khái quát về chẩn đoán bệnh nhi khoa theo y học cổ truyền

1. ( /(tUing I I I
KHAI QUAT VE CHAN DOAN
Chan doan benh rung du'a tren cd sd tu chan, bat cUdng
ma ticn hanh. Song vi trong khi kham benh. tre em thUdng
hav keu khoc vUiil' vav lam anh hUdng den hdi thd va mach
tUdng. nen trong tu chan dac biet lay vong chan lam chu you,
nhung cung can phai tong hdp cac chUng hau khac ma tien
hanh phan ti'ch bien chun^ mdi c6 the toan dien dUdc.
i. tC
tchAn
A. VONG CHAN
1. Vong than
Quan sat tong hdp cac hien tUdng ve tinh th in , thai do
bieu hien cua tre em de co the phan biet dUdc tinh trang hu
thuc cua benh va ngUdi benh.
Cu the: han thUdng tinh than lfing le; nhiet thi tinh th in
roi loan, thUdng keu khoc; hu thi tinh th in suy kem; thuc
tinh thAn khoe kho&n, hay giav giua lan Ion.
Tinh than thanh sang, khi cd thong ldi, tien lUdng chua
benh tot; than mat khi bien. than moi met khi due la tien
lUdng khong tot. Thien Di tinh bien khi luan sach To van noi:
"Than con thi song, than mat thi chet".
2. Vong hinh the
Hinh the khoe manh. linh hoat thuoc thuc chiing; hinh the
yeu gay thuoc hu. Gan xUdng cung cap thuec thuc, mem yeu ue
oai thuoc hu. Da thjt tudi nhuan. toe day kin thuoc thuc; da
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2. uni Kho rap, toe lua thua thuoc hu. Lau ngay thop chua kin la
do tien thien bat tuc.
Tre khoe khoin thi kho bi benh, neu dot nhien bi benh
cung tUdng doi dl chula. Tre em giy hu yeu, gay mon de mic
benh, khi mac benh roi cung lau khoi. Van Mat Trai noi: "Hinh
khi deu thuc la bam khi day du, khong co benh, de nuoi; hinh
khi deu hu la bam khi khong du, nhieu benh, kho nuoi”.
3. Vong sac mat
3.1. Sac m£t do
S ic mat do chu ve nhiet (tre em sd sinh mat do tUdi khong
phai la hien tUdng benh).
- Sic do hong la ben trong nhiet thieu dot manh phin
nhieu 1
&khi uit, ddm hoa.
- Sic do ma co in dUdng sic xanh, hai m it trdn ngUdc la
nhi§t cue sinh phong giy co gi$t.
- Sic do hong kem ia long, chan tay lanh la chiing doi
dUdng.
3.2. sac xanh
Sac xanh chu ve phong.
- Chting kinh sd kem sic xanh la chting cham via.
- in dUdng xanh chu ve kinh gi&t va ia chay.
- Sic xanh, moi chum khong bu difdc^ gaj^ irwi£ llO'li v^ir
dUdng ron.
- Xanh ma tring la hu phong.
Sic xanh hien ra la benh da nfing, d tre em th'iidng thay"
rat nhieu.
T2-CK NK
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3. 3.3. S£c trang
Sac trang chu ve hu han.
- Tr^ng nhdt gap trong ia long, non mUa.
- Khi vang, khi trang la ty hu, cam tich.
- Trang bdt la nguyen dUdng hu.
3.4. Sac vang
S^c vang chu ve ty vi bi thap tre.
- Vang tUdi thuoc tha'p nhiet thuc tfch.
- Vang toi md thuoc han thap hai ty.
3.5. S4c den
Sic den phan nhieu la benh nguy kich.
- Huyet thira tUdng sac xanh den trong kinh phong co giat.
- Mat den nhu tro than la chu chting ac hoac dau.
- Quanh mieng den xam la than khi da suy kiet.
4. Ngu quan, tien am, hau am
Su bieu hien khac thUdng d ngu quan, tien am, hau am
phan anh benh bien cua noi tang. Sach au khoa thiet canh noi:
"Ngu tang khong the trong thay dUdc, chi co the trong vao ngu
quan va tien am, h^u am la dau hieu cua ngu tang ma thoi;
, neu s&c khittr v6i ng&y thUdng ma sic cua ngu quan lai phu
hdp vdi s&c mat thi tang phu hu hay thuc khong co khi nao la
khong nghiem". Than khai khieu d tien am va hau am hdp lai
thanh 9 khieu, quan sat ngu quan ia mot khau quan trong
trong vong can cua nhi khoa.
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4. 4.1. Xem m$t
Mat la khieu cua can, tat ca tinh hoa cua ngu tang deu
don len mat, cho nen xet xem hinh sac cua mat co the doan
biet dUdc benh bien cua noi tang ma mau chot la d cho than
khi' con hay mat.
- Long trSng sac do la dUdng nhiet, sac vang la thap uat,
sac xanh la the khiep nhUdc ma can phong thinh.
- Nude mat chay nhieu kem mi mat do hong can de phong
sdi moc
- Khoc khong co nude mat, khong ke han nhiet hu thuc,
ph&n nhieu la chiing nang.
- Mi mat sung hup la tha'p thinh c6 the phat thuy thung.
- Quang mat lom sau, mat moi, th&n u ru la khi hu dich
thoat.
- Mat do ngau la can thinh phong nhiet.
- Mach mau do suot den con ngUdi la hoa dot than am.
- Luc ngu hd trong mSt benh phan nhieu thuoc ty hu.
- Long trSng cua mat co cac diem ban thUdng do cam ti'ch
boc len.
- Bat dau bi benh ma mat hoa, tinh than toi md can lUu y
nhiet nhap tam bao.
- Benh lau ngay con ngUdi khuech tan rong ra bieu hien
nguyen than sap tuyet.
- Mat nhin thang, ngudc len hay nhin nghieng hoac neu
kich thich vao goc mui, mat ma co mi la can phong dong d
trong hoac dam nhiet be tac khieu co the dieu tri; ngUdc lai
kich thi'ch vao khong co phan ling la kho chijta, dau hieu chet
den ndi.
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5. 4.2. Xem mui
- Dau chot mui xanh. chau may lai ma khoc khong run
phan nhieu vi dau bung.
- Hdi thd ra to ma nong nhu dot, lai kiem co mui hoi thoi la
phe co thuc nhiet.
- Hdi thd ra lanh ma cham rai, nho yeu bieu hien chinh khi
hu ma am han n&ng.
- Mui chay nu6c trong la cam phai phong han.
- Nu6c mui due vang la phong nhiet pham phe.
- Nude mui due chay rong rong, mui hoi thoi la phong
nhiet vko den nao goi la ty uyen.
- Minh nong nhu dot, lo mui kho, khong co nude mui la phe
nhiet hai tan.
- Mui nhu hun khoi, lau chui khong troi hoac nong dut,
suyln thd, canh mui ph£tp phong, so vai la phong hoa deu
manh, hien tu<?ng am hu khf nghich len deu la chting nSng.
4.3. Ti4r 6m
Tien am thu6c th&n. Tre em trai biu dai sSn chftc m^u
tham den 1^ than khi dly du.
- Biu dai khong san, long thong, sSc nhdt la than khi hu yeu.
- Biu dai sUng thung la ty than bi hu lanh.
- Hon dai sung dau la chiing san khi.
- Biu dai co nit la can khi, than khi deu tuyet.
- Tre em gai am ho do hong u6t la co thap nhiet d bang
quang.
- Cua minh ngvfa, Udt chu y co nhiem trung.
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6. 4.4. Hau am
■Hau mon sung do, nong dau la nhiet d dai trang.
- Ngiia hau mon la c6 giun kim.
- Hau mon chay mau gap trong benh tri.
- Had mon co khoi sau khi di ngoai la sa trUc trang.
5. Xem liroi, xem hong
5.1. Reu ludi
Reu lu3i la benh bien cua ph£n ve, ph£n khi va trudng vi.
- Reu trftng mong la thdi k£ d£u cua b§nh ngoai cam, b?nh
ta con 6 ph&n bilu.
- Reu ludi trang day ma trdn la tha'p troc boc len.
- Reu lU0i v&ng trong vi nhiSt.
- Vang day d giufa ban la thap uat ket.
- Gitfa ludi co reu moc ti'm la trong da day co do an ngUng
dong lai.
Chu y: tre sd sinh lu3i do hong khong co reu, tre m6i bu
khap lUdi co reu trang mong va trdn thuoc hien tUdng binh
thUdng.
5.2. Chat ludi
Chat lu5i bieu hien tinh trang benh bien cua tam, phan
dinh, phan huyet.
- Chat ludi hong nhat la thuoc hu nhiet.
- Hong sSm thuoc thuc nhiet.
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7. Do IUdi la nhii't nhap v;n' Iam ban.
- lain: do sain, mua co diem do la nhiet (toe lam hai ’ a:il
- Ludi do -am, noi gai gap trong tam hoa hue U'-n do am hi
thUdngton ma gay nen.
• Ludi turn nhuan la tan dich hinh thUdng.
- Ludi kho rao la tan dich hi ton thUdng.
- Ludi co cho khong reu k iem hat sam gap trong nhiet tich
ty vi.
5.4. Hau hgng
HAu hong la lo thong de thd va An uong. Cac benh viem
hong (nhu nga), loet hong (hiu sa). bach h&u phln nhieu thay
d tre em cho nen can quan sat hau hong.
- Khong muon nuot kem theo 1 ben ho&c 2 ben hong sUng
phu len nhu con ngai goi la nhu nga.
- Hong do loet, dau nhiic kem theo minh nong va co nhiing
qu&ng do an hien tren mat da g&p trong benh lan h&u sa.
- Hau sUng dau co diem tr&ng, cue trSng la bach h&u.
6. Ring, Idi
- Rang co cau vang dong lai la khi thap troc boic len.
- Rang kho rao ma sang la vi nhiet, tan dich ton thUdng.
- Kho nhu xUdng kho la huyet dich d than kiet.
- Ldi sung vd dau la nhiet tich trang vi de phong tiu ma
nha cam.
- Ke rang chay mau vi vi nhiet boc len (cung co khi vi
huvet hu gay nen).

