

经络有密切的联系

首先 我们来学习第一个问耳

中医认为 耳为宗脉之所聚

其中 足少阳胆经 支脉入耳

手少阳三焦经

支脉也入耳

足阳明胃经 上耳前

足太阳膀胱经

从顶巅至耳上

而六阴经 通过经别与阳经相合在耳上

同时 耳为肾之窍

所以

问耳不仅能够了解耳的局部病变

还可以了解肝胆

肾等有关脏腑的病变

一般来讲 耳病的实证 (病位)多在肝胆

而耳病的虚证(病位)通常是在肾

现在我们来介绍一下

耳病的症状 以及问诊的要点

常见耳病的症状 有耳鸣 耳聋

重听 耳胀 耳闭等等

问耳的时候 要注意问耳病的

特点 新久程度以及耳病的兼症

首先我们来学习

临床上非常常见的耳鸣耳聋的症状

耳鸣

是指 病人自觉耳内鸣响

如闻蝉鸣

或如潮声 妨碍听觉的症状

而耳聋是指

听力减退

甚至听觉完全丧失的症状

耳鸣 耳聋既可以单发

也可以双侧发作

或同时出现

又或者是先后发生

如果突然耳鸣

声大如蛙鸣 或如潮声

按之鸣声不减

或者是突发暴聋

这属于实证

通常与肝胆火旺 上扰清窍

痰火郁结 气血瘀阻

风邪上扰 或者是药毒损伤等等有关系

如果渐渐地出现耳鸣

声音细小

如闻蝉鸣 按之鸣声减轻

或者是暂止

或耳渐聋这是属于虚证的表现

通常与肾精亏损

耳失所养 脾气亏虚 清阳不升

肝肾阴虚 肝阳上亢的病变有关系

重听 是指病人自觉听力减退

听音不清 声音重复的症状

如果重听突然发作

这是痰浊上蒙 风邪上扰耳窍的实证的表现

如果渐渐地出现重听

这是肾精亏损 耳窍失荣的虚证的表现

耳胀 耳闭的特点 分别为

耳胀 是自觉耳内胀闷不适的症状

耳闭 是耳内胀闭 且有堵塞感

听力减退的症状

耳胀 耳闭都是由于风邪侵扰 经气痞塞

痰湿蕴结 邪毒滞留 气血瘀阻所导致的

好了

介绍完了问耳这一个内容 下面 我们来学习一下问目部分

目是肝的开窍

五脏六腑之精气 皆上注于目为之精

所以问目 不仅可以了解目的局部病变

还可以了解肝及其他脏腑的病变情况

常见目的症状有目痒 目痛

目眩 目昏 雀盲 歧视等

问目病时 应该注意问目病的特点 新久 程度

以及兼症的变化

首先我们谈一下目痒

目痒 是指病人自觉眼睑 眦内

或目珠有痒感

轻者轻揉则止 重者极痒难耐

目痒严重 伴有畏光流泪 灼热感

通常是属于肝经风火上扰所引起的实证表现

而目微微地痒而势缓

通常是属于肝血虚 目失濡养的虚证的表现

目痛 是指病人单眼或双眼疼痛的症状

可见于许多眼科的疾病

病因复杂

一般来讲 目痛剧烈者 属于实证

通常与肝火上炎 肝经风火上扰有关

目痛微者

通常是属于虚证 与阴虚火旺病有关

目眩又称为眼花 是指病人自觉视物旋晕动荡

如坐舟车 或眼前有蚊蝇飞动的症状

如果目眩兼有面赤 头胀 头痛 头重的症状

通常是风火 痰浊上扰清窍引起的实证病变

而如果目眩兼有神疲 气短 头晕 耳鸣

通常是属于脾虚或者肝肾亏虚等虚证所引起的病症

最后我们讲讲目昏 雀盲 歧视

目昏 是指视物昏暗不明 模糊不清

雀盲 又称为夜盲 雀目和鸡盲

它是指白天视力正常

而黄昏和夜晚的时候则视力不清

歧视 是指的视物重影

视一物成二物而不清

无论是目昏 雀盲 还是歧视

均为肝肾亏虚 精血不足 目失所养所导致的

常见于老年 体弱或久病之人

以上是问耳目的内容

本节课就上到这里

Diagnostics in Chinese Medicine课程列表:

Week 1 Introduction

-Introductory remark

--Introductory remark

--QQ groups、WeChat public account

-Introduction

--Introduction

--【Discussion 1】Why do you want to take this course?

