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同学们好
下面我们来学习局部望诊之望四肢诊病
由于人体五体合五脏
比如 心主四肢血脉
肺主四肢皮毛 脾主肌肉四肢
肝主四肢筋膜 肾主四肢之骨
所以五脏均与四肢有关
而脾与四肢的关系尤为密切
四肢有手足三阴三阳经络循行
故四肢与经络关系也很密切
因此 望四肢可诊察五脏病变
和循行于四肢的经脉病变
望四肢 主要望手足 手掌和手腕
手指和脚趾的形态变化
以及动态异常等等
首先 我们来看看四肢形态的异常变化
当肌肉萎缩时 通常见于气血亏虚
或经脉闭阻 肢体失养的病人
当四肢肿胀 通常见于水肿病病人
下肢青筋暴露
见于寒湿内停 络脉瘀阻的病人
膝盖肿大 又称为鹤膝风
通常见于风寒湿痹或风湿热痹的病人
手指变形 成梭状指
通常见于痰瘀互结的风湿病病人
手指变形 为杵状指
就是手指端膨大
通常见于心肺气虚 血瘀痰阻的病人
而下肢畸形
比如 O型腿 X型腿 足内翻或足外翻等
这些下肢畸形的病人
通常都会见于先天不足 肾气不充
或后天失养 发育不良的佝偻病病人
下面我们看看四肢动态的异常
其中肢体痿废 是指
肢体肌肉萎缩 筋脉迟缓 痿废不用
多见于痿病
常因精津亏虚 或 湿热浸淫
筋脉失养所导致的一种病证
若一侧上下肢体痿废不用 称为半身不遂
多见于中风病病人
多因风痰阻闭经络所致
若双下肢痿废不用 见于截瘫的病人
多因腰脊外伤 或瘀血阻络所致
四肢抽搐 是指四肢筋脉拘急与弛张间做
舒缩交替 动作有力
多因为肝风内动 筋脉拘急所导致的病证
手足拘急 是指手足肌肉挛急不舒
屈伸不利 多因寒邪凝滞
或气血亏虚 经脉失养所导致的病证
手足颤动 是指双手或下肢颤动
或振摇不定 不能自主
多由血虚 筋脉失养
或饮酒过度所致
也可为肝风内动的先兆
手足蠕动 是指手足时时掣动 动作迟缓无力
类似虫之蠕行
多为脾胃气虚 筋脉失养
或阴虚动风的病人
循衣摸床 撮空理线
是指重病神昏的病人
不自主地伸手抚摸衣被 床沿
或伸手向空 手指时分时合
状似穿针引线
这是重病失神之象
以上是望四肢诊病的内容
本节课就上到这里
-Introductory remark
--QQ groups、WeChat public account
-Introduction
--【Discussion 1】Why do you want to take this course?
-Unit test for Introduction
-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
-Unit test for week 1
-2.0 Outline
--【Discussion 2】How to understand the holistic view centered on the Zang Fu theory?
-2.1 Liver
--【Discussion 3】Why is repose more important than vigorous exercise in recuperation for patients with
-2.2 Heart
-2.3 Spleen
-2.4 Lung
--2.4 Lung
-2.5 Kidney
-2.6 Six fu organs
-Frequently Asked Questions
-Unit test for week 2
-3.1 Qi
--3.1 Qi
-3.2 Blood
-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
-Unit test for week 3
-4.0 Outline
-4.1 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
-Unit test for week 4
-5.0 Outline of inquiry
--【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
-Frequently Asked Questions
-Unit test for week 5
-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
-5.7 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
-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
-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
-6.2.4 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
-6.3 Observation of excreta
-6.4 Observation of infantile fingerprints
--6.4 Observation of infantile fingerprints
-Frequently Asked Questions
-Unit test for week 8
-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
-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
-9.1 Listening
-9.2.1 Abnormal sound
-9.2.2 Abnormal language
-9.2.3 Respiratory abnormality
--9.2.3 Respiratory abnormality
-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
--【Discussion 13】How to diagnose by smelling?
-Unit test for week 11
-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
--10.2.4 Palpating hands and feet, palpating acupoints
--【Discussion 14】How to determine whether external or internal injuries?
-Unit test for week 12
-Conclusion
-Final Exam
--Final Exam