8. - Tre nghien rang phan nhieu thuoc vi nhiet hoac co giun
san.
- Neu nghien rang ldi la sap phat dong kinh.
7. Moi, tai
- Moi trang nhat bieu hien ty hu thieu mau.
- Moi kho chay la benh thuoc nhiet.
- Kho chay tim den la huyet nhiet ton hai den am.
- Quanh mieng sic xanh gap trong can phong lam hai ty,
de phong co rut kinh giat.
- Tre em chot tai lanh xanh, sau tai co van do £ln hien,
minh nong mat do la soli s&p moc.
- Sau tai hien van do thUdng do phong nhiet.
- Tai xanh 1k do lanh ki6m ch6t tai lanh se phat chufng
kinh phong.
- Tai sUng dau lam mu gap trong hoa can ddm xong len.
- Benh lau ngay, vanh tai co rut lai nhu van cting thang
ra, mat may xanh met ma kho khan hoac xanh den la hien
tUdng than tuyet kho chiia.
8. Xem chi v£n
Xem chi van la phUdng phap dac biet de chan doan benh
tat tre em dudi 3 tuoi. Chi ngon tay la dUdng mach lac hien ra
tif ho' khau thang den me tren phia trong ngon tay tro va dUdc
chia ra:
- Dot 1 cua ngon tro gan ho' kh^u la phong quan.
- Dot 2 cua ngon tro la khi quan.
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9. D o t c u a iiltoii t r o la m e n h q u a n .
C h i n g o n l a v h i n h t h u o n g m a u d o vaiiL,', a n n a p h .- n t r * m u '
m a k h o n g l) K 'ii lo r a p h o n g q u a n . K h i co b e n h h m h t h a i c u a c h i
v a n h i e n d o i m a u sac. v i t h e n a m d u d e q u y h i a t g i u p d i e u t r i
Khi thuc hanh tay trai thay thuoc cam ngon tro tre e m .
ngon cai hoac ngon tro cua tay phai thay thuoc miet nho nho
tu menh quan vao de thUc day khi huyet cho do luu thong lam
cho chi van de thay. quan sat chi van noi hay chim, mau sac, 6
bo vi nao de chan doan va dieu tri.
8.1. Noi, chim
Chi van noi hay chim la de phan biet bieu, ly.
- Chi van noi ra ngoai la benh 6 bieu.
- Chi van chim vao trong la ta d ly.
Sach a'u a'u t&p thanh noi: "Chi tay thong vdi mach thai
uyen, he co ngoai ta mach thai uyen phu thi chi tay cung noi".
Do la noi ve chi van noi, chim vdi hien tUdng mach phu
trim .
8.2. Do, tia
Chi van do hay tia la de phan biet han, nhiet.
- Chi van noi ro, mau do tUdi (khong phai do bam tim len)
la ta d ngoai mdi xam pham vao, benh con d bieu.
- Chi van do nhat, sang bong la trung khi hu nhUdc, dinh
ve khong day du, thuoc chiing hu han.
- Chi van do bam (ti'm tham) la ta nhiet uat tre.
- Chi van xanh ti'm gap trong can kinh co phong nhiet.
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10. - Chi' van xanh chu ve kinh phong, dau ddn; xanh kiem ti'm
den la huyet lac hi uat dong lai thuoc benh nang.
8.3. Hoat (nhat) hay tre
Xem chi van hoat hay tre la de phan biet hu, thuc.
- Hoat la chi ngon tay nhat, thuoc hu.
+ Do nhat la hu han, xanh nhat la hu kiem co phong, tim
nhat trong hu co nhiet.
+ Chi ngon tay nhdt nhat gap trong dUdng khf hu suy ,
sac trang bech, moi ludi nhdt nhat.
+ Chi ngon tay nhat (khong ke benh mdi hoac lau ngay)
deu thuoc hu.
- Chi van tre khong dUdc luu ldi vi benh lam ng&n tre su
van hanh cua dinh ve, benh do phong nhiet ho&c an uong trcl
tre deu thuoc chting thuc.
8.4. Xem tam quan
Xem tam quan la de biet benh nang nhe.
Tom lai: thong qua xem chi van de chan doan am dUdng,
nong sau, nang nhe. Cu the nhu chi van xuat hien d phong
quan la benh mdi, ta con d nong; chi v&n xuat hien d khi quan
la benh ta dang manh; chi van d menh quan thi benh da nang.
Neu chi tay thang len mong tay (thin quan xa giap) thuoc
chung nguy hiem.
B. VAN CHAN
Chu yeu nghe nhiing am thanh, nghe tieng noi nang, hdi
thd, ho hen cua tre em, dong thdi dung khiiu giac de ngui nghe
cac mui hdi thd trong mieng va nUdc tieu tre em.
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11. 1. Tieng khoc va tieng noi
1.1. Tieng khoc
Xeu khoc hinh tinning, khoc to dai nhiing khong <
ro nuhc
mat. moi ngav chi khoc vai lan ma khong co benh trang gi
khac. thi do la hinh thUdng.
• Khoc lien mien, keo dai ma duoi sUc, lie dUdc hu la het
khoc thi do la khoc vi doi.
- Khoc cao, gay gat, luc khoan luc nhat, khi khoc khi
khong thUdng gap trong dau bung.
- Khoc cham ren ri bieu hien cam tich.
•Khoc khan, hdi the) khong thong trong dau yet hau.
- Neu khoc gay git nho yeu ho&c khong co nUdc m&t deu
thuoc benh nang.
1.2. Tieng noi
■Noi nho tram yeu thuoc hu han.
- Tieng im am vang doi thuoc thuc nhiet.
- Noi nang ne khong trong treo la th&'p.
- Noi vudng vi'u la dam.
- Noi khan phan nhieu la phong dam phuc hoa.
2. Hdi thd va ho hen
2.1. Hof thd
■Suyen thd gap. thd to la phe nong boc len.
- Ddm kho khe. tieng keo cua la phong ddm nhiet til be.
- Hdi thd nho yeu khong co silc thuoc chiing hu.
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12. - Thd ra nhieu, thd vao it la benh trim trong.
2.2. Ho hen
- Ho d§ dang thong ldi, ddm mui deu trlng ra la ngoai cam
phong ta.
- Ho kho khan, thd to thuoc phe nhiet.
- Ho khan khong ddm hoac ddm kho ra, khan tieng la phoi
rao.
- Ho tiifng cdn lien tiep khong dilt hoac sau cdn ho lai non
mvia gap trong ho ga.
3. Ngui khi vj
- Mieng hoi la trudng vi co nhiet ua't xong len.
- 0 hSng la trong da day co do an dinh tre.
- Dai tien long trang, tanh hoi do ty dUdng khong van hoa
dUdc.
- Di ngoai ra nguyen chat la ty than hu han.
- Phan mui chua gap trong thuc tich.
- Mui hoi khong chiu dUdc la ty vi co nhiet doc chifa dong
lai.
- Niidc tieu due ngau, co mui tanh la bang quang bi thap.
- Tieu trong dai khong co mui la trong co han.
- Tieu vang do, khai la trong co nhiet.
C. VAN CHAN
Chu yeu la hoi ngUdi nha cua tre. Trong phan hoi benh
nen chu y la co nhiing dilm giong ngUdi ldn.

