General Introduction of Traditional Chinese Medicine Surgery
1. Gong Qingxuan, the earliest surviving surgical monograph "Liu Juanzi Ghost Remedy", pioneered mercury ointment to treat skin diseases
6. The most influential academic school in the history of TCM surgery: Ming and Qing Dynasties
① "Orthodox school" Ming Chen Shigong's "Surgery Zhengzong" as a representative
②"Quanshengpai" Qing Wang Weide's "Surgery Syndrome and Treatment Collection" as a representative
③The "experience school" is represented by Qing Gao Jinting's "Ulcer Experience Collection"
Basic Terminology of Traditional Chinese Medicine Surgery
1. The naming principle is generally based on
Incidence site: such as child carbuncle, breast carbuncle, gangrene, etc.
Form: Snake head boil, Liriodendron wind, etc.
Disease characteristics: rotten boils, streamers, wet sores, etc.
4. Should refer to
5. Pouch pus
Etiology and Pathogenesis of Traditional Chinese Medicine Surgery
1. Surgical diseases are especially common in "heat poisoning" and "fire poisoning." According to the "Surgical Heart Techniques", "carbuncle is originally caused by fire poisoning."
2. The main pathogenesis of surgical diseases is: the prosperity and decline of the evil and the positive, the stagnation of qi and blood, the obstruction of the meridians and the visceral disorder
Dialectics of TCM Surgical Diseases
Upper part syndrome differentiation: The upper part of the human body includes the head, face, neck and upper limbs. The etiology is mostly wind-heat and wind-heat
Syndrome differentiation in the middle part: The middle part of the human body, including the chest, abdomen, waist, and back, is where the five internal organs live, and the cause is mostly stagnation of qi and depression of fire.
Lower part of the syndrome: the lower part of the human body refers to the buttocks, front and back yin, legs, shins, feet, cold and dampness, dampness and heat are common.
2. Yin and Yang dialectics: the general outline of the dialectics of the eight outlines, and the general outline of the dialectics of all other surgical diseases
Yang Syndrome and Yin Syndrome
Acute onset chronic onset
The skin color is red and pale or dark purple or the skin color remains unchanged
Skin temperature is cold or not hot
Swelling range, the root disc is condensed and the root disc is loose
The lumps are soft and moderately hard as stone or soft as cotton
Pain feels severe pain, refusing to press the pain to ease, dull pain, no pain or soreness
The disease position is deep and shallow skin, muscle, shallow in epitope, blood veins, muscles, deep in inner position
Pus quality Thick pus thin
Ulcer shape, granulation red, lively and moist, granulation pale or dark purple
The length of the disease is longer than the shorter
Tongue coating and pulse condition Red tongue coating yellow pulse more than pale tongue coating less pulse insufficient
The prognosis is easy to diminish, easy to collapse, easy to converge, more smooth and difficult to diminish, difficult to collapse and difficult to converge, and more reverse
3. Identify swelling
Phlegm: swollen or soft like a cotton bun, varying in size and shape, everywhere, neither red nor hot, with the same skin color, seen in scrofula, lipoma
Emphysema: The skin is tight and soft, and the skin is sunken when pressed. It is like a subcutaneous gas reservoir, full of elasticity, not red or hot. It often grows with mood and anger. It is seen in gas galls and breast addiction.
Causes of pain: Wind pain: Pain has no fixed place, suddenly one after another, taking notes very fast, and when encountering wind, it is dramatic. See in Xingbi and so on.
4. Diagnosis of pus
Method to confirm pus ①Contact method ②Light transmission method ③Point pressure method ④Punch method: Method for puncturing pus ⑤B ultrasound
TCM surgical treatment of diseases
2. Support method: divided into two methods: supplementary support and through support
3. Complementary method
3. Incision selection: in order to facilitate drainage, choose the lowest point or thinnest part of the abscess cavity to enter the knife. Generally, the sore should be cut directly through the meridian to avoid injury to the blood network; radiation incision to avoid injury to the breast network;
The face should be cut along the natural texture of the skin as much as possible;
Finger abscess should be incised from the side;
For abscesses in the joint area, the incision should be avoided as far as possible. If it is an abscess in the joint area, a transverse incision, arc incision or S-shaped incision is generally performed
For low paraanal abscesses, radial incisions should be made with the anal canal as the center
5. Hanging wire method
Sore Yang Syndrome: Golden Cream, Yulu Cream
Half-yin and half-yang syndrome: Chonghe ointment
Yin syndrome: Huiyang Yulong ointment
3. Neck carbuncle
4. Have gangrene
7, go yellow
8. Invasion (dry sinking, virtual sinking, dry sinking)
Hair (cellulitis) erysipelas
Pathogenic bacteria Staphylococcus aureus, hemolytic streptococcus, anaerobic bacteria β-hemolytic streptococcus
Subcutaneous, subfascial, intermuscular, intradermal reticular lymph nodes throughout the body
The local symptoms are dark red, the center is obvious, the border is unclear, bright red, the center is light, the border is clear,
The swelling is more obvious, larger than the inflammation range, and the edge is slightly higher than normal skin
