Pediatric four diagnostic
Look, smell, and asked, cut, known as “the four diagnostic methods, TCM diagnosis disease. Clinically, these four aspects can be neglected, could not be viewed in isolation from a particular aspect, should be “The combination of all complement each other. Pediatric physiological and pathological features, growth and development, and disease response are different from adults, and the baby will not verbal, older pediatric speech, also often can not properly tell the illness plus treatment crying often called interference affect the pulse breath, causing difficulties to the diagnosis of the past were therefore attach great importance to pediatric medical home by inspection, and accumulated rich experience in this regard.
Pediatric hope clinic is divided into overall by inspection, and segment by inspection, the overall look of attending look look, look morphology, segment by inspection, including the trial seedlings awakened discernible spotted observed two will see fingerprints.
Refers to the to observe pediatric mental state and facial color.
Pediatric eyes, demeanor, facial expressions, dynamic languages, reaction observed in order to understand the five internal organs, the essence of ups and downs and the severity and prognosis of pediatric by inspection. Where the spirits, two orders of God, lively face, ruddy complexion, mix thoroughly breathing, quick response, are blood reconcile air plenty of non-performance of the disease, although disease, but also how light and easy to the more. If you looked sluggish, apathetic or lethargy or irritability, two mesh atheism, looking dull, uneven breathing, are sick the performance. The pale of normal children, regardless of what color should be red and shiny. Although some children than white skin, rosy, blood reconcile.
The facial look attending the change to colored speculated that the disease, refers to the so-called colored red, green, yellow, white, black, also known as colored attending.
Leaving it white, mostly cold syndrome, deficiency syndrome. Face white puffy Yang and Pan-water, common in the nephrotic syndrome; minimalist white face, lip color pale, mostly blood deficiency, anemia seen in children; pale limbs Jueleng multi-yang storm off seen in shock.
Appear before the yellow, mostly deficiency or wet. Pale complexion, emaciation, the spleen and stomach disorders, common toxins, Malnutrition; yellow face and minimalist, with white spots, often for the intestinal parasites; the complexion bright yellow, sun yellow, damp common in acute hepatitis and some biliary disorders; pale yellow and dull, for the the cold dampness block overcast yellow, common in obstructive jaundice. Neonatal week face all yellow, can be self-limiting, a living rational tire yellow, disdain morbid.
Appear before the red, mostly heat syndrome. Red face, red eyes, sore throat swelling, for exogenous wind-heat; afternoon zygomatic Red, hot flashes, measured lip red yin deficiency heat, visible in pediatric tuberculosis. Neonatal the complexion Nenhong normal skin, disdain morbid.
Cyan appear before the mostly cold syndrome, pain syndrome, stasis card. Plainer see, grimacing, abdominal pain in the cold; surface green and dull, coma, convulsions, common in convulsions and seizures; surface green lip purple, shortness of breath, for lung obstruction, blood stasis, such as severe pneumonia and heart failure.
Leaving it black, mostly cold syndrome, pain syndrome, panic epilepsy, or wet stopping drinking. Looking Qinghei, hand, foot against the cold, chill in the certificate; looking black and dull, both abdominal pain and vomiting for drug or food poisoning; looking Qinghei miserable darkness kidney decline absolutely, regardless of new disease chronic illness are the case of critically ill. Black and red moist pediatric complexion, body strong disease, is congenital kidney plenty of performance.
There is also the face five parts combined with the five internal organs, as a way to infer severity. Five parts means the left cheek, right cheek, forehead, nose and chin. The left cheek is the liver, the right cheek is the lungs, the heart of the case on the amount of the spleen, nose, chin is a kidney. Right cheek, for example, and lung, the fall of the Ministry of skin color whitish disease, skin color is white lung sick right cheek appeared crimson is seriously ill, because white is the true nature of the lung, the lung is a gold, and red for the fire, the element of fire is grams of gold, so seriously ill. Of course, this method of observation and speculation is not absolute reference clinical diagnosis only.