13. 1. Hoi ve nong lanh
- Hay cii dong duoi ra co vao tim cho am, muon dUdc ap
vao long phan nhieu sd ret.
- Khi bu mieng tre nong la phat sot.
- Tre sot. sd lanh khong co mo hoi la cam phong han. Tre
sot, sd gio, ra mo hoi la cam phong nhiet. Tre luc sot luc ret la
chiing han nhiet vang lai, benh thuoc ban bieu ban ly. Sot cao
keo dai la benh d ly.
- Tre sot co cdn goi la trieu nhiet, ra mo hoi trpm g£p trong
chiing hu lao.
- Tre sd lanh thich dip chan ma khong sot thuoc chiing ly
han hoSc dUdng hu.
2. Hoi ve mo hoi
- Luc ngu ra mo hoi (dao han) g&p trong coi xtfdng, suy
dinh dudng.
- Binh thUdng de ra mo hoi thuoc khi hu (dudng hu), hay
gap trong benh phe khi hu, ty hu, roi loan tieu hoa.
- Ra mo hoi kem theo chan tay lanh la benh hiem ngheo.
3. Hoi ve dau, than minh
- Phat sot, ham chui dlu vao ngu gSp trong dau diu.
- Phat sot, quay trd khong yen thUdng minh m&y dau
nhiic.
- Dlu gay ciing trong kinh phong.
4. Hoi ve dai tien, tieu tien
- Nude tieu nhieu ma trong la thuoc han.

14. - Nude tieu it, vhng la thuoc nhiet.
- Nude tieu nhuf nude vo gao la thuoc thap nhiet.
- Sot cao ma dai l't hoac khong dai la nhiet thinh thUdng
tan.
- Dai tien tao la trUdng vi nhiet.
- Dai tien long loang kem theo chat khong tieu la ty hu.
- TrUdc khi ia, tre khoc quay thUdng vi dau bung kho ia.
- Phan co mau mui la chiing kiet ly.
5. Hoi ve 3n uong
- Mieng moi kho rao, bu luon la tre khat.
- Muon bu luon, it muon £n la kh^u vi m&'t binh thUdng.
- An nhieu chong doi la vi hoa thinh.
- An ft, chan an, bung day la thUc tfch hoac ty vi hu.
- Tre khong thfch bu hoac khi ngam vu la khoc thUdng do
lUdi, mieng Id dau.
- Tre an bu vao ma de non la do thuc tfch hoac do vi nhiet
hoac do benh ve nao - mang nao.
6. Hoi ve giac ngu
- Ngu yen lang, hdi thd dieu hoa la thin khf deu yen tinh.
- Dang ngu giat minh keu la thuoc phien tao khong yen.
- Ngu hay giat minh la tam khf hu.
- Ngu hay nghien rang la trung tfch.
- Tre ft ngu, ngu khong yen giac gap trong tam vi nhiet.
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15. N'noai 1,1 hm vi : 1
1
1!i hinh .'iir klioe truoc khi mar brnh.
.jU:<! nnh sinh trwyru pH.it .Iu< . dieu kiyti cham ><u -mb. h' -at.
b e n h >
11 .i i it'ii su i'.i nhan. tinh hinh ticm chung. tiep ui
nmion lav va qua trinh phat benh.
I). THIET CHAN
Thiet chan bao gom: bat mach, nan bung, nan chan tay va
sd thop.
1. Bit mach
- Chi co the sii dung 1 ngon tay ma dinh dUdc. Mach tre em
dap tUdng doi nhanh. tre dudi 3 tuoi thi 1 hdi thd mach dap 6 -
7 lan, mach binh thUdng thi so tuoi tang la so mach giam.
- Xem phu, trim, tri, sac de chan doan am dudng, bieu ly,
han nhiet. Mach phu an nhe ngon tay da co mach dap la benh
d bieu; mach trim an sau mdi thay mach dap la benh cf ly;
mach tri cham hdn so vdi cung liia tuoi la chiing han; mach sac
nhanh hdn so vdi mach cung lCfa tuoi la chiing nhiet.
- Xem mach co luc la chiing thuc, mach vo luc la chiing hu.
2. Sd nln
Sd nan bao gom: sd thop, sd bung va chan tay.
- Tre em dudi 1 tuoi thop chua kin, neu thang tuoi ldn ma
thop con rong hoac chua lien gap trong benh coi xUdng.
- Thop lom sau xuong phan nhieu do tien thien suy kem,
dudng khi ha ham.
- Dau tran nong hdn ngUc bung va long ban tay la nong
ngoai cam.
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16. - Long bay tay nong hdn dau va tran la hu nhiet.
- Long ban tay nong hdn mu ban tay la noi nhiet.
- Dau chan deu nong la dudng nhiet manh llm.
- Dau nong ma chan tay lanh la nhiet ta be tic d trong,
thUdng thay d benh sdi hoac thuy dau luc mdi bit dau phat.
- Tran do mo hoi la ly han, d trong dudng khi sap thoat.
- Chi lanh ngon tay giuta la thuy dau hoac sdi sip phat.
- Chan tay lanh gia la dudng khi' suy kiet, cung co khi ta
nhiet an nap sau ma gay ra.
Sd n&n bung de biet tinh hinh lanh nong, mem ciing, ua
n&n hoac khong Ua nin de chan doan phan biet han nhiet, hu
thuc.
* Viing bung ron lanh mem, Ua n&n la trang vi co phong
han.
- Bung nong, ciing rln la trang vi co nhiet tich; khong
thich n&n la thuc ta da ket tu lai.
- Bung trudng day de vao rong la khi trUcing.
- Bung trUdng day ciing co gan xanh thuoc chiing cam tich.
II. BAT Cl/ONG
Sau khi kham benh, ngUdi thay thuoc cin quy nap cac
trieu chiing thu nap dUdc tren lam sang thanh nhiing hoi
chiing benh ly d§ danh gia dUdc vi tri, tinh chat, trang thai va
cac xu the chung cua benh tat giup cho viec chan doan va de ra
cac phUdng phap chiia benh chinh xac.
Quy nap theo bat cUdng trong nhi khoa cung gom: bieu ly,
han nhiet, hu thuc, am dUdng.
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17. 1. Bieu va ly
Bieu a ly la hai cuony linh de xac dinh vi tri nong -au >ua
he nil. de tien liiong va de ra phuong ])hap chua benh thich hop
(henh d bieu thi phat tan; benh o' ly thi dung phep thanh. on.
tieu, ho v.v...)
1.1. Bieu chung
Bieu chiing thUdng la giai doan dau cua benh ngoai cam,
henh con d hen ngoai. d nong.
Cac bieu hien lam sang thUdng co: phat sot, sd gio, sd lanh,
ra mo hoi, dau dau, dau minh may, ngat mui, ho, reu ludi
trang mong, mach phu.
1.2. Ly chung
Ly chiing la benh c
f trong sau, thUdng la benh cua cac tang
phu, benh truyen nhiem d giai doan toan phat, doi khi co kem
theo bien chiing nhu mat nude, dien giai hoSc chay mau.
Cac bieu hien lam sang chu yeu la: tre sot cao, quay khoc
nhieu, khat nUclc; nang hdn thi hon me, co giat, chat ludi do,
reu lUdi vang, nude tieu do, tao bon hoac ia chay, mach sac.
Benh d ly co the til ngoai truyen vao hoac do ta khf trung
ngay vao tang phu. Su phan biet giiia bieu ■chiing va ly chiing
thUdng can cu vao sot cao, sd nong hay sot nhe kem sd lanh,
khat nUdc hay khong. chat ludi do hay nhat, reu ludi vang hay
trang, mach phu hay mach tram.
2. Han va nhiet
Han va nhiet la hai cUdng linh dung de danh gia tfnh chat
cua benh, til do giup cho thay thuoc chan doan cac loai hinh
cua benh tat va de ra phUdng phap chijta benh hdp ly (benh
han dung thuoc nhiet va benh nhiet dung thuoc han; nhiet thi
cham. han thi cUu).

