Second talk about the basic skills of traditional Chinese Medicine- please check your basic Chinese medicine with examplesLearning anything,
Second talk about the basic skills of traditional Chinese Medicine
- please check your basic Chinese medicine with examples
Learning anything, the key is to lay a good foundation, it is like building a house, the foundation did not play, to build a very high, it is very difficult to learn Chinese medicine is also the same.
What is the basic course of traditional Chinese medicine, we must think the problem I love to mention too simple, is not the "base", "patient", "prescription", "pharmacy", "internal medicine"?
First, out of two medical records to test you
Is this the door? I don't answer these questions. To really be so a few courses, then you really understand? Perhaps you will say who do not know, almost I will back, ha ha, I will talk about the treatment of a few patients, take an examination of your basic skills!
1 cases of axillary sweating disorder:
This case is to look at your basic theory of Chinese medicine in the end how to learn?
A male, 30 years old, left armpit sweat, remember that this is the only place small glass sweating, per hour (eight money) with a cup of sweat, in 1 years, very distressed, occasionally have include dry mouth, tongue ulcer, soretongue. As for the medicine before, what Yiqi Gubiao Ziyinqingre, liver qi stagnation, yin and Yang, regulating Ying and wei. Oh, a thick medical record.
This patient is when I do the students, following the famous doctor Song Yong (Ding Ganren Shanghai Wannan Medical Student Internship) witnessed, copying the medical record, at the time, Mr. Song looked at the patient's tongue (reddish tongue, thin yellow tongue coating, pulse). They held a party together, what, guess, I think most of the friends think!
What side? Daochishan! Surprise you, who said with hidrosis daochishan? Can the red lead powder have the function of stopping sweat? May not be recorded in such a book, but the result is that the patient side of the 5 agents, the time of the two examination is Khan stopped!
Can you figure out why the old gentleman of the Song Dynasty came out this way?
Understand that you can learn the basics of Chinese medicine!
Please think and then look down!!!
Some friends may have opened a daochishan very confused, the axillary hidrosis don't worry, we will analyze.
First, let us review what is the function of the heart in the theory of viscera? The main gods, blood, joy in emotions, sweat as the fluid, opens into the tongue, heart and small intestine......
Well, we go back to head to look at the main syndromes: dry mouth, with tongue ulcers, sore tongue, reddish tongue, thin yellow tongue coating, the main syndromes are manifested in the tongue, and we see that at the hot ah, firelight meridian red, the heart opens into the tongue, oh and this is not simple? Let me ask you, at the armpit sweating and what is the relationship? How can I use the red powder?
Let us look at the hand towards the small Yin Heart Sutra: "canon" is said: "the main vein of hand Shaoyin heart, from the heart, is the heart, the branch, from the heart on his throat, the Department of the target system, the straight from the heart, but the complex lung, under the armpit next, after the low er......" , hand to hand with the sun. Heart meridian in the armpit had a point called "spring", why is it called "spring"? This is a place where water is easy!
This patient strong firelight, followed by red tongue, the tongue is so rotten, burned the tongue, the fire is not enough, steaming heart liquid leakage, the fluid of the heart is sweat ah, where relief? Of course, from the first spring eyes leaked. Oh, so under the armpit sweat. Think about how hot springs come from? Oh, don't forget to think of analogy"!
Where there is a cure for evil, you have to give the evil way out, or sweat, or under, or spit, the heat you have to find a way to let him out, where to vent? The heart is connected with small intestine, use daochishan diuresis, the fire from the urine and discharge, the so-called fire down. Evil go, is also Anne, a year of disease medicine Liaosi Liao will be solved.
The use of simple, the theory is also simple, are some of the basic theory of Chinese medicine, right? It may be that you will be back, but did you use it in the analysis of the case? No use, although you will back, it can not count your basic skills.
2 - 2 Record Exam entry exam my tutor
The medical records of Chinese medicine, prescription to test your basic skills and clinical thinking!
When I was in graduate school, I really teaching clinic is an old professor (a professor with the Guizhi Houpu Xingzi Decoction). My tutor was busy with the administration, so he asked me to give it to him. The more than and 10 year old professor will follow doctors in Hunan -- his uncle to learn later into the College of traditional Chinese medicine to study 5 years later with the division of the late old Chinese national Zengmou by 5 years. Not only the theory, clinical level is high, is not a famous real masters! That you may not understand, said the old gentleman and a high level of clinical medicine, indifferent to fame and wealth, and never like to write! So although in the local very famous, but it is not the reputation in the country! But his patient is very much, it has often Difficult miscellaneous diseases!