【Hope morphology】
Shaped body, the state is dynamic. The pediatric body by inspection head Hang, torso, limbs, skin, hair, finger (toe) A check should be the order. Head and sent us little late closing fontanel, lower extremity twin song, seen in rickets; big head jaw shrinkage anterior fontanel of lenient with benign beads drooping, seen in hydrocephalus; abdominal swelling, emaciated limbs, show blue veins on the amount, mostly nutrition adverse (Malnutrition). “Hair is more than blood, brown hair, or the vertical hair sparse, or come off easily, are physically weak blood loss performance. Nails thin, pale, crisp, for the battalion deficiency of blood loss seen in severe anemia; nail color purple, or were clubbed, heart yang, qi stagnation seen in congenital heart disease.
See, pediatric hi prostrate, often within the milk food product; hi lying curled, mostly abdominal pain; Hei side mostly Xiongxie, pain in the dynamic by inspection;
If supine, lack of exercise, eyes glazed, mostly for chronic illness, serious illness, physical virtual.
Stiff neck, the limbs twitch, even opisthotonus, there is the case of convulsion; if tumbling uneasy, call cry noisy, hands hilarious, acute abdominal pain; if sitting Chuanji,, or wheezing sputum sound for asthma.
[Miao Khieu]
Miao awakened tongue is the heart of the seedlings, the liver opens into the eyes, lungs, opens into the nose, spleen opens into the mouth, kidney opens into the ear and the two yin.
. Observed tongue normal pediatric tongue pink and moist, telescopic movable. The pale tongue as virtual blood loss; tongue red drop blood into the camp for the evil; mamillata no moss Yin-chun; tongue purple blood stasis; tongue red stabbed, evil heat hyperactivity. Tongue white color for the cold, greasy tongue coating for the cold dampness inside stagnation; tongue yellow hot; the damp yellow greasy moss stripping; fever, as Shangyin; tongue Bitter exfoliative are shaped like a map of the stomach qi yin deficiency.
Observation date eye conjunctiva pale, blood deficiency, such as anemia in children;
Sclera, yellow, case the Damp containment of jaundice disease, such as acute hepatitis; swollen eyelids, Pan is wet, such as acute glomerulonephritis; patterns retraction, crying without tears, seen in dehydration, the two heads Shangcuan convulsion episodes of levy.
3 police nose stuffy, runny, as a cold wind chill; nasal flow yellow tears, hot cold wind; epistaxis lung heat or blood heat Wang Xing, such as thrombocytopenic purpura; nostrils dry lung Tianjin injury or exogenous dry evil;
The nose incitement to lung obstruction, such as children with pneumonia.
4 observation port police port should be carefully observed changes in the color of the lips, moistening and shape. Pale lip color is blood virtual loss; the lip color bruising cold syndrome and Stagnation Syndrome; lip color Yinghong violent diarrhea Qi and Yin injury; lips dry for the disability allowance levy. Detect the teeth and gums, teeth, apart from bone, gums case of stomach, gums redness, is a stomach fire red; delayed tooth out, for lack of kidney, such as rickets;
Newborn gums with white patches, sucking the impact of the “die”. The pharynx is the channel of the lung and stomach, pharynx red fever exogenous wind-heat; pharyngeal the red milk moth enlargement, for exogenous wind-heat or lung and stomach Huo-yen, such as acute tonsillitis; white pseudomembrane pharyngodynia, difficult to wipe away for diphtheria of the levy. Mouth ulcers for acute stomatitis; mouthful of white dust found in thrush.
5. Observe ear and two overcast ear, pain pus for hepatobiliary Huowang, such as otitis media; earlobe diffuse swelling seen in mumps.
Scrotum swollen when complex, crying swollen even for inguinal hernia; swelling of the scrotum, penis, often nephropathy performance. Baby anal wet red pain for diaper dermatitis; perianal scratch, often anal itching caused by burning echinococcosis; stool hard with blood for anal fissure; after rectal prolapse, qi deficiency genus found in rectal prolapse.
