Chapter 65 Symptomatic appearance

After Yu Jiayan has experienced so many dealings with quack doctors, he often feels puzzled, why do these people always make mistakes?Diagnosis is a matter of life and death, no one can bear it if you keep putting it off like this! So Comrade Yu Jiayan, in the spirit of responsibility, began to think carefully about how to help these people improve their professional quality. Finally, I finally figured it out, well, others can't control it, let's start with my own disciples, so I called my disciples and held a meeting! All the disciples came to the scene one after another. Teacher Yu Jiayan began to lecture: "Everyone, after leaving the teacher, don't be afraid of trouble when seeing a doctor. Don't make a decision like before: 'I'll prescribe this medicine!' Then walk away."

Everyone was inexplicably: "Then what should I do?" "What should I do?" Teacher Yu Jiayan wrote a few big characters on the small blackboard: "We must first discuss the illness and then take the medicine!" Everyone, you look at me and I look at you, and you all feel strange: "Discuss the disease first? This is quite new, what do you mean?" Facing the surprised eyes of the students, teacher Yu Jiayan began to explain: "Talk about the disease first, that is, after the pulse is diagnosed, don't rush to prescribe medicine for others. You should first think carefully, and then explain the disease clearly to others. What is the cause of this disease, what is your constitution, where is the problem now, how to treat it, what method is used, what medicine is used, and what effect will be achieved. These must be explained clearly to others first, and then Then prescribe medicine to Fang Zi, after such careful thinking, we will ensure that everyone avoids detours."

Look at how carefully Yu Jiayan thinks. Now everyone evaluates that Yu Jiayan's concept is not outdated today. Not only is it not outdated, but it is also worth learning. The disciples understood and prepared to end the meeting: "Good teacher, we will follow." Yu Jiayan shouted to everyone: "Don't worry, there are more!" "What else?" Yu Jiayan said: "This is not complete enough, and I need to write a formula for discussing the disease." "Oh my god? What is the disease-discussing formula?" Don't underestimate this discussion formula, once Yu Jiayan's discussion formula is put forward, it's amazing!There are different teachings. Since then, the first complete medical record format in the history of Chinese medicine was born!

Yu Jiayan said: “To receive a patient, you must first write down the year, month, day, and location of the consultation, and also record the patient’s age, body shape (even fat and thin, and height), skin color, etc. , dryness or moisture of the skin, clarity of the voice, length of the voice, mood, when the onset, history of taking medicine, effect of previous medicine, whether the condition is severe during the day or at night, how cold and hot the body is, how the diet is, How do you urinate?" and so on. By the way, the format of this medical record is definitely not outdated today (except, of course, there is no Western medicine content in it), and some of the content is even more complete than today's. For example, about the state of the patient's voice, generally today I won’t record it, but in fact, this auscultation (hearing with the ears, not the one with the nose) was very important in ancient times. Modern research believes that the voice of speech is indeed an important source of information for diagnosis. The University of Macau A sound diagnostic instrument was developed. After recording the sound and analyzing it, it turned out that the conclusion was almost the same as that obtained by other methods. I visited this instrument, and I was filled with emotion.

"There's really enough content this time!" The disciples thought one after another. Teacher Yu Jiayan woke up a disciple who was distracted with the tip of a chalk, and then patiently told everyone: "Don't worry, it's not enough!" "what?" "Why do you write down the year of the consultation, because you want to know the zodiac and the earthly branches of the patient's illness year, so you need to mark the luck of the year (don't get me wrong, it's not the good luck we say, but the luck of the year) A theory created by the ancients to change the climate pattern caused by the movement of celestial bodies); why write down the month? That is to record the impact of the four seasons of spring, summer, autumn and winter on the patient's disease, which should also be written down; why write down the reception The location? That is to take into account the impact of geographical conditions on the patient's disease, and it should be recorded." Wait, the teacher Yu Jiayan stipulated that there is more than one, so I won't give you details, and I will omit some lines below.

The disciples thought: With such details, it should be all right this time, right? Teacher Yu Jiayan put on a straight face: "I tell you, this is not enough!" The disciples were all dizzy: "My God? What else?" Yu Jiayan stipulated: "Before prescribing a prescription, you have to write down what kind of prescription you are using, what kind of prescription is based on it, what are the properties and flavors of the medicines in the prescription, what are they going to be used for, when will it be effective, and what If you can heal in time, you must write it down in advance.”

Finally, Teacher Yu Jiayan looked into the stunned eyes of the students and gave a lecture: "If you want to become a qualified doctor, you must follow this regulation, otherwise you will delay the patients, and you will become the most hated quack doctor yourself! All right, the meeting is over!" Thanks to the mess of government work at that time, otherwise, if doctors were really required according to Yu Jiayan’s format, it would be broken. It is conceivable that half of the doctors should close their doors immediately. If you don't have a certain level, you can't write so many analyzes at all.

It should be said that it may not be possible to do this now. Many doctors will say that if we write so much content, then we don’t need to see a doctor in a day. We just fill in the form there. Now some doctors have to see dozens of patients in one morning. An average of ten minutes, there is no time to ask these things. However, we have to know these contents. If one day, the diagnosis and treatment environment of Chinese medicine improves, and there are specialists like foreign clinics outside the clinic, then we can ask the reception staff to fill in these contents first. That's it, leave the most critical content, and let the doctor fill it in by himself.

In addition, for example, when will my medicine take effect and what effect do you see? Now doctors generally don’t say this, for fear that if it fails to achieve the effect, they will sue you. However, good doctors in ancient times must say it, and they have a spectrum. , and even in some cases, this is used as a standard to measure the level of a doctor. Although these standards could not be fully promoted at the time, Yu Jiayan asked his students to do the same, and wrote this rule into the opening chapter of "Yi Yi Cao" as a norm.