-Unit test for Introduction

Week 1 Basic Theory of Chinese Medicine 1:Yin-Yang and Five Elements Theory

-1.1 Yin-yang theory

--1.1 Yin-yang theory

-1.2 The theory of five elements

--1.2.1 The theory of five elements

--1.2.2 Application of the theory of five elements

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 1

Week 2 Basic Theory of Chinese Medicine 2:Zang-Fu Theory

-2.0 Outline

--2.0 Outline

--【Discussion 2】How to understand the holistic view centered on the Zang Fu theory?

-2.1 Liver

--2.1 Liver

--【Discussion 3】Why is repose more important than vigorous exercise in recuperation for patients with

-2.2 Heart

--2.2 Heart

-2.3 Spleen

--2.3 Spleen

-2.4 Lung

--2.4 Lung

-2.5 Kidney

--2.5 Kidney

-2.6 Six fu organs

--2.6 Six fu organs

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 2

Week 3 Basic Theory of Chinese Medicine 3:Qi,Blood and Body Fluid Theory

-3.1 Qi

--3.1 Qi

-3.2 Blood

--3.2 Blood

-3.3 Body fluid

--3.3 Body fluid

-3.4 The relationship of qi, blood and body fluid

--3.4 The relationship of qi, blood and body fluid

--【Discussion 4】A discussion about the theory of qi, blood and body fluid

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 3

Week 4 Basic Theory of Chinese Medicine 4: The theory of etiologic factor

-4.0 Outline

--4.0 Outline

-4.1 Six exogenous factors

--4.1.1 Six exogenous factors

--4.1.2 Nature and pathogenicity of wind and cold

--4.1.3 Nature and pathogenicity of summer heat and damp

--4.1.4 Nature and pathogenicity of dryness and fire

-4.2 Etiology of visceral impairment

--4.2 Etiology of visceral impairment

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 4

Week 5 Diagnosis methods: Inquiry (1)

-5.0 Outline of inquiry

--5.0.1 Outline of inquiry(1)

--5.0.2 Outline of inquiry(2)

--【Discussion 5】If you were a patient, how would you describe your condition to your doctor first?

-5.1 Inquiry of Chills and fever

--5.1.1 Chills and fever(Aversion to cold with fever)

--5.1.2 Chills and fever(Chills without fever)

--5.1.3 Chills and fever(Fever without chills)

--5.1.4 Chills and fever(Alternative chills and fever)

--【Discussion 6】How to understand "if you have clinical manifestations of cold, that is exterior syndr

-5.2 Inquiry of perspiration

--5.2 Inquiry of perspiration

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 5

Week 6 Diagnosis methods: Inquiry (2)

-5.3 Inquiring of pain

--5.3 Inquiring of pain

--【Discussion 7】How to understand "stagnation leading to pain and innourish leading to pain"?

-5.4 Inquiring of head, body, thorax and abdomen

--5.4 Inquiring of head, body, thorax and abdomen

-5.5 Inquiring of ears and eyes

--5.5 Inquiring of ears and eyes

-5.6 Inquiring of sleep

--5.6 Inquiring of sleep

-5.7 Inquiring of food and drink, appetite and taste

--5.7 Inquiring of food and drink, appetite and taste

-5.8 Inquiring of defecation and urination

--5.8.1 Inquiring of defecation

--5.8.2 Inquiring of urination

-5.9 Inquiring of infantile and women's disease

--5.9 Inquiring of infantile and women's disease

-Unit test for week 6

Week 7 Diagnosis methods: Observation (1)

-6.0 Outline of Observation

--6.0 Outline of Observation

--【Discussion 8】Please use the whole body inspection (including the expression, complexion and figure)

-6.1.1 Observation of vitality

--6.1.1 Observation of vitality

-6.1.2 Observation of the color

--6.1.2.1 The content, principles of inspection of the color

--6.1.2.2 Indication of diseases by five colors

--【Discussion 9】How do you understand the normal complexion of a normal people?

