NovelsAlex Chapter 668 Patient's Subjective Feeling Cannot Be the Main Judgment Basis
Chapter 668 Patient's Subjective Feeling Cannot Be the Main Judgment Basis
Chapter 668 Patient's Subjective Feeling Cannot Be the Main Judgment Basis
"In my opinion, this patient is not a rare disease, but the pores are opened after sweating, and the watch is closed by the wind and cold, and then the whole person becomes a stuffy jar with no internal and external connections.
The righteousness in the body wants to exorcise the evil and go out, but the exterior has been closed by the cold and evil, and this is what happens under the struggle between good and evil.
It's like a flock of sheep are locked in a sheepfold, and a dog inside drives the flock to run out, but the door of the sheepfold is closed, and the sheep keep hitting the door, which makes the noise uneasy. "
Nasutu looked at Ge Gen and said slowly, and also used a vivid analogy.
It's not that Ge Gen doesn't understand, it's just a way of expressing his thoughts.
And because he used to herd sheep, he likes to use the analogy of herding sheep.
"Ah?" Ge Gen opened his mouth wide, "You said the patient has a cold syndrome?"
(Syndrome of coldness on the surface of the sun, also called superficial cold syndrome, the evil culprit of wind-cold is the external appearance, the interstitial striae are blocked, causing internal and external obstruction, and internal qi cannot be stretched and outwardly expressed.
The syndrome of coldness on the surface of the sun is a saying that the syndrome differentiation of the six meridians is mixed with the differentiation of the eight principles.
Syndrome differentiation of six meridians and syndrome differentiation of eight principles are two different methods of syndrome differentiation in Chinese medicine. )
"It must be the disease, otherwise the patient wouldn't have such a headache." Nasutu said, "When I saw him, I felt that he had become a stuffy jar closed inside and out."
Ge Gen lowered his head in doubt and looked at the patient Wang Qiang's symptoms he recorded again.
High fever, severe headache, no chills, no sweat, nausea and vomiting, cough.
Dry mouth and desire to drink, poor appetite, short red urine.
Tongue tip edge is red, fur is white.
Floating pulse.
……
In TCM syndrome differentiation, the most important thing is to distinguish between cold and heat, and the most difficult thing is often to distinguish between cold and heat!
Because the patients encountered in reality are not as typical as those written in books. They are often complicated with cold and heat, just like lard and sheep oil mixed together after heating, making you unable to distinguish which is lard and which is sheep. Oil, more lard, or more suet!
Cold on the outside and hot on the inside, cold on the inside and hot on the outside, cold at the top and hot at the bottom, hot at the top and cold at the bottom...
Grandma's, it's hard!
Therefore, Pueraria has been practicing medicine for more than ten years, and I dare not say that I can already distinguish between cold and heat!
And even famous doctors in ancient times often sighed that yin and yang were difficult to distinguish!
……
Ge Gen collected his mind and fixed his eyes on the phrase "no aversion to cold".
No chills!
According to the book, the main symptom of Taiyang typhoid patients is aversion to cold!
In addition, there are a lot of symptoms such as fever, head pain, limb pain, wheezing without sweating, etc.
And no aversion to cold, isn't this special grandma's disease of volt temperature?
How can it become a solar watch cold syndrome?
"But, Doctor Huang, the patient has no aversion to cold."
Ge Gen reached out and clenched his fist and knocked on his forehead and said to Nasutu.
"Aversion to cold is just a subjective feeling of the patient, and it may not be accurate."
Nasutu looked at Ge Gendao from the reading glasses.
"Furthermore, the patient took so many cold and cold medicines at Dengxian Hospital, which made the cold in the body worse.
In this way, the inside of the patient's body is cold, and the outside is closed by the cold evil, so it is not easy to feel the cold.This is very possible.
It's like when a person is about to freeze to death, he doesn't feel the cold, but instead feels very hot, and takes off all his clothes, for a reason. "
After hearing this, Ge Gen thought carefully about Nasutu's words.
"Doctor Ge, according to my experience, patients' subjective feelings are not reliable.
Subjective feeling is inherently vague, and it is even more vague and unreliable when spoken from the mouth of a patient with a confused brain and unresponsiveness.
Therefore, when a doctor sees a doctor, it is better not to take the subjective feeling expressed by the patient as the main basis for judgment.
On this point, those who cannot fully listen to what is written in the book must think flexibly and dialectically. "
Nasutu said slowly.
This Mrs. Ge is very good, and he is still willing to share his experience and views with this young man.
Hearing what Sutu said, Ge Gen felt as if someone had knocked on his forehead hard, it was a feeling of enlightenment!
"Then Doctor Huang, how do you treat this patient Wang Qiang?" He asked.
"Sweating to relieve the appearance, exorcising evil spirits and going out? Just add and subtract Mahuang Decoction." Na Sutu said firmly.
Ephedra soup? !
Ge Gen frowned. In the hot weather of August, the patient had a high fever and severe head pain. He instinctively dared not use Mahuang Decoction.
Not only him, but now most doctors are generally taboo to use ephedra soup.
When encountering patients with no sweat, high fever and headache, it is better to clear away heat and detoxify, and avoid using Mahuang Decoction that makes sweat!