Persistent burning, severe facial pain
Relapse and impermanence
1. Breast carbuncle: Cause 1. Stagnation of milk 2. Liver depression and stomach heat 3. Feeling of external evil.
2. Milk leakage
5. Breast addiction:
Recipe: Xiaoyao Loubei Powder Modified
②Chong Ren Disorder
Governing Law: Tune She Chong Ren
Recipe: Erxian Decoction and Siwu Decoction
6. Nucleus (breast fibroadenoma): It is characterized by breast tuberculosis in young women between 20 and 25 years old, which is shaped like a pill egg, with clear borders, smooth surface, and pushing movement.
7. Milk rock (differentiation key/breast fibroadenoma)
8. The etiology and pathogenesis of galls (meat galls, gas galls, stone galls)
Skin and sexually transmitted diseases
1. Identify common symptoms of skin diseases
2. Principles of external use:
1 According to the stage of the disease
2 pay attention to control infection
3 Medication should be mild first and then strong
4 The drug concentration should be low to high first
5 Keep an eye on drug sensitivity
6For external use ointment, please use cotton to dip in various vegetable oil or paraffin wax to gently remove the ointment used last time. Do not scrub with gasoline, soap or hot water.
3. Snake sore
4. Foot moisture: equivalent to tinea pedis in western medicine
5. Wet sore:
6. Differentiation of acute eczema and contact dermatitis
Acute eczema contact dermatitis
The cause is often unclear and there is an obvious cause
The location is not fixed, often symmetry occurs often limited to the contact location
The rash is pleomorphic, papules, blisters, etc. The boundary is unclear and simple, with edema and blisters, and the boundary is clear
Unclear history of exposure
Main symptoms: Itching, intense itching or burning
Prognosis often has recurrence, remove the cause, no recurrence if no contact
The patch test is negative and more positive
7, addiction rash
8. Features of psoriasis
11. Features of secondary syphilis skin lesions
Hilar and rectal disease
1. Tooth line
2. Anorectal ring
3. Hematochezia, swelling and pain, prolapse and pus
4. Digital anorectal examination: understand the lesions of the lower rectum, anal canal and surrounding anus.
5. Internal hemorrhoids
Its clinical manifestations: blood in the stool, prolapse, damp perianal, itching, pain, constipation
6. Thrombotic external hemorrhoids: It is characterized by sudden severe pain in the anus and dark purple blood clots. It usually occurs at 3 or 9 o'clock in the bladder lithotomy position.
7. Anal leakage: Classification: simple anal leakage and complex anal leakage
Complex anal leakage (refers to more than 3 openings inside and outside the anus
8. Anal fissure: its characteristics: periodic pain in the anus, bleeding, and constipation
Peripheral vascular disease
3. The main clinical manifestations of tendon tumors are purple veins, with coiled protrusions like earthworms, forming masses
4, ecthyma: mainly occurs in the lower third of the inner and outer sides of the legs.
4. Gangrene: It is more common in young men, elderly people or diabetic patients.
[Cold-dampness blocking type] Yanghe Decoction
[Blood Stasis Type] Taohong Siwu Decoction
【Damp-heat and poisonous type】Simiao Yongan Decoction
【Heat Toxin Injury Yin Type】Gu Bu Tang
[Qi and sound deficiency type] Huang's Biejia Decoction
5. The change of intestinal carbuncle
1. Chronic carbuncle 2. Abdominal mass 3. Damp-heat jaundice 4. Internal and external fistula formation
Differential diagnosis; 1. Perforation of stomach and duodenal ulcer 2. Right ureteral calculi 3. Obstetrics and gynecology diseases: ectopic pregnancy, rupture of ovarian follicle or corpus luteum cyst, torsion of ovarian cyst, acute salpingitis
1. Regardless of whether the pus is formed or not, you can choose golden powder, Yulu powder or Shuangbai powder
2. Chinese medicine anal drops