[Resolution Banzhen]
Where, in the form of large and small, is generally higher than the leather, the pressure of not fade, called “plaques”; Where shaped small leather, the pressure of higher such as corn, fade, known as the “rash”. Spots and rash every seen in pediatric infectious diseases, such as measles, scarlet fever, chicken pox, epidemic cerebrospinal meningitis, of miscellaneous diseases can be seen in children purpura embolism. According to the shape, there are fine rash cellular rash, the wheal, white dumb different name. The so-called fine rash, the rash small as granulites, such as rubella, scarlet fever rash; called herpes refers to the form of different sizes, higher than the leather, containing liquid, such as chickenpox; called wheal skin limitations edema as cloud-like group, one after another, scratches obvious, such as urticaria;
White ruffian, also known as white prickly heat, heat rash, herpes small uplift slurry containing white white the dumb more common in typhoid (wet temperature) or other hot venereal prolonged fever sweating.
【Hope the two would】
Apart from stool of newborns and smaller suckling than thin, normal children stool yellow wet and dry to moderate. Dry stool guitar for internal heat or yin deficiency heat; stool thin interbedded with white clot milk food for internal injuries; stool thin yellow foul smell damp heat toxins found in bacillary dysentery. The infant stool jam color with paroxysmal crying noisy, beware of intussusception. Yellow urine a short astringent for the hot and humid bet; urine color looked like Migan Shui, eating disorders, poor digestion; urine color is red, or was dark brown, is hematuria levy; dark yellow urine, damp, is the sign of jaundice .
Police fingerprint
The observation refers also called to see the jaws of death three tests that observed pediatric index finger radial side of the superficial veins, is used to identify the cause of the disease and the nature of children less than 3 years old, and the estimated prognosis of the disease an auxiliary diagnostic methods. Starting with the first section of the index finger metacarpal radial side (jaws of death), the first section of the wind off, Section 2 gas shut for life off the third quarter. Fingerprints of normal children, should be red, yellow, and president, faint does not reveal more than Leifengguan the event of illness, the ups and downs of the fingerprint, color, location, etc. for each change, “Youyou integration” with the “Fall of the points table, purpurin distinguish cold and heat the short lag given the actual situation, the three tests measuring the severity of four verses made a high-level overview. Floating main table, Shen main diseases in the table, fingerprint floating reveal Evils in inside measurement Shen while not easy to reveal; the red main cold purple main heat, fingerprint color bright red exogenous cold, pink Deficiency is dark purple to heat evil evil heat stagnation, purplish black ridden card is critically ill; short main virtual stagnation is a real “lag” refers to the fingerprint Shibuya stagnation, push the poor of that color to talk about is the lack of blood, light cyan physically weak wind, lilac physically weak thermal fingerprint stagnation, often due to phlegm, food stagnation, stagnation caused by evil heat; three tests of the wind, gas, ordered three tests, fingerprints are now in the wind off, Evils early into the card is still light shallow, up in the air to close further aggravate disease, and arrive ordered shut, even through off shoot A (nails), the disease has been very critical. Must see fingerprints in the bright light of the doctors also can use the finger to the wind off from children with life off gently pushed down, repeated several times, so fingerprints readily revealed. Fingerprint diagnostic methods, the ancient physicians alternative for children under 3 years of age, Qiemo a diagnosis method also can not simply use fingerprint determine the nature of the disease, when the data obtained were analyzed together with other diagnostic methods in order to arrive at a correct conclusions.
Children by inspection, with brightly lit viewing conditions, should be carried out in the natural light, especially observing facial color, the seedlings the awakened and skin rash, should follow this requirement in order to obtain the correct information. By inspection according to the order, starting with the overall look consultation, Pediatric look and form an initial impression, and then segment by inspection. By inspection to be careful, patient, not rough and sloppy, To prevent missing signs, If you are spotted, you must observe the body part of the skin, including eye and oral mucosa should check not just look at a skin under conclusions. Some by inspection of the contents of the younger children, cause uncooperative, such as the observation of the eyes, mouth, throat, etc., can be flexible to the completion of the project and then carried on the four diagnostic.