Pediatrics four diagnoses
Pediatrics four diagnoses
◆ smelling
Smelling doctors use hearing and smell a way to diagnose the disease. Listen to the sound, including wails, language sound, the sound of a cough and breathing; smelling mouth odor in children, urine odor, vomit odor.
Wails
Crying children a “language” will be crying when pediatric physical discomfort or pain. Normal children crying, it should be loud and long, and tears. When the baby because of hunger, thirst, acupuncture, insect bites, the sleep or wet diapers can cause discomfort and crying, when you need to get to meet or pain lift will stop crying. The suckling crying because of hunger caused lingering weakness, mouth as sucking like; abdominal pain caused by the sharp sound of crying, the suddenly slow suddenly anxious, when time; sharp wails array as with vomiting and jam-like stool, need consider intussusception; the crying hoarse breathing adverse, mostly due to laryngeal edema. In short pediatric crying loud Zhuang Li the empirical, cries fine and weak for the deficiency. Crying clear the Heshun better, sharp or thin weak for crying.
[Language sound]
Pediatric speech, language, sound can be used as a diagnostic reference. The normal pediatric Language loud and clear is better. Voice low, as the Qi Deficiency Lung weak performance; moaning endlessly, mostly physical discomfort; shouted loudly, often for pain; ravings of delirium, the camp evil heat, common in warm disease process; language muddy, often due to exogenous cold; voice hoarse throat and vocal cord disorders.
Coughing
The coughing sound Chang Lee, sputum easy to spit up for the light. Kesheng Chhnang flow clear nasal discharge is exogenous cold; the Kesheng Zhongzhuo thick yellow sputum, for exogenous wind-heat; dry cough without disease mostly Feizao, or pharyngitis caused by; coughing array for, and echo , often for pertussis; the Kesheng hoarse, such as bark, common laryngitis or laryngeal diphtheria. Under normal circumstances, the empirical Kesheng pitched deficiency Kesheng low the sputum Kesheng Zhongzhuo, no disease when Kesheng dry.
Breathing
The normal children breathing evenly peace, the pace is moderate.
Due to the Pulmonary Division respiratory, kidney reception of Qi, the sound of breathing abnormalities often reflect lung and kidney lesions. The pediatric lung delicate, respiratory diseases more. Breathing rough and powerful is mostly exogenous heat syndrome; shortness of breath, throat wheezing, sputum evil obstruct the lung, such as asthma certificate; shortness of breath, rude fanned the nose, per pneumonia Chuansouyin see; respiratory distress, face blue cough often obstructive respiratory tract; breathing low, double suction as cries for lung will never, such as respiratory failure. Addition, baby shortness of breath, with daily respiration, often for a stuffy nose or nasal dirt blocking the nasal cavity, gently moist latter pick to go to Chang Lee.
Mouth odor
Breath foul smell, and more due to stomach heat, or mouth sores, the Yagan due; heating gas Suanfu, mostly fresh injury; breath foul, prevalent in the Blood Syndrome, such as bleeding gums; mouth smell of spit purulent sputum with blood, common in lung abscess; breath, such as rotten apple performance acidosis; mouth ketone smelly uremia.
Urine odor
Stool smell foul, damp heat toxins; stool sour and thin, mostly fresh injury; under Lee Ching Valley, no obvious odor, spleen and kidney deficiency. Scanty dark urine, smell the smell of urine smell, mostly hot and humid place; urine long less with the card Spleen Deficiency.
Smelling need to master sound property law, such as the sound of static is a cold, acoustic noise is hot, the sound of low genus virtual sound high true. Crying crying In addition to the factors of the disease, due attention should be paid to exclude non-disease factors such as thirst, hunger, acupuncture. Listed above for smelling check project, should also pay attention to the observation of vomit, sputum, sweat, and exclude special odor caused by consumption of certain foods, so as to avoid the resolution.
cold and heat
Pediatric fever is generally slightly lower morning, afternoon night. Fever cold sweat-free, for exogenous cold; fever afraid of the wind and sweat, for exogenous wind-heat; persistent fever is not afraid of the cold, into the evil heat; cold and heat exchanges for the evil half table half years; fever continuous thermal potential gull Zhang, tongue thick and greasy, damp; Summer fever a long time to subside, no sweat polyuria, heat disease; evening or afternoon fever, often accompanied by night sweats, TB found in children; pediatric cold, poor appetite Shenpi more in the cold or the yang of the evidence.