The teacher has a strange temper. He is not interested in young people. Why? Poor! Now young people will learn so many years in the school of traditional Chinese medicine, "typhoid fever", "Golden Chamber" and other general as elective course of study, a smattering of knowledge, there are a few people can back a few? There are students! Five years have not back Siwu Decoction! That is to say, this can not blame him, we are not well grounded in Chinese class. It is not hard to understand me at his first suffered cold attitude.
I was in graduate school for almost a year, every time to see the teacher, I say: "teacher, I come". And he said, "Oh, you're here," and that's not the case. Then I said, "teacher, I'm gone," he said, "Oh, you're gone". Be neither hot nor cold, let you feel cold. To the second grade to my clinic, I find him, I said the teacher I want to sit with you zuozhen. He didn't give me a chance, but he gave me such a medical record:
He said that this case is a test of Chinese medicine, deputy director of the medical records of the problem, it is said that the country was well-known clinical experts Liu Bingfan professor. The following questions, minimalist, but accounted for a piece of paper with 70 points. At that time, there are nearly half of the reference to the case was reversed! Our courtyard 15 reference, more than half of the people did not pass!
A male, 3 years suffering from diabetes, in traditional Chinese medicine treatment is not effective, vomiting, a medical diagnosis, to "typhoid fever" Wuzhuyu Decoction in remission, B medical treatment to Wuzhuyu Decoction plus Sanleng and Ezhu, rhubarb, the number of flat card agent.
Question: 1 what is the pathogenesis of this case? How to form? 2 why a medical WZYD invalid B Medical Wuzhuyu decoction is effective? What is the function of 3 Sanleng and Ezhu, rhubarb in this case?
This case is slightly thought, it gives the teacher answer. He is not clear, only a gleam in the eyes is not easy to make people feel satisfied, the next is from the "Treatise on Febrile Diseases", "Golden Chamber", Jinyuan four everyone's academic thought, until the Ming and Qing Dynasties famous doctors down a road test. Finished, gave me a word, "no matter when you come".
The teacher charged me from the heart, the whole year, I get to his office every night, for I do all by the school!
Said a lot of the way, or come back to look at this case how to analysis? Don't worry about the answer. You have to think about it!
How specific analysis, I want to borrow one called "Wei Zi" netizens discuss (I love the Lilac Garden around, see Chinese and Western medical discussions to see more, say less, casual interest in, put this case out please see, there is the users answer. And there are many things to see, I hope the friends often go to see, very long horizontal! Figures in brackets is added by me).
"Although the former had diabetes, new onset with vomiting, vomiting syndrome, taking into account the pathological features of diabetes.
Diabetes, often discussed as a false theory. Virtual theory, and based on Yin deficiency (pathogenesis of diabetes is manifested as Yin scorching, heat syndrome). A medicine (so B medicine) by Wu Zhuyu (Wu Zhuyu, a treatise on the decoction of ginseng, ginger, jujube) investment. Patients have inverse, Yin Han (middle Jiao deficiency, turbid Yin on the inverse of the witness). Yin cold syndrome (middle Jiao deficiency) come from? Or with medicine (by diabetes Yin hot pathological characteristics of bondage, and had cast the white tiger, lady), rehmannia root generation, consumption in Jiao Yang gas.
Evodia, Wenzhong tonic, Jiangni vomiting, cold vomiting the rule of Yangming is very appropriate, a medical is invalid? Non cold cold is too heavy, and its evil stasis, caused by retention in middle jiao. This so-called evil, or for food, or for stasis, or both three. The spleen and stomach deficiency, lost in the warm cold food transport, each node is expected. Or who says: Sanleng Ezhu, rhubarb is feasible in blood, it is blood stasis or evil. Yes, diabetes long, Yin Yin is inevitable, less blood, blood gas and no load loss. This theory also makes sense.