18. 2.1. Han chung
Han chiing co bieu hien so lanh, thfch am, khong sot hoac
sot khong cao, mieng nhat khong khat nil6c hoac thfch uong
nude am nong, sic mat xanh tring, chan tay lanh, nUdc tieu
trong dai, dai tien long loang, chat lu6i nhat, reu tring trdn va
Udt, mach tram tri. Chiing han thUdng ket hdp vdi cac cUdng
linh khac nhu bieu han, ly han.
2.2. Nhiet chiing
Nhiet chiing thUdng gap trong nhi khoa, bieu hien chu yeu
la: sot, khat nude, mat do, m it do, chan tay nong, tieu tien
ngin do, dai tien tao, reu ludi vang kho, ch&'t ludi do, mach
sac.
Su phan biet han chiing va nhiet chiing chu yeu dua vao:
sot sd nong hay sd lanh, khat nude hay khong khat, mfit do
hay tring xanh, tay chan n6ng hay lanh, tieu tien do ft hay
trong d^i, dai tien tao hay ia chay, reu ludi vang hay tring,
mach tri hay mach sac.
Trong mot so trUdng hdp han nhiet thac tap hoac chan
nhiet gia han, chan han gia nhiet thi can phan biet ro.
3. Hu va thirc
Hu va thuc la hai cUdng linh dung de danh gia trang thai
ngUdi benh va nguyen nhan gay benh, tir do th iy thuoc thuc
hien nguyen tic chula benh: hu thi bo, thuc thi ta.
3.1. Hu chiing
Bieu hien chfnh khf (chfnh khf cd the gom co 4 phin chfnh
la am, dudng, khf, huyet) suy nhudc v^ sil phan ilng cua cd the
doi vdi tac nhan gay benh giam sut.
T3- CK. NK
33

19. Mu'-u hit*1
1 chu veil tren lam sails.’ la: tinh than veil <iu#.i.
ngUdi met moi khong cn su e . >ac mat trantz nhot. hm h'■j ■
. iiifiu
noi. thd ngan. tu ra mo hoi hoac ta mo hoi trom. <ti tieu luon
hoac khong tu chu. chat lu<ii nhdt. mach te nhUdc vo luc.
3.2. Thuc chung
Chiing thuc la chi ta khi dang manh. co the tre con khoe
va sU phan ling cua tre doi vdi nguyen nhan gay henh manh.
ThUdng gap trong cam phai ngoai ta hay do khi tre. huyet ii,
dam tich, trung tich va u nUdt.
Cac bi§u hien chinh tren lam sang: tieng thd tho manh,
phien tao, ngUc sUdn day trUdng, dau nhiic cU an, dai buot, dai
rSt hoSc bi tieu tien, tao bon hoac mot ran, reu ludi vang,
mach thuc hijfu luc.
Su phan biet hu chiing va thuc chiing c^n cl vao may diem
sau: benh mdi mSc hay benh lau ngay; tieng noi, tieng khoc hdi
thd to hay nho, tre cU dong tay chan yeu hay manh, tre de
thieu thang hay du thang, dau cU an hay thien an, mach vo luc
hay hviu luc. Trong thuc te co mot so trUdng hdp hu trung hiep
thuc nen cin phai luu y.
4. Am dirong
Day la hai cUdng linh tong quat de danh gia xu the chung
cua benh tat. Chiing d bieu, chiing nhiet, chiing thuc thuoc
dudng; chiing d ly, chiing han, chiing hu thuoc am .
Su m it thSng bang cua am dudng bieu hien bang su thien
thang (am thinh. dudng thinh) va su thien suy (am hu, dudng
hU; vong am. vong dudng).
4.1. Am chiing va duong chiing
■ Am chiing thUdng bao gom cac chiing hu va han, co bieu
hien: ngUdi lanh, chan tay lanh, tinh than met moi, tieng thd
34