Q Khan
Sweating more during the day, a little move that out, called “spontaneous” is a the qi deficiency Methodist solid performance; called “night sweats night sweating, woke Khan ended, Yin or Yin of the two imaginary; sweating, such as oil, more than dripping death yang collapse, more common in shock; sweating hot puzzled, fever is evil from the table into the signs. Pediatric skin is tender and thin, Teng reason not close, easy sweating, sleep after yang ascending, often head forehead Weihan this disdain morbid.
【Asked the head and body]
Asked the head and body is itching discomfort and activities ask children with head and body parts, the generally older pediatric complained of headaches, dizziness, body pain, itching and discomfort, and infants can only cry or grab hold discomforts. Fever chills, headache, for exogenous cold; headache, vomiting, fever convulsions, evil heat into the camp, such as epidemic encephalitis; head dizziness, generally found in high fever, anemia; fever limb pain, often cold or rheumatism performance. Exanthematous diseases and skin diseases every skin scratching, such as measles, chicken pox, scarlet fever, hives, etc..
【Asked the two will be]
What is asked the number of children with bowel and bladder, nature. Color, and defecation urination feeling. Stool frequency increased significantly, thin texture, spleen not health movement, such as diarrhea; increased stool frequency, Chibai sticky freeze lag is hot and humid, such as bacillary dysentery; constipation, abdominal pain, mostly within the real The loss of heat or Yin-chun; worm of stool row, accompanied by abdominal pain, intestinal parasites prevalent in the disease. Urine long or nocturnal enuresis, for kidney yang loss, not solid Xiayuan; frequent urination, pain during search for hot and humid place, such as urinary tract infections; urine tingling, while countless drops or discharged sand urinary tract stones.
Q diet
Ask satisfied eating and drinking, children time eating normal food intake without vomiting and diarrhea, is a normal phenomenon. If distention do not think of drinking milk, fresh wounds Indigestion; diarrhea without thinking fresh milk, spleen not health movement; Eat less and it is not real, emaciation, more common in malnutrition (Malnutrition). Thirst hi drink cold compared to the heat syndrome; thirst hi drink hot, or thirst, or cold syndrome; frequently cited drinking, dry lips, stomach yin deficiency, body fluid depletion.
Q thoracoabdominal
Chest fullness and frequent cough, the pathogenic wind beam lungs, such as bronchitis; chest department smothering, roaring hoot sputum call, to phlegm obstruction pulmonary collaterals, such as asthma;
Chest pain, fever, cough, shortness of breath, to temperature evil Fanfei, such as lobar pneumonia; chest tightness, heart palpitations, surface Green shortness of breath, weak heart yang effort stasis seen in heart failure; abdominal pain, faint Cullen found ascariasis; epigastric or Youxie pain, face both yellow jaundice is hot and humid.
Q sleepy
Normal children sleep better in quiet, the younger the longer sleep time. The irritability little sleep, night sweats hair thinning seen rickets; sleep in the age teeth, mostly for ascariasis; restless sleep at night, anal scratching, for the enterobiasis. Drowsiness and lethargy, in The warm diseases evil hearts packets, or sputum Mongolia orifices due, is in critical condition performance.
In pediatric interrogation, but also to ask personal history, vaccination history, genetic history, as well as the risk of infectious diseases. Personal history include the and asked production, feeding; development, production history to ask parities, parity, whether full-term, natural delivery or dystocia, whether abortion, as well as the delivery service, place of birth, birth status, health and nutrition of the mother during pregnancy. Asked infant feeding and supplementary food feeding history add a case, the time of weaning, and after weaning situation the eating habits of older children, loss of appetite, diet varieties. Developmental history, including physical and mental development of enrollment in children should understand the learning situation, suggesting that the situation of mental development.
Breath foul smell, and more due to stomach heat, or mouth sores, the Yagan due; heating gas Suanfu, mostly fresh injury; breath foul, prevalent in the Blood Syndrome, such as bleeding gums; mouth smell of spit purulent sputum with blood, common in lung abscess; breath, such as rotten apple performance acidosis; mouth ketone smelly uremia.
Urine odor
Stool smell foul, damp heat toxins; stool sour and thin, mostly fresh injury; under Lee Ching Valley, no obvious odor, spleen and kidney deficiency. Scanty dark urine, smell the smell of urine smell, mostly hot and humid place; urine long less with the card Spleen Deficiency.
Smelling need to master sound property law, such as the sound of static is a cold, acoustic noise is hot, the sound of low genus virtual sound high true. Crying crying In addition to the factors of the disease, due attention should be paid to exclude non-disease factors such as thirst, hunger, acupuncture. Listed above for smelling check project, should also pay attention to the observation of vomit, sputum, sweat, and exclude special odor caused by consumption of certain foods, so as to avoid the resolution.