But I personally prefer cold phlegm. In the triangular broken blood, and feasible zedoary gas, rhubarb laxative, and all three Xiaoshi of the plot of power. If it is to promote blood circulation, with wine rhubarb is not more appropriate? If diarrhea mainly, rhubarb is the first choice. This system is visible with the rhubarb laxative digestion. The combination of the three, promote digestion of visible".
I was given the answer is: the pathogenesis of diabetes is Yin hot, cold medicine to take medicine before, then induced in Yang is not digesting food, so that food product, resistance to coke, stomach shangni. It has a medical WZYD deficiency cold in middle Jiao and pathogenesis, but failed to eliminate stagnation, resistance to product, then the stomach can decrease the vomiting. B plus medicine Sanleng and Ezhu, rhubarb were negative, and rhubarb can stagnation, so specimens surface treatment, disease to more thoughtful!
In fact, these second medical records in the test of the basic skills of Chinese medicine, what the test, test your prescription, the basic skills of traditional Chinese medicine!
Why refer to more than half of the people can not pass, what is the basic skills are not solid, why not see the disease? This is a test! People are not half of the subtropical high pass, which you dare easily say based Chinese learning?
Two, how to learn the basic skills of traditional Chinese medicine!
The above two cases do good, please try to read the "guide to clinical practice", if you don't feel it difficult to read, it is the basic function of traditional Chinese medicine you even solid, then as long as you can adhere to the practice, you will have good luck!
How to learn the basic functions of traditional Chinese medicine?
Here's what I think:
1 to master the basic skills of traditional Chinese medicine the first secret - back pain
Familiar with the five basic courses, to achieve chaos cooked in the chest, which of the five basic courses? Is that "base", "patient", "prescription", "pharmacy", "internal medicine", to what extent? Say so, the "base" casually point out, you can be very correct, complete expression, such as the concept of Wei Qi, Wei Qi, generation, features, functions, the same can not forget. "The patient" is the same, say a symptom, you should be able to speak without thinking of the etiology and pathology of common. "Traditional Chinese medicine" you put the taste of the classics, the effect of firmly remember. Medicine casually talk about what you're familiar like disease, syndrome type, common name medicine etc..
Five basic courses to master, can not say that your basic skills on the line, and the "Treatise on Febrile Diseases", "Golden Chamber", "warm" and "cold" and "heat disease", "knowledge", "Hunan Tangtou gejue frequency is", "Fu" of pearl sac resistance etc.. You must be back, only have five basic courses, you can only say that the treatment of miscellaneous diseases have an understanding of how to treat disease, epidemic febrile disease, less the same, you can not do the traditional Chinese medicine.
Back, for the study of Chinese medicine is a very painful thing, but when you back, it is stored in the brain of a large amount of information, to the time of use, perhaps an inspiration to the problem solved.
I say an example, please look at the importance of recitation.
3 cases of special type of Hu Zheng -- who
When I was working in the countryside, I worked in a township hospital. For a time, every afternoon I saw a more than 50 year old farmer holding the quilt to infusion, back and forth, there are 20 Yu Tian.
That afternoon he is not attending the doctor, I am on duty, the patient to open the infusion, I asked, how old to see you every day to play a bit, how? The farmer told me, fever more than and 20 days, has not been fever. I asked how fever ah, he said, every night fever, morning fever. I thought, this is the most typical early night hot cold fever due to yin deficiency symptoms, with this impression also ignored First impressions are strongest, and evidence of interrogation (doctor Zuiji, casually asked First impressions are strongest) asked, he said, you this disease eat three Chinese will be good, do not believe you try! When the doctor is not a long time, the lack of experience. Oh, the patient said that ah, you gave me a watch, I want to thank you! What, Qinghao Biejia soup, effective? If it works, I don't talk to anyone. I blew it up!
Three days later, the patient came and said only one sentence: "doctor, I did not burn back, you have no use, I also sold a load of rice!"
I almost didn't find a hole in the ground!
But I can't do it, since I'm bragging, how do I have to hold on, where to fall and get up?!
So I find the face, I said you are ill for more than and 20 days, "early loss, I pay the 3 medicine, is the first to supplement your righteousness, righteousness enough I can give you Quxie treatment, or you can bear? In fact, it is not allowed!
In the face of the patient, was angry, what exogenous fever, all internal injuries fever syndrome type I have in mind. It is not like that, the patient's pulse, a serious pulse appearance, is in the hand? Is pondering countermeasures!