20. tieng khoc nho, tre nam quay vao trong va thfch am, khong
khat, tieu tien trong dai, dai tien long, s&c mat trang, liidi
nhot, mach tram nhUdc.
- Duong chiing gom cac chiing thuc va nhiet, co bieu hien
chan tay am, tinh than hieu dong, nam quay ra ngoai, thd to
tho, khoc to, phat sot, sd nong, khat nude, tieu tien do ft, dai
tien tao, mat do, ludi do reu vang, mach hoat sac.
4.2. Am huva dtrong h i/
- Am hu thUdng sinh noi nhiet, co bieu hien: trieu nhiet, ra
mo hoi trom, dau nhilc trong xUdng, ngu tam phien nhiet, hong
kho, ho khan, hai go ma do, vat va kho ngu, ludi do ft reu,
mach te sac.
- Dudng hu sinh ngoai h&n, c6 bieu hien: sd lanh, chan tay
lanh, d iy bung, ch&m tieu, tieu tien trong dai, dai tien long
loang, reu ludi trSng, ch&'t lu3i nhat, mach nhUdc vo ltfc.
4.3. Vong am, vong dircmg
- Vong am la hien tUdng mat nude, mat tan dich thUdng
gap trong ia chay mat nUdc hoac mat mau, hoac ra mo hoi
nhieu. Am dudng nUdng tUa vao nhau cho nen khi mat nUdc,
mat tan dich den giai doan nao do se gay vong dudng tile la
choang truy tim mach, con goi la thoat dUdng.
Vong am thUdng chan tay am, khat nUdc, thfch uong nude
lanh, mo hoi nong vi man va khong dfnh, ludi kho, mach thon
phu vo luc ma mach xfch nhUdc.
- Vong dudng thi chan tay lanh, khong khat nUdc, thfch
uo'ng nUdc am nong, mo hoi lanh vi nhat va dfnh, ludi nhuan,
mach vi muon tuyet.
35

21. III. cA c h Oi c h ltn g b Enh
Cac hoi chung henh gom cac hoi chung henh ve khi. huyet.
tan dich; cac hoi chiing henh thuoc cac tang phu va cac hoi
chUng benh ngoai cam nhu luc kinh va ve, khi. dinh. huyet.
A. CAC HOI CHUNG BENH VE KHI, HUYET, TAN DICH
1. Cac hoi chung benh ve khi
Cac hoi chUng benh ve khi gom; khi hu, khi tre va khi
nghich.
1.1. Khf hu
Khf hu la do cong nang hoat dong cua cd the va noi tang bi
giam sut, thudng gap d ngUdi co benh man tfnh, ngUdi gia yeu,
ngUdi benh d thdi ky hoi phuc sau khi m ic benh ning.
- Bieu hien lam sang chu yeu la: ngUdi met moi khong co
silc, hdi thd ngin, tieng khoc nho, tu ra mo hoi, an uong kem,
sic mat tring nhdt, chit ludi beu, mach hu vo luc. Ngoai ra co
the khf hu ha ham gap trong sa true trang, thoat vi, dai son
v.v...
- PhUdng phap dieu tri; bo khf, fch khf hoic fch khi, thing
de.
- Bai thuoc; Til quan tii thang, Bo trung fch khf thang.
1.2. Khf tre
Khf tre do cd ning hoat dong cua cd the hay mot bo phan
cua cd the bi trd ngai, thudng do nguyen nhan cam phai ngoai
ta, tinh than sang chin hoic in uong khong dieu hoa.
- Bieu hien lam sin g: diy, trUdng v i dau. Khi tre d ngUc
sUdn thi gay dau ngUc sUdn; khf tre d trung tieu g iy dau
36

22. thudng vi; khi tre d ha tieu gay dau bung vung ha vi. Dac tinh
cdn dau do khi' tre thudng luc dau nhieu, luc dau l't, vi tri dau
khong nhat dinh, kem theo bung d&y trUdng, d hdi hoic trung
tien thi giam dau.
- PhUdng phap dieu tri: hanh khi.
- Bai thuoc: Viet cuc hoan.
1.3. Khi nghich
- Khf nghich hay thay d phe, thudng do dam va khi nghich
lam cho phe khi khong tuyen giang dUdc gay hen suyln, tiic
ngUc, kho thd.
PhUdng phap dieu tri: giang khi, binh suyen.
Bai thuoc: Dinh suyln thang.
- Khi nghich 6 vi thudng do thuc tich, han tr^ gay non
miia, n&c hay d hdi.
PhUdng phap dieu tri: ly khf, giang nghich.
Bai thuoc: Dinh hUdng thi de thang.
- Can khi nghich gay dau tiic ngUc sUdn hofic dau thUdng vi.
PhUdng phap dieu tri: giang khi, thuan khi.
Bai thuoc: Tii ma am.
2. Hoi chumg benh ve huyet
Hoi chiing benh ve huyet bao gom: huyet hu, huyet vf,
huyet nhiet va xuat huyet.
2.1. Huyet hu
- Huyet hu do ty hu khong sinh dUdc huyet hay do xu&'t
huyet qua nhieu.
37

23. Bitju hien lam sang chu yeu la sac mat xanh nhdt hoac hdi
vang, moi trang nhdt, hoa mat chong mat, ngu hay giat minh,
chat ludi nhat, mach te sac.
- PhUdng phap dieu tri: bo huvet.
- Bai thuoc: Tii vat thang hoac Dudng quy bo huvet thang.
2.2. Huyet C
r
Huyet O
rla hien tUdng sung huyet tai cho hay sung huyet d
tang phu do chan thudng, viem nhiem hoac khf tre.
- Bieu hien lam sang: dau tai ndi
l huyet, dau du doi nhu
dui dam, dau co vi tri nhat dinh kem theo sUng trUdng, dau cU
an, sic mSt xanh toi, moi mieng tim, chat ludi xanh tim co
nhiing diem d huyet, mach sap.
- PhUdng phap dieu tri: hoat huyet, khiJt d.
- Bai thuoc: TCf v&t d&o hong.
2.3. Huyet nhi$t
Huyet nhiet do phan huyet co nhiet hay nhiet ta xam
pham huyet phan gay xua't huyet (nhiet bile huyet vong hanh).
Bieu hien lam sang: ngUdi tre nong, dem nong nhieu hdn
ngay, tre vat va quay khoc, mieng kho khong muon uong, cha't
lUdi do sam, mach te sac. Neu nhiet manh biic huyet vong
hanh gay chay mau cam, non ra mau, dai tien ra mau.
PhUdng phap dieu tri: thanh nhiet, lUdng huyet.
Bai thuoc: Te giac dia hoang thang.
2.4. Xuat huyet (chay mau)
Chay mau thudng do cac nguyen nhan: ty khi hu khong
thong nhiep dUdc huyet, huyet nhiet (hay nhiet bCfc huyet vong
hanh), huyet ijf.

24. - Xuat huyet do huyet nhiet: mau do tUdi, tre vat va tran
troc, chat ludi do, mach te sac.
- Xuat huyet do ty hu khong thong nhiep dUdc huyet: mau
nhat mau, mau ra keo dai ri ri, sac mat trang nhat, chat ludi
beu, mach te vo luc.
- Xuat huyet do huyet li: mau ra ti'm co cuc kem theo dau
dii doi, ludi xanh ti'm co diem ii huyet, mach sap.
PhUdng phap dieu tri: lUdng huyet, chi huyet (do huyet
nhiet) dung Tii sinh hoan; bo khi', nhiep huyet (do ty khf hu)
dung Hoang tho thang; hoat huyet, chi huyet (do huyet O
r)
dung Tha't ly tan.
3. Hoi chCmg benh ve tan djch
Hoi chiing benh ve tan dich bao gom: tan dich khong d£y
du va ii dong tan dich.
3.1. Thieu tan djch
Tan dich thieu la do mo hoi ra nhieu, ia chay mat nu6c,
mat mau, non nuia nhieu, tieu tien nhieu, sot cao keo dai lam
mat nUdc hoac do cong nang cua ty, phe, than bi roi loan.
Bieu hien lam sang: mieng khat, hong kho, moi kho, da
nhSn nheo, tieu tien ngan va l't, tao bon, mach te sac; neu sot
cao gay mat tan dich thi tre vat va, khat nUdc, chat lUdi do,
reu lUdi vang, mach te sac; neu kem theo met moi, thd ngan,
chat ludi beu nhat, mach hu nhUdc thi do la khi am hu.
PhUdng phap dieu tri: thanh nhiet dudng am sinh tan
(trUdng hdp sot cao keo dai) dung Tang dich thang; l'ch khi'
sinh tan (neu khi' am deu hu) dung Sinh mach tan
39

