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7.1.1 The morphology and structure of the tongue课程教案、知识点、字幕

同学们好

今天我们来学习中医舌诊

舌诊是观察病人的舌质和舌苔的变化

也就是观察病人的舌象

来诊察病情的方法

舌诊是中医望诊的重要组成部分

是极具有中医特色的诊断方法之一

因此舌诊我们单独列为一章来学习

舌诊主要是观察病人的舌质和舌苔的变化

舌质和舌苔 我们称为舌象

舌质和舌苔又是什么呢

舌质 我们可以理解为舌的肌肉组织

舌苔 就是舌肌上覆盖的一层半透明的黏膜

首先我们要了解一下

舌头的形态与结构

舌头是一个肌性器官

由黏膜和舌肌组成

舌具有辨别滋味 调节声音

搅拌食物 协助吞咽的作用

舌头的上面叫舌背

中医称为舌面 下面称为舌底

舌背又分为舌体和舌根两部分

舌体和舌根之间有一条人字界沟

伸舌时一般只能看到舌体

所以中医诊舌的部位

主要是舌体

舌体的前端称为舌尖

舌体的中部称为舌中

舌体的后部

人字界沟之前 称为舌根

舌体两侧称为舌边

舌体的正中有一条不很明显的纵行皱褶 称为舌正中沟

舌上卷时 可见到舌底

舌面上覆盖着一层半透明的黏膜

舌背的黏膜粗糙 形成许多突起 称为舌乳头

根据舌乳头形状的不同 舌乳头分为四种

有丝状乳头 菌状乳头

叶状乳头 轮廓乳头

轮廓乳头 一般为七到九个

排列在人字沟前方

叶状乳头位于舌侧缘

叶状乳头 轮廓乳头 都含有味蕾

因此主要与味觉有关

由于这两种乳头在舌根部

伸舌时不容易见到

舌象主要与丝状乳头 菌状乳头有着密切的联系

我们来看这张显微镜下的舌乳头图

丝状乳头 数量最多 遍布舌背

乳头呈圆锥形 尖端略向咽部倾斜

它的复层扁平上皮细胞角化脱落

再混以食物残渣 唾液和细菌等等

使舌黏膜表面覆盖一层白色的薄苔

称为舌苔

舌苔常随着健康的变化而发生改变

菌状乳头 数量最少

多位于舌尖与舌缘

散在于丝状乳头之间

(菌状)乳头呈蘑菇状

上皮不角化 内有味蕾

富含血管 呈红色

菌状乳头的形态和色泽改变

是观察舌质变化的主要因素

舌苔是由上皮细胞的脱落

食物残渣 唾液 和细菌

堆积在舌面丝状乳头上而形成的

这些堆积物看似是无用的

相信很多人都曾经试图想刷掉这层堆积物

但是 这层堆积物能够刷掉吗

答案是 这层看似无用的堆积物 也就是舌苔

是刷不掉的

为什么会这样呢

中医认为

舌苔是胃气熏蒸所形成的 是刷不掉的

有舌苔 就等于有胃气

胃气 我们前面讲过 就是脾胃功能

也就是脾胃运化吸收的功能

当胃气充足 脾胃功能正常

气血津液就能够充足

气是属阳

血和津液属阴

气血 津液 阴阳 中医又称为正气

因此舌苔刷不掉 表明有胃气 正气充足

正气充足的人

要么就没有病

要么 即使有病 病也是比较轻的

预后比较好

这也就是我们常说的一句话

有胃气则生 无胃气则死

下面我们来看看这两个舌苔

一个图是有舌苔

另外一个图是无舌苔

有舌苔的图可以看到舌乳头

存在舌乳头说明 有舌苔

这个图是 薄白苔

表明有胃气 正气是充足的

另外一张 没有舌苔

也没看见凸起的舌乳头

舌乳头是萎缩的

这是不可能形成舌苔的

这种无苔的舌象

表明胃气匮乏 正气大亏

这节课我们就讲到这里

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

7.1.1 The morphology and structure of the tongue笔记与讨论

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