Once it is used improperly, it will cause the patient's heartbeat to increase, blood pressure to increase, and go straight to the forehead..., Grandma's, the consequences are simply unimaginable!
Using Sangjuyin and Yinqiaosan to clear away heat and detoxify, even if it is useless, there is nothing wrong with it.
It is not obvious if it has happened, and generally it will not cause the patient's immediate severe reaction...
Thinking of this, Ge Gen beat his head with his fist and stayed in the county hospital for more than ten years. Taiping was used to it. Now even after spending so long with Li Maoyang who dared to use medicine, he still can't change his mind!
Many times, he can't help but want to use Taifang.
It is very difficult for many doctors to improve their medical skills for decades, and this has a lot to do with it. They are afraid of taking responsibility when they are sick, so they dare not use medicines!
Therefore, it will never be difficult to experience the feeling of picking millet out of the fire!
But masters are all trained by tightrope walking!
"Doctor Ge, if you feel that you are getting used to it, you may be worried about using the modified Mahuang Decoction. We can also use acupuncture to relieve the patient's body temperature, and then use the modified Mahuang Decoction."
Seeing that Ge Gen was in a bit of a dilemma, Nasutu proposed a more compromised plan.
After all, he hasn't obtained his medical qualification certificate yet. In this consulting room, Pueraria Gegen is finally responsible.
"That's okay, let's use acupuncture to untie the watch first." Ge Gen let out a sigh of relief.
Li Maoyang is not here, his psychological pressure is really great!
"Dani, let that patient named Wang Qiang come here." He said to Yan Danni who was in charge of the first diagnosis.
Yan Danni was listening to the wonderful discussion between the two, and she was a little distracted. Hearing what Ge Gen said, she was stunned for a moment, and quickly got up to call the patient Wang Qiang.
"Why hasn't your little genius doctor come back yet? You still take patients seriously? Didn't you say that your little genius doctor will be back soon?"
The patient Wang Qiang held his head and chattered all the way, Yan Danni could only coax him with nice words all the way.
She said earlier that Li Maoyang's coming back soon was to recruit patients for their group, and it was not easy for her to make a diagnosis.
"Now I will give you acupuncture treatment first, this is the treatment plan proposed by our boss!"
Wang Qiang kept nagging when he entered the consultation room, Ge Gen could only lie to him while sterilizing the needle.
Follow good people to learn from good people, and follow the priest to dance to the gods. After following Li Maoyang for so long, he has also learned to lie to a certain extent.
It really worked. After Wang Qiang heard what he said, he stopped nagging.
Hey~, this also played a psychological comforting role!Ge Gen smiled wryly in his heart, the name of a person, the shadow of a tree, when will he, Ge Gen, gain his own reputation...
Jiebiao points are mostly distributed on the head and the back of the nape, mainly involving the Governor Vessel, the Bladder Meridian of Foot Taiyang, the Gallbladder Meridian of Foot Shaoyang, and some extra points outside the meridians.
Such as Taiyang point, Dazhui point, Taodao point, Fengfu point, Dazhu point, etc. Novices should not dare to acupuncture these points.
However, with Pueraria lobata's current acupuncture technique, basically any acupoint can be pricked, and it will be pricked.
The level has already reached Deqi.
Although Nasutu's acupuncture technique has also reached Deqi, but after all, he is old and his hands and eyes are not as good as Puerariae. He can't do this kind of work with Puerariae.
Wang Qiang's headache was obviously relieved after kudzu acupuncture was done. He rubbed his head and kept muttering: "Oh, the little genius doctor is still a little genius doctor. After acupuncture like this, the headache really doesn't hurt too much!"
Ge Gen couldn't help but smile wryly.
"Take your time." Nasutu came over and patted him on the shoulder and smiled.
Yan Danni also looked at Ge Gen and smiled.
"It's nothing." Ge Gen waved his hands and smiled, while continuing to think about Nasutu's treatment advice.
Magui (Ephedra Guitti) is pungent and warm, and does not have many disadvantages of promoting heat. As long as sweat can be produced, the Xuanfu (sweat pores) are opened, and the internal qi is harmonious, the cold will dissipate and the evil will come out...
Or, dare to use it once?
After taking the medicine, the patient is left here. If there is any problem, the clinic is currently also very strong...
With that in mind, he gradually made up his mind.
Then he discussed with Nasutu and came up with a prescription: raw ephedra, cinnamon twigs, nepeta, windproof, and raw licorice.
He asked Yan Danni to decoct the medicine. Not long after giving the medicine to the patient Wang Qiang, Wang Qiang broke out in sweat, and his body temperature dropped from nearly 40 degrees to more than 37 degrees immediately!
And Wang Qiang's headache didn't hurt anymore, and his pulse also calmed down!
It’s just that there are still some mild symptoms such as dry mouth and fatigue, which can be adjusted with the addition and subtraction of Maimendong Decoction.
Fuck, it really works like a drum!
Well, without the spirit of walking a tightrope, you will never be able to practice superb medical skills.
The second update today.40 chapters are owed plus changes, and the remaining 112.88 meters are rewarded and 125 monthly tickets.
(End of this chapter)