第95章 二女学医
最新网址:m.ltxsdz.com
浩道:“先给你们说说大夫如何看病。龙腾小说网ltxs520.com——面对,要搞清楚他的病是怎么回事,就要整体审察、诊法合参。就是望、闻、问、切四个角度来检查病情,综合四个方面的情况,判断出病人究竟是什么证,得了什么病。病位和病性是什么,然后对症下药。所以,望闻问切四种诊法都要熟悉,都要能获取足够的信息以便帮助辨证。”
二女点点头,庞雨琴道:“如何望闻问切?”
“望就是观察病人外在情况,包括全身和头面、五官、四肢、排泄物,特别是舌象情况,不同的病症会又不同的变化;闻就是听声音和气味,包括呼吸,说话、咳嗽、心音、肠胃音以及一些特殊气味,不同的病症会造成一些特定的变化,观察这些,就知道是什么病症了。一个良医,对这些种种变化,都必须烂熟于胸。问,就是问病人的主要感觉,以往病史,问寒热,疼痛、睡眠、饮食、二便等等。切就是切脉了,这是医者了解病情最主要的手段之一。一时半会也说不完,这样吧,遇到具体病人,我抽空给你们讲。”
雪霏儿当然不满足,道:“那你先教我们切诊好不好?下次来个病人,我切脉看看。”
“行啊。”杜文浩随手抓住庞雨琴的手放平,指着她手腕部道:“血脉贯通全身,内连脏腑,外达肌表,所以脉象能反映全身脏腑功能、气血、阴阳等综合的情况。脉象的种类,历来说法不同,西晋王叔和的《脉经》分述三部九侯,寸口脉法,共有二十四种脉象。明朝……,嗯不世……,研究脉象增加了一些,共二十八种。也过是将其中的细化了。”
雪霏儿摸了摸:己的手腕脉搏,奇道:“就这么一摸,就知道啥病?简直太神了!”
杜文浩笑道:“当然没这么,光闭着眼睛切脉就知道什么病,那是神吹。切诊只是四诊之一,辨证一定要诊法合参,不能抓了芝麻丢了西瓜头不顾尾,那就成了头痛医头脚痛医脚的庸医了。四诊那一项都不能少当然,具体病症,可能会在偏重某一种或者某几种。”
“你还是说说怎么诊脉吧。”
“你呀,这么心急,这性格太适合行医哦医者必须泰山崩于前而不动,临危不乱算遇到急症马上要死的病人,也不能乱了手脚,只有这样才能准确诊察病情,找到有效的急救办法。扯远了,回到切诊来说,切诊的方法很多比如《素问》,就有三部九侯诊法就是遍诊人全身各个地方血脉的搏动,医圣张仲景在《伤寒杂病论》里也提出了寸口、)阳、太溪三部诊法医者最常用的,就是寸口诊法。寸口脉从手掌往手肘方向为寸、关、尺三部,双手各有三部,共六部脉。”
“全身么多血脉,为啥单单用寸口切诊呢?”
“问得好!其道理很简单。寸口属于手太阴肺经脉。是血流循环地起始。经全身十二经脉。又归于寸口。所以寸口是脉大会之所。而寸口部脉气最旺。脉象也最有代表性。而且。寸口在手腕这。诊脉也比较方便。如果诊别地地方。比如张仲景说地诊趺阳、太溪。这两处穴道都在脚上。如果是个老汉还好办。大不了脚臭一点。如果是个大姑娘小媳妇。总不能抱着人家金莲摸来摸去地吧?”
“嘻嘻嘻……”二女掩嘴笑了。
雪)儿怪模怪样道:“要是琴姐病了。先生你倒可以捧着她地金莲诊趺阳、太溪。不妨事地。她乐意着哩。”
“你这死妮子!找打!”庞雨琴羞红了脸。伸手去拧她。
雪)儿咯咯笑着躲开:“行了别闹了。先生在传医术哩!”
庞雨琴狠狠瞪了她一眼。坐好了仰着红扑扑地脸蛋望着杜文浩。
杜文浩也有些不好意思,轻咳一声,续道:“切脉寸口,还有一个原因,就是寸口还可以反映人体总起的盛衰,要知道,肺脾同属太阴经……”
“什么是太阴经?”雪霏儿仰着俏脸又问。
“太阴经就是……,我在跟你说切脉,你又跑去问经脉,都弄乱了,一个个来,那么多不懂的都要解释,明天天亮也说不完切脉的问题。”
庞雨琴笑道:“是啊霏儿,别打岔,听先生说嘛。”
“好好,我不打岔,你接着说。”
“嗯……,我说到哪了?”
“肺脾同属太阴经!”雪)儿笑道,“算了,你先别解释了,还是直接告诉我们怎么切脉吧,我好想试试看。”
“行,寸口六部脏腑分候中,左右寸、关、尺都与五脏六腑有对应关系,寸关尺的变化,就反映出五脏六腑的变化。”
接着,杜文浩简要给她
了二十八中脉象的特点和它们反应的病症。说完脉又简单介绍了舌诊的要领,说了舌质、舌形、舌态和舌下络脉在舌诊中的重要意义,又重点说了舌苔类型和所主病症,又简要解说了八纲辨证的基本征候和特点。
刚说到这里,便先后进来了两个病人。一问之下,都是伤风。
第一个病人坐下,不停咳嗽。
杜文浩先给他切脉之后,对二女道:“你们俩试试我方才教你们的东西,看看他们是什么病症。”
“好啊!”雪)儿问那病人:“你怎么了?”
那病人惑地了瞧杜文浩:“不是杜大夫坐堂吗?……咳咳”
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