The patient was sitting in front of me, very silent, very few words, I did not say he would never say a word. "Silent!", a sudden inspiration came up, and the "Treatise on the" provisions immediately come to mind, "typhoid fever five or six days, stroke, chills and fever, chest pain Association full, silent and do not want to upset the diet, vomiting, or chest trouble without vomiting, or thirsty, or belly pain, or by, or heart palpitations, urination......" Shaoyang, "as the disease, mouth pain, dry throat, dizziness also".
How about dinner? Answer: do not want to eat. Bitter? Answer: mouth. Dry? Answer: dry throat!
Xiaocaihu card! A special type of fever, chills and fever! Of course, the result is 2 agent heat evil as retreat!
Back, is absolutely not less for learning Chinese people! In our teaching we found that some of the students are familiar with some of the important ancient books back, but not because of acupuncture, the meridian line didn't remember, this is very adverse to the clinical, if a disease in a section, you can't the method of syndrome differentiation, local syndrome differentiation meridian lesions not only need, but also consider to go through in the formula, in the hope that we can work under! After the lecture I talks to specific cases!
2 to master the basic skills of Chinese medicine: second tips to think
Back, you still think more, in college teaching for many years, I found a lot of students in the learning process, the lack of habit of thinking, back down things, you do not think, it is difficult to really digest and absorb!
In our basic theory of traditional Chinese medicine, there is a word called "the liver rises in the left, the lung falls to the right", why is not the liver rises in the right, the lung is left, some people thought this sentence is how come? Can anyone answer? (question 1)
For example, in front of the second cases, two were used Sanleng and Ezhu, Qi blood effect, this is the most commonly used clinical. But, on the other hand, they have the same digestion of product function, you thought not, use the two drugs at what time? We are in the clinical use of digestion, such as hawthorn, chicken the divine comedy. Why did the above doctor use these two flavors?
I have a year to the first private university of Chinese medicine, the national compulsory lectures for half a month (nine Yi mountain University, like the famous professor Zhu Liangchun have this obligation to the school lectures, visible TCM cause attention!), in teaching me about the treatment of dyspepsia, I said with spit first class. The second lesson in my example I spoke with diarrhea. So some students asked me, teacher, this law, while you indigestion while talking with the reducing method, while that in the end of the spit, with what method cure?
The students I can say his basic skills are not good, but he can make such a problem, he diligent in thinking, he will slowly deep understanding of traditional Chinese medicine.
Why is there a three law, I do not explain here, please love to answer.
Two why will appear dyspepsia treatment, vomiting, three kinds of anti in? In the pathogenesis of the three method corresponding to the pathogenesis of disease due to indigestion. What is the difference between the position? What are some of the typical clinical manifestations?
3 to master the basic skills of Chinese medicine practice -- the first secret
Familiar with Wang Shuhe, rather than clinical! After learning the basic theory of your actual practice, how to do? Some students said that we rarely see Chinese medicine, rarely in clinical use of Chinese medicine. There are two kinds of training, one is combined with the specific circumstances of the patient, the specific case of exercise prescription, through the actual clinical curative effect, determine the basic theory that you use the correct! This is the most effective method is the most direct.
Second kinds of methods, there is not much you Chinese patients, of remedial method, a large number of ancient and modern medical records reading. Some students said, I have seen a lot of medical records, but my clinical level is not high. I would like to ask you, how do you read?
Read the medical records, first you carefully read the case, then according to their medical records of prescription information, and then the author compared to see if the same. Why do you not agree? In the same way, why the author will add and subtract the original side, why should choose the side of the few drugs, the reason for the addition and subtraction?
Read read reviews of the best medical records.
I asked my students to see the medical records, and then tell me what is learned? The students like reading novels as a case of several night watching, you can learn what he said? I tell you that I am! Records from the pillow, but sometimes spend an hour, a case can not end, why, to think, do not know you have to check the information, or look at the white also see!
There are starting to see more Chinese medicine medicine, medicine it looks better than general case of fast, why, because the outcome of medical knowledge of treatment, many diseases are analyzed in detail. The main points and treatment on the disease medication are key points, it is much easier to learn. Most can enlighten people's thinking. Like "doctor in Qing Dynasty is the essence of medical words" is worth learning a book, of course, there are many others.
From the book, to clinical practice, you will increase a lot of confidence.
To be a good medicine, not a lot of case study, it is difficult to practice.
Recommended reading medical records:
"The doctors medical case class series" Liu "selected four case" "medical case" "yuyicao" Xing Xuan case "case" "Wang Mengying case", "Wu Jutong case" "vegetarian" latent medical words "Huang Wendong case" "case" "Zhang CiGong Pu Fuzhou case" "Yue" "the beauty of traditional Chinese medicine case card guide case" and so on.
I also recommend a book called "smelt like case", this book is a teacher of my writing, and the general case is different, in volume six records a lot of failure or mistreatment of the case, very enlightening.
4 to master the basic skills of Chinese medicine, to reflect on the fourth tips
Another way to improve the basic skills of traditional Chinese medicine is to reflect on, many people work in the clinical years, but you can see his prescription, you can see that his theory is still very poor, learned so many years, so many years of practice, why is the basic skill bar is not good, the key point is the lack of. Reflection! Can deepen the understanding of the basic theory of traditional Chinese medicine in practice.
A disease finished, your tracking effect, the effect is not good, why not good, out of the wrong, wrong? Write down what you think. Write more clinical notes, the writing process is the process of further study.
Some people see a lifetime disease, is not progress, why? No effect, no further exploration. Effective do not summarize, this is not good.
Reflection, writing, which deepen the understanding of the basic theory of traditional Chinese medicine is of great significance, I give you a look at my notes. Take a look at whether you can learn something in the failed case, whether there is a deeper understanding of the role of traditional Chinese medicine "plaster"!
The road less set of medical words (excerpt) - misuse of gypsum, and forget the message
"Shen Nong's herbal classic" sweet cold cream marble. But after the Ming and Qing Dynasties, part of the medicine through clinical practice, think big heat gypsum agent does not take effect, light weight is 42, half a catty (82), the late Qing Dynasty physician Zhang Xichun in "medical sincerely participate in the West recorded" clearly pointed out that gypsum Ganwei cold products. It has been debated, and learning Chinese medicine the author is cure failure from unable to agree on which is right, a clinical case of a talk of personal taste of gypsum, perhaps to understand the taste of gypsum has benefit.
Yu Cengzhi a certain patient, suffering from pulmonary heart disease, 3 heart failure, wheezing, shortness of breath, sit not supine, palpitations, body dropsy, and a large amount of pleural effusion by western medicine, anti-inflammatory, cardiac, diuretic, vasodilator (continuous intravenous infusion of sodium nitroprusside was more than a month can not ease). After the case with large dose of Shenfu Decoction added salvia, astragalus, Tinglizi, Plantago, ten day retreat treatment taste all the symptoms were flat. When patients take cold wind hot, corruption, and then by the evil wind disease, fever, wheezing, cough, sputum white matter sticky, thirsty Si Yin, red tongue, yellow moss, pulse floating number. To Ge Gen, bupleurum, windproof, mint, Peucedanum, almond, licorice, Platycodon spicy cool solution table, eliminating phlegm and relieving cough. Two party service agent, in addition beneficial very aversion to cold, fever, dry mouth, cold drink and drink less, difficult to spit, thick yellow sputum, red tongue with yellow coating, slippery pulse number. This is the card table has the solution, lung heat dampness, clear solution to lung heat with bitter cold, considered the bitter cold injury Yang Yang, there are disadvantages, so instead of sweet and cold zhuyeshigao decoction. With the plaster Ganwei cold clearing lung heat, cold and sweet nourishing Yin root, pinellia Huatan gypsum, the producer of Ophiopogon acrid, although the phlegm heat can also be used, leaves sweet light light texture clear heat out, rice, licorice care of turkey. The admission prescription of symptomatic, unexpectedly a fever, and two stool diarrhea, wheezing, shortness of breath, breath gradually small, cold limbs, weak pulse. Although after the combination of traditional Chinese and Western medicine treatment will not turn the tide, Yang died in decline.
In the case of abrupt change, rather than confused. Then ask from the teacher, teacher after treatment with smell after repeated attacks of the cloud: in patients with heart failure, the repeated use of Shenfu and ills, heart and kidney yang momentum micro ten clear, you should now use the heat and chill plaster injury Yang deficiency, principal offender ""