25. 3.2. Tan djch if dong
Tan dich O
f dong thudng gap trong cac benh dam am. thuy
thung v.v...
Bieu hien lam sang: hen suyen, ddm nhieu, trong ngUc, thd
ng^n gap, mang sUdn day trUdng, bung trUdng day. an k£m,
mieng nhat, tieu tien it, dai tien long, mat mat phu, chan phu,
co trUdng, reu ludi day, mach nhu.
PhUdng phap dieu tri: thong dUdng hoa am (do phe khi
khong tuyen giang) dung Viet t£ thang; kien ty hoa thap (do ty
hu khong v&n hoa dUdc thuy tha'p) dung ThUc ty am; on thin
ldi thuy (do than khong khi hoa) dung Te sinh than khi hoan.
B. HOI CHUNG BENH TANG PHU
1. Tam
1.1. Hi/chiing
1.1.1. TSm duong hu, tSm khi hif: do mot so' benh khac nhu thtfp
tim, suv tim, truy tim mach hoac mat mo hoi, mat tan dich
nhieu lam anh hUdng den khf huyet.
- Bieu hien lam sang: trong ngUc, thd ngan, tu ra mo hoi,
hoat dong benh tang len.
+ Neu tam khf hu (kem them hien tUdng khi hu): sic mat
xanh. met moi vo luc; lUdi nhat mem beu, reu tring, mach hu.
+ Neu tam dudng hu (kem them hien tUdng dudng hu);
ngUdi lanh, tay chan lanh, sic mat xanh, ludi nhat, mach
nhUdc ket dai.
+ Neu tam dudng hu thoat (choang, truy tim mach):then
cac chiing ra mo hoi khong ngvTng, chan tay quyet lanh, mo
xanh tim, thd nho yeu, ludi tim xam, mach nho muon mift.
40

26. - PhUdng phap chfla:
+ Bo fch tam khf (neu tam khf hu): dung Dudng tam
thang.
+ On thong tam dudng (neu tam dudng hu): dung Que chi
cam thao thang.
+ Hoi dudng cUu nghich (neu tam dUdng hu thoat): dung
Nhan sam tU nghich thang.
1.1.2. TSm huyet hu va tam am hu. tam huyet hu va tam am hu
la do sU sinh ra huyet giam sut hoac xay ra sau khi mat mau,
chan thudng.
- Bieu hien lam sang: trong ngUc, hoi hop, de kinh sd, vat
va, m&'t ngu hay quen.
+ Neu tam huyet hu (kem theo hien tUdng huyet hu): hoa
mat, chong mat, sic mat xanh, moi nh<?t ludi nhat, mach phu
vo luc.
+ Neu tam am hu (kem theo hien tUdng am hu): sot nhe, tu
ra mo hoi, ngu tam phien nhiet, mieng kho, ludi do reu ft,
mach te sac.
- PhUdng phap chtia:
+ Dudng tam huyet, an thin (neu tam huyet hu): dung bai
TU vat thang.
+ Tu dudng tam am, an thin (neu tam am hu): dung bai
Thien vUdng bo tam dan.
1.2. Thi/t chung
1.2.1. T£m hda thinh: tam hoa thinh la do tinh chf, dam tre hoa
hoa d ben trong cd the, an do cay beo nhieu hoac uong nhieu
thuoc nong gay ra.
41

27. - Bieu hien lam sang: tre quay khoc, vat va khong ngu,
khat nUdc, ludi mieng Id dau. chay mau cam. chat ludi do,
mach sac.
- PhUdng phap chUa: thanh ta tam hoa, dung Thanh tam
hoan hoAc Hoang lien giai doc thang.
1.2.2. Dam hoa nhiSm tam va dam me tam khieu: do tinh thAn hi
kich dong gay khi ket lai san sinh ra thap, thap hoa dam troc
gay trd ngai den tam...
- Bieu hien lam sang: tinh than khac thudng, thAn chf hon
loan, tre quay khoc la het.
+ Neu dam hoa nhieu tam: kem theo vat va, mat ngu, de
kinh sd, mieng dAng, nAng thi noi lung tung cUdi noi huyen
thuyen, thao cuong, reu ludi vang day, mach hoat hiitu luc.
+ Neu dam me tam khieu k6m theo tinh th£n dan don, n6i
mot minh; nAng thi dot nhien nga lan, ddm kho khe, reu ludi
trang day, mach trAm huyen hoat.
- PhUdng phap chtia:
+ Thanh tam ta hoa, trU dam khai khieu (dam hoa nhieu
tam): dung bai On ddm thang gia giam.
+ TrU dam khai khieu (dam me tam khieu): dung bai An
cung ngUu hoang hoan hoac Tu tuyet dan.
2. Phe
2.1. Hu chung
2.1.1. Phe khi hU: do ho lau ngay lam ton thudng phe khf, hoic
do ty khf hu khong van hoa do tinh vi cua thuy coc len phe lam
phe khf hu (ty tho hu khong sinh dUdc phe kim). Ngoai ra tam,
than, khf hu cung anh hUdng den phe.
42

28. - Bieu hien lam sang: ho khong co siic, thd ngan, ngai noi,
tieng noi nho, ngUdi met vo luc, tu ra mo hoi, sac mat trang
bech, chat ludi nhat, mach hu nhupc.
- Phuong phap chUa: bo fch phe khf, dung bai Bao nguyen
thang hoac Sam linh bach truat tan.
2.1.2. Phe am hU: do mac benh lau ngay hoac benh mdi mac
lam ton thudng den phe am; hay gap trong lao phoi, hen phe
quan.
Phe am hu co 2 mUc do: am hu ddn thuan va am hu hoa
vUpng.
- Bieu hien lam sang: ngUdi g£y, met moi, tieng khoc tieng
noi nho.
+ Am hu don thu&n: ho ngay cang nang, khong co ddm,
ho&c ft, ma dfnh, hong kho ngtia, ch&'t ludi hdi do, ft tan dich,
mach te vo luc.
+ Neu am hu hoa vUdng: them cac chUng ho ra mau, mieng
kho khat, chieu phat sot, ra mo hoi trom, chat ludi do, mach te
sac.
- PhUdng phap chUa:
+ Tu am dudng phe (phe am hu): dung bai Sinh mach tan
hoiic Bach hdp co' kim thang.
+ Tu am giang hoa (am hu hoa vUdng): dung bai Bat tien
trUdng tho hoan.
2.2. Thuc chung
2.2.1. Phong han pham phe: do phong han lam phe khf khong
tuyen giang; hay gap trong hen phe quan, viem thanh quan,
khai th£u.
43

