Xiaohua
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Around syndrome differentiation
Inquiring diagnosis emphasizes systematic, comprehensive and careful aspects, in fact, it is not necessary to inquire every aspect, because each disease has its own cause and pathogenesis, as well as regularity of development and different features of clinical symptoms, so the doctor should master key points in inquiring, which is helpful to improve diagnostic levels.
1. Around syndrome differentiation
Syndrome differentiation is the premise of treatment, the doctor should inquiring around syndrome differentiation For example, when the doctor considers heat syndrome, whether thirsty, brown urine and constipation or not should be inquired, in order to ensure heat syndrome further, the doctor will inquire in which zang organs the heat is, such as vexation and irritability indicate liver fire-heat, insomnia indicates heart fire-heat, polyorexia indicates stomach fire-heat, etc..
2. Griping main symptoms
Main symptoms are the main complaints of the patients, the doctor will grip the main symptoms but not ˇ°divergenceˇ±. For example, high fever due to exopathy, whether aversion to cold and sweat or not, time and features of the fever, etc. should be inquired, simultaneous onset of fever and aversion to cold indicate exogenous pathogenic heat; alternating chills and fever indicate heat between exterior and interior; high fever and tidy fever, or fever without chills indicate interior pathogenic heat, and excessive heat in qi fen; fever in the afternoon, and protracted unsurfaced fever, etc. indicate stagnated damp-heat; night fever indicates pathogenic heat is in ying fen. Besides, the doctor should check concomitant symptoms, for example, heat without sweating indicates wind-cold attack or interior heat concomitant with exterior cold; unsmooth sweating, and fever is relieved during sweating, which indicates exteriors damp-heat; profuse sweating, and fever can not be relieved during sweating, which indicates severe interior heat, the doctor can differentiate different fevers which provides basis for syndrome differentiation.
3. ˇ°Preemptive strategyˇ±
The doctor should guess concomitant syndromes of the diseases based on the pathogenesis, regularity of disease development, then inquire more deeply step by step, in order to ˇ°seize the initiative for preemptive strategyˇ±, this is one of techniques of inquiring diagnosis. For example, for liver qi stagnation marked by fullness in hypochondrium, chest distress, abdominal distension, and preference for sighing, the doctor will consider excess of qi inducing fire, and inquire whether vexation, irritability, dry moth and bitter taste in mouth, brown urine, and constipation or not, the doctor will also inquire whether dizziness, numbness and spasm of limbs, because liver fire usually results in liver wind. At the same time, excessive liver (wood) fire restricts spleen (earth), marked by poor appetite, abdominal distension, etc.; the other aspect is liver fire consuming kidney yin, marked by dizziness, even wind stroke. So inquiring concomitant syndromes may predict the diseases.
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