-6.1.3 Observation of the appearance

--6.1.3 Observation of the appearance

-6.1.4 Observation of figure and posture

--6.1.4 Observation of figure and posture

-Unit test for week 7

Week 8 Diagnosis methods: Observation (2)

-6.2.1 Observation of head and face

--6.2.1 Observation of head and face

-6.2.2 Observation of five sensory organs

--6.2.2.1Observation of five sensory organs(observation of eyes,ears,nose)

--6.2.2.2Observation of five sensory organs(observation of lips,teeth and gums,throat)

-6.2.3 Observation of body

--6.2.3 Observation of body

-6.2.4 Observation of limbs

--6.2.4 Observation of limbs

-6.2.5 Observation of two lower orifices

--6.2.5 Observation of two lower orifices

-6.2.6 Observation of skin

--6.2.6 Observation of skin

-6.3 Observation of excreta

--6.3 Observation of excreta

-6.4 Observation of infantile fingerprints

--6.4 Observation of infantile fingerprints

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 8

Week 9 Diagnosis methods: Inspection of tongue

-7.1 Outline of tongue inspection

--7.1.1 The morphology and structure of the tongue

--7.1.2 The principle of tongue examination

--7.1.3 The method and precaution of tongue examination

--7.1.4 The content of tongue examination, normal tongue

-7.2 Inspection of tongue structure

--7.2.1 Observe the color of tongue

--7.2.2 Observe the shape of tongue

--7.2.3 Observe the states of tongue

--7.2.4 Observation of sublingual vein

-7.3 Observation of tongue coating

--7.3.1 Observation of coating texture

--7.3.2 Observe the color of coating

-7.4 Clinical significance of tongue diagnosis

--7.4 Clinical significance of tongue diagnosis

--【Discussion 10】Why to observe the tongue can be used to diagnose disease?

-Unit test for week 9

Week 10 Diagnosis methods::Pulse examination

-8.1 The principle of pulse examination

--8.1 The principle of pulse examination

-8.2 The regions and methods of pulse examination

--8.2 The regions and methods of pulse examination

-8.3 The elements of pulse examination and the normal pulse

--8.3 The elements of pulse examination and the normal pulse

-8.4 Characteristics and significance of pulse

--8.4.1 Superficial pulse, deep pulse, slow pulse, rapid pulse

--8.4.2 Surging pulse, thin pulse, long pulse, short pulse

--8.4.3 Feeble pulse, forceful pulse, slippery pulse, uneven

--8.4.4 Taut pulse, tense pulse,soggy pulse, moderate pulse

--8.4.5 Knotted, slow-regular-intermittent, irregularly abrupt

-8.5 Similar pulse, concurrent pulse, pulse indicating deterioration of visceral qi۞

--8.5 Similar pulse, concurrent pulse, pulse indicating deterioration of visceral qi۞

--【Discussion 11】Why is complex pulse more common than single-factor pulse?

-8.6 Women’s pulse, children’s pulse

--8.6 Women’s pulse, children’s pulse

-8.7 The clinical significance of pulse diagnosis

--8.7 The clinical significance of pulse diagnosis

-Unit test for week 10

Week 11 Diagnosis methods:Listening and smelling examination

-9.1 Listening

--9.1 Listening

-9.2.1 Abnormal sound

--9.2.1 Abnormal sound

-9.2.2 Abnormal language

--9.2.2 Abnormal language

-9.2.3 Respiratory abnormality

--9.2.3 Respiratory abnormality

-9.2.4 Cough

--9.2.4 Cough

--【Discussion 12】How to observe the patient's cough sound and sputum changes to determine whether the

-9.2.5 Abnormal sounds of the stomach and intestines

--9.2.5 Abnormal sounds of the stomach and intestines

-9.3 Smelling

--9.3 Smelling

--【Discussion 13】How to diagnose by smelling?

-Unit test for week 11

Week 12 Diagnosis methods:Palpation

-10.1 The method, meaning and precautions of palpation

--10.1 The method, meaning and precautions of palpation

-10.2 Contents of palpation

--10.2.1 Palpating chest and hypochondrium

--10.2.2 Palpating stomach and abdomen

--10.2.3 Palpating skin

--10.2.4 Palpating hands and feet, palpating acupoints

--【Discussion 14】How to determine whether external or internal injuries?

-Unit test for week 12

Conclusion

-Conclusion

--Conclusion

Final Exam

-Final Exam

--Final Exam

5.5 Inquiring of ears and eyes笔记与讨论

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