29. - Bieu hien lam sang: ho ma tieng ho manh, co khi suyen,
ddm loang trang de khac. mieng khong khat, chay ntfdc mui
trong, sd lanh. dau minh. reu ludi trang mong, mach phu
khan.
- PhUdng phap chQa: tan han tuyen phe, dung bai Hanh td
tan hoac Chi khai tan.
2.2.2. Phong nhiet pham phe: do phong nhiet lam phe khf
khong tuyen giang; gap trong viem phoi, viem phe quan cS'p.
- Bieu hien lam sang: ho ddm vang dinh kho khac, thinh
thoang khac ra ddm dinh mau, mieng kho, thfch uong ntfdc,
chay nude mui due, dau hong, dau liidi do, mach phu sac.
* Phiidng phap chiia: thanh nhiet tuyen phe, dung b&i Ma
hanh thach cam thang hoac Ngan kieu tan.
2.2.3. Ddm troc lam tro ngai phe: dam tha'p lam phe m£t stf
tuyen giang; gap trong hen phe quan, ap xe phoi.
- Bieu hien lam sang:
+ Ho ddm nhieu, sac trang de khac, thay kho khe ttfc ngtfc,
reu lUdi trang day, mach hoat.
+ Neu la dam thap thi benh nhan sd lanh, ddm loang, khi
gap lanh benh cang tang. Neu am ta ngvfng lai d phe thay xuat
hien cac chiing ngUc day tiic, ho dau ngiic, reu ltfdi trang mong.
- PhUdng phap chiia: tao tha'p hoa dam, dung bai Nhi tr4n
thang hoac Bach hdp co kim thang.
3- Ty
3.1. Hu chung
3.1.1. Ty khi hit. do tang ngvfdi yeu, de non thieu thang, ftn
uong kem dinh dudng gay ra. Vi ty co chiic n&ng ki§n vftn, chu

30. thang khi, thong huyet nen ty hu co nhiing bieu hieu lam sang
phong phu.
- Bieu hien lam sang: an kem, tieu hoa kem, ngUdi met
moi vo luc, thd ngln, ngai noi, tieng noi va tieng khoc nho, sic
mSt hdi vang hay trang.
+ Neu ty mat kien van thi kem theo d&y bung, cham tieu,
song phan, chat ludi nhat beu, reu ludi tring, mach hu.
+ Neu ty hu ha ham: ia chay man tinh, sa true trang, sa da
day ho&c sa cac noi tang khac, chat luoi nhat, mach hu nhUdc.
+ Neu t£ khong thong huyet: dai tien ra mau, xuat huyet
dudi da, ch&'t lu5i nhat, mach hu nhUdc.
- PhUdng phap chuta:
+ Kien ty ich khi (neu ty mat kien v4n): dung bai Sam linh
bach tru&t tan.
+ Ich khi thang de (neu ty hu ha ham): dung bai Bo trung
l'ch khf thang.
+ Kien ty nhiep huyet (neu ty hu khong thong huyet):
dung bai Quy ty thang gia giam.
3.1.2. Ty duang hif. do ty khi hu hay do Sn do lanh lam ton
thudng dUdng khi cua ty.
- Bieu hien lam sang: dau bung am 1, gap lanh dau tang,
chUdm nong dd dau, dai tien phan long loang, ngUdi lanh, tay
chan lanh, ludi nhat, reu tring, mach tram tri.
- PhUdng phap chUa: on trung kien ty, dung bai Hoang ky
kien trung thang ho^c HUdng sa luc quan tii thang.
45

31. 3.2. Thuc chung
3.2 1. Ty bi han thap. do an uong phai do lanh hoac bj cam do
mua. lanh. am thap gay benh cho ty. lam ty mat chuc nang
van hoa, gap trong ia chay do lanh.
- Bieu hien lam sang: an xong hung trUdng. ldm giong
buon non hoac non mua. ngUdi met nang ne, dai tien long, tieu
tien it. mieng khong khat, reu ludi trang day. mach nhu hoan.
PhUdng phap chiia: on trung hoa thap, dung bai Hole
hUdng chfnh khi tan hoac Bat hoan kim chi'nh khi tan.
3.2.2. Ty bi thap nhiet: gap trong ia chay nhiem trung, kiet ly,
hoang dam.
- Bieu hien lam sang: bung trUdng dly, 1dm giong buon
non, ngUdi met, than nang ne, hoang dam sic vang tUdi, sot,
mieng ding, nude tieu l't ma vang, reu ludi vang day, mach
nhu sac.
- PhUdng phap chUa: thanh ldi thap nhiet, dung bai Cat
can cam lien thang hoac Nhan tran cao thang.
3.2.3. Ty h u do giun
- Bieu hien lam sang: dau bung vung quanh ron, bung dly
truong, mat hdi vang, ngUdi gay, reu ludi tring di'nh, d hdi,
mach nhu.
- PhUdng phap chua: kien ty, trU trung tich; dung bai Hoa
trung hoan, O mai hoan hoac Phi nhi hoan.
4. Can
4.1. Can hoa thutJng viem: thudng gap trong viem gan, cac
chung chay mau.
46

32. - Bieu hien lam sang: hoa mat, chong mat, nhUc dlu, tai u.
phien tao, de cau, mat do, mat do, mieng dang, hoang dam,
nude tieu vang, hoac co khi ho ra mau, non ra mau, chay mau
cam, ludi do reu vang, mach huyen sac.
- PhUdng phap chuta: thanh can giang hoa, dung bai Long
ddm ta can thang.
4.2. Thap nhiet dean kinh
Do thap nhiet 0 ben trong lam khi cua kinh can bi U tre,
viec sd tiet cua can va sU tiet mat cua ddm bi trd ngai gay ra
chUng can kinh thap nhiet, gap trong hoang dam.
- Bieu hien lam sang: mang sUdn dau tUc, vang da, tieu
tien ngln do, reu ludi vang day, mach huyen sac.
- PhUdng phap chiia: thanh tha'p nhiet d can ddm, dung bai
Nhan trln chi tvk thang.
4.3. Can phong noi ddng
Can phong noi dong (goi tat la noi phong) gap trong sot cao
gay co giat hoac do can huyet hu khong nuoi dudng dUdc can
mach gay ra (nhu trong dong kinh, benh nao, mang nao).
- Bieu hien lam sang:
+ Sot cao co giat (nhiet cUc sinh phong): sot cao, hon me,
gay cUng, co khi ngUdi uo'n cong, tay chan co quip, chat ludi
do, mach huyen sac.
+ Can dudng vUdng, co 2 mile do:
. ChUng can dudng thudng xung: nhiic dlu, chong mat, u
tai, phien tao, hay cau, mat ngu, hay quen, chat ludi do, it tan
dich, mach huyen.
. Chiing trung phong: dot nhien nga, ludi ciing, noi kho,
liet nUa ngUdi, co khi hon me ba't tinh.

33. + Can huyet hu sinh phong: dau dau. chong mat. hoa mat,
chan tay co quap run va te bi, thi luc giam, sac mat vang nhat,
ludi nhat it reu, mach huyen te.
- PhUdng phap chiia:
+ Thanh nhiet tUc phong (neu sot cao co giat): dung bai Te
giac dia hoang thang.
+ Binh can tUc phong (can dudng vUpng): dung bai Thien
ma cau dang Im.
+ Dudng huyet tUc phong (neu can huyet hu sinh phong):
dung bai A giao ke tu hoang thang.
4.4. Hdn tr§ a kinh can
Han xam nhap vao kinh can lam can khf ngUng tre khdng
thong, gap trong viem tinh hoan.
- Bieu hien lam sang: dau bung vung ha vi lan xuong tinh
hoan, tinh hoan sUng to sa xuong, reu lu3i trin g, chtft ludi
nhuan, mach trim huyen.
- PhUdng phap chUa: tan han noan can (noan: lam a'm),
dung bai Quat hach hoan hoac Noan can tiin.
5. Than
Tsing than gom than am va than dUdng. Benh cua than chi
co bieu hien cac chUng benh thuoc hU: than am hu va than
dudng hu.
5.1. Than di/ung hit
Than dudng hu do bam to tien thien khong du, dinh dudng
kem, hoac mac benh lau ngay gay ra; gap trong dai d&m, thuy
thung, coi xUdng suy dinh dudng.
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34. - Bieu hien lam sang: sd lanh, tay chan lanh, sic mat
trang, cham lien thop, cham biet di, chat ltfdi nhat, reu trang,
mach trim tri hoac 2 mach xich vo ltfc.
+ Neu than dudng htf bit co' thi thtfdng kem theo dai dam,
coi xUdng.
+ Neu than dudng htf khong khi hoa bai tiet dUdc ntfdc gay
phu toan than (nhat la hai chi dudi), an lom, bung day, dai l't,
kho thd, chat ludi nhat mem beu, mach trim te.
- Phiidng phap chiia:
+ On bo than dtfdng co' nhiep (neu dai dam): dung bai Sue
tuyen hoan.
+ On difdng ldi thuy (ne'u phu thung do than dtfdng htf):
dung bai Te sinh than khi hoan.
5.2. Than am hif
Than am htf do mat mau nhieu, mat tan dich, dinh dudng
kem, hay gap d nhiing benh do sot cao keo dai, ngtfdi mac benh
lau ngay hoac uong thuoc nong keo dai.
Bieu hien lam sang kem htf nhiet (am htf sinh noi nhiet):
hoa mat, chong mat, u tai, cham moc rang, cham lien thop,
mieng kho, ngu tam phien nhiet, ra mo hoi trom, chit ludi do,
mach te sac.
PhUdng phap chiia: bo than am, dung bai Luc vi hoan.
C. HOI CHUNG VE, K H I, DINH, HUYET
Ve, khi, dinh, huvet la 4 giai doan nong sau, nhe nang cua
on benh (benh truyen nhiem cap tinh).
- Phan ve la giai doan dau, tUdng ling vdi giai doan viem
long, khdi phat cua benh truyen nhiem.
T
4-CK.NK .n

35. - Phan khi. dinh. huyet la giai doan toan phat.
+ Khong co bien chiing (ttfdng Cfng giai doan khi).
+ Co bien chiing: mat tan djch, nhiem doc than kinh, roi
loan thanh mach gay chay mau (ttfdng ling giai doan dinh,
huyet).
On benh do phong, nhiet, thu, tao gay ra. Dac diem chung
cua on benh la gay sot cao va lam ton thtfdng den phan am
(tan dich, huyet dich) d cac tang phu.
1. PhSn ve
Ph^n ve la bieu hien benh 6 thdi ky dau cua on benh, vi tri
la d da long va phe, thuoc ph£n bieu. Dac diem noi bat la phat
sot, hdi sd lanh va sd gio, mach sac, thtfdng dung cac thuoc t&n
ltfdng giai bieu de chiia.
- Ta tai bi mao: phat sot, hdi sd gio, sd lanh, dau hong,
khong khat, ho, mach phu sac.
+ Phtfdng phap chiia: thanh tan giai bieu (vtfa dung thuoc
thanh vtfa dung thuoc phat tan)
+ Bai thuoc: Ngan kieu tan.
- Ta tai phe: sot, ho co ddm it, dau hong, dau ngtfc, sd gio,
sd lanh, reu ltfdi vang, mach sac.
+ Phtfdng phap chiia: tuyen phe tan nhiet.
+ Bai thuoc: Tang cuc am.
2. Phln khi
On nhiet vao phan khi la giai doan sau thuoc ly. Tri$u
chiing chu yeu la sot cao, sd nong ma khong sd lanh, khat
ntfdc. Benh co the d phan ve truyen vao (tif sd r6t sang sd
nong) hay ta trtfc trung ngay vao phan khi.
50

36. - Benh thuoc chiing kinh dtfdng minh: sot cao, sd nong. ra
mo hoi nhieu, khat nhieu, tre vat va quay khoc, reu ltfdi vang
kho, mach hong dai.
+ Phtfdng phap dieu tri: thanh nhiet, sinh tan.
+ Bai thuoc: Bach ho thang.
- Benh thuoc chtfng phu dtfdng minh: tao bon khong thong,
sot cao, ra mo hoi, bung diy dau, ctf an, tre quay nhieu, co khi
me sang, ltfdi kho, ntfdc tieu do, mach tram thtfc.
+ Phtfdng phap chiia: thanh nhiet, thong ha.
+ Bai thuoc: Dai thita khi thang.
3. Phin dinh
On nhiet vao phin dinh, vi tri benh d tam va tam bao lac,
chtfng trang chu yeu la huyet nhiet v& trieu chiing tinh thin
kinh. Benh cl phin dinh m i c6 moc ban chin d ngo&i goi 1
&
dinh ve hdp t&. Benh cl phin dinh c6 the tii v$ thing vao, tit
phan khi chuyen vao hoac ta trtfc trung vao phan dinh.
- Nhiet lam ton thtfdng dinh am: ch&'t ltfdi do giang, sot,
dem sot cao hdn, tre vat va, khong ngu, noi lam nham, mach te
sac.
+ Phtfdng phap chiia: thanh dinh thau nhiet hay dtfdng am
thanh nhiet.
+ Bai thuoc: Thanh dinh thang.
- Nhiet vao tam bao: hon me, noi lam nham, vat va, ltfdi do
giang, mach hoat sac hoac te sac.
+ Phtfdng phap chiia: thanh tam, khai khieu.
+ Bai thuoc: Thanh cung thang.
51

37. 4. Phan huyet
On nhiet vao phan huyet la giai doan tram trpng, vi tri
benh d vao tang can va than. d can sinh chiing "dong huyet*
tiic la nhiet biic huyet ra ngoai mach gay chay mau va sinh
chiing "dong phong" do huyet hao ton khong nuoi dtfdng dtfdc
can mac gay co giat, co quap. O than gay sue huyet, tan dich
hao ton nhieu gay chiing thtfdng am hay chtfng vong am.
Benh co the ttf khf phan truyen vao hay ttf dinh ph$n
truyen sang.
- Huyet nhiet gay chay mau (chay mau cam, dai tien ra
mau, tii ban, dai ra mau v.v...), mau do slim hdi tim, sot cao
lien tuc ve dem n&ng hdn, vit va khong ngu, long b in tay bin
chan nong, ch^t ltfdi do giang, mach sac.
+ Phtfdng phap chiia: ltfdng huyet, tan ii.
+ Bai thuoc: Te giac dia hoang thang.
• Can nhidt dong phong: nhiic d&u, hoa m&t, chong mit,
m it do, vat va, mieng kho rao, ltfng gay ciing dd, co giit tifng
cdn, chat ltfdi do giang, mach huyen sac.
+ Phtfdng phap chiia: thanh can ttfc phong.
+ Bai thuoc: An cung ngtfu hoang hoan hoac Chi bao ddn.
- Huyet nhiet thtfdng am: ngtfdi sot, m&t do, long ban tay
ban chan nong, mieng kho, ltfdi rao, tinh th£n met moi, u tai,
mach htf vo ltfc; vat va khong ngu, sdm mat toi nong, neu n&ng
hdn la chiing vong am (mat ntfdc) than hinh g£y go, da kho
nhan nheo, thop lom, mat trung, dai it, ltfdi kho co rut, tre li
bi, hai go ma do, d&u ngon tay ngon chan lanh, mach te muoo
tuyet.
+ Phtfdng phap dieu tri: ttf am, dtfdng tan.
+ Bai thuoc: Sinh mach tan gia giam.
52