Director Yao Hongyin shares: Chinese medicine consultation is a major discipline

What is a consultation? Consultation is to know the patient’s daily habits, status, and the specific cause of the disease, as well as the past medical history and whether the disease runs in the family for some conditions. Many people think that consultation is simply asking the patient questions, but in fact, there are certain procedures. Zhang Jingyue, a famous medical doctor in the Ming Dynasty, wrote a ten-question song: “One question is about cold and heat, two about sweat, three about head and body, four about stool, five about diet and six about chest, seven about deafness and eight about thirst, and nine about old diseases and ten about causes. The ten questions include the identification of external and internal injuries, so how to explain the specific? First, ask the hot and cold: there are hot and cold mostly for the surface, external evidence, without hot and cold mostly for the internal evidence, miscellaneous evidence of internal injuries; fever and vicious chills for the disease in Yang, without heat and vicious chills for the disease in Yin. In addition, fever and vicious chills with head and body pain are Sun diseases; fever without vicious chills and thirst are Yang Ming diseases; fever and chills with bitter mouth, dry throat and dizziness are Shaoyang diseases. There is also no fever, but vicious cold, hands and feet often cold for the deficiency of cold evidence; hot flashes or a baking hot, burning heart of the hands and feet for the deficiency of heat evidence. Second, ask sweat: sweat and heat and cold have a great connection, there is an external fever without sweat is typhoid, there is sweat is typhoid, sweat out of the heat is gradually declining, sweat after the heat increases is the gradual entry of evil. The deficiency evidence of Yin deficiency night sweat, feeling tired after sweating; Yang deficiency spontaneous sweating, feeling cold after sweating. There are also sweating and shivering, sweating similar to deficiency and lying down with a quiet pulse, called war sweating, which is a sign of disease turnaround, so there is no need to be alarmed. Third, ask the head: headache with endless, cold and heat is mostly external sensation, headache belongs to the Sun, forehead pain belongs to Yangming, pain on both sides belongs to Shaoyang, and pain on the top of the head belongs to Zheyin. Those with intermittent pain and dizziness and heavy swelling are mostly internal injuries. Those with pain and swelling and heat are liver fire; those with dizziness and photophobia are liver yang; those with severe pain and blue face are liver cold; those with heavy dizziness and ringing head are brain deficiency. Phlegm-damp internal obstruction and failure to raise clear yang can also cause dizziness, but mostly with greasy tongue and nausea. Ask the body: aches and pains all over the body, with symptoms of external sensation, sweating that is reduced, not with cold and heat, pain in the joints, or travel to the limbs, for wind-cold damp paralysis, often related to the climate; numbness in the hands and feet, or a numbness in the body for the Qi deficiency; only the big finger or index finger feel numb, extending to the elbow and arm for the precursor of stroke. Asking about metabolism: those who can eat when the stool is closed are Yang knots, those who cannot eat are Yin knots; those who are full of abdominal distension and pain are real, those who are not full are deficient; those who are sick for a long time or the elderly or women in labor often have difficulty in passing stool are dry with blood and fluid; those who are dry first and then tantalized are deficient in middle energy; those who often have thin stool are deficient in spleen. Clear urine is cold, yellow and red is hot, cloudy and unpleasant is damp heat. Fifth, ask the diet: the stomach is the main receiver, the spleen is the main digester. The stomach is strong when it can eat easily, the spleen is weak when it is difficult to consume, the stomach is hot when it likes to eat cold, the stomach is cold when it likes to eat warm, and the stomach is hot when it eats. Eating in and vomiting at night is cold. Mouth bitter for the liver and gallbladder fire, mouth sweet for the spleen damp heat, mouth acid for the liver and stomach disharmony, mouth salty for the kidney deficiency water flood. Mouth light more clear water for the stomach cold. Sixth, ask the chest: chest tightness is mostly qi stagnation; chest full of pain for the knotted chest; no pain and swelling even under the heart for gangrene; chest pain through the back, back pain through the heart, for chest paralysis. Ask the chest symptoms must be linked to the two hypochondrium, such as hypochondriac pain belongs to the stomach, get food swelling pain for the real, after eating pain slow for the deficiency. Ask about the ears: violent deafness is mostly real, because the fire of liver and gall bladder is rebellious; long deafness is deficient, because the liver and kidney are internally deficient in yin. Deafness often starts with tinnitus, such as the sound of tide and wind for wind-heat; such as the sound of cicada singing for yin deficiency; there is also pus for swelling, seems to sound like deafness for damp-heat of the liver meridian. Eight, ask thirst: dry mouth can drink for true thirst, the stomach has fire; can not drink, drink is not much, for false thirst, the stomach has moisture. Thirsty like cold drink for the stomach heat, but like hot drink for the internal cold. At the same time, good or bad sleep, should also be noted. For example, insomnia is a sign of weakness; short sleep and easy waking is a sign of nervous disturbance; excessive dreaming in sleep is a sign of strong phase fire; alarming cry in dream is a sign of bile Qi deficiency; tightness in chest and diaphragm and restless sleep is an internal blockage of dampness and phlegm. In addition, whether the memory is declining, whether the libido is normal, whether there is spermatorrhea, etc., as long as they are related to the disease, they should be asked, and not tired of seeking details.