Diagnostics of Traditional Chinese Medicine: Ten Questions and Two Convenience Questions

"Ten Questions about Song" means: "When you ask about cold and heat, two questions about sweat, three questions about head and body, four questions about defecation, five questions about diet, six questions about chest pain, seven questions about deafness, eight questions about thirst, nine questions about the causes of old diseases and ten questions about pain, then take medicine to participate in the mechanism change; In particular, women must ask about their menstrual period, which can be seen in the late closure and collapse; Add a note to tell pediatrics that smallpox and measles are all tested. "

Asking about the second defecation is to ask the patient about the defecation, such as the nature, color, smell, amount, time, interval, feeling and accompanying symptoms of defecation. Asking about the situation of defecation and defecation can judge the strength of digestive function and the metabolism of body fluid, and it is also an important basis for distinguishing the nature of cold and heat.

The characteristics, properties and tastes of these two kinds of stools are described in Observation and Smell respectively. Introduce the frequency and amount of defecation, abnormal feeling during defecation and defecation time.

1, ask shit

Healthy people usually defecate once or twice a day, which is yellow and soft, and the defecation is smooth and unobstructed. If they are affected by diseases, their digestive function is dereliction of duty, such as mucus and undigested food. Dysfunction of qi, blood, body fluid and viscera can cause abnormal defecation frequency and defecation feeling.

(l) Abnormal defecation: Abnormal defecation refers to the increase or decrease of defecation frequency, which exceeds the normal range and can be divided into constipation and diarrhea.

1 constipation: constipation. It means that the feces stay in the intestine for too long, the interval between defecation is prolonged, and the number of defecation is reduced, usually once every four to seven days, which is called constipation. Its pathogenesis has always been caused by conduction dysfunction of large intestine. It can be seen in gastrointestinal heat accumulation, qi stagnation, deficiency of both qi and blood, stagnation of yin and cold and other syndromes.

② Diarrhea: Also known as loose stool or diarrhea, that is, the stool is soft and shapeless, even watery, the interval between defecation is shortened, and the frequency of defecation is increased, more than three or four times a day. It is always caused by spleen and stomach dysfunction, water stagnation and excessive activity of large intestine. It can be seen in spleen deficiency, kidney yang deficiency, liver depression and spleen deficiency, food injury, damp-heat accumulation in large intestine, exogenous pathogenic factors and other syndromes.

(2) Abnormal feeling of defecation: Abnormal feeling of defecation means that there is obvious discomfort during defecation, and different causes and pathogenesis lead to different feelings.

① Anus burning: refers to burning sensation in anus during defecation. Its pathogenesis is caused by damp-heat accumulation in large intestine. Can be seen in damp-heat diarrhea, summer-heat diarrhea and other syndromes.

② Uncomfortable defecation: abdominal pain, poor defecation and stagnation. Most of them are caused by poor operation of intestinal gas. It can be seen in the syndromes of liver depression invading the spleen, diarrhea due to eating disorder, and accumulation of damp heat.

3 Abdominal pain, diarrhea from time to time, and anal swelling will make you uncomfortable. Urgent and unbearable, it is urgent; When defecating, the amount of defecation is very small, and when the anus falls to the ground, it will be uncomfortable, or there is no desire to defecate. This is called heaviness, and both are called urgency after heaviness.

This is one of the main symptoms of dysentery. Mostly due to damp-heat evil resistance and intestinal qi stagnation.

4 Slippery incontinence: that is, long-term diarrhea can't heal, the stool can't be controlled, and it slips out, also known as "slippery diarrhea". Most of them are caused by long-term illness, spleen and kidney weakness and anal failure. Visible in spleen yang deficiency, kidney yang deficiency, or spleen and kidney yang deficiency.

⑤ Anal air falling: that is, the anus has a feeling of falling, and even the anus wants to come out. Most of them are caused by spleen-qi deficiency and stagnation of middle qi. It is more common in the syndrome of stagnation of middle qi.

Step 2 ask for urine

Under normal circumstances, healthy people urinate about 1000- 1800 ml day and night, 3-5 times during the day and 0-/kloc-0 times at night. Because of drinking water, temperature, sweating, age and other factors, the frequency and amount of urination can be slightly different. Affected by the disease, if the body fluid is not enough to nourish blood, the gasification function is abnormal, the water and drink stay, the number of urination, the amount of urine and the feeling during urination can be abnormal.

(1) Abnormal urine volume: Abnormal urine volume refers to excessive or insufficient urine volume day and night, which is beyond the normal range.

① Increased urine output: mostly caused by cold coagulation, stagnation of water and gas, or deficiency of kidney yang, stagnation of yang, and leakage of water and liquid. It can be seen in deficiency-cold syndrome, kidney-yang deficiency syndrome and diabetes.

② Decreased urine volume: it can be caused by insufficient body fluid, insufficient urine source, urethral obstruction or yang deficiency, no right to gasify, and water can't enter the bladder and overflow the skin. Visible in excess heat, sweating, vomiting, edema, stranguria, stranguria and other syndromes.

(2) Abnormal urination times:

① The frequency of urination increased; Also known as frequent urination, it is always caused by the failure of bladder gasification function. It is more common in damp-heat in lower energizer, deficiency-cold in lower energizer, and unstable kidney-qi.

② Decreased frequency of micturition: it can be seen in dysuria and introduced when micturition is abnormal.

(3) Abnormal micturition: It refers to the change of micturition feeling and micturition process, resulting in abnormal conditions, such as dysuria, urinary incontinence, enuresis, urinary closure, etc.

① astringent pain in urination: that is, unsmooth urination accompanied by acute burning pain, mostly caused by damp heat entering the bladder, scorching meridians and unsmooth qi movement. Visible in gonorrhea.

② Obstruction: urinary obstruction, dripping out is incontinence, and urinary obstruction, dripping out is closure, which is generally called incontinence. The pathogenesis is excess and deficiency. Most of them are caused by damp-heat accumulation, stagnation of liver qi or blood stasis, and stones blocking urethra. Deficiency is mostly caused by qi deficiency, kidney yang deficiency and unfavorable bladder gasification in the elderly.

Endless dripping: I can't help dripping after urinating. Most of them are caused by unstable kidney qi.

④ Urinary incontinence: It means that consciously controlled urine cannot leave on its own. Most of them are deficiency of kidney qi, and the lower element is not solid; Deficiency and cold of lower energizer, bladder loss of heat, can not limit water and fluid. If the patient loses consciousness and urinates, the condition is critical.

⑤ Enuresis: refers to the spontaneous discharge of urine during sleep, commonly known as bed wetting. More common in children. Its basic pathogenesis is bladder atony. It can be seen in deficiency of kidney yin and kidney yang, spleen deficiency